Abstract

MICA (major histocompatibility complex class I chain-related gene A) interacts with NKG2D on immune cells to regulate host immune responses. We aimed to determine whether MICA alleles are associated with AS susceptibility in Taiwanese. MICA alleles were determined through haplotype analyses of major MICA coding SNP (cSNP) data from 895 AS patients and 896 normal healthy controls in Taiwan. The distributions of MICA alleles were compared between AS patients and normal healthy controls and among AS patients, stratified by clinical characteristics. ELISA was used to determine soluble MICA (sMICA) levels in serum of AS patients and healthy controls. Stable cell lines expressing four major MICA alleles (MICA*002, MICA*008, MICA*010 and MICA*019) in Taiwanese were used for biological analyses. We found that MICA*019 is the only major MICA allele significantly associated with AS susceptibility (PFDR = 2.25 × 10−115; OR, 14.90; 95% CI, 11.83–18.77) in Taiwanese. In addition, the MICA*019 allele is associated with syndesmophyte formation (PFDR = 0.0017; OR, 1.69; 95% CI, 1.29–2.22) and HLA-B27 positivity (PFDR = 1.45 × 10−33; OR, 28.79; 95% CI, 16.83–49.26) in AS patients. Serum sMICA levels were significantly increased in AS patients as compared to healthy controls. Additionally, MICA*019 homozygous subjects produced the highest levels of sMICA, compared to donors with other genotypes. Furthermore, in vitro experiments revealed that cells expressing MICA*019 produced the highest level of sMICA, as compared to other major MICA alleles. In summary, the MICA*019 allele, producing the highest levels of sMICA, is a significant risk factor for AS and syndesmophyte formation in Taiwanese. Our data indicate that a high level of sMICA is a biomarker for AS.

Highlights

  • Ankylosing spondylitis (AS), a form of insidious and debilitating spondyloarthritis (SpA), is characterized by chronic inflammation and osteo-proliferation of the axial skeletons, including the spine and sacroiliac joints, usually resulting in bone fusion of affected areas [1]

  • The spectra of MICA coding SNP (cSNP) and alleles were determined by sequencing analysis of 896 Taiwanese healthy blood donors and 895 AS patients

  • Among 32 total MICA cSNPs, that were identified in the combined population of healthy controls and AS patients, 22 are common cSNPs within MICA extracellular domains

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Summary

Introduction

Ankylosing spondylitis (AS), a form of insidious and debilitating spondyloarthritis (SpA), is characterized by chronic inflammation and osteo-proliferation of the axial skeletons, including the spine and sacroiliac joints, usually resulting in bone fusion of affected areas [1]. Cells of innate and adaptive immune systems participate in the initiation, development and perpetuation of AS. The most relevant immune cell type in the pathogenesis of AS has not been fully elucidated [2]. Cells, the CD56bright subset of NK cells with immune-regulatory properties, accumulate in inflammatory tissue sites (such as synovial membrane and skin lesions) of rheumatoid arthritis and psoriatic patients [3,4,5,6]. NK cells, a type of lymphocytes of the innate immune system, serve as regulatory immune cells in shaping adaptive immune responses by interacting with dendritic cells, macrophages, T cells and endothelial cells. NK cells play a protective role in the development of experimental arthritis, an effect possibly mediated by suppressing Th17 cell generation via IFN-γ production [17]

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