Ortíz-Fernández Lourdes, Martín Javier, Alarcón-Riquelme Marta E
Institute of Parasitology and Biomedicine López-Neyra, CSIC, Parque Tecnológico de La Salud, 18016, Granada, Spain.
GENYO. Center for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government, Av de la Ilustración 114, Parque Tecnológico de La Salud, 18016, Granada, Spain.
Clin Rev Allergy Immunol. 2023 Jun;64(3):392-411. doi: 10.1007/s12016-022-08951-z. Epub 2022 Jun 24.
Systemic lupus erythematosus, systemic sclerosis, rheumatoid arthritis, and Sjögren's syndrome are four major autoimmune rheumatic diseases characterized by the presence of autoantibodies, caused by a dysregulation of the immune system that leads to a wide variety of clinical manifestations. These conditions present complex etiologies strongly influenced by multiple environmental and genetic factors. The human leukocyte antigen (HLA) region was the first locus identified to be associated and still represents the strongest susceptibility factor for each of these conditions, particularly the HLA class II genes, including DQA1, DQB1, and DRB1, but class I genes have also been associated. Over the last two decades, the genetic component of these disorders has been extensively investigated and hundreds of non-HLA risk genetic variants have been uncovered. Furthermore, it is widely accepted that autoimmune rheumatic diseases share molecular disease pathways, such as the interferon (IFN) type I pathways, which are reflected in a common genetic background. Some examples of well-known pleiotropic loci for autoimmune rheumatic diseases are the HLA region, DNASEL13, TNIP1, and IRF5, among others. The identification of the causal molecular mechanisms behind the genetic associations is still a challenge. However, recent advances have been achieved through mouse models and functional studies of the loci. Here, we provide an updated overview of the genetic architecture underlying these four autoimmune rheumatic diseases, with a special focus on the HLA region.
系统性红斑狼疮、系统性硬化症、类风湿性关节炎和干燥综合征是四种主要的自身免疫性风湿性疾病,其特征是存在自身抗体,由免疫系统失调引起,可导致多种临床表现。这些疾病呈现出复杂的病因,受到多种环境和遗传因素的强烈影响。人类白细胞抗原(HLA)区域是第一个被确定与之相关的基因座,并且仍然是这些疾病中每一种疾病最强的易感因素,特别是HLA II类基因,包括DQA1、DQB1和DRB1,但I类基因也与之相关。在过去二十年中,对这些疾病的遗传成分进行了广泛研究,发现了数百种非HLA风险基因变异。此外,人们普遍认为自身免疫性风湿性疾病共享分子疾病途径,例如I型干扰素(IFN)途径,这在共同的遗传背景中有所体现。自身免疫性风湿性疾病中一些著名的多效性基因座的例子包括HLA区域、DNASEL13、TNIP1和IRF5等。确定遗传关联背后的因果分子机制仍然是一项挑战。然而,最近通过小鼠模型和基因座的功能研究取得了进展。在这里,我们提供了这四种自身免疫性风湿性疾病潜在遗传结构的最新概述,特别关注HLA区域。