title: Autoimmunity in primary antibody deficiency is associated with protein tyrosine phosphatase nonreceptor type 22 (PTPN22).
abstract: BACKGROUND
  The 1858T allele of protein tyrosine phosphatase nonreceptor type 22 (PTPN22; R620W) exhibits one of the strongest and most consistent associations with sporadic autoimmune disease. Although autoimmunity is common in patients with primary antibody deficiency (PAD), it remains unknown whether its pathogenesis is similar when it arises in this context compared with in immunocompetent patients.
  
  
  OBJECTIVE
  We set out to determine whether the 1858T allele of PTPN22 was associated with PAD or with autoimmunity in the context of PAD.
  
  
  METHODS
  We genotyped rs2476601 (g.1858C>T), a single nucleotide polymorphism encoding substitution of arginine for tryptophan in PTPN22 (R620W), in 193 patients with PAD and 148 control subjects from an Australian cohort. We also performed a subgroup analysis according to the presence of autoimmunity and B-cell phenotypes.
  
  
  RESULTS
  C/T and T/T PTPN22 genotypes were more common in patients with PAD than in the matched control subjects (C/T, 18.1% vs 9.5%; T/T, 1.04% vs 0.6%). The T allele was associated with an increased risk of PAD relative to control subjects (odds ratio, 2.10; 95% CI, 1.11-4.00). The distribution of genotypes in control subjects was similar to those reported previously and did not deviate significantly from Hardy-Weinberg equilibrium. We found a strong association between the 1858T allele and PAD with coexistent autoimmune diseases. In patients with PAD and autoimmunity, 16 (43.2%) of 37 had at least one T allele of PTPN22 compared with 27 (17.3%) of 156 with the C/C genotype (P=.0014; odds ratio, 3.64; 95% CI, 1.68-7.88). We found no evidence that this effect was mediated by enrichment of CD21low B cells.
  
  
  CONCLUSIONS
  The 1858T PTPN22 allele is strongly associated with autoimmunity in patients with PAD.
authors.affiliation: Department of Immunology and Translational Research, Canberra Hospital, and Department of Immunology, John Curtin School of Medical Research, Australian National University, Canberra, Australia.
authors.forename: Gary Y J
authors.initials: GY
authors.lastname: Chew
authors.forename: Umang
authors.initials: U
authors.lastname: Sinha
authors.forename: Paul A
authors.initials: PA
authors.lastname: Gatenby
authors.forename: Theo
authors.initials: T
authors.lastname: DeMalmanche
authors.forename: Stephen
authors.initials: S
authors.lastname: Adelstein
authors.forename: Roger
authors.initials: R
authors.lastname: Garsia
authors.forename: Pravin
authors.initials: P
authors.lastname: Hissaria
authors.forename: Martyn A
authors.initials: MA
authors.lastname: French
authors.forename: Anastasia
authors.initials: A
authors.lastname: Wilson
authors.forename: Belinda
authors.initials: B
authors.lastname: Whittle
authors.forename: Philippa
authors.initials: P
authors.lastname: Kirkpatrick
authors.forename: D Sean
authors.initials: DS
authors.lastname: Riminton
authors.forename: David A
authors.initials: DA
authors.lastname: Fulcher
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Cook
mesh_terms: D000328:Adult; D000483:Alleles; D019943:Amino Acid Substitution; D001315:Australia; D015551:Autoimmunity / Q000235:genetics*; D001402:B-Lymphocytes / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D016022:Case-Control Studies; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D060005:Genotyping Techniques; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000235:genetics* / Q000276:immunology; D016130:Immunophenotyping; D008297:Male; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide; D054596:Protein Tyrosine Phosphatase, Non-Receptor Type 22 / Q000235:genetics* / Q000276:immunology; D012307:Risk Factors
chemical_list: C516765:PTPN22 protein, human; D054596:Protein Tyrosine Phosphatase, Non-Receptor Type 22