Genetics: BTN2A2 and BTN3A3

Hutan

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DecodeME candidate ME/CFS gene

In DecodeME, we attempted to link GWAS variants to target genes. Here we discuss the top two tiers of predicted linked genes that we are most confident about –‘Tier 1’ and ’Tier 2’.

We defined genes as Tier 1 genes if: (i) they are protein-coding genes, (ii) they have GTEx-v10 expression quantitative trait loci (eQTLs) lying within one of the FUMA-defined ME/CFS-associated intervals, and (iii) their expression and ME/CFS risk are predicted to share a single causal variant with a posterior probability for colocalisation (H4) of at least 75%. For this definition, we disregarded the histone genes in the chr6p22.2 HIST1 cluster, as their sequences and functions are highly redundant (1). This prioritisation step yielded 29 Tier 1 genes.

For the intervals without Tier 1 genes, three Tier 2 genes were defined as the closest protein-coding genes without eQTL association: FBXL4 (chr6q16.1), OLFM4 (chr13q14.3), and CCPG1 (chr15q21.3).


CHROMOSOME 6p
Chr6p contained seven Tier 1 genes.

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BTN2A2 (Tier 1)

• Protein: Butyrophilin subfamily 2 member A2. UniProt. GeneCards. The allele that increases the risk of ME/CFS is associated with decreasing BTN2A2 gene expression.

• Molecular function: Mouse Btn2a2 inhibits T-cell activation and promotes the induction of regulatory T cells (Tregs) (31). It also promotes central tolerance to prevent autoimmune disease (32).

• Cellular function: Innate immunity, microbe-sensing.

• Link to disease: Butyrophilins confer immunity against diverse pathogenic bacteria and parasites.

• Potential relevance to ME/CFS: Stoichiometric imbalance of BTN2A and BTN3A levels could alter the ability of Vγ9Vδ2 T cells to discriminate microbial- from self-antigens, and to kill infected cells. Vγ9Vδ2 T cells can be activated by TLR3 and TLR4 ligands. TLR4 variants have been associated with Long Covid in a combinatorial genetics analysis (33).

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BTN3A3 (Tier 1)

• Protein: Butyrophilin subfamily 3 member A3. UniProt. GeneCards.
The allele that increases the risk of ME/CFS is associated with increased BTN3A3 expression in skin not exposed to the sun.

• Molecular function: Co-expression of BTN3A3 synergises with BTN3A1 to greatly boost the efficiency of pAg sensing (42). Confers a chaperone-like function in boosting cell surface expression of BTN3A1 (43).

• Cellular function: Innate immunity, microbe-sensing.

• Link to disease: Butyrophilins confer immunity against diverse pathogenic bacteria and parasites.

• Potential relevance to ME/CFS: Stoichiometric imbalance of BTN2A and BTN3A levels could alter the ability of Vγ9Vδ2 T cells to discriminate microbial- from self-antigens, and to kill infected cells. Vγ9Vδ2 T cells can be activated by TLR3 and TLR4 ligands. TLR4 variants have been associated with Long Covid in a combinatorial genetics analysis (33).



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Reference 31 is
Ammann JU, Cooke A, Trowsdale J. Butyrophilin Btn2a2 inhibits TCR activation and phosphatidylinositol 3-kinase/Akt pathway signaling and induces Foxp3 expression in T lymphocytes. J Immunol. 2013 May 15;190(10):5030–6.

Reference 32 is
Frech M, Danzer H, Uchil P, Azizov V, Schmid E, Schälter F, et al. Butyrophilin 2a2 (Btn2a2) expression on thymic epithelial cells promotes central T cell tolerance and prevents autoimmune disease. J Autoimmun. 2023 Sep;139:103071.

Reference 33 is
Taylor K, Pearson M, Das S, Sardell J, Chocian K, Gardner S. Genetic risk factors for severe and fatigue dominant long COVID and commonalities with ME/CFS identified by combinatorial analysis. J Transl Med. 2023 Nov 1;21(1):775.

Reference 43 is
Vantourout P, Laing A, Woodward MJ, Zlatareva I, Apolonia L, Jones AW, et al. Heteromeric interactions regulate butyrophilin (BTN) and BTN-like molecules governing γδ T cell biology. Proc Natl Acad Sci U S A. 2018 Jan 30;115(5):1039–44.
 
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I think it might be a good idea to add BTN3A3 to this thread @Hutan as they linked the two in the report above. BTN3A3 has increased expression and BTN2A2 has decreased expression.
Potential relevance to ME/CFS: Stoichiometric imbalance of BTN2A and BTN3A levels could alter the ability of Vγ9Vδ2 T cells to discriminate microbial- from self-antigens, and to kill infected cells.
 
The chr6p22.2 locus includes seven Tier 1 genes, with BTN2A2 and TRIM38 eQTLs colocalised with ME/CFS risk in the most tissues (7 and 5, respectively). Complexes involving butyrophilin3 and -2 homologues (BTN3A1, BTN3A2, BTN3A3, BTN2A1 and BTN2A2) allow innate-like Vγ9Vδ2 T cells to distinguish self-derived from non-self-derived pyrophosphate antigens (pAgs) (47).

[47] is —

A Brief Molecular History of Vγ9Vδ2 TCR-Mediated Phosphoantigen Sensing
Vγ9Vδ2 T-cells are universally present in humans and represent one of the most prevalent TCR reactivities, evolutionarily conserved across diverse mammalian species. They are an innate-like subset featuring a semi-invariant TCR repertoire that drives their well-recognized reactivity to small, non-peptidic phosphoantigens (pAg). Crucially, they can distinguish between highly immunostimulatory microbially derived pAg and much less potent host-derived pAg, with the former effectively acting as a pathogen associated molecular pattern (PAMP) and the Vγ9Vδ2 TCR as a surrogate pattern recognition receptor (PRR).

Ample evidence supports important Vγ9Vδ2-mediated contributions to immunity against diverse pathogenic bacteria and parasites, mediated by their potent effector and immunoregulatory functions. The molecular basis of the pAg sensing mechanism underpinning such responses has, however, remained highly mysterious. Despite this, past studies have established that pAg sensing is MHC-independent, extremely fast, exquisitely pAg-sensitive, and dependent upon target cell expression of key BTN-family molecules, notably BTN3A and BTN2A1.

Here we contextualize these findings and several recent studies addressing pAg sensing. We integrate these into a single unified theory of pAg sensing interpretable from different perspectives, both intracellular and extracellular, biophysical, and topological. We prioritize critical questions to address in the context of this proposed model. Finally, we suggest the model will provide a molecular template for antigen recognition by other related γδ T-cell subsets.

Web | PDF | Immunological Reviews | Open Access

See also Butyrophilin 2A1 is essential for phosphoantigen reactivity by γδ T cells (2020, Science)
 
Other s4me threads mentioning these genes
 
Regarding the link between these genes and anxiety, the DecodeME results paper says:
Two GWAS (66,67) reported associations to anxiety near BTN2A2. We could not perform coloc analysis because their full summary statistics are not available. However, low LD between lead variants (R2 < 0.05 in the British in England and Scotland [GBR] population) indicate that the genetic signals contributing to ME/CFS and anxiety at the chr6p22.2 locus are distinct.

References to those GWAS looking at anxiety are:

66 Hu J, Lupton MK, Byrne EM, Martin NG, Whiteman DC, Olsen CM, et al. Unravelling Sex Differences in the Genetic Architecture of Anxiety: A Genome-Wide Association Study in the UK Biobank [Internet]. 2025 [cited 2025 Jul 24]. Available from: https://www.medrxiv.org/content/10.1101/2025.02.09.25321968v1

67 Friligkou E, Løkhammer S, Cabrera-Mendoza B, Shen J, He J, Deiana G, et al. Gene discovery and biological insights into anxiety disorders from a large-scale multi-ancestry genome-wide association study. Nat Genet. 2024 Oct;56(10):2036–45.
 
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