Primary Biliary Cholangitis in British Columbia First Nations: Clinical features and discovery of novel genetic susceptibility loci

• Published in: Liver International
• Main Authors: Asuri, Sirisha, McIntosh, Sarah, Taylor, Valerie, Rokeby, Andrew, Kelly, James, Shumansky, Karey, Field, Lanora Leigh, Yoshida, Eric M., Arbour, Laura
• Other Authors: Canadian Liver Foundation, Michael Smith Foundation for Health Research
• Format: Article in Journal/Newspaper
• Language: English
• Published: Wiley 2018
• Subjects: First Nations
• Online Access: http://dx.doi.org/10.1111/liv.13686; https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fliv.13686; https://onlinelibrary.wiley.com/doi/pdf/10.1111/liv.13686

Abstract Background & Aims Primary Biliary Cholangitis (PBC) is a chronic autoimmune liver disease characterized by destruction of intrahepatic bile ducts, portal inflammation and cirrhosis. Although rare in most populations, it is prevalent and often familial in British Columbia First Nations. We hypothesized that major genetic factors increased the risk in First Nations. Methods In all, 44 individuals with Primary Biliary Cholangitis and 61 unaffected relatives from 32 First Nations families participated. Family history and co‐morbidities were documented. Medical records were reviewed and available biopsies were re‐reviewed by our team pathologist. Genotyping was performed on DNA from 36 affected persons and 27 unaffected relatives using the Affymetrix Human Mapping 500K Array Set. MERLIN software was used to carry out multipoint parametric and nonparametric linkage analysis. Candidate genes were identified and entered into Innate DB and KEGG software to identify potential pathways affecting pathogenesis. Results In all, 34% of families were multiplex. Fifty per cent of cases and 33% of unaffected relatives reported other autoimmune disease. Three genomic regions (9q21, 17p13 and 19p13) produced LOD scores of 2.3 or greater suggestive of linkage, but no single linkage peak reached statistical significance. Candidate genes identified in the three regions suggested involvement of IL 17, NF κB, IL 6, JAK ‐ STAT , IFN γ and TGF β immune signalling pathways. Specifically, four genes— ACT 1, PIN 1, DNMT 1 and NTN 1 —emerged as having roles in these pathways that may influence Primary Biliary Cholangitis pathogenesis. Conclusions Our whole genome linkage study results reflect the multifactorial nature of Primary Biliary Cholangitis, support previous studies suggesting signalling pathway involvement and identify new candidate genes for consideration.