PSORS1 ( psoriasis susceptibility gene 1) is a major susceptibility locus for psoriasis. Several fine-mapping studies have highlighted a 300-kb candidate region of PSORS1 where multiple biologically plausible candidate genes were suggested. The most recent study has indicated HLA-Cw6 as the primary PSORS1 risk allele within the candidate region in a Caucasian population. In this study, a family-based association analysis of the PSORS1 locus was performed by analyzing 10 polymorphic microsatellite markers from the PSORS1 region as well as HLA- B, HLA- C and CDSN loci in 163 Chinese families of psoriasis. Five marker loci show strong evidence ( P, 10 23), and one marker locus shows weak evidence ( P = 0.04) for association. The haplotype cluster analysis showed that all the risk haplotypes are Cw6 positive and share a 369-kb region of homologous marker alleles which carries all the risk alleles, including HLA- Cw6 and CDSN*TTC, identified in this study. The recombinant haplotype analysis of the HLA- Cw6 and CDSN*TTC alleles in 228 Chinese families showed that the HLA- Cw6-/CDSN*TTC+ recombinant haplotype is clearly not associated with risk for psoriasis (T:NT = 29: 57, p = 0.0025) in a Chinese population, suggesting that the CDSN*TTC allele itself does not confer risk without the presence of the HLA- Cw6 allele. The further exclusion analysis of the non-risk HLA- Cw6 2/CDSN*TTC+ recombinant haplotypes with common recombination breakpoints has allowed us to refine the location of PSORS1 to a small candidate region. Finally, we performed a conditional linkage analysis and showed that the HLA- Cw6 is a major risk allele but does not explain the full linkage evidence of the PSORS1 locus in a Chinese population. By performing a series of family-based association analyses of haplotypes as well as an exclusion analysis of recombinant haplotypes, we were able to refine the PSORS1 gene to a small critical region where HLA-C is a strong candidate to be the PSORS1 susceptibility gene.
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