Abstract

BackgroundSystemic lupus erythematosus (SLE) is a systemic multisystem autoimmune disorder influenced by genetic background and environmental factors. Our aim here was to replicate findings of associations between 7 of the implicated single nucleotide polymorphisms (SNPs) in IRF5, BLK, STAT4, TNFAIP3, SPP1, TNIP1 and ETS1 genes with susceptibility to childhood-onset SLE in the Japanese population. In particular, we focused on gender differences in allelic frequencies.Methodology/Principal FindingsThe 7 SNPs were genotyped using TaqMan assays in 75 patients with childhood-onset SLE and in 190 healthy controls. The relationship between the cumulative number of risk alleles and SLE manifestations was explored in childhood-onset SLE. Logistic regression was used to test the effect of each polymorphism on susceptibility to SLE, and Wilcoxon rank sum testing was used for comparison of total risk alleles. Data on rs7574865 in the STAT4 gene and rs9138 in SPP1 were replicated for associations with SLE when comparing cases and controls (corrected P values ranging from 0.0043 to 0.027). The rs2230926 allele of TNFAIP3 was associated with susceptibility to SLE in males, but after Bonferroni correction there were no significant associations with any of the other four SNPs in IRF5, BLK, TNIP1 and ETS1 genes. The cumulative number of risk alleles was significantly increased in childhood-onset SLE relative to healthy controls (P = 0.0000041). Male SLE patients had a slightly but significantly higher frequency of the TNFAIP3 (rs2230926G) risk allele than female patients (odds ratio [OR] = 4.05, 95% confidence interval [95%CI] = 1.46–11.2 P<0.05).ConclusionsAssociations of polymorphisms in STAT4 and SPP1 with childhood-onset SLE were confirmed in a Japanese population. Although these are preliminary results for a limited number of cases, TNFAIP3 rs2230926G may be an important predictor of disease onset in males. We also replicated findings that the cumulative number of risk alleles was significantly increased in childhood-onset SLE.

Highlights

  • Systemic lupus erythematosus (SLE) is an autoimmune connective tissue disease which presents with various clinical symptoms and disorders in many internal organs

  • Associations of polymorphisms in signal transducer and activator of transcription-4 (STAT4) and SPP1 with childhood-onset SLE were confirmed in a Japanese population

  • These are preliminary results for a limited number of cases, tumor necrosis factor alpha-induced protein 3 (TNFAIP3) rs2230926G may be an important predictor of disease onset in males

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Summary

Introduction

Systemic lupus erythematosus (SLE) is an autoimmune connective tissue disease which presents with various clinical symptoms and disorders in many internal organs. Childhood-onset SLE represents 10–20% of all SLE cases, and is associated with greater disease severity than adult-onset SLE, including more rapid renal damage. Recent large-scale association studies revealed a relationship between genetic risk factors and patient age at disease onset [4]. Relative to adult-onset SLE, there is a higher genetic risk in childhood-onset SLE; this influences age of disease onset, which is an important predictor of disease severity [4]. We hypothesize that gender-specific genetic effects of childhood-onset SLE are involved in its etiology. To test this hypothesis, here we explore the distribution of known susceptibility loci in a cohort of Japanese childhood-onset SLE patients. We focused on gender differences in allelic frequencies

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