HLA Complex Genetics & Biology

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HLA Complex Genetics & Biology M. Tevfik DORAK Environmental & Occupational Health College of Public Health Florida International University Miami, USA http://www.dorak.info Mount Sinai Medical Center Department of Pathology Miami Beach, FL December 1, 2011

Part I Why is the HLA complex so complex? What are the unique characteristics of the HLA complex? Immune and non-immune components of the HLA complex Part II Clinical utility of HLA typing

First, a little history

Inbred mouse strains are homozygous for H-2 haplotypes Heterozygosity for the susceptibility haplotype did not have an effect

Why is There an HLA Association in Almost Any Disease? The very first MHC association was with leukemia in mice (1964) and with Hodgkin disease in humans (1967) Many cancers show associations and some (NPC) even show linkage to MHC CAH and HH genes were first located in and around HLA by association studies Autoimmune disorders and infectious diseases show the strongest associations Besides, sarcoidosis, birth weight, obesity, long QT syndrome and many others show associations with HLA alleles or haplotypes

HLA COMPLEX 1994

HLA COMPLEX 2001 Cooke & Hill. Genetics of susceptibility to human infectious diseases Nature Reviews Genetics (2001) 2, 967-977

HLA COMPLEX 2001

Classical HLA complex Shiina et al, 2004 (www)

(www)

Part I Why is the HLA complex so complex? What are the unique characteristics of the HLA complex? Immune and non-immune components of the HLA complex Part II Clinical utility of HLA typing

Human Major Histocompatibility Complex Most gene-dense region in the genome Xie, 2003 (www)

Linkage Disequilibrium HLA-B47 association with congenital adrenal hyperplasia (Dupont et al, Lancet 1977) HLA-B14 association with late-onset adrenal hyperplasia (Pollack et al, Am J Hum Genet 1981) Is congenital adrenal hyperplasia an immune system-mediated disease?

Linkage Disequilibrium HLA-B47 association with congenital adrenal hyperplasia is due to deletion of CYP21A2 on HLA-B47DR7 haplotype HLA-B14 association with late-onset adrenal hyperplasia is due to an exon 7 missense mutation (V281L) in CYP21A2 on HLA-B14DR1 haplotype

Non-HLA Genes of the HLA Complex Involved in Fundamental Cellular Processes

Transcription Factors in the Extended MHC Ziegler, 2005 (www)

Part I Why is the HLA complex so complex? What are the unique characteristics of the HLA complex? Immune and non-immune components of the HLA complex Part II Clinical utility of HLA typing

Peculiar Features of the HLA region Most gene dense Paralog regions and genes CNV and structural variation Very high linkage disequilibrium over very long range resulting from conserved extended haplotypes (CEH) Extremely polymorphic Very strong selective pressures Extreme geographical, racial and ethnic differential in allele frequencies So many lineages and groupings of alleles & haplotypes So many functional dimorphisms or supertypes with no single corresponding SNPs

(www)

HLA Polymorphisms Highest resolution DNA level HLA alleles: Related to transplantation success, susceptibility to diseases related to antigen presentation (autoimmune disorders, infectious diseases) Serological HLA antigens: Relevant to transplantation and disease associations HLA epitopes (Bw4/Bw6; C1/C2): Interactions with NK cell Functional supertypes: Involved in antigen presentation Genetic supertypes: Represents ancestral lineages

HLA Polymorphisms Current disease association studies are mainly concerned with high resolution allelic associations and may miss out a lot of information Examination of functional groupings and lineages rather than individual alleles may be a more powerful approach

Functional multi-allelic HLA polymorphisms Functional supertypes Cross-reactive groups (CREGs) Codon 114 Codon 116 Bw4/Bw6 epitopes Functional supertypes Codon 114 Codon 116 C1/C2 epitopes Phylogenetic lineages Codon 86 Codon 57 Class III region HLA-C HLA-A HLA-B HLA- DRB3/4/5 HLA- DRB1 HLA- DQB1

Functional multi-allelic HLA polymorphisms SNPs 4+ digit alleles forming supertypes Specificities (2 digit) Phylogenetic groups DRB1*01 01/10 DRB1*03 DRB3 DRB1*04 DRB4 DRB1*07 DRB4 DRB1*08 DRB3 (08) DRB1*09 DRB1*10 DRB1*11 DRB1*12 DRB3 DRB3 DRB4 01/10 DRB1*13 DRB1*14 DRB1*15 DRB1*16 DRB3 DRB3 DRB5 DRB5

A hypothetical dataset illustrating the approach to data analysis for detection of proxy markers for functional polymorphisms in the HLA-B locus. Each HLA-B genotype is converted to corresponding polymorphisms and coded as 1 for possession of the amino acids shown for positions 114 and 116, or for belonging to the supertype group (st_b07 etc.). SNP genotypes will be coded for the presence of variant alleles (00 = wild type, 01 = heterozygote, 11 = variant homozygote). In this hypothetical example, SNP1 shows an absolute correlation with aa114 Asp (114_Asp); SNP2 with supertype B08 (st_b08) and SNP3 with aa116 Tyr (116_Tyr). CREGs are not included in this example, but will be assessed at this stage of the project.

Expressed HLA-DRB gene content of HLA class II haplotypes (second DRB gene determines the ancestral lineage) (www)

HLA-DR/DQ Region

Part I Why is the HLA complex so complex? What are the unique characteristics of the HLA complex? Immune and non-immune components of the HLA complex Part II Clinical utility of HLA typing

NEJM 2000 Classical HLA molecules

(www)

NEJM 2000

NEJM 2000

Immune Nonresponsiveness is a Recessive Trait Association studies should examine recessive genetic model

HLA Homozygosity Immune response is a dominant trait and lack of immune response is recessive Conventional HLA and disease association studies examine the dominant model and current SNP-based association studies are analyzed for additive model Data from HLA region should always be analyzed for recessive model since dominant or additive model may not be able to unmask an association with homozygosity

Non-HLA Genes of the HLA Complex Involved in Fundamental Cellular Processes

MHC & DNA Repair

DDR1 DAXX Motoyama, 2004 (www) IEX-1 Nakamura Y. Cancer Sci 2004

DNA damage checkpoint machinery In response to DNA damage, ATM and ATR phosphorylate histone H2AX and thereby facilitate the recruitment and phosphorylation of mediators such as MDC1, 53BP1, BRCA1, and the MRE11 RAD50 NBS1 complex. Stalling of the DNA replication fork results in the recruitment of the ATR ATRIP complex by RPA. In turn, the formation of nuclear foci of mediator complexes promotes transmission of the DNA damage signal to downstream targets such as Chk1, Chk2, FANCD2, and SMC1. The PCNA-like RAD1 RAD9 Hus1 complex, the RFC-like RAD17, and Claspin may collaborate in checkpoint regulation by detecting different aspects of a DNA replication fork. The mismatch repair proteins MLH1 and MSH also implicate in the activation of ATM-Chk2 pathway. The kinases Chk1 and Chk2 phosphorylate effectors such as p53, CDC25A, and CDC25C and thereby delay cell cycle progression or induce senescence or apoptosis via activation of the G1 S, intra-s, or G2 cell cycle checkpoints. Thus, these DNA damage checkpoint mechanisms cooperate with DNA repair machinery to suppress genomic instability and cancer. Motoyama, 2004 (www)

DAXX gene is within the HLA complex.

IEX1 / IER3 gene is within the HLA complex.

(in the 1980s, we did not know much about non-hla genes) But now we do! Shiina et al, 2004 (www)

Part I Why is the HLA complex so complex? What are the unique characteristics of the HLA complex? Immune and non-immune components of the HLA complex Part II Clinical utility of HLA typing

ACKNOWLEDGEMENTS - I Cardiff, UK Birmingham, AL Newcastle, UK Hamilton, NJ Professor Alan K Burnett Professor Ken I Mills Dr Wenshuo Shao Dr Richard A Kaslow Professor Andy G Hall Professor Louise Parker Dr Caroline Relton Rachel MacKay Brittany Morrison Charronne Davis Esma Ucisik-Akkaya Dr Thuy Do Dr Grant Gallagher & Dr Eli Mordechai

ACKNOWLEDGEMENTS - II My current team: Amy, Sandeep & Malar (& Meredith) Florida International University RSCPHSW EOH