Association between vitamin D receptor genes polymorphisms with systemic lupus erythematosus in children

Authors

  • Hanan M. Hamed Pediatrics Department, National Research Centre, Cairo, Egypt
  • Manal F. Elshamaa Pediatrics Department, National Research Centre, Cairo, Egypt
  • Iman A. S. Khalifa Pediatrics Department, Cairo University, Cairo, Egypt
  • Manal E. Kandil Pediatrics Department, National Research Centre, Cairo, Egypt
  • Solaf Kamel Clinical Pathology Department, National Research Centre, Cairo, Egypt
  • Dina Kandil Clinical Pathology Department, National Research Centre, Cairo, Egypt
  • Hebatallah Farouk Clinical Pathology Department, National Research Centre, Cairo, Egypt

DOI:

https://doi.org/10.56511/JIPBS.2017.v4.i04.pp162-169

Abstract

Background: Several vitamin D receptor polymorphisms have been associated with SLE development and clinical manifestations. So, the aim of the study was to evaluate the possible association between the common VDR gene polymorphisms and SLE susceptibility and severity in children. Patients and methods: Thirty six  lupus children, 29 females (80.6%)  and 7 males (19.6 %) were recruited from the  Collagen Clinic, Children Hospital, Cairo University between February and November, 2016. Forty three healthy age and sex matched children were included as a control group.  Five ml venous blood sample was withdrawn under aseptic conditions from the studied groups. Two ml were put in a sterile tube containing EDTA for genotyping of BsmI (rs1544410), ApaI (rs7975232), TaqI (rs731236) and FokI (rs2228570) polymorphisms by real time PCR.  The rest was centrifuged and serum was used for assessment of: serum calcium, vitamin D level, total and intact Parathormonee (IPTH) level, and fibroblast growth factor 23(FGF23). All were done by ELISA. Results: The serum calcium, vitamin D level and IPTH were significantly lower in patients than that in controls (p=0.001, p=0.001 & p=0.007) respectively, while FGF23 was significantly higher in the patients (p=0.02). The risk of SLE was significantly higher among patients carrying (Fok1 AA) (OR=2.6, & p =0.04). SLICC values >3 were higher in SLE patients with FokI AA and BsmI CT genotypes (p=0.03 & p=0.1 respectively). GACC haplotype was significantly higher in patients (p=0.02, OR=3.24). Conclusion: The VDR gene polymorphisms and haplotypes were associated with SLE. FokI AA and BsmI CT genotypes carry a worse prognosis.

Keywords:

Systemic lupus erythematosus, Vitamin D, Vitamin D receptor – haplotype

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References

Hochberg MC: Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1997; 40: 1725.

Li PH, Hing W, Wong S: Relationship between autoantibody clustering and clinical subsets in SLE: Cluster and association analyses in Hong Kong Chinese. Rheumatology (Oxford) 2013; 52: 337 – 345.

Uva L, Miguel D, Pinheiro C, Freitas JP, Marques Gomes M, Filipe P: Cutaneous manifestations of systemic lupus erythematosus. Autoimmune Dis 2012; 2012: 834291.

Arnson Y, Amital H, Shoenfeld Y: Vitamin D and autoimmunity: new aetiological and therapeutic considerations. Ann Rheum Dis. 2007; 66:1137 – 114.

Kamen DL: Vitamin D in lupus – new kid on the block? Bull NYU HospJt Dis. 2010; 68: 218 – 222.

Vinhquc L K, Nguyen LT: The beneficial role of vitamin D in systemic lupus erythematosus (SLE). Clin Rheumatol. 2012; 31: 1423 – 1435.

Shimada T, Kakitani M, Yamazaki Y: Targeted ablation of FGF23 demonstrates an essential physiological role of FGF23 in phosphate and vitamin D metabolism. J Clin Invest. 2004; 113:561-8

Baum M, Schiavi S, Dwarakanath V, Quigley R: Effect of fibroblast growth factor-23 on phosphate transport in proximal tubules. Kidney Int. 2005; 68:1148 – 1153.

Toloza SM, Cole DE, Gladman DD, Ibañez D, Urowitz MB: Vitamin D insufficiency in a large female SLE cohort. Lupus 2010; 19(1):13-19. 10.1177/0961203309345775 [ PubMed ] [ Cross Ref ].

Jacobs J, Korswagen LA, Schilder AM, van Tuyl LH, Dijkmans BA, Lems WF, Voskuyl AE, Bultink IE: Six-year follow-up study of bone mineral density in patients with systemic lupus erythematosus. Osteoporos Int. 2013; 24:1827 – 1833.

Nejentsev S, Cooper JD, Godfrey L: Analysis of the vitamin D receptor gene sequence variants in type 1 diabetes. Diabetes 2004; 53: 2709 – 2712.

Zhang J, Li W, Liu J: Polymorphisms in the vitamin D receptor gene and type 1 diabetes mellitus risk: An update by metaanalysis. Mol Cell Endocrinol 2012; 355: 135 – 142.

Alonso-Perez E, Suarez-Gestal M, Calaza M: Association of systemic lupus erythematosus clinical features with European population genetic substructure. PloS One 2011; 6: e29033.

Luo XY, Wu LJ, Chen L: The association of vitamin D receptor gene ApaI and BsmI polymorphism with systemic lupus erythematosus [in Chinese]. ZhonghuaNeiKeZaZhi. 2012; 51: 131 – 135.

Abbasi M, Rezaieyazdi Z, Afshari JT, Hatef M, Sahebari M, Saadati N: Lack of association of vitamin D receptor gene BsmI polymorphisms in patients with systemic lupus erythematosus. Rheumatol Int. 2010; 30: 1537 – 1539.

Petri M, Orbai AM, Alarco ´ n GS, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum .2012; 64: 2677 – 2686.

Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH.Derivation of the SLEDAI. A Disease Activity Index for lupus patients. The Committee on Prognosis Studies in SLE. Arthritis Rheum.1992; 35:630 – 640.

Gladman D, Ginzler E, Goldsmith C: Systemic lupus international collaborative clinics: Development of a damage index in systemic lupus erythematosus. J Rheumatol. 1992; 19: 1820 – 1821.

Bertsias G, Ioannidis JP, Boletis J: EULAR recommendations for the management of systemic lupus erythematosus. Report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics. Ann Rheum Dis. 2008; 67: 195 – 205.

Bertsias GK, Ioannidis JP, Aringer M: EULAR recommendations for the management of systemic lupus erythematosus with neuropsychiatric manifestations: Report of a task force of the EULAR standing committee for clinical affairs. Ann Rheum Dis. 2010; 69: 2074 – 2082.

Bertsias GK, Tektonidou M, Amoura Z: Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis. Ann Rheum Dis. 2012; 71:1771 – 1782.

World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013; 310(20): 2191-

doi: 10.1001/jama.2013.281053.

Chan YH: Biostatistics 103: Qualitative Data – Tests of Independence. Singapore Med J. 2003; 44(10): 498-503.

Holick MF: Vitamin D deficiency. N Engl J Med. 2007; 357:266 – 81

Singh A, Kamen DL: Potential benefits of vitamin D for patientswith systemic lupus erythematosus. Dermatoendocrinol 2012; 4: 146 – 151.

Mok CC, Birmingham DJ, Ho LY, Hebert LA, Song H, Rovin BH: Vitamin D deficiency as marker for disease activity and damage in systemic lupus erythematosus: a comparison with anti-dsDNA and antiC1q. Lupus 2012; 21(1):36-42. 10.1177/0961203311422094 [ PubMed ] [ Cross Ref ].

Suzan M., Aisha M. S: Vitamin D Deficiency in Patients with Systemic Lupus Erythematosus Oman Med J. 2013; 28(1): 42 – 47.

Le Goaziou MF, Contardo G, Dupraz C, Martin A, Laville M, SchottPethelaz AM: Risk factors for vitamin D deficiency in women aged 20-50 years consulting in general practice: a cross-sectional study. Eur J Gen Pract 2011; 17(3):146-152. 10.3109/13814788.2011.560663 [ PubMed ] [ Cross Ref ].

Bogaczewicz J, Sysa-Jedrzejowska A, Arkuszewska C, Zabek J, Kontny E, Wozniacka A: Prevalence of autoantibodies directed against 1,25(OH)2D3 in patients with systemic lupus Erythematosus 2010; 28(164):103-7. [ PubMed ]

Shaikh A, Berndt T, Kumar R.: Regulation of phosphate homeostasis by the phosphatonins and other novel mediators. PediatrNephrol. 2008; 23:1203-1.

Jüppner H, Wolf M, Salusky IB: FGF-23: More than a regulator of renal phosphate handling?. J Bone Miner Res. 2010; 25:2091-10.

Krajisnik T, Björklund P, Marsell R, Ljunggren O, Akerström G, Jonsson KB, Westin G, Larsson TE: Fibroblast growth factor23 regulates parathyroid hormone and 1alpha-hydroxylase expression in cultured bovine parathyroid cells. J Endocrinol. 2007; 195:125 – 131.

Celik E, Guzel S, Abali R, Guzelant AY, CelikGuzel E,Kuçukyalcin V: The relationship between fibroblast growth factor 23 and osteoporosis in postmenopausal women. Minerva Med. 2013; 104:497 – 504.

Mirza MA, Karlsson MK, Mellström D, Orwoll E, Ohlsson C, Ljunggren O, Larsson TE: Serum fibroblast growth factor-23 (FGF-23) and fracture risk in elderly men. J Bone Miner Res. 2011; 26:857 – 864.

C.-C. Lai & W.-S. Chen & D.-M. Chang & Y.-P. Tsao & T.-H. Wu & C.- T. Chou & C.-Y. Tsai: Increased serum fibroblast growth factor-23 and decreased bone turnover in patients with systemic lupus erythematosus under treatment with cyclosporine and steroid but not steroid only. OsteoporosInt. 2015; 26:601 – 610.

Wolf M, Koch TA, Bregman DB.: Effects of iron deficiency anemia and its treatment on fibroblast tgrowth factor 23 and phosphate homeostasis in women. J Bone Miner Res. 2013; 28:1793 – 1803.

Tizaoui K, Kaabachi W, Hamzaoui A, Hamzaoui K: Association between vitamin D receptor polymorphisms and multiple sclerosis: Systematic review and meta-analysis of case-control studies. Cell MolImmunol. Epub ahead of print 7 July 2014. DOI: 10.1038/ cmi.2014.47.

van Etten E, Verlinden L, Giulietti A: The vitamin D receptor gene FokI polymorphism: Functional impact on the immune system. Eur J Immunol. 2007; 37: 395 – 405.

Ritterhouse LL, Crowe SR, Niewold TB: Vitamin D deficiency is associated with an increased autoimmune response in healthy individuals and in patients with systemic lupus erythematosus. Ann Rheum Dis. 2011; 70: 1569 – 1574.

Ozaki Y, Nomura S, Nagahama M, Yoshimura C, Kagawa H, Fukuhara S.: Vitamin-D receptor genotype and renal disorder in Japanese patients with systemic lupus erythematosus. Nephron 2000; 85: 86 – 91.

Luo XY, Wu LJ, Chen L, et al.: The association of vitamin D receptor gene ApaI and BsmI polymorphism with systemic lupus erythematosus [article in Chinese]. ZhonghuaNeiKeZaZhi. 2012; 51: 131 – 135.

Emerah AA, El-Shal AS.: Role of vitamin D receptor gene polymorphisms and serum 25-hydroxyvitamin D level in Egyptian female patients with systemic lupus erythematosus. MolBiol Rep. 2013; 40: 6151 – 6162.

Huang CM, Wu MC, Wu JY, Tsai FJ: No association of vitamin D receptor gene start codon fok 1 polymorphisms in Chinese patients with systemic lupus erythematosus. J Rheumatol 2002; 29(6):1211 – 1213.

Mostowska A, Lianeri M, Wudarski M, Olesin ´ska M, Jagodzin ´ski PP: Vitamin D receptor gene BsmI, FokI, ApaI and TaqI polymorphisms and the risk of systemic lupus erythematosus. MolBiol Rep. 2013; 40(2):803 – 810.

Monticielo OA, Brenol JC, Chies JA, Longo MG, Rucatti GG, Scalco R et al .The role of BsmI and FokI vitamin D receptor gene polymorphisms and serum 25-hydroxyvitamin D in Brazilian patients with systemic lupus erythematosus. Lupus 2012; 21(1):43 – 52.

Carvalho C, Marinho A, Leal1 B, Bettencourt A, Boleixa D, Almeida I, Farinha F, Costa PP, Vasconcelos C and Silva1BM: Association between vitamin D receptor (VDR) gene polymorphisms and systemic lupus erythematosus in Portuguese patients. Lupus 2015; 24:846 – 853.

Luo XY, Yang MH, Wu FX, Wu LJ, Chen L, Tang Z, Liu NT, Zeng XF, Guan JL, Yuan GH: Vitamin D receptor gene BsmI polymorphism B allele, but not BB genotype, is associated with systemic lupus erythematosus in a Han Chinese population. Lupus 2012; 21(1):53 – 59.

J de Azeveˆ do Silva1 , K Monteiro Fernandes, JA Tre´s Pancotto, T SoteroFragoso, EA Donadi, SCrovella and P Sandrin-Garcia: Vitamin D receptor (VDR) gene polymorphisms and susceptibility to systemic lupus erythematosus clinical manifestations. Lupus 2013; 22:1110 – 1117.

Acikbas I, Sanlı B, Tepeli E, Ergin S, Aktan S, Bagci H : Vitamin D receptor gene polymorphisms and haplotypes (ApaI, BsmI, FokI, TaqI) in Turkish psoriasis patients. Med SciMonit 2012; 18(11):661 – 666.

Published

05-10-2017
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How to Cite

Hanan M. Hamed, Manal F. Elshamaa, Iman A. S. Khalifa, Manal E. Kandil, Solaf Kamel, Dina Kandil, and Hebatallah Farouk. “Association Between Vitamin D Receptor Genes Polymorphisms With Systemic Lupus Erythematosus in Children”. Journal of Innovations in Pharmaceutical and Biological Sciences, vol. 4, no. 4, Oct. 2017, pp. 162-9, doi:10.56511/JIPBS.2017.v4.i04.pp162-169.

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Research Article