Abstract
Objective Major histocompatibility complex strongly contributes to susceptibility to systemic lupus erythematosus (SLE). In the European populations, HLA-DRB1∗03:01 and DRB1∗15:01 are susceptibility alleles, but C4 locus was reported to account for the association of DRB1∗03:01. With respect to DRB1∗15:01, strong linkage disequilibrium with a variant rs2105898T in the XL9 region, located between DRB1 and DQA1 and regulates HLA-class II expression levels, was reported; however, the causative allele remains to be determined. Leveraging the genetic background of the Japanese population, where DRB1∗15:01 and DRB1∗15:02 are commonly present and only DRB1∗15:01 is associated with SLE, this study aimed to distinguish the genetic contribution of DRB1∗15:01 and XL9 variants. Methods Among the XL9 variants, two (rs2105898 and rs9271593) previously associated variants in the European populations and two (rs9271375 and rs9271378) which showed a trend towards association in a Japanese Genome-Wide Association Study were selected. Associations of the XL9 variants and HLA-DRB1 were examined in 442 Japanese SLE patients and 779 controls. Genotyping of the XL9 variants was performed by TaqMan SNP Genotyping Assay and direct sequencing. HLA-DRB1 alleles were determined by PCR-reverse sequence-specific oligonucleotide probes. Results Among the XL9 variants, associations of rs2105898T and rs9271593C were replicated in the Japanese population. However, these associations became no longer significant when conditioned on DRB1∗15:01. In contrast, the association of DRB1∗15:01 remained significant after conditioning on the XL9 variants. Conclusion In the Japanese population, HLA-DRB1∗15:01 was found to be primarily associated with SLE, and to account for the apparent association of XL9 region.
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Kawasaki, A., Kusumawati, P. A., Kawamura, Y., Kondo, Y., Kusaoi, M., Amano, H., … Tsuchiya, N. (2023). Genetic dissection of HLA-DRB1∗15:01 and XL9 region variants in Japanese patients with systemic lupus erythematosus: Primary role for HLA-DRB1∗15:01. RMD Open, 9(2). https://doi.org/10.1136/rmdopen-2023-003214
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