Interferon regulatory factor 5 (IRF5) gene variants are associated with multiple sclerosis in three distinct populations

IRF5 is a transcription factor involved both in the type I interferon and the toll-like receptor signalling pathways. Previously, IRF5 has been found to be associated with systemic lupus erythematosus, rheumatoid arthritis and inflammatory bowel diseases. Here we investigated whether polymorphisms i...

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Published in:Journal of medical genetics Vol. 45; no. 6; p. 362
Main Authors: Kristjansdottir, G, Sandling, J K, Bonetti, A, Roos, I M, Milani, L, Wang, C, Gustafsdottir, S M, Sigurdsson, S, Lundmark, A, Tienari, P J, Koivisto, K, Elovaara, I, Pirttilä, T, Reunanen, M, Peltonen, L, Saarela, J, Hillert, J, Olsson, T, Landegren, U, Alcina, A, Fernández, O, Leyva, L, Guerrero, M, Lucas, M, Izquierdo, G, Matesanz, F, Syvänen, A-C
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Published: England 01-06-2008
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Abstract IRF5 is a transcription factor involved both in the type I interferon and the toll-like receptor signalling pathways. Previously, IRF5 has been found to be associated with systemic lupus erythematosus, rheumatoid arthritis and inflammatory bowel diseases. Here we investigated whether polymorphisms in the IRF5 gene would be associated with yet another disease with features of autoimmunity, multiple sclerosis (MS). We genotyped nine single nucleotide polymorphisms and one insertion-deletion polymorphism in the IRF5 gene in a collection of 2337 patients with MS and 2813 controls from three populations: two case-control cohorts from Spain and Sweden, and a set of MS trio families from Finland. Two single nucleotide polymorphism (SNPs) (rs4728142, rs3807306), and a 5 bp insertion-deletion polymorphism located in the promoter and first intron of the IRF5 gene, showed association signals with values of p<0.001 when the data from all cohorts were combined. The predisposing alleles were present on the same common haplotype in all populations. Using electrophoretic mobility shift assays we observed allele specific differences in protein binding for the SNP rs4728142 and the 5 bp indel, and by a proximity ligation assay we demonstrated increased binding of the transcription factor SP1 to the risk allele of the 5 bp indel. These findings add IRF5 to the short list of genes shown to be associated with MS in more than one population. Our study adds to the evidence that there might be genes or pathways that are common in multiple autoimmune diseases, and that the type I interferon system is likely to be involved in the development of these diseases.
AbstractList IRF5 is a transcription factor involved both in the type I interferon and the toll-like receptor signalling pathways. Previously, IRF5 has been found to be associated with systemic lupus erythematosus, rheumatoid arthritis and inflammatory bowel diseases. Here we investigated whether polymorphisms in the IRF5 gene would be associated with yet another disease with features of autoimmunity, multiple sclerosis (MS). We genotyped nine single nucleotide polymorphisms and one insertion-deletion polymorphism in the IRF5 gene in a collection of 2337 patients with MS and 2813 controls from three populations: two case-control cohorts from Spain and Sweden, and a set of MS trio families from Finland. Two single nucleotide polymorphism (SNPs) (rs4728142, rs3807306), and a 5 bp insertion-deletion polymorphism located in the promoter and first intron of the IRF5 gene, showed association signals with values of p<0.001 when the data from all cohorts were combined. The predisposing alleles were present on the same common haplotype in all populations. Using electrophoretic mobility shift assays we observed allele specific differences in protein binding for the SNP rs4728142 and the 5 bp indel, and by a proximity ligation assay we demonstrated increased binding of the transcription factor SP1 to the risk allele of the 5 bp indel. These findings add IRF5 to the short list of genes shown to be associated with MS in more than one population. Our study adds to the evidence that there might be genes or pathways that are common in multiple autoimmune diseases, and that the type I interferon system is likely to be involved in the development of these diseases.
Author Sandling, J K
Fernández, O
Lucas, M
Izquierdo, G
Syvänen, A-C
Wang, C
Guerrero, M
Tienari, P J
Saarela, J
Kristjansdottir, G
Gustafsdottir, S M
Leyva, L
Matesanz, F
Hillert, J
Bonetti, A
Reunanen, M
Landegren, U
Alcina, A
Pirttilä, T
Peltonen, L
Olsson, T
Elovaara, I
Koivisto, K
Lundmark, A
Milani, L
Roos, I M
Sigurdsson, S
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/18285424$$D View this record in MEDLINE/PubMed
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References 11303025 - J Biol Chem. 2001 Jun 29;276(26):23382-90
6847134 - Ann Neurol. 1983 Mar;13(3):227-31
15821736 - Nat Genet. 2005 May;37(5):486-94
12218129 - J Immunol. 2002 Sep 15;169(6):3120-30
10554670 - Biomed Pharmacother. 1999 Sep;53(8):358-70
11244049 - Annu Rev Immunol. 2001;19:623-55
17420929 - J Neurol. 2007 May;254(5):682-4
12587097 - Am J Hum Genet. 2003 Mar;72(3):598-610
16251966 - Nature. 2005 Oct 27;437(7063):1365-9
15818675 - Arthritis Rheum. 2005 Apr;52(4):1185-95
17554300 - Nature. 2007 Jun 7;447(7145):661-78
16642019 - Nat Genet. 2006 May;38(5):550-5
16973343 - Curr Opin Immunol. 2006 Dec;18(6):643-9
17660816 - Nat Genet. 2007 Sep;39(9):1108-13
15155907 - Proc Natl Acad Sci U S A. 2004 Jun 1;101(22):8420-4
9399875 - Nucleic Acids Res. 1998 Jan 1;26(1):362-7
16283615 - Ann Neurol. 2005 Dec;58(6):840-6
17411341 - PLoS Genet. 2007 Apr 6;3(4):e49
10486336 - Am J Hum Genet. 1999 Oct;65(4):1170-7
11694349 - Mol Cell Endocrinol. 2001 Nov 26;184(1-2):135-41
12707359 - J Immunol. 2003 May 1;170(9):4776-84
8447318 - Am J Hum Genet. 1993 Mar;52(3):506-16
16186814 - Nat Genet. 2005 Oct;37(10):1108-12
16596167 - PLoS Genet. 2006 Mar;2(3):e42
2058872 - Ann Intern Med. 1991 Aug 1;115(3):178-83
16837931 - Genes Immun. 2006 Sep;7(6):522-31
17982456 - Nat Genet. 2007 Dec;39(12):1477-82
18063667 - Hum Mol Genet. 2008 Mar 15;17(6):872-81
17412832 - Proc Natl Acad Sci U S A. 2007 Apr 17;104(16):6758-63
17038340 - Bioinformatics. 2006 Dec 1;22(23):2960-1
17660530 - N Engl J Med. 2007 Aug 30;357(9):851-62
17360610 - Proc Natl Acad Sci U S A. 2007 Feb 27;104(9):3067-72
17223656 - Ann Rheum Dis. 2007 Aug;66(8):1008-14
17568788 - Genes Immun. 2007 Jul;8(5):429-38
16760194 - Rheumatology (Oxford). 2007 Jan;46(1):49-56
17189288 - Hum Mol Genet. 2007 Mar 15;16(6):579-91
15665823 - Nature. 2005 Mar 10;434(7030):243-9
17660817 - Nat Genet. 2007 Sep;39(9):1083-91
17599733 - Arthritis Rheum. 2007 Jul;56(7):2202-10
12604793 - Proc Natl Acad Sci U S A. 2003 Mar 4;100(5):2610-5
16080120 - Am J Hum Genet. 2005 Sep;77(3):454-67
17881657 - Hum Mol Genet. 2007 Dec 15;16(24):3008-16
15657875 - Am J Hum Genet. 2005 Mar;76(3):528-37
12086159 - Clin Rheumatol. 2002 May;21(2):108-13
11484692 - N Engl J Med. 2001 Aug 2;345(5):340-50
12083401 - Biotechniques. 2002 Jun;Suppl:70-2, 74, 76-7
15155525 - Brain. 2004 Aug;127(Pt 8):1717-22
15805103 - J Biol Chem. 2005 Jun 3;280(22):21078-90
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Snippet IRF5 is a transcription factor involved both in the type I interferon and the toll-like receptor signalling pathways. Previously, IRF5 has been found to be...
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StartPage 362
SubjectTerms Case-Control Studies
Cohort Studies
European Continental Ancestry Group - genetics
Female
Finland
Genetic Predisposition to Disease - genetics
Haplotypes
Humans
Interferon Regulatory Factors - genetics
Linkage Disequilibrium - genetics
Male
Multiple Sclerosis - genetics
Mutation - genetics
Polymorphism, Single Nucleotide - genetics
Promoter Regions, Genetic - genetics
Sp1 Transcription Factor - metabolism
Spain
Sweden
Title Interferon regulatory factor 5 (IRF5) gene variants are associated with multiple sclerosis in three distinct populations
URI https://www.ncbi.nlm.nih.gov/pubmed/18285424
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