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Genes comunes en infecciones y enfermedades autoinmunes Javier Martín Autoimmune Diseases: complex aetiology Rioux & Abbas, Nature , 2005 The Genetic Theory of Infectious Diseases Contribution of human genetic factors in host-pathogen interactions C-C Chemokine receptor type 5 CCR5 AIDS Contribution of human genetic factors in host-pathogen interactions Duffy antigen/chemokine receptor DARC malaria Contribution of human genetic factors in host-pathogen interactions Handel & Horuk, Trend Parasitol, 2010 Genome Wide Association studies –GWAs• • • • Description of the Human Genome Advances in genotyping technologies Reduction in genotyping costs HapMap project Genome-Wide Association Studies (GWAS) Altshuler & Daly & Lander; Science, 2008 Strategy for GWA studies Strategy for GWA studies • Case/control studies. Replication phase. P values < 10-8 • Genetic markers across the whole genome (from 300.000 to 2.5 million SNPs). • Common variants > 5% • Non-hypothesis-driven analysis. • Hypothesis generating approach. GWAS in Infectious Diseases De Bakker & Telenti, Nat Genet, 2010 GWAS in Infectious Diseases GWAS in Infectious Diseases Khor & Hibberd, Trend Genet, 2012 GWAS in Infectious Diseases: The MHC region Khor & Hibberd, Trend Genet, 2012 GWAS in Leprosy HLA Zhang et al, NEJM, 2009 GWAS in Malaria Jallow M et al., Nat Genet, 2009 GWAS in Leishmaniasis HLA in Autoimmune Diseases HLA association DQA1*02: Celiac disease DRB1*04: DRB1*03: DRB1*15: DRB1* 11: RA T1D, SLE MS, SLE SSc B*27: Ankylosing spondylitis Cw6: psoriasis. GWAS in Autoimmune Diseases Lupus Scleroderma MHC in Infectious & Autoimmune Diseases Infectious Diseases Autoimmune Diseases Malaria -B*53 RA -DRB1*04 Tuberculosis HLA SLE -DRB1*03 Leprosy - DRB1**15 MS -DRB1*15 AIDS - B*57 / -B*27 AS - B*27 HCV MICA, -DQB1*03 T1D HBV -DR, -DP CeD - DQ2/DQ8 Dengue MICA, MICB IBD - DRB*1 - DQB1*03 MHC in Infectious & Autoimmune Diseases Overlap of leprosy genes with other diseases Inflammatory Bowel Diseases Psoriasis -blue Parkinson –red- Abel & Alcais & Schurr, Curr Opin Immunol, 2014 The host-pathogen interface for leprosy and Crohn’s disease Khor & Hibberd, Trend Genet, 2012 Common genes in Infection and Autoimmunity Common genes in Infection and Autoimmunity Common genes in Infection and Autoimmunity Better understanding disease pathogenesis Prognosis / biomarkers Personalized or Stratified Medicine New therapeutic targets Las estudios amplios del genoma –GWAS- han sido muy fructíferos a la hora de identificar genes asociados a enfermedades autoinmunes y en menor grado a enfermedades infecciosas. Existe una genética compartida entre ambos tipos de patología , aunque queda aún mucho por entender como funciona. La realización de análisis conjuntos de los GWAS de enfermedades infecciosas y autoinmune podrían arrojar nuevos datos acerca de la genética compartida entre este tipo de patologías. Sería muy útil incorporar datos del genoma de los patógenos a estos estudios genómicos en humanos. Aunque el objetivo primario de los estudio genómicos es mejorar el conocimiento de los mecanismos patogénicos, no hay duda que los avances en esta área se podrán traducir en mejoras para los pacientes. Common genes in Infection and Autoimmunity Lee et al., Science , 2014