Paediatrics Publications

Title

Brief Report: Deficiency of Complement 1r Subcomponent in Early-Onset Systemic Lupus Erythematosus: The Role of Disease-Modifying Alleles in a Monogenic Disease

Authors

Erkan Demirkaya, National Human Genome Research Institute (NHGRI)Follow
Qing Zhou, National Human Genome Research Institute (NHGRI)
Carolyne K. Smith, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Michael J. Ombrello, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Natalie Deuitch, National Human Genome Research Institute (NHGRI)
Wanxia L. Tsai, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Patrycja Hoffmann, National Human Genome Research Institute (NHGRI)
Elaine F. Remmers, National Human Genome Research Institute (NHGRI)
Masaki Takeuchi, National Human Genome Research Institute (NHGRI)
Yong Hwan Park, National Human Genome Research Institute (NHGRI)
Jae Jin Chae, National Human Genome Research Institute (NHGRI)
Kenan Barut, Istanbul Üniversitesi
Dogan Simsek, Gulhane Education and Research Hospital
Amra Adrovic, Istanbul Üniversitesi
Sezgin Sahin, Istanbul Üniversitesi
Salim Caliskan, Istanbul Üniversitesi
Settara C. Chandrasekharappa, National Human Genome Research Institute (NHGRI)
Sarfaraz A. Hasni, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Amanda K. Ombrello, National Human Genome Research Institute (NHGRI)
Massimo Gadina, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Daniel L. Kastner, National Human Genome Research Institute (NHGRI)
Mariana J. Kaplan, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Ozgur Kasapcopur, Istanbul Üniversitesi
Ivona Aksentijevich, National Human Genome Research Institute (NHGRI)

Document Type

Article

Publication Date

9-1-2017

Journal

Arthritis and Rheumatology

Volume

69

Issue

9

First Page

1832

Last Page

1839

URL with Digital Object Identifier

10.1002/art.40158

Abstract

Objective: To identify a genetic cause of early-onset systemic lupus erythematosus (SLE) in a large consanguineous family from Turkey and to study the mechanisms of the disease. Methods: We performed whole-exome sequencing and single-nucleotide polymorphism array genotyping in family members with and without SLE. Protein and gene expression, cytokine profile, neutrophil extracellular trap (NET) formation, and presence of low-density granulocytes were evaluated in patient primary cells and serum samples. Results: We identified a novel, homozygous, loss-of-function mutation (p.Pro445Leufs*11) in the C1R gene. Using the Sanger method of DNA sequencing in 14 family members, we confirmed the presence of the mutation in 4 patients with SLE and in an asymptomatic 9-year-old girl. Complement levels were low in sera from patients with truncated C1r protein. Two siblings with SLE who were available for detailed evaluation exhibited strong type I interferon (IFN) inflammatory signatures despite their disease being clinically inactive at the time of sampling. The type I IFN transcriptional signature in the patients’ blood correlated with disease expressivity, whereas the neutrophil signature in peripheral blood mononuclear cells was likely associated with disease severity. The female patient with SLE with the most severe phenotype presented with a stronger neutrophil signature, defined by enhanced NET formation and the presence of low-density granulocytes. Analysis of exome data for modifying alleles suggested enrichment of common SLE-associated variants in the more severely affected patients. Lupus-associated HLA alleles or HLA haplotypes were not shared among the 4 affected subjects. Conclusion: Our findings revealed a novel high-penetrance mutation in C1R as the cause of monogenic SLE. Disease expressivity in this family appears to be influenced by additional common and rare genetic variants.

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