Doctor of Philosophy, The Ohio State University, 2016, Molecular, Cellular and Developmental Biology
Complement C4 is an immune protein with a wide range of effector functions, including disposal of apoptotic materials, clearance of immune complexes, and activation of the classical complement pathway resulting in cytolysis of microbes. Homozygous deficiencies of C4 or early complement components (C1q, C1r, or C1s), albeit rare, are strongly associated with the autoimmune disease systemic lupus erythematosus (SLE). Much more common than a complete genetic deficiency is “low” gene copy number (GCN) of C4, which varies among human genomes from two to eight copies. Low GCN of C4, specifically of the isotype C4A, is associated with SLE disease risk. However, it is known that C4A-deficient haplotypes in European Americans are in strong linkage disequilibrium (LD) with HLA allele DRB1*0301 on chromosome 6, which has been associated with other autoimmune diseases, including juvenile dermatomyositis (JDM). It remains a puzzle whether C4A deficiency, DRB1*0301, or both are responsible for the primary disease association because of the strong LD exhibited between the two genetic variants. We assessed GCNs for C4A, C4B, and HLA-DRB1 alleles in genetic risk of JDM.
C4A deficiency was a risk factor for JDM independent of DRB1*0301, but the effect size was stronger when C4A deficiency and DRB1*0301 were present together. JDM patients with C4A deficiency had higher prevalence of elevated serum muscle enzymes at disease diagnosis and elevated erythrocyte-bound C4-derived activation products (E-C4d). We also observed that C4A deficiency is a strong risk factor for pediatric SLE susceptibility as is the case for adult SLE reported previously, but the effect size was greater in pediatric populations. Our regression analyses of Caucasian SLE patients and controls suggested that DRB1*0301 was likely secondary to C4A deficiency on disease susceptibility.
Given the common observation of C4A deficiency in patients afflicted with JDM or SLE, a logical step forward would be the esta (open full item for complete abstract)
Committee: Chack-Yung Yu D.Phil. (Advisor); Carlos Alvarez Ph.D. (Committee Member); Heithem El-Hodiri Ph.D. (Committee Member); Wael Jarjour M.D. (Committee Member); Yusen Liu Ph.D. (Committee Member)
Subjects: Genetics; Immunology; Molecular Biology