The association of psoriasis with human leukocyte antigens in Korean population and the influence of age of onset and sex

Abstract

To identify HLA markers that may contribute to the genetic susceptibility of Koreans to psoriasis, we studied 84 psoriasis patients, with serologic HLA types of A, B, and genotypes of HLA-Cw, DRB1, DQA1, DQB1, DPB1 alleles. The distribution of HLA markers and the associated haplotypes were analyzed according to age and sex. HLA-Cw*0602 showed the strongest association with psoriasis (relative risk = 36.0, p < 10-8, Pc < 8 X 10-7). The frequencies of A1 (relative risk=17.0, p < 9 X 10-7, Pc < 7 X 10-5), A30 (relative risk=5.5, p < 2 X 10-5, Pc < 0.001), B13 (relative risk = 5.6, p < 4 X 10 -6, Pc < 3 X 10 -4), B37 (relative risk = 30.3, p < 7 X 10-7, Pc < 6 X 10-5), DRB1*07 (relative risk = 5.9, p < 2 X 10-6, Pc < 8 X 10 -5), DRB1*10 (relative risk = 26.4, p < 4 X 10-6, Pc < 3 X 10-4), DQA1*02 (relative risk = 6.2, p < 5 X 10-7, Pc < 4 X 10-4), DQB1*02 (relative risk = 2.5, p < 0.005, Pc = ns) and DPB1*1701 (relative risk=24.6, p < 9 X 10-6, Pc < 7 X 10-4) were also significantly increased in Korean psoriasis patients. Type I and type II psoriasis were subdivided into groups of below and above 30y of age, because of the significant difference found in HLA-Cw*0602 phenotype frequency between the two groups (83.9% vs. 54.5%, p < 0.009). In addition to HLA-Cw*0602, the frequencies of B37 and DPB1*1701 were significantly higher in type I as opposed to type II psoriasis. HLA-A30-B13-Cw*0602-DRB1*07-DQA1* 02-DQB1*02 was identified as a high risk haplotype. This was particularly true at an early age in the female. HLA-A33-B44-Cw*1401-DRB1* 13-DQA1* 01-DQB1*06-DPB1*0401 was defined as a protective haplotype for psoriasis. The extended haplotype HLA- A1-B37-Cw*0602-DRB1*10-DQA1*01-DQB1*05 was discovered to be a high-risk factor in Koreans. To summarize, this study demonstrates the differential association of HLA according to sex, and identifies a newly found high-risk haplotype and a protective haplotype in Korean psoriasis patients.