The Association of HLA-DQB1*04 and DQB1*03 with Neuromyelitis Optica Spectrum Disorders: A Case-Control Study Considering Genetic Ancestry
Jairo Gaitan Alfonso1, Jaime Toro2, Juliana Lago3, Helena Groot3, Daniela Rodriguez1, Carolina Restrepo-Aristizabal4, Cesar Franco Ruiz4, Mariana Torres-Bustamante4, Angie Montejo3, Luisa Marquez3, Diana Narvaez3, Juan Rodriguez noriega1, David Cuellar Giraldo2, Habib Georges Moutran Barroso2, Fabian Cortés-Muñoz5, Daniel León3, Thomas Medina Ramirez1, Laura Serna1, Saul Reyes6
1Fundación Santa Fe de Bogotá, 2Universidad El Bosque, 3Universidad de los Andes, 4Fundación Instituto Neurológico de Colombia, 5Fundación Clínica Shaio, 6The Royal London Hospital
Objective:

This study aims to establish the association between HLA class II alleles and the presence of Neuromyelitis Optica Spectrum Disorder (NMOSD) in a Colombian population


Background:
NMOSD is a demyelinating disease with a low prevalence in Latin America. International studies have identified associations between the risk of NMOSD and alleles of the human leukocyte antigen (HLA) class II complex. However, there are currently no studies in Colombia.
Design/Methods:

A multicenter case-control study was conducted with NMOSD patients diagnosed with the 2015 Wingerchuk criteria, recruited between 2020 and 2023 from Bogotá and Medellín, Colombia. Controls, without demyelinating or autoimmune diseases, were recruited from the same cities as were the cases. Blood samples from both groups were analyzed to identify HLA-DRB1 and HLA-DQB1 alleles using sequence-specific primer polymerase chain reaction (SSP-PCR). The mitochondrial hypervariable region 1 was amplified, and haplogroups were determined with HaploGrep software. Genomic ancestry was estimated by genotyping ancestry-informative markers. Logistic regression models assessed associations between HLA polymorphisms and NMOSD.


Results:

A total of 82 patients with NMOSD (mean age 43.8 ± 13.3 years; 83% females) and 164 controls (mean age 36.4 ± 11.5 years; 85% females) were enrolled. Mitochondrial haplogroup frequencies were similar between groups, indicating comparable genetic backgrounds. Ancestry analysis revealed distinct population structures. In multivariate logistic regression, the HLA-DQB1*04 allele was significantly associated with increased NMOSD risk (OR = 3.16, CI: 1.58-6.34, p < 0.0023), while the HLA-DQB1*03 allele was associated with a protective effect (OR = 0.23, CI: 0.12-0.46, p < 0.0023).


Conclusions:

This study provides new insights into the genetic characterization of NMOSD in Colombia. Our findings suggest that HLA-DQB1*04 allele confers susceptibility to NMOSD, while DQB1*03 allele may exert a protective effect in our population. The notable disparities in African ancestry contribution between patients and controls underscore the importance of considering ethnic diversity in elucidating NMOSD susceptibility.


10.1212/WNL.0000000000210486
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