Sex-specific HLA alleles contribute to the modulation of COVID-19 severity
Article
Spartano, S., Faggiano, M.V., Guidi, G., D’Ambrosio, P., Vaisfeld, A., Novelli, A., Falqui, S., Cingolani, A., Lambertenghi, L., Visentin, A., Azzini, A., Righi, E., Trecarichi, E., Mazzitelli, M., Coletti, S., Mous, J., Rademacher, T.W., Torti, C., Tacconelli, E., Fantoni, M., Cauda, R. and Tiziano, F. 2024. Sex-specific HLA alleles contribute to the modulation of COVID-19 severity. International Journal of Molecular Sciences. 25 (23). https://doi.org/10.3390/ijms252313198
Type | Article |
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Title | Sex-specific HLA alleles contribute to the modulation of COVID-19 severity |
Authors | Spartano, S., Faggiano, M.V., Guidi, G., D’Ambrosio, P., Vaisfeld, A., Novelli, A., Falqui, S., Cingolani, A., Lambertenghi, L., Visentin, A., Azzini, A., Righi, E., Trecarichi, E., Mazzitelli, M., Coletti, S., Mous, J., Rademacher, T.W., Torti, C., Tacconelli, E., Fantoni, M., Cauda, R. and Tiziano, F. |
Abstract | Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, responsible for Coronavirus Disease 2019 (COVID-19), exhibits a spectrum of clinical manifestations, ranging from asymptomatic to severe pulmonary dysfunction or death. The variability in COVID-19 severity has largely been attributed to the host’s genetic characteristics, suggesting a polygenic genetic architecture, without significant strong evidence of sex-related genetic differences. In this Italian retrospective case–control study, we investigated the association between COVID-19 severity (severe vs. asymptomatic/oligosymptomatic healed individuals) and HLA gene variants, analyzed by next-generation sequencing (NGS). We identified significant HLA alleles (according to the conventional nomenclature), SNPs and haplotypes in the HLA-B, -C, -F, -DQA1, -DRB1, and -DRB5 genes associated with COVID-19 severity. Interestingly, these variants showed biological sex-related effects. Also, we identified specific haplotypes associated with COVID-19 severity that are shared by different conventional HLA alleles, indicated here as “super-haplotypes”. These haplotypes had a biological sex-specific impact on disease severity and markedly increased the risk of severe COVID-19 compared to the conventional HLA alleles (odds ratio of up to 15). Our data suggest that the revision of the current HLA nomenclature may help to identify variants with a stronger effect on disease susceptibility and that association studies could benefit from the stratification of patients by biological sex. If replicated in other disease models, these findings could help to define the functional diversity in immune response between sexes, also based on the HLA system. Finally, due to the global pandemic’s mortality rate, we hypothesize here that SARS-CoV-2 may have acted as a natural selection trigger, leading to a drift in HLA allelic frequencies in the general population. |
Keywords | immune system modulation; Italy - epidemiology; biological sex differences; HLA Antigens - genetics; Humans; Case-Control Studies; Retrospective Studies; HLA gene variants; Middle Aged; Haplotypes; Genetic Predisposition to Disease; Severity of Illness Index; Gene Frequency; Adult; Female; Aged; genetic architecture; Alleles; next-generation sequencing; genetic association study; Male; Polymorphism, Single Nucleotide; COVID-19 - genetics - immunology - virology; COVID-19; case–control study; SARS-CoV-2; Sex Factors |
Sustainable Development Goals | 3 Good health and well-being |
Middlesex University Theme | Health & Wellbeing |
Publisher | MDPI |
Journal | International Journal of Molecular Sciences |
ISSN | |
Electronic | 1422-0067 |
Publication dates | |
Online | 08 Dec 2024 |
08 Dec 2024 | |
Publication process dates | |
Submitted | 26 Sep 2024 |
Accepted | 20 Nov 2024 |
Deposited | 20 Jan 2025 |
Output status | Published |
Publisher's version | License File Access Level Open |
Digital Object Identifier (DOI) | https://doi.org/10.3390/ijms252313198 |
PubMed ID | 39684907 |
PubMed Central ID | PMC11642212 |
National Library of Medicine ID | ID101092791 |
https://repository.mdx.ac.uk/item/1z5024
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