title: Cytotoxic T-lymphocyte-associated antigen-4 single nucleotide polymorphisms and haplotypes in primary biliary cirrhosis.
abstract: OBJECTIVE
  Twin and family studies suggest that there is a significant heritable component to primary biliary cirrhosis (PBC). Selected cytotoxic T-lymphocyte-associated antigen-4 (CTLA4) gene polymorphisms have been proposed as nonspecific determinants of disease risk in a variety of autoimmune diseases, including PBC. However, there has been considerable debate over the validity of these associations and the precise location of the disease-promoting polymorphism.
  
  
  METHODS
  We investigated 6 single-nucleotide polymorphisms in the CTLA4 gene in a total of 327 PBC patients and 391 healthy controls: 247 patients and 292 controls from the United Kingdom and a further 80 patients and 99 controls from northern Italy.
  
  
  RESULTS
  The previously reported association with CTLA4 A+49G was not replicated in the Italian series, and there were no significant differences in the distribution of any of the 6 polymorphisms comparing allele, genotype, or haplotype distribution in patients vs healthy controls in the UK series. Furthermore, there were no significant associations with the clinical variables of histologic stage, portal hypertension, or Mayo score. However, when PBC-40 Fatigue Domain scores were considered, a number of significant trends were noted, but none were significant after correction for multiple testing. Thus, fatigue scores were higher in those with the CTLA4 -319 T allele (P < .05, p corrected not significant) and in those with the CTLA4 +49 AA genotype (P < .05, pc not significant).
  
  
  CONCLUSIONS
  Contrary to previous reports the CTLA4 gene is not a major risk factor for PBC, nor is it a major determinant of disease progression.
authors.affiliation: Centre for Liver Research, School of Clinical Medical Sciences, The Faculty of Medical Sciences, Newcastle University, Framlington Place, Newcastle-upon-Tyne, United Kingdom. p.t.donaldson@ncl.ac.uk
authors.forename: Peter
authors.initials: P
authors.lastname: Donaldson
authors.forename: Sivakumar
authors.initials: S
authors.lastname: Veeramani
authors.forename: Anna
authors.initials: A
authors.lastname: Baragiotta
authors.forename: Annarosa
authors.initials: A
authors.lastname: Floreani
authors.forename: Carla
authors.initials: C
authors.lastname: Venturi
authors.forename: Simon
authors.initials: S
authors.lastname: Pearce
authors.forename: Valerie
authors.initials: V
authors.lastname: Wilson
authors.forename: David
authors.initials: D
authors.lastname: Jones
authors.forename: Oliver
authors.initials: O
authors.lastname: James
authors.forename: John
authors.initials: J
authors.lastname: Taylor
authors.forename: Julia
authors.initials: J
authors.lastname: Newton
authors.forename: Margaret
authors.initials: M
authors.lastname: Bassendine
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000235:genetics*; D000943:Antigens, Differentiation / Q000235:genetics*; D060908:CTLA-4 Antigen; D018450:Disease Progression; D005260:Female; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006239:Haplotypes; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008105:Liver Cirrhosis, Biliary / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D021141:Nucleic Acid Amplification Techniques; D020641:Polymorphism, Single Nucleotide; D016036:Seroepidemiologic Studies; D006113:United Kingdom / Q000453:epidemiology; D044465:White People / Q000235:genetics
chemical_list: D015703:Antigens, CD; D000943:Antigens, Differentiation; D060908:CTLA-4 Antigen; C556706:CTLA4 protein, human