1. Evidence for additional genetic risk indicators of relapse-onset MS within the HLA region.
- Author
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de Jong BA, Huizinga TW, Zanelli E, Giphart MJ, Bollen EL, Uitdehaag BM, Polman CH, and Westendorp RG
- Subjects
- Adult, Alleles, Case-Control Studies, Female, Gene Dosage, Genetic Linkage, Genetic Testing, HLA-DR3 Antigen genetics, Haplotypes, Heterozygote, Histocompatibility Testing, Humans, Male, Microsatellite Repeats genetics, Middle Aged, Multiple Sclerosis, Relapsing-Remitting epidemiology, Multivariate Analysis, Netherlands epidemiology, Odds Ratio, Promoter Regions, Genetic genetics, Risk Assessment, Risk Factors, Tumor Necrosis Factor-alpha genetics, Genetic Predisposition to Disease, HLA-DR2 Antigen genetics, Multiple Sclerosis, Relapsing-Remitting genetics
- Abstract
Background: Human leukocyte antigen (HLA)-DR2 carriership is associated with an increased risk for MS. Genome searches using microsatellite markers have consistently shown that additional genetic factors contribute to susceptibility for MS., Objective: To identify loci within the HLA region that predispose to relapse-onset MS independently of HLA-DR2., Method: A case-control study involving 159 patients with definite relapse-onset MS and 273 control subjects was conducted. Six highly polymorphic microsatellite markers encoded within the HLA-C to DR region, that is, D6S1014, D6S273, TNFa, MIB, C1_2_5, and C1_3_2, three single-nucleotide tumor necrosis factor (TNF) promoter gene polymorphisms at positions -238, -308, and -376, and HLA-DR2 carriership were typed., Results: These data confirmed the well-known association between the HLA-DR2 haplotype and relapse-onset MS, yielding an odds ratio (OR) of 3.6 (95% CI: 2.4 to 5.4; p < 0.0001). Multivariate analyses revealed that C1_3_2*354 was also associated with an increased risk for developing relapse-onset MS independently of HLA-DR2 (OR: 2.0; 95% CI: 1.2 to 3.1; p = 0.004). This allele is encoded within an ancestral haplotype that is highly linked to HLA-DR3. The joint effect of this ancestral haplotype and HLA-DR2 resulted in an OR of 8.7 (95% CI: 2.7 to 29; p < 0.0001) to develop relapse-onset MS. In addition, a protective risk factor was found: carriers of TNFa*107 had a 0.5-fold lower risk to develop relapse-onset MS (95% CI: 0.3 to 0.9; p = 0.026)., Conclusion: Within the HLA region, other loci besides HLA-DR2 haplotype modulate susceptibility for relapse-onset MS.
- Published
- 2002
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