Genome-wide association scan in psoriasis: new insights into chronic inflammatory disease

Genome-wide association scans have delivered on their promise of revealing susceptibility polymorphisms underlying common diseases. This comprehensive psoriasis study by Liu and colleagues reports confirmation of previously identified genes (HLA-C, IL12B and IL23R), identifies several novel psoriasis loci and is the first to report psoriatic arthritis association on a genome-wide scale. Along with other recent studies, this work gives further evidence that IL-23-mediated signaling is a key component of both psoriasis and psoriatic arthritis pathogenesis. Importantly, this study provides evidence of a single-nucleotide polymorphism (SNP), 35 kb upstream of HLA-C, which is stronger than Cw(star)0602 - the variant traditionally attributed to the MHC-linked psoriasis-susceptibility effect. Within this region, the authors also discovered an independent SNP with very strong predisposing effects. SNPs in the COG6 region and the USP8-TNFAIP813 region are among the novel psoriasis associations reported. In addition, a region showing linkage on chromosome 1q demonstrated association in the epidermal differentiation complex. Four SNPs over a 439-kb region on chromosome 4q27, where KIAA1109, ADAD1 and two cytokine-encoding genes (IL2 and IL21) reside, exhibit intriguing correlation with psoriatic arthritis, although the signal strength is moderate. These results, while still preliminary, may substantially expand our knowledge of psoriasis and psoriatic arthritis genetics, opening new avenues of chronic inflammatory disease research.