Systemic Lupus Erythematosus (SLE) is a prototypic autoimmune disorder
with a complex pathogenesis in which genetic, hormonal and environmental factors
play a role. Rare mutations in the TREX1 gene, the major mammalian
3′-5′ exonuclease, have been reported in sporadic SLE cases.
Some of these mutations have also been identified in a rare pediatric neurologic
condition featuring an inflammatory encephalopathy known as
Aicardi-Goutières syndrome (AGS). We sought to investigate the frequency
of these mutations in a large multi-ancestral cohort of SLE cases and
Forty single-nucleotide polymorphisms (SNPs), including both common
and rare variants, across the TREX1 gene were evaluated in ∼8370
patients with SLE and ∼7490 control subjects. Stringent quality
control procedures were applied and principal components and admixture
proportions were calculated to identify outliers for removal from analysis.
Population-based case-control association analyses were performed. P values,
false discovery rate q values, and odds ratios with 95% confidence
intervals were calculated.
The estimated frequency of TREX1 mutations in our lupus cohort was
0.5%. Five heterozygous mutations were detected at the Y305C
polymorphism in European lupus cases but none were observed in European
controls. Five African cases incurred heterozygous mutations at the E266G
polymorphism and, again, none were observed in the African controls. A rare
homozygous R114H mutation was identified in one Asian SLE patient whereas
all genotypes at this mutation in previous reports for SLE were
heterozygous. Analysis of common TREX1 SNPs (MAF >10%)
revealed a relatively common risk haplotype in European SLE patients with
neurologic manifestations, especially seizures, with a frequency of
58% in lupus cases compared to 45% in normal controls
(p=0.0008, OR=1.73, 95% CI=1.25-2.39).
Finally, the presence or absence of specific autoantibodies in certain
populations produced significant genetic associations. For example, a strong
association with anti-nRNP was observed in the European cohort at a coding
synonymous variant rs56203834 (p=2.99E-13, OR=5.2,
Our data confirm and expand previous reports and provide additional
support for the involvement of TREX1 in lupus pathogenesis.