4.3 Article

Genetic risk factors for pediatric-onset multiple sclerosis

Journal

MULTIPLE SCLEROSIS JOURNAL
Volume 24, Issue 14, Pages 1825-1834

Publisher

SAGE PUBLICATIONS LTD
DOI: 10.1177/1352458517733551

Keywords

Multiple sclerosis; genetics; epidemiology; pediatrics

Funding

  1. NIH NINDS [1R01NS071463, R01NS049510]
  2. NIH NIEHS [R01ES017080]
  3. NIH NIAID [R01AI076544]
  4. National MS Society [HC 0165]
  5. Robert Wood Johnson Foundation
  6. Wayne and Gladys Valley Foundation
  7. Ellison Medical Foundation
  8. NIH [RC2AG036607]

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Background: Strong evidence supports the role of both genetic and environmental factors in pediatric-onset multiple sclerosis (POMS) etiology. Objective: We comprehensively investigated the association between established major histocompatibility complex (MHC) and non-MHC adult multiple sclerosis (MS)-associated variants and susceptibility to POMS. Methods: Cases with onset <18 years (n = 569) and controls (n = 16,251) were included from the United States and Sweden. Adjusted logistic regression and meta-analyses were performed for individual risk variants and a weighted genetic risk score (wGRS) for non-MHC variants. Results were compared to adult MS cases (n = 7588). Results: HLA-DRB1*15:01 was strongly associated with POMS (odds ratio (OR)(meta) = 2.95, p < 2.0 x 10(-16)). Furthermore, 28 of 104 non-MHC variants studied (23%) were associated (p < 0.05); POMS cases carried, on average, a higher burden of these 28 variants compared to adults (ORavg = 1.24 vs 1.13, respectively), though the difference was not significant. The wGRS was strongly associated with POMS (ORmeta = 2.77, 95% confidence interval: 2.33, 3.32, p < 2.0 x 10(-16)) and higher, on average, when compared to adult cases. Additional class III risk variants in the MHC region associated with POMS were revealed after accounting for HLA-DRB1*15:01 and HLA-A*02. Conclusion: Pediatric and adult MS share many genetic variants suggesting similar biological processes are present. MHC variants beyond HLA-DRB1*15:01 and HLA-A*02 are also associated with POMS.

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