Abstract
Keloid disease (KD) is a common fibroproliferative disorder that can occur following cutaneous injury in genetically susceptible individuals. Familial predisposition, high prevalence in certain populations and occurrence in twins suggest a strong genetic component to KD. However, to date no single causative gene has been identified. Copy number variations (CNVs) in genes have been associated with several human diseases including common skin disorders. The objective of this study was, therefore to determine if CNVs in the human genome may contribute to the development of KD. Agilent SurePrint G3 one Million microarrays were used to detect DNA copy number differences in keloid scars of four Caucasian females and compared to commercial reference DNA samples. Subsequent validation was performed with quantitative polymerase chain reactions (qPCR) using 15 KD cases and 27 Caucasian controls. Further validation using a second cohort was carried out with an additional 11 Caucasian controls and 10 KD cases developed from minor skin puncture wounds (caused by acne, vaccination or chickenpox). HLA-DRB1*15 was typed using allele-specific primers in PCR. Five CNV regions located at chromosome (chr) 6p21.32, chr11q11, chr17q12, chr8p23.1, chr22q13.1, chr19p13.1 and chr2q14.3 were selected for validation with qPCR. When comparing controls to subgroups of KD, according to their cause of scarring, chr6p21.32 (primer design targetting HLA-DRB5) was significantly (P < 0.005) associated with KD developed from minor skin puncture wounds, which is further validated using a larger sample size (P < 0.001). The presence of HLA-DRB5 was associated with HLA-DRB1*15 status; 18 out of 19 individuals were positive for both HLA-DRB5 and HLA-DRB1*15 allele. In conclusion, these preliminary findings further support the possible contribution of the HLA genes in KD pathogenesis.
References
Ashcroft KJ, Syed F, Arscott G, Bayat A (2011) Assessment of the influence of HLA class I and class II loci on the prevalence of keloid disease in Jamaican Afro-Caribbeans. Tissue Antigens (in press)
Beckmann JS, Estivill X, Antonarakis SE (2007) Copy number variants and genetic traits: closer to the resolution of phenotypic to genotypic variability. Nat Rev Genet 8(8):639–646
Berman B, Villa A (2003) Imiquimod 5% cream for keloid management. Dermatol Surg 29(10):1050–1051
Bloom D (1956) Heredity of keloids: review of the literature and report of a family with multiple keloids in five generations. N Y State J Med 56(4):511–519
Bock O, Schmid-Ott G, Malewski P, Mrowietz U (2006) Quality of life of patients with keloid and hypertrophic scarring. Arch Dermatol Res 297(10):433–438
Bowcock AM, Krueger JG (2005) Getting under the skin: the immunogenetics of psoriasis. Nat Rev Immunol 5(9):699–711
Boyce DE, Ciampolini J, Ruge F, Murison MS, Harding KG (2001) Inflammatory-cell subpopulations in keloid scars. Br J Plast Surg 54(6):511–516
Brown JJ, Ollier WE, Thomson W, Bayat A (2008) Positive association of HLA-DRB1*15 with keloid disease in Caucasians. Int J Immunogenet 35(4–5):303–307
Bunce M, O’Neill CM, Barnardo MC, Krausa P, Browning MJ, Morris PJ, Welsh KI (1995) Phototyping: comprehensive DNA typing for HLA-A, B, C, DRB1, DRB3, DRB4, DRB5 & DQB1 by PCR with 144 primer mixes utilizing sequence-specific primers (PCR-SSP). Tissue Antigens 46(5):355–367
Chen Y, Gao JH, Liu XJ, Yan X, Song M (2006) Characteristics of occurrence for Han Chinese familial keloids. Burns 32(8):1052–1059
Christen U, von Herrath MG (2004) Induction, acceleration or prevention of autoimmunity by molecular mimicry. Mol Immunol 40(14–15):1113–1120
Clark JA, Turner ML, Howard L, Stanescu H, Kleta R, Kopp JB (2009) Description of familial keloids in five pedigrees: evidence for autosomal dominant inheritance and phenotypic heterogeneity. BMC Dermatol 9:8
Fellermann K, Stange DE, Schaeffeler E, Schmalzl H, Wehkamp J, Bevins CL, Reinisch W, Teml A, Schwab M, Lichter P, Radlwimmer B, Stange EF (2006) A chromosome 8 gene-cluster polymorphism with low human beta-defensin 2 gene copy number predisposes to Crohn disease of the colon. Am J Hum Genet 79(3):439–448
Fong EP, Bay BH (2002) Keloids—the sebum hypothesis revisited. Med Hypotheses 58(4):264–269
Gregersen JW, Kranc KR, Ke X, Svendsen P, Madsen LS, Thomsen AR, Cardon LR, Bell JI, Fugger L (2006) Functional epistasis on a common MHC haplotype associated with multiple sclerosis. Nature 443(7111):574–577
Gupta S, Sharma VK (2011) Standard guidelines of care: keloids and hypertrophic scars. Indian J Dermatol Venereol Leprol 77(1):94–100
Hollox EJ, Huffmeier U, Zeeuwen PL, Palla R, Lascorz J, Rodijk-Olthuis D, van de Kerkhof PC, Traupe H, de Jongh G, den Heijer M, Reis A, Armour JA, Schalkwijk J (2008) Psoriasis is associated with increased beta-defensin genomic copy number. Nat Genet 40(1):23–25
Karolchik D, Hinrichs AS, Furey TS, Roskin KM, Sugnet CW, Haussler D, Kent WJ (2004) The UCSC Table Browser data retrieval tool. Nucl Acids Res. 32(Database issue):D493–D496
Kazeem AA (1988) The immunological aspects of keloid tumor formation. J Surg Oncol 38(1):16–18
Lim CP, Phan TT, Lim IJ, Cao X (2009) Cytokine profiling and Stat3 phosphorylation in epithelial-mesenchymal interactions between keloid keratinocytes and fibroblasts. J Invest Dermatol 129(4):851–861
Lu WS, Cai LQ, Wang ZX, Li Y, Wang JF, Xiao FL, Quan C, He SM, Yang S, Zhang XJ (2010) Association of HLA class I alleles with keloids in Chinese Han individuals. Hum Immunol 71(4):418–422
Lu WS, Wang JF, Yang S, Xiao FL, Quan C, Cheng H, Wang PG, Zhang AP, Cai LQ, Zhang XJ (2008) Association of HLA-DQA1 and DQB1 alleles with keloids in Chinese Hans. J Dermatol Sci 52(2):108–117
Lu WS, Zhang WY, Li Y, Wang ZX, Zuo XB, Cai LQ, Zhu F, Wang JF, Sun LD, Zhang XJ, Yang S (2010) Association of HLA-DRB1 alleles with keloids in Chinese Han individuals. Tissue Antigens 76(4):276–281
Lu WS, Zuo XB, Wang ZX, Cai LQ, Zhu F, Li Y, Zheng HF, Sun LD, Yang S, Zhang XJ (2011) Association of HLA haplotype with keloids in Chinese Hans. Burns
Marneros AG, Norris JE, Olsen BR, Reichenberger E (2001) Clinical genetics of familial keloids. Arch Dermatol 137(11):1429–1434
Marneros AG, Norris JE, Watanabe S, Reichenberger E, Olsen BR (2004) Genome scans provide evidence for keloid susceptibility loci on chromosomes 2q23 and 7p11. J Invest Dermatol 122(5):1126–1132
Martin-Garcia RF, Busquets AC (2005) Postsurgical use of imiquimod 5% cream in the prevention of earlobe keloid recurrences: results of an open-label, pilot study. Dermatol Surg 31(11 Pt 1):1394–1398
Melnikova I (2009) Psoriasis market. Nat Rev Drug Discov 8(10):767–768
Muller-Hilke B (2009) HLA class II and autoimmunity: epitope selection vs differential expression. Acta Histochem 111(4):379–381
Nakashima M, Chung S, Takahashi A, Kamatani N, Kawaguchi T, Tsunoda T, Hosono N, Kubo M, Nakamura Y, Zembutsu H (2010) A genome-wide association study identifies four susceptibility loci for keloid in the Japanese population. Nat Genet 42(9):768–771
Oksenberg JR, Baranzini SE, Sawcer S, Hauser SL (2008) The genetics of multiple sclerosis: SNPs to pathways to pathogenesis. Nat Rev Genet 9(7):516–526
Omo-Dare P (1975) Genetic studies on keloid. J Natl Med Assoc 67(6):428–432
Redon R, Ishikawa S, Fitch KR, Feuk L, Perry GH, Andrews TD, Fiegler H, Shapero MH, Carson AR, Chen W, Cho EK, Dallaire S, Freeman JL, Gonzalez JR, Gratacos M, Huang J, Kalaitzopoulos D, Komura D, MacDonald JR, Marshall CR, Mei R, Montgomery L, Nishimura K, Okamura K, Shen F, Somerville MJ, Tchinda J, Valsesia A, Woodwark C, Yang F, Zhang J, Zerjal T, Armengol L, Conrad DF, Estivill X, Tyler-Smith C, Carter NP, Aburatani H, Lee C, Jones KW, Scherer SW, Hurles ME (2006) Global variation in copy number in the human genome. Nature 444(7118):444–454
Seifert O, Mrowietz U (2009) Keloid scarring: bench and bedside. Arch Dermatol Res 301(4):259–272
Shih B, Bayat A (2010) Genetics of keloid scarring. Arch Dermatol Res 302(5):319–339
Walker MR, Nepom GT (2006) Major histocompatibility complex and autoimmunity. In: Rose NR, Mackay IR (eds) The autoimmune diseases. Elsevier, London, pp 47–58
Wong KK, deLeeuw RJ, Dosanjh NS, Kimm LR, Cheng Z, Horsman DE, MacAulay C, Ng RT, Brown CJ, Eichler EE, Lam WL (2007) A comprehensive analysis of common copy-number variations in the human genome. Am J Hum Genet 80(1):91–104
Xue H, McCauley RL, Zhang W (2000) Elevated interleukin-6 expression in keloid fibroblasts. J Surg Res 89(1):74–77
Yang Y, Chung EK, Wu YL, Savelli SL, Nagaraja HN, Zhou B, Hebert M, Jones KN, Shu Y, Kitzmiller K, Blanchong CA, McBride KL, Higgins GC, Rennebohm RM, Rice RR, Hackshaw KV, Roubey RA, Grossman JM, Tsao BP, Birmingham DJ, Rovin BH, Hebert LA, Yu CY (2007) Gene copy-number variation and associated polymorphisms of complement component C4 in human systemic lupus erythematosus (SLE): low copy number is a risk factor for and high copy number is a protective factor against SLE susceptibility in European Americans. Am J Hum Genet 80(6):1037–1054
Zhang J, Feuk L, Duggan GE, Khaja R, Scherer SW (2006) Development of bioinformatics resources for display and analysis of copy number and other structural variants in the human genome. Cytogenet Genome Res 115(3–4):205–214
Acknowledgments
The senior author is funded by NIHR (UK).
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Shih, B., Bayat, A. Comparative genomic hybridisation analysis of keloid tissue in Caucasians suggests possible involvement of HLA-DRB5 in disease pathogenesis. Arch Dermatol Res 304, 241–249 (2012). https://doi.org/10.1007/s00403-011-1182-4
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00403-011-1182-4