Epidemiological Trends of Rheumatoid Arthritis and PADI4, PTPN22, and HLA-DRB9 Genes Distribution in the Kazakhstan Population

Argul Issilbayeva; Almagul  Kushugulova; Assel  Meiramova; Samat  Kozhakhmetov; Zhanar  Akhmetova; Madiyar   Nurgaziyev; Laura  Chulenbayeva; Dmitriy  Babenko; Jeannette  Kunz; Bayan  Ainabekova

doi:10.3889/oamjms.2021.6472

Authors

Argul Issilbayeva Laboratory of Human Microbiome and Longevity, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Nur-Sultan, Kazakhstan; Department of Internal Medicine with the Course of Gastroenterology, Endocrinology and Pulmonology, NJSC Astana Medical University, Nur-Sultan, Kazakhstan https://orcid.org/0000-0002-7350-6083
Almagul Kushugulova Laboratory of Human Microbiome and Longevity, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Nur-Sultan, Kazakhstan https://orcid.org/0000-0001-9479-0899
Assel Meiramova Laboratory of Human Microbiome and Longevity, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Nur-Sultan, Kazakhstan; Department of Internal Medicine with the Course of Gastroenterology, Endocrinology and Pulmonology, NJSC Astana Medical University, Nur-Sultan, Kazakhstan https://orcid.org/0000-0002-5427-3931
Samat Kozhakhmetov Laboratory of Human Microbiome and Longevity, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Nur-Sultan, Kazakhstan https://orcid.org/0000-0001-9668-0327
Zhanar Akhmetova Laboratory of Human Microbiome and Longevity, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Nur-Sultan, Kazakhstan; Department of Internal Medicine with Geriatrics course, NJSC Astana Medical University, Nur-Sultan, Kazakhstan https://orcid.org/0000-0001-9220-5596
Madiyar Nurgaziyev Laboratory of Human Microbiome and Longevity, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Nur-Sultan, Kazakhstan https://orcid.org/0000-0003-2397-4978
Laura Chulenbayeva Laboratory of Human Microbiome and Longevity, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Nur-Sultan, Kazakhstan https://orcid.org/0000-0002-8691-9485
Dmitriy Babenko Research Center, Karaganda Medical University, Karagandy, Kazakhstan https://orcid.org/0000-0003-2280-2146
Jeannette Kunz Department of Medicine, School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan https://orcid.org/0000-0002-0776-3233
Professor Bayan Alkenovna Astana Medical University https://orcid.org/0000-0002-5427-3931

DOI:

https://doi.org/10.3889/oamjms.2021.6472

Keywords:

Rheumatoid arthritis, Epidemiology, Single-nucleotide polymorphisms, Peptidylarginine deiminase 4, Protein tyrosine phosphatase 22, Human leukocyte antigens-DRB9

Abstract

BACKGROUND: The prevalence of rheumatoid arthritis (RA) is 1% in the global population. The lack of epidemiological studies in developing countries makes it difficult to obtain a complete global epidemiological picture of RA. RA develops due to the interaction of multiple genetic and environmental factors, though the contribution of these factors to the various disease occurrence seen in different populations is unclear.

AIM: The aim of our study was to analyze the dynamics of the general prevalence and incidence of RA among the population of Kazakhstan in 2017–2019 as well as to investigate the three most common single-nucleotide polymorphisms (SNP) of RA in the Kazakhstan population.

METHODS: The analysis of statistical data on Form 12 “On the health of the people and the health care system” was carried out. Prevalence and incidence rates were calculated according to generally accepted rules. Demographic data for the Republic of Kazakhstan were obtained from the official website stat.gov.kz. Our study included 70 RA patients and 113 control subjects. Blood samples were collected and genotyped for peptidylarginine deiminase 4 (PADI4), protein tyrosine phosphatase 22, and human leukocyte antigen (HLA)-DRB9 SNPs by reverse transcription polymerase chain reaction.

RESULTS: The prevalence of RA in Kazakhstan in 2017–2019 was 0.36–0.38%, with an incidence rate of 0.085–0.087%, which can be comparable to data of other countries in Central Asia. The allele and genotypes frequency analyses were carried out between patients and controls. The HLA-DRB9 showed significant association of the G allele odds ratio (OR) 1.96 (95% confidence interval [CI]: 1.252–3.081), p= 0.0025 and G/G genotype OR = 3.67 (95% CI: 1.58–8.54), p = 0.00162 with RA in our sample. Strong association between anti-citrullinated protein antibody (ACPA) profile and PADI4 (OR 12.19 [95% CI: 2.19–67.94], p = 0.00115) was found.

CONCLUSION: There was an increase in RA prevalence with age among females and a higher crude prevalence and incidence of RA in the southern regions of Kazakhstan. HLA-DRB9 prevailed in Kazakhstani patients with RA, PADI4 showed association with ACPA-positive RA. Further studies on larger samples are required to confirm our obtained results.

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Author Biography

Professor Bayan Alkenovna, Astana Medical University

Professor. MD. The Head of the Department of Internal Medicine with the course of gastroenterology, endocrinology and pulmonology, NJSC Medical University Astana, Nur-Sultan.

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