Amezcua Lilyana, Beecham Ashley H, Delgado Silvia R, Chinea Angel, Burnett Margaret, Manrique Clara Patricia, Gomez Refujia, Comabella Manuel, Montalban Xavier, Ortega Melissa, Tornes Leticia, Lund Brett T, Islam Talat, Conti David, Oksenberg Jorge R, McCauley Jacob L
Department of Neurology Keck School of Medicine University of Southern California Los Angeles California.
Dr. John T. Macdonald Department of Human Genetics Miller School of Medicine University of Miami Miami Florida.
Ann Clin Transl Neurol. 2018 Sep 23;5(11):1362-1371. doi: 10.1002/acn3.646. eCollection 2018 Nov.
Hispanics with multiple sclerosis (MS) present younger and more often with optic neuritis (ON) as compared to Whites in the western United States. Regional differences related to Hispanic genetic admixture could be responsible. We investigated the association between global genetic ancestry and ON and age at onset of MS in Hispanics.
Data were obtained for 1033 self-identified Hispanics with MS from four MS-based registries from four academic institutions across the United States January 2016-April 2017. Multivariate regression models, utilizing genetic ancestry estimates for Native American (NA), African, and European ancestry, were used to assess the relationship between genetic ancestry and ON presentation and age of MS onset, defined as age at first symptom.
Genetic ancestry and ON proportions varied by region where NA ancestry and ON proportions were highest among Hispanics in the southwestern United States (40% vs. 19% overall for NA and 38% vs. 25% overall for ON). A strong inverse correlation was observed between NA and European ancestry ( = -0.83). ON presentation was associated with younger age of onset (OR: 0.98; 95% CI: 0.96-0.99; =7.80 × 10) and increased NA ancestry (OR: 2.35 for the highest versus the lowest quartile of NA ancestry; 95% CI: 1.35-4.10; = 2.60 × 10). Younger age of onset was found to be associated with a higher proportion NA (Beta: -5.58; = 3.49 × 10) and African ancestry (Beta: -10.07; = 1.39 × 10).
Ethnic differences associated with genetic admixture could influence clinical presentation in Hispanics with MS; underscoring the importance of considering genetic substructure in future clinical, genetic, and epigenetic studies in Hispanics.
在美国西部,与白人相比,患有多发性硬化症(MS)的西班牙裔发病年龄更小,且更常伴有视神经炎(ON)。这可能与西班牙裔基因混合的地区差异有关。我们调查了西班牙裔人群的全球基因血统与视神经炎及MS发病年龄之间的关联。
2016年1月至2017年4月期间,从美国四个学术机构的四个基于MS的登记处获取了1033名自我认定为西班牙裔的MS患者的数据。利用美洲原住民(NA)、非洲和欧洲血统的基因血统估计值,采用多变量回归模型评估基因血统与视神经炎表现及MS发病年龄(定义为首次出现症状时的年龄)之间的关系。
基因血统和视神经炎比例因地区而异,在美国西南部的西班牙裔中,NA血统和视神经炎比例最高(NA总体为40%,而总体为19%;视神经炎总体为38%,而总体为25%)。观察到NA和欧洲血统之间存在强烈的负相关(r = -0.83)。视神经炎表现与发病年龄较小相关(OR:0.98;95%CI:0.9,6 - 0.99;P = 7.80×10)以及NA血统增加相关(NA血统最高四分位数与最低四分位数相比,OR:2.35;95%CI:1.35 - 4.10;P = 2.60×10)。发现发病年龄较小与较高比例的NA(β:-5.58;P = 3.49×10)和非洲血统(β:-10.07;P = 1.39×10)相关。
与基因混合相关的种族差异可能会影响西班牙裔MS患者的临床表现;强调在未来针对西班牙裔的临床、基因和表观遗传学研究中考虑基因亚结构的重要性。