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Systemic lupus erythematosus: a genetic epidemiology study of 695 patients from China

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Abstract

Our purpose was to explore potential genetic models for systemic lupus erythematosus (SLE) and analyze genetic epidemiologic characteristics of SLE in a Chinese population. Data for 695 patients with SLE were obtained by using a uniform questionnaire. Patients, clinical characteristics and their family history were analyzed using software. A complex segregation analysis was conducted to propose potential genetic models for SLE. The mean ± SD age of onset were 30.2 ± 10.5 years and mean time to progression to SLE was 32.5 ± 44.4 months. The most frequent initial manifestations were malar rash (61.3%). During the evolution of the disease, the main clinical features were arthritis in 73.6% of our patients, followed by malar rash (68.1%), and renal involvement (56.7%). As the first symptom, the late-onset group (onset of disease beyond the age of 50 years) less often showed malar rash (45% vs. 63.4% in the early-onset group; p = 0.001). There were no significant differences in the other cumulative clinical symptoms between late-onset and early-onset group, except for a lower prevalence of malar rash, photosensitivity and alopecia and a higher prevalence of mucosal ulcers in the late-onset group. A positive family history of SLE was obtained in 50 patients (7.2%). There were no statistical differences in clinical characteristics between familial SLE and sporadic SLE patients. The heritability of SLE was 43.6%, the genetic model of SLE could be polygenetic model and major gene mode is the best fitted one. SLE could be a multifactorial disease with polygenetic model.

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References

  1. Alarcon-Segovia D, Alarcon-Riquelme ME, Cardiel MH, Pons-Estel BA et al (2005) Familial aggregation of systemic lupus erythematosus, rheumatoid arthritis, and other autoimmune diseases in 1,177 lupus patients from the GLADEL cohort. Arthritis Rheum 52:1138–1147

    Article  PubMed  Google Scholar 

  2. Arnett FC, Shulman LE (1976) Studies in familial systemic lupus erythematosus. Medicine (Baltimore) 55:313–322

    Article  CAS  Google Scholar 

  3. Akaike H (1974) A new look at the statistical model identification. IEEE Trans Autom Control AC 9:716–723

    Article  Google Scholar 

  4. Boddaert J, Huong du LT, Amoura Z et al (2004) Late-onset systemic lupus erythematosus: a personal series of 47 patients and pooled analysis of 714 cases in the literature. Medicine (Baltimore) 83:348–359

    Article  Google Scholar 

  5. Bonney GE (1986) Regressive logistic models for familial disease and other binary traits. Biometrics 42:611–625

    Article  PubMed  CAS  Google Scholar 

  6. Buckman KJ, Moore SK, Ebbin AJ et al (1978) Familial systemic lupus erythematosus. Arch Intern Med 138:1674–1676

    Article  PubMed  CAS  Google Scholar 

  7. Brunjes S, Zike K, Julian R (1961) Familial systemic lupus erythematosus. A review of the literature with a report of ten additional cases in four families. Am J Med 30:529–536

    Article  Google Scholar 

  8. Cervera R, Khamashta MA, Font J et al (1993) Systemic lupus erythematosus: clinical and immunologic patterns of disease expression in a cohort of 1,000 patients. The European working party on systemic lupus erythematosus. Medicine (Baltimore) 72:113–124

    CAS  Google Scholar 

  9. Emery AEH (1986) Methodology in medical genetics. Churchill Livingston Inc., New York

    Google Scholar 

  10. Font J, Cervera R, Ramos-Casals M et al (2004) Clusters of clinical and immunologic features in systemic lupus erythematosus: analysis of 600 patients from a single center. Semin Arthritis Rheum 33:217–230

    Article  PubMed  Google Scholar 

  11. Font J, Pallares L, Cervera R et al (1991) Systemic lupus erythematosus in the elderly: clinical and immunological characteristics. Ann Rheum Dis 50:702–705

    PubMed  CAS  Google Scholar 

  12. Giles I, Isenberg D (2001) Lupus in the family–analysis of a cohort followed from 1978 to 1999. Lupus 10:38–44

    Article  PubMed  CAS  Google Scholar 

  13. Houman MH, Smiti-Khanfir M, Ben Ghorbell I et al (2004) Systemic lupus erythematosus in Tunisia: demographic and clinical analysis of 100 patients. Lupus 113:204–211

    Google Scholar 

  14. Ho CT, Mok CC, Lau CS et al (1998) Late onset systemic lupus erythematosus in southern Chinese. Ann Rheum Dis 57:437–440

    Article  PubMed  CAS  Google Scholar 

  15. Hochberg MC (1997) Updating the American college of rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 40:1725

    PubMed  CAS  Google Scholar 

  16. Hopkinson ND, Doherty M, Powell RJ (1994) Clinical features and race- specific incidence/prevalence rates of systemic lupus erythematosus in a geographically complete cohort of patients. Ann Rheum Dis 53:675–680

    PubMed  CAS  Google Scholar 

  17. Koskenmies S, Widen E, Kere J, Julkunen H (2001) Familial systemic lupus erythematosus in Finland. J Rheumatol 28:758–760

    PubMed  CAS  Google Scholar 

  18. Johnson AE, Cavalcanti FS, Gordon C et al (1994) Cross-sectional analysis of the differences between patients with systemic lupus erythematosus in England, Brazil and Sweden. Lupus 3:501–506

    PubMed  CAS  Google Scholar 

  19. Lawrence JS, Martins CL, Drake GL (1987) A family survey of lupus erythematosus. 1. Heritability. J Rheumatol 14:913–921

    PubMed  CAS  Google Scholar 

  20. Michel M, Johanet C, Meyer O et al (2001) Familial lupus erythematosus. Clinical and immunologic features of 125 multiplex families. Medicine (Baltimore) 80:153–158

    Article  CAS  Google Scholar 

  21. Mak SK, Lam EK, Wong AK (1998) Clinical profile of patients with late-onset SLE: not a benign subgroup. Lupus 7:23–28

    Article  PubMed  CAS  Google Scholar 

  22. Maddison PJ (1987) Systemic lupus erythematosus in the elderly. J Rheumatol Suppl 14:182–187

    PubMed  Google Scholar 

  23. Nath SK, Kilpatrick J Harley JB (2004) Genetics of human systemic lupus erythematosus: the emerging picture. Curr Opin Immunol 16:794–800

    Article  PubMed  CAS  Google Scholar 

  24. Nossent JC (1992) Systemic lupus erythematosus on the Caribbean island of Curacao: an epidemiological investigation. Ann Rheum Dis 51:1197–1201

    Article  PubMed  CAS  Google Scholar 

  25. Projunina L, Alarcon-Riquelme M (2004) The genetic basis of systemic lupus erythematosus—knowledge of today and thoughts for tomorrow. Hum Mol Genet 1:143–148

    Article  CAS  Google Scholar 

  26. Petri M (2002) Epidemiology of systemic lupus erythematosus. Best Pract Res Clin Rheumatol 16:847–858

    Article  PubMed  Google Scholar 

  27. Sayarlioglu M, Cefle A, Kamali S et al (2005) Characteristics of patients with late onset systemic lupus erythematosus in Turkey. Int J Clin Pract 59:183–187

    Article  PubMed  CAS  Google Scholar 

  28. Sullivan KE (2000) Genetics of systemic lupus erythematosus. Clinical implications. Rheum Dis Clin North Am 26:229–256

    Article  PubMed  CAS  Google Scholar 

  29. Sestak AL, Shaver TS, Moser KL et al (1999) Familial aggregation of lupus and autoimmunity in an unusual multiplex pedigree. J Rheumatol 26:1495–1499

    PubMed  CAS  Google Scholar 

  30. S.A.G.E (1988) Statistical analysis for genetic epidemiology, release, 3.1. User’s manual. Computer program package from the department of epidemiology and biostatistics, Rammelkamp center for education and research, Metrohealth campus, Case Western Reserve University, Cleveland

  31. Tsao BP (2003) The genetics of human systemic lupus erythematosus. Trends Immunol 11:595–602

    Article  CAS  Google Scholar 

  32. Vilar MJ, Sato EI (2002) Estimating the incidence of systemic lupus erythematosus in a tropical region (Natal, Brazil). Lupus 11:528–532

    Article  PubMed  Google Scholar 

  33. Vila LM, Mayor AM, Valentin AH et al (1999) Clinical and immunological manifestations in 134 Puerto Rican patients with systemic lupus erythematosus. Lupus 8:279–286

    Article  PubMed  CAS  Google Scholar 

  34. Yasmeen A, Ahmad, Ian N Bruce (2001) Genetic epidemiology systemic lupus erythematosus. Arthritis Res 3:331–336

    Article  Google Scholar 

Download references

Acknowledgments

We thank all the patients concerned for their voluntary participation in the present study. This work was supported by grant (2003AA227030) from Chinese High Tec. Programs (863).

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Correspondence to X. J. Zhang.

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Wang, J., Yang, S., Chen, J.J. et al. Systemic lupus erythematosus: a genetic epidemiology study of 695 patients from China. Arch Dermatol Res 298, 485–491 (2007). https://doi.org/10.1007/s00403-006-0719-4

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  • DOI: https://doi.org/10.1007/s00403-006-0719-4

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