FcγRIIa (CD32) Polymorphism and Onchocercal Skin Disease: Implications for the Development of Severe Reactive Onchodermatitis (ROD)

Magdi M. M. Ali Tropical Medicine Research Institute, National Centre for Research, Khartoum, Sudan; Department of Immunology, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden; Department of Clinical Epidemiology Karolinska Hospital, Karolinska Institute, Stockholm, Sweden; Clinical Research Centre, Örebro University Hospital, Sweden; Department of Neurology, Khartoum Teaching Hospital, Sudan; Department of Neurology Rashid Hospital, Dubai, UAE; Departments of Dermatology and of Biochemistry, Faculty of Medicine, University of Juba, Sudan; Department of Microbiology and Immunology, Faculty of Medicine, University of Khartoum; Department of Clinical Immunology, Faculty of Medicine, King Fahad Medical City, Riyadh, Saudia Arabia

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Gehad ElGhazali Tropical Medicine Research Institute, National Centre for Research, Khartoum, Sudan; Department of Immunology, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden; Department of Clinical Epidemiology Karolinska Hospital, Karolinska Institute, Stockholm, Sweden; Clinical Research Centre, Örebro University Hospital, Sweden; Department of Neurology, Khartoum Teaching Hospital, Sudan; Department of Neurology Rashid Hospital, Dubai, UAE; Departments of Dermatology and of Biochemistry, Faculty of Medicine, University of Juba, Sudan; Department of Microbiology and Immunology, Faculty of Medicine, University of Khartoum; Department of Clinical Immunology, Faculty of Medicine, King Fahad Medical City, Riyadh, Saudia Arabia

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Scott M. Montgomery Tropical Medicine Research Institute, National Centre for Research, Khartoum, Sudan; Department of Immunology, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden; Department of Clinical Epidemiology Karolinska Hospital, Karolinska Institute, Stockholm, Sweden; Clinical Research Centre, Örebro University Hospital, Sweden; Department of Neurology, Khartoum Teaching Hospital, Sudan; Department of Neurology Rashid Hospital, Dubai, UAE; Departments of Dermatology and of Biochemistry, Faculty of Medicine, University of Juba, Sudan; Department of Microbiology and Immunology, Faculty of Medicine, University of Khartoum; Department of Clinical Immunology, Faculty of Medicine, King Fahad Medical City, Riyadh, Saudia Arabia

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Salah E. Farouk Tropical Medicine Research Institute, National Centre for Research, Khartoum, Sudan; Department of Immunology, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden; Department of Clinical Epidemiology Karolinska Hospital, Karolinska Institute, Stockholm, Sweden; Clinical Research Centre, Örebro University Hospital, Sweden; Department of Neurology, Khartoum Teaching Hospital, Sudan; Department of Neurology Rashid Hospital, Dubai, UAE; Departments of Dermatology and of Biochemistry, Faculty of Medicine, University of Juba, Sudan; Department of Microbiology and Immunology, Faculty of Medicine, University of Khartoum; Department of Clinical Immunology, Faculty of Medicine, King Fahad Medical City, Riyadh, Saudia Arabia

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Amre Nasr Tropical Medicine Research Institute, National Centre for Research, Khartoum, Sudan; Department of Immunology, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden; Department of Clinical Epidemiology Karolinska Hospital, Karolinska Institute, Stockholm, Sweden; Clinical Research Centre, Örebro University Hospital, Sweden; Department of Neurology, Khartoum Teaching Hospital, Sudan; Department of Neurology Rashid Hospital, Dubai, UAE; Departments of Dermatology and of Biochemistry, Faculty of Medicine, University of Juba, Sudan; Department of Microbiology and Immunology, Faculty of Medicine, University of Khartoum; Department of Clinical Immunology, Faculty of Medicine, King Fahad Medical City, Riyadh, Saudia Arabia

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Suzan I. A. Noori Tropical Medicine Research Institute, National Centre for Research, Khartoum, Sudan; Department of Immunology, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden; Department of Clinical Epidemiology Karolinska Hospital, Karolinska Institute, Stockholm, Sweden; Clinical Research Centre, Örebro University Hospital, Sweden; Department of Neurology, Khartoum Teaching Hospital, Sudan; Department of Neurology Rashid Hospital, Dubai, UAE; Departments of Dermatology and of Biochemistry, Faculty of Medicine, University of Juba, Sudan; Department of Microbiology and Immunology, Faculty of Medicine, University of Khartoum; Department of Clinical Immunology, Faculty of Medicine, King Fahad Medical City, Riyadh, Saudia Arabia

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Mahdi M. Shamad Tropical Medicine Research Institute, National Centre for Research, Khartoum, Sudan; Department of Immunology, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden; Department of Clinical Epidemiology Karolinska Hospital, Karolinska Institute, Stockholm, Sweden; Clinical Research Centre, Örebro University Hospital, Sweden; Department of Neurology, Khartoum Teaching Hospital, Sudan; Department of Neurology Rashid Hospital, Dubai, UAE; Departments of Dermatology and of Biochemistry, Faculty of Medicine, University of Juba, Sudan; Department of Microbiology and Immunology, Faculty of Medicine, University of Khartoum; Department of Clinical Immunology, Faculty of Medicine, King Fahad Medical City, Riyadh, Saudia Arabia

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Omar E. Fadlelseed Tropical Medicine Research Institute, National Centre for Research, Khartoum, Sudan; Department of Immunology, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden; Department of Clinical Epidemiology Karolinska Hospital, Karolinska Institute, Stockholm, Sweden; Clinical Research Centre, Örebro University Hospital, Sweden; Department of Neurology, Khartoum Teaching Hospital, Sudan; Department of Neurology Rashid Hospital, Dubai, UAE; Departments of Dermatology and of Biochemistry, Faculty of Medicine, University of Juba, Sudan; Department of Microbiology and Immunology, Faculty of Medicine, University of Khartoum; Department of Clinical Immunology, Faculty of Medicine, King Fahad Medical City, Riyadh, Saudia Arabia

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Klavs Berzins Tropical Medicine Research Institute, National Centre for Research, Khartoum, Sudan; Department of Immunology, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden; Department of Clinical Epidemiology Karolinska Hospital, Karolinska Institute, Stockholm, Sweden; Clinical Research Centre, Örebro University Hospital, Sweden; Department of Neurology, Khartoum Teaching Hospital, Sudan; Department of Neurology Rashid Hospital, Dubai, UAE; Departments of Dermatology and of Biochemistry, Faculty of Medicine, University of Juba, Sudan; Department of Microbiology and Immunology, Faculty of Medicine, University of Khartoum; Department of Clinical Immunology, Faculty of Medicine, King Fahad Medical City, Riyadh, Saudia Arabia

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The pathologic manifestations of Onchocerca volvulus infection depend on the interplay between the host and the parasite. A genetic single nucleotide polymorphism in the FcγRIIa gene, resulting in arginine (R) or histidine (H) at position 131, affects the binding to the different IgG subclasses and may influence the clinical variations seen in onchocerciasis. This study investigated the relationship between this polymorphism and disease outcome. FcγRIIa genotyping was performed on clinically characterized onchocerciasis patients (N = 100) and healthy controls (N = 74). FcγRIIa genotype R/R131 frequencies were significantly higher among patients with severe dermatopathology (P < 0.001). Increased risk of developing this form was mostly associated with one tribe (Masalit) (OR = 3.2, 95% CI 1–9.9, P = 0.042). The H131 allele was found to be significantly associated with a reduced risk of having the severe form of the disease (adjusted OR = 0.26, 95% CI = 0.13–0.46, P < 0.001). Our findings suggest that the polymorphism influences the clinical outcome of onchocerciasis.

Author Notes

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