Rothwell Simon, Lamb Janine A, Chinoy Hector
aCentre for Musculoskeletal Research, University of Manchester, Manchester, UK bCentre for Integrated Genomic Medical Research, University of Manchester, Manchester, UK cCentre for Musculoskeletal Research and National Institute of Health Research, Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, University of Manchester, Manchester, UK.
Curr Opin Rheumatol. 2016 Nov;28(6):651-6. doi: 10.1097/BOR.0000000000000328.
This article reviews the advances that have been made in our understanding of the genetics of the idiopathic inflammatory myopathies (IIM) in the past 2 years, with a particular focus on polymyositis, dermatomyositis and inclusion body myositis.
Two large human leukocyte antigen (HLA) imputation studies have confirmed a strong association with the 8.1 ancestral haplotype in clinical subgroups of myositis and suggest multiple independent associations on this haplotype. Risk in these genes may be due to specific amino acid positions within the peptide-binding grooves of HLA molecules. A large genetic study in 2566 IIM patients revealed associations such as PTPN22, STAT4, UBE2L3 and BLK, which overlap with risk variants reported in other seropositive autoimmune diseases. There is also evidence of different genetic architectures in clinical subgroups of IIM. Candidate gene studies in the Japanese and Chinese populations have replicated previous IIM associations which suggest common aetiology between ethnicities.
International collaborations have facilitated large genetic studies in IIM that have revealed much about the genetics of this rare complex disease both within the HLA region and genome-wide. Future approaches, such as sequencing and trans-ethnic meta-analyses, will advance our knowledge of IIM genetics.
本文回顾了过去两年间我们在特发性炎性肌病(IIM)遗传学认识方面取得的进展,尤其关注多发性肌炎、皮肌炎和包涵体肌炎。
两项大型人类白细胞抗原(HLA)归因研究证实,在肌炎临床亚组中,8.1祖先单倍型与之存在强关联,并提示该单倍型上存在多个独立关联。这些基因中的风险可能归因于HLA分子肽结合槽内的特定氨基酸位置。一项针对2566例IIM患者的大型遗传学研究揭示了如蛋白酪氨酸磷酸酶非受体型22(PTPN22)、信号转导和转录激活因子4(STAT4)、泛素结合酶E2L3(UBE2L3)和B淋巴细胞酪氨酸激酶(BLK)等关联,这些关联与其他血清学阳性自身免疫性疾病中报道的风险变异存在重叠。在IIM临床亚组中也存在不同遗传结构的证据。日本和中国人群的候选基因研究重复了先前IIM的关联,这表明不同种族间病因具有共性。
国际合作推动了IIM的大型遗传学研究,这些研究揭示了HLA区域内以及全基因组范围内这种罕见复杂疾病的遗传学特征。未来的方法,如测序和跨种族荟萃分析,将推进我们对IIM遗传学的认识。