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Patient ancestry significantly contributes to molecular heterogeneity of systemic lupus erythematosus
Michelle D. Catalina, Prathyusha Bachali, Anthony E. Yeo, Nicholas S. Geraci, Michelle A. Petri, Amrie C. Grammer, Peter E. Lipsky
Michelle D. Catalina, Prathyusha Bachali, Anthony E. Yeo, Nicholas S. Geraci, Michelle A. Petri, Amrie C. Grammer, Peter E. Lipsky
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Research Article

Patient ancestry significantly contributes to molecular heterogeneity of systemic lupus erythematosus

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Abstract

Gene expression signatures can stratify patients with heterogeneous diseases, such as systemic lupus erythematosus (SLE), yet understanding the contributions of ancestral background to this heterogeneity is not well understood. We hypothesized that ancestry would significantly influence gene expression signatures and measured 34 gene modules in 1566 SLE patients of African ancestry (AA), European ancestry (EA), or Native American ancestry (NAA). Healthy subject ancestry-specific gene expression provided the transcriptomic background upon which the SLE patient signatures were built. Although standard therapy affected every gene signature and significantly increased myeloid cell signatures, logistic regression analysis determined that ancestral background significantly changed 23 of 34 gene signatures. Additionally, the strongest association to gene expression changes was found with autoantibodies, and this also had etiology in ancestry: the AA predisposition to have both RNP and dsDNA autoantibodies compared with EA predisposition to have only anti-dsDNA. A machine learning approach was used to determine a gene signature characteristic to distinguish AA SLE and was most influenced by genes characteristic of the perturbed B cell axis in AA SLE patients.

Authors

Michelle D. Catalina, Prathyusha Bachali, Anthony E. Yeo, Nicholas S. Geraci, Michelle A. Petri, Amrie C. Grammer, Peter E. Lipsky

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Figure 5

Association of corticosteroid (CS) use and immunosuppressive therapy with changes in gene expression profiles.

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Association of corticosteroid (CS) use and immunosuppressive therapy wit...
Female SLE patients (1566 patients; GSE88884) were separated by ancestry and GSVA scores for each cell type or process module in patients receiving each therapy and were compared with GSVA scores for each cell type or process module in patients taking all other therapies. The patient numbers are in parentheses. Sidak multiple comparisons test was used to determine significant differences between therapies. The mean difference in GSVA score related to the treatment is shown for therapies with P < 0.05. Two EA patients were receiving cyclophosphamide and are included in the immunosuppressive (IS) calculation for EA.

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