A sequencing study of CTLA4 in Pakistani rheumatoid arthritis cases

PLoS One. 2020 Sep 18;15(9):e0239426. doi: 10.1371/journal.pone.0239426. eCollection 2020.


Rheumatoid arthritis (RA) is a multifactorial autoimmune disease. The interaction of genetic and environmental factors is likely necessary for RA. Among potential genetic factors, many major histocompatibility complex (MHC) and non-MHC variants may be involved in RA susceptibility. CTLA4 is involved in the regulation of T-cell response during an immune reaction, and multiple CTLA4 single nucleotide polymorphisms (SNPs) have been associated with numerous autoimmune diseases, including RA. To our knowledge, the genetic association of CTLA4 with RA risk has not been examined previously in the Pakistani population. In this study, we sequenced the entire CTLA4 gene and flanking regions in 95 Pakistani RA cases followed the screening of identified variants in Study 1 sample consisting of 350 RA cases and controls. Four common significant variants identified in Study 1 sample were further examined in a larger Study 2 replication sample comprising 1,678 independent RA cases and controls. We report significant associations of three variants from the combined analysis: rs3087243 (OR = 1.26, p = 4.47E-03), rs5742909 (OR = 1.78, p = 4.60E-03), and rs11571319 (OR = 1.48, p = 6.64E-03); the latter is a novel association in the Pakistani sample.

MeSH terms

  • Adult
  • Arthritis, Rheumatoid / genetics*
  • CTLA-4 Antigen / genetics*
  • Case-Control Studies
  • Female
  • Genotype
  • Humans
  • Male
  • Pakistan
  • Polymorphism, Single Nucleotide
  • Sequence Analysis*


  • CTLA-4 Antigen
  • CTLA4 protein, human

Grants and funding

The author(s) received no specific funding for this work.