Novel genetic variants of HLA gene associated with Thai Behcet’s disease (BD) patients using next generation sequencing technology

Behçet's disease (BD) manifests as an autoimmune disorder featuring recurrent ulcers and multi-organ involvement, influenced by genetic factors associated with both HLA and non-HLA genes, including TNF-α and ERAP1. The study investigated the susceptible alleles of both Class I and II molecules of the HLA gene in 56 Thai BD patients and 192 healthy controls through next-generation sequencing using a PacBio kit. The study assessed 56 BD patients, primarily females (58.9%), revealing diverse manifestations including ocular (41.1%), vascular (35.7%), skin (55.4%), CNS (5.4%), and GI system (10.7%) involvement. This study found associations between BD and HLA-A*26:01:01 (OR 3.285, 95% CI 1.135–9.504, P-value 0.028), HLA-B*39:01:01 (OR 6.176, 95% CI 1.428–26.712, P-value 0.015), HLA-B*51:01:01 (OR 3.033, 95% CI 1.135–8.103, P-value 0.027), HLA-B*51:01:02 (OR 6.176, 95% CI 1.428–26.712, P-value 0.015), HLA-C*14:02:01 (OR 3.485, 95% CI 1.339–9.065, P-value 0.01), HLA-DRB1*14:54:01 (OR 1.924, 95% CI 1.051–3.522, P-value 0.034), and HLA-DQB1*05:03:01 (OR 3.00, 95% CI 1.323–6.798, P-value 0.008). However, after Bonferroni correction none of these alleles were found to be associated with BD. In haplotype analysis, we found a strong linkage disequilibrium in HLA-B*51:01:01, HLA-C*14:02:01 (P-value 0.0, Pc-value 0.02). Regarding the phenotype, a significant association was found between HLA-DRB1*14:54:01 (OR 11.67, 95% CI 2.86–47.57, P-value 0.001) and BD with ocular involvement, apart from this, no distinct phenotype-HLA association was documented. In summary, our study identifies specific HLA associations in BD. Although limited by a small sample size, we acknowledge the need for further investigation into HLA relationships with CNS, GI, and neurological phenotypes in the Thai population.