BACKGROUND: The development of factor (F) VIII neutralizing alloantibodies (inhibitors) is a major complication of treatment with FVIII concentrates in hemophilia A and the etiology is still poorly understood. The low-affinity Fc gamma receptors (FcγR), which are expressed on immune cells, provide an important link between cellular and humoral immunity by interacting with IgG subtypes. Genetic variations of the genes encoding FcγRs (FCGR genes) have been associated with susceptibility to infectious and autoimmune diseases. OBJECTIVES: The aim of this study was to investigate the association between genetic variation of FCGR and inhibitor development in severe hemophilia A. PATIENTS/ METHODS: In this case-control study samples of 85 severe hemophilia A patients (siblings from 44 families) were included. Single nucleotide polymorphisms and copy number variation of the FCGR2 and FCGR3 gene cluster were studied in an FCGR-specific multiplex ligation-dependent probe amplification assay. Frequencies were compared in a generalized estimating equation regression model. RESULTS: Thirty-six patients (42%) had a positive history of inhibitor development. The polymorphism 131R > H in the FCGR2A gene was associated with an increased risk of inhibitor development (odds ratio [OR] per H-allele, 1.8; 95% confidence interval [CI], 1.1-2.9). This association persisted in 29 patients with high titer inhibitors (OR per H-allele, 1.9; 95% CI, 1.2-3.2) and in 44 patients with the F8 intron 22 inversion (OR per H-allele, 2.6; 95% CI, 1.1-6.6). CONCLUSIONS: Hemophilia A patients with the HH genotype of the FCGR2A polymorphism 131R > H have a more than 3-fold increased risk of inhibitor development compared with patients with the RR genotype.
BACKGROUND: The development of factor (F) VIII neutralizing alloantibodies (inhibitors) is a major complication of treatment with FVIII concentrates in hemophilia A and the etiology is still poorly understood. The low-affinity Fc gamma receptors (FcγR), which are expressed on immune cells, provide an important link between cellular and humoral immunity by interacting with IgG subtypes. Genetic variations of the genes encoding FcγRs (FCGR genes) have been associated with susceptibility to infectious and autoimmune diseases. OBJECTIVES: The aim of this study was to investigate the association between genetic variation of FCGR and inhibitor development in severe hemophilia A. PATIENTS/ METHODS: In this case-control study samples of 85 severe hemophilia Apatients (siblings from 44 families) were included. Single nucleotide polymorphisms and copy number variation of the FCGR2 and FCGR3 gene cluster were studied in an FCGR-specific multiplex ligation-dependent probe amplification assay. Frequencies were compared in a generalized estimating equation regression model. RESULTS: Thirty-six patients (42%) had a positive history of inhibitor development. The polymorphism 131R > H in the FCGR2A gene was associated with an increased risk of inhibitor development (odds ratio [OR] per H-allele, 1.8; 95% confidence interval [CI], 1.1-2.9). This association persisted in 29 patients with high titer inhibitors (OR per H-allele, 1.9; 95% CI, 1.2-3.2) and in 44 patients with the F8 intron 22 inversion (OR per H-allele, 2.6; 95% CI, 1.1-6.6). CONCLUSIONS:Hemophilia Apatients with the HH genotype of the FCGR2A polymorphism 131R > H have a more than 3-fold increased risk of inhibitor development compared with patients with the RR genotype.
Authors: Nicoletta Sorvillo; Robin B Hartholt; Esther Bloem; Magdalena Sedek; Anja ten Brinke; Carmen van der Zwaan; Floris P van Alphen; Alexander B Meijer; Jan Voorberg Journal: Haematologica Date: 2015-12-03 Impact factor: 9.941
Authors: Samuel Lessard; Chunla He; Deepak K Rajpal; Katherine Klinger; Christine Loh; Tim Harris; Jennifer Dumont Journal: Front Med (Lausanne) Date: 2022-06-23
Authors: Marjon H Cnossen; Iris van Moort; Simone H Reitsma; Moniek P M de Maat; Roger E G Schutgens; Rolf T Urbanus; Hester F Lingsma; Ron A A Mathot; Samantha C Gouw; Karina Meijer; Annelien L Bredenoord; Rieke van der Graaf; Karin Fijnvandraat; Alexander B Meijer; Emile van den Akker; Ruben Bierings; Jeroen C J Eikenboom; Maartje van den Biggelaar; Masja de Haas; Jan Voorberg; Frank W G Leebeek Journal: J Thromb Haemost Date: 2022-06-02 Impact factor: 16.036
Authors: Fatina I Fadel; Manal F Elshamaa; Ahmed Salah; Eman A Elghoroury; Safaa Abd El-Rahman; Mona Hamed Ibrahim; Solaf Kamel Journal: Cent Eur J Immunol Date: 2017-12-30 Impact factor: 2.085