Working Paper Review Version 1 This version is not peer-reviewed

HLA-A29 and Birdshot Uveitis: Further down the Rabbit Hole

Version 1 : Received: 28 August 2020 / Approved: 30 August 2020 / Online: 30 August 2020 (17:39:55 CEST)

How to cite: Kuiper, J.J.; Venema, W.J. HLA-A29 and Birdshot Uveitis: Further down the Rabbit Hole. Preprints 2020, 2020080682 Kuiper, J.J.; Venema, W.J. HLA-A29 and Birdshot Uveitis: Further down the Rabbit Hole. Preprints 2020, 2020080682

Abstract

HLA class I alleles constitute established risk factors for non-infectious uveitis and preemptive genotyping of HLA class I alleles is standard practice in the diagnostic work-up. The HLA-A29 serotype is indispensable to Birdshot Uveitis (BU) and renders this enigmatic eye condition a unique model to better understand how the antigen processing and presentation machinery contributes to non-infectious uveitis or chronic inflammatory conditions in general. This review will discuss salient points regarding the protein structure of HLA-A29 using and how key amino acid positions impact the peptide binding preference and interaction with T cells. We discuss to what extent the risk genes ERAP1 and ERAP2 uniquely affect HLA-A29 and how the discovery of a HLA-A29-specific submotif may impact autoantigen discovery. We further provide a compelling argument to solve the long-standing question why BU only affects HLA-A29-positive individuals from Western-European ancestry by exploiting data from the 1000 Genomes Project. We combine novel insights from structural and immunopeptidomic studies and discuss the functional implications of genetic associations across the HLA class I antigen presentation pathway to refine the etiological basis of Birdshot Uveitis.

Subject Areas

HLA; Uveitis; Birdshot; Antigen Presentation Pathway; Autoimmune Disease; Inflammation; ERAP1 and ERAP2

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