Race Differences in Immunogenetic Features and Photosensitivity of Cutaneous Lupus Erythematosus from the Aspect of Japanese Studies

Abstract

Skin lesions of collagen diseases are influenced by environmental triggers, such as UV light, and are variable in cutaneous lupus erythematosus (LE), such as systemic LE (SLE), chronic discoid LE (CDLE), subacute cutaneous LE (SCLE), and LE tumidus (LET). Although there are a few conflicting reports on photosensitivity in collagen diseases, many Japanese dermatologists feel there are photosensitivity differences in LE between Asians and Caucasians with SCLE and LET. To address this issue, we have carried out genetic studies of Japanese SLE and CDLE patients and reviewed the race differences in photosensitivity of cutaneous LE from Japanese studies. Human leukocyte antigen (HLA) studies in Japanese patients revealed that HLA-DRB1*1501 association was with CDLE and SLE. The association between HLA-Cw6 and CDLE was first reported in a Japanese population, and a HLA-A33-B44-DRB1*1302 haplotype showed a positive association in CDLE. However, these results are not compatible with those from Caucasian subjects. There are no significant associations among HLA studies, photosensitivity, and anti-Ro/SS-A antibodies in Japanese CLE patients. Photosensitivity will be a key factor to dissolve multifactorial complexes of LE etiopathogenesis. An axis of photosensitivity, anti-Ro/SS-A antibodies, and apoptosis via tumor necrosis factor-alpha is the best marker to verify the contribution of genetics in CLE patients. The incidence and degree of photosensitivity of SCLE and LET are much lower in Japanese than in Caucasians. This discrepancy may lead to investigations of CLE pathogenesis through global collaborations.

Association of discoid lupus erythematosus with clinical manifestations and damage accrual in a multiethnic lupus cohort

“…There is evidence that genetic and environmental factors are involved in the pathogenesis of this complex disease (11–16). Genetic associations have been reported in patients with CLE including polymorphisms of genes encoding HLA, TNF-α, and complement molecules (12–15).…”

Evaluation of the quality of life of lupus erythematosus patients with cutaneous lesions in Japan

“…Those patients with photosensitivity comprised 38.9% of all patients in our study (SLE: 18/34 cases, CLE: 2/15 cases), whereas a recent survey of Japanese patients revealed that 59% (49/83 cases) of SLE and 39% (12/31cases) of chronic discoid LE (CDLE) patients had photosensitivity, which was determined by standard clinical examinations, including the medical histories of the patients. 21 Biazar et al reported that 71.6% of 1002 patients with CLE (1001 from European countries and one from Brazil) were photosensitive according to the patients' history. 22 Previous reports demonstrated a weak correlation between a poor QOL with younger age, 2 but no connection between the QOL and current age.…”

The genetic contribution of HLA‐DRB5*01:01 to systemic lupus erythematosus in Thailand

“…Among Caucasians, an association with HLA‐DRB1*15:01 and DR3 has been observed (Grumet et al ., ; Davies et al ., ). A significant increase in HLA‐B1*15:01 has been observed in the Japanese (Dong et al ., ; Hashimoto et al ., ; Furukawa et al ., ), Korean (Hong et al ., ) and Taiwanese populations (Pan et al ., ). An association with HLA‐DRB5*01:01 also has been observed in Japanese populations (Hashimoto et al ., ).…”