Abstract
A genetic study, particularly in HLA-DRs, has never been performed in Thai patients with systemic sclerosis (SSc). This study was performed to investigate the association between the HLA-DR series in Thai SSc patients. HLA-DR subtypes were determined in 50 Thai SSc patients and 99 healthy controls (HCs). All SSc patients met the ACR classification criteria for SSc. HLA-DR typing was performed using INNO-LiPA HLA-DRB Decoder kits (INNOGENETICS) and reconfirmed using MICRO SSP HLA DNA Typing kits (ONE LAMBDA). The allele frequency (AF) of HLA-DR*15, compared with HC, was significantly higher in all SSc patients (41.0 vs 21.7 %, Pc = 0.0083) and SSc patients with anti-Scl70 antibody positive (anti-Scl70+) (47.1 %, Pc = 0.0018). Among the HLA-DR*15 alleles, the AF of the DRB1*15:02 was increased significantly in all SSc patients (29.0 vs 12.6 %, Pc = 0.0219) and SSc patients with anti-Scl70+ (32.4 vs 12.6 %, Pc = 0.0196). The AF of the HLA-DRB5*01:02 allele was also increased in all SSc patients (27.0 vs 12.6 %, Pc = 0.0166) and in SSc patients with anti-Scl70+ (29.4 %, Pc = 0.0124). The AF of the DR*04 was significantly lower in the SSc patients (1.0 vs 9.6 %, Pc = 0.0399). However, the AF of the DRB1*15:02 and DRB5*01:02 was not different among SSc patients with or without clinical manifestations (pulmonary fibrosis, digital pitting scar, sclerodactyly, myositis, and sicca symptoms). In addition, there was no significant association between clinical manifestations among individuals who carried HLA-DRB1*15:02 or DRB5*01:02. HLA-DRB1*15:02 and DRB5*01:02 alleles were significantly elevated in Thai SSc patients, especially in those with anti-Scl70+. The HLA-DRB1*04 was a protective allele against Thai SSc patients.
Similar content being viewed by others
References
Gabrielli A, Avvedimento EV, Krieg T (2009) Scleroderma. N Engl J Med 360:1989–2003
Agarwal SK, Tan FK, Arnett FC (2008) Genetics and genomic studies in scleroderma (systemic sclerosis). Rheum Dis Clin North Am 34:17–40
Agarwal SK, Reveille JD (2010) The genetics of scleroderma (systemic sclerosis). Curr Opin Rheumatol 22:133–138
Romano E, Manetti M, Guiducci S, Ceccarelli C, Allanore Y, Matucci-Cerinic M (2011) The genetics of systemic sclerosis: an update. Clin Exp Rheumatol 29:S75–S86
Takeuchi F, Nakano K, Yamada H, Hong GH, Nabeta H, Yoshida A et al (1994) Association of HLA-DR with progressive systemic sclerosis in Japanese. J Rheumatol 21:857–863
Reveille JD, Fischbach M, McNearney T, Friedman AW, Aguilar MB, Lisse J et al (2001) Systemic sclerosis in 3 US ethnic groups: a comparison of clinical, sociodemographic, serologic, and immunogenetic determinants. Semin Arthritis Rheum 30:332–346
Arnett FC, Gourh P, Shete S, Ahn CW, Honey RE, Agarwal SK et al (2010) Major histocompatibility complex (MHC) class II alleles, haplotypes and epitopes which confer susceptibility or protection in systemic sclerosis: analyses in 1300 Caucasian, African-American and Hispanic cases and 1000 controls. Ann Rheum Dis 69:822–827
Assassi S, Del Junco D, Sutter K, McNearney TA, Reveille JD, Karnavas A et al (2009) Clinical and genetic factors predictive of mortality in early systemic sclerosis. Arthr Rheum 61:1403–1411
Kuwana M, Inoko H, Kameda H, Nojima T, Sato S, Nakamura K et al (1999) Association of human leukocyte antigen class II genes with autoantibody profiles, but not with disease susceptibility in Japanese patients with systemic sclerosis. Intern Med 38:336–344
Akimoto S, Abe M, Ishikawa O (2000) HLA-DRB1 and DQB1 genes in Japanese patients with systemic sclerosis. J Rheumatol 27:2940–2942
Kang SH, Park MH, Song EY, Kang SJ, Lee EB, Song YW et al (2001) Association of HLA class II genes with systemic sclerosis in Koreans. J Rheumatol 28:1577–1583
Joung CI, Jun JB, Chung WT, Song GG, Choe JY, Chang HK et al (2006) Association between the HLA-DRB1 gene and clinical features of systemic sclerosis in Korea. Scand J Rheumatol 35:39–43
Zhou X, Lee JE, Arnett FC, Xiong M, Park MY, Yoo YK et al (2009) HLA-DPB1 and DPB2 are genetic loci for systemic sclerosis: a genome-wide association study in Koreans with replication in North Americans. Arthr Rheum 60:3807–3814
Subcommittee for scleroderma criteria of the American Rheumatism Association Diagnostic and Therapeutic Criteria Committee (1980) Preliminary criteria for the classification of systemic sclerosis (scleroderma). Arthritis Rheum 23:581–590
LeRoy EC, Black C, Fleischmajer R, Jablonska S, Krieg T, Medsger TA Jr et al (1988) Scleroderma (systemic sclerosis): classification, subsets and pathogenesis. J Rheumatol 15:202–205
Mukerjee D, St George D, Knight C, Davar J, Wells AU, Du Bois RM et al (2004) Echocardiography and pulmonary function as screening tests for pulmonary arterial hypertension in systemic sclerosis. Rheumatol (Oxford) 43:461–466
Badesch DB, Abman SH, Simonneau G, Rubin LJ, McLaughlin VV (2007) Medical therapy for pulmonary arterial hypertension: updated ACCP evidence-based clinical practice guidelines. Chest 131:1917–1928
Louthrenoo W, Kasitanon N, Wichainun R, Wangkaew S, Sukitawut W, Ohnogi Y et al (2011) Lack of CTGF*-945C/G Dimorphism in Thai Patients with Systemic Sclerosis. Open Rheumatol J 5:59–63
Haldane JB (1956) The estimation and significance of the logarithm of a ratio of frequencies. Ann Hum Genet 20:309–311
Loubiere LS, Lambert NC, Madeleine MM, Porter AJ, Mullarkey ME, Pang JM et al (2005) HLA allelic variants encoding DR11 in diffuse and limited systemic sclerosis in Caucasian women. Rheumatol (Oxford) 44:318–322
Gladman DD, Kung TN, Siannis F, Pellett F, Farewell VT, Lee P (2005) HLA markers for susceptibility and expression in scleroderma. J Rheumatol 32:1481–1487
Simeon CP, Fonollosa V, Tolosa C, Palou E, Selva A, Solans R et al (2009) Association of HLA class II genes with systemic sclerosis in Spanish patients. J Rheumatol 36:2733–2736
Vlachoyiannopoulos PG, Dafni UG, Pakas I, Spyropoulou-Vlachou M, Stavropoulos-Giokas C, Moutsopoulos HM (2000) Systemic scleroderma in Greece: low mortality and strong linkage with HLA-DRB1*1104 allele. Ann Rheum Dis 59:359–367
Frezza D, Giambra V, Tolusso B, De Santis M, Bosello S, Vettori S et al (2007) Polymorphism of immunoglobulin enhancer element HS1,2A: allele *2 associates with systemic sclerosis. Comparison with HLA-DR and DQ allele frequency. Ann Rheum Dis 66:1210–1215
Geirsson AJ, Steinsson K, Guthmundsson S, Sigurthsson V (1994) Systemic sclerosis in Iceland. A nationwide epidemiological study. Ann Rheum Dis 53:502–505
Imanishi T, Akaza T, Kimura A, Tokunaga K, Gojobori T (1992) Allele and haplotype frequencies for HLA and complement loci in various ethnic groups In: Tsuji K, Aizawa M, Sasazuki T (eds) HLA 1991. Oxford University Press, Oxford, pp 1065–1220
Briggs DC, Vaughan RW, Welsh KI, Myers A, duBois RM, Black CM (1991) Immunogenetic prediction of pulmonary fibrosis in systemic sclerosis. Lancet 338:661–662
Fanning GC, Welsh KI, Bunn C, Du Bois R, Black CM (1998) HLA associations in three mutually exclusive autoantibody subgroups in UK systemic sclerosis patients. Br J Rheumatol 37:201–207
Morel PA, Chang HJ, Wilson JW, Conte C, Saidman SL, Bray JD et al (1994) Severe systemic sclerosis with anti-topoisomerase I antibodies is associated with an HLA-DRw11 allele. Hum Immunol 40:101–110
Acknowledgments
This study was supported in part by the Faculty of Medicine, Chiang Mai University Endowment Fund, no. 01-2004 (Dr. Louthrenoo) and Grants-in-Aid for Science Research from the Ministry of Education, Culture, Sport, Science, and Technology of Japan, no. 17406026 (Dr. Takeuchi and Dr. Kuwata). Dr. Worawit Louthrenoo received funding support from the Faculty of Medicine, Chiang Mai University Endowment Fund (no. 01-2004). Drs. Fujio Takeuchi and Shoji Kuwata received funding support of Grants-in-Aid for Science Research from the Ministry of Education, Culture, Sport, Science, and Technology of Japan (no. 17406026).
Conflict of interest
All authors declare no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Louthrenoo, W., Kasitanon, N., Wichainun, R. et al. Association of HLA-DRB1*15:02 and DRB5*01:02 allele with the susceptibility to systemic sclerosis in Thai patients. Rheumatol Int 33, 2069–2077 (2013). https://doi.org/10.1007/s00296-013-2686-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00296-013-2686-3