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. 2020 Mar 9;10(1):4316.
doi: 10.1038/s41598-020-61331-5.

NFKB2 Polymorphisms Associate With the Risk of Developing Rheumatoid Arthritis and Response to TNF Inhibitors: Results From the REPAIR Consortium

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Free PMC article

NFKB2 Polymorphisms Associate With the Risk of Developing Rheumatoid Arthritis and Response to TNF Inhibitors: Results From the REPAIR Consortium

Jose Manuel Sánchez-Maldonado et al. Sci Rep. .
Free PMC article

Abstract

This study sought to evaluate the association of 28 single nucleotide polymorphisms (SNPs) within NFKB and inflammasome pathway genes with the risk of rheumatoid arthritis (RA) and response to TNF inhibitors (TNFi). We conducted a case-control study in a European population of 1194 RA patients and 1328 healthy controls. The association of potentially interesting markers was validated with data from the DANBIO (695 RA patients and 978 healthy controls) and DREAM (882 RA patients) registries. The meta-analysis of our data with those from the DANBIO registry confirmed that anti-citrullinated protein antibodies (ACPA)-positive subjects carrying the NFKB2rs11574851T allele had a significantly increased risk of developing RA (PMeta_ACPA + = 0.0006) whereas no significant effect was found in ACPA-negative individuals (PMeta_ACPA- = 0.35). An ACPA-stratified haplotype analysis including both cohorts (n = 4210) confirmed that ACPA-positive subjects carrying the NFKB2TT haplotype had an increased risk of RA (OR = 1.39, P = 0.0042) whereas no effect was found in ACPA-negative subjects (OR = 1.04, P = 0.82). The meta-analysis of our data with those from the DANBIO and DREAM registries also revealed a suggestive association of the NFKB2rs1056890 SNP with larger changes in DAS28 (OR = 1.18, P = 0.007). Functional experiments showed that peripheral blood mononuclear cells from carriers of the NFKB2rs1005044C allele (in LD with the rs1056890, r2 = 1.00) showed increased production of IL10 after stimulation with LPS (P = 0.0026). These results provide first evidence of a role of the NFKB2 locus in modulating the risk of RA in an ACPA-dependent manner and suggest its implication in determining the response to TNFi. Additional studies are now warranted to further validate these findings.

Conflict of interest statement

V.A. has received compensation for consultancy and for being a member of an advisory board from MSD (Merck) and Janssen. B.G. received funding for research from AbbVie, Biogen, and Pfizer. M.L.H. received funding for research from Abbvie, Biogen, BMS, CellTrion, MSD, Novartis, Orion, Pfizer, Samsung and UCB. The rest of authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Association of the NFKB2rs11574851 SNP with the risk of RA in ACPA-positive patients. Association estimates according a random effect model. P =0.0006.
Figure 2
Figure 2
Meta-analysis of the association of the NFKB2rs1056890 SNP with response to TNFi [A] and correlation with higher levels of IL10 after stimulation of PBMCs (n = 377) with LPS [B]. [A] Association estimates according to a random effect model. PMeta = 0.0077. [B] Correlation with IL10 was analysed using genotype data of the NFKB2rs1005044 SNP, a marker in strong LD with the rs1056890 (r2 = 1.00).

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