Scientific Reports (Oct 2023)

Genetic variation in the human leukocyte antigen region confers susceptibility to Clostridioides difficile infection

  • Kathleen Ferar,
  • Taryn O. Hall,
  • Dana C. Crawford,
  • Robb Rowley,
  • Benjamin A. Satterfield,
  • Rongling Li,
  • Loren Gragert,
  • Elizabeth W. Karlson,
  • Mariza de Andrade,
  • Iftikhar J. Kullo,
  • Catherine A. McCarty,
  • Abel Kho,
  • M. Geoffrey Hayes,
  • Marylyn D. Ritchie,
  • Paul K. Crane,
  • Daniel B. Mirel,
  • Christopher Carlson,
  • John J. Connolly,
  • Hakon Hakonarson,
  • Andrew T. Crenshaw,
  • David Carrell,
  • Yuan Luo,
  • Ozan Dikilitas,
  • Joshua C. Denny,
  • Gail P. Jarvik,
  • David R. Crosslin

DOI
https://doi.org/10.1038/s41598-023-45649-4
Journal volume & issue
Vol. 13, no. 1
pp. 1 – 15

Abstract

Read online

Abstract Clostridioides difficile (C. diff.) infection (CDI) is a leading cause of hospital acquired diarrhea in North America and Europe and a major cause of morbidity and mortality. Known risk factors do not fully explain CDI susceptibility, and genetic susceptibility is suggested by the fact that some patients with colons that are colonized with C. diff. do not develop any infection while others develop severe or recurrent infections. To identify common genetic variants associated with CDI, we performed a genome-wide association analysis in 19,861 participants (1349 cases; 18,512 controls) from the Electronic Medical Records and Genomics (eMERGE) Network. Using logistic regression, we found strong evidence for genetic variation in the DRB locus of the MHC (HLA) II region that predisposes individuals to CDI (P > 1.0 × 10–14; OR 1.56). Altered transcriptional regulation in the HLA region may play a role in conferring susceptibility to this opportunistic enteric pathogen.