Relationship Between IL36RN Gene Mutation And Generalized Pustular Psoriasis:A Meta Analysis

Objective: The reason for conducing this study was that the interdependency between interleukin 36 receptor antagonist gene(IL36RN)mutation and Generalized Pustular Psoriasis(GPP)appearence should be interpreted more detailedly,and to study the genetic heterogeneity between GPP and PV,adults and children.Finally,to study the genetic pattern of c.115+6T>C,the most common single-nucleotide polymorphism.Methods: To conduce thorough literature review,studies were got from the electronic resource such as China Knowledge Network(i.e.CNKI),Pubmed database resources,and EMBASE database resources,Cohrane database resources,along with Wanfang database resources(Wanfang).Only studies published up to December 2019 were included.According to standardized Newscastle–Ottawa scal.e,we assessed the researched papers’ quality.The odds ratios,as the final index of outcome,were pooled and analysed using STATA 14,along with corresponding 95% confidence intervals(95% CIs).Egger test was conduced to check the publication bias.Five common gene models were built and analysed to assess the association between the polymorphism c.115+6T>C and subtypes of GPP.Results: In the end,we picked up ten most congruent studies to go through the final test.And 683 GPP cases were in them.As the meta-analyses present to us,that strong statistical correlation between IL36 RN mutation GPP with or without psoriasis vulgaris(PV)(OR=3.82,95%CI 2.63–5.56)and between adult GPP and paediatric GPP(OR=0.42,95%CI 0.23–0.77)was notified.No obvious discrepancy between European patients(OR=4.03,95%CI 2.23–7.26)and Asian patients was found.The gene models showed clear associations between the polymorphism c.115+6T>C and GPP through the dominant model(OR 2.74,95%CI 2.06–3.64),recessive(OR 4.33,95%CI 2.84–6.60),homozygote(OR 4.37,95%CI 2.88–6.62),heterozygote(OR 2.26,95%CI 1.32–3.85)and allelic model(OR 3.35,95%CI 2.63–4.27).Conclusion: The IL36 RN mutation is strongly related to GPP without psoriasis vulgaris and the early onset of GPP.Furthermore,single nucleotide polymorphisms of IL36 RN genes c.115+6T>C play an important role in GPP pathogenesis,especially in homozygous mutations,showing dominant genetic patterns.