RS35705950 polymorphism of MUC5B Gene: Association with Rheumatoid Arthritis and Interstitial lung disease in Tunisian Population

##plugins.themes.academic_pro.article.main##

Azza Saad
Khadija Baccouche
Hajer Fodha
Amel Haj Khelil
Rym Fakhfakh
Dhouha Khalifa
Nejla El Amri
Ali Saad
Elyess Bouajina

Abstract

Introduction: Interstitial lung disease (ILD) is the most common extra-articular manifestation in rheumatoid arthritis (RA). Studies have concluded that there is an association between rs35705950 polymorphism of the MUC5B gene and RA-ILD.


Aim: To explore this polymorphism in a cohort of Tunisian patients suffering from RA with or without ILD and stufdy its association to ILD during RA.


Methods : A case-control study involving 61 patients followed for RA, 26 with ILD and 35 without pulmonary involvement and 62 healthy controls. This was an association study between genetic marker and RA-ILD by genotyping the rs35705950 polymorphism using PCR-RFLP.


Results: No association was found between rs35705950 polymorphism and RA. However, the comparison of RA-ILD patients with controls showed a significant association with the allele frequencies of rs35705950 polymorphism (p=0.008; OR=2.61; CI [1.2-5.66]). Indeed, the minor T allele increased the risk of developing ILD by 2.61 for RA patients compared to the controls. Comparison of allele frequencies in RA-ILD patients and RA patients without ILD showed a significant association between the minor T allele of the studied polymorphism and RA-ILD (p= 0.02; OR= 2.66; CI [1.09-6.5]). In the adjusted model, this risk increased in case of smoking (p=0.025; OR=3,84; CI [1,13-13,08]) and/or female gender (p=0.013; OR = 4,63; CI [1,33-16,17]).


Conclusion: Our work has confirmed the role of the polymorphism of MUC5B promoter in the appearance of ILD during RA in Tunisian patients. This variant could be used to early detect preclinical ILD in patients with RA.

Keywords:

rheumatoid arthritis, interstitial lung disease, genetic polymorphism, mucin 5b

##plugins.themes.academic_pro.article.details##

References

  1. Chopra A, Abdel-Nasser A. Epidemiology of rheumatic musculoskeletal disorders in the developing world. Best Pract Res Clin Rheumatol. 2008;22(4):583 604.
  2. Kvien TK. Epidemiological Aspects of Rheumatoid Arthritis: The Sex Ratio. Ann N Y Acad Sci. 1 juin 2006;1069(1):212 22.
  3. Turesson C. Extra-articular disease manifestations in rheumatoid arthritis: incidence trends and risk factors over 46 years. Ann Rheum Dis. 1 août 2003;62(8):722 7.
  4. Maradit-Kremers H, Nicola PJ, Crowson CS, Ballman KV, Gabriel SE. Cardiovascular death in rheumatoid arthritis: A population-based study. Arthritis Rheum. mars 2005;52(3):722 32.
  5. Antin-Ozerkis D, Evans J, Rubinowitz A, Homer RJ, Matthay RA. Pulmonary Manifestations of Rheumatoid Arthritis. Clin Chest Med. sept 2010;31(3):451 78.
  6. Wang N, Zhang Q, Jing X, Guo J, Huang H, Xu Z. The Association Between MUC5B Mutations and Clinical Outcome in Patients with Rheumatoid Arthritis-Associated Interstitial Lung Disease: A Retrospective Exploratory Study in China. MedSci Monit.2020 6;26: e920137.
  7. Juge PA, Lee JS, Ebstein E, Furukawa H, Dobrinskikh E, Gazal S, et al. MUC5B Promoter Variant and Rheumatoid Arthritis with Interstitial Lung Disease. N Engl J Med. 2018 ;379(23) :2209 19.
  8. Dai Y, Wang W, Yu Y, Hu S. Rheumatoid arthritis–associated interstitial lung disease: an overview of epidemiology, pathogenesis, and management. Clin Rheumatol. 2021;40(4):1211 20.
  9. Adegunsoye A. MUC5B promoter variant: genomic fingerprint for early identification of undiagnosed pulmonary fibrosis. Thorax. 2019;74(12):1111 2.
  10. Arnett FC, Edworthy SM, Bloch DA, Mcshane DJ, Fries JF, Cooper NS, et al. The american rheumatism association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988;31(3):315 24.
  11. Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO, et al. 2010 Rheumatoid arthritis classification criteria: An American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2010;62(9):2569 81.
  12. the RACI consortium, the GARNET consortium, Okada Y, Wu D, Trynka G, Raj T, et al. Genetics of rheumatoid arthritis contributes to biology and drug discovery. Nature. 2014;506(7488):376 81
  13. van der Vis JJ, Snetselaar R, Kazemier KM, ten Klooster L, Grutters JC, van Moorsel CHM. Effect of Muc5b promoter polymorphism on disease predisposition and survival in idiopathic interstitial pneumonias: MUC5B in familial interstitial pneumonia. Respirology.2016;21(4):712 7.
  14. Joo YB, Ahn SM, Bang SY, Park Y, Hong SJ, Lee Y, et al. MUC5B promoter variant rs35705950, rare but significant susceptibility locus in rheumatoid arthritis-interstitial lung disease with usual interstitial pneumonia in Asian populations. RMD Open. 2022;8(2):e002790.
  15. England BR, Hershberger D. Management issues in rheumatoid arthritis-associated interstitial lung disease. CurrOpinRheumatol. 2020;32(3):255 63.
  16. S, Raghu G. Rheumatoid arthritis-interstitial lung disease: manifestations and current concepts in pathogenesis and management. Eur Respir Rev. 2021;30(160):210011.