rs231775

This is a variant in the CTLA4 gene that changes a threonine to an alanine.

GWAS Catalog Trait Associations (3)

Genome-wide significant associations (p < 5×10⁻⁸) from the NHGRI-EBI GWAS Catalog.

autoimmune thyroid disease

Allele G
OR 1.18
p 2.0e-74
N 754,406
Large GWAS
European
Zeng Y et al. Genetic Associations Between Stress-Related Disorders and Autoimmune Disease. The American Journal of Psychiatry 180(4):294-304 (2023)
Allele G
OR 1.17
p 6.0e-55
N 376,871
Large GWAS
European

Graves disease

Allele G
OR 0.20
p 2.0e-59
N 2,460,657
Large GWAS
multi-ancestry

alopecia areata

Allele G
OR 1.40
p 2.0e-20
N 7,565
Meta-analysis
European

ClinVar annotation

Risk Factor★★★
8 submitters13 publications

Autoimmune lymphoproliferative syndrome due to CTLA4 haploinsufficiency; Celiac disease, susceptibility to, 3; Hashimoto thyroiditis, susceptibility to; Systemic lupus erythematosus, susceptibility to; TYPE 1 DIABETES MELLITUS 12, SUSCEPTIBILITY TO; not specified

View on ClinVar →

Research that mentions this SNP (21)

Genetic variants in a long noncoding RNA related to Sunitinib Resistance predict risk and survival of patients with renal cell carcinoma
AssociationN=2,024Qianwei Xing et al.(2019)· Cancer Medicine

A two-stage case-control study of 1002 RCC cases and 1022 controls examined associations between lncARSR polymorphisms and renal cell carcinoma (RCC) risk and survival in a Chinese population. rs7859384 GA/GG genotypes were associated with decreased RCC risk across four genetic models (all P < 0.05; OR = 0.77, 95% CI = 0.64-0.94 for stage I/II; OR = 0.79, 95% CI = 0.65-0.95 for clear cell RCC) and higher overall survival (adjusted HR = 0.34, 95% CI = 0.16-0.73, P = 0.005).

Traits studied:Clear cell RCCRCC survivalRCC susceptibilityRenal cell carcinoma (RCC)Sunitinib resistance
Reduction of CD83 Expression on B Cells and the Genetic Basis for Rheumatoid Arthritis: Comment on the Article by Thalayasingam et al
FunctionalN=16Yumi Tsuchida et al.(2018)· Arthritis &amp; Rheumatology

This functional study integrates epigenomic datasets (ATAC-seq, Hi-C, ChIP-seq, RNA-seq) from fibroblast-like synoviocytes (FLS) to map the functional relevance of 101 fine-mapped rheumatoid arthritis GWAS associations. FLS regulatory elements account for 24% of RA heritability, and the study assigns putative target genes to RA risk loci, identifying TNFAIP3, IFNAR1, CDK6, RBPJ and others as disease-relevant genes. TNF stimulation reveals dynamic chromatin interactions and differential gene expression at RA-associated regulatory regions.

Traits studied:Rheumatoid arthritis
PD-1 genotype of the donor is associated with acute graft-versus-host disease after HLA-identical sibling donor stem cell transplantation
AssociationN=1,485Nazly Santos et al.(2018)· Annals of Hematology

This study examined two PD-1 gene polymorphisms (rs36084323 and rs11568821) in donors of 1485 HLA-identical sibling hematopoietic stem cell transplants. The rs36084323 GG genotype was associated with increased acute GvHD risk (HR 2.2, P=0.033), while the rs11568821 AA genotype showed much stronger association (HR 4.5, P<0.001). The rs11568821 AA genotype also remained significant for severe (grades III-IV) GvHD (HR 4.15, P<0.001). PD-1 genotype did not significantly affect overall survival, relapse incidence, or chronic GvHD.

Traits studied:Acute graft-versus-host diseaseChronic graft-versus-host diseaseOverall survival after transplantationRelapse incidenceTransplant-related mortality
CTLA-4 polymorphisms are associated with treatment outcomes of patients with multiple myeloma receiving bortezomib-based regimens
AssociationN=240Xiao-Ying Qin et al.(2018)· Annals of Hematology

This study investigated five CTLA-4 SNPs (rs733618, rs4553808, rs5742909, rs3087243, rs231775) in 86 multiple myeloma patients and 154 controls to evaluate their association with bortezomib treatment outcomes. The rs733618 GG genotype was associated with significantly lower disease-free survival (0% vs 57.4%, P=0.020) and overall survival (46.3% vs 83.3%, P=0.026) compared to GA+AA carriers, with multivariate analysis showing rs733618 GG as a risk factor for overall survival (HR=0.012, 95% CI=0.001-0.199, P=0.002).

Traits studied:Bortezomib treatment responseDisease-free survivalMultiple myelomaNonhematologic adverse eventsOverall survival
NOTCH4 is a possible novel susceptibility gene for dilated cardiomyopathy in the Chinese population: A case‐control study
AssociationN=821Xiaoqing Shi et al.(2018)· Journal of Clinical Laboratory Analysis

A case-control study of 273 DCM patients and 548 controls in the Chinese Han population examined seven genetic variants associated with cardiac neonatal lupus. The study found that the T allele of rs3134942 in NOTCH4 increased DCM risk by 61% (OR=1.61, 95% CI: 1.15-2.27, P=6.57×10⁻³) in additive and dominant models. Additionally, rs2472299 in CYP1A2 was associated with reduced DCM risk in the dominant model (OR=0.72, P=4.24×10⁻²) and correlated with smoking status in patients.

Traits studied:Cardiac neonatal lupusDCMDilated cardiomyopathySystemic lupus erythematosus
A CT60G&gt;A polymorphism in the CTLA-4 gene of the recipient may confer susceptibility to acute graft versus host disease after allogeneic hematopoietic stem cell transplantation
AssociationN=312Lidia Karabon et al.(2015)· Immunogenetics

This study of 312 donor-recipient pairs undergoing hematopoietic stem cell transplantation found that recipient CT60G>A (rs3087243) [GG] genotype in CTLA-4 is an independent risk factor for acute graft-versus-host disease (aGvHD) with OR 2.63 (95% CI 1.45-4.59, p=0.001), while possessing allele A in both CTLA-4 c.49A>G (rs231775) and CT60G>A polymorphisms decreased aGvHD risk approximately 1.5-fold (RR 0.69, p=0.008).

Traits studied:Acute graft-versus-host disease (aGvHD)
Cytotoxic T-lymphocyte antigen 4 (CTLA4) +49AG and CT60 gene polymorphisms in Alopecia Areata: a case–control association study in the Italian population
AssociationN=319Francesca Megiorni et al.(2013)· Archives of Dermatological Research

Case-control study of 130 Italian alopecia areata patients and 189 controls examining CTLA4 polymorphisms +49AG (rs231775) and CT60 (rs3087243). CT60 G allele showed significant association with increased disease risk (OR=1.72, p=0.041), particularly in patchy alopecia (OR=2.28, p=0.022). The +49AG polymorphism showed no significant association. Haplotype G(+49AG)-A(CT60) was protective (OR=0.28, p=0.014).

Traits studied:Alopecia AreataAlopecia TotalisAlopecia Universalis
Associations of polymorphisms in the genes of FGFR2, FGF1, and RBFOX2 with breast cancer risk by estrogen/progesterone receptor status
AssociationN=2,416Yu‐Ling Cen et al.(2013)· Molecular Carcinogenesis

A hospital-based case-control study in rural and urban India (1,204 cases; 1,212 controls) examined genetic and lifestyle risk factors for breast cancer. Four SNPs in FGFR2 (rs1219648, rs2420946, rs2981575, rs2981582) showed positive associations with breast cancer (ORs 1.32-1.47). Additional SNPs in obesity and metabolic genes (rs374748 in FBN2, rs2922763 in HNF4G, rs2116830 in KCNMA1, rs11121832 in MTHFR, rs16886165 in MAP3K1, rs11594610 in TCF7L2, rs2274459 in MLN) were associated with increased breast cancer risk. Waist-to-hip ratio ≥0.95 showed strong association (OR 3.78; 95% CI 2.92-4.89), and women living first 20 years in rural areas showed protective effect (OR 0.77).

Traits studied:Breast cancerBreast cancer riskER+/PR+ breast cancerER/PR negative breast cancerTriple negative breast cancer
Genetic polymorphisms in IL10RA and TNF modify the association between blood transfusion and risk of non‐Hodgkin lymphoma
AssociationN=1,023Xiaofeng Bi et al.(2012)· American Journal of Hematology

Population-based case-control study of Connecticut women showing that genetic polymorphisms in IL10RA (rs9610) and TNF (rs1800629) genes modify the association between blood transfusion and non-Hodgkin lymphoma (NHL) risk. IL10RA rs9610 GG genotype carriers with transfusion history had increased NHL risk (OR=1.9, 95% CI: 1.1-3.2), while AG/AA carriers had decreased risk (OR=0.6, 95% CI: 0.4-0.9), with significant gene-transfusion interaction (P=0.003).

Traits studied:B-cell lymphomaDiffuse large B-cell lymphomaFollicular lymphomaMarginal zone B-cell lymphomaNon-Hodgkin lymphomaSmall lymphocytic lymphoma/chronic lymphocytic leukemiaT-cell lymphoma
Evidence for gene–gene epistatic interactions among susceptibility loci for systemic lupus erythematosus
ReviewHughes T. et al.(2012)· Arthritis &amp; Rheumatism

A comprehensive review of genetic variants contributing to systemic lupus erythematosus (SLE), covering both polygenic (>100 susceptibility loci) and monogenic (1-10% of cases) contributions identified through NGS techniques. Key susceptibility genes include STAT4, BANK1, TNFAIP3, BLK, IRF5, ETS1, and TNIP1, with early-onset SLE showing greater genetic burden particularly in Black, Asian, and Hispanic ancestries.

Traits studied:AutoimmunitySystemic lupus erythematosus
Genetic sequence variants and the development of secondary primary cancers in patients with head and neck cancers
AssociationN=531Abul Kalam Azad et al.(2012)· Cancer

This case-control association study evaluated 23 genetic sequence variants in 17 genes across DNA repair, cell cycle, and other pathways in 531 stage I-II radiation-treated head and neck cancer (HNC) patients to identify associations with secondary primary cancers (SPCs). Among the variants tested, the DNMT3B C149T variant (rs2424913) showed a strong significant association with SPC development, with adjusted hazard ratios of 2.23 (95% CI, 1.32-3.78; P = .003) for TT versus CC genotype and 1.49 (95% CI, 1.15-1.95; P = .003) per T allele. A haplotype cluster of 5 DNMT3B variants in strong linkage disequilibrium also showed significant associations (P < .003), suggesting aberrant DNA methylation is an important modulator of field cancerization in HNC.

Traits studied:Head and neck cancerSecondary primary cancer (SPC)
Association of RANBP1 haplotype with smooth pursuit eye movement abnormality
ReviewHyun Sub Cheong et al.(2011)· American Journal of Medical Genetics Part B: Neuropsychiatric Genetics

This comprehensive review examines the genomics of schizophrenia and pharmacogenomics of antipsychotic drugs, synthesizing evidence on over 200 genes associated with psychotic disorders. The authors discuss five categories of genes relevant to antipsychotic response: disease-associated genes, mechanism-of-action genes, drug metabolism genes (particularly CYP2D6, CYP2C19, CYP2C9, CYP3A4), drug transporter genes, and pleiotropic genes. The review details pharmacogenomic profiles of 20+ antipsychotic drugs and demonstrates significant ethnic and interindividual variation in drug metabolism phenotypes, with examples including CYP2D6 extensive metabolizers (55.71% of population), intermediate metabolizers (34.7%), poor metabolizers (2.28%), and ultra-rapid metabolizers (7.31%).

Traits studied:Alzheimer diseaseAntipsychotic drug responseAntipsychotic drug side effectsAnxiety disordersBipolar disorderCNS disordersDepressive disorderParkinson's diseasePsychotic disordersSchizoaffective disorderSchizophreniaTardive dyskinesiaVascular dementia
Association of a rheumatoid arthritis susceptibility variant at the CCL21 locus with premature mortality in inflammatory polyarthritis patients
AssociationN=2,324Tracey M. Farragher et al.(2010)· Arthritis Care &amp; Research

This cohort study of 2,324 subjects with inflammatory polyarthritis tested 17 rheumatoid arthritis (RA) susceptibility SNPs for association with all-cause and cardiovascular disease (CVD) mortality. Carriage of the CCL21 risk allele rs2812378 was associated with increased CVD mortality (HR 1.33, 95% CI 1.01-1.75) and all-cause mortality (HR 1.40, 95% CI 1.04-1.87), with the strongest effects observed in anti-CCP antibody-positive patients with both the CCL21 risk alleles and shared epitope (SE) alleles (all-cause HR 3.20, 95% CI 1.52-6.72; CVD HR 3.73, 95% CI 1.30-10.72). SNPs at the TRAF1/C5 locus were not significantly associated with mortality in this study.

Traits studied:All-cause mortalityCardiovascular disease mortalityInflammatory polyarthritisRheumatoid arthritis
Polymorphisms in the CD28/CTLA4/ICOS genes: role in malignant melanoma susceptibility and prognosis?
AssociationN=1,497Marna G. Bouwhuis et al.(2010)· Cancer Immunology, Immunotherapy

This case-control study examined 28 SNPs across CD28, CTLA4, and ICOS genes in 763 German melanoma patients and 734 controls to assess association with melanoma susceptibility and prognosis. While two CD28 polymorphisms (rs3181098 and rs3181100) showed differential allele distribution (OR 1.18, P=0.05 and OR 0.83, P=0.02 respectively), after multiple testing correction no convincing associations with melanoma risk or disease prognosis were detected.

Traits studied:Melanoma prognosisMelanoma susceptibilityMetastasis-free survivalOverall survival
CTLA4/ICOS gene variants and haplotypes are associated with rheumatoid arthritis and primary biliary cirrhosis in the Canadian population
Meta-analysisN=20,496Walker EJ et al.(2009)· Arthritis &amp; Rheumatism

Meta-analysis of 27 case-control studies (9,805 RA patients, 10,691 controls) found that the CTLA-4 A49G polymorphism (rs231775) is significantly associated with increased rheumatoid arthritis risk. The G allele showed elevated risk: GG vs AA OR=1.13 (95% CI 1.03-1.23), GA vs AA OR=1.19 (95% CI 1.07-1.33), and GA+GG vs AA OR=1.18 (95% CI 1.07-1.29). Association was consistent in both Asian and Caucasian populations.

Traits studied:Rheumatoid arthritis
Lack of association of functional CTLA4 polymorphisms with juvenile idiopathic arthritis
AssociationN=1,447Sampath Prahalad et al.(2008)· Arthritis &amp; Rheumatism

This study investigated the association between three functional CTLA4 polymorphisms (C-318T rs5742909, A49G rs231775, and CT60 rs3087243) and juvenile idiopathic arthritis (JIA) using family-based and case-control analyses in a large cohort (531 JIA families plus 365 independent JIA cases and 551 controls). The authors found no significant associations between any of the CTLA4 variants and JIA overall or most JIA subtypes, and a meta-analysis of published studies also failed to confirm an association between CTLA4 variants and JIA.

Traits studied:Enthesitis-related arthritisExtended oligoarticular JIAJuvenile idiopathic arthritis (JIA)Persistent oligoarticular JIARF-negative polyarticular JIARF-positive polyarticular JIASystemic JIA
Common variants in genes that mediate immunity and risk of multiple myeloma
AssociationN=672Elizabeth E. Brown et al.(2007)· International Journal of Cancer

A case-control study of 127 multiple myeloma (MM) cases and 545 controls examined 82 common variants in 45 genes mediating immunity. IL4R rs2107356 (−28120T homozygotes, OR=1.91, 95% CI 1.08-3.38) and FCGR2A rs1801274 (−120G homozygotes, OR=1.95, 95% CI 1.06-3.60) were significantly associated with increased MM risk. A haplotype in the LTA*TNF complex (LTA −82C/−90G*TNF −1036C/−487G/−417G, OR=1.63, 95% CI 1.02-2.61) was also associated with increased MM risk compared to controls.

Traits studied:Multiple myeloma
The –786C/T single‐nucleotide polymorphism in the promoter of the gene for endothelial nitric oxide synthase: Insensitivity to physiologic stimuli as a risk factor for rheumatoid arthritis
AssociationN=219Inga Melchers et al.(2006)· Arthritis &amp; Rheumatism

This journal issue contains multiple genetic association studies on rheumatoid arthritis (RA). A key REMARCA study (146 aCCP+ RA patients vs 314 controls) identified polymorphisms in CTLA4 (rs231775 +49A/G), IL10 (rs1800872 -592A/C), and IL6R (rs8192284 +358A/C) associated with high inflammatory disease activity, with CTLA4 and IL10 minor alleles showing increased risk (OR=1.4, p=0.02 and OR=1.9, p<0.0001 respectively) and IL6R minor allele being protective (OR=0.7, p=0.03). A separate study analyzed NOS3, PPARG, PPARGC1A, PPARGC1B and PAI1 polymorphisms in 73 RA patients for cardiovascular risk.

Traits studied:Cardiovascular riskHigh inflammatory disease activityRheumatoid arthritis
Association between the PTPN22 gene and rheumatoid arthritis and juvenile idiopathic arthritis in a UK population: Further support that PTPN22 is an autoimmunity gene
AssociationN=436Anne Hinks et al.(2005)· Arthritis &amp; Rheumatism

Candidate gene association study of 122 early rheumatoid arthritis (RA) patients and 314 healthy controls found that PTPN22 rs2476601 (OR=1.5, 95% CI 1.0-2.3, p=0.05) and TNFAIP3 rs675520 (OR=1.7) polymorphisms were significantly associated with RA risk. Anti-cyclic citrullinated peptide (ACPA) antibody production was associated with PTPN22, TNFAIP3, CTLA4, and TNF-α polymorphisms in a dose-dependent manner.

Traits studied:ACPA (anti-cyclic citrullinated peptide) antibody productionEarly rheumatoid arthritisRheumatoid arthritisRheumatoid factor (IgM RF) production
Haplotype analysis in simplex families and novel analytic approaches in a case–control cohort reveal no evidence of association of the CTLA‐4 gene with rheumatoid arthritis
Meta-analysisN=20,496Anne Barton et al.(2004)· Arthritis &amp; Rheumatism

Meta-analysis of 27 case-control studies (9,805 RA patients, 10,691 controls) found significant association between CTLA-4 A49G polymorphism (rs231775) and rheumatoid arthritis risk. G allele increased RA susceptibility overall (GA vs AA: OR=1.19) and particularly in Asian populations (GG vs AA: OR=1.34). No publication bias was detected.

Traits studied:Rheumatoid arthritis
Association of the CT60 marker of the CTLA4 gene with systemic lupus erythematosus
AssociationN=114Belén Torres et al.(2004)· Arthritis &amp; Rheumatism

This case-control study examined CTLA-4 gene polymorphisms (CT60 and +49 A/G) in 114 Egyptian chronic hepatitis C patients receiving interferon-alpha therapy, comparing 54 with thyroid disorders (35 hypothyroidism, 19 Graves' disease) to 60 controls. The AG genotype at +49 was significantly associated with both hypothyroidism (OR: 2.6, 95% CI: 1.1-6.1, P=0.02) and Graves' disease (OR: 2.97, 95% CI: 1.02-8.6, P=0.039), while the CC genotype at CT60 was protective (OR: 2.4 for hypothyroidism, OR: 3.5 for Graves' disease, P<0.05).

Traits studied:Autoimmune thyroid diseaseGraves' diseaseHypothyroidism

About CTLA4

This gene is a member of the immunoglobulin superfamily and encodes a protein which transmits an inhibitory signal to T cells. The protein contains a V domain, a transmembrane domain, and a cytoplasmic tail. Alternate transcriptional splice variants, encoding different isoforms, have been characterized. The membrane-bound isoform functions as a homodimer interconnected by a disulfide bond, while the soluble isoform functions as a monomer. Mutations in this gene have been associated with insulin-dependent diabetes mellitus, Graves disease, Hashimoto thyroiditis, celiac disease, systemic lupus erythematosus, thyroid-associated orbitopathy, and other autoimmune diseases. [provided by RefSeq, Jul 2008]

View all CTLA4 variants →

Gene information from NCBI Gene. Variant classifications from ClinVar.

Community Wiki

No community notes yet for this variant. Sign in to start one.

Comments

Sign in to join the discussion.

Loading comments…