Haplotype analysis discriminates genetic risk for DR3-associated endocrine autoimmunity and helps define extreme risk for Addison's disease

J Clin Endocrinol Metab. 2010 Oct;95(10):E263-70. doi: 10.1210/jc.2010-0508. Epub 2010 Jul 14.

Abstract

Context: Multiple autoimmune disorders (e.g. Addison's disease, type 1 diabetes, celiac disease) are associated with HLA-DR3, but it is likely that alleles of additional genes in linkage disequilibrium with HLA-DRB1 contribute to disease.

Objective: The objective of the study was to characterize major histocompatability complex (MHC) haplotypes conferring extreme risk for autoimmune Addison's disease (AD).

Design, setting, and participants: Eighty-six 21-hydroxylase autoantibody-positive, nonautoimmune polyendocrine syndrome type 1, Caucasian individuals collected from 1992 to 2009 with clinical AD from 68 families (12 multiplex and 56 simplex) were genotyped for HLA-DRB1, HLA-DQB1, MICA, HLA-B, and HLA-A as well as high density MHC single-nucleotide polymorphism (SNP) analysis for 34.

Main outcome measures: AD and genotype were measured.

Result: Ninety-seven percent of the multiplex individuals had both HLA-DR3 and HLA-B8 vs. 60% of simplex AD patients (P = 9.72 × 10(-4)) and 13% of general population controls (P = 3.00 × 10(-19)). The genotype DR3/DR4 with B8 was present in 85% of AD multiplex patients, 24% of simplex patients, and 1.5% of control individuals (P = 4.92 × 10(-191)). The DR3-B8 haplotype of AD patients had HLA-A1 less often (47%) than controls (81%, P = 7.00 × 10(-5)) and type 1 diabetes patients (73%, P = 1.93 × 10(-3)). Analysis of 1228 SNPs across the MHC for individuals with AD revealed a shorter conserved haplotype (3.8) with the loss of the extended conserved 3.8.1 haplotype approximately halfway between HLA-B and HLA-A.

Conclusion: Extreme risk for AD, especially in multiplex families, is associated with haplotypic DR3 variants, in particular a portion (3.8) but not all of the conserved 3.8.1 haplotype.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Addison Disease / genetics*
  • Addison Disease / immunology
  • Adult
  • Autoimmune Diseases / genetics
  • Autoimmune Diseases / immunology
  • Autoimmunity / genetics*
  • DNA Mutational Analysis
  • Endocrine Cells / immunology*
  • Female
  • Gene Frequency
  • Genetic Predisposition to Disease*
  • HLA-B8 Antigen / genetics
  • HLA-DR3 Antigen / genetics
  • HLA-DR3 Antigen / physiology*
  • Haplotypes
  • Humans
  • Linkage Disequilibrium
  • Male
  • Pedigree
  • Polymorphism, Single Nucleotide / physiology
  • Risk

Substances

  • HLA-B8 Antigen
  • HLA-DR3 Antigen