IRF5 haplotypes demonstrate diverse serological associations which predict serum interferon alpha activity and explain the majority of the genetic association with systemic lupus erythematosus. Academic Article uri icon

Overview

abstract

  • OBJECTIVE: High serum interferon α (IFNα) activity is a heritable risk factor for systemic lupus erythematosus (SLE). Auto-antibodies found in SLE form immune complexes which can stimulate IFNα production by activating endosomal Toll-like receptors and interferon regulatory factors (IRFs), including IRF5. Genetic variation in IRF5 is associated with SLE susceptibility; however, it is unclear how IRF5 functional genetic elements contribute to human disease. METHODS: 1034 patients with SLE and 989 controls of European ancestry, 555 patients with SLE and 679 controls of African-American ancestry, and 73 patients with SLE of South African ancestry were genotyped at IRF5 polymorphisms, which define major haplotypes. Serum IFNα activity was measured using a functional assay. RESULTS: In European ancestry subjects, anti-double-stranded DNA (dsDNA) and anti-Ro antibodies were each associated with different haplotypes characterised by a different combination of functional genetic elements (OR>2.56, p<1.9×10(-14) for both). These IRF5 haplotype-auto-antibody associations strongly predicted higher serum IFNα in patients with SLE and explained >70% of the genetic risk of SLE due to IRF5. In African-American patients with SLE a similar relationship between serology and IFNα was observed, although the previously described European ancestry-risk haplotype was present at admixture proportions in African-American subjects and absent in African patients with SLE. CONCLUSIONS: The authors define a novel risk haplotype of IRF5 that is associated with anti-dsDNA antibodies and show that risk of SLE due to IRF5 genotype is largely dependent upon particular auto-antibodies. This suggests that auto-antibodies are directly pathogenic in human SLE, resulting in increased IFNα in cooperation with particular combinations of IRF5 functional genetic elements. SLE is a systemic autoimmune disorder affecting multiple organ systems including the skin, musculoskeletal, renal and haematopoietic systems. Humoral autoimmunity is a hallmark of SLE, and patients frequently have circulating auto-antibodies directed against dsDNA, as well as RNA binding proteins (RBP). Anti-RBP autoantibodies include antibodies which recognize Ro, La, Smith (anti-Sm), and ribonucleoprotein (anti-nRNP), collectively referred to as anti-retinol-binding protein). Anti-retinol-binding protein and anti-dsDNA auto-antibodies are rare in the healthy population. These auto-antibodies can be present in sera for years preceding the onset of clinical SLE illness and are likely pathogenic in SLE.

authors

  • Niewold, Timothy
  • Kelly, Jennifer A
  • Kariuki, Silvia N
  • Franek, Beverly S
  • Kumar, Akaash A
  • Kaufman, Kenneth M
  • Thomas, Kenaz
  • Walker, Daniel
  • Kamp, Stan
  • Frost, Jacqueline M
  • Wong, Andrew K
  • Merrill, Joan T
  • Alarcón-Riquelme, Marta E
  • Tikly, Mohammed
  • Ramsey-Goldman, Rosalind
  • Reveille, John D
  • Petri, Michelle A
  • Edberg, Jeffrey C
  • Kimberly, Robert P
  • Alarcón, Graciela S
  • Kamen, Diane L
  • Gilkeson, Gary S
  • Vyse, Timothy J
  • James, Judith A
  • Gaffney, Patrick M
  • Moser, Kathy L
  • Crow, Mary K
  • Harley, John B

publication date

  • November 16, 2011

Research

keywords

  • Interferon Regulatory Factors
  • Interferon-alpha
  • Lupus Erythematosus, Systemic

Identity

PubMed Central ID

  • PMC3307526

Scopus Document Identifier

  • 84863115400

Digital Object Identifier (DOI)

  • 10.1136/annrheumdis-2011-200463

PubMed ID

  • 22088620

Additional Document Info

volume

  • 71

issue

  • 3