An Amino Acid Motif In HLA-DRB1 Distinguishes Patients With Uveitis In Juvenile Idiopathic Arthritis

Abstract

ObjectivesUveitis is a visually-debilitating disorder that affects up to 30% of children with the most common forms of juvenile idiopathic arthritis (JIA). The disease mechanisms predisposing only a subgroup of children to uveitis are unknown. To identify genetic susceptibility loci for uveitis in JIA, we conducted a genome-wide association study totalling 522 JIA cases.\n\nMethodsTwo cohorts of JIA patients with ophthalmological follow-up were separately genotyped and then imputed using a genome-wide imputation reference panel, and an HLA-specific reference panel used for imputing amino acids and HLA types in the major histocompatibility complex (MHC). After imputation, we performed genome-wide and MHC-specific analyses. We used a reverse immunology approach to model antigen presentation at 13 common HLA-DRB1 allotypes.\n\nResultsWe identified the amino acid serine at position 11 (serine-11) in HLA-DRB1 as associated to increased risk of uveitis (OR = 2.60, p = 5.43 x 10-10). We found the serine-11 signal to be specific to females (pfemales = 7.61 x 10-10, pmales = 0.18). Serine-11 resides in the YST-motif in the peptide binding groove of the HLA-DRB1 protein; all three amino acids are in perfect linkage disequilibrium and show identical association to disease. Quantitative prediction of binding affinity revealed that discernable peptide-binding preferences distinguish HLA-DRB1 allotypes with the YST-motif.\n\nConclusionOur findings highlight a genetically distinct, sexually-dimorphic feature of JIA-uveitis compared to JIA without uveitis in HLA-DRB1. The association indicates the potential involvement for antigen presentation by HLA-DRB1 in the development of uveitis in JIA.