Gerussi Alessio, Soskic Blagoje, Asselta Rosanna, Invernizzi Pietro, Gershwin Merrill E
Division of Gastroenterology, Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza, Italy.
Human Technopole, Viale Rita Levi-Montalcini 1, 20157 Milan, Italy.
J Autoimmun. 2022 Dec;133:102922. doi: 10.1016/j.jaut.2022.102922. Epub 2022 Oct 7.
Autoimmune diseases are common conditions characterized by loss of tolerance, female predominance and a remarkable heterogeneity among different populations. Most often they are polygenic and several genetic loci have been linked with the risk of developing autoimmune diseases. However, causal inference is difficult. When the genomic revolution began there were high hopes of translating fast genetic analyses to the bedside but this has proven to be challenging. Nonetheless, over the last decade, fine-mapping strategies have greatly improved; one of the most significant research lines focuses on the in vivo and ex vivo definition of the effect of genetic variants within the target tissues and within specific subpopulations of immune cells that are involved in the disease pathogenesis. This strategy also includes the longitudinal tracking of a large number of immunophenotypes in many individuals to build a large reference atlas for variant characterization. In this review, we discuss the results obtained by GWAS in autoimmune diseases and review recent advances in fine mapping strategies. More importantly, we discuss gaps and future directions.
自身免疫性疾病是常见病症,其特征为免疫耐受丧失、女性居多且不同人群间存在显著异质性。这些疾病大多是多基因的,多个基因位点已被证实与自身免疫性疾病的发病风险相关。然而,因果推断颇具难度。基因组革命伊始,人们满怀期望能将快速基因分析应用于临床,但事实证明这极具挑战性。尽管如此,在过去十年间,精细定位策略有了极大改进;其中最重要的研究方向之一聚焦于对目标组织内以及参与疾病发病机制的免疫细胞特定亚群内基因变异效应的体内和体外定义。该策略还包括对众多个体的大量免疫表型进行纵向追踪,以构建用于变异特征描述的大型参考图谱。在本综述中,我们讨论了全基因组关联研究(GWAS)在自身免疫性疾病中所获结果,并回顾了精细定位策略的最新进展。更重要的是,我们探讨了差距与未来方向。