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Autoimmunity in primary antibody deficiency is associated with protein tyrosine phosphatase nonreceptor type 22 (PTPN22) - 30/03/13

Doi : 10.1016/j.jaci.2012.06.023 
Gary Y.J. Chew, MB BS, FRACP, FRCPA a, b, Umang Sinha, MSc a, b, Paul A. Gatenby, MB BS, PhD, FRACP, FRCPA a, Theo DeMalmanche, MB BS, FRACP, FRCPA c, Stephen Adelstein, MB BS, PhD, FRACP, FRCPA d, Roger Garsia, MB BS, PhD, FRACP, FRCPA d, Pravin Hissaria, MB BS, MD, DM, FRCPA, FRACP e, Martyn A. French, MB ChB, MD, FRACP FRCPath, FRCP f, Anastasia Wilson, BSc, MPH & TM a, b, Belinda Whittle, BSc g, Philippa Kirkpatrick, BSc, MBA h, D. Sean Riminton, MB BS, PhD, FRACP, FRCPA h, David A. Fulcher, MB BS, PhD, FRACP, FRCPA i, Matthew C. Cook, MB BS, PhD, FRACP, FRCPA a, b,
a Department of Immunology and Translational Research, Canberra Hospital, Canberra, Australia 
b Department of Immunology, John Curtin School of Medical Research, Australian National University, Canberra, Australia 
c HAPS Immunology, New Lambton, Australia 
d Department of Immunology, Royal Prince Alfred Hospital, Camperdown, Australia 
e SA Pathology/Royal Adelaide Hospital, Head of Translational Clinical Research LabIMVS/SA Pathology, Adelaide, Australia 
f Department of Clinical Immunology, Royal Perth Hospital and PathWest Laboratory Medicine and School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Australia 
g Genomics Research, Australian Phenomics Facility, Australian National University, Canberra, Australia 
h Department of Immunology, Concord Hospital, Sydney, Australia 
i Department of Immunopathology, Level 2, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Sydney, Australia 

Corresponding author: Matthew C. Cook, MB BS, PhD, FRACP, FRCPA, Department of Immunology and Translational Research, Level 6, Bldg 10, Canberra Hospital, PO Box 11, Woden, ACT, Australia.

Abstract

Background

The 1858T allele of protein tyrosine phosphatase nonreceptor type 22 (PTPN22; R620W) exhibits one of the strongest and most consistent associations with sporadic autoimmune disease. Although autoimmunity is common in patients with primary antibody deficiency (PAD), it remains unknown whether its pathogenesis is similar when it arises in this context compared with in immunocompetent patients.

Objective

We set out to determine whether the 1858T allele of PTPN22 was associated with PAD or with autoimmunity in the context of PAD.

Methods

We genotyped rs2476601 (g.1858C>T), a single nucleotide polymorphism encoding substitution of arginine for tryptophan in PTPN22 (R620W), in 193 patients with PAD and 148 control subjects from an Australian cohort. We also performed a subgroup analysis according to the presence of autoimmunity and B-cell phenotypes.

Results

C/T and T/T PTPN22 genotypes were more common in patients with PAD than in the matched control subjects (C/T, 18.1% vs 9.5%; T/T, 1.04% vs 0.6%). The T allele was associated with an increased risk of PAD relative to control subjects (odds ratio, 2.10; 95% CI, 1.11-4.00). The distribution of genotypes in control subjects was similar to those reported previously and did not deviate significantly from Hardy-Weinberg equilibrium. We found a strong association between the 1858T allele and PAD with coexistent autoimmune diseases. In patients with PAD and autoimmunity, 16 (43.2%) of 37 had at least one T allele of PTPN22 compared with 27 (17.3%) of 156 with the C/C genotype (P = .0014; odds ratio, 3.64; 95% CI, 1.68-7.88). We found no evidence that this effect was mediated by enrichment of CD21low B cells.

Conclusion

The 1858T PTPN22 allele is strongly associated with autoimmunity in patients with PAD.

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Key words : Primary antibody deficiency, common variable immunodeficiency, selective IgA deficiency, IgG subclass deficiency, specific antibody deficiency, autoimmunity, protein tyrosine phosphatase nonreceptor type 22

Abbreviations used : ANZADA, Csk, CVID, FITC, Lyp, OR, PAD, PTPN22, SNP, TCR, Zap70


Plan


 Supported by the National Health and Medical Research Council (Australia) (project grant 585464 to D.A.F. and M.C.C.).
 Disclosure of potential conflict of interest: G. Y. J. Chew has received research support from the National Health and Medical Research Council (Australia). P. Hissaria has received consultancy fees from CSL. D. A. Fulcher has received research support from the National Health and Medical Research Council. M. C. Cook has received research support from the National Health and Medical Research Council and the Australasia Society of Clinical Immunology and Allergy. The rest of the authors declare that they have no relevant conflicts of interest.


© 2012  American Academy of Allergy, Asthma & Immunology. Publié par Elsevier Masson SAS. Tous droits réservés.
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