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CD58 polymorphisms associated with the risk of neuromyelitis optica in a Korean population
© Kim et al.; licensee BioMed Central Ltd. 2014
Received: 19 November 2013
Accepted: 18 March 2014
Published: 24 March 2014
Neuromyelitis optica (NMO) is a serious inflammatory demyelinating disease (IDD), characterized by the inflammation and demyelination of optic nerves and spinal cords, which subsequently leads to the loss of function. In a previous genome-wide association study, cluster of differentiation 58 (CD58) region was found to be susceptible for the risk of multiple sclerosis (MS) in Caucasian, and the association between CD58 variants and MS was replicated in Americans. However, no study has been conducted to explore the possible association between CD58 and NMO yet. Thus, this study aimed to investigate the association of CD58 polymorphisms with the risk of NMO in a Korean population.
Using TaqMan assay, 6 single nucleotide polymorphisms (SNPs) were genotyped in 98 NMO patients and 237 normal controls (N = 336). Logistic regression analysis was conducted to find a possible association between CD58 polymorphisms and NMO.
The analysis results showed that 6 variations (rs2300747, rs1335532, rs12044852, rs1016140, CD58_ht1, and CD58_ht3) showed significant associations (P = 0.002 ~ 0.008, P corr = 0.01 ~ 0.04).
The genetic variations in CD58 may be associated with the susceptibility of NMO in a Korean population. Based on previous studies, we suspect that the A allele of rs2300747 may decrease CD58 RNA expression, thus increasing NMO risk. Also, we deduced that the G allele of rs1016140 caused an increase of T cell activity, which in turn eased the access of AQP4 antibody into central nervous system (CNS) and ultimately leading to NMO development.
Neuromyelitis optica (NMO), which belongs to inflammatory demyelinating diseases (IDDs), is caused by the demyelination of axons in optic nerves and spinal cords. Although NMO has similarities with multiple sclerosis (MS), previous studies reported that MS and NMO may have different etiology [1–3]. In MS, demyelination causes symptoms such as a loss of sensitivity, hypoesthesia, parenthesis, disturbance of vision such as double vision, and muscle weakness. On the other hand, a loss of vision and spinal cord function are the most significant symptoms in NMO [1, 2]. It is also known that the prevalence of MS is higher in Caucasians than Asians (1 ~ 4/100,000 in Asian vs. 30 ~ 150/100,000 in Caucasian) [4, 5]. Contrary to MS, the prevalence of NMO is higher in non-Caucasians including African, Hispanic, and Asian .
Previous studies have shown that IDDs are complex-trait diseases with both genetic and environmental factors. However, compared to MS, there have been far less studies on NMO. In our previous study, a genome-wide association study (GWAS) was conducted for NMO and MS, showing that the risk polymorphisms for NMO and MS were different from each other . Another study conducted in our group has shown that SNPs in cluster of differentiation 6 (CD6) and tumor necrosis factor receptor superfamily member 1A (TNFRSF1A) were associated with NMO, but not with MS . These studies have shown that there are definite merits in conducting genetic association studies of NMO independently.
Cluster of Differentiation 58 (CD58), also known as lymphocyte function-associated antigen 3 (LFA-3), is one of cell adhesion molecules abundantly expressed on antigen presenting cells (APCs) . Conjugation between CD58 and CD2 or LFA-2, expressed in T-cell, is crucial for T-cell activation . Furthermore, the importance of T-cell in MS development is well documented in previous studies [11, 12]. To date, several association studies were conducted between CD58 and IDDs since the first GWAS identified the gene’s association with MS . Follow-up studies have shown that CD58 SNPs such as rs2300747 and rs12044852 were associated with MS risk [14–18]. However, no study has looked into the association between CD58 and NMO. Therefore, in the present study, we have conducted association studies between CD58 polymorphisms and NMO in a Korean population.
Characteristics of study subjects
Number of subject
Age (mean (min.-max.))
Onset age (mean ± Std)
33.5 ± 12.26
Duration (year, mean ± Std)
7.0 ± 4.42
Single nucleotide polymorphism (SNP) selection and genotyping
Six SNPs of CD58 were selected based on following conditions: (1) linkage disequilibrium (LD, minor allele frequency (> 0.05)), (2) locations (SNPs in exons were preferred), (3) previously reported SNP, (4) amino acid changes (non-synonymous SNPs were preferred). Genotype data of Asian (Chinese and Japanese) population from database of International HapMap Project (http://hapmap.ncbi.nlm.nih.gov/) were used for selection. Then, the selected SNPs were genotyped in 99 NMO cases and 237 healthy controls using TaqMan assay on the ABI prism 7900HT sequence detection system (Applied Biosystems, USA). The TaqMan primer information was listed in Additional file 1: Table S1.
LD was obtained using the HaploView software (version 4.2) from the Broad Institute (http://www.broadinstitute.org/mpg/haploview), with examination of Lewontin’s D’ (|D’|) and the LD coefficient r 2 between all pairs of bi-allelic loci . P-values for Hardy-Weinberg equilibrium (HWE) were also calculated using the HaploView software. Haplotypes were first estimated using PHASE software , and then computed using Statistical Analysis System (SAS). Associations for NMO under logistic model were adjusted by age (continuous value) and sex (male = 0, female = 1) as covariates using SAS. In order to correct for the multiple testing error, the SNPSpD program (http://gump.qimr.edu.au/general/daleN/SNPSpD/) was used, with the correction number of 4.5055. An in silico analysis was conducted by using Pupasuite 3.1 (http://pupasuite.bioinfo.cipf.es/) .
Association analysis using CD58 polymorphisms and haplotypes with NMO risk
OR (95% CI)
(n = 98)
(n = 237)
In the present study, we have conducted logistic analysis to find a possible significant association between CD58 polymorphisms and NMO in a Korean population. Previously, several studies have reported the associations of CD58 polymorphisms such as rs12044857, rs1335532 and rs2300747, with MS [13, 17, 18]. Our results showed that the SNPs reported to be associated with MS (rs2300747, rs13355332, and rs12044852) in previous studies [15, 17] were significantly associated with NMO as well. In addition, rs1016140, which was not previously studied for MS or NMO, also showed a significant association in our results.
Comparison of previous studies on CD58 – MS/NMO association
Hafler et al. (2007) 
US and UK (MS)
2322/5418 (1540 family trios)
1.9 × 10 −5 (1.24)
Rubio et al. (2008) 
Bahlo et al. (2009) *
Australia, NZ, UK, and US (MS)
9.6 × 10 −8 (1.28)
De Jager et al. (2009) *
US, UK, Belgium, Japanese, Chinese, and Finland (MS)
3558/4420 (1768 family trios)
1.1 × 10 −6 (1.22)
Brynedal et al. (2009) *
4.3 × 10 −4 (1.39)
Qiu et al. (2013) 
In order to further study the function of the CD58 SNPs, we have conducted in silico analysis of the 4 intronic SNPs associated with NMO. As a result, no SNPs were predicted to cause alternative splicing or be an exonic splicing enhancer or silencer (data not shown). However, previous reports suggest that there may be functional backgrounds on at least 2 SNPs, rs2300747 and rs1016140. In a recent study, the G allele of rs2300747 was found to limit the MS inflammation by increasing the CD58 RNA expression . In our study, we showed that the A allele of rs2300747 was associated with the increased risk for NMO (Pcor. = 0.03, OR (95% CI) = 1.73 (1.23-2.43)). We suspect that the decreased CD58 RNA expression, caused by the A allele, may increase NMO risk as well, although further functional studies are required to confirm this notion.
A recent study has shown that T cell-mediated central nervous system (CNS) inflammation is a pre-requisite for the access of AQP4 antibody into CNS, an integral step in the development of NMO . In a separate study, it was reported that rs1016140 was associated with the decreased peak antibody level of hepatitis B virus and decreased T cell activity . Another study also reported that the CD58 haplotype (rs1414275-rs11588376-rs1016140) might affect the response level of CD58 with T cell co-stimulatory molecules to decrease the T cell activity . In the present study, the G allele of rs1016140 was associated with the increased NMO risk. We suspect that the increased T cell activity caused by the G allele may lead to the more robust CNS inflammation, which in turn eases the access of AQP4 antibody into CNS, and ultimately leads to NMO development. Further studies would be needed to confirm our notion about the role of rs1016140 in the NMO etiology.
Although our study reports a potential association between CD58 polymorphisms and NMO, some limitations are present which should be addressed in the future. First, number of patients and controls enrolled in the study was relatively small, due to the rarity of the disease. This might have caused the low P-value of HWE for rs17426456. Second, there was a disparity in the gender ratio, as there were far more female subjects than male subjects in the study. However, it has been reported that NMO is approximately 3 to 5 times more common in women than men . In addition, association analysis was adjusted for gender to accommodate for this disparity. Lastly, functional study would be required to examine the actual effect of CD58 SNPs.
We have conducted association analyses between CD58 polymorphisms and NMO to find that 4 SNPs and 2 Haplotypes of CD58 were significantly associated with the increased risk of NMO. From previous studies, we have deduced the possible functional background of rs2300747 and rs1016140, but the roles of other polymorphisms remain unknown. Our study is the first to find significant association between CD58 polymorphisms and NMO in a Korean population. However, further studies may be required to confirm the functional role of CD58 polymorphisms with NMO. We expect the results in the present study to provide a new insight on the role of CD58 in NMO and be helpful in developing new treatments for the diseases.
Written informed consent was obtained from the patient for the publication of this report and any accompanying images.
Jason Yongha Kim and Joon Seol Bae are joint first authors.
This work was supported by Korea Science and Engineering Foundation (KOSEF) funded by the Korea government (MEST) (No. 2011–0004453). The biospecimens for this study were provided by National Biobank of Korea (KOBB-2010-19).
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