PhD, University of Cincinnati, 2018, Medicine: Immunology
Juvenile idiopathic arthritis (JIA) is a complex disease characterized by inflammation of the joints and surrounding tissues that manifests before the age of 16 and persists for at least six weeks. It is a heterogeneous disease categorized into seven subtypes and has a prevalence of approximately 1 in 1,000 children. Two subtypes, oligoarticular and rheumatoid factor-negative (RF⁻) polyarticular JIA (poly RF⁻), are the most common and are primarily differentiated by the number of involved joints during the first six months of disease. JIA has a strong genetic component, which has been elucidated by association studies that interrogate common variation in case-control populations. These studies have identified more than 30 JIA susceptibility loci. Yet, a significant proportion of the genetic heritability for JIA remains unaccounted for, as such studies have included limited sample sizes, heterogeneous patient cohorts, only interrogated candidate regions or common variants, or have not adequately considered additive or epigenetic effects. The overarching hypothesis for the work described in this dissertation is that both common variants and de novo mutations (DNMs) associated with oligoarticular and poly RF⁻ JIA contribute to disease pathogenesis. This hypothesis was tested using genome-wide arrays and whole exome sequencing (WES), followed by bioinformatic analyses. Common variants and DNMs among oligoarticular and poly RF⁻ JIA patients identified novel susceptibility loci and highlighted biological pathways of potential significance to disease pathogenesis. First, evidence of common variation association was found for nine loci (P < 1x10⁻⁶): PRR9_LOR, ILDR1_CD86, WDFY4, PTH1R, RNF215, AHI1_LINC00271, JAK1, LINC00951, and HBP1. Of these, PRR9_LOR, ILDR1_CD86, RNF215, LINC00951, and HBP1 are reported as autoimmune disease susceptibility loci for the first time, while WDFY4, PTH1R, AHI1_LINC00271, and JAK1 have been associated in other autoimmune diseases. Single nucle (open full item for complete abstract)
Committee: Susan Thompson Ph.D. (Committee Chair); Alexei Grom M.D. (Committee Member); John Harley M.D. Ph.D. (Committee Member); Jonathan Katz Ph.D. (Committee Member); William Nichols Ph.D. (Committee Member); William Ridgway M.D. (Committee Member)
Subjects: Immunology