{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:35:30Z","timestamp":1785432930975,"version":"3.56.0"},"reference-count":46,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Laboratory Analysis"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cytotoxic T\u2010lymphocyte\u2010associated protein 4 (CTLA\u20104) is one of the essential brakes expressed on T cells that prevent T\u2010cell hyperactivation\u2010associated autoimmune disorders. Several <jats:italic>CTLA4<\/jats:italic> polymorphisms were implicated in the regulation of gene expression. We aimed to explore the association of <jats:italic>CTLA4<\/jats:italic> expression and rs231775 (c.49A&gt;G) variant with vitiligo risk and severity of the disease in a sample of the Middle Eastern population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The <jats:italic>CTLA4<\/jats:italic> gene expression and genotyping for rs231775 (A\/G) variant were assessed in 161 vitiligo patients and 165 controls using a real\u2010time polymerase chain reaction. Vitiligo Area Severity Index (VASI) and Vitiligo Disease Activity score (VIDA) were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A higher frequency of rs231775 G allele was observed in vitiligo cases than controls (45% vs. 33%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.002). After adjustment of age, sex, family history of vitiligo, and <jats:italic>CTLA<\/jats:italic> expression level, using multivariate analysis, G\/G carriers were associated with a higher risk of vitiligo under recessive (OR\u00a0=\u00a02.94, 95% CI\u00a0=\u00a01.61\u20135.35, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), dominant (OR\u00a0=\u00a01.87, 95% CI\u00a0=\u00a01.14\u20133.06, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.013), and homozygote comparison (OR\u00a0=\u00a03.34, 95% CI\u00a0=\u00a01.73\u20136.42, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.001) models. Although the <jats:italic>CTLA4<\/jats:italic> relative expression levels were comparable to that of controls, G\/G carriers exhibited a significantly lower expression profile (median\u00a0=\u00a00.63, IQR\u00a0=\u00a00.34\u20131.75) than A\/A (median\u00a0=\u00a01.43, IQR\u00a0=\u00a00.39\u20134.25, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.018) and A\/G carriers (median\u00a0=\u00a01.68, IQR\u00a0=\u00a00.49\u20133.92, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.007). No significant associations of <jats:italic>CTLA4<\/jats:italic> variant\/expression with disease severity and\/or activity were observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The CTLA4 rs231775 variant was associated with vitiligo susceptibility and gene expression; the risky genotype (GG) was associated with lower <jats:italic>CTLA4<\/jats:italic> relative expression levels than the other genotypes. Further large\u2010scale studies in different populations are warranted.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcla.23777","type":"journal-article","created":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T14:39:44Z","timestamp":1619879984000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Impact of cytotoxic T\u2010lymphocyte\u2010associated protein 4 codon 17 variant and expression on vitiligo risk"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7178-7646","authenticated-orcid":false,"given":"Nawal S.","family":"Gouda","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology and Immunology Faculty of Medicine Northern Border University Arar Saudi Arabia"},{"name":"Department of Medical Microbiology and Immunology Faculty of Medicine Mansoura University Mansoura 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