Objectives Idiopathic inflammatory myopathies (IIM) are a heterogeneous group of rare autoimmune diseases in which both genetic and environmental factors play important roles. To identify genetic factors of IIM including polymyositis (PM), dermatomyositis (DM), and clinically amyopathic DM (CADM), we performed the first genome-wide association study (GWAS) for IIM in an Asian population.Methods We genotyped and tested 496,819 SNPs for association using 576 IIM patients and 6,270 control subjects. We also examined the causal mechanism of disease associated variants by in silico analyses using publicly available data sets as well as by in in vitro analyses using reporter assays and apoptosis assays.
ResultsWe identified a variant in WDFY4 that was significantly associated with CADM (rs7919656; odds ratio (OR)=3.87; P=1.5×10 Furthermore, we demonstrated that both WDFY4 and tr-WDFY4 interacted with pattern recognition receptors such as TLR3, TLR4, TLR9, and MDA5 and augmented the NF-κB activation by these receptors. WDFY4 isoforms also enhanced MDA5-induced apoptosis, to a greater extent in the tr-WDFY4-transfected cells.Conclusions As CADM is characterized by the appearance of anti-MDA5 autoantibodies and severe lung inflammation, the WDFY4 variant may play a critical role in the pathogenesis of CADM.