Pathogenicity and impact of HLA class I alleles in aplastic anemia patients of different ethnicities Journal Article
| Authors: | Olson, T. S.; Frost, B. F.; Duke, J. L.; Dribus, M.; Xie, H. M.; Prudowsky, Z. D.; Furutani, E.; Gudera, J.; Shah, Y. B.; Ferriola, D.; Dinou, A.; Pagkrati, I.; Kim, S.; Xu, Y.; He, M.; Zheng, S.; Nijim, S.; Lin, P.; Xu, C.; Nakano, T. A.; Oved, J. H.; Carreno, B. M.; Bolon, Y. T.; Gadalla, S. M.; Marsh, S. G. E.; Paczesny, S.; Lee, S. J.; Monos, D. S.; Shimamura, A.; Bertuch, A. A.; Gragert, L.; Spellman, S. R.; Babushok, D. V. |
| Article Title: | Pathogenicity and impact of HLA class I alleles in aplastic anemia patients of different ethnicities |
| Abstract: | Acquired aplastic anemia (AA) is caused by autoreactive T cell-mediated destruction of early hematopoietic cells. Somatic loss of human leukocyte antigen (HLA) class I alleles was identified as a mechanism of immune escape in surviving hematopoietic cells of some patients with AA. However, pathogenicity, structural characteristics, and clinical impact of specific HLA alleles in AA remain poorly understood. Here, we evaluated somatic HLA loss in 505 patients with AA from 2 multi-institutional cohorts. Using a combination of HLA mutation frequencies, peptide-binding structures, and association with AA in an independent cohort of 6,323 patients from the National Marrow Donor Program, we identified 19 AA risk alleles and 12 non-risk alleles and established a potentially novel AA HLA pathogenicity stratification. Our results define pathogenicity for the majority of common HLA-A/B alleles across diverse populations. Our study demonstrates that HLA alleles confer different risks of developing AA, but once AA develops, specific alleles are not associated with response to immunosuppression or transplant outcomes. However, higher pathogenicity alleles, particularly HLA-B*14:02, are associated with higher rates of clonal evolution in adult patients with AA. Our study provides insights into the immune pathogenesis of AA, opening the door to future autoantigen identification and improved understanding of clonal evolution in AA. © 2022, Olson et al. This is an open access article published under the terms of the Creative Commons Attribution 4.0 International License. |
| Keywords: | adult; controlled study; treatment outcome; gene mutation; major clinical study; genetics; pathogenesis; allele; disease association; cohort analysis; genetic variability; alleles; gene frequency; pathology; retrospective study; immune response; hla antigen class 1; histocompatibility antigens class i; clinical evaluation; autoantigen; allogeneic hematopoietic stem cell transplantation; pathogenicity; genetic risk; protein structure; hla a antigen; hla b antigen; ethnicity; cyclosporine; hla-b antigens; hla antigen; hla antigens; thymocyte antibody; aplastic anemia; genetic identification; clonal evolution; anemia, aplastic; hla a gene; hla b gene; humans; human; article; population structure |
| Journal Title: | JCI Insight |
| Volume: | 7 |
| Issue: | 22 |
| ISSN: | 2379-3708 |
| Publisher: | Amer Soc Clinical Investigation Inc |
| Date Published: | 2022-11-22 |
| Start Page: | e163040 |
| Language: | English |
| DOI: | 10.1172/jci.insight.163040 |
| PUBMED: | 36219480 |
| PROVIDER: | scopus |
| PMCID: | PMC9746824 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 January 2023 -- Source: Scopus |
