Epistasis within the MHC contributes to the genetic architecture of celiac disease

Epistasis has long been thought to contribute to the genetic aetiology of complex diseases, yet few robust epistatic interactions in humans have been detected. We have conducted exhaustive genome-wide scans for pairwise epistasis in five independent celiac disease (CD) case-control studies, using a rapid model-free approach to examine over 500 billion SNP pairs in total. We found 20 significant epistatic signals within the HLA region which achieved stringent replication criteria across multiple studies and were independent of known CD risk HLA haplotypes. The strongest independent CD epistatic signal corresponded to genes in the HLA class III region, in particular and which are known to contain variants for non-Hodgkin’s lymphoma and early menopause, co-morbidities of celiac disease. Replicable evidence for epistatic variants outside the MHC was not observed. Both within and between European populations, we observed striking consistency of epistatic models and epistatic model distribution. Within the UK population, models of CD based on both epistatic and additive single-SNP effects increased explained CD variance by approximately 1% over those of single SNPs. Models of only epistatic pairs or additive single-SNPs showed similar levels of CD variance explained, indicating the existence of a substantial overlap of additive and epistatic components. Our findings have implications for the determination of genetic architecture and, by extension, the use of human genetics for validation of therapeutic targets.