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Campagna MP, Havrdova EK, Horakova D, Izquierdo G, Matesanz F, Eichau S, Lechner-Scott J, Taylor BV, García-Sanchéz MI, Alcina A, van der Walt A, Butzkueven H, Jokubaitis VG. No evidence for association between rs10191329 severity locus and longitudinal disease severity in 1813 relapse-onset multiple sclerosis patients from the MSBase registry. Mult Scler 2024:13524585241240406. [PMID: 38511853 DOI: 10.1177/13524585241240406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
BACKGROUND The International Multiple Sclerosis Genetics Consortium and MultipleMS Consortium recently reported a genetic variant associated with multiple sclerosis (MS) severity. However, it remains unclear if these variants remain associated with more robust, longitudinal measures of disease severity. METHODS We examined the top variant, rs10191329, from Harroud et al.'s study in 1813 relapse-onset MS patients from the MSBase Registry to assess association with longitudinal disease severity. RESULTS Our analysis revealed no significant association between rs10191329 genotype and longitudinal binary disease severity (p > 0.05). CONCLUSION These findings highlight the complexity of genetic factors mediating long-term MS outcomes and the need for further research.
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Affiliation(s)
- Maria Pia Campagna
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia
| | - Eva Kubala Havrdova
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Dana Horakova
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | | | - Fuencisla Matesanz
- Instituto de Parasitología y Biomedicina López Neyra, CSIC, Granada, Spain
| | - Sara Eichau
- Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Jeannette Lechner-Scott
- Department of Neurology, John Hunter Hospital, Newcastle, NSW, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
| | - Bruce V Taylor
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Maria-Isabel García-Sanchéz
- UGC Neurología, Hospital Universitario Virgen Macarena, Nodo Biobanco del Sistema Sanitario Público de Andalucía, Sevilla, Spain
| | - Antonio Alcina
- Instituto de Parasitología y Biomedicina López Neyra, CSIC, Granada, Spain
| | - Anneke van der Walt
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia
- Department of Neurology, Alfred Health, Melbourne, VIC, Australia
| | - Helmut Butzkueven
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia
- Department of Neurology, Alfred Health, Melbourne, VIC, Australia
| | - Vilija G Jokubaitis
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia
- Department of Neurology, Alfred Health, Melbourne, VIC, Australia
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Jokubaitis VG, Campagna MP, Ibrahim O, Stankovich J, Kleinova P, Matesanz F, Hui D, Eichau S, Slee M, Lechner-Scott J, Lea R, Kilpatrick TJ, Kalincik T, De Jager PL, Beecham A, McCauley JL, Taylor BV, Vucic S, Laverick L, Vodehnalova K, García-Sanchéz MI, Alcina A, van der Walt A, Havrdova EK, Izquierdo G, Patsopoulos N, Horakova D, Butzkueven H. Not all roads lead to the immune system: the genetic basis of multiple sclerosis severity. Brain 2022:6854441. [DOI: 10.1093/brain/awac449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 11/06/2022] [Indexed: 12/05/2022] Open
Abstract
Abstract
Multiple sclerosis is a leading cause of neurological disability in adults. Heterogeneity in multiple sclerosis clinical presentation has posed a major challenge for identifying genetic variants associated with disease outcomes.
To overcome this challenge, we used prospectively ascertained clinical outcomes data from the largest international multiple sclerosis Registry, MSBase. We assembled a cohort of deeply phenotyped individuals of European ancestry with relapse-onset multiple sclerosis. We used unbiased genome-wide association study and machine learning approaches to assess the genetic contribution to longitudinally defined multiple sclerosis severity phenotypes in 1,813 individuals.
Our primary analyses did not identify any genetic variants of moderate to large effect sizes that met genome-wide significance thresholds. The strongest signal was associated with rs7289446 (β=-0.4882, P = 2.73 × 10−7), intronic to SEZ6L on chromosome 22. However, we demonstrate that clinical outcomes in relapse-onset multiple sclerosis are associated with multiple genetic loci of small effect sizes. Using a machine learning approach incorporating over 62,000 variants together with clinical and demographic variables available at multiple sclerosis disease onset, we could predict severity with an area under the receiver operator curve of 0.84 (95% CI 0.79–0.88). Our machine learning algorithm achieved positive predictive value for outcome assignation of 80% and negative predictive value of 88%. This outperformed our machine learning algorithm that contained clinical and demographic variables alone (area under the receiver operator curve 0.54, 95% CI 0.48–0.60).
Secondary, sex-stratified analyses identified two genetic loci that met genome-wide significance thresholds. One in females (rs10967273; βfemale =0.8289, P = 3.52 × 10−08), the other in males (rs698805; βmale = -1.5395, P = 4.35 × 10−08), providing some evidence for sex dimorphism in multiple sclerosis severity. Tissue enrichment and pathway analyses identified an overrepresentation of genes expressed in central nervous system compartments generally, and specifically in the cerebellum (P = 0.023). These involved mitochondrial function, synaptic plasticity, oligodendroglial biology, cellular senescence, calcium and g-protein receptor signalling pathways. We further identified six variants with strong evidence for regulating clinical outcomes, the strongest signal again intronic to SEZ6L (adjusted hazard ratio 0.72, P = 4.85 × 10−4).
Here we report a milestone in our progress towards understanding the clinical heterogeneity of multiple sclerosis outcomes, implicating functionally distinct mechanisms to multiple sclerosis risk. Importantly, we demonstrate that machine learning using common single nucleotide variant clusters, together with clinical variables readily available at diagnosis can improve prognostic capabilities at diagnosis, and with further validation has the potential to translate to meaningful clinical practice change.
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Affiliation(s)
- Vilija G Jokubaitis
- Department of Neuroscience, Central Clinical School, Monash University , Melbourne , Australia
- Department of Neurology, Alfred Health , Melbourne , Australia
- Department of Medicine, University of Melbourne , Melbourne , Australia
- Department of Neurology, Melbourne Health , Melbourne , Australia
| | - Maria Pia Campagna
- Department of Neuroscience, Central Clinical School, Monash University , Melbourne , Australia
| | - Omar Ibrahim
- Department of Neuroscience, Central Clinical School, Monash University , Melbourne , Australia
| | - Jim Stankovich
- Department of Neuroscience, Central Clinical School, Monash University , Melbourne , Australia
| | - Pavlina Kleinova
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital , Prague , Czech Republic
| | - Fuencisla Matesanz
- Instituto de Parasitología y Biomedicina López Neyra, CSIC , Granada , Spain
| | - Daniel Hui
- Brigham and Women’s Hospital, Harvard Medical School , MA , USA
| | - Sara Eichau
- Hospital Universitario Virgen Macarena , Sevilla , Spain
| | - Mark Slee
- College of Medicine and Public Health, Flinders University , Adelaide , Australia
| | - Jeannette Lechner-Scott
- Department of Neurology, John Hunter Hospital , Newcastle , Australia
- School of Medicine and Public Health, University of Newcastle , Newcastle , Australia
| | - Rodney Lea
- Genomics Research Centre, Centre of Genomics and Personalised Health, Queensland University of Technology , Australia
| | - Trevor J Kilpatrick
- Department of Neurology, Melbourne Health , Melbourne , Australia
- Melbourne Neuroscience Institute, University of Melbourne , Melbourne , Australia
| | - Tomas Kalincik
- Department of Neurology, Melbourne Health , Melbourne , Australia
- CORe, Department of Medicine, University of Melbourne , Australia
| | - Philip L De Jager
- Multiple Sclerosis Center and the Center for Translational and Computational Neuroimmunology, Department of Neurology, Columbia University, New York , NY , USA
| | - Ashley Beecham
- John. P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami , FL , USA
| | - Jacob L McCauley
- John. P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami , FL , USA
| | - Bruce V Taylor
- Menzies Institute for Medical Research, University of Tasmania , Hobart , Australia
| | - Steve Vucic
- Westmead Institute, University of Sydney , Sydney , Australia
| | - Louise Laverick
- Department of Medicine, University of Melbourne , Melbourne , Australia
| | - Karolina Vodehnalova
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital , Prague , Czech Republic
| | - Maria-Isabel García-Sanchéz
- UGC Neurología. Hospital Universitario Virgen Macarena, Nodo Biobanco del Sistema Sanitario Público de Andalucía , Sevilla , Spain
| | - Antonio Alcina
- Instituto de Parasitología y Biomedicina López Neyra, CSIC , Granada , Spain
| | - Anneke van der Walt
- Department of Neuroscience, Central Clinical School, Monash University , Melbourne , Australia
- Department of Neurology, Alfred Health , Melbourne , Australia
- Department of Medicine, University of Melbourne , Melbourne , Australia
- Department of Neurology, Melbourne Health , Melbourne , Australia
| | - Eva Kubala Havrdova
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital , Prague , Czech Republic
| | - Guillermo Izquierdo
- Hospital Universitario Virgen Macarena , Sevilla , Spain
- Fundación DINAC , Sevilla , Spain
| | | | - Dana Horakova
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital , Prague , Czech Republic
| | - Helmut Butzkueven
- Department of Neuroscience, Central Clinical School, Monash University , Melbourne , Australia
- Department of Neurology, Alfred Health , Melbourne , Australia
- Department of Medicine, University of Melbourne , Melbourne , Australia
- Department of Neurology, Melbourne Health , Melbourne , Australia
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