| Title | Filaggrin mutations that confer risk of atopic dermatitis confer greater risk for eczema herpeticum. | | Author(s) | Gao PS, Rafaels NM, Hand T, Murray T, Boguniewicz M, Hata T, Schneider L, Hanifin JM, Gallo RL, Gao L, Beaty TH, Beck LA, Barnes KC, Leung DY | | Institution | Johns Hopkins Asthma and Allergy Center, Johns Hopkins University School of Medicine, Baltimore, Md 21224, USA. | | Source | J Allergy Clin Immunol 2009 Sep; 124(3):507-13, 513.e1-7. | | MeSH | Adolescent
Adult
Child
Child, Preschool
Dermatitis, Atopic
Female
Gene Frequency
Genetic Predisposition to Disease
Haplotypes
Humans
Infant
Intermediate Filament Proteins
Kaposi Varicelliform Eruption
Male
Middle Aged
Mutation
Polymorphism, Single Nucleotide
Skin
Young Adult
| | Abstract | BACKGROUND: Loss-of-function null mutations R501X and 2282del4 in the skin barrier gene, filaggrin (FLG), represent the most replicated genetic risk factors for atopic dermatitis (AD). Associations have not been reported in African ancestry populations. Atopic dermatitis eczema herpeticum (ADEH) is a rare but serious complication of AD resulting from disseminated cutaneous herpes simplex virus infections.
OBJECTIVE: We aimed to determine whether FLG polymorphisms contribute to ADEH susceptibility.
METHODS: Two common loss-of-function mutations plus 9 FLG single nucleotide polymorphisms were genotyped in 278 European American patients with AD, of whom 112 had ADEH, and 157 nonatopic controls. Replication was performed on 339 African American subjects.
RESULTS: Significant associations were observed for both the R501X and 2282del4 mutations and AD among European American subjects (P = 1.46 x 10(-5), 3.87 x 10(-5), respectively), but the frequency of the R501X mutation was 3 times higher (25% vs 9%) for ADEH than for AD without eczema herpeticum (EH) (odds ratio [OR], 3.4; 1.7-6.8; P = .0002). Associations with ADEH were stronger with the combined null mutations (OR, 10.1; 4.7-22.1; P = 1.99 x 10(-11)). Associations with the R501X mutation were replicated in the African American population; the null mutation was absent among healthy African American subjects, but present among patients with AD (3.2%; P = .035) and common among patients with ADEH (9.4%; P = .0049). However, the 2282del4 mutation was absent among African American patients with ADEH and rare (<1%) among healthy individuals.
CONCLUSION: The R501X mutation in the gene encoding filaggrin, one of the strongest genetic predictors of AD, confers an even greater risk for ADEH in both European and African ancestry populations, suggesting a role for defective skin barrier in this devastating condition. | | Language | eng | | Pub Type(s) | Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
| | PubMed ID | 19733298 |
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