Trio-based exome sequencing and high-resolution HLA typing in families of patients with autoimmune adrenal insufficiency and autoimmune polyglandular syndrome

• Published in: PloS one Vol. 19; no. 10; p. e0312335
• Main Authors: Buianova, Anastasiia, Yukina, Marina, Cheranev, Valery, Suchalko, Oleg, Shmitko, Anna, Samitova, Alina, Nuralieva, Nurana, Kulagina, Elena, Savvateeva, Elena, Troshina, Ekaterina, Rebrikov, Denis, Gryadunov, Dmitry, Korostin, Dmitriy
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 18.10.2024
• Subjects: Addison Disease - genetics; Addison Disease - immunology; Adolescent; Adrenal insufficiency; Adult; Age; AIRE Protein; Alleles; Analysis; Antibodies; Antigens; Autoimmune diseases; Autoimmunity; Cancer; Care and treatment; Children; Diagnosis; Disease; Endocrine disorders; Endocrine gland diseases; Endocrinology; Exome Sequencing; Families & family life; Female; Females; Gene frequency; Gene sequencing; Genetic aspects; Genetic Predisposition to Disease; Goiter; Haplotypes; Health aspects; High resolution; Histocompatibility antigen HLA; Histocompatibility Testing; Hospitalization; Humans; Hypertension; Hypothyroidism; Immunology; Laboratories; Male; Medical history; Patients; Pedigree; Polyendocrinopathies, Autoimmune - genetics; Polyendocrinopathies, Autoimmune - immunology; Population genetics; Risk assessment; Tissue typing; Transcription Factors - genetics; Ulcers; Whole genome sequencing; Russia; United States > US; Germany
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0312335

Autoimmune adrenal insufficiency (AAI) is a rare disease. This research evaluates three patients with AAI, including autoimmune polyglandular syndrome (APS) type 2. Two patients had APS or AAI during childhood, and one had a history of endocrine autoimmune disease, indicating a possible hereditary basis of the condition. Trio-based exome sequencing and high-resolution HLA typing were employed to analyze patients and their parents. Benign or likely benign variants of the AIRE gene were identified in all participants of the study. These variants, coupled with clinical data and the results of antibody studies to type I interferons, helped to exclude APS-1. Patients with APS-2, in contrast to patient with AAI, inherited distinct variants of unknown significance in the CLEC16A gene, which is associated with autoimmune diseases, including AAI. Various risk alleles in other genes associated with autoimmunity were identified in all patients. HLA typing of class II loci revealed alleles related to APS. Nevertheless, the frequencies of the haplotypes identified are substantial in the healthy Russian population. Immunological tests can detect antibody carriers and assess the risk of autoimmune disease development. In the future, to identify genetic predictors of autoimmune endocrinopathies, it is recommended to analyze the whole genome of patients and their relatives, examining clinically relevant variants in non-coding regions.