Association between HLA-Cw6 allele expression and characteristics of Javanese ethnic psoriasis patients in Indonesia
Abstract
BACKGROUND Psoriasis is an autoimmune disease with involvement of genetic and environmental factors. The HLA-Cw6 allele is the strongest genetic factor that correlates with earlier onset and more severe clinical manifestation of psoriasis. In Javanese ethnic, HLA-Cw6 allelic expression has not been identified, although increasing psoriasis patients were found in hospital dermatology departments. The study was aimed to determine the allelic expression of HLA-Cw6 based on the onset and severity of psoriasis in Javanese ethnic.
METHODS A cross-sectional study was conducted from March to September 2018. Sixty psoriasis patients in the Margono Soekarjo Hospital and Banyumas Regional General Hospital were recruited consecutively. Psoriasis type, diagnosis, onset, and disease severity were assessed by dermatologists. HLA-Cw6 allelic expression was identified by DNA isolation, quantitative testing, and HLA-Cw6 genotyping. Fisherâs exact and chi-square tests were used to evaluate the association of HLA-Cw6 with age, clinical type, disease severity, onset, and gender.
RESULTS The HLA-Cw6 allele positivity was identified at 297 base pairs (bp), while control showed at 618 bp bands. Among 60 subjects, 13 subjects (22%) showed HLACw6 positivity, and 47 subjects (78%) were HLA-Cw6 negative. HLA-Cw6 genotypes were similarly distributed concerning age, onset, gender, clinical type, and disease severity in psoriasis patients of Javanese ethnic (p > 0.05).
CONCLUSIONS HLA-Cw6 expression type may not have influence to the characteristics of patients with psoriasis.
References
Anand DA, Anandaram H. A review on global prevalence and recent advancements in the genetics of psoriasis. MOJ Proteomics Bioinform. 2017;6(2):243-8. https://doi.org/10.15406/mojpb.2017.06.00189
Parisi R, Symmons DP, Griffiths CE, Ashcroft DM. Global epidemiology of psoriasis: a systematic review of incidence and prevalence. J Invest Dermatol. 2013;133(2):377-85. https://doi.org/10.1038/jid.2012.339
World Health Organization. Global report on psoriasis 2016 [Internet]. World Health Organization; 2016 [cited 2017 May 18]. Available from http://www.who.int/iris/handle/10665/204417.
Chen L, Tsai TF. HLA-Cw6 and psoriasis. Br J Dermatol. 2018;178(4):854-62. https://doi.org/10.1111/bjd.16083
Chandra A, Lahiri A, Senapati S, Basu B, Ghosh S, Mukhopadhyay I, et al. Increased risk of psoriasis due to combined effect of HLA-Cw6 and LCE3 risk alleles in Indian population. Sci Rep. 2016;6:24059. https://doi.org/10.1038/srep24059
Prinz JC. Human leukocyte antigen-class I alleles and the autoreactive T cell response in psoriasis pathogenesis. Front Immunol. 2018;9:954. https://doi.org/10.3389/fimmu.2018.00954
Boehncke WH, Schön MP. Psoriasis. Lancet. 2015;386(9997): 983-94. https://doi.org/10.1016/S0140-6736(14)61909-7
West J, Ogston S, Berg J, Palmer C, Fleming C, Kumar V, et al. HLA-Cw6-positive patients with psoriasis show improved response to methotrexate treatment. Clin Exp Dermatol. 2017;42:651-5. https://doi.org/10.1111/ced.13100
Lestari KS, Darwin E, Jacoeb T, Tjong D. The relationship between human leukocyte antigen-cw6 allele and psoriasis vulgaris. Dermatol Reports. 2019;11(1S):8054. https://doi.org/10.4081/dr.2019.8054
Theodorakopoulou E, Yiu ZZ, Bundy C, Chularojanamontri L, Gittins M, Jamieson LA, et al. Early- and late-onset psoriasis: a cross-sectional clinical and immunocytochemical investigation. Br J Dermatol. 2016;175(5):1038-44. https://doi.org/10.1111/bjd.14886
Gudjónsson JE, Kárason A, Rúnarsdóttir EH, Antonsdóttir AA, Hauksson VB, Jónsson HH, et al. Distinct clinical differences between HLA-Cw*0602 positive and negative psoriasis patients - an analysis of 1019 HLA-C- and HLA-B-typed patients. J Invest Dermatol. 2006;126:740-5. https://doi.org/10.1038/sj.jid.5700118
Feldman S, Krueger G. Psoriasis assessment tools in clinical trials. Ann Rheum Dis. 2005;64(Suppl 2):ii65-8. https://doi.org/10.1136/ard.2004.031237
Rebała K, Szczerkowska-Dobosz A, Niespodziana K, Wysocka J. Simple and rapid screening for HLA-Cw*06 in Polish patients with psoriasis. Clin Exp Dermatol. 2010;35(4):431-6. https://doi.org/10.1111/j.1365-2230.2009.03627.x
Hirata J, Hirota T, Ozeki T, Kanai M, Sudo T, Tanaka T, et al. Variants at HLA-A, HLA-C, and HLA-DQB1 confer risk of psoriasis vulgaris in Japanese. J Invest Dermatol. 2018;138(3):542-8. https://doi.org/10.1016/j.jid.2017.10.001
Gudjónsson JE, Kárason A, Antonsdóttir AA, Rúnarsdóttir EH, Gulcher JR, Stefánsson K, et al. HLA-Cw6-positive and HLA-Cw6- negative patients with psoriasis vulgaris have distinct clinical features. J Invest Dermatol. 2002;118(2):362-5. https://doi.org/10.1046/j.0022-202x.2001.01656.x
Indhumathi S, Rajappa M, Chandrashekar L, Ananthanarayanan PH, Thappa DM, Negi VS. The HLA-C*06 allele as a possible genetic predisposing factor to psoriasis in South Indian Tamils. Arch Dermatol Res. 2016;308(3):193-9. https://doi.org/10.1007/s00403-016-1618-y
Fan X, Yang S, Sun LD, Liang YH, Gao M, Zhang KY, et al. Comparison of clinical features of HLA-Cw*0602-positive and-negative psoriasis patients in a Han Chinese population. Acta Derm Venereol. 2007;87(4):335-40. https://doi.org/10.2340/00015555-0253
Foulkes AC, Brown SJ. Genetic prediction of treatment response in psoriasis is still a work in progress. Br J Dermatol. 2017;177(2):344-5. https://doi.org/10.1111/bjd.15691
Talamonti M, Galluzzo M, van den Reek JM, de Jong RM, Lambert JL, Malagoli P, et al. Role of the HLA-C*06 allele in clinical response to ustekinumab: evidence from real life in a large cohort of European patients. Br J Dermatol. 2017;177:489-96. https://doi.org/10.1111/bjd.15387
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