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Genetics and functional genomics of multiple sclerosis

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Abstract

Multiple sclerosis (MS) is an inflammatory neurodegenerative disease with genetic predisposition. Over the last decade, genome-wide association studies with increasing sample size led to the discovery of robustly associated genetic variants at an exponential rate. More than 200 genetic loci have been associated with MS susceptibility and almost half of its heritability can be accounted for. However, many challenges and unknowns remain. Definitive studies of disease progression and endophenotypes are yet to be performed, whereas the majority of the identified MS variants are not yet functionally characterized. Despite these shortcomings, the unraveling of MS genetics has opened up a new chapter on our understanding MS causal mechanisms.

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References

  1. Thompson AJ, Baranzini SE, Geurts J, Hemmer B, Ciccarelli O (2018) Multiple sclerosis. Lancet 391:1622–1636

    Article  PubMed  Google Scholar 

  2. Loma I, Heyman R (2011) Multiple sclerosis: pathogenesis and treatment. Curr Neuropharmacol 9:409–416

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Walton C, King R, Rechtman L, Kaye W, Leray E, Marrie RA, Robertson N, La Rocca N, Uitdehaag B, van der Mei I, Wallin M, Helme A, Angood Napier C, Rijke N, Baneke P (2020) Rising prevalence of multiple sclerosis worldwide: insights from the Atlas of MS, third edition. Mult Scler 26:1816–1821

    Article  PubMed  PubMed Central  Google Scholar 

  4. Collaborators GBDMS (2019) Global, regional, and national burden of multiple sclerosis 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 18:269–285

    Article  Google Scholar 

  5. Ramagopalan SV, Dobson R, Meier UC, Giovannoni G (2010) Multiple sclerosis: risk factors, prodromes, and potential causal pathways. Lancet Neurol 9:727–739

    Article  PubMed  Google Scholar 

  6. Urru SA, Antonelli A, Sechi GM, Group MSW (2020) Prevalence of multiple sclerosis in Sardinia: a systematic cross-sectional multi-source survey. Mult Scler 26:372–80

    Article  PubMed  Google Scholar 

  7. Handel AE, Giovannoni G, Ebers GC, Ramagopalan SV (2010) Environmental factors and their timing in adult-onset multiple sclerosis. Nat Rev Neurol 6:156–166

    Article  PubMed  Google Scholar 

  8. Filippi M, Bar-Or A, Piehl F, Preziosa P, Solari A, Vukusic S, Rocca MA (2018) Multiple sclerosis. Nat Rev Dis Primers 4:43

    Article  PubMed  Google Scholar 

  9. Patsopoulos NA (2018) Genetics of multiple sclerosis: an overview and new directions. Cold Spring Harb Perspect Med 8:a028951

    Article  PubMed  PubMed Central  Google Scholar 

  10. Willer CJ, Dyment DA, Risch NJ, Sadovnick AD, Ebers GC, Canadian Collaborative Study G (2003) Twin concordance and sibling recurrence rates in multiple sclerosis. Proc Natl Acad Sci U S A 100:12877–82

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Compston A, Coles A (2002) Multiple sclerosis. Lancet 359:1221–1231

    Article  PubMed  Google Scholar 

  12. Nielsen NM, Westergaard T, Rostgaard K, Frisch M, Hjalgrim H, Wohlfahrt J, Koch-Henriksen N, Melbye M (2005) Familial risk of multiple sclerosis: a nationwide cohort study. Am J Epidemiol 162:774–778

    Article  PubMed  Google Scholar 

  13. Westerlind H, Ramanujam R, Uvehag D, Kuja-Halkola R, Boman M, Bottai M, Lichtenstein P, Hillert J (2014) Modest familial risks for multiple sclerosis: a registry-based study of the population of Sweden. Brain 137:770–778

    Article  PubMed  PubMed Central  Google Scholar 

  14. Ristori G, Cannoni S, Stazi MA, Vanacore N, Cotichini R, Alfo M, Pugliatti M, Sotgiu S, Solaro C, Bomprezzi R, Di Giovanni S, Figa Talamanca L, Nistico L, Fagnani C, Neale MC, Cascino I, Giorgi G, Battaglia MA, Buttinelli C, Tosi R, Salvetti M (2006) Multiple sclerosis in twins from continental Italy and Sardinia: a nationwide study. Ann Neurol 59:27–34

    Article  PubMed  Google Scholar 

  15. Bertrams J, Kuwert E, Liedtke U (1972) HL-A antigens and multiple sclerosis. Tissue Antigens 2:405–408

    Article  CAS  PubMed  Google Scholar 

  16. Matzaraki V, Kumar V, Wijmenga C, Zhernakova A (2017) The MHC locus and genetic susceptibility to autoimmune and infectious diseases. Genome Biol 18:76

    Article  PubMed  PubMed Central  Google Scholar 

  17. Winchester R, Ebers G, Fu SM, Espinosa L, Zabriskie J, Kunkel HG (1975) B-cell alloantigen Ag 7a in multiple sclerosis. Lancet 2:814

    Article  CAS  PubMed  Google Scholar 

  18. Naito S, Namerow N, Mickey MR, Terasaki PI (1972) Multiple sclerosis: association with HL-A3. Tissue Antigens 2:1–4

    Article  CAS  PubMed  Google Scholar 

  19. Jersild C, Fog T, Hansen GS, Thomsen M, Svejgaard A, Dupont B (1973) Histocompatibility determinants in multiple sclerosis, with special reference to clinical course. Lancet 2:1221–1225

    Article  CAS  PubMed  Google Scholar 

  20. Haines JL, Terwedow HA, Burgess K, Pericak-Vance MA, Rimmler JB, Martin ER, Oksenberg JR, Lincoln R, Zhang DY, Banatao DR, Gatto N, Goodkin DE, Hauser SL (1998) Linkage of the MHC to familial multiple sclerosis suggests genetic heterogeneity. The Multiple Sclerosis Genetics Group. Hum Mol Genet 7:1229–1234

    Article  CAS  PubMed  Google Scholar 

  21. Compston DA, Batchelor JR, McDonald WI (1976) B-lymphocyte alloantigens associated with multiple sclerosis. Lancet 2:1261–1265

    Article  CAS  PubMed  Google Scholar 

  22. Olerup O, Hillert J (1991) HLA class II-associated genetic susceptibility in multiple sclerosis: a critical evaluation. Tissue Antigens 38:1–15

    Article  CAS  PubMed  Google Scholar 

  23. Hollenbach JA, Oksenberg JR (2015) The immunogenetics of multiple sclerosis: a comprehensive review. J Autoimmun 64:13–25

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Barcellos LF, Oksenberg JR, Green AJ, Bucher P, Rimmler JB, Schmidt S, Garcia ME, Lincoln RR, Pericak-Vance MA, Haines JL, Hauser SL, Genetics MS, G. (2002) Genetic basis for clinical expression in multiple sclerosis. Brain 125:150–158

    Article  CAS  PubMed  Google Scholar 

  25. Ebers GC, Kukay K, Bulman DE, Sadovnick AD, Rice G, Anderson C, Armstrong H, Cousin K, Bell RB, Hader W, Paty DW, Hashimoto S, Oger J, Duquette P, Warren S, Gray T, O’Connor P, Nath A, Auty A, Metz L, Francis G, Paulseth JE, Murray TJ, Pryse-Phillips W, Nelson R, Freedman M, Brunet D, Bouchard JP, Hinds D, Risch N (1996) A full genome search in multiple sclerosis. Nat Genet 13:472–476

    Article  CAS  PubMed  Google Scholar 

  26. Sawcer S, Jones HB, Feakes R, Gray J, Smaldon N, Chataway J, Robertson N, Clayton D, Goodfellow PN, Compston A (1996) A genome screen in multiple sclerosis reveals susceptibility loci on chromosome 6p21 and 17q22. Nat Genet 13:464–468

    Article  CAS  PubMed  Google Scholar 

  27. International Multiple Sclerosis Genetics C, Hafler DA, Compston A, Sawcer S, Lander ES, Daly MJ, De Jager PL, de Bakker PI, Gabriel SB, Mirel DB, Ivinson AJ, Pericak-Vance MA, Gregory SG, Rioux JD, McCauley JL, Haines JL, Barcellos LF, Cree B, Oksenberg JR, Hauser SL (2007) Risk alleles for multiple sclerosis identified by a genomewide study. N Engl J Med 357:851–862

    Article  Google Scholar 

  28. Wiendl H, Gross CC (2013) Modulation of IL-2Ralpha with daclizumab for treatment of multiple sclerosis. Nat Rev Neurol 9:394–404

    Article  CAS  PubMed  Google Scholar 

  29. Barata JT, Durum SK, Seddon B (2019) Flip the coin: IL-7 and IL-7R in health and disease. Nat Immunol 20:1584–1593

    Article  CAS  PubMed  Google Scholar 

  30. Gregory SG, Schmidt S, Seth P, Oksenberg JR, Hart J, Prokop A, Caillier SJ, Ban M, Goris A, Barcellos LF, Lincoln R, McCauley JL, Sawcer SJ, Compston DA, Dubois B, Hauser SL, Garcia-Blanco MA, Pericak-Vance MA, Haines JL, Genetics MS, G. (2007) Interleukin 7 receptor alpha chain (IL7R) shows allelic and functional association with multiple sclerosis. Nat Genet 39:1083–1091

    Article  CAS  PubMed  Google Scholar 

  31. Lundmark F, Duvefelt K, Iacobaeus E, Kockum I, Wallstrom E, Khademi M, Oturai A, Ryder LP, Saarela J, Harbo HF, Celius EG, Salter H, Olsson T, Hillert J (2007) Variation in interleukin 7 receptor alpha chain (IL7R) influences risk of multiple sclerosis. Nat Genet 39:1108–1113

    Article  CAS  PubMed  Google Scholar 

  32. Comabella M, Craig DW, Camina-Tato M, Morcillo C, Lopez C, Navarro A, Rio J, Biomarker MSSG, Montalban X, Martin R (2008) Identification of a novel risk locus for multiple sclerosis at 13q31.3 by a pooled genome-wide scan of 500,000 single nucleotide polymorphisms. PLoS One 3:e3490

    Article  PubMed  PubMed Central  Google Scholar 

  33. Aulchenko YS, Hoppenbrouwers IA, Ramagopalan SV, Broer L, Jafari N, Hillert J, Link J, Lundstrom W, Greiner E, Dessa Sadovnick A, Goossens D, Van Broeckhoven C, Del-Favero J, Ebers GC, Oostra BA, van Duijn CM, Hintzen RQ (2008) Genetic variation in the KIF1B locus influences susceptibility to multiple sclerosis. Nat Genet 40:1402–1403

    Article  CAS  PubMed  Google Scholar 

  34. Baranzini SE, Wang J, Gibson RA, Galwey N, Naegelin Y, Barkhof F, Radue EW, Lindberg RL, Uitdehaag BM, Johnson MR, Angelakopoulou A, Hall L, Richardson JC, Prinjha RK, Gass A, Geurts JJ, Kragt J, Sombekke M, Vrenken H, Qualley P, Lincoln RR, Gomez R, Caillier SJ, George MF, Mousavi H, Guerrero R, Okuda DT, Cree BA, Green AJ, Waubant E, Goodin DS, Pelletier D, Matthews PM, Hauser SL, Kappos L, Polman CH, Oksenberg JR (2009) Genome-wide association analysis of susceptibility and clinical phenotype in multiple sclerosis. Hum Mol Genet 18:767–778

    Article  CAS  PubMed  Google Scholar 

  35. De Jager PL, Jia X, Wang J, de Bakker PI, Ottoboni L, Aggarwal NT, Piccio L, Raychaudhuri S, Tran D, Aubin C, Briskin R, Romano S, International MSGC, Baranzini SE, McCauley JL, Pericak-Vance MA, Haines JL, Gibson RA, Naeglin Y, Uitdehaag B, Matthews PM, Kappos L, Polman C, McArdle WL, Strachan DP, Evans D, Cross AH, Daly MJ, Compston A, Sawcer SJ, Weiner HL, Hauser SL, Hafler DA, Oksenberg JR (2009) Meta-analysis of genome scans and replication identify CD6, IRF8 and TNFRSF1A as new multiple sclerosis susceptibility loci. Nat Genet 41:776–82

    Article  PubMed  PubMed Central  Google Scholar 

  36. Australia, New Zealand Multiple Sclerosis Genetics C (2009) Genome-wide association study identifies new multiple sclerosis susceptibility loci on chromosomes 12 and 20. Nat Genet 41:824–828

    Article  Google Scholar 

  37. Jakkula E, Leppa V, Sulonen AM, Varilo T, Kallio S, Kemppinen A, Purcell S, Koivisto K, Tienari P, Sumelahti ML, Elovaara I, Pirttila T, Reunanen M, Aromaa A, Oturai AB, Sondergaard HB, Harbo HF, Mero IL, Gabriel SB, Mirel DB, Hauser SL, Kappos L, Polman C, De Jager PL, Hafler DA, Daly MJ, Palotie A, Saarela J, Peltonen L (2010) Genome-wide association study in a high-risk isolate for multiple sclerosis reveals associated variants in STAT3 gene. Am J Hum Genet 86:285–291

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Sanna S, Pitzalis M, Zoledziewska M, Zara I, Sidore C, Murru R, Whalen MB, Busonero F, Maschio A, Costa G, Melis MC, Deidda F, Poddie F, Morelli L, Farina G, Li Y, Dei M, Lai S, Mulas A, Cuccuru G, Porcu E, Liang L, Zavattari P, Moi L, Deriu E, Urru MF, Bajorek M, Satta MA, Cocco E, Ferrigno P, Sotgiu S, Pugliatti M, Traccis S, Angius A, Melis M, Rosati G, Abecasis GR, Uda M, Marrosu MG, Schlessinger D, Cucca F (2010) Variants within the immunoregulatory CBLB gene are associated with multiple sclerosis. Nat Genet 42:495–497

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Nischwitz S, Cepok S, Kroner A, Wolf C, Knop M, Muller-Sarnowski F, Pfister H, Roeske D, Rieckmann P, Hemmer B, Ising M, Uhr M, Bettecken T, Holsboer F, Muller-Myhsok B, Weber F (2010) Evidence for VAV2 and ZNF433 as susceptibility genes for multiple sclerosis. J Neuroimmunol 227:162–166

    Article  CAS  PubMed  Google Scholar 

  40. International Multiple Sclerosis Genetics C, Wellcome Trust Case Control C, Sawcer S, Hellenthal G, Pirinen M et al (2011) Genetic risk and a primary role for cell-mediated immune mechanisms in multiple sclerosis. Nature 476:214–9

    Article  Google Scholar 

  41. Patsopoulos NA, Bayer Pharma MSGWG, Steering Committees of Studies Evaluating I-b, CCRA, Consortium AN, GeneMsa, International Multiple Sclerosis Genetics C, Esposito F, Reischl J, Lehr S, Bauer D, Heubach J, Sandbrink R, Pohl C, Edan G, Kappos L, Miller D, Montalban J, Polman CH, Freedman MS, Hartung HP, Arnason BG, Comi G, Cook S, Filippi M, Goodin DS, Jeffery D, O’Connor P, Ebers GC, Langdon D, Reder AT, Traboulsee A, Zipp F, Schimrigk S, Hillert J, Bahlo M, Booth DR, Broadley S, Brown MA, Browning BL, Browning SR, Butzkueven H, Carroll WM, Chapman C, Foote SJ, Griffiths L, Kermode AG, Kilpatrick TJ, Lechner-Scott J, Marriott M, Mason D, Moscato P, Heard RN, Pender MP, Perreau VM, Perera D, Rubio JP, Scott RJ, Slee M, Stankovich J, Stewart GJ, Taylor BV, Tubridy N, Willoughby E, Wiley J, Matthews P, Boneschi FM, Compston A, Haines J, Hauser SL, McCauley J, Ivinson A, Oksenberg JR, Pericak-Vance M, Sawcer SJ, De Jager PL, Hafler DA, de Bakker PI (2011) Genome-wide meta-analysis identifies novel multiple sclerosis susceptibility loci. Ann Neurol 70:897–912

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Matesanz F, Gonzalez-Perez A, Lucas M, Sanna S, Gayan J, Urcelay E, Zara I, Pitzalis M, Cavanillas ML, Arroyo R, Zoledziewska M, Marrosu M, Fernandez O, Leyva L, Alcina A, Fedetz M, Moreno-Rey C, Velasco J, Real LM, Ruiz-Pena JL, Cucca F, Ruiz A, Izquierdo G (2012) Genome-wide association study of multiple sclerosis confirms a novel locus at 5p13.1. PLoS One 7:e36140

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. International Multiple Sclerosis Genetics C, Lill CM, Schjeide BM, Graetz C, Ban M, Alcina A, Ortiz MA, Perez J, Damotte V, Booth D, Lopez de Lapuente A, Broer L, Schilling M, Akkad DA, Aktas O, Alloza I, Antiguedad A, Arroyo R, Blaschke P, Buttmann M, Chan A, Compston A, Cournu-Rebeix I, Dorner T, Epplen JT, Fernandez O, Gerdes LA, Guillot-Noel L, Hartung HP, Hoffjan S, Izquierdo G, Kemppinen A, Kroner A, Kubisch C, Kumpfel T, Li SC, Lindenberger U, Lohse P, Lubetzki C, Luessi F, Malhotra S, Mescheriakova J, Montalban X, Papeix C, Paredes LF, Rieckmann P, Steinhagen-Thiessen E, Winkelmann A, Zettl UK, Hintzen R, Vandenbroeck K, Stewart G, Fontaine B, Comabella M, Urcelay E, Matesanz F, Sawcer S, Bertram L, Zipp F (2013) MANBA, CXCR5, SOX8, RPS6KB1 and ZBTB46 are genetic risk loci for multiple sclerosis. Brain 136:1778–1782

    Article  Google Scholar 

  44. International Multiple Sclerosis Genetics C, Beecham AH, Patsopoulos NA, Xifara DK, Davis MF et al (2013) Analysis of immune-related loci identifies 48 new susceptibility variants for multiple sclerosis. Nat Genet 45:1353–1360

    Article  Google Scholar 

  45. Andlauer TF, Buck D, Antony G, Bayas A, Bechmann L, Berthele A, Chan A, Gasperi C, Gold R, Graetz C, Haas J, Hecker M, Infante-Duarte C, Knop M, Kumpfel T, Limmroth V, Linker RA, Loleit V, Luessi F, Meuth SG, Muhlau M, Nischwitz S, Paul F, Putz M, Ruck T, Salmen A, Stangel M, Stellmann JP, Sturner KH, Tackenberg B, Then Bergh F, Tumani H, Warnke C, Weber F, Wiendl H, Wildemann B, Zettl UK, Ziemann U, Zipp F, Arloth J, Weber P, Radivojkov-Blagojevic M, Scheinhardt MO, Dankowski T, Bettecken T, Lichtner P, Czamara D, Carrillo-Roa T, Binder EB, Berger K, Bertram L, Franke A, Gieger C, Herms S, Homuth G, Ising M, Jockel KH, Kacprowski T, Kloiber S, Laudes M, Lieb W, Lill CM, Lucae S, Meitinger T, Moebus S, Muller-Nurasyid M, Nothen MM, Petersmann A, Rawal R, Schminke U, Strauch K, Volzke H, Waldenberger M, Wellmann J, Porcu E, Mulas A, Pitzalis M, Sidore C, Zara I, Cucca F, Zoledziewska M, Ziegler A, Hemmer B, Muller-Myhsok B (2016) Novel multiple sclerosis susceptibility loci implicated in epigenetic regulation. Sci Adv 2:e1501678

    Article  PubMed  PubMed Central  Google Scholar 

  46. International Multiple Sclerosis Genetics C (2019) Multiple sclerosis genomic map implicates peripheral immune cells and microglia in susceptibility. Science 365:eaav7188

    Article  Google Scholar 

  47. Visscher PM, Hill WG, Wray NR (2008) Heritability in the genomics era–concepts and misconceptions. Nat Rev Genet 9:255–266

    Article  CAS  PubMed  Google Scholar 

  48. Brynedal B, Duvefelt K, Jonasdottir G, Roos IM, Akesson E, Palmgren J, Hillert J (2007) HLA-A confers an HLA-DRB1 independent influence on the risk of multiple sclerosis. PLoS One 2:e664

    Article  PubMed  PubMed Central  Google Scholar 

  49. Patsopoulos NA, Barcellos LF, Hintzen RQ, Schaefer C, van Duijn CM, Noble JA, Raj T, Imsgc Anzgene, Gourraud PA, Stranger BE, Oksenberg J, Olsson T, Taylor BV, Sawcer S, Hafler DA, Carrington M, De Jager PL, de Bakker PI (2013) Fine-mapping the genetic association of the major histocompatibility complex in multiple sclerosis: HLA and non-HLA effects. PLoS Genet 9:e1003926

    Article  PubMed  PubMed Central  Google Scholar 

  50. Moutsianas L, Jostins L, Beecham AH, Dilthey AT, Xifara DK, Ban M, Shah TS, Patsopoulos NA, Alfredsson L, Anderson CA, Attfield KE, Baranzini SE, Barrett J, Binder TM, Booth D, Buck D, Celius EG, Cotsapas C, D’Alfonso S, Dendrou CA, Donnelly P, Dubois B, Fontaine B, Lar Fugger L, Goris A, Gourraud PA, Graetz C, Hemmer B, Hillert J, International IBDGC, Kockum I, Leslie S, Lill CM, Martinelli-Boneschi F, Oksenberg JR, Olsson T, Oturai A, Saarela J, Sondergaard HB, Spurkland A, Taylor B, Winkelmann J, Zipp F, Haines JL, Pericak-Vance MA, Spencer CC, Stewart G, Hafler DA, Ivinson AJ, Harbo HF, Hauser SL, De Jager PL, Compston A, McCauley JL, Sawcer S, McVean G, International Multiple Sclerosis Genetics C (2015) Class II HLA interactions modulate genetic risk for multiple sclerosis. Nat Genet 47:1107–13

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Manolio TA, Collins FS, Cox NJ, Goldstein DB, Hindorff LA, Hunter DJ, McCarthy MI, Ramos EM, Cardon LR, Chakravarti A, Cho JH, Guttmacher AE, Kong A, Kruglyak L, Mardis E, Rotimi CN, Slatkin M, Valle D, Whittemore AS, Boehnke M, Clark AG, Eichler EE, Gibson G, Haines JL, Mackay TF, McCarroll SA, Visscher PM (2009) Finding the missing heritability of complex diseases. Nature 461:747–753

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Lee S, Abecasis GR, Boehnke M, Lin X (2014) Rare-variant association analysis: study designs and statistical tests. Am J Hum Genet 95:5–23

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. International Multiple Sclerosis Genetics Consortium. Electronic address ccye, International Multiple Sclerosis Genetics C (2020) Low-frequency and rare-coding variation contributes to multiple sclerosis risk. Cell 180:403

    Article  Google Scholar 

  54. Ramagopalan SV, Dyment DA, Cader MZ, Morrison KM, Disanto G, Morahan JM, Berlanga-Taylor AJ, Handel A, De Luca GC, Sadovnick AD, Lepage P, Montpetit A, Ebers GC (2011) Rare variants in the CYP27B1 gene are associated with multiple sclerosis. Ann Neurol 70:881–886

    Article  CAS  PubMed  Google Scholar 

  55. Ban M, Caillier S, Mero IL, Myhr KM, Celius EG, Aarseth J, Torkildsen O, Harbo HF, Oksenberg J, Hauser SL, Sawcer S, Compston A (2013) No evidence of association between mutant alleles of the CYP27B1 gene and multiple sclerosis. Ann Neurol 73:430–432

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Zrzavy T, Leutmezer F, Kristoferitsch W, Kornek B, Schneider C, Rommer P, Berger T, Zimprich A (2020) Exome-sequence analyses of four multi-incident multiple sclerosis families. Genes (Basel) 11:988

    Article  CAS  Google Scholar 

  57. Jia X, Madireddy L, Caillier S, Santaniello A, Esposito F, Comi G, Stuve O, Zhou Y, Taylor B, Kilpatrick T, Martinelli-Boneschi F, Cree BAC, Oksenberg JR, Hauser SL, Baranzini SE (2018) Genome sequencing uncovers phenocopies in primary progressive multiple sclerosis. Ann Neurol 84:51–63

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. Kurtzke JF (1983) Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 33:1444–1452

    Article  CAS  PubMed  Google Scholar 

  59. Roxburgh RH, Seaman SR, Masterman T, Hensiek AE, Sawcer SJ, Vukusic S, Achiti I, Confavreux C, Coustans M, le Page E, Edan G, McDonnell GV, Hawkins S, Trojano M, Liguori M, Cocco E, Marrosu MG, Tesser F, Leone MA, Weber A, Zipp F, Miterski B, Epplen JT, Oturai A, Sorensen PS, Celius EG, Lara NT, Montalban X, Villoslada P, Silva AM, Marta M, Leite I, Dubois B, Rubio J, Butzkueven H, Kilpatrick T, Mycko MP, Selmaj KW, Rio ME, Sa M, Salemi G, Savettieri G, Hillert J, Compston DA (2005) Multiple Sclerosis Severity Score: using disability and disease duration to rate disease severity. Neurology 64:1144–1151

    Article  CAS  PubMed  Google Scholar 

  60. International Multiple Sclerosis Genetics C (2011) Genome-wide association study of severity in multiple sclerosis. Genes Immun 12:615–625

    Article  Google Scholar 

  61. Brynedal B, Wojcik J, Esposito F, Debailleul V, Yaouanq J, Martinelli-Boneschi F, Edan G, Comi G, Hillert J, Abderrahim H (2010) MGAT5 alters the severity of multiple sclerosis. J Neuroimmunol 220:120–124

    Article  CAS  PubMed  Google Scholar 

  62. George MF, Briggs FB, Shao X, Gianfrancesco MA, Kockum I, Harbo HF, Celius EG, Bos SD, Hedstrom A, Shen L, Bernstein A, Alfredsson L, Hillert J, Olsson T, Patsopoulos NA, De Jager PL, Oturai AB, Sondergaard HB, Sellebjerg F, Sorensen PS, Gomez R, Caillier SJ, Cree BA, Oksenberg JR, Hauser SL, D’Alfonso S, Leone MA, Martinelli Boneschi F, Sorosina M, van der Mei I, Taylor BV, Zhou Y, Schaefer C, Barcellos LF (2016) Multiple sclerosis risk loci and disease severity in 7,125 individuals from 10 studies. Neurol Genet 2:e87

    Article  PubMed  PubMed Central  Google Scholar 

  63. Briggs FBS, Yu JC, Davis MF, Jiangyang J, Fu S, Parrotta E, Gunzler DD, Ontaneda D (2019) Multiple sclerosis risk factors contribute to onset heterogeneity. Mult Scler Relat Disord 28:11–16

    Article  PubMed  Google Scholar 

  64. Gianfrancesco MA, Stridh P, Shao X, Rhead B, Graves JS, Chitnis T, Waldman A, Lotze T, Schreiner T, Belman A, Greenberg B, Weinstock-Guttman B, Aaen G, Tillema JM, Hart J, Caillier S, Ness J, Harris Y, Rubin J, Candee M, Krupp L, Gorman M, Benson L, Rodriguez M, Mar S, Kahn I, Rose J, Roalstad S, Casper TC, Shen L, Quach H, Quach D, Hillert J, Hedstrom A, Olsson T, Kockum I, Alfredsson L, Schaefer C, Barcellos LF, Waubant E, Network of Pediatric Multiple Sclerosis C. (2018) Genetic risk factors for pediatric-onset multiple sclerosis. Mult Scler 24:1825–1834

    Article  CAS  PubMed  Google Scholar 

  65. Wattjes MP, Steenwijk MD, Stangel M (2015) MRI in the diagnosis and monitoring of multiple sclerosis: an update. Clin Neuroradiol 25(Suppl 2):157–165

    Article  PubMed  Google Scholar 

  66. Baranzini SE, Srinivasan R, Khankhanian P, Okuda DT, Nelson SJ, Matthews PM, Hauser SL, Oksenberg JR, Pelletier D (2010) Genetic variation influences glutamate concentrations in brains of patients with multiple sclerosis. Brain 133:2603–2611

    Article  PubMed  PubMed Central  Google Scholar 

  67. Gourraud PA, Sdika M, Khankhanian P, Henry RG, Beheshtian A, Matthews PM, Hauser SL, Oksenberg JR, Pelletier D, Baranzini SE (2013) A genome-wide association study of brain lesion distribution in multiple sclerosis. Brain 136:1012–1024

    Article  PubMed  PubMed Central  Google Scholar 

  68. Matsushita T, Madireddy L, Sprenger T, Khankhanian P, Magon S, Naegelin Y, Caverzasi E, Lindberg RL, Kappos L, Hauser SL, Oksenberg JR, Henry R, Pelletier D, Baranzini SE (2015) Genetic associations with brain cortical thickness in multiple sclerosis. Genes Brain Behav 14:217–227

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  69. Isobe N, Keshavan A, Gourraud PA, Zhu AH, Datta E, Schlaeger R, Caillier SJ, Santaniello A, Lizee A, Himmelstein DS, Baranzini SE, Hollenbach J, Cree BA, Hauser SL, Oksenberg JR, Henry RG (2016) Association of HLA genetic risk burden with disease phenotypes in multiple sclerosis. JAMA Neurol 73:795–802

    Article  PubMed  PubMed Central  Google Scholar 

  70. Stangel M, Fredrikson S, Meinl E, Petzold A, Stuve O, Tumani H (2013) The utility of cerebrospinal fluid analysis in patients with multiple sclerosis. Nat Rev Neurol 9:267–276

    Article  CAS  PubMed  Google Scholar 

  71. Mero IL, Gustavsen MW, Saether HS, Flam ST, Berg-Hansen P, Sondergaard HB, Jensen PE, Berge T, Bjolgerud A, Muggerud A, Aarseth JH, International Multiple Sclerosis Genetics C, Myhr KM, Celius EG, Sellebjerg F, Hillert J, Alfredsson L, Olsson T, Oturai AB, Kockum I, Lie BA, Andreassen BK, Harbo HF (2013) Oligoclonal band status in Scandinavian multiple sclerosis patients is associated with specific genetic risk alleles. PLoS One 8:e58352

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Goris A, Pauwels I, Gustavsen MW, van Son B, Hilven K, Bos SD, Celius EG, Berg-Hansen P, Aarseth J, Myhr KM, D’Alfonso S, Barizzone N, Leone MA, Martinelli Boneschi F, Sorosina M, Liberatore G, Kockum I, Olsson T, Hillert J, Alfredsson L, Bedri SK, Hemmer B, Buck D, Berthele A, Knier B, Biberacher V, van Pesch V, Sindic C, Bang Oturai A, Sondergaard HB, Sellebjerg F, Jensen PE, Comabella M, Montalban X, Perez-Boza J, Malhotra S, Lechner-Scott J, Broadley S, Slee M, Taylor B, Kermode AG, Gourraud PA, International Multiple Sclerosis Genetics C, Sawcer SJ, Andreassen BK, Dubois B, Harbo HF (2015) Genetic variants are major determinants of CSF antibody levels in multiple sclerosis. Brain 138:632–43

    Article  PubMed  PubMed Central  Google Scholar 

  73. Buck D, Albrecht E, Aslam M, Goris A, Hauenstein N, Jochim A, International Multiple Sclerosis Genetics C, Wellcome Trust Case Control C, Cepok S, Grummel V, Dubois B, Berthele A, Lichtner P, Gieger C, Winkelmann J, Hemmer B (2013) Genetic variants in the immunoglobulin heavy chain locus are associated with the IgG index in multiple sclerosis. Ann Neurol 73:86–94

    Article  CAS  PubMed  Google Scholar 

  74. Zhou Y, Graves JS, Simpson S Jr, Charlesworth JC, Mei IV, Waubant E, Barcellos LF, Belman A, Krupp L, Lucas R, Ponsonby AL, Taylor BV, Ausimmmune AusLong, investigators g. (2017) Genetic variation in the gene LRP2 increases relapse risk in multiple sclerosis. J Neurol Neurosurg Psychiatry 88:864–868

    Article  PubMed  Google Scholar 

  75. Vandebergh M, Andlauer TFM, Zhou Y, Mallants K, Held F, Aly L, Taylor BV, Hemmer B, Dubois B, Goris A (2021) Genetic variation in WNT9B increases relapse hazard in multiple sclerosis. Ann Neurol 89:884–894

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  76. Hilven K, Vandebergh M, Smets I, Mallants K, Goris A, Dubois B (2018) Genetic basis for relapse rate in multiple sclerosis: association with LRP2 genetic variation. Mult Scler 24:1773–1775

    Article  CAS  PubMed  Google Scholar 

  77. Sirugo G, Williams SM, Tishkoff SA (2019) The missing diversity in human genetic studies. Cell 177:1080

    Article  CAS  PubMed  Google Scholar 

  78. Amezcua L, McCauley JL (2020) Race and ethnicity on MS presentation and disease course. Mult Scler 26:561–567

    Article  PubMed  PubMed Central  Google Scholar 

  79. Langer-Gould A, Brara SM, Beaber BE, Zhang JL (2013) Incidence of multiple sclerosis in multiple racial and ethnic groups. Neurology 80:1734–1739

    Article  PubMed  Google Scholar 

  80. Johnson BA, Wang J, Taylor EM, Caillier SJ, Herbert J, Khan OA, Cross AH, De Jager PL, Gourraud PA, Cree BC, Hauser SL, Oksenberg JR (2010) Multiple sclerosis susceptibility alleles in African Americans. Genes Immun 11:343–350

    Article  CAS  PubMed  Google Scholar 

  81. Isobe N, Gourraud PA, Harbo HF, Caillier SJ, Santaniello A, Khankhanian P, Maiers M, Spellman S, Cereb N, Yang S, Pando MJ, Piccio L, Cross AH, De Jager PL, Cree BA, Hauser SL, Oksenberg JR (2013) Genetic risk variants in African Americans with multiple sclerosis. Neurology 81:219–227

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  82. Isobe N, Madireddy L, Khankhanian P, Matsushita T, Caillier SJ, More JM, Gourraud PA, McCauley JL, Beecham AH, International Multiple Sclerosis Genetics C, Piccio L, Herbert J, Khan O, Cohen J, Stone L, Santaniello A, Cree BA, Onengut-Gumuscu S, Rich SS, Hauser SL, Sawcer S, Oksenberg JR (2015) An ImmunoChip study of multiple sclerosis risk in African Americans. Brain 138:1518–30

    Article  PubMed  PubMed Central  Google Scholar 

  83. Reich D, Patterson N, De Jager PL, McDonald GJ, Waliszewska A, Tandon A, Lincoln RR, DeLoa C, Fruhan SA, Cabre P, Bera O, Semana G, Kelly MA, Francis DA, Ardlie K, Khan O, Cree BA, Hauser SL, Oksenberg JR, Hafler DA (2005) A whole-genome admixture scan finds a candidate locus for multiple sclerosis susceptibility. Nat Genet 37:1113–1118

    Article  CAS  PubMed  Google Scholar 

  84. Shriner D (2013) Overview of admixture mapping. Curr Protoc Hum Genet 76(1):23

    Google Scholar 

  85. Nakatsuka N, Patterson N, Patsopoulos NA, Altemose N, Tandon A, Beecham AH, McCauley JL, Isobe N, Hauser S, De Jager PL, Hafler DA, Oksenberg JR, Reich D (2020) Two genetic variants explain the association of European ancestry with multiple sclerosis risk in African-Americans. Sci Rep 10:16902

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  86. Beecham AH, Amezcua L, Chinea A, Manrique CP, Rubi C, Isobe N, Lund BT, Santaniello A, Beecham GW, Burchard EG, Comabella M, Patsopoulos N, Fitzgerald K, Calabresi PA, De Jager P, Conti DV, Delgado SR, Oksenberg JR, McCauley JL (2020) The genetic diversity of multiple sclerosis risk among Hispanic and African American populations living in the United States. Mult Scler 26:1329–1339

    Article  CAS  PubMed  Google Scholar 

  87. Dashti M, Ateyah K, Alroughani R, Al-Temaimi R (2020) Replication analysis of variants associated with multiple sclerosis risk. Sci Rep 10:7327

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  88. Chen S, Zhang J, Liu QB, Zhuang JC, Wu L, Xu YF, Li HF, Wu ZY, Xiao BG (2018) Variant of EOMES associated with increasing risk in Chinese patients with relapsing-remitting multiple sclerosis. Chin Med J (Engl) 131:643–647

    Article  CAS  Google Scholar 

  89. Nakamura Y, Matsushita T, Sato S, Niino M, Fukazawa T, Yoshimura S, Hisahara S, Isobe N, Shimohama S, Watanabe M, Yoshida K, Houzen H, Miyazaki Y, Yamasaki R, Kikuchi S, Kira J, Genetics JMS, C. (2016) Latitude and HLA-DRB1*04:05 independently influence disease severity in Japanese multiple sclerosis: a cross-sectional study. J Neuroinflammation 13:239

    Article  PubMed  PubMed Central  Google Scholar 

  90. Watanabe M, Nakamura Y, Sato S, Niino M, Fukaura H, Tanaka M, Ochi H, Kanda T, Takeshita Y, Yokota T, Nishida Y, Matsui M, Nagayama S, Kusunoki S, Miyamoto K, Mizuno M, Kawachi I, Saji E, Ohashi T, Shimohama S, Hisahara S, Nishiyama K, Iizuka T, Nakatsuji Y, Okuno T, Ochi K, Suzumura A, Yamamoto K, Kawano Y, Tsuji S, Hirata M, Sakate R, Kimura T, Shimizu Y, Nagaishi A, Okada K, Hayashi F, Sakoda A, Masaki K, Shinoda K, Isobe N, Matsushita T, Kira JI (2021) HLA genotype-clinical phenotype correlations in multiple sclerosis and neuromyelitis optica spectrum disorders based on Japan MS/NMOSD Biobank data. Sci Rep 11:607

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  91. Magyari M, Sorensen PS (2020) Comorbidity in multiple sclerosis. Front Neurol 11:851

    Article  PubMed  PubMed Central  Google Scholar 

  92. Alonso A, Hernan MA, Ascherio A (2008) Allergy, family history of autoimmune diseases, and the risk of multiple sclerosis. Acta Neurol Scand 117:15–20

    CAS  PubMed  Google Scholar 

  93. Barcellos LF, Kamdar BB, Ramsay PP, DeLoa C, Lincoln RR, Caillier S, Schmidt S, Haines JL, Pericak-Vance MA, Oksenberg JR, Hauser SL (2006) Clustering of autoimmune diseases in families with a high-risk for multiple sclerosis: a descriptive study. Lancet Neurol 5:924–931

    Article  CAS  PubMed  Google Scholar 

  94. Broadley SA, Deans J, Sawcer SJ, Clayton D, Compston DA (2000) Autoimmune disease in first-degree relatives of patients with multiple sclerosis. A UK survey. Brain 123(Pt 6):1102–1111

    Article  PubMed  Google Scholar 

  95. Greenberg BM, Casper TC, Mar SS, Ness JM, Plumb P, Liang S, Goyal M, Weinstock-Guttman B, Rodriguez M, Aaen GS, Belman A, Barcellos LF, Rose JW, Gorman MP, Benson LA, Candee M, Chitnis T, Harris YC, Kahn IL, Roalstad S, Hart J, Lotze TE, Rensel M, Rubin JP, Schreiner TL, Tillema JM, Waldman AT, Krupp L, Graves J, Drake K, Waubant E (2021) Familial history of autoimmune disorders among patients with pediatric multiple sclerosis. Neurol Neuroimmunol Neuroinflamm 8:e1049

    Article  PubMed  PubMed Central  Google Scholar 

  96. Cotsapas C, Voight BF, Rossin E, Lage K, Neale BM, Wallace C, Abecasis GR, Barrett JC, Behrens T, Cho J, De Jager PL, Elder JT, Graham RR, Gregersen P, Klareskog L, Siminovitch KA, van Heel DA, Wijmenga C, Worthington J, Todd JA, Hafler DA, Rich SS, Daly MJ, Consortia FONo. (2011) Pervasive sharing of genetic effects in autoimmune disease. PLoS Genet 7:e1002254

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  97. Dubois PC, Trynka G, Franke L, Hunt KA, Romanos J, Curtotti A, Zhernakova A, Heap GA, Adany R, Aromaa A, Bardella MT, van den Berg LH, Bockett NA, de la Concha EG, Dema B, Fehrmann RS, Fernandez-Arquero M, Fiatal S, Grandone E, Green PM, Groen HJ, Gwilliam R, Houwen RH, Hunt SE, Kaukinen K, Kelleher D, Korponay-Szabo I, Kurppa K, MacMathuna P, Maki M, Mazzilli MC, McCann OT, Mearin ML, Mein CA, Mirza MM, Mistry V, Mora B, Morley KI, Mulder CJ, Murray JA, Nunez C, Oosterom E, Ophoff RA, Polanco I, Peltonen L, Platteel M, Rybak A, Salomaa V, Schweizer JJ, Sperandeo MP, Tack GJ, Turner G, Veldink JH, Verbeek WH, Weersma RK, Wolters VM, Urcelay E, Cukrowska B, Greco L, Neuhausen SL, McManus R, Barisani D, Deloukas P, Barrett JC, Saavalainen P, Wijmenga C, van Heel DA (2010) Multiple common variants for celiac disease influencing immune gene expression. Nat Genet 42:295–302

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  98. Smyth DJ, Plagnol V, Walker NM, Cooper JD, Downes K, Yang JH, Howson JM, Stevens H, McManus R, Wijmenga C, Heap GA, Dubois PC, Clayton DG, Hunt KA, van Heel DA, Todd JA (2008) Shared and distinct genetic variants in type 1 diabetes and celiac disease. N Engl J Med 359:2767–2777

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  99. Stahl EA, Raychaudhuri S, Remmers EF, Xie G, Eyre S, Thomson BP, Li Y, Kurreeman FA, Zhernakova A, Hinks A, Guiducci C, Chen R, Alfredsson L, Amos CI, Ardlie KG, Consortium B, Barton A, Bowes J, Brouwer E, Burtt NP, Catanese JJ, Coblyn J, Coenen MJ, Costenbader KH, Criswell LA, Crusius JB, Cui J, de Bakker PI, De Jager PL, Ding B, Emery P, Flynn E, Harrison P, Hocking LJ, Huizinga TW, Kastner DL, Ke X, Lee AT, Liu X, Martin P, Morgan AW, Padyukov L, Posthumus MD, Radstake TR, Reid DM, Seielstad M, Seldin MF, Shadick NA, Steer S, Tak PP, Thomson W, van der Helm-van Mil AH, van der Horst-Bruinsma IE, van der Schoot CE, van Riel PL, Weinblatt ME, Wilson AG, Wolbink GJ, Wordsworth BP, Consortium Y, Wijmenga C, Karlson EW, Toes RE, de Vries N, Begovich AB, Worthington J, Siminovitch KA, Gregersen PK, Klareskog L, Plenge RM (2010) Genome-wide association study meta-analysis identifies seven new rheumatoid arthritis risk loci. Nat Genet 42:508–14

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  100. Liu JZ, Almarri MA, Gaffney DJ, Mells GF, Jostins L, Cordell HJ, Ducker SJ, Day DB, Heneghan MA, Neuberger JM, Donaldson PT, Bathgate AJ, Burroughs A, Davies MH, Jones DE, Alexander GJ, Barrett JC, Sandford RN, Anderson CA, Consortium UKPBC, Wellcome Trust Case Control C (2012) Dense fine-mapping study identifies new susceptibility loci for primary biliary cirrhosis. Nat Genet 44:1137–41

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  101. Okada Y, Wu D, Trynka G, Raj T, Terao C, Ikari K, Kochi Y, Ohmura K, Suzuki A, Yoshida S, Graham RR, Manoharan A, Ortmann W, Bhangale T, Denny JC, Carroll RJ, Eyler AE, Greenberg JD, Kremer JM, Pappas DA, Jiang L, Yin J, Ye L, Su DF, Yang J, Xie G, Keystone E, Westra HJ, Esko T, Metspalu A, Zhou X, Gupta N, Mirel D, Stahl EA, Diogo D, Cui J, Liao K, Guo MH, Myouzen K, Kawaguchi T, Coenen MJ, van Riel PL, van de Laar MA, Guchelaar HJ, Huizinga TW, Dieude P, Mariette X, Bridges SL Jr, Zhernakova A, Toes RE, Tak PP, Miceli-Richard C, Bang SY, Lee HS, Martin J, Gonzalez-Gay MA, Rodriguez-Rodriguez L, Rantapaa-Dahlqvist S, Arlestig L, Choi HK, Kamatani Y, Galan P, Lathrop M, consortium R, consortium G, Eyre S, Bowes J, Barton A, de Vries N, Moreland LW, Criswell LA, Karlson EW, Taniguchi A, Yamada R, Kubo M, Liu JS, Bae SC, Worthington J, Padyukov L, Klareskog L, Gregersen PK, Raychaudhuri S, Stranger BE, De Jager PL, Franke L, Visscher PM, Brown MA, Yamanaka H, Mimori T, Takahashi A, Xu H, Behrens TW, Siminovitch KA, Momohara S, Matsuda F, Yamamoto K, Plenge RM (2014) Genetics of rheumatoid arthritis contributes to biology and drug discovery. Nature 506:376–81

    Article  CAS  PubMed  Google Scholar 

  102. Onengut-Gumuscu S, Chen WM, Burren O, Cooper NJ, Quinlan AR, Mychaleckyj JC, Farber E, Bonnie JK, Szpak M, Schofield E, Achuthan P, Guo H, Fortune MD, Stevens H, Walker NM, Ward LD, Kundaje A, Kellis M, Daly MJ, Barrett JC, Cooper JD, Deloukas P, Type 1 Diabetes Genetics C, Todd JA, Wallace C, Concannon P, Rich SS (2015) Fine mapping of type 1 diabetes susceptibility loci and evidence for colocalization of causal variants with lymphoid gene enhancers. Nat Genet 47:381–6

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  103. Tsoi LC, Spain SL, Knight J, Ellinghaus E, Stuart PE, Capon F, Ding J, Li Y, Tejasvi T, Gudjonsson JE, Kang HM, Allen MH, McManus R, Novelli G, Samuelsson L, Schalkwijk J, Stahle M, Burden AD, Smith CH, Cork MJ, Estivill X, Bowcock AM, Krueger GG, Weger W, Worthington J, Tazi-Ahnini R, Nestle FO, Hayday A, Hoffmann P, Winkelmann J, Wijmenga C, Langford C, Edkins S, Andrews R, Blackburn H, Strange A, Band G, Pearson RD, Vukcevic D, Spencer CC, Deloukas P, Mrowietz U, Schreiber S, Weidinger S, Koks S, Kingo K, Esko T, Metspalu A, Lim HW, Voorhees JJ, Weichenthal M, Wichmann HE, Chandran V, Rosen CF, Rahman P, Gladman DD, Griffiths CE, Reis A, Kere J, Collaborative Association Study of P, Genetic Analysis of Psoriasis C, Psoriasis Association Genetics E, Wellcome Trust Case Control C, Nair RP, Franke A, Barker JN, Abecasis GR, Elder JT, Trembath RC (2012) Identification of 15 new psoriasis susceptibility loci highlights the role of innate immunity. Nat Genet 44:1341–8

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  104. Cortes A, Brown MA (2011) Promise and pitfalls of the Immunochip. Arthritis Res Ther 13:101

    Article  PubMed  PubMed Central  Google Scholar 

  105. Bulik-Sullivan B, Finucane HK, Anttila V, Gusev A, Day FR, Loh PR, ReproGen C, Psychiatric Genomics C, Genetic Consortium for Anorexia Nervosa of the Wellcome Trust Case Control C, Duncan L, Perry JR, Patterson N, Robinson EB, Daly MJ, Price AL, Neale BM (2015) An atlas of genetic correlations across human diseases and traits. Nat Genet 47:1236–41

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  106. Bentham J, Morris DL, Graham DSC, Pinder CL, Tombleson P, Behrens TW, Martin J, Fairfax BP, Knight JC, Chen L, Replogle J, Syvanen AC, Ronnblom L, Graham RR, Wither JE, Rioux JD, Alarcon-Riquelme ME, Vyse TJ (2015) Genetic association analyses implicate aberrant regulation of innate and adaptive immunity genes in the pathogenesis of systemic lupus erythematosus. Nat Genet 47:1457–1464

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  107. Cooper JD, Smyth DJ, Smiles AM, Plagnol V, Walker NM, Allen JE, Downes K, Barrett JC, Healy BC, Mychaleckyj JC, Warram JH, Todd JA (2008) Meta-analysis of genome-wide association study data identifies additional type 1 diabetes risk loci. Nat Genet 40:1399–1401

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  108. Cordell HJ, Han Y, Mells GF, Li Y, Hirschfield GM, Greene CS, Xie G, Juran BD, Zhu D, Qian DC, Floyd JA, Morley KI, Prati D, Lleo A, Cusi D, Canadian USPBCC, Italian PBCGSG, Consortium U-P, Gershwin ME, Anderson CA, Lazaridis KN, Invernizzi P, Seldin MF, Sandford RN, Amos CI, Siminovitch KA (2015) International genome-wide meta-analysis identifies new primary biliary cirrhosis risk loci and targetable pathogenic pathways. Nat Commun 6:8019

    Article  CAS  PubMed  Google Scholar 

  109. Goyette P, Boucher G, Mallon D, Ellinghaus E, Jostins L, Huang H, Ripke S, Gusareva ES, Annese V, Hauser SL, Oksenberg JR, Thomsen I, Leslie S, International Inflammatory Bowel Disease Genetics C, Australia, New Zealand I, Belgium IBDGC, Italian Group for IBDGC, Consortium NIBDG, United Kingdom I, Wellcome Trust Case Control C, Quebec IBDGC, Daly MJ, Van Steen K, Duerr RH, Barrett JC, McGovern DP, Schumm LP, Traherne JA, Carrington MN, Kosmoliaptsis V, Karlsen TH, Franke A, Rioux JD (2015) High-density mapping of the MHC identifies a shared role for HLA-DRB1*01:03 in inflammatory bowel diseases and heterozygous advantage in ulcerative colitis. Nat Genet 47:172–9

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  110. Liu JZ, van Sommeren S, Huang H, Ng SC, Alberts R, Takahashi A, Ripke S, Lee JC, Jostins L, Shah T, Abedian S, Cheon JH, Cho J, Dayani NE, Franke L, Fuyuno Y, Hart A, Juyal RC, Juyal G, Kim WH, Morris AP, Poustchi H, Newman WG, Midha V, Orchard TR, Vahedi H, Sood A, Sung JY, Malekzadeh R, Westra HJ, Yamazaki K, Yang SK, International Multiple Sclerosis Genetics C, International IBDGC, Barrett JC, Alizadeh BZ, Parkes M, Bk T, Daly MJ, Kubo M, Anderson CA, Weersma RK (2015) Association analyses identify 38 susceptibility loci for inflammatory bowel disease and highlight shared genetic risk across populations. Nat Genet 47:979–86

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  111. Anttila V, Bulik-Sullivan B, Finucane HK, Bras J, Duncan L, Escott-Price V, Falcone G, Gormley P, Malik R, Patsopoulos N, Ripke S, Walters R, Wei Z, Yu D, Lee P, Breen G, Bulik C, Daly M, Dichgans M, Faraone S, Guerreiro R, Holmans P, Kendler K, Koeleman B, Mathews C, Scharf J, Sklar P, Williams J, Wood N, Cotsapas C, Palotie A, Smoller J, Sullivan P, Rosand J, Corvin A, Neale B (2016) Analysis of shared heritability in common disorders of the brain. bioRxiv 5:3339

    Google Scholar 

  112. De Jager PL, Chibnik LB, Cui J, Reischl J, Lehr S, Simon KC, Aubin C, Bauer D, Heubach JF, Sandbrink R, Tyblova M, Lelkova P, Steering committee of the Bs, Steering committee of the Bs, Steering committee of the LTFs, Steering committee of the CCRs, Havrdova E, Pohl C, Horakova D, Ascherio A, Hafler DA, Karlson EW (2009) Integration of genetic risk factors into a clinical algorithm for multiple sclerosis susceptibility: a weighted genetic risk score. Lancet Neurol 8:1111–9

    Article  PubMed  PubMed Central  Google Scholar 

  113. de Mol CL, Jansen PR, Muetzel RL, Knol MJ, Adams HH, Jaddoe VW, Vernooij MW, Hintzen RQ, White TJ, Neuteboom RF (2020) Polygenic multiple sclerosis risk and population-based childhood brain imaging. Ann Neurol 87:774–787

    Article  PubMed  PubMed Central  Google Scholar 

  114. Jacobs BM, Noyce AJ, Bestwick J, Belete D, Giovannoni G, Dobson R (2021) Gene-Environment Interactions in Multiple Sclerosis: a UK Biobank Study. Neurol Neuroimmunol Neuroinflamm 8:e1007

    Article  PubMed  PubMed Central  Google Scholar 

  115. Mokry LE, Ross S, Ahmad OS, Forgetta V, Smith GD, Goltzman D, Leong A, Greenwood CM, Thanassoulis G, Richards JB (2015) Vitamin D and risk of multiple sclerosis: a Mendelian randomization study. PLoS Med 12:e1001866

    Article  PubMed  PubMed Central  Google Scholar 

  116. Rhead B, Baarnhielm M, Gianfrancesco M, Mok A, Shao X, Quach H, Shen L, Schaefer C, Link J, Gyllenberg A, Hedstrom AK, Olsson T, Hillert J, Kockum I, Glymour MM, Alfredsson L, Barcellos LF (2016) Mendelian randomization shows a causal effect of low vitamin D on multiple sclerosis risk. Neurol Genet 2:e97

    Article  PubMed  PubMed Central  Google Scholar 

  117. Jacobs BM, Noyce AJ, Giovannoni G, Dobson R (2020) BMI and low vitamin D are causal factors for multiple sclerosis: a Mendelian randomization study. Neurol Neuroimmunol Neuroinflamm 7:e662

    Article  PubMed  PubMed Central  Google Scholar 

  118. Gianfrancesco MA, Stridh P, Rhead B, Shao X, Xu E, Graves JS, Chitnis T, Waldman A, Lotze T, Schreiner T, Belman A, Greenberg B, Weinstock-Guttman B, Aaen G, Tillema JM, Hart J, Caillier S, Ness J, Harris Y, Rubin J, Candee M, Krupp L, Gorman M, Benson L, Rodriguez M, Mar S, Kahn I, Rose J, Roalstad S, Casper TC, Shen L, Quach H, Quach D, Hillert J, Baarnhielm M, Hedstrom A, Olsson T, Kockum I, Alfredsson L, Metayer C, Schaefer C, Barcellos LF, Waubant E, Network of Pediatric Multiple Sclerosis C (2017) Evidence for a causal relationship between low vitamin D, high BMI, and pediatric-onset MS. Neurology 88:1623–1629

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  119. Mokry LE, Ross S, Timpson NJ, Sawcer S, Davey Smith G, Richards JB (2016) Obesity and Multiple Sclerosis: A Mendelian Randomization Study. PLoS Med 13:e1002053

    Article  PubMed  PubMed Central  Google Scholar 

  120. Gianfrancesco MA, Glymour MM, Walter S, Rhead B, Shao X, Shen L, Quach H, Hubbard A, Jonsdottir I, Stefansson K, Strid P, Hillert J, Hedstrom A, Olsson T, Kockum I, Schaefer C, Alfredsson L, Barcellos LF (2017) Causal effect of genetic variants associated with body mass index on multiple sclerosis susceptibility. Am J Epidemiol 185:162–171

    PubMed  PubMed Central  Google Scholar 

  121. Harroud A, Mitchell RE, Richardson TG, Morris JA, Forgetta V, Davey Smith G, Baranzini SE, Richards JB (2021) Childhood obesity and multiple sclerosis: a Mendelian randomization study. Mult Scler 27:2150–2158

    Article  CAS  PubMed  Google Scholar 

  122. Lu H, Wu PF, Zhang W, Liao X (2021) Circulating interleukins and risk of multiple sclerosis: a Mendelian randomization study. Front Immunol 12:647588

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  123. Mitchell RE, Bates K, Wootton RE, Harroud A, Richards JB, Davey Smith G, Munafo MR (2020) Little evidence for an effect of smoking on multiple sclerosis risk: a Mendelian randomization study. PLoS Biol 18:e3000973

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  124. Vandebergh M, Goris A (2020) Smoking and multiple sclerosis risk: a Mendelian randomization study. J Neurol 267:3083–3091

    Article  PubMed  PubMed Central  Google Scholar 

  125. Mo XB, Lei SF, Qian QY, Guo YF, Zhang YH, Zhang H (2019) Integrative analysis revealed potential causal genetic and epigenetic factors for multiple sclerosis. J Neurol 266:2699–2709

    Article  CAS  PubMed  Google Scholar 

  126. Zhou Y, Cuellar-Partida G, Simpson Yap S, Lin X, Claflin S, Burdon K, Charlesworth J, Taylor B (2021) Utilising multi-large omics data to elucidate biological mechanisms within multiple sclerosis genetic susceptibility loci. Mult Scler 27:2141–2149

    Article  CAS  PubMed  Google Scholar 

  127. Jacobs BM, Taylor T, Awad A, Baker D, Giovanonni G, Noyce AJ, Dobson R (2020) Summary-data-based Mendelian randomization prioritizes potential druggable targets for multiple sclerosis. Brain Commun 2:fcaa119

    Article  PubMed  PubMed Central  Google Scholar 

  128. International Multiple Sclerosis Genetics C (2019) A systems biology approach uncovers cell-specific gene regulatory effects of genetic associations in multiple sclerosis. Nat Commun 10:2236

    Article  Google Scholar 

  129. Gregory AP, Dendrou CA, Attfield KE, Haghikia A, Xifara DK, Butter F, Poschmann G, Kaur G, Lambert L, Leach OA, Promel S, Punwani D, Felce JH, Davis SJ, Gold R, Nielsen FC, Siegel RM, Mann M, Bell JI, McVean G, Fugger L (2012) TNF receptor 1 genetic risk mirrors outcome of anti-TNF therapy in multiple sclerosis. Nature 488:508–511

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  130. Group TLMSSGaTUoBCMMA (1999) TNF neutralization in MS: results of a randomized, placebo-controlled multicenter study. The Lenercept Multiple Sclerosis Study Group and The University of British Columbia MS/MRI Analysis Group. Neurology 53:457–465

    Article  Google Scholar 

  131. van Oosten BW, Barkhof F, Truyen L, Boringa JB, Bertelsmann FW, von Blomberg BM, Woody JN, Hartung HP, Polman CH (1996) Increased MRI activity and immune activation in two multiple sclerosis patients treated with the monoclonal anti-tumor necrosis factor antibody cA2. Neurology 47:1531–1534

    Article  PubMed  Google Scholar 

  132. Bosch X, Saiz A, Ramos-Casals M, Group BS (2011) Monoclonal antibody therapy-associated neurological disorders. Nat Rev Neurol 7:165–72

    Article  CAS  PubMed  Google Scholar 

  133. Alcina A, Fernandez O, Gonzalez JR, Catala-Rabasa A, Fedetz M, Ndagire D, Leyva L, Guerrero M, Arnal C, Delgado C, Lucas M, Izquierdo G, Matesanz F (2010) Tag-SNP analysis of the GFI1-EVI5-RPL5-FAM69 risk locus for multiple sclerosis. Eur J Hum Genet 18:827–831

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  134. Hoppenbrouwers IA, Aulchenko YS, Ebers GC, Ramagopalan SV, Oostra BA, van Duijn CM, Hintzen RQ (2008) EVI5 is a risk gene for multiple sclerosis. Genes Immun 9:334–337

    Article  CAS  PubMed  Google Scholar 

  135. Didonna A, Isobe N, Caillier SJ, Li KH, Burlingame AL, Hauser SL, Baranzini SE, Patsopoulos NA, Oksenberg JR (2015) A non-synonymous single-nucleotide polymorphism associated with multiple sclerosis risk affects the EVI5 interactome. Hum Mol Genet 24:7151–7158

    CAS  PubMed  PubMed Central  Google Scholar 

  136. Bagdanoff JT, Donoviel MS, Nouraldeen A, Tarver J, Fu Q, Carlsen M, Jessop TC, Zhang H, Hazelwood J, Nguyen H, Baugh SD, Gardyan M, Terranova KM, Barbosa J, Yan J, Bednarz M, Layek S, Courtney LF, Taylor J, Digeorge-Foushee AM, Gopinathan S, Bruce D, Smith T, Moran L, O’Neill E, Kramer J, Lai Z, Kimball SD, Liu Q, Sun W, Yu S, Swaffield J, Wilson A, Main A, Carson KG, Oravecz T, Augeri DJ (2009) Inhibition of sphingosine-1-phosphate lyase for the treatment of autoimmune disorders. J Med Chem 52:3941–3953

    Article  CAS  PubMed  Google Scholar 

  137. Kappos L, Radue EW, O’Connor P, Polman C, Hohlfeld R, Calabresi P, Selmaj K, Agoropoulou C, Leyk M, Zhang-Auberson L, Burtin P, Group FS (2010) A placebo-controlled trial of oral fingolimod in relapsing multiple sclerosis. N Engl J Med 362:387–401

    Article  CAS  PubMed  Google Scholar 

  138. Behrangi N, Fischbach F, Kipp M (2019) Mechanism of siponimod: anti-inflammatory and neuroprotective mode of action. Cells 8:24

    Article  CAS  PubMed Central  Google Scholar 

  139. Chun J, Hartung HP (2010) Mechanism of action of oral fingolimod (FTY720) in multiple sclerosis. Clin Neuropharmacol 33:91–101

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  140. Didonna A, Canto Puig E, Ma Q, Matsunaga A, Ho B, Caillier SJ, Shams H, Lee N, Hauser SL, Tan Q, Zamvil SS, Oksenberg JR (2020) Ataxin-1 regulates B cell function and the severity of autoimmune experimental encephalomyelitis. Proc Natl Acad Sci U S A 117:23742–23750

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  141. Ma Q, Didonna A (2021) The novel multiple sclerosis susceptibility gene ATXN1 regulates B cell receptor signaling in B-1a cells. Mol Brain 14:19

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  142. Baumgarth N (2011) The double life of a B-1 cell: self-reactivity selects for protective effector functions. Nat Rev Immunol 11:34–46

    Article  CAS  PubMed  Google Scholar 

  143. Martinelli-Boneschi F, Esposito F, Brambilla P, Lindstrom E, Lavorgna G, Stankovich J, Rodegher M, Capra R, Ghezzi A, Coniglio G, Colombo B, Sorosina M, Martinelli V, Booth D, Oturai AB, Stewart G, Harbo HF, Kilpatrick TJ, Hillert J, Rubio JP, Abderrahim H, Wojcik J, Comi G (2012) A genome-wide association study in progressive multiple sclerosis. Mult Scler 18:1384–1394

    Article  PubMed  Google Scholar 

  144. Housley WJ, Fernandez SD, Vera K, Murikinati SR, Grutzendler J, Cuerdon N, Glick L, De Jager PL, Mitrovic M, Cotsapas C, Hafler DA (2015) Genetic variants associated with autoimmunity drive NFkappaB signaling and responses to inflammatory stimuli. Sci Transl Med 7:291ra93

    Article  PubMed  PubMed Central  Google Scholar 

  145. Ponath G, Lincoln MR, Levine-Ritterman M, Park C, Dahlawi S, Mubarak M, Sumida T, Airas L, Zhang S, Isitan C, Nguyen TD, Raine CS, Hafler DA, Pitt D (2018) Enhanced astrocyte responses are driven by a genetic risk allele associated with multiple sclerosis. Nat Commun 9:5337

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  146. Shen K, Reichelt M, Kyauk RV, Ngu H, Shen YA, Foreman O, Modrusan Z, Friedman BA, Sheng M, Yuen TJ (2021) Multiple sclerosis risk gene Mertk is required for microglial activation and subsequent remyelination. Cell Rep 34:108835

    Article  CAS  PubMed  Google Scholar 

  147. Beltran E, Gerdes LA, Hansen J, Flierl-Hecht A, Krebs S, Blum H, Ertl-Wagner B, Barkhof F, Kumpfel T, Hohlfeld R, Dornmair K (2019) Early adaptive immune activation detected in monozygotic twins with prodromal multiple sclerosis. J Clin Invest 129:4758–4768

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  148. Esaulova E, Cantoni C, Shchukina I, Zaitsev K, Bucelli RC, Wu GF, Artyomov MN, Cross AH, Edelson BT (2020) Single-cell RNA-seq analysis of human CSF microglia and myeloid cells in neuroinflammation. Neurol Neuroimmunol Neuroinflamm 7:e732

    Article  PubMed  PubMed Central  Google Scholar 

  149. Jakel S, Agirre E, Mendanha Falcao A, van Bruggen D, Lee KW, Knuesel I, Malhotra D, Ffrench-Constant C, Williams A, Castelo-Branco G (2019) Altered human oligodendrocyte heterogeneity in multiple sclerosis. Nature 566:543–547

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  150. Masuda T, Sankowski R, Staszewski O, Bottcher C, Amann L, Sagar SC, Nessler S, Kunz P, van Loo G, Coenen VA, Reinacher PC, Michel A, Sure U, Gold R, Grun D, Priller J, Stadelmann C, Prinz M (2019) Spatial and temporal heterogeneity of mouse and human microglia at single-cell resolution. Nature 566:388–392

    Article  CAS  PubMed  Google Scholar 

  151. Schafflick D, Xu CA, Hartlehnert M, Cole M, Schulte-Mecklenbeck A, Lautwein T, Wolbert J, Heming M, Meuth SG, Kuhlmann T, Gross CC, Wiendl H, Yosef N, Meyer ZU, Horste G (2020) Integrated single cell analysis of blood and cerebrospinal fluid leukocytes in multiple sclerosis. Nat Commun 11:247

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  152. Schirmer L, Velmeshev D, Holmqvist S, Kaufmann M, Werneburg S, Jung D, Vistnes S, Stockley JH, Young A, Steindel M, Tung B, Goyal N, Bhaduri A, Mayer S, Engler JB, Bayraktar OA, Franklin RJM, Haeussler M, Reynolds R, Schafer DP, Friese MA, Shiow LR, Kriegstein AR, Rowitch DH (2019) Neuronal vulnerability and multilineage diversity in multiple sclerosis. Nature 573:75–82

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  153. Absinta M, Maric D, Gharagozloo M, Garton T, Smith MD, Jin J, Fitzgerald KC, Song A, Liu P, Lin JP, Wu T, Johnson KR, McGavern DB, Schafer DP, Calabresi PA, Reich DS (2021) A lymphocyte-microglia-astrocyte axis in chronic active multiple sclerosis. Nature 597:709–714

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  154. Kaufmann M, Evans H, Schaupp AL, Engler JB, Kaur G, Willing A, Kursawe N, Schubert C, Attfield KE, Fugger L, Friese MA (2021) Identifying CNS-colonizing T cells as potential therapeutic targets to prevent progression of multiple sclerosis. Med (N Y) 2:296-312e8

    Google Scholar 

  155. Pappalardo JL, Zhang L, Pecsok MK, Perlman K, Zografou C, Raddassi K, Abulaban A, Krishnaswamy S, Antel J, van Dijk D, Hafler DA (2020) Transcriptomic and clonal characterization of T cells in the human central nervous system. Sci Immunol 5:eabb8786

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  156. Ramesh A, Schubert RD, Greenfield AL, Dandekar R, Loudermilk R, Sabatino JJ Jr, Koelzer MT, Tran EB, Koshal K, Kim K, Probstel AK, Banerji D, University of California SFMSET, Guo CY, Green AJ, Bove RM, DeRisi JL, Gelfand JM, Cree BAC, Zamvil SS, Baranzini SE, Hauser SL, Wilson MR (2020) A pathogenic and clonally expanded B cell transcriptome in active multiple sclerosis. Proc Natl Acad Sci U S A 117:22932–22943

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  157. Fernandes SJ, Ericsson M, Khademi M, Jagodic M, Olsson T, Gomez-Cabrero D, Kockum I, Tegner J (2021) Deep characterization of paired chromatin and transcriptomes in four immune cell types from multiple sclerosis patients. Epigenomics 13:1607–1618

    Article  CAS  PubMed  Google Scholar 

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Funding

This work was supported in part by National Multiple Sclerosis Society (grants JF-1808–32223 and RG-1707–28657).

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This article is a contribution to the special issue on: Genetics and functional genetics of Autoimmune diseases - Guest Editors: Yukinori Okada & Kazuhiko Yamamoto

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Kim, W., Patsopoulos, N. Genetics and functional genomics of multiple sclerosis. Semin Immunopathol 44, 63–79 (2022). https://doi.org/10.1007/s00281-021-00907-3

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