Impact of TNFAIP3 Genetic Polymorphisms on Primary Immune Thrombocytopenia in Egyptian Adults: Case-control Study

Authors

  • Mohamed Zanaty Department of Biotechnology and Life Sciences, Faculty of Postgraduate Studies for Advanced Sciences, Beni-Suef University, Beni-Suef, Egypt https://orcid.org/0000-0002-5386-8570
  • Osama Korayem Department of Biotechnology and Life Sciences, Faculty of Postgraduate Studies for Advanced Sciences, Beni-Suef University, Beni-Suef, Egypt https://orcid.org/0000-0001-7793-2760
  • Mohamed H. Meabed Department of Pediatrics, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
  • Doaa El Demerdash Department of Internal Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt https://orcid.org/0000-0002-5061-9536
  • Wafaa M. Abdelghany Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt https://orcid.org/0000-0001-6072-1318

DOI:

https://doi.org/10.3889/oamjms.2022.6539

Keywords:

Immune thrombocytopenia, TNFAIP3, Linkage disequilibrium, Susceptibility, Prognosis

Abstract

BACKGROUND: Immune Thrombocytopenia (ITP) is a common acquired hematological disease. Genetic polymorphisms play an important role in ITP pathogenesis and prognosis. TNF-α-induced protein 3 (TNFAIP3) is a negative regulator of NF-kB in many signaling pathways. Several variants of TNFAIP3 have been associated with various inflammatory autoimmune disorders.

AIM: Our study aimed to study the association of TNFAIP3 single nucleotide polymorphisms (SNPs); rs2230926 & rs5029939 with ITP susceptibility, as well ITP prognosis by follow up the cases for 18 months.

METHODS: One hundred and ten ITP patients as well 110 matched unrelated normal controls were enrolled in our study. The polymorphisms were assessed by real-time polymerase chain reaction (real time PCR).

RESULTS: There were a significant difference between cases and control groups regarding rs2230926 T>G and rs5029939 C>G frequencies with p < 0.05. Linkage disequilibrium (LD) analysis of the two variants revealed that there was a significant LD (p < 0.001). Non-cutaneous bleeding manifestations were observed mainly in the mutant genotypes of rs2230926 and rs5029939. The ITP patients with mutant genotypes of rs5029939 showed more need to use 2nd line immunosuppressive therapy as well the mutant genotypes of rs2230926 showed more steroid dependence and less complete recovery.

CONCLUSION: Our data concluded the presence of LD between rs5029939 and rs2230926. The mutant genotypes of both variants were associated with increase the susceptibility to ITP and accompanied by worse clinical manifestations and poor response to the treatment in the adult Egyptian patients.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Lambert MP, Gernsheimer TB. Clinical updates in adult immune thrombocytopenia. Blood. 2017;129(21):2829-35. https://doi.org/10.1182/blood-2017-03-754119 PMid:28416506 DOI: https://doi.org/10.1182/blood-2017-03-754119

Khodadi E, Asnafi AA, Shahrabi S, et al. Bone marrow niche in immune thrombocytopenia: A focus on megakaryopoiesis. Ann Hematol. 2016;95(11):1765-76. https://doi.org/10.1007/s00277-016-2703-1 PMid:27236577 DOI: https://doi.org/10.1007/s00277-016-2703-1

Zufferey A, Kapur R, Semple JW. Pathogenesis and therapeutic mechanisms in immune thrombocytopenia (ITP). J Clin Med. 2017;6(2):16. https://doi.org/10.3390/jcm6020016 PMid:28208757 DOI: https://doi.org/10.3390/jcm6020016

Cines DB, Bussel JB, Liebman HA, Prak ET. The ITP syndrome: Pathogenic and clinical diversity. Blood. 2009;113(26):6511-21. https://doi.org/10.1182/blood-2009-01-129155 PMid:19395674 DOI: https://doi.org/10.1182/blood-2009-01-129155

Goubran H, Hart C, Othman I, Seghatchian J. Flow cytometry and immune thrombocytopenic purpura. Trans Apher Sci. 2018;57(6):800-3. https://doi.org/10.1016/j.transci.2018.10.018 DOI: https://doi.org/10.1016/j.transci.2018.10.018

Xuan M, Li H, Fu R, Yang Y, Zhang D, Zhang X, et al. Association of ABCB1 gene polymorphisms and haplotypes with therapeutic efficacy of glucocorticoids in Chinese patients with immune thrombocytopenia. Hum Immunol. 2014;75(4):317-21. https://doi.org/10.1016/j.humimm.2014.01.013 PMid:24486577 DOI: https://doi.org/10.1016/j.humimm.2014.01.013

Rasi S, Rossi D, Gaidano G. TNFAIP3 (tumor necrosis factor, alpha-induced protein 3). Atlas Genet Cytogenet Oncol Haematol. 2010;5:488-92. https://doi.org/10.4267/2042/44762 DOI: https://doi.org/10.4267/2042/44762

Zhao H, Wang L, Luo H, Li QZ, Zuo X. TNFAIP3 downregulation mediated by histone modification contributes to T-cell dysfunction in systemic lupus erythematosus. Rheumatology. 2017;56(5):835-43. https://doi.org/10.1093/rheumatology/kew508 PMid:28158872 DOI: https://doi.org/10.1093/rheumatology/kew508

Matsuzawa Y, Oshima S, Takahara M, Maeyashiki C, Nemoto Y, Kobayashi M, et al. TNFAIP3 promotes survival of CD4 T cells by restricting MTOR and promoting autophagy. Autophagy. 2015;11(7):1052-62. https://doi.org/10.1080/15548627.2015.1055439 PMid:26043155 DOI: https://doi.org/10.1080/15548627.2015.1055439

Zhou H, Yang J, Liu L, Zhang D, Zhou K, Li H, et al. The polymorphisms of tumor necrosis factor-induced protein 3 gene may contribute to the susceptibility of chronic primary immune thrombocytopenia in Chinese population. Platelets. 2016;27(1):26-31. https://doi.org/10.3109/09537104.2015.1022142 PMid:25806576 DOI: https://doi.org/10.3109/09537104.2015.1022142

Musone SL, Taylor KE, Lu TT, Nititham J, Ferreira RC, Ortmann W, et al. Multiple polymorphisms in the TNFAIP3 region are independently associated with systemic lupus erythematosus. Nat Genet. 2008;40(9):1062-4. https://doi.org/10.1038/ng.202 PMid:19165919 DOI: https://doi.org/10.1038/ng.202

Adrianto I, Wen F, Templeton A, Wiley G, King JB, Lessard CJ, et al. Association of a functional variant downstream of TNFAIP3 with systemic lupus erythematosus. Nat Genet. 2011;43(3):253-8. PMid:21336280 DOI: https://doi.org/10.1038/ng.766

Bates JS, Lessard CJ, Leon JM, Nguyen T, Battiest LJ, Rodgers J, et al. Meta-analysis and imputation identifies a 109 kb risk haplotype spanning TNFAIP3 associated with lupus nephritis and hematologic manifestations. Genes Immun. 2009;10(5):470-7. https://doi.org/10.1038/gene.2009.31 PMid:19387456 DOI: https://doi.org/10.1038/gene.2009.31

Ciccacci C, Latini A, Perricone C, Conigliaro P, Colafrancesco S, Ceccarelli F, et al. TNFAIP3 gene polymorphisms in three common autoimmune diseases: Systemic lupus erythematosus, rheumatoid arthritis, and primary Sjogren syndrome-association with disease susceptibility and clinical phenotypes in Italian patients. J Immunol Res 2019;2019:6728694. https://doi.org/10.1155/2019/6728694 PMid:31534975 DOI: https://doi.org/10.1155/2019/6728694

Neunert C, Lim W, Crowther M, Cohen A, Solberg L, Crowther MA. The American society of hematology 2011 evidence-based practice guideline for immune thrombocytopenia. Blood. 2011;117(16):4190-207. https://doi.org/10.1182/blood-2010-08-302984 PMid:21325604 DOI: https://doi.org/10.1182/blood-2010-08-302984

Rodeghiero F, Stasi R, Gernsheimer T, Michel M, Provan D, Arnold DM, Bussel JB, et al. Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: Report from an international working group. Blood. 2009;113(11):2386-93. https://doi.org/10.1182/blood-2008-07-162503 PMid:19005182 DOI: https://doi.org/10.1182/blood-2008-07-162503

Berger S, Schlather M, de los Campos G, Weigend S, Preisinger R, Erbe M, et al. A scale-corrected comparison of linkage disequilibrium levels between genic and non-genic regions. PLoS One. 2015;10(10):e0141216. https://doi.org/10.1371/journal.pone.0141216 PMid:26517830 DOI: https://doi.org/10.1371/journal.pone.0141216

Swinkels M, Rijkers M, Voorberg J, Vidarsson G, Leebeek FW, Jansen AJ. Emerging concepts in immune thrombocytopenia. Front Immunol. 2018;9:880. https://doi.org/10.3389/fimmu.2018.00880 PMid:29760702 DOI: https://doi.org/10.3389/fimmu.2018.00880

Vereecke L, Beyaert R, van Loo G. Genetic relationships between A20/TNFAIP3, chronic inflammation and autoimmune disease. Biochem Soc Trans. 2011;39(4):1086-91. https://doi.org/10.1042/bst0391086 PMid:21787353 DOI: https://doi.org/10.1042/BST0391086

Ma A, Malynn BA. A20: Linking a complex regulator of ubiquitylation to immunity and human disease. Nat Rev Immunol. 2012;12(11):774-85. https://doi.org/10.1038/nri3313 Mid:23059429 DOI: https://doi.org/10.1038/nri3313

Kool M, Van Loo G, Waelput W, De Prijck S, Muskens F, Sze M, et al. The ubiquitin-editing protein a20 prevents dendritic cell activation, recognition of apoptotic cells, and systemic autoimmunity. Immunity. 2011;35(1):82-96. https://doi.org/10.1016/j.immuni.2011.05.013 PMid:21723156 DOI: https://doi.org/10.1016/j.immuni.2011.05.013

Broen JC, Coenen MJ, Radstake TR. Genetics of systemic sclerosis: An update. Curr Rheumatol Rep. 2012;14(1):11-21. https://doi.org/10.1007/s11926-011-0221-7 Mid:22102179 DOI: https://doi.org/10.1007/s11926-011-0221-7

Abd El-Hady M, Mosallam DS, Anis K, Mansour BS, Yassa ME. Tumor necrosis factor induced protein 3 gene polymorphism and the susceptibility to chronic primary immune thrombocytopenia in Egyptian children: A case-control study. Egypt J Med Hum Genet 2021;22(12):1-9. https://doi.org/10.1186/s43042-020-00129-6 DOI: https://doi.org/10.1186/s43042-020-00129-6

Downloads

Published

2022-01-02

How to Cite

1.
Zanaty M, Korayem O, Meabed MH, El Demerdash D, Abdelghany WM. Impact of TNFAIP3 Genetic Polymorphisms on Primary Immune Thrombocytopenia in Egyptian Adults: Case-control Study. Open Access Maced J Med Sci [Internet]. 2022 Jan. 2 [cited 2024 Apr. 16];10(A):525-30. Available from: https://oamjms.eu/index.php/mjms/article/view/6539