Molecular basis for increased susceptibility of Indigenous North Americans to seropositive rheumatoid arthritis.
Ann Rheum Dis
; 76(11): 1915-1923, 2017 11.
Article
em En
| MEDLINE
| ID: mdl-28801345
ABSTRACT
OBJECTIVE:
The pathogenetic mechanisms by which HLA-DRB1 alleles are associated with anticitrullinated peptide antibody (ACPA)-positive rheumatoid arthritis (RA) are incompletely understood. RA high-risk HLA-DRB1 alleles are known to share a common motif, the 'shared susceptibility epitope (SE)'. Here, the electropositive P4 pocket of HLA-DRB1 accommodates self-peptide residues containing citrulline but not arginine. HLA-DRB1 His/Phe13ß stratifies with ACPA-positive RA, while His13ßSer polymorphisms stratify with ACPA-negative RA and RA protection. Indigenous North American (INA) populations have high risk of early-onset ACPA-positive RA, whereby HLA-DRB1*0404 and HLA-DRB1*1402 are implicated as risk factors for RA in INA. However, HLA-DRB1*1402 has a His13ßSer polymorphism. Therefore, we aimed to verify this association and determine its molecular mechanism.METHODS:
HLA genotype was compared in 344 INA patients with RA and 352 controls. Structures of HLA-DRB1*1402-class II loaded with vimentin-64Arg59-71, vimentin-64Cit59-71 and fibrinogen ß-74Cit69-81 were solved using X-ray crystallography. Vimentin-64Cit59-71-specific and vimentin59-71-specific CD4+ T cells were characterised by flow cytometry using peptide-histocompatibility leukocyte antigen (pHLA) tetramers. After sorting of antigen-specific T cells, TCRα and ß-chains were analysed using multiplex, nested PCR and sequencing.RESULTS:
ACPA+ RA in INA was independently associated with HLA-DRB1*1402. Consequent to the His13ßSer polymorphism and altered P4 pocket of HLA-DRB1*1402, both citrulline and arginine were accommodated in opposite orientations. Oligoclonal autoreactive CD4+ effector T cells reactive with both citrulline and arginine forms of vimentin59-71 were observed in patients with HLA-DRB1*1402+ RA and at-risk ACPA- first-degree relatives. HLA-DRB1*1402-vimentin59-71-specific and HLA-DRB1*1402-vimentin-64Cit59-71-specific CD4+ memory T cells were phenotypically distinct populations.CONCLUSION:
HLA-DRB1*1402 broadens the capacity for citrullinated and native self-peptide presentation and T cell expansion, increasing risk of ACPA+ RA.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Artrite Reumatoide
/
Indígenas Norte-Americanos
/
Predisposição Genética para Doença
/
Cadeias HLA-DRB1
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Ann Rheum Dis
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Austrália