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The Journal of Immunology, 2002, 169: 1604-1610.
Copyright © 2002 by The American Association of Immunologists

V75R576 IL-4 Receptor {alpha} Is Associated with Allergic Asthma and Enhanced IL-4 Receptor Function1

Kimberly A. Risma*, Ning Wang{dagger}, Ryan P. Andrews*, Christie M. Cunningham*, Mark B. Ericksen*, Jonathan A. Bernstein{ddagger}, Ranajit Chakraborty{dagger} and Gurjit K. Khurana Hershey2,*

* Division of Allergy and Immunology, Department of Pediatrics, Children’s Hospital Medical Center, Cincinnati, OH 45229; and {dagger} Center for Genome Information, Department of Environmental Health, and {ddagger} Division of Immunology, Department of Internal Medicine, University of Cincinnati Medical Center, Cincinnati, OH 45267


    Abstract
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Asthma is a complex polygenic disease. Many studies have implicated the importance of IL-4R{alpha} in the development of allergic inflammation and its gene has been implicated in the genetics of asthma and atopy. In this study, we examined the functional consequences of two of the human IL-4R{alpha} allelic variants that have been found to associate with asthma and atopy. We examined the effects of each variant alone and in combination on IL-4-dependent gene induction. We found that neither the Q576R nor the I75V variants affected IL-4-dependent CD23 expression. However, the combination of V75R576 resulted in expression of an IL-4R{alpha} with enhanced sensitivity to IL-4. We next examined the genetics of five of the known IL-4R{alpha} allelic variants in asthmatic and nonatopic populations. Strikingly, the association of V75/R576 with atopic asthma was greater than either allele alone and the association of R576 with atopic asthma was dependent on the coexistence of V75. A haplotype analysis revealed a single IL-4R{alpha} haplotype that was associated with allergic asthma, VACRS, further confirming the importance of the V75 and R576 combination in the genetics of asthma. This is the first report demonstrating that a functional alteration in IL-4R{alpha} requires the coexistence of two naturally occurring single nucleotide polymorphisms (snps) in combination; neither snp alone is sufficient. These data illustrate the importance of studying snps in combination, because the functional significance of a given snp may only be evident in a specific setting of additional snps in the same or different genes.


    Introduction
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Atopic disorders, including asthma, are very prevalent, affecting up to 40% of populations (1), and their incidence is on the rise (2). Although environmental factors are important in the development of atopy, there is a strong genetic predisposition. Children who have one parent with asthma have an ~25% chance of developing asthma, and those whose mother and father both have asthma may have as high as a 50% risk of disease (3). A study of 5864 Norwegian twins indicated that the relative risk of developing asthma was 17.9 among twins whose identical co-twin had a positive history of asthma, vs only 2.3 for fraternal twins (4). In another study of Finnish twins, in families where one of the parents was asthmatic, up to 87% of the susceptibility to asthma was explained by genetic influences (5). Among infants and young children who have wheezing with viral infections, a personal history or a family history of allergy is the factor most strongly associated with the development of asthma (6). Several genes and chromosomal regions have been linked to atopy and asthma, supporting the polygenic nature of these disorders.

IL-4, a pleiotropic cytokine produced by Th2 cells and mast cells, is a central mediator of allergic inflammation. Along with IL-13, it is the major cytokine responsible for the induction of IgE synthesis and, furthermore, IL-4 acts on Th0 cells to promote their differentiation into Th2 cells (7, 8). In hematopoietic cells, IL-4 exerts its activities by interacting with a specific cell surface receptor comprised of a binding component, IL-4R{alpha}, and the common {gamma}-chain, which is shared by multiple cytokine receptors. In the absence of the common {gamma}-chain, IL-4 can use the type II IL-4R, comprised of IL-4R{alpha} and the IL-13R{alpha}1 chain (9, 10). This receptor complex is also the cognate functional receptor for IL-13 (10). Although IL-13 shares many functions with IL-4, they also have distinct roles. In parasitic infection models, IL-13 has a critical role in the Th2-dependent expulsion of Nippostrongylus brasiliensis (11) and IL-13 appears to be more important than IL-4 in mucus hypersecretion (12). Furthermore, IL-13 has recently been shown to be a key mediator of the allergic response independent of IL-4 in mouse models whereby IL-13 blockade prevented allergen-induced airway hyperresponsiveness (13, 14).

The genes for both IL-4 (15, 16) and IL-13 (17, 18) have been associated with asthma and atopy. Both IL-4 and IL-13 use the {alpha}-chain of the IL-4R (IL-4R{alpha}) as a part of their respective receptor systems. The gene for IL-4R{alpha} represents an ideal candidate gene for atopy susceptibility because of: 1) its pivotal role in both IL-4 and IL-13 signaling, 2) its key role in allergic inflammation by promoting IgE production and Th2 cell development, and 3) its location on chromosome 16, which has been linked to asthma (19). Eight naturally occurring allelic variants of IL-4R{alpha} have been reported (20), and several of these have been associated with atopy (21, 22). These variants occur as the result of single nucleotide polymorphisms (snps)3 in the coding sequence of the gene for IL-4R{alpha} that result in single amino acid changes. Two of the IL-4R{alpha} allelic variants that have been associated in multiple studies with asthma and atopy are the I75V and Q576R polymorphisms (numbering including the 25-aa signal peptide) (21, 22). These variants have been also been referred to as I50V and Q551R in other studies that used numbering beginning with the mature protein (23). Our laboratory found that the presence of the R576 allele correlated with the severity of asthma, and there appeared to be a gene dosage effect (24). However, studies in other populations have failed to find an association of atopy with these IL-4R{alpha} variants (25, 26).

To understand the biologic consequences of these variants, it is important to examine their functional consequences. Although studies have been done examining the functional consequences of a particular polymorphism in IL-4R{alpha} in isolation (21, 26, 27, 28), no studies thus far have examined the functional consequences of IL-4R{alpha} polymorphisms in combination as they occur in nature. Both the Q576R and I75V polymorphisms are common and occur in combination in the general population. Herein, we carefully examine the functional consequences of these polymorphisms alone and in combination. Furthermore, we also determine the allele frequencies of several IL-4R{alpha} polymorphic variants alone and in combination to elucidate relationships between the genetics and the biology of IL-4R{alpha} variants in atopic and nonatopic populations.


    Materials and Methods
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Subjects

Two hundred unrelated adult asthmatic patients were prospectively recruited from allergy offices affiliated with the University of Cincinnati Medical Center (Cincinnati, OH). Asthma was diagnosed in accordance with the American Thoracic Society criteria by demonstrating a 12% or greater increase in FEV1 after a bronchodilator or after a 2-wk trial of oral corticosteroids (29, 30). Pulmonary function testing was performed according to the 1994 revised American Thoracic Society guidelines using Pneumedics Dataloop (Norwalk, CT) (30). Subjects underwent skin prick testing including positive and negative controls and a panel of 14 common environmental Ags indigenous to the Ohio valley (ALK Laboratories, Wallingford, CT). They were instructed to discontinue antihistamines before skin testing in accordance with the published guidelines (31). Patients were divided into atopic and nonatopic groups based on the results of the skin tests. Those with positive reactions (>=3 mm wheal with erythema) to 1 or more Ags tested were designated atopic. There were equal proportions (24%) of smokers (past or present history) in the atopic and nonatopic asthma groups, and there were no significant differences in smoking between the genotypic groups. For the nonatopic, nonasthmatic control group, healthy, unrelated volunteers were prospectively recruited from the employee pool of University of Cincinnati Medical Center and Children’s Hospital Medical Center (Cincinnati, OH). Individuals were excluded from this group if they reported a history of allergies, asthma, chronic cough, chronic obstructive pulmonary disease, or smoking. They underwent skin prick testing as outlined above, and those who demonstrated no positive reactions (excluding histamine) were included in the control group. Informed consent was obtained from all participants in these studies. These studies were approved by the Children’s Hospital Medical Center Institutional Review Board.

Cells and reagents

A201.1 murine B cells, a gift from Dr. G. Milligan (Children’s Hospital Medical Center), are derived from the parent line A20. The cells are B220+IgG+Ia+IgA-IgM-IgD- and were originally derived from a BALB/c mouse. Cells were maintained in complete RPMI, consisting of RPMI 1640 (Life Technologies, Grand Island, NY) supplemented with 10% FBS (Life Technologies), 2 mM L-glutamine (BioWhittaker, Walkersville, MD), 100 U/ml penicillin, 100 µg/ml streptomycin (BioWhittaker), and 50 µM 2-ME (Sigma-Aldrich, St. Louis, MO). Recombinant human and mouse IL-4 were purchased from R&D Systems (Minneapolis, MN). Polyclonal anti-Stat6 Ab, S-20, was purchased from Santa Cruz Biotechnology (Santa Cruz, CA). FITC-coupled anti-murine CD23 Ab was purchased from BD PharMingen (San Diego, CA). [{gamma}-32P]ATP was purchased from NEN (Boston, MA). FITC-conjugated goat anti-rabbit IgG was purchased from Southern Biotechnology Associates (Birmingham, AL).

cDNA constructs, site-directed mutagenesis, and expression vectors

Human IL-4R{alpha} cDNA, obtained from Dr. J. Ryan (Virginia Commonwealth University, Richmond, VA), was subcloned into the mammalian expression vector pREP9 (Invitrogen, Carlsbad, CA). Site-directed mutagenesis was performed using the Quickchange mutagenesis kit from Stratagene (La Jolla, CA) according to the manufacturer’s instructions. To generate the construct encoding R576, the primers were 5'-CCACTGGCTATCGGGAGTTTGTACATGCGGTGGAGCAGG-3' and its reverse complement, 5'-CCTGCTCCACCGCATGTACAAACTCCCGATAGCCACTGG-3'. For Val75, the primers used were 5'-GCCCACACGTGTGTCCCTGAGAACAACGG-3' and its reverse complement, 5'-CCGTTGTTCTCAGGGACACACGTGTGGGC-3'. The cDNA constructs were verified by DNA sequencing before transfection.

Transfection

A total of 5 x 106 A201.1 cells were washed, resuspended in RPMI containing 20 µg of uncut pREP9.humanIL-4R{alpha} and pulsed with a Genepulser II electroporation device (Bio-Rad, Melville, NY) set at 960 µF and 200 V. After electroporation, cells were grown for 24 h in 10 ml complete RPMI, then selected for resistance to neomycin (G418 sulfate; BioWhittaker) at 1000 µg/ml for 12–21 days, respectively. Cell populations were screened by flow cytometry for CD23 surface expression in response to stimulation with human IL-4 (10 ng/ml) for 48 h and/or by staining with anti-IL-13R{alpha}1-FITC Ab. Positive transfectant pools were cloned by limiting dilution.

Scatchard analysis

Scatchard analyses were done as previously described (32). 125I-labeled recombinant human IL-4 was obtained from NEN.

EMSA

EMSA assays were performed as previously described (33). A 100-fold excess of unlabeled nucleotide (20 ng) was used in cold competition samples, and 1 µl of anti-Stat6 polyclonal Ab was added to supershift samples.

Flow cytometry

A201.1 cells (5 x 105) were washed in cold PBS with 1% FBS and stained with FITC-conjugated anti-mouse CD23 Ab (BD PharMingen) in the presence of anti-FcR Ab 2.4G2 (BD PharMingen) for 30 min on ice. Cells were washed in cold PBS with 1% FBS and analyzed on a FACScan or FACSVantage instrument (BD Biosciences, San Jose, CA).

Immunoprecipitation and immunoblotting

A201.1 cells (2 x 107) were pelleted by centrifugation at 20,000 x g at 4°C and reconstituted in immunoprecipitation lysis buffer (50 mM Tris (pH 8), 150 mM NaCl, 1% Nonidet P-40, 1 mM PMSF, 10 µg/ml leupeptin, 10 µg/ml aprotinin, 5 mM iodoacetamide, 1 mM sodium orthovanadate, 20 mM NaF, 1 mM EDTA). Cells were incubated on ice for 30 min and lysates were clarified by centrifugation at 20,000 x g for 20 min at 4°C. Soluble Stat6 was immunoprecipitated with anti-Stat6 polyclonal Ab followed by protein A/G plus agarose (Santa Cruz Biotechnology) as previously described (32). Briefly, precipitates were washed three times in immunoprecipitation lysis buffer, reconstituted in Laemmli buffer, and resolved by electrophoresis on 10% SDS-PAGE gels.

Proteins were transferred to nitrocellulose membranes and blocked overnight in block solution (20 mM Tris (pH 7.4), 150 mM NaCl, 3.1% BSA, 0.1% polyethylene glycol). Membranes were probed with anti-phosphotyrosine mAb PY20 (BD Transduction Laboratories, Lexington, KY) or anti-Stat6 polyclonal Ab. Bound Abs were detected by incubation with anti-mouse or anti-rabbit IgG Abs conjugated to HRP (BD Transduction Laboratories) followed by ECL using ECL substrate (Amersham, Arlington Heights, IL).

Genotyping of IL-4R{alpha} snps

Genomic DNA was isolated from EDTA anti-coagulated whole blood using the GenomicPrep kit from Amersham Pharmacia Biotech (Piscataway, NJ). The Q576R and S786P variants were genotyped as previously described (24, 28). For the I75V snp, we attempted to use the primers and assay conditions described by Mitsuyasu et al. (21) to genotype the I75 and V75 alleles; however, we obtained ambiguous results with their protocol. Another Japanese group reported similar difficulties with this assay (25). The difficulty in distinguishing between these alleles stems from the proximity of the responsible missense mutation next to a splice acceptor site. Thus, to reliably distinguish between these alleles, we determined the intronic sequence upstream to the exon containing the I75V substitution. Using a proximal exonic 5' primer, we PCR amplified a 4-kb intron from genomic DNA. We sequenced this intron and designed primers using a 5' intronic primer (5'-GGAAGAGTCTGATGCGGTTCC-3') and a downstream 3' exonic primer (5'-CAGCCCACAGGTCCAGTGTATAG-3') to amplify a 207-bp segment containing the I75V mutation. Subsequent digestion of this fragment with MslI readily distinguished between the I75 and V75 variants, because the V75 mutation generates an additional MslI site. For genotyping of the E400A snp, the following primers were used: sense, 5'-CGTCTGCCTGTTGTGCTATGTCAG-3'; and antisense, 5'-AAAAGCCCCCATTCTCCTCTCC-3'. The 530-bp product was digested with Cac8I, which cuts twice in the R400 allele but only once in the C400 allele. For the C431R allele, the following primers were used: sense, 5'-GAAAAAGGGAGCTTCTGTGCATC-3'; and antisense, 5'-CGTCTCTGTGCAAGTCAGGTTGTC-3'. The 324-bp product was then digested with Tsp451, which cuts only in the presence of the R431 allele.

Statistical analyses

Fisher’s exact or {chi}2 tests were used to test for statistically significant differences in snp allele frequencies between patients and controls.

There are two main existing algorithms for inferring haplotypes based on unrelated genotype data of populations: one is described by Clark (34), and another is based on the expectation maximization algorithm (35, 36, 37). However, both algorithms have their limitations. For Clark’s method (34), its reliability needs to be improved when the level of recombination is large. In the expectation maximization algorithm, although assumptions such as random mating in the sample population are required, it also allows a "free" recombination scheme. Therefore, we used a new algorithm in the present studies to infer haplotypes. This algorithm begins with the four-gametes test to identify segments where no recombination has occurred, and the individual haplotype of each segment can be obtained quickly and reliably. Then the individual haplotypes combining all segments can be obtained by using the maximum parsimony principle. Frequencies of haplotypes at the population level, which can explain all individuals, are calculated by gene-counting method. This algorithm can also provide detailed recombination information among all pairs of loci.

The inferred haplotype frequencies between groups were analyzed in a 2 x C contingency table, where the {chi}2 goodness-of-fit statistics were calculated, and the significance was evaluated by exact test using shuffling method (generated by 104 random permutations of the data).


    Results
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Generation of stable transfectants expressing IL-4R{alpha} variants

To elucidate the functional consequences of specific IL-4R{alpha} amino acid substitutions, we developed an in vitro transfection model system. IL-4 is absolutely species specific; thus, human IL-4 binds only to human IL-4R{alpha} and not to murine IL-4R{alpha}, and murine IL-4 binds only to murine IL-4R{alpha} (38). Furthermore, murine cells transfected with human IL-4R{alpha} cDNA gain the ability to bind and respond to human IL-4 (39). We transfected the wild-type human IL-4R{alpha} cDNA into the murine B cell lymphoma cell line A201.1. We chose the A201.1 cells for our studies because they displayed a strong positive response to murine IL-4 (Fig. 1GoB). Transfected cells acquired the ability to respond to human IL-4, while untransfected cells remained responsive only to murine IL-4. The transfectant pools were cloned by limiting dilution and the clones were stable over time (Fig. 1GoB). We generated human IL-4R{alpha} cDNA constructs encoding the different I75V and Q576R variant combinations by site-directed mutagenesis as shown schematically in Fig. 1GoA. The constructs were transfected into A201.1 cells and a minimum of three clones were obtained expressing each of the variant IL-4R{alpha} combinations.



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FIGURE 1. A, Schematic depiction of human IL-4R{alpha} cDNA constructs used for transfection. B, Transfection of murine A201.1 cells with wild-type human IL-4R{alpha} cDNA renders them responsive to human IL-4. A201.1 cells were transfected with 20 µg of human IL-4R{alpha} cDNA in the expression vector, pREP9. After undergoing antibiotic selection, the transfectants were tested for their ability to respond to human and murine IL-4. Cells were incubated for 48 h in the presence of medium alone (dotted line), 50 ng/ml human IL-4 (thick line), or 50 ng/ml murine IL-4 (thin line) for 48 h, and then assayed for CD23 expression by flow cytometry using a FITC-labeled anti-CD23. C, Scatchard analysis of 125I-labeled recombinant human IL-4 binding to murine A201.1 cells transfected with human IL-4R{alpha}. Two representative clones are depicted which express the IQ, wild-type, (•) or VQ ({blacksquare}) HuIL-4R{alpha} constructs. Both clones expressed 1600–1900 receptors per cell with a Kd of 1.5–2 x 10-9 M-1.

 
Treatment of A201.1 cells with IL-4 results in the induction of CD23 expression. CD23 expression in transfectants was nearly equivalent following stimulation with human and murine IL-4, demonstrating that the expression of human IL-4R{alpha} on the transfectants approximated that of the endogenous murine receptor. To ensure that the transfectants express similar levels of IL-4R{alpha}, we confirmed near equal levels of human IL-4R{alpha} expression by Scatchard analyses (Fig. 1GoC and data not shown). All clones expressed similar levels of surface human IL-4R{alpha}. Approximately 1600–1900 receptors per cell were detected and displayed a Kd of 1.5–2 x 10-9 M-1 regardless of the amino acid substitutions. Thus, the I75V and Q576R amino acid substitutions do not alter the binding affinity of IL-4R{alpha}.

V75R576 IL-4R{alpha} is associated with enhanced receptor sensitivity to IL-4

Next we investigated whether there were any differences in the sensitivity of IL-4-dependent gene induction among the various transfectants. Neither the Q576R (Fig. 2GoA) nor the I75V (Fig. 2GoB) substitution alone altered IL-4-dependent CD23 induction. However, the combination of V75 and R576 together resulted in enhanced receptor function as evidenced by increased sensitivity to IL-4 (Fig. 2GoC). The half-maximal dose for IQ, VQ, and IR were 0.6, 0.6, and 1.2 ng/ml, respectively, while the half-maximal dose for the VR transfectants was 0.22 ng/ml. While the maximal levels of CD23 induction by IL-4 achieved were similar in all the transfectants, increased sensitivity was observed in the presence of the VR combination with a 3- to 5-fold shift in the dose-response curve.



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FIGURE 2. The V75R576 combination IL-4R{alpha} polymorphic variant, but not I75 or R576 alone, is associated with enhanced IL-4 responsiveness. A, Three distinct A201.1 transfectant clones expressing either the wild-type I75Q576 ({circ}) or the I75R576 (•) IL-4R{alpha} variant were treated with increasing doses of IL-4 for 48 h and then assayed for CD23 expression by flow cytometry using a FITC-labeled anti-CD23 Ab. CD23 expression is represented as a percentage of the maximal response achieved with murine IL-4 through the endogenous receptor. The results are expressed as the means and SDs (error bars) of three experiments analyzing three clones expressing each transfectant variant. B, A comparison of I75Q576 ({circ}) and V75Q576 (•) transfectants analyzed in the same fashion as in A. C, A comparison of I75R576 ({circ}) and V75R576 (•) transfectants analyzed in the same fashion as in A. *, Statistically significant differences.

 
Analysis of I75V and Q576R human IL-4R{alpha} snps in asthmatic and nonasthmatic populations

Next we examined how the functional data that we had obtained correlated with the genetics of IL-4R{alpha} in asthmatic populations. We have previously shown that the Q576R IL-4R{alpha} variant is significantly associated with atopy (22) and with the severity of asthma (24). However, the R576 mutation only resulted in enhanced IL-4R{alpha} function in the context of a valine at position 75. Thus, we hypothesized that we would see a similar association between V75 and R576 in a group of asthmatic and nonatopic individuals. We genotyped a group of asthmatic (n = 200) and nonatopic controls (n = 65) for I75V and Q576R. The asthmatic individuals were further subdivided into allergic and nonallergic groups based on the results of skin prick testing to 14 common environmental Ags. By this criteria, 145 (72.5%) of the 200 asthmatics were atopic and 55 (27.5%) were nonatopic, which approximates published reports on the prevalence of atopy in asthmatic patients (40, 41). The data are summarized in Table IGo. The I75V and Q576R polymorphisms were not in linkage disequilibrium. Q576R was significantly associated with atopic asthma (p = 0.015) but not nonatopic asthma. We found no association between I75V alone and either atopic or nonatopic asthma.


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Table I. Allele frequencies (%) of Q576R and I75V IL-4R{alpha} snps in atopic and nonatopic populations

 
Next we examined pairwise combinations of the I75V and Q576R alleles (Table IIGo). We have found seven individuals who are homozygous for both V75 and R576, supporting the natural occurrence of this combination. In our transfectant data, we found that the VR combination IL-4R{alpha} was associated with enhanced IL-4-dependent CD23 expression. To investigate whether the VR combination was also significantly associated with asthma, we reasoned that the V75 and R576 would need to be in the same IL-4R{alpha} protein. Thus, we divided the subjects into two groups: individuals with at least a VR combination (VV/QR, IV/RR, VV/RR) and those without a VR combination (II/RR, IV/QQ, II/QQ, II/QR, or VV/QQ). The heterozygote individuals (IV/QR) in whom the V75 and R576 may or may not occur in the same receptor protein were excluded from this analysis. We then examined the percentage of individuals in these groups with atopic or nonatopic asthma (Table IIGo). Strikingly, we only observed a significant association with atopic asthma in the presence of the VR combination. When we examined the genotypes that yielded the IR combination IL-4R{alpha} (II/QR, IV/RR, II/RR), the association of R576 was barely significant (p = 0.04). Thus, the association of V75/R576 with atopic asthma was greater than either allele alone and the association of R576 with atopic asthma is dependent on the coexistence of a valine at position 75.


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Table II. Pairwise combinations of I75V and Q576R alleles1

 
Haplotype analysis of IL-4R{alpha} snps

Next, we wanted to better characterize the genetics of the IL-4R{alpha} snps and determine the most frequent haplotypes that were associated with asthma in this population. To do this, we genotyped 193 of the asthmatic individuals (140 atopic and 53 nonatopic) and 56 of the nonatopic controls for five known polymorphic variants in IL-4R{alpha} including I75V, E400A, C431R, Q576R, and S786P. The data summarizing the allele frequencies of each of these allelic variants in our populations are shown in Table IIIGo. The R576 allele was significantly associated with atopic asthma (p = 0.015), but no significant associations were observed with any of the other alleles.


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Table III. Allele frequencies of human IL-4R{alpha} polymorphic variants

 
To determine the most frequent IL-4R{alpha} haplotypes observed in these populations, a haplotype analysis was performed (Table IVGo). Only one haplotype was found to be significantly associated with atopic asthma and that was haplotype 6, VACRS (V75, A400, C431, R576, S786). This further confirms that the V at position 75 and the R at position 576 are important. The other positions contain the wild-type amino acids, except the alanine at position 400 (from a glutamic acid). Thus, this amino acid may act in a concerted manner with the V75 and R576 combination.


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Table IV. Haplotype frequencies of IL-4R{alpha} haplotypes in asthma (atopic and nonatopic) and controls

 

    Discussion
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Asthma is a major health concern in the U.S. and worldwide. It is the most common chronic disease of childhood (1) and its incidence is on the rise (2). Considerable effort is taking place to delineate the mediators of allergic inflammation, specifically asthma. Elucidating the genetics of atopy is complicated by the presence of multiple genes, disease-modifying environmental and genetic factors, and population heterogeneity. As the pool of candidate genes for atopy and asthma continues to grow, it is critical that the functional consequences of these genes are examined. Herein, we demonstrate for the first time that the V75R576 combination IL-4R{alpha} is associated with enhanced IL-4R{alpha} function. Transfectants expressing the V75R576 IL-4R{alpha} displayed enhanced sensitivity to IL-4. Neither the V75 nor the R576 alone was associated with altered IL-4R{alpha} function. This observation is of wide general significance because it illustrates the importance of examining the functional consequences of snps in combination. A given snp may only be relevant in the context of a second or a combination of additional snps in the same gene or other genes. Furthermore, a given snp may have no effect individually or in combination with a different set of snps. Genetic association studies have often been difficult to interpret due to poor reproducibility in other populations. One reason for this may be that a given genetic variant may not be important unless it is in the context of a second snp or additional snps. This would contribute to disparate results in different populations.

We examined the frequencies of the I75V and Q576R polymorphisms in a population of asthmatic and control individuals and found that the V75R576 combination was significantly associated with atopic asthma in a group of patients with asthma. Furthermore, the association of V75 and R576 combination with asthma was greater than the V75 or R576 alleles alone. This agreed well with the functional data in our transfectants where we found that the VR combination was associated with an enhancement of IL-4R{alpha} function that was greater that either the V75 or R576 IL-4R{alpha} alone. Our data agree with previous reports, which found no change in IL-4R{alpha} function with the Q576R polymorphism alone (27). We performed a haplotype analysis to identify the haplotypes that occurred in our populations and to determine which, if any, of these haplotypes were associated with atopy and/or asthma. We found that only haplotype was associated with atopic asthma in our group, VACRS. The haplotype analysis that we used has the advantage that it does not use a free recombination model and thus is not dependent on Hardy-Weinberg equilibrium. Haplotype analysis done in other populations have also revealed significant associations between IL-4R{alpha} haplotypes and asthma (23). It will be important to study the functional consequences of each of these associated haplotypes to elucidate the mechanisms underlying the genetic associations and to verify the biologic relevance of these associations. If there is no functional alteration in the context of the implicated haplotype, there maybe a linkage disequilibrium with yet unidentified polymorphisms, as suggested previously (23).

Because IL-4R{alpha} is also a component of the IL-13R complex, it is important to examine the impact of the atopy-associated IL-4R{alpha} polymorphisms and haplotypes on IL-13 function. It remains possible that the effect of the implicated IL-4R{alpha} polymorphisms and haplotypes may be more pronounced on IL-13 signaling given the central importance of IL-13 in the development of asthma (13, 14). This is further supported by the recent report demonstrating interactive genetic effects between snps in IL-4R{alpha} and the IL-13 promoter (42). Relatively modest changes in IL-4R{alpha} function coupled with increases in ligand (IL-13) production by promoter polymorphisms (17, 18) or ligand (IL-13) activity by polymorphisms in the coding sequence (17) may result in a large enough functional change to be biologically and genetically relevant. Interpretation of functional studies of snps are difficult because any one snp in isolation or even any combination of snps in a single gene may lead to only a modest change in function. However, combination of this modest change with additional changes in gene products in the same pathway may result in a significant biologic alteration. We have recently developed an in vitro model system to study IL-13 signaling (33) and are currently using this model to study the effects of atopy-associated IL-4R{alpha} allelic variants on IL-13 signaling.

Delineating the mechanisms underlying genetic associations with atopy is critical to our understanding of the pathogenesis of atopic disorders. In this report, we investigated the functional effects of 2 IL-4R{alpha} snps in isolation and in combination. It is currently unclear how the receptor mutations result in altered gene induction. Studies are under way to explore this. Our initial experiments demonstrate that the mechanism is more complex than a simple change in Stat6 activation levels (our unpublished observations). Receptor activation may lead to the activation of a nuclear phosphatase or another protein that directly effects the life cycle of Stat6. Although important questions remain, our data provide novel insights into the molecular mechanisms of two atopy-associated IL-4R{alpha} snps and into the IL-4 signaling.


    Acknowledgments
 
We are grateful to Drs. Marc E. Rothenberg, Jeffrey A. Whitsett, and Fred D. Finkelman for critical review of the manuscript. We thank Connie Petitt for excellent secretarial support.


    Footnotes
 
1 This work was supported by National Institutes of Health Grant R01AI46652-01A1 and a Basil O’Connor Starter Scholar Research Award from the March of Dimes. Back

2 Address correspondence and reprint requests to Dr. Gurjit K. Khurana Hershey, Division of Allergy and Immunology, Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229. E-mail address: Gurjit.Hershey{at}chmcc.org Back

3 Abbreviation used in this paper: snp, single nucleotide polymorphism. Back

Received for publication April 19, 2002. Accepted for publication May 17, 2002.


    References
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 

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