Abstract
Individuals with Behçet's disease suffer from episodic inflammation often affecting the orogenital mucosa, skin and eyes. To discover new susceptibility loci for Behçet's disease, we performed a genome-wide association study (GWAS) of 779,465 SNPs with imputed genotypes in 1,209 Turkish individuals with Behçet's disease and 1,278 controls. We identified new associations at CCR1, STAT4 and KLRC4. Additionally, two SNPs in ERAP1, encoding ERAP1 p.Asp575Asn and p.Arg725Gln alterations, recessively conferred disease risk. These findings were replicated in 1,468 independent Turkish and/or 1,352 Japanese samples (combined meta-analysis P < 2 × 10−9). We also found evidence for interaction between HLA-B*51 and ERAP1 (P = 9 × 10−4). The CCR1 and STAT4 variants were associated with gene expression differences. Three risk loci shared with ankylosing spondylitis and psoriasis (the MHC class I region, ERAP1 and IL23R and the MHC class I–ERAP1 interaction), as well as two loci shared with inflammatory bowel disease (IL23R and IL10) implicate shared pathogenic pathways in the spondyloarthritides and Behçet's disease.
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Acknowledgements
This research was supported by the Intramural Research Programs of the National Human Genome Research Institute, the National Institute of Arthritis and Musculoskeletal and Skin Diseases, and the Center for Human Immunology, Autoimmunity and Inflammation of the US National Institutes of Health, and by the Istanbul University Research Fund, the Research on Specific Disease of the Health Science Research Grants from the Japanese Ministry of Health, Labor, and Welfare, and the Japan Rheumatism Foundation. We thank A. Wilson for helpful comments on this manuscript.
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The study was designed by Y. Kirino, G.B., A.G., M.J.O., E.F.R. and D.L.K. Analysis was carried out by Y. Kirino, G.B., Y. Kim, A.M., A.G., E.F.R. and D.L.K. Sample procurement and data generation were performed by Y. Kirino, G.B., Y.I., N.M., I.T.-T., E.S., Y.O., F.S.S., B.E., H.I., Z.E., A.C., N.A., D.U., C.S., A.U., M.T., Y. Kim, G.M.W., M.J.O., A.M., A.G., E.F.R. and D.L.K. The manuscript was written by Y. Kirino, G.B., Y. Kim, M.J.O., A.G., E.F.R. and D.L.K. All authors read and approved the final version of the manuscript.
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Kirino, Y., Bertsias, G., Ishigatsubo, Y. et al. Genome-wide association analysis identifies new susceptibility loci for Behçet's disease and epistasis between HLA-B*51 and ERAP1. Nat Genet 45, 202–207 (2013). https://doi.org/10.1038/ng.2520
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DOI: https://doi.org/10.1038/ng.2520
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