The IFITM3 gene is classified as an interferon-stimulated gene (ISG) and a member of the IFITM protein family. The IFITM3 protein showed potent antiviral capacity against not only influenza A viruses but also Ebola virus (EBOV), Marburg virus (MARV), severe acute respiratory syndrome coronavirus (SARS-CoV), dengue virus (DEV), West Nile virus (WNV), and Zika virus (ZIKV) (Perreira et al. 2013; Zani and Yount 2018). Since the IFITM3 protein plays a pivotal role in blocking the invasion of several viruses, polymorphism studies that affect protein integrity or expression levels have received attention. Previous case–control studies and meta-analyses have confirmed the association of the rs12252 SNP with the severity of pandemic influenza A 2009 virus infection (Chen et al. 2018; Prabhu et al. 2018; Xuan et al. 2015; Yang et al. 2015). However, a study in a Korean population did not confirm the correlation of the disease severity of pandemic influenza A 2009 virus infection with the rs12252 SNP of the IFITM3 gene (Kim and Jeong 2017). In addition, the European population did not carry the risk genotype of the rs12252 SNP. Since these studies did not include correlation analysis of the worldwide distribution of pandemic influenza A 2009 virus-infected patients, a follow-up study suggested the rs34481144 SNP as a novel risk factor for pandemic influenza A 2009 virus infection. The rs34481144 SNP is located in a CpG island, and the A allele of the rs34481144 SNP disrupts the binding site of CTCF. In addition, the rs34481144 SNP acts as not only a proximal promoter of the IFITM3 gene but also a distal promoter of adjacent genes, including IFITM1, IFITM2, and B4GALNT4. These results indicate that the rs34481144 SNP is an important site and regulates cascade-like IFITM3-related immune signaling. However, the Korean population did not harbor the rs34481144 SNP (Allen et al. 2017). In a recent study, the genotype of the rs6598045 SNP, which is located in the proximal promoter of the IFITM3 gene, modulated the transcriptional activity of the IFITM3 gene and was significantly associated with susceptibility to pandemic influenza A 2009 virus infection in the Korean population (Kim et al. 2020 ). Although the rs12252, rs34481144, and rs6598045 SNPs are related to the severity of pandemic influenza A 2009 infection or susceptibility to this virus, the ethnic distribution of the risk genotypes of these three SNPs has not been summarized thus far.
In the present study, we found significant difference of the genotype and allele frequencies of the IFITM3 polymorphisms among several ethnic groups. In addition, we summarized ethnic variations in the risk genotypes of the rs12252, rs34481144, and rs6598045 SNPs. Interestingly, the European, American, and South Asian populations showed very low frequencies of the risk genotype of the rs12252 SNP (Fig. 2). In addition, the Korean, East Asian, and African populations did not carry the risk genotype of the rs34481144 SNP (Fig. 3). Furthermore, the risk genotype of the rs6598045 SNP showed variation among ethnic groups (Fig. 4). Since no single SNP could fully explain the severity or susceptibility of pandemic influenza A 2009 virus infection, evaluation of susceptibility based on haplotypes of the IFITM3 polymorphisms is highly desirable in the future. In addition, a recent study has been reported that rs12252 SNP is associated with severity of coronavirus disease 2019 (COVID-19) (Zhang et al 2020). Thus, evaluation on an association between IFITM3 SNPs and susceptibility or severity of COVID-19 is needed in the future.
Since the IFITM3 protein has a highly homologous CD225 domain and is conserved among several species, it is necessary to investigate it in several viral host animals. In primate genome, IFITM3 protein is the most ancient antiviral protein of the IFITM locus and has undergone repeated duplication in each independent lineage. In addition, some IFITM3 genes in non-human primates have amino-terminal variations that alter protein localization and function (Compton et al 2016). A recent study reported a difference in the expression level of IFITM3 protein between avian influenza-susceptible animals and avian influenza-resistant animals (Smith et al. 2015). In addition, a difference in the genetic distribution of polymorphisms of the chicken IFITM3 gene was also identified between layers and broilers, which are bred for eggs and meats, respectively (Kim et al. 2019, 2020 ). Furthermore, since pig IFITM3 protein showed a defensive capacity against classical swine fever virus (CSFV), African swine fever virus (ASFV), and foot and mouth disease virus (FMDV), further investigation of the polymorphisms of animal IFITM3 genes is needed in the future (Li et al. 2019; Munoz-Moreno et al. 2016; Xu et al. 2014).
In conclusion, we investigated the ethnic distribution of the risk genotypes of the rs12252, rs34481144, and rs6598045 SNPs with respect to pandemic influenza A 2009 virus infection. We observed significant differences in these three SNPs among the ethnic groups. In addition, we investigated the distribution of risk genotypes for pandemic influenza A 2009 virus infection. To the best of our knowledge, this is the first report of simultaneous evaluation of risk genotypes of the IFITM3 gene with respect to pandemic influenza A 2009 virus infection.