Risk of relapse of ANCA-associated vasculitis among patients homozygous for the proteinase 3 gene Val119Ile polymorphism

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ..

BACKGROUND: The frequency of proteinase 3 gene (PRTN3) polymorphisms in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is not fully characterised. We hypothesise that the presence of a PRTN3 gene polymorphism (single nucleotide polymorphism (SNP) rs351111) is relevant for clinical outcomes.

METHODS: DNA variant calling for SNP rs351111 (chr.19:844020, c.355G>A) in PRTN3 gene assessed the allelic frequency in patients with PR3-AAV included in the Rituximab in ANCA-Associated Vasculitis trial. This was followed by RNA-seq variant calling to characterise the mRNA expression. We compared clinical outcomes between patients homozygous for PRTN3-Ile119 or PRTN3-Val119.

RESULTS: Whole blood samples for DNA calling were available in 188 patients. 75 patients with PR3-AAV had the allelic variant: 62 heterozygous PRTN3-Val119Ile and 13 homozygous for PRTN3-Ile119. RNA-seq was available for 89 patients and mRNA corresponding to the allelic variant was found in 32 patients with PR3-AAV: 25 heterozygous PRTN3-Val119Ile and 7 homozygous for PRTN3-Ile119. The agreement between the DNA calling results and mRNA expression of the 86 patients analysed by both methods was 100%. We compared the clinical outcomes of 64 patients with PR3-AAV: 51 homozygous for PRTN3-Val119 and 13 homozygous for PRTN3-Ile119. The frequency of severe flares at 18 months in homozygous PRTN3-Ile119 was significantly higher when compared with homozygous PRTN3-Val119 (46.2% vs 19.6%, p=0.048). Multivariate analysis identified homozygous PR3-Ile119 as main predictor of severe relapse (HR 4.67, 95% CI 1.16 to 18.86, p=0.030).

CONCLUSION: In patients with PR3-AAV, homozygosity for PRTN3-Val119Ile polymorphism appears associated with higher frequency of severe relapse. Further studies are necessary to better understand the association of this observation with the risk of severe relapse.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:9

Enthalten in:

RMD open - 9(2023), 1 vom: 11. März

Sprache:

Englisch

Beteiligte Personen:

Casal Moura, Marta [VerfasserIn]
Deng, Zuoming [VerfasserIn]
Brooks, Stephen R [VerfasserIn]
Tew, Wei [VerfasserIn]
Fervenza, Fernando C [VerfasserIn]
Kallenberg, Cees G M [VerfasserIn]
Langford, Carol A [VerfasserIn]
Merkel, Peter A [VerfasserIn]
Monach, Paul A [VerfasserIn]
Seo, Philip [VerfasserIn]
Spiera, Robert F [VerfasserIn]
St Clair, E William [VerfasserIn]
Stone, John H [VerfasserIn]
Prunotto, Marco [VerfasserIn]
Grayson, Peter C [VerfasserIn]
Specks, Ulrich [VerfasserIn]

Links:

Volltext

Themen:

Antibodies, Antineutrophil Cytoplasmic
Autoantibodies
EC 3.4.21.76
Granulomatosis with polyangiitis
Journal Article
Myeloblastin
Outcome Assessment, Health Care
Polymorphism, Genetic
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Systemic vasculitis

Anmerkungen:

Date Completed 31.03.2023

Date Revised 12.04.2024

published: Print

Citation Status MEDLINE

doi:

10.1136/rmdopen-2022-002935

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM354955993