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Abstract Number: 617

Shared HLA Class I and II Alleles in Susceptibility to Ankylosing Spondylitis Among Three Ethnic Groups

Mark Hwang1, Xiaodong Zhou2, Michael H. Weisman3, Michael M. Ward4, Jiucun Wang5, Lianne S. Gensler6, Hejian Zou5, Dongyi He7, Matthew A. Brown8, Paul Scheet9 and John D. Reveille10,11, 1Medicine, University of Texas Health Science Center at Houston, Houston, TX, 2Rheumatology, University of Texas Health Science Center at Houston, Houston, TX, 3Rheumatology, Cedars-Sinai Medical Center, Los Angeles, CA, 4Bldg 10 CRC Rm 4-1339, NIAMS/NIH, Bethesda, MD, 5Rheumatology, Huashan Hospital, Shanghai, China, 6Medicine/Rheumatology, University of California, San Francisco, San Francisco, CA, 7No.540 xinhua Road .Shanghai, Shanghai Guanghua Hospital, Shanghai, China, 8University of Queensland Diamantina Institute, Brisbane, Australia, 9MD Anderson Cancer Center, Houston, TX, 10Internal Medicine/Rheumatology, University of Texas Health Science Center at Houston, Houston, TX, 11Internal Medicine/Rheumatology, Univ of Texas Health Science Center at Houston, Houston, TX

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Ankylosing spondylitis (AS), Ethnic studies, genetics and major histocompatibility complex (MHC)

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Session Information

Title: Spondyloarthropathies and Psoriatic Arthritis - Pathogenesis, Etiology

Session Type: Abstract Submissions (ACR)

Background/Purpose :  The purpose of this study is to examine associations of HLA class I and class II alleles with AS in different patients populations of whites of European ancestry (EA) and African-American (AA) ethnicities, as well as HLA-B locus associations in Han Chinese (HC).

Methods:  HLA-A, -B, -C, -DRB1, -DQB1 and -DPB1 alleles were examined by DNA typing in unrelated patients from the Prospective Study of Outcomes in Ankylosing Spondylitis cohort, the North American Spondylitis Consortium and Australo-Anglo-American Spondyloarthritis Consortium. For the HLA-B locus analyses, an additional 578 British and Australian AS patients from the Australo-Anglo-American Spondylitis Consortium and 360 HC AS patients were also analyzed. Included therefore in the study were 1829 EA, 62 AA patients and 360 HC who met modified New York criteria for AS.  Controls were North American white and African American as well as Han Chinese subjects without history of rheumatic disease.  To remove an associated effect of HLA-B*27 due to linkage disequilibrium, analyses were also conducted on HLA-B*27 non-carriers only.  Statistical analysis was done by construction of 2×2 tables and testing the proportion of alleles in cases vs. controls with Fisher’s exact test.  Other analyses included permutation-based omnibus testing and “relative predispositional effects” (RPE) analysis

Results: HLA-B27 occurred in 88.7% of EA, 61% of AA, and 93% of HC patients compared to 7.5%, 2% and 7.6%, respectively, of ethnicity matched controls. HLA-B*07 was negatively associated with AS in all three ethnic groups (6.2 % versus 14.9% in EA, p 3.655 x10-26  , 3.2% versus  14% in AA(p=0.02), and 1% versus 12% in HC (p=0.0018). Among EA AS patients, HLA-B27 noncarriers showed positive associations with HLA-B*38 (OR=2.94, p =0.0008) and DRB1*04:04 (OR= 3.02 p = 0.0065) and negative associations with HLA-B*07 and HLA-DRB1*03, HLA-DRB1*15:01 and their respective linked alleles DQB1*02:01 and DQB1*06. Additional associations with HLA-B*14(OR = 1.74, p < 0.001) and HLA-B*40 (OR = 1.32, p = 0.02) were observed via RPE analysis, which excludes the HLA-B*27 alleles. No associations were seen with HLA-DPB1 alleles or with HLA-A*02 (the latter seen in a much larger study where HLA alleles were imputed but not directly genotyped). Among AA patients, positive associations were seen in HLA-B*27 (OR = 75.11, p <0.0001), HLA-B*40 (OR = 8.33, p = 0.01) and HLA-DRB1*13:02 (OR = 2.43, p = 0.02).  No statistically significant associations were seen in HLA-DQB1, HLA-DPB1 alleles. In the HC, no association was seen with B*40:01 (B60) although an association was seen by a covariate via logistic regression analysis (p=0.02, OR=2.3) and by RPE analysis (p=0.01, OR=1.56). Negative associations were also demonstrated with HLA-B*13, B*15, B*46 and B*51.

Conclusion: This is the largest directly genotyped HLA study to date.  These data, analyzing the largest number of AS patients in three patient populations examined to date, suggest other HLA alleles to be operative in AS predisposition in addition to HLA-B*27. The shared association of certain alleles in all three groups suggests a direct role in AS pathogenesis


Disclosure:

M. Hwang,
None;

X. Zhou,
None;

M. H. Weisman,
None;

M. M. Ward,
None;

J. Wang,
None;

L. S. Gensler,

UCB,

5,

AbbVie,

5,

Celgene Corporation,

9;

H. Zou,
None;

D. He,
None;

M. A. Brown,
None;

P. Scheet,
None;

J. D. Reveille,
None.

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