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The Involvement of HLA Class II Alleles in Multiple Sclerosis: A Systematic Review with Meta-analysis
A De Silvestri1, C Capittini1,2, G Mallucci3
1Clinical Epidemiology and Biometric Unit, IRCCS Policlinico S. Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy.
Abstract:
Multiple Sclerosis (MS) displays a heterogeneous clinical onset and progression, which are mostly unpredictable, but demyelination of the central nervous system (CNS) leads to substantial deficits of sensory, motor, autonomic, and neurocognitive functions. Considering all genetic studies on MS, including the advanced genome-wide association studies, the risk linked to HLA alleles remains the highest among other susceptibility genetic variants. However, given the genetic variability of HLA alleles in different ethnic groups, we conducted a systematic review of reviews and meta-analyses aiming at summarizing all the results on the association between MS and HLA class II genes. We systematically searched meta-analyses and systematic reviews dealing with MS and HLA in all ethnicities. From 154 records, we included 5 articles collecting HLA data from 15,232 MS patients and 24,194 ethnically matched controls. DRB1∗15 (OR ranging from 1.39 in Chinese Han to 2.59 in Caucasians) and DQB1∗06:02 (OR ranging from 1.91 in Caucasians to 2.49 in Colombian) alleles confer an increased risk for MS transethnically (Caucasians, Chinese, South Americans, Carribeans, Middle Easterners, Japanese, and North Africans). DRB1∗01, DRB1∗09, DRB1∗11, DRB1∗12, and DRB1∗16 alleles were protective, in agreement with the type of amino-acidic (aa) residues (ranging from position 9 to 90) included in pockets 1, 4, 6, 7, and 9, which are most involved in peptide presentation. Changes in aa residues affect the capability of HLA molecules in binding myelin peptides. DQB1∗06:02 risk allele seems to be the most interesting target as humanized mice expressing only DQB1∗06:02 develop MS-like disease mediated by autoimmune reactions against myelin oligodendrocytic basic protein that stabilizes the myelin. Our summary of results from a high number of patients and controls suggests that allelic variants from both DQB1 and DRB1 genes are equally involved in MS susceptibility/protection transethnically.
Insights
Human leukocyte antigen (HLA) class II genes, specifically DRB1 and DQB1 alleles, are significantly associated with Multiple Sclerosis (MS) susceptibility and protection across diverse ethnic groups. The DQB1*06:02 allele is a key risk factor, implicated in MS-like disease development in mice.
Area of Science:
- Immunogenetics
- Neuroimmunology
- Human Genetics
Background:
- Multiple Sclerosis (MS) is a CNS demyelinating disease with unpredictable progression.
- Genetic factors, particularly Human Leukocyte Antigen (HLA) alleles, confer the highest risk for MS.
- Ethnic variability in HLA alleles necessitates a global analysis of their association with MS.
Purpose of the Study:
- To systematically review and meta-analyze existing literature on the association between MS and HLA class II genes across all ethnicities.
- To summarize the transethnic risk and protective roles of specific HLA class II alleles in MS susceptibility.
Main Methods:
- Systematic search of meta-analyses and systematic reviews concerning MS and HLA associations.
- Inclusion of 5 articles with data from 15,232 MS patients and 24,194 ethnically matched controls.
- Analysis of Human Leukocyte Antigen (HLA) class II gene variants, including DRB1 and DQB1 alleles.
Main Results:
- DRB1*15 and DQB1*06:02 alleles significantly increase MS risk across various ethnic groups (e.g., Caucasians, Chinese, South Americans).
- DRB1*01, DRB1*09, DRB1*11, DRB1*12, and DRB1*16 alleles demonstrate a protective effect against MS.
- The DQB1*06:02 risk allele is implicated in MS-like disease in humanized mice, mediated by autoimmune responses to myelin peptides.
Conclusions:
- Both DQB1 and DRB1 gene variants play crucial, and potentially equal, roles in MS susceptibility and protection globally.
- Understanding HLA class II associations provides insights into MS pathogenesis and potential therapeutic targets.
- The specific amino acid residues within HLA molecules influence peptide binding and autoimmune responses in MS.
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