RÉSUMÉ
The HLA genes are associated with various autoimmune pathologies, with the control of the immune response also being significant in organs and cells transplantation. The aim of the study is to identify the HLA-A, HLA-B, and HLA-C alleles frequencies in the analyzed Romanian cohort. We performed HLA typing using next-generation sequencing (NGS) in a Romanian cohort to estimate class I HLA allele frequencies up to a six-digit resolution. A total of 420 voluntary donors from the National Registry of Voluntary Hematopoietic Stem Cell Donors (RNDVCSH) were included in the study for HLA genotyping. Peripheral blood samples were taken and brought to the Fundeni Clinical Institute during 2020-2021. HLA genotyping was performed using the Immucor Mia Fora NGS MFlex kit. A total of 109 different alleles were detected in 420 analyzed samples, out of which 31 were for HLA-A, 49 for HLA-B, and 29 for HLA-C. The most frequent HLA-A alleles were HLA-A*02:01:01 (26.11%), HLA-A*01:01:01 (12.5%), HLA-A*24:02:01 (11.67%), HLA-A*03:01:01 (9.72%), HLA-A*11:01:01, and HLA-A*32:01:01 (each with 8.6%). For the HLA-B locus, the most frequent allele was HLA-B*18:01:01 (11.25%), followed by HLA-B*51:01:01 (10.83%) and HLA-B*08:01:01 (7.78%). The most common HLA-C alleles were HLA-C*07:01:01 (17.36%), HLA-C*04:01:01 (13.47%), and HLA-C*12:03:01 (10.69%). Follow-up studies are ongoing for confirming the detected results.
Sujet(s)
Fréquence d'allèle , Antigènes HLA-A , Antigènes HLA-B , Antigènes HLA-C , Donneurs de tissus , Humains , Antigènes HLA-C/génétique , Antigènes HLA-A/génétique , Antigènes HLA-B/génétique , Mâle , Femelle , Allèles , Roumanie , Cellules souches hématopoïétiques/métabolisme , Transplantation de cellules souches hématopoïétiques , Adulte , Séquençage nucléotidique à haut débit , Test d'histocompatibilité/méthodes , Génotype , Adulte d'âge moyenRÉSUMÉ
HLA-A*33:33:02 differs from HLA-A*33:33:01 by one synonymous nucleotide change C>T in exon 3 (TCC>TCT).
Sujet(s)
Allèles , Exons , Antigènes HLA-A , Humains , Antigènes HLA-A/génétique , Inde , Séquence nucléotidique , Test d'histocompatibilité , Analyse de séquence d'ADN , Mâle , Polymorphisme de nucléotide simple , FemelleRÉSUMÉ
Birdshot chorioretinopathy is an inflammatory eye condition strongly associated with MHC-I allele HLA-A29. The striking association with MHC-I suggests involvement of T cells, whereas natural killer (NK) cell involvement remains largely unstudied. Here we show that HLA-A29-positive birdshot chorioretinopathy patients have a skewed NK cell pool containing expanded CD16 positive NK cells which produce more proinflammatory cytokines. These NK cells contain populations that express CD8A which is involved in MHC-I recognition on target cells, display gene signatures indicative of high cytotoxic activity (GZMB, PRF1 and ISG15), and signaling through NK cell receptor CD244 (SH2D1B). Long-term monitoring of a cohort of birdshot chorioretinopathy patients with active disease identifies a population of CD8bright CD244bright NK cells, which rapidly declines to normal levels upon clinical remission following successful treatment. Collectively, these studies implicate CD8bright CD244bright NK cells in birdshot chorioretinopathy.
Sujet(s)
Choriorétinopathie de type birdshot , Antigènes HLA-A , Cellules tueuses naturelles , Famille des molécules de signalisation de l'activation des lymphocytes , Analyse sur cellule unique , Humains , Cellules tueuses naturelles/immunologie , Cellules tueuses naturelles/métabolisme , Choriorétinopathie de type birdshot/immunologie , Choriorétinopathie de type birdshot/métabolisme , Antigènes HLA-A/génétique , Antigènes HLA-A/métabolisme , Antigènes HLA-A/immunologie , Analyse sur cellule unique/méthodes , Famille des molécules de signalisation de l'activation des lymphocytes/métabolisme , Famille des molécules de signalisation de l'activation des lymphocytes/génétique , Antigènes CD8/métabolisme , Antigènes CD8/génétique , Choriorétinite/immunologie , Choriorétinite/génétique , Femelle , Récepteurs du fragment Fc des IgG/métabolisme , Récepteurs du fragment Fc des IgG/génétique , Mâle , Cytokines/métabolisme , Adulte , Protéines liées au GPI/métabolisme , Protéines liées au GPI/génétique , Adulte d'âge moyen , PerforineRÉSUMÉ
The novel HLA-A*33:01:21 allele, first described in a potential bone marrow donor from Brazil.
Sujet(s)
Allèles , Exons , Antigènes HLA-A , Humains , Séquence nucléotidique , Transplantation de moelle osseuse , Brésil , Test d'histocompatibilité , Antigènes HLA-A/génétique , Analyse de séquence d'ADN/méthodes , Donneurs de tissusRÉSUMÉ
One nucleotide substitution in codon 320 of A*03:01:01:01 results in the novel allele, HLA-A*03:478.
Sujet(s)
Allèles , Asiatiques , Exons , Test d'histocompatibilité , Humains , Asiatiques/génétique , République de Corée , Analyse de séquence d'ADN/méthodes , Séquence nucléotidique , Codon , Antigène HLA-A3/génétique , Antigènes HLA-A/génétique , Polymorphisme de nucléotide simple , Alignement de séquencesRÉSUMÉ
The genetic diversity of killer cell immunoglobulin-like receptors (KIRs) and human leukocyte antigen (HLA) genes influences the host's immune response to viral pathogens. This study aims to explore the impact of five single nucleotide polymorphisms (SNPs) in KIR3DL2 and HLA-A genes on hepatitis C virus (HCV) infection. A total of 2251 individuals were included in the case-control study. SNPs including KIR3DL2 rs11672983, rs3745902, rs1654644, and HLA-A rs3869062, rs12202296 were genotyped. By controlling various confounding factors using a modified logistic regression model, as well as incorporating stratified analysis, joint effects analysis, and multidimensional bioinformatics analysis, we analyzed the relationship between SNPs and HCV infection. The logistic regression analysis showed a correlation between KIR3DL2 rs11672983 AA, KIR3DL2 rs3745902 TT, and increased HCV susceptibility (p < 0.01). Stratified analysis indicated that KIR3DL2 rs1654644 and HLA-A rs3869062 also heightened HCV susceptibility in certain subgroups. A linear trend of rising HCV infection rates was observed when combining KIR3DL2 rs11672983 AA and KIR3DL2 rs3745902 TT (ptrend = 0.007). Bioinformatics analysis suggested these SNPs' regulatory potential and their role in altering messenger RNA secondary structure, implying their functional relevance in HCV susceptibility. Our findings indicate that KIR3DL2 rs11672983 AA and KIR3DL2 rs3745902 TT are significantly associated with increased susceptibility to HCV infection.
Sujet(s)
Prédisposition génétique à une maladie , Génotype , Hépatite C , Polymorphisme de nucléotide simple , Humains , Mâle , Femelle , Études cas-témoins , Hépatite C/génétique , Hépatite C/virologie , Hépatite C/immunologie , Adulte d'âge moyen , Adulte , Antigènes HLA-A/génétique , Hepacivirus/génétique , Hepacivirus/immunologie , Récepteurs KIR/génétique , Sujet âgé , Récepteur KIR3DL2/génétiqueRÉSUMÉ
The novel HLA-A*30:221 allele differs from HLA-A*30:01:01:01 by one nucleotide substitution in Exon 7.
Sujet(s)
Allèles , Exons , Antigènes HLA-A , Séquençage nucléotidique à haut débit , Test d'histocompatibilité , Humains , Séquençage nucléotidique à haut débit/méthodes , Antigènes HLA-A/génétique , Test d'histocompatibilité/méthodes , Séquence nucléotidique , Polymorphisme de nucléotide simple , Analyse de séquence d'ADN/méthodes , Alignement de séquencesRÉSUMÉ
Pancreatic ductal adenocarcinoma (PDAC) is characterised by immune evasion that contribute to poor prognosis. Cancer-associated fibroblasts (CAFs) play a pivotal role in orchestrating the PDAC tumour microenvironment. We investigated the role of CAF-derived extracellular vesicle (EV)-packaged long non-coding RNAs (lncRNAs) in immune evasion and explored gene therapy using engineered EVs loading small interfering RNAs (siRNAs) as a potential therapeutic strategy. Our findings highlight the significance of EV-packaged lncRNA RP11-161H23.5 from CAF in promoting PDAC immune evasion by downregulating HLA-A expression, a key component of antigen presentation. Mechanistically, RP11-161H23.5 forms a complex with CNOT4, a subunit of the mRNA deadenylase CCR4-NOT complex, enhancing the degradation of HLA-A mRNA by shortening its poly(A) tail. This immune evasion mechanism compromises the anti-tumour immune response. To combat this, we propose an innovative approach utilising engineered EVs as natural and biocompatible nanocarriers for siRNA-based gene therapy and this strategy holds promise for enhancing the effectiveness of immunotherapy in PDAC. Overall, our study sheds light on the critical role of CAF-derived EV-packaged lncRNA RP11-161H23.5/CNOT4/HLA-A axis in PDAC immune evasion and presents a novel avenue for therapeutic intervention.
Sujet(s)
Fibroblastes associés au cancer , Carcinome du canal pancréatique , Vésicules extracellulaires , Antigènes HLA-A , Tumeurs du pancréas , ARN long non codant , Humains , ARN long non codant/génétique , ARN long non codant/métabolisme , Fibroblastes associés au cancer/métabolisme , Fibroblastes associés au cancer/immunologie , Vésicules extracellulaires/métabolisme , Vésicules extracellulaires/immunologie , Tumeurs du pancréas/immunologie , Tumeurs du pancréas/génétique , Tumeurs du pancréas/thérapie , Carcinome du canal pancréatique/immunologie , Carcinome du canal pancréatique/génétique , Carcinome du canal pancréatique/thérapie , Lignée cellulaire tumorale , Antigènes HLA-A/génétique , Antigènes HLA-A/immunologie , Antigènes HLA-A/métabolisme , Échappement immunitaire , Régulation de l'expression des gènes tumoraux , Régulation négative , Petit ARN interférent , Microenvironnement tumoral/immunologie , Animaux , Échappement de la tumeur à la surveillance immunitaire , SourisRÉSUMÉ
OBJECTIVE: To analyze a Chinese pedigree with a recombination occurring between the HLA-A/C loci in both parents. METHODS: A patient who was planning to undergo hematopoietic stem cell transplantation due to "aplastic anemia" in February 2022 was selected as the study subject. Peripheral blood samples were collected from the patient, his parents and brother. HLA-A/C/B/DRB1/DQB1 high-resolution typing was carried out by using sequence-based typing and sequence-specific oligonucleotides. The recombination was identified by pedigree analysis. The HLA haplotype of each individual was identified by genealogical analysis. The parentage possibility was determined by short tandem repeat analysis. HLA-A/C/B/DRB1/DRB345/DQA1/DQB1/DPA1/DPB1 were determined with next-generation high-throughput sequence-based typing. The recombination sites were analyzed by family study. RESULTS: The high parentage possibilities of the family was confirmed by short tandem repeat analysis. Recombination was found between the HLA-A*24:02 A*33:03/C*14:03 in the paternally transmitted haplotype, whilst HLA-A*01:01 A*03:01/C*08:02 was found in the maternally transmitted haplotype, which had resulted in two novel HLA haplotypes in the proband. CONCLUSION: A rare case with simultaneous recombination of the paternal and maternal HLA-A/C loci has been discovered, which may facilitate further study of the mechanisms of the HLA recombination.
Sujet(s)
Asiatiques , Antigènes HLA-A , Haplotypes , Pedigree , Recombinaison génétique , Adulte , Femelle , Humains , Mâle , Asiatiques/génétique , Peuples d'Asie de l'Est , Test d'histocompatibilité , Antigènes HLA-A/génétique , Antigènes HLA-C/génétique , Répétitions microsatellites , ParentsRÉSUMÉ
HLA-A*32:01:01:41 differs from the HLA-A*32:01:01:01 allele by one nucleotide substitution in the intron 3.
Sujet(s)
Allèles , Exons , Antigènes HLA-A , Séquençage nucléotidique à haut débit , Test d'histocompatibilité , Introns , Humains , Séquençage nucléotidique à haut débit/méthodes , Antigènes HLA-A/génétique , Test d'histocompatibilité/méthodes , Séquence nucléotidique , Polymorphisme de nucléotide simple , Analyse de séquence d'ADN/méthodes , Alignement de séquencesRÉSUMÉ
The individual HLA-related susceptibility to emerging viral diseases such as COVID-19 underscores the importance of understanding how HLA polymorphism influences peptide presentation and T cell recognition. Similar to HLA-A*0101, which is one of the earliest identified HLA alleles among the human population, HLA-A*2601 possesses a similar characteristic for the binding peptide and acts as a prevalent allomorph in HLA-I. In this study, we found that, compared with HLA-A*0101, HLA-A*2601 individuals exhibit distinctive features for the T cell responses to SARS-CoV-2 and influenza virus after infection and/or vaccination. The heterogeneous T cell responses can be attributed to the distinct preference of HLA-A*2601 and HLA-A*0101 to T cell epitope motifs with negative-charged residues at the P1 and P3 positions, respectively. Furthermore, we determined the crystal structures of the HLA-A*2601 complexed to four peptides derived from SARS-CoV-2 and human papillomavirus, with one structure of HLA-A*0101 for comparison. The shallow pocket C of HLA-A*2601 results in the promiscuous presentation of peptides with "switchable" bulged conformations because of the secondary anchor in the median portion. Notably, the hydrogen bond network formed between the negative-charged P1 anchors and the HLA-A*2601-specific residues lead to a "closed" conformation and solid placement for the P1 secondary anchor accommodation in pocket A. This insight sheds light on the intricate relationship between HLA I allelic allomorphs, peptide binding, and the immune response and provides valuable implications for understanding disease susceptibility and potential vaccine design.
Sujet(s)
COVID-19 , Déterminants antigéniques des lymphocytes T , SARS-CoV-2 , Humains , Déterminants antigéniques des lymphocytes T/immunologie , Déterminants antigéniques des lymphocytes T/génétique , SARS-CoV-2/immunologie , SARS-CoV-2/génétique , COVID-19/immunologie , COVID-19/virologie , Antigènes HLA-A/immunologie , Antigènes HLA-A/génétique , Antigènes HLA-A/métabolisme , Antigènes HLA-A/composition chimique , Peptides/immunologie , Peptides/composition chimique , Allèles , Antigène HLA-A1RÉSUMÉ
BACKGROUND: Immune checkpoint blockade (ICB) therapy provides remarkable clinical benefits for multiple cancer types. However, the overall response rate to ICB therapy remains low in esophageal squamous cell carcinoma (ESCC). This study aimed to identify biomarkers of ICB therapy for ESCC and interrogate its potential clinical relevance. METHODS: We investigated gene expression in 42 treatment-naïve ESCC tumor tissues and identified differentially expressed genes, tumor-infiltrating lymphocytes and immune-related genes signatures associated with differential immunotherapy responses. We systematically assessed the tumor microenvironment using the NanoString GeoMx digital spatial profiler, single-cell RNA-seq and multiplex immunohistochemistry in ESCC. Finally, we evaluated the associations between HLA-A-positive tertiary lymphoid structures (TLSs) and patients' responses to ICB in 60 ESCC patients. RESULTS: Tumor infiltrating B lymphocytes and several immune-related gene signatures, such as the antigen presenting machinery (APM) signature, are significantly elevated in ICB treatment responders. Multiplex immunohistochemistry identified the presence of HLA-A+ TLSs and showed that TLS-resident cells increasingly express HLA-A as TLSs mature. Most TLS-resident HLA-A+ cells are tumor-infiltrating T (TIL-T) or tumor-infiltrating B (TIL-B) lymphocytes. Digital spatial profiling of spatially distinct TIL-T lymphocytes and single-cell RNA-seq data from 60 ESCC tumor tissues revealed that CXCL13-expressing exhausted TIL-Ts inside TLSs are reactivated with elevated expression of the APM signature as TLSs mature. Finally, we demonstrated that HLA-A+ TLSs and their major cellular components, TIL-Ts and TIL-Bs, are associated with a clinical benefit from ICB treatment for ESCC. CONCLUSIONS: HLA-A+ TLSs are present in ESCC tumor tissues. TLS-resident TIL-Ts with elevated expression of the APM signature may be reactivated. HLA-A+ TLSs and their major cellular components, TIL-Ts and TIL-Bs, may serve as biomarkers for ICB-treated ESCC patients.
Sujet(s)
Tumeurs de l'oesophage , Carcinome épidermoïde de l'oesophage , Antigènes HLA-A , Immunothérapie , Lymphocytes TIL , Structures lymphoïdes tertiaires , Microenvironnement tumoral , Humains , Lymphocytes TIL/immunologie , Carcinome épidermoïde de l'oesophage/immunologie , Carcinome épidermoïde de l'oesophage/anatomopathologie , Carcinome épidermoïde de l'oesophage/thérapie , Carcinome épidermoïde de l'oesophage/génétique , Structures lymphoïdes tertiaires/immunologie , Structures lymphoïdes tertiaires/anatomopathologie , Tumeurs de l'oesophage/immunologie , Tumeurs de l'oesophage/anatomopathologie , Tumeurs de l'oesophage/thérapie , Tumeurs de l'oesophage/traitement médicamenteux , Tumeurs de l'oesophage/génétique , Immunothérapie/méthodes , Microenvironnement tumoral/immunologie , Antigènes HLA-A/immunologie , Antigènes HLA-A/génétique , Femelle , Mâle , Inhibiteurs de points de contrôle immunitaires/usage thérapeutique , Inhibiteurs de points de contrôle immunitaires/pharmacologie , Adulte d'âge moyen , Sujet âgé , Marqueurs biologiques tumoraux/métabolismeRÉSUMÉ
HLA-A*01:454 and HLA-A*31:229, two novel HLA-A alleles detected during routine typing by next-generation sequencing.
Sujet(s)
Allèles , Exons , Antigènes HLA-A , Séquençage nucléotidique à haut débit , Test d'histocompatibilité , Humains , Antigènes HLA-A/génétique , Analyse de séquence d'ADN/méthodes , Antigène HLA-A1/génétique , Séquence nucléotidiqueRÉSUMÉ
OBJECTIVE: This study seeks to elucidate the association between HLA-A, HLA-B, and HLA-DRB1 alleles and their relative risk contributions to ALL within an Iranian cohort. METHODS: Utilizing a robust case-control design, this research involved 71 ALL patients and 71 age and sex-matched healthy individuals. Genotyping of specified HLA alleles was performed using the advanced PCR-SSP technique. RESULTS: Our findings reveal a marked increase in the prevalence of the HLA-DRB1*04 allele among patients diagnosed with ALL compared to the control group (P<0.027). Conversely, the alleles HLA-A*26 (P=0.025), HLA-A*33 (P=0.020), and HLA-DRB1*03 (P=0.035) were observed at significantly reduced frequencies within the patient population. CONCLUSION: Our findings highlight HLA-DRB1*04 as a potential genetic marker for increased susceptibility to ALL, while HLA-A*26, HLA-A*33, and HLA-DRB1*03 emerge as protective factors.
Sujet(s)
Allèles , Prédisposition génétique à une maladie , Antigènes HLA-A , Antigènes HLA-B , Chaines HLA-DRB1 , Leucémie-lymphome lymphoblastique à précurseurs B et T , Humains , Études cas-témoins , Chaines HLA-DRB1/génétique , Femelle , Mâle , Iran/épidémiologie , Antigènes HLA-B/génétique , Antigènes HLA-A/génétique , Leucémie-lymphome lymphoblastique à précurseurs B et T/génétique , Pronostic , Études de suivi , Adulte , Génotype , Adolescent , Enfant , Jeune adulte , Enfant d'âge préscolaire , Marqueurs biologiques tumoraux/génétiqueRÉSUMÉ
Long-term immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) requires the identification of T-cell epitopes affecting host immunogenicity. In this computational study, we explored the CD8+ epitope diversity estimated in 27 of the most common HLA-A and HLA-B alleles, representing most of the United States population. Analysis of 16 SARS-CoV-2 variants [B.1, Alpha (B.1.1.7), five Delta (AY.100, AY.25, AY.3, AY.3.1, AY.44), and nine Omicron (BA.1, BA.1.1, BA.2, BA.4, BA.5, BQ.1, BQ.1.1, XBB.1, XBB.1.5)] in analyzed MHC class I alleles revealed that SARS-CoV-2 CD8+ epitope conservation was estimated at 87.6%-96.5% in spike (S), 92.5%-99.6% in membrane (M), and 94.6%-99% in nucleocapsid (N). As the virus mutated, an increasing proportion of S epitopes experienced reduced predicted binding affinity: 70% of Omicron BQ.1-XBB.1.5 S epitopes experienced decreased predicted binding, as compared with ~3% and ~15% in the earlier strains Delta AY.100-AY.44 and Omicron BA.1-BA.5, respectively. Additionally, we identified several novel candidate HLA alleles that may be more susceptible to severe disease, notably HLA-A*32:01, HLA-A*26:01, and HLA-B*53:01, and relatively protected from disease, such as HLA-A*31:01, HLA-B*40:01, HLA-B*44:03, and HLA-B*57:01. Our findings support the hypothesis that viral genetic variation affecting CD8 T-cell epitope immunogenicity contributes to determining the clinical severity of acute COVID-19. Achieving long-term COVID-19 immunity will require an understanding of the relationship between T cells, SARS-CoV-2 variants, and host MHC class I genetics. This project is one of the first to explore the SARS-CoV-2 CD8+ epitope diversity that putatively impacts much of the United States population.
Sujet(s)
COVID-19 , Biologie informatique , Déterminants antigéniques des lymphocytes T , SARS-CoV-2 , Humains , Déterminants antigéniques des lymphocytes T/immunologie , Déterminants antigéniques des lymphocytes T/génétique , SARS-CoV-2/immunologie , SARS-CoV-2/génétique , COVID-19/immunologie , COVID-19/virologie , États-Unis/épidémiologie , Biologie informatique/méthodes , Lymphocytes T CD8+/immunologie , Antigènes HLA-B/génétique , Antigènes HLA-B/immunologie , Allèles , Antigènes HLA-A/génétique , Antigènes HLA-A/immunologie , Indice de gravité de la maladie , Glycoprotéine de spicule des coronavirus/immunologie , Glycoprotéine de spicule des coronavirus/génétiqueRÉSUMÉ
HLA-A*31:01:53 differs from HLA-A*31:01:02:01 by one nucleotide change at nucleotide 900 in exon 5 from G to A.
Sujet(s)
Allèles , Asiatiques , Exons , Antigènes HLA-A , Séquençage nucléotidique à haut débit , Humains , Asiatiques/génétique , Séquence nucléotidique , Codon , Peuples d'Asie de l'Est , Test d'histocompatibilité/méthodes , Antigènes HLA-A/génétique , Polymorphisme de nucléotide simple , Analyse de séquence d'ADN/méthodesRÉSUMÉ
By developing evidence-based pharmacogenetics guidelines to optimize pharmacotherapy, the Dutch Pharmacogenetics Working Group (DPWG) aims to advance the implementation of pharmacogenetics (PGx). This guideline outlines the gene-drug interaction of CYP2C9 and HLA-B with phenytoin, HLA-A and HLA-B with carbamazepine and HLA-B with oxcarbazepine and lamotrigine. A systematic review was performed and pharmacotherapeutic recommendations were developed. For CYP2C9 intermediate and poor metabolisers, the DPWG recommends lowering the daily dose of phenytoin and adjust based on effect and serum concentration after 7-10 days. For HLA-B*15:02 carriers, the risk of severe cutaneous adverse events associated with phenytoin, carbamazepine, oxcarbazepine, and lamotrigine is strongly increased. For carbamazepine, this risk is also increased in HLA-B*15:11 and HLA-A*31:01 carriers. For HLA-B*15:02, HLA-B*15:11 and HLA-A*31:01 positive patients, the DPWG recommends choosing an alternative anti-epileptic drug. If not possible, it is recommended to advise the patient to report any rash while using carbamazepine, lamotrigine, oxcarbazepine or phenytoin immediately. Carbamazepine should not be used in an HLA-B*15:02 positive patient. DPWG considers CYP2C9 genotyping before the start of phenytoin "essential" for toxicity prevention. For patients with an ancestry in which the abovementioned HLA-alleles are prevalent, the DPWG considers HLA-B*15:02 genotyping before the start of carbamazepine, phenytoin, oxcarbazepine, and lamotrigine "beneficial", as well as genotyping for HLA-B*15:11 and HLA-A*31:01 before initiating carbamazepine.
Sujet(s)
Anticonvulsivants , Carbamazépine , Cytochrome P-450 CYP2C9 , Antigènes HLA-A , Antigènes HLA-B , Humains , Anticonvulsivants/effets indésirables , Anticonvulsivants/usage thérapeutique , Cytochrome P-450 CYP2C9/génétique , Antigènes HLA-B/génétique , Antigènes HLA-A/génétique , Carbamazépine/effets indésirables , Carbamazépine/usage thérapeutique , Lamotrigine/usage thérapeutique , Oxcarbazépine , Pays-Bas , Phénytoïne/effets indésirables , PharmacogénétiqueRÉSUMÉ
OBJECTIVE: This study aimed to establish the association between HLA-A, B, DR genotypes and gastrointestinal variables in patients with SpA without inflammatory bowel disease (IBD). METHODS: Retrospective study of 91 patients with SpA and 401 healthy controls, with typing by Illumina Sequencing/PacBio and LIFECODES HLA-PCR/SSO multiplex sequencing technology. The presence of gastrointestinal symptoms was evaluated by administering a survey, and those who presented 2 or more symptoms were taken for clinical evaluation by rheumatology and gastroenterology, colonoscopy and histopathological study. (Ethics committee approval). RESULTS: The 59,3% of the patients were men, with a mean age of 43,9±11.4 years; 80,2% were classified as ankylosing spondylitis. 14, 28 and 19 genotypes for the HLA-A*, HLA-B* and HLA-DR* loci were identified in both groups, of which a relationship with gastrointestinal symptoms was identified: A*26, A*29 and B*27 were associated to abdominal pain, DRB1*11 and DRB1*16 with abdominal distention, A*30, B*38, DRB1*13 and DRB1*14 with weight loss, B*40 with diarrhea >4 weeks, and presence of mucus in the stools with A*02 and DRB1*11 (p<0.05). Furthermore, the presence of B*15 had a statistical relationship with intolerance to some food, highlighting the B*27 genotype in relation to grains and dairy products, A*23 with grains, vegetables and meats, and B*49 with vegetables and dairy (p<0.05). Regarding the endoscopic variables, macroscopic changes were found in the ileum mucosa related to A*02, B*48, DRB1*14 and the relationship between B*27 and ulcers at this level should be highlighted. Macroscopic changes in the sigmoid colon with B*48 and the rectum with A*30. In microscopic changes, inflammatory alterations of the ileum are mentioned with genotypes DRB1*07, DRB1*13 and DRB1*14, a genotype that is related to changes in the ileum both endoscopically and histologically (p<0.05). CONCLUSIONS: These findings indicate a potential genetic predisposition related to HLA genotypes that may increase the likelihood of food intolerance, gastrointestinal symptoms, and even visible and microscopic changes, specifically in the ileal tissue. The study highlights the presence of B*27 and other noteworthy HLA class I and class II genes (such as DRB1*14) in the diverse Colombian population.
OBJETIVO: Establecer la asociación entre genotipos HLA-A, B, DR y variables gastrointestinales en pacientes con EspA, sin enfermedad inflamatoria intestinal (EII). MÉTODOS: Estudio retrospectivo de 91 pacientes con EspA y 401 controles sanos, con tipificación por tecnología de secuenciación Illumina Sequencing/PacBio, y LIFECODES HLA-PCR/SSO multiplex. Se evaluó la presencia de síntomas gastrointestinales por aplicación de una encuesta, y, aquellos que presentaran dos o más síntomas, fueron llevados a valoración clínica por reumatología y gastroenterología, colonoscopia y estudio histopatológico. (Aprobación del Comité de Ética, HMC, 2022 - 2020). RESULTADOS: El 59,3% de los pacientes fueron hombres, con edad media de 43,9 ± 11,4 años. El 80,2% se clasificó como espondilitis anquilosante. Se identificaron en ambos grupos 14, 28 y 19 genotipos para los loci HLA-A*, HLA-B* y HLA-DR*, de los cuales se identificó relación con síntomas gastrointestinales: A*26, A*29 y B*27, con dolor abdominal; DRB1*11 y DRB1*16, con distensión abdominal; A*30, B*38, DRB1*13 y DRB1*14, con pérdida de peso; B*40, con diarrea >4 semanas y presencia de moco en las deposiciones con A*2 y DRB1*11 (p<0,05). Además, la presencia de B*15, tuvo relación estadística con intolerancia a algún tipo de alimento, a resaltar el genotipo B*27, en relación con granos y lácteos; A*23 con granos, verduras y carnes; y el B*49, con verduras y lácteos (p<0,05). Frente a las variables endoscópicas, se encontraron cambios macroscópicos en la mucosa de íleon relacionados con A*02, B*48, DRB1*14 y, a destacar, la relación B*27 con úlceras a este nivel. Cambios macroscópicos en colon sigmoides con B*48 y en recto con A*30. En cambios microscópicos, se mencionan alteraciones inflamatorias de íleon con genotipos DRB1*07, DRB1*13 y DRB1*14, genotipos que se relaciona a cambios en íleon tanto endoscópica e histológicamente (p<0,05). CONCLUSIONES: Estos resultados sugieren una posible susceptibilidad genética asociada al HLA, con genotipos que pueden predisponer a intolerancia alimentaria, síntomas gastrointestinales, e incluso, a cambios macroscópicos e histológicos, particularmente en tejido de íleon, entre los cuales está presente el B*27, pero resaltan otros interesantes en HLA clase I, como clase II (DRB1*14), en una población de alto mestizaje como la colombiana.
Sujet(s)
Maladies gastro-intestinales , Génotype , Spondylarthrite , Humains , Mâle , Femelle , Adulte , Études rétrospectives , Maladies gastro-intestinales/génétique , Maladies gastro-intestinales/étiologie , Spondylarthrite/génétique , Spondylarthrite/complications , Adulte d'âge moyen , Maladies inflammatoires intestinales/génétique , Maladies inflammatoires intestinales/complications , Antigènes HLA/génétique , Antigènes HLA-A/génétique , Antigènes HLA-B/génétiqueRÉSUMÉ
The novel HLA-A*30:218 allele, first described in a potential bone marrow donor from Brazil.