HLA and KIR genetic association and NK cells in anti-NMDAR encephalitis.
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Peris Sempere Vicente, Luo Guo, Muñiz-Castrillo Sergio, Pinto Anne-Laurie, Picard Géraldine, Rogemond Véronique, Titulaer Maarten J, Finke Carsten, Leypoldt Frank, Kuhlenbäumer Gregor, GENERATE study group, Jones Hannah F, Dale Russell C, Binks Sophie, Irani Sarosh R, Bastiaansen Anna E, de Vries Juna M, de Bruijn Marienke A A M, Roelen Dave L, Kim Tae-Joon, Chu Kon, Lee Soon-Tae, Kanbayashi Takamichi, Pollock Nicholas R, Kichula Katherine M, Mumme-Monheit Abigail, Honnorat Jérôme, Norman Paul J, Mignot Emmanuel
Аннотация
METHODS: We conducted a Genome Wide Association Study (GWAS) with subsequent control-matching using Principal Component Analysis (PCA) and HLA imputation, in a multi-ethnic cohort of anti-NMDAR encephalitis (n=479); KIR and HLA were further sequenced in a large subsample (n=323). PCA-controlled logistic regression was then conducted for carrier frequencies (HLA and KIR) and copy number variation (KIR). HLA-KIR interaction associations were also modeled. Additionally, single cell sequencing was conducted in peripheral blood mononuclear cells from 16 cases and 16 controls, NK cells were sorted and phenotyped.
RESULTS: Anti-NMDAR encephalitis showed a weak HLA association with DRB1*01:01~DQA1*01:01~DQB1*05:01 (OR=1.57, 1.51, 1.45; respectively), and DRB1*11:01 (OR=1.60); these effects were stronger in European descendants and in patients without an underlying ovarian teratoma. More interestingly, we found increased copy number variation of KIR2DL5B (OR=1.72), principally due to an overrepresentation of KIR2DL5B*00201. Further, we identified two allele associations in framework genes, KIR2DL4*00103 (25.4% vs. 12.5% in controls, OR=1.98) and KIR3DL3*00302 (5.3% vs. 1.3%, OR=4.44). Notably, the ligands of these KIR2DL4 and KIR3DL3, respectively, HLA-G and HHLA2, are known to act as immune checkpoint with immunosuppressive functions. However, we did not find differences in specific KIR-HLA ligand interactions or HLA-G polymorphisms between cases and controls. Similarly, gene expression of CD56dim or CD56bright NK cells did not differ between cases and controls.
DISCUSSION: Our observations for the first time suggest that the HLA-KIR axis might be involved in anti-NMDAR encephalitis. While the genetic risk conferred by the identified polymorphisms appears small, a role of this axis in the pathophysiology of this disease appears highly plausible and should be analyzed in future studies.