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Early-onset autoimmune vitiligo associated with an enhancer variant haplotype that upregulates class II HLA expression
Early-onset autoimmune vitiligo associated with an enhancer variant haplotype that upregulates class II HLA expression
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Early-onset autoimmune vitiligo associated with an enhancer variant haplotype that upregulates class II HLA expression
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Early-onset autoimmune vitiligo associated with an enhancer variant haplotype that upregulates class II HLA expression
Early-onset autoimmune vitiligo associated with an enhancer variant haplotype that upregulates class II HLA expression

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Early-onset autoimmune vitiligo associated with an enhancer variant haplotype that upregulates class II HLA expression
Early-onset autoimmune vitiligo associated with an enhancer variant haplotype that upregulates class II HLA expression
Journal Article

Early-onset autoimmune vitiligo associated with an enhancer variant haplotype that upregulates class II HLA expression

2019
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Overview
Vitiligo is an autoimmune disease in which melanocyte destruction causes skin depigmentation, with 49 loci known from previous GWAS. Aiming to define vitiligo subtypes, we discovered that age-of-onset is bimodal; one-third of cases have early onset (mean 10.3 years) and two-thirds later onset (mean 34.0 years). In the early-onset subgroup we found novel association with MHC class II region indel rs145954018, and independent association with the principal MHC class II locus from previous GWAS, represented by rs9271597; greatest association was with rs145954018del-rs9271597A haplotype ( P  = 2.40 × 10 −86 , OR = 8.10). Both rs145954018 and rs9271597 are located within lymphoid-specific enhancers, and the rs145954018del-rs9271597A haplotype is specifically associated with increased expression of HLA-DQB1 mRNA and HLA-DQ protein by monocytes and dendritic cells. Thus, for vitiligo, MHC regulatory variation confers extreme risk, more important than HLA coding variation. MHC regulatory variation may represent a significant component of genetic risk for other autoimmune diseases. GWAS have led to the identification of 49 genetic loci associated with vitiligo. Here, the authors observe a bimodal distribution of age-of-onset and find a novel genetic locus specifically associated with early-onset vitiligo, located in a regulatory element in the MHC class II region.