Distinct clinical differences between HLA-Cw*0602 positive and negative psoriasis patients--an analysis of 1019 HLA-C- and HLA-B-typed patients.
A major susceptibility gene for psoriasis is located in the major histocompatibility complex class I region on chromosome 6 very close to the HLA-Cw6 gene. We collected a cohort of 1,019 patients with chronic plaque psoriasis. The patients were typed for HLA-C and HLA-B. A total of 654 (64.2%) were HLA-Cw*0602 positive but 365 (35.8%) carried other HLA-C alleles. We confirmed that HLA-Cw*0602 positive patients have younger age of onset (17.5 vs 24.3 years, P<10(-10)), higher incidence of guttate and the eruptive type of psoriasis (P<0.0001), more frequent exacerbations with throat infections (P=0.01), higher incidence of the Koebner's phenomenon (P=0.01), and more extensive disease (P=0.03). A striking new finding was a diverging pattern of disease severity in HLA-Cw*0602 positive and negative patients depending on the age of onset of the disease (P=0.0006). HLA-Cw*0602 positive women also had more frequent remissions during pregnancy (P<0.0001). All types of nail changes were, however, more common in the Cw*0602 negative patients (P=0.003) and they more often had multiple types of nail lesions (P<0.0001). The three ancestral haplotypes of Cw*0602 all conferred an increase in odds ratio but showed no difference in any of the clinical features studied. Our findings indicate that the genetic factor on chromosome 6 has a strong influence on the phenotype of the disease, and underline that differences in clinical features of psoriasis may be to a large extent genetically determined.
Gudjonsson
Johann E
JE
National University Hospital of Iceland, Reykjavik.
Karason
Ari
A
Runarsdottir
E Hjaltey
EH
Antonsdottir
Arna A
AA
Hauksson
Valdimar B
VB
Jónsson
Hjörtur H
HH
Gulcher
Jeff
J
Stefansson
Kari
K
Valdimarsson
Helgi
H
D000293:Adolescent; D000328:Adult; D002896:Chromosomes, Human, Pair 6 / Q000235:genetics; D002908:Chronic Disease; D005260:Female; D015235:HLA-B Antigens / Q000032:analysis*; D015236:HLA-C Antigens / Q000032:analysis* / Q000235:genetics; D006801:Humans; D008297:Male; D011247:Pregnancy; D011565:Psoriasis / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology*; D012720:Severity of Illness Index
D015235:HLA-B Antigens; D015236:HLA-C Antigens; C491620:HLA-C*06:02 antigen