A subset of atopic dermatitis is associated with increased susceptibility to eczema herpeticum (ADEH+). We previously reported that common single nucleotide polymorphisms (SNPs) in the IFN-γ(IFNG)and IFN-γ receptor 1(IFNGR1)genes were associated with the ADEH+ phenotype.Objective:
We sought to interrogate the role of rare variants in interferon pathway genes for the risk of ADEH+.Methods:
We performed targeted sequencing of interferon pathway genes (IFNG,IFNGR1,IFNAR1, andIL12RB1) in 228 European American patients with AD selected according to their eczema herpeticum status, and severity was measured by using the Eczema Area and Severity Index. Replication genotyping was performed in independent samples of 219 European American and 333 African American subjects. Functional investigation of loss-of-function variants was conducted by using site-directed mutagenesis.Results:
We identified 494 single nucleotide variants encompassing 105 kb of sequence, including 145 common, 349 (70.6%) rare (minor allele frequency <5%), and 86 (17.4%) novel variants, of which 2.8% were coding synonymous, 93.3% were noncoding (64.6% intronic), and 3.8% were missense. We identified 6 rareIFNGR1missense variants, including 3 damaging variants (Val14Met [V14M], Val61Ile, and Tyr397Cys [Y397C]) conferring a higher risk for ADEH+ (P= .031). Variants V14M and Y397C were confirmed to be deleterious, leading to partialIFNGR1deficiency. Seven commonIFNGR1SNPs, along with common protective haplotypes (2–7 SNPs), conferred a reduced risk of ADEH+ (P= .015-.002 andP= .0015-.0004, respectively), and both SNP and haplotype associations were replicated in an independent African American sample (P= .004-.0001 andP= .001-.0001, respectively).Conclusion:
Our results provide evidence that both genetic variants in the gene encodingIFNGR1are implicated in susceptibility to the ADEH+ phenotype.