Psoriasis Clinical Trial
Official title:
Role of HLA and KIR in the Natural History of Psoriasis
This study will examine the genetic basis of psoriasis and psoriatic arthritis. It is known
that genes play an important role in determining who gets psoriasis or psoriatic arthritis.
This study will look for specific gene variants (alleles) that run in families with these
conditions, or are found more often in people with these conditions than in those without
them.
Participants for this study were identified through the dermatology services of the
University of Michigan Medical Center, the Ann Arbor Veterans Affairs Medical Center, the
University of Kiel, and Henry Ford Hospital. Additional families were provided by the
National Psoriasis Foundation Tissue Bank. They include people with psoriasis or psoriatic
arthritis, or both, in addition to some family members of patients. Only families in which
the age of the patient at disease onset was below 40 years are included. Patients were
included if they had lesions covering more than 1 percent of their total body surface area or
if at least two skin, scalp, nail, or joint lesions were diagnosed as psoriasis. Healthy
volunteers are also enrolled as control subjects.
Participants undergo the following procedures, as follows:
Patients with psoriasis and people without psoriasis who have multiple family members with
the disease
- Skin evaluation
- Photographs of lesions for documentation
Patients with psoriatic arthritis and people without psoriatic arthritis who have multiple
family members with the disease
- Joint evaluation and possibly ultrasound
- Joint X-rays or review of existing X-rays
Patients with psoriasis only, with psoriatic arthritis, and healthy volunteers
- Blood draw of 30 milliliters. Some of the blood collected will be used to test for
rheumatoid factor and C-reactive protein in patients with psoriatic arthritis.
- Periodic questionnaires to update health status information
The aim of the study is to examine the role of HLA and killer immunoglobulin-like receptors
(KIR) in the natural history of psoriasis vulgaris. Psoriasis is a chronic inflammatory
disease of the skin with features of an autoimmune disease, and previous studies have
revealed an association with certain HLA class I alleles, notably HLA-Cw*0602. Natural Killer
(NK) cells are a unique group of lymphocytes involved in surveillance of killing of foreign
or infected cells through a mechanism involving recognition of HLA class I molecules by an
extremely diverse set of receptors on the NK cell surface. A major group of these receptors
are the KIRs. Thus, a relationship between KIR/HLA genotype and psoriasis is biologically
plausible, and indeed previous data from our laboratory have shown a strong association with
the activating genes KIR2DS1 and KIR2DS2 and development of psoriatic arthritis, a
well-recognized complication of psoriasis.
Dr. James Elder and colleagues at the University of Michigan have identified a cohort of more
than 560 families through the dermatology services of the University of Michigan Medical
Center, the University of Kiel, Henry Ford Hospital, and the National Psoriasis Foundation
Tissue Bank. Individuals have been well characterized clinically, and information on race,
ethnicity, age at onset, current age, and history of inflammatory bowel disease and/or other
autoimmune disorders has been obtained. The large size of the cohort will provide substantial
statistical power, which is of major importance in any KIR/HLA association study.
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