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Parodi L, Comeau ME, Georgakis MK, Mayerhofer E, Chung J, Falcone GJ, Malik R, Demel SL, Worrall BB, Koch S, Testai FD, Kittner SJ, McCauley JL, Hall CE, Mayson DJ, Elkind MSV, James ML, Woo D, Rosand J, Langefeld CD, Anderson CD. Deep Resequencing of the 1q22 Locus in Non-Lobar Intracerebral Hemorrhage. Ann Neurol 2024; 95:325-337. [PMID: 37787451 PMCID: PMC10843118 DOI: 10.1002/ana.26814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 09/22/2023] [Accepted: 09/28/2023] [Indexed: 10/04/2023]
Abstract
OBJECTIVE Genome-wide association studies have identified 1q22 as a susceptibility locus for cerebral small vessel diseases, including non-lobar intracerebral hemorrhage (ICH) and lacunar stroke. In the present study, we performed targeted high-depth sequencing of 1q22 in ICH cases and controls to further characterize this locus and prioritize potential causal mechanisms, which remain unknown. METHODS A total of 95,000 base pairs spanning 1q22, including SEMA4A, SLC25A44, and PMF1/PMF1-BGLAP were sequenced in 1,055 spontaneous ICH cases (534 lobar and 521 non-lobar) and 1,078 controls. Firth regression and Rare Variant Influential Filtering Tool analysis were used to analyze common and rare variants, respectively. Chromatin interaction analyses were performed using Hi-C, chromatin immunoprecipitation followed by sequencing, and chromatin interaction analysis with paired-end tag databases. Multivariable Mendelian randomization assessed whether alterations in gene-specific expression relative to regionally co-expressed genes at 1q22 could be causally related to ICH risk. RESULTS Common and rare variant analyses prioritized variants in SEMA4A 5'-UTR and PMF1 intronic regions, overlapping with active promoter and enhancer regions based on ENCODE annotation. Hi-C data analysis determined that 1q22 is spatially organized in a single chromatin loop, and that the genes therein belong to the same topologically associating domain. Chromatin immunoprecipitation followed by sequencing and chromatin interaction analysis with paired-end tag data analysis highlighted the presence of long-range interactions between the SEMA4A-promoter and PMF1-enhancer regions prioritized by association testing. Multivariable Mendelian randomization analyses demonstrated that PMF1 overexpression could be causally related to non-lobar ICH risk. INTERPRETATION Altered promoter-enhancer interactions leading to PMF1 overexpression, potentially dysregulating polyamine catabolism, could explain demonstrated associations with non-lobar ICH risk at 1q22, offering a potential new target for prevention of ICH and cerebral small vessel disease. ANN NEUROL 2024;95:325-337.
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Affiliation(s)
- Livia Parodi
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
| | - Mary E Comeau
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Center for Precision Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Marios K Georgakis
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
| | - Ernst Mayerhofer
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Jaeyoon Chung
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Guido J Falcone
- Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven, CT, USA
| | - Rainer Malik
- Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
| | - Stacie L Demel
- Department of Neurology, University of Cincinnati, Cincinnati, OH, USA
| | - Bradford B Worrall
- Department of Neurology, University of Virginia, Charlottesville, VA, USA
| | - Sebastian Koch
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Fernando D Testai
- Department of Neurology & Neurorehabilitation, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Steven J Kittner
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Jacob L McCauley
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Christiana E Hall
- Department of Neurology, University of Texas Southwestern, Dallas, TX, USA
| | - Douglas J Mayson
- Division of Stroke, Medstar Georgetown University Hospital, Washington, DC, USA
| | - Mitchell S V Elkind
- Department of Neurology, Vagelos College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | - Daniel Woo
- Department of Neurology, University of Cincinnati, Cincinnati, OH, USA
| | - Jonathan Rosand
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Carl D Langefeld
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Center for Precision Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Christopher D Anderson
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
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Parodi L, Mayerhofer E, Narasimhalu K, Yechoor N, Comeau ME, Rosand J, Langefeld CD, Anderson CD. Social Determinants of Health and Cerebral Small Vessel Disease: Is Epigenetics a Key Mediator? J Am Heart Assoc 2023:e029862. [PMID: 37345795 DOI: 10.1161/jaha.123.029862] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
Cerebral small vessel disease is highly prevalent, particularly in marginalized communities, and its incidence is expected to increase given the aging global population. Cerebral small vessel disease contributes to risk for stroke, vascular cognitive impairment and dementia, late-life depression, and gait disorders. A growing body of evidence suggests that adverse outcomes, including cerebral small vessel disease, caused by traditional cardiovascular risk factors are at least partly mediated by epigenetic changes, some of them already beginning during fetal development. Societal and health care access inequities, summarized under the umbrella term social determinants of health, put a higher burden of cardiovascular risk factors on marginalized populations and expose them to an increased risk for adverse outcomes. Social epigenetics has begun to deliver solid evidence that social determinants of health lead to distinct epigenetic signatures that potentially mediate the biological effect of environmental exposures on cardiovascular risk factors. Here, we provide a review of the most recent advances in the epigenetics of cerebral small vessel disease risk factors and social determinants of health and call for research efforts combining insights from both fields to reach a deeper understanding of the causal pathways, ultimately facilitating discovery of new treatment targets for a disease whose burden is magnified by existing health disparities.
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Affiliation(s)
- Livia Parodi
- Center for Genomic Medicine Massachusetts General Hospital Boston MA USA
- The Broad Institute of Harvard and MIT Cambridge MA USA
- Henry and Allison McCance Center for Brain Health Massachusetts General Hospital Boston MA USA
- Department of Neurology Brigham and Women's Hospital Boston MA USA
| | - Ernst Mayerhofer
- Center for Genomic Medicine Massachusetts General Hospital Boston MA USA
- The Broad Institute of Harvard and MIT Cambridge MA USA
- Henry and Allison McCance Center for Brain Health Massachusetts General Hospital Boston MA USA
| | - Kaavya Narasimhalu
- Center for Genomic Medicine Massachusetts General Hospital Boston MA USA
- The Broad Institute of Harvard and MIT Cambridge MA USA
- Henry and Allison McCance Center for Brain Health Massachusetts General Hospital Boston MA USA
| | - Nirupama Yechoor
- Center for Genomic Medicine Massachusetts General Hospital Boston MA USA
- The Broad Institute of Harvard and MIT Cambridge MA USA
- Henry and Allison McCance Center for Brain Health Massachusetts General Hospital Boston MA USA
| | - Mary E Comeau
- Department of Biostatistics and Data Science, Division of Public Health Sciences Wake Forest University School of Medicine Winston-Salem NC USA
- Center for Precision Medicine Wake Forest University School of Medicine Winston-Salem NC USA
| | - Jonathan Rosand
- Center for Genomic Medicine Massachusetts General Hospital Boston MA USA
- The Broad Institute of Harvard and MIT Cambridge MA USA
- Henry and Allison McCance Center for Brain Health Massachusetts General Hospital Boston MA USA
| | - Carl D Langefeld
- Department of Biostatistics and Data Science, Division of Public Health Sciences Wake Forest University School of Medicine Winston-Salem NC USA
- Center for Precision Medicine Wake Forest University School of Medicine Winston-Salem NC USA
| | - Christopher D Anderson
- Center for Genomic Medicine Massachusetts General Hospital Boston MA USA
- The Broad Institute of Harvard and MIT Cambridge MA USA
- Henry and Allison McCance Center for Brain Health Massachusetts General Hospital Boston MA USA
- Department of Neurology Brigham and Women's Hospital Boston MA USA
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Parodi L, Comeau ME, Georgakis MK, Mayerhofer E, Chung J, Falcone GJ, Malik R, Demel SL, Worrall BB, Koch S, Testai FD, Kittner SJ, McCauley JL, Hall CE, Mayson DJ, Elkind MS, James ML, Woo D, Rosand J, Langefeld CD, Anderson CD. Deep resequencing of the 1q22 locus in non-lobar intracerebral hemorrhage. medRxiv 2023:2023.04.18.23288754. [PMID: 37162822 PMCID: PMC10168419 DOI: 10.1101/2023.04.18.23288754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Objective Genome-wide association studies have identified 1q22 as a susceptibility locus for cerebral small vessel diseases (CSVDs), including non-lobar intracerebral hemorrhage (ICH) and lacunar stroke. In the present study we performed targeted high-depth sequencing of 1q22 in ICH cases and controls to further characterize this locus and prioritize potential causal mechanisms, which remain unknown. Methods 95,000 base pairs spanning 1q22 , including SEMA4A, SLC25A44 and PMF1 / PMF1-BGLAP were sequenced in 1,055 spontaneous ICH cases (534 lobar and 521 non-lobar) and 1,078 controls. Firth regression and RIFT analysis were used to analyze common and rare variants, respectively. Chromatin interaction analyses were performed using Hi-C, ChIP-Seq and ChIA-PET databases. Multivariable Mendelian randomization (MVMR) assessed whether alterations in gene-specific expression relative to regionally co-expressed genes at 1q22 could be causally related to ICH risk. Results Common and rare variant analyses prioritized variants in SEMA4A 5'-UTR and PMF1 intronic regions, overlapping with active promoter and enhancer regions based on ENCODE annotation. Hi-C data analysis determined that 1q22 is spatially organized in a single chromatin loop and that the genes therein belong to the same Topologically Associating Domain. ChIP-Seq and ChIA-PET data analysis highlighted the presence of long-range interactions between the SEMA4A -promoter and PMF1 -enhancer regions prioritized by association testing. MVMR analyses demonstrated that PMF1 overexpression could be causally related to non-lobar ICH risk. Interpretation Altered promoter-enhancer interactions leading to PMF1 overexpression, potentially dysregulating polyamine catabolism, could explain demonstrated associations with non-lobar ICH risk at 1q22 , offering a potential new target for prevention of ICH and CSVD.
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Myserlis EP, Georgakis MK, Demel SL, Sekar P, Chung J, Malik R, Hyacinth HI, Comeau ME, Falcone G, Langefeld CD, Rosand J, Woo D, Anderson CD. A Genomic Risk Score Identifies Individuals at High Risk for Intracerebral Hemorrhage. Stroke 2023; 54:973-982. [PMID: 36799223 PMCID: PMC10050100 DOI: 10.1161/strokeaha.122.041701] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 01/11/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND Intracerebral hemorrhage (ICH) has an estimated heritability of 29%. We developed a genomic risk score for ICH and determined its predictive power in comparison to standard clinical risk factors. METHODS We combined genome-wide association data from individuals of European ancestry for ICH and related traits in a meta-genomic risk score ([metaGRS]; 2.6 million variants). We tested associations with ICH and its predictive performance in addition to clinical risk factors in a held-out validation dataset (842 cases and 796 controls). We tested associations with risk of incident ICH in the population-based UK Biobank cohort (486 784 individuals, 1526 events, median follow-up 11.3 years). RESULTS One SD increment in the metaGRS was significantly associated with 31% higher odds for ICH (95% CI, 1.16-1.48) in age-, sex- and clinical risk factor-adjusted models. The metaGRS identified individuals with almost 5-fold higher odds for ICH in the top score percentile (odds ratio, 4.83 [95% CI, 1.56-21.2]). Predictive models for ICH incorporating the metaGRS in addition to clinical predictors showed superior performance compared to the clinical risk factors alone (c-index, 0.695 versus 0.686). The metaGRS showed similar associations for lobar and nonlobar ICH, independent of the known APOE risk locus for lobar ICH. In the UK Biobank, the metaGRS was associated with higher risk of incident ICH (hazard ratio, 1.15 [95% CI, 1.09-1.21]). The associations were significant within both a relatively high-risk population of antithrombotic medications users, as well as among a relatively low-risk population with a good control of vascular risk factors and no use of anticoagulants. CONCLUSIONS We developed and validated a genomic risk score that predicts lifetime risk of ICH beyond established clinical risk factors among individuals of European ancestry. Whether implementation of the score in risk prognostication models for high-risk populations, such as patients under antithrombotic treatment, could improve clinical decision making should be explored in future studies.
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Affiliation(s)
- Evangelos Pavlos Myserlis
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Henry and Alisson McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Medical University of South Carolina, Charleston, SC, USA
| | - Marios K. Georgakis
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Henry and Alisson McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Stacie L. Demel
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Padmini Sekar
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jaeyoon Chung
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Rainer Malik
- Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Hyacinth I. Hyacinth
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Mary E. Comeau
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Center for Precision Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Guido Falcone
- Division of Neurocritical Care & Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven, CT, USA
| | - Carl D. Langefeld
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Center for Precision Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Jonathan Rosand
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Henry and Alisson McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Daniel Woo
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Christopher D. Anderson
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Henry and Alisson McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
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Xu P, Wang M, Sharma NK, Comeau ME, Wabitsch M, Langefeld CD, Civelek M, Zhang B, Das SK. Multi-omic integration reveals cell-type-specific regulatory networks of insulin resistance in distinct ancestry populations. Cell Syst 2023; 14:41-57.e8. [PMID: 36630956 PMCID: PMC9852073 DOI: 10.1016/j.cels.2022.12.005] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 09/26/2022] [Accepted: 12/13/2022] [Indexed: 01/12/2023]
Abstract
Our knowledge of the cell-type-specific mechanisms of insulin resistance remains limited. To dissect the cell-type-specific molecular signatures of insulin resistance, we performed a multiscale gene network analysis of adipose and muscle tissues in African and European ancestry populations. In adipose tissues, a comparative analysis revealed ethnically conserved cell-type signatures and two adipocyte subtype-enriched modules with opposite insulin sensitivity responses. The modules enriched for adipose stem and progenitor cells as well as immune cells showed negative correlations with insulin sensitivity. In muscle tissues, the modules enriched for stem cells and fibro-adipogenic progenitors responded to insulin sensitivity oppositely. The adipocyte and muscle fiber-enriched modules shared cellular-respiration-related genes but had tissue-specific rearrangements of gene regulations in response to insulin sensitivity. Integration of the gene co-expression and causal networks further pinpointed key drivers of insulin resistance. Together, this study revealed the cell-type-specific transcriptomic networks and signaling maps underlying insulin resistance in major glucose-responsive tissues. A record of this paper's transparent peer review process is included in the supplemental information.
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Affiliation(s)
- Peng Xu
- Department of Genetics & Genomic Sciences, Mount Sinai Center for Transformative Disease Modeling, Icahn Genomics Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Minghui Wang
- Department of Genetics & Genomic Sciences, Mount Sinai Center for Transformative Disease Modeling, Icahn Genomics Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Neeraj K Sharma
- Department of Internal Medicine, Section of Endocrinology and Metabolism, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Mary E Comeau
- Department of Biostatistics and Data Science, Division of Public Health Sciences, and Center for Precision Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Martin Wabitsch
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Eythstr. 24, D-89075 Ulm, Germany
| | - Carl D Langefeld
- Department of Biostatistics and Data Science, Division of Public Health Sciences, and Center for Precision Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Mete Civelek
- Center for Public Health Genomics, Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22908, USA
| | - Bin Zhang
- Department of Genetics & Genomic Sciences, Mount Sinai Center for Transformative Disease Modeling, Icahn Genomics Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Swapan K Das
- Department of Internal Medicine, Section of Endocrinology and Metabolism, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
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Wang Y, Guga S, Wu K, Khaw Z, Tzoumkas K, Tombleson P, Comeau ME, Langefeld CD, Cunninghame Graham DS, Morris DL, Vyse TJ. COVID-19 and systemic lupus erythematosus genetics: A balance between autoimmune disease risk and protection against infection. PLoS Genet 2022; 18:e1010253. [PMID: 36327221 PMCID: PMC9632821 DOI: 10.1371/journal.pgen.1010253] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/18/2022] [Indexed: 11/06/2022] Open
Abstract
Genome wide association studies show there is a genetic component to severe COVID-19. We find evidence that the genome-wide genetic association signal with severe COVID-19 is correlated with that of systemic lupus erythematosus (SLE), having formally tested this using genetic correlation analysis by LD score regression. To identify the shared associated loci and gain insight into the shared genetic effects, using summary level data we performed meta-analyses, a local genetic correlation analysis and fine-mapping using stepwise regression and functional annotation. This identified multiple loci shared between the two traits, some of which exert opposing effects. The locus with most evidence of shared association is TYK2, a gene critical to the type I interferon pathway, where the local genetic correlation is negative. Another shared locus is CLEC1A, where the direction of effects is aligned, that encodes a lectin involved in cell signaling, and the anti-fungal immune response. Our analyses suggest that several loci with reciprocal effects between the two traits have a role in the defense response pathway, adding to the evidence that SLE risk alleles are protective against infection. We observed a correlation between the genetic associations with severe COVID-19 and those with systemic lupus erythematosus (SLE, Lupus), and aimed to discover which genetic loci were shared by these diseases and what biological processes were involved. This resulted in the discovery of several genetic loci, some of which had alleles that were risk for both diseases and some of which were risk for severe COVID-19 yet protective for SLE. The locus with most evidence of shared association (TYK2) is involved in interferon production, a process that is important in response to viral infection and known to be dysregulated in SLE patients. Other shared associated loci contained genes also involved in the defense response and the immune system signaling. These results add to the growing evidence that there are alleles in the human genome that provide protection against viral infection yet are risk for autoimmune disease.
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Affiliation(s)
- Yuxuan Wang
- Department of Medical & Molecular Genetics, King’s College London, London, United Kingdom
| | - Suri Guga
- Department of Medical & Molecular Genetics, King’s College London, London, United Kingdom
| | - Kejia Wu
- Department of Medical & Molecular Genetics, King’s College London, London, United Kingdom
| | - Zoe Khaw
- Department of Medical & Molecular Genetics, King’s College London, London, United Kingdom
| | - Konstantinos Tzoumkas
- Department of Medical & Molecular Genetics, King’s College London, London, United Kingdom
| | - Phil Tombleson
- NIHR GSTFT/KCL Biomedical Research Centre, London, United Kingdom
| | - Mary E. Comeau
- Department of Biostatistics and Data Science and Center for Precision Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Carl D. Langefeld
- Department of Biostatistics and Data Science and Center for Precision Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America
| | | | - David L. Morris
- Department of Medical & Molecular Genetics, King’s College London, London, United Kingdom
- * E-mail:
| | - Timothy J. Vyse
- Department of Medical & Molecular Genetics, King’s College London, London, United Kingdom
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7
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Sawyer RP, Demel SL, Comeau ME, Marion M, Rosand J, Langefeld CD, Woo D. Alzheimer's disease related single nucleotide polymorphisms and correlation with intracerebral hemorrhage incidence. Medicine (Baltimore) 2022; 101:e30782. [PMID: 36181103 PMCID: PMC9524946 DOI: 10.1097/md.0000000000030782] [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] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Apolipoprotein E alleles have been associated with both Alzheimer's disease (AD) and intracerebral hemorrhage (ICH). In addition, ICH is associated with a markedly high risk of subsequent dementia compared to other subtypes of stroke. We sought to evaluate if other genetic markers for AD were also associated with ICH. We examined whether published AD risk single nucleotide polymorphisms (SNPs) and haplotypes were associated with ICH utilizing genome-wide association study data from 2 independent studies (genetic and environmental risk factors for hemorrhagic stroke [GERFHS] study and genetics of cerebral hemorrhage with anticoagulation [GOCHA]). Analyses included evaluation by location of ICH. GERFHS and GOCHA cohorts contained 745 ICH cases and 536 controls for analysis. The strongest association was on 1q32 near Complement receptor type 1 (CR1), where rs6701713 was associated with all ICH (P = .0074, odds ratio [OR] = 2.07) and lobar ICH (P = .0073, OR = 2.80). The 51 most significant 2-SNP haplotypes associated with lobar ICH were identified within the Clusterin (CLU) gene. We identified that variation within CR1 and CLU, previously identified risk factors for AD, and are associated with an increased risk for ICH driven primarily by lobar ICH. Previous work implicated CR1 and CLU in cerebral amyloid clearance, the innate immune system, and cellular stress response.
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Affiliation(s)
- Russell P. Sawyer
- University of Cincinnati College of Medicine, Department of Neurology and Rehabilitation Medicine, Cincinnati, OH, USA
- *Correspondence: Russell P. Sawyer, Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, 260 Stetson Street ML 0525, Cincinnati, OH 45267-0525, USA (e-mail: )
| | - Stacie L. Demel
- University of Cincinnati College of Medicine, Department of Neurology and Rehabilitation Medicine, Cincinnati, OH, USA
| | - Mary E. Comeau
- Department of Biostatistics and Data Science, Wake Forest University, Winston-Salem, NC, USA
| | - Miranda Marion
- Department of Biostatistics and Data Science, Wake Forest University, Winston-Salem, NC, USA
| | - Jonathan Rosand
- Henry and Allison McCance Center for Brain Health, Division of Neurocritical Care and Emergency Neurology, Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Carl D. Langefeld
- Department of Biostatistics and Data Science, Wake Forest University, Winston-Salem, NC, USA
| | - Daniel Woo
- University of Cincinnati College of Medicine, Department of Neurology and Rehabilitation Medicine, Cincinnati, OH, USA
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8
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Woo D, Comeau ME, Venema SU, Anderson CD, Flaherty M, Testai F, Kittner S, Frankel M, James ML, Sung G, Elkind M, Worrall B, Kidwell C, Gonzales N, Koch S, Hall C, Birnbaum L, Mayson D, Coull B, Malkoff M, Sheth KN, McCauley JL, Osborne J, Morgan M, Gilkerson L, Behymer T, Coleman ER, Rosand J, Sekar P, Moomaw CJ, Langefeld CD. Risk Factors Associated With Mortality and Neurologic Disability After Intracerebral Hemorrhage in a Racially and Ethnically Diverse Cohort. JAMA Netw Open 2022; 5:e221103. [PMID: 35289861 PMCID: PMC8924717 DOI: 10.1001/jamanetworkopen.2022.1103] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 12/12/2021] [Indexed: 12/17/2022] Open
Abstract
Introduction Intracerebral hemorrhage (ICH) is the most severe subtype of stroke. Its mortality rate is high, and most survivors experience significant disability. Objective To assess primary patient risk factors associated with mortality and neurologic disability 3 months after ICH in a large, racially and ethnically balanced cohort. Design, Setting, and Participants This cohort study included participants from the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study, which prospectively recruited 1000 non-Hispanic White, 1000 non-Hispanic Black, and 1000 Hispanic patients with spontaneous ICH to study the epidemiological characteristics and genomics associated with ICH. Participants included those with uniform data collection and phenotype definitions, centralized neuroimaging review, and telephone follow-up at 3 months. Analyses were completed in November 2021. Exposures Patient demographic and clinical characteristics as well as hospital event and imaging variables were examined, with characteristics meeting P < .20 considered candidates for a multivariate model. Elements included in the ICH score were specifically analyzed. Main Outcomes and Measures Individual characteristics were screened for association with 3-month outcome of neurologic disability or mortality, as assessed by a modified Rankin Scale (mRS) score of 4 or greater vs 3 or less under a logistic regression model. A total of 25 characteristics were tested in the final model, which minimized the Akaike information criterion. Analyses were repeated removing individuals who had withdrawal of care. Results A total of 2568 patients (mean [SD] age, 62.4 [14.7] years; 1069 [41.6%] women and 1499 [58.4%] men) had a 3-month outcome determination available, including death. The final logistic model had a significantly higher area under the receiver operating characteristics curve (C = 0.88) compared with ICH score alone (C = 0.76; P < .001). Among characteristics associated with neurologic disability and mortality were larger log ICH volume (OR, 2.74; 95% CI, 2.36-3.19; P < .001), older age (OR per 1-year increase, 1.04; 95% CI, 1.02-1.05; P < .001), pre-ICH mRS score (OR, 1.62; 95% CI, 1.41-1.87; P < .001), lobar location (OR, 0.22; 95% CI, 0.16-0.30; P < .001), and presence of infection (OR, 1.85; 95% CI, 1.42-2.41; P < .001). Conclusions and Relevance The findings of this cohort study validate ICH score elements and suggest additional baseline and interim patient characteristics were associated with variation in 3-month outcome.
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Affiliation(s)
- Daniel Woo
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Mary E. Comeau
- Department of Biostatistics and Data Science, Center for Precision Medicine, Wake Forest University, Winston-Salem, North Carolina
| | | | | | - Matthew Flaherty
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Fernando Testai
- Department of Neurology and Rehabilitation Medicine, University of Illinois College of Medicine, Chicago
| | - Steven Kittner
- Department of Neurology, Baltimore Veterans Administration Medical Center, University of Maryland School of Medicine, Baltimore
| | - Michael Frankel
- Department of Neurology, Emory University, Grady Memorial Hospital, Atlanta, Georgia
| | - Michael L. James
- Departments of Anesthesiology and Neurology, Duke University, Durham, North Carolina
| | - Gene Sung
- Neurocritical Care and Stroke Division, University of Southern California, Los Angeles
| | - Mitchell Elkind
- Department of Neurology, Columbia University, New York, New York
| | - Bradford Worrall
- Department of Neurology, University of Virginia, Charlottesville
| | | | | | - Sebastian Koch
- Department of Neurology, University of Miami, Miller School of Medicine, Miami, Florida
| | - Christiana Hall
- Department of Neurology and Neurotherapeutics, UT–Southwestern, Dallas, Texas
| | - Lee Birnbaum
- Department of Neurology, University of Texas at San Antonio, San Antonio
| | - Douglas Mayson
- Department of Neurology, Medstar Georgetown University Hospital, Washington, District of Columbia
| | - Bruce Coull
- Department of Neurology, University of Arizona, Tucson
| | - Marc Malkoff
- Department of Neurology and Neurosurgery, University of Tennessee Health Sciences, Memphis
| | - Kevin N. Sheth
- Department of Neurology, Yale University, New Haven, Connecticut
| | - Jacob L. McCauley
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida
| | - Jennifer Osborne
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Misty Morgan
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Lee Gilkerson
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Tyler Behymer
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Elisheva R. Coleman
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Jonathan Rosand
- Center for Genomic Medicine, Massachusetts General Hospital, Boston
| | - Padmini Sekar
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Charles J. Moomaw
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Carl D. Langefeld
- Department of Biostatistics and Data Science, Center for Precision Medicine, Wake Forest University, Winston-Salem, North Carolina
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Hooper D, Howard TD, Williamson BJ, BEHYMER TP, Comeau ME, Zimmerman K, Khandwala V, Gilkerson LA, Kittner SJ, Roh DJ, James ML, Testai FD, Vahidy FS, Bagga RS, Thornton JB, Maloney T, Sawyer RPP, Shatz RS, Boyne P, Dunning K, Vagal A, Langefeld CDD, Woo D. Abstract TP10: Inflammatory And Neurodegenerative Gene Expression Changes Occur Long-term After ICH. Stroke 2022. [DOI: 10.1161/str.53.suppl_1.tp10] [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] [Indexed: 11/16/2022]
Abstract
Objective:
There is a high prevalence of progressive cognitive impairment in intracerebral hemorrhage (ICH) survivors. We sought to identify gene expression changes, in association with long-term neurodegeneration, among patients 12-24 months post-ICH.
Methods:
The
Recovery and Outcomes from StrokE (ROSE)
study prospectively recruits patients with spontaneous, supratentorial ICH, collecting baseline peripheral blood samples and MRI with diffusion tract imaging (DTI). The
Recovery of StrokE-Longitudinal Assessment with Neuroimaging (ROSE-LAWN)
study performs long term follow-up at 12-24 months on cases enrolled in ROSE. We report on the first five cases enrolled in the ROSE-LAWN study from December 2020 to March 2021. Controls were matched to an overall ICH population by age, sex, and race. RNA-sequencing, aligned to human genome assembly GRCh38, was tested for differential gene expression. Canonical pathway enrichment and network analyses were computed for differentially expressed genes using Ingenuity Pathway Analysis, STRING and MCODE.
Results:
RNA-seq analysis of 5 ICH cases [male, 80%; median age, 61 (45 - 73); black, 40%; ICH volume, 14.88cc ± 13.07] and 13 controls [male, 54%; median age, 74 (69 - 79); black, 15%] identified 554 differentially expressed genes (genomic control adjusted p < 0.01), of which 24 met the false discovery rate correction for multiple comparisons (FDR < 0.05). The most significant difference was observed in hypoxia up-regulated 1 (
HYOU1),
a heat shock protein related gene (p = 2.64E-11). Pathway analysis identified enrichment of dopamine and serotonin receptor signaling (p = 8.74E-03, 2.23E-02), cell cycle regulation (p = 1.75E-02) and agranulocyte adhesion pathways (p = 2.18E-02). Comparison of baseline and follow-up MRI DTI demonstrated extensive cortical tract degeneration, beyond the initial injury.
Conclusion:
These results provide novel evidence of significant gene expression changes occurring years after the initial ICH. Despite resolution of the ICH, persistent inflammation may correlate with progressive neurodegeneration and subsequent cognitive impairment in ICH survivors. Future studies with greater sample sizes are supported by this work.
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Affiliation(s)
- Destiny Hooper
- Neurology and Rehabilitation, Univ of Cincinnati, Cincinnati, OH
| | - Timothy D Howard
- Biostatistics and Data Science, Wake Forest Univ, Winston-Salem, NC
| | | | - Tyler P BEHYMER
- Neurology and Rehabilitation, Univ of Cincinnati, Cincinnati, OH
| | - Mary E Comeau
- Biostatistics and Data Science and Cntr for Precision Medicine, Wake Forest Univ, Winston-Salem, NC
| | - Kip Zimmerman
- Biostatistics and Data Science and Cntr for Precision Medicine, Wake Forest Univ, Winston-Salem, NC
| | - Vivek Khandwala
- Neurology and Rehabilitation, Univ of Cincinnati, Cincinnati, OH
| | - Lee A Gilkerson
- Neurology and Rehabilitation, Univ of Cincinnati, Cincinnati, OH
| | | | | | | | - Fernando D Testai
- Neurology and Rehabilitation Medicine, Univ of Illinois, Chicago, IL
| | - Farhaan S Vahidy
- Cntrs for Outcomes Rsch, Houston Methodist Rsch Institute, Houston, TX
| | | | | | | | | | - Rhonna S Shatz
- Neurology and Rehabilitation, Univ of Cincinnati, Cincinnati, OH
| | - Pierce Boyne
- Neurology and Rehabilitation, Univ of Cincinnati, Cincinnati, OH
| | - Kari Dunning
- Neurology and Rehabilitation, Univ of Cincinnati, Cincinnati, OH
| | | | - Carl D. D Langefeld
- Biostatistics and Data Science and Cntr for Precision Medicine, Wake Forest Univ, Winston-Salem, NC
| | - Daniel Woo
- Neurology and Rehabilitation, Univ of Cincinnati, Cincinnati, OH
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10
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Das SK, Ainsworth HC, Dimitrov L, Okut H, Comeau ME, Sharma N, Ng MCY, Norris JM, Chen YDI, Wagenknecht LE, Bowden DW, Hsu FC, Taylor KD, Langefeld CD, Palmer ND. Metabolomic architecture of obesity implicates metabolonic lactone sulfate in cardiometabolic disease. Mol Metab 2021; 54:101342. [PMID: 34563731 PMCID: PMC8640864 DOI: 10.1016/j.molmet.2021.101342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 09/17/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE Identify and characterize circulating metabolite profiles associated with adiposity to inform precision medicine. METHODS Untargeted plasma metabolomic profiles in the Insulin Resistance Atherosclerosis Family Study (IRASFS) Mexican American cohort (n = 1108) were analyzed for association with anthropometric (body mass index, BMI; waist circumference, WC; waist-to-hip ratio, WHR) and computed tomography measures (visceral adipose tissue, VAT; subcutaneous adipose tissue, SAT; visceral-to-subcutaneous ratio, VSR) of adiposity. Genetic data, inclusive of genome-wide array-based genotyping, whole exome sequencing (WES) and whole genome sequencing (WGS), were evaluated to identify the genetic contributors. Phenotypic and genetic association signals were replicated across ancestries. Transcriptomic data were analyzed to explore the relationship between genetic and metabolomic data. RESULTS A partially characterized metabolite, tentatively named metabolonic lactone sulfate (X-12063), was consistently associated with BMI, WC, WHR, VAT, and SAT in IRASFS Mexican Americans (PMA <2.02 × 10-27). Trait associations were replicated in IRASFS African Americans (PAA < 1.12 × 10-07). Expanded analyses revealed associations with multiple phenotypic measures of cardiometabolic health, e.g. insulin sensitivity (SI), triglycerides (TG), diastolic blood pressure (DBP) and plasminogen activator inhibitor-1 (PAI-1) in both ancestries. Metabolonic lactone sulfate levels were heritable (h2 > 0.47), and a significant genetic signal at the ZSCAN25/CYP3A5 locus (PMA = 9.00 × 10-41, PAA = 2.31 × 10-10) was observed, highlighting a putative functional variant (rs776746, CYP3A5∗3). Transcriptomic analysis in the African American Genetics of Metabolism and Expression (AAGMEx) cohort supported the association of CYP3A5 with metabolonic lactone sulfate levels (PFDR = 6.64 × 10-07). CONCLUSIONS Variant rs776746 is associated with a decrease in the transcript levels of CYP3A5, which in turn is associated with increased metabolonic lactone sulfate levels and poor cardiometabolic health.
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Affiliation(s)
- Swapan K Das
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Hannah C Ainsworth
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Latchezar Dimitrov
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Hayrettin Okut
- Office of Research, University of Kansas Medical Center, Wichita, Kansas, USA
| | - Mary E Comeau
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Neeraj Sharma
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Maggie C Y Ng
- Division of Genetic Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jill M Norris
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
| | - Yii-der I Chen
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Lynne E Wagenknecht
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Donald W Bowden
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Fang-Chi Hsu
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Kent D Taylor
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Carl D Langefeld
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Nicholette D Palmer
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
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11
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Kittner SJ, Sekar P, Comeau ME, Anderson CD, Parikh GY, Tavarez T, Flaherty ML, Testai FD, Frankel MR, James ML, Sung G, Elkind MSV, Worrall BB, Kidwell CS, Gonzales NR, Koch S, Hall CE, Birnbaum L, Mayson D, Coull B, Malkoff MD, Sheth KN, McCauley JL, Osborne J, Morgan M, Gilkerson LA, Behymer TP, Demel SL, Moomaw CJ, Rosand J, Langefeld CD, Woo D. Ethnic and Racial Variation in Intracerebral Hemorrhage Risk Factors and Risk Factor Burden. JAMA Netw Open 2021; 4:e2121921. [PMID: 34424302 PMCID: PMC8383133 DOI: 10.1001/jamanetworkopen.2021.21921] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 06/15/2021] [Indexed: 12/19/2022] Open
Abstract
Importance Black and Hispanic individuals have an increased risk of intracerebral hemorrhage (ICH) compared with their White counterparts, but no large studies of ICH have been conducted in these disproportionately affected populations. Objective To examine the prevalence, odds, and population attributable risk (PAR) percentage for established and novel risk factors for ICH, stratified by ICH location and racial/ethnic group. Design, Setting, and Participants The Ethnic/Racial Variations of Intracerebral Hemorrhage Study was a case-control study of ICH among 3000 Black, Hispanic, and White individuals who experienced spontaneous ICH (1000 cases in each group). Recruitment was conducted between September 2009 and July 2016 at 19 US sites comprising 42 hospitals. Control participants were identified through random digit dialing and were matched to case participants by age (±5 years), sex, race/ethnicity, and geographic area. Data analyses were conducted from January 2019 to May 2020. Main Outcomes and Measures Case and control participants underwent a standardized interview, physical measurement for body mass index, and genotyping for the ɛ2 and ɛ4 alleles of APOE, the gene encoding apolipoprotein E. Prevalence, multivariable adjusted odds ratio (OR), and PAR percentage were calculated for each risk factor in the entire ICH population and stratified by racial/ethnic group and by lobar or nonlobar location. Results There were 1000 Black patients (median [interquartile range (IQR)] age, 57 [50-65] years, 425 [42.5%] women), 1000 Hispanic patients (median [IQR] age, 58 [49-69] years; 373 [37.3%] women), and 1000 White patients (median [IQR] age, 71 [59-80] years; 437 [43.7%] women). The mean (SD) age of patients with ICH was significantly lower among Black and Hispanic patients compared with White patients (eg, lobar ICH: Black, 62.2 [15.2] years; Hispanic, 62.5 [15.7] years; White, 71.0 [13.3] years). More than half of all ICH in Black and Hispanic patients was associated with treated or untreated hypertension (PAR for treated hypertension, Black patients: 53.6%; 95% CI, 46.4%-59.8%; Hispanic patients: 46.5%; 95% CI, 40.6%-51.8%; untreated hypertension, Black patients: 45.5%; 95% CI, 39.%-51.1%; Hispanic patients: 42.7%; 95% CI, 37.6%-47.3%). Lack of health insurance also had a disproportionate association with the PAR percentage for ICH in Black and Hispanic patients (Black patients: 21.7%; 95% CI, 17.5%-25.7%; Hispanic patients: 30.2%; 95% CI, 26.1%-34.1%; White patients: 5.8%; 95% CI, 3.3%-8.2%). A high sleep apnea risk score was associated with both lobar (OR, 1.68; 95% CI, 1.36-2.06) and nonlobar (OR, 1.62; 95% CI, 1.37-1.91) ICH, and high cholesterol was inversely associated only with nonlobar ICH (OR, 0.60; 95% CI, 0.52-0.70); both had no interactions with race and ethnicity. In contrast to the association between the ɛ2 and ɛ4 alleles of APOE and ICH in White individuals (eg, presence of APOE ɛ2 allele: OR, 1.84; 95% CI, 1.34-2.52), APOE alleles were not associated with lobar ICH among Black or Hispanic individuals. Conclusions and Relevance This study found sleep apnea as a novel risk factor for ICH. The results suggest a strong contribution from inadequately treated hypertension and lack of health insurance to the disproportionate burden and earlier onset of ICH in Black and Hispanic populations. These findings emphasize the importance of addressing modifiable risk factors and the social determinants of health to reduce health disparities.
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Affiliation(s)
- Steven J. Kittner
- Geriatric Research and Education Clinical Center, Department of Neurology, Baltimore Veterans Administration Medical Center, University of Maryland School of Medicine, Baltimore
| | - Padmini Sekar
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Mary E. Comeau
- Department of Biostatistics and Data Science, Wake Forest University, Winston-Salem, North Carolina
| | - Christopher D. Anderson
- Henry and Allison McCance Center for Brain Health and Center for Genomic Medicine, Massachusetts General Hospital, Boston
| | - Gunjan Y. Parikh
- Department of Neurology, University of Maryland School of Medicine, Baltimore
| | - Tachira Tavarez
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Matthew L. Flaherty
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Fernando D. Testai
- Department of Neurology and Rehabilitation Medicine, University of Illinois College of Medicine, Chicago, Illinois
| | - Michael R. Frankel
- Department of Neurology, Emory University, Grady Memorial Hospital, Atlanta, Georgia
| | - Michael L. James
- Departments of Anesthesiology and Neurology, Duke University, Durham, North Carolina
| | - Gene Sung
- Neurocritical Care and Stroke Division, University of Southern California, Los Angeles
| | - Mitchell S. V. Elkind
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Bradford B. Worrall
- Departments of Neurology and Public Health Sciences, University of Virginia, Charlottesville
| | | | - Nicole R. Gonzales
- Department of Neurology, McGovern Medical School at UTHealth, Houston, Texas
| | - Sebastian Koch
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida
| | - Christiana E. Hall
- Department of Neurology and Neurotherapeutics, University of Texas–Southwestern, Dallas
| | - Lee Birnbaum
- Department of Neurology, University of Texas–San Antonio
| | - Douglas Mayson
- Department of Neurology, Medstar Georgetown University Hospital, Washington, DC
| | - Bruce Coull
- Department of Neurology, University of Arizona–Tucson
| | - Marc D. Malkoff
- Department of Neurology and Neurosurgery, University of Tennessee Health Sciences, Memphis
| | - Kevin N. Sheth
- Department of Neurology, Yale University, New Haven, Connecticut
| | - Jacob L. McCauley
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida
| | - Jennifer Osborne
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Misty Morgan
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Lee A. Gilkerson
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Tyler P. Behymer
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Stacie L. Demel
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Charles J. Moomaw
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Jonathan Rosand
- Henry and Allison McCance Center for Brain Health and Center for Genomic Medicine, Massachusetts General Hospital, Boston
| | - Carl D. Langefeld
- Department of Biostatistics and Data Science, Wake Forest University, Winston-Salem, North Carolina
| | - Daniel Woo
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
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12
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Sharma NK, Comeau ME, Montoya D, Pellegrini M, Howard TD, Langefeld CD, Das SK. Integrative Analysis of Glucometabolic Traits, Adipose Tissue DNA Methylation, and Gene Expression Identifies Epigenetic Regulatory Mechanisms of Insulin Resistance and Obesity in African Americans. Diabetes 2020; 69:2779-2793. [PMID: 32928872 PMCID: PMC7679782 DOI: 10.2337/db20-0117] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 08/28/2020] [Indexed: 12/13/2022]
Abstract
Decline in insulin sensitivity due to dysfunction of adipose tissue (AT) is one of the earliest pathogenic events in type 2 diabetes. We hypothesize that differential DNA methylation (DNAm) controls insulin sensitivity and obesity by modulating transcript expression in AT. Integrating AT DNAm profiles with transcript profile data measured in a cohort of 230 African Americans (AAs) from the African American Genetics of Metabolism and Expression cohort, we performed cis-expression quantitative trait methylation (cis-eQTM) analysis to identify epigenetic regulatory loci for glucometabolic trait-associated transcripts. We identified significantly associated cytosine-guanine dinucleotide regions for 82 transcripts (false discovery rate [FDR]-P < 0.05). The strongest eQTM locus was observed for the proopiomelanocortin (POMC; ρ = -0.632, P = 4.70 × 10-27) gene. Epigenome-wide association studies (EWAS) further identified 155, 46, and 168 cytosine-guanine dinucleotide regions associated (FDR-P < 0.05) with the Matsuda index, SI, and BMI, respectively. Intersection of EWAS, transcript level to trait association, and eQTM results, followed by causal inference test identified significant eQTM loci for 23 genes that were also associated with Matsuda index, SI, and/or BMI in EWAS. These associated genes include FERMT3, ITGAM, ITGAX, and POMC In summary, applying an integrative multiomics approach, our study provides evidence for DNAm-mediated regulation of gene expression at both previously identified and novel loci for many key AT transcripts influencing insulin resistance and obesity.
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Affiliation(s)
- Neeraj K Sharma
- Department of Internal Medicine, Section of Endocrinology and Metabolism, Wake Forest School of Medicine, Winston-Salem, NC
| | - Mary E Comeau
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Dennis Montoya
- Department of Molecular, Cell and Developmental Biology, University of California Los Angeles, Los Angeles, CA
| | - Matteo Pellegrini
- Department of Molecular, Cell and Developmental Biology, University of California Los Angeles, Los Angeles, CA
| | - Timothy D Howard
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC
| | - Carl D Langefeld
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Swapan K Das
- Department of Internal Medicine, Section of Endocrinology and Metabolism, Wake Forest School of Medicine, Winston-Salem, NC
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Abstract
Intensive blood pressure control decreases the rate of cardiovascular events by >25% compared with standard blood pressure control. We sought to determine whether the decrease in cardiovascular events seen with intensive blood pressure control is associated with an increased rate of other causes of hospitalization. This is a post hoc analysis of SPRINT (Systolic Blood Pressure Intervention Trial) in 9361 adult participants with hypertension and elevated cardiovascular risk. Participants were randomly assigned to an intensive or standard systolic blood pressure goal (<120 or <140 mm Hg, respectively). The primary outcome was hospitalization rates per 100 person-years for hospitalizations not associated with SPRINT primary events. After excluding hospitalizations linked to SPRINT primary events, there were 4678 participants with a rate of 19.70 hospitalizations per 100 person-years, compared with 4683 participants with a rate of 19.65 (P=0.37). Equivalence testing shows that these hospitalization rates were statistically equivalent at the P=0.05 level. Of those with hospitalizations, >1 hospitalization was seen in 38.8% of intensive arm participants and 41.9% of standard arm participants (P=0.08). The mean cumulative count of nonprimary event hospitalizations was comparable between the two arms. The most common causes of hospitalization were cardiovascular (23.6%) followed by injuries, including bone and joint therapeutic procedures (15.7%), infections (12.0%), and nervous systems disorders (10.7%). No categories of hospitalization were statistically more common in the intensive arm compared with the standard arm. Thus, the decrease in cardiovascular events seen with intensive blood pressure control is not associated with an increased rate of other causes of hospitalization. Registration- URL: https://www.clinicaltrials.gov; Unique identifier: NCT01206062.
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Affiliation(s)
- Michael V Rocco
- From the Departments of Internal Medicine (M.V.R., B.I.F., A.T.H.), Wake Forest School of Medicine, Winston-Salem, NC
| | - Mary E Comeau
- Biostatistics and Data Science (M.E.C., M.C.M., C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC
| | - Miranda C Marion
- Biostatistics and Data Science (M.E.C., M.C.M., C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC
| | - Barry I Freedman
- From the Departments of Internal Medicine (M.V.R., B.I.F., A.T.H.), Wake Forest School of Medicine, Winston-Salem, NC
| | - Amret T Hawfield
- From the Departments of Internal Medicine (M.V.R., B.I.F., A.T.H.), Wake Forest School of Medicine, Winston-Salem, NC
| | - Carl D Langefeld
- Biostatistics and Data Science (M.E.C., M.C.M., C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC
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Traylor M, Anderson CD, Rutten-Jacobs LCA, Falcone GJ, Comeau ME, Ay H, Sudlow CLM, Xu H, Mitchell BD, Cole JW, Rexrode K, Jimenez-Conde J, Schmidt R, Grewal RP, Sacco R, Ribases M, Rundek T, Rosand J, Dichgans M, Lee JM, Langefeld CD, Kittner SJ, Markus HS, Woo D, Malik R. Subtype Specificity of Genetic Loci Associated With Stroke in 16 664 Cases and 32 792 Controls. Circ Genom Precis Med 2019; 12:e002338. [PMID: 31306060 DOI: 10.1161/circgen.118.002338] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Genome-wide association studies have identified multiple loci associated with stroke. However, the specific stroke subtypes affected, and whether loci influence both ischemic and hemorrhagic stroke, remains unknown. For loci associated with stroke, we aimed to infer the combination of stroke subtypes likely to be affected, and in doing so assess the extent to which such loci have homogeneous effects across stroke subtypes. METHODS We performed Bayesian multinomial regression in 16 664 stroke cases and 32 792 controls of European ancestry to determine the most likely combination of stroke subtypes affected for loci with published genome-wide stroke associations, using model selection. Cases were subtyped under 2 commonly used stroke classification systems, TOAST (Trial of Org 10172 Acute Stroke Treatment) and causative classification of stroke. All individuals had genotypes imputed to the Haplotype Reference Consortium 1.1 Panel. RESULTS Sixteen loci were considered for analysis. Seven loci influenced both hemorrhagic and ischemic stroke, 3 of which influenced ischemic and hemorrhagic subtypes under both TOAST and causative classification of stroke. Under causative classification of stroke, 4 loci influenced both small vessel stroke and intracerebral hemorrhage. An EDNRA locus demonstrated opposing effects on ischemic and hemorrhagic stroke. No loci were predicted to influence all stroke subtypes in the same direction, and only one locus (12q24) was predicted to influence all ischemic stroke subtypes. CONCLUSIONS Heterogeneity in the influence of stroke-associated loci on stroke subtypes is pervasive, reflecting differing causal pathways. However, overlap exists between hemorrhagic and ischemic stroke, which may reflect shared pathobiology predisposing to small vessel arteriopathy. Stroke is a complex, heterogeneous disorder requiring tailored analytic strategies to decipher genetic mechanisms.
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Affiliation(s)
- Matthew Traylor
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge (M.T., H.S.M.).,William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (M.T.)
| | - Christopher D Anderson
- Center for Genomic Medicine (C.D.A., J.R.), Massachusetts General Hospital, Boston.,J. Philip Kistler Stroke Research Center, Department of Neurology (C.D.A., J.R.), Massachusetts General Hospital, Boston.,Division of Neurocritical Care and Emergency Neurology, Department of Neurology (C.D.A., J.R.), Massachusetts General Hospital, Boston.,Program in Medical and Population Genetics, Broad Inst, Cambridge, MA (C.D.A., J.R.)
| | - Loes C A Rutten-Jacobs
- German Center for Neurodegenerative Diseases, Population Health Sciences, Bonn, Germany (L.C.A.R.-J.)
| | - Guido J Falcone
- Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven, CT (G.J.F.)
| | - Mary E Comeau
- Department of Biostatistical Sciences, Division of Public Health Sciences, School of Medicine, Wake Forest University, Winston-Salem, NC (M.E.C., C.D.L.)
| | - Hakan Ay
- Stroke Service (H.A.), Massachusetts General Hospital, Boston.,A.A. Martinos Center for Biomedical Imaging, Department of Radiology (H.A.), Massachusetts General Hospital, Boston
| | - Cathie L M Sudlow
- Center for Clinical Brain Sciences, University of Edinburgh (C.L.M.S.).,Usher Institute of Population Health Sciences and Informatics, Nine Bioquarter, Edinburgh, United Kingdom (C.L.M.S.)
| | - Huichun Xu
- Division of Endocrinology, Diabetes and Nutrition, Department of Medicine (H.X., B.D.M.,), University of Maryland School of Medicine
| | - Braxton D Mitchell
- Division of Endocrinology, Diabetes and Nutrition, Department of Medicine (H.X., B.D.M.,), University of Maryland School of Medicine.,Geriatrics Research and Education Clinical Center, Baltimore Veterans Administration Medical Center (B.D.M.)
| | - John W Cole
- Department of Neurology (S.J.K., J.W.C), University of Maryland School of Medicine.,Department of Neurology, Veterans Affairs Medical Center, Baltimore, MD (J.W.C., S.J.K)
| | - Kathryn Rexrode
- Channing Division of Network Medicine and Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Boston, MA (K.R.)
| | - Jordi Jimenez-Conde
- Neurovascular Research Unit, Department of Neurology (J.J.-C.), Institut Municipal d'Investigacio´ Medica-Hospital del Mar, Universitat Autonoma de Barcelona, Spain.,Program in Inflammation and Cardiovascular Disorders (J.J.-C.), Institut Municipal d'Investigacio´ Medica-Hospital del Mar, Universitat Autonoma de Barcelona, Spain
| | - Reinhold Schmidt
- Department of Neurology, Medical University of Graz, Austria (R. Schmidt)
| | - Raji P Grewal
- Neuroscience Institute, Saint Francis Medical Center, School of Health and Medical Sciences, Seton Hall University, South Orange, NJ (R.P.G.)
| | - Ralph Sacco
- Department of Neurology, Miller School of Medicine, University of Miami, FL (R. Sacco, T.R.)
| | - Marta Ribases
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona (M.R.).,Department of Psychiatry, Hospital Universitari Vall d'Hebron (M.R.).,Biomedical Network Research Center on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain (M.R.)
| | - Tatjana Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, FL (R. Sacco, T.R.)
| | - Jonathan Rosand
- Center for Genomic Medicine (C.D.A., J.R.), Massachusetts General Hospital, Boston.,J. Philip Kistler Stroke Research Center, Department of Neurology (C.D.A., J.R.), Massachusetts General Hospital, Boston.,Division of Neurocritical Care and Emergency Neurology, Department of Neurology (C.D.A., J.R.), Massachusetts General Hospital, Boston.,Program in Medical and Population Genetics, Broad Inst, Cambridge, MA (C.D.A., J.R.)
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität München (M.D., R.M.).,Munich Cluster for Systems Neurology (SyNergy), Germany (M.D.)
| | - Jin-Moo Lee
- Department of Neurology, Radiology, and Biomedical Engineering, Washington University School of Medicine, St Louis, MO (J.-M.L.)
| | - Carl D Langefeld
- Department of Biostatistical Sciences, Division of Public Health Sciences, School of Medicine, Wake Forest University, Winston-Salem, NC (M.E.C., C.D.L.)
| | - Steven J Kittner
- Department of Neurology (S.J.K., J.W.C), University of Maryland School of Medicine.,Department of Neurology, Veterans Affairs Medical Center, Baltimore, MD (J.W.C., S.J.K)
| | - Hugh S Markus
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge (M.T., H.S.M.)
| | - Daniel Woo
- Department of Neurology and Rehabilitation Medicine and Comprehensive Stroke Center, University of Cincinnati, OH (D.W.)
| | - Rainer Malik
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität München (M.D., R.M.)
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15
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Sharma NK, Chuang Key CC, Civelek M, Wabitsch M, Comeau ME, Langefeld CD, Parks JS, Das SK. Genetic Regulation of Enoyl-CoA Hydratase Domain-Containing 3 in Adipose Tissue Determines Insulin Sensitivity in African Americans and Europeans. Diabetes 2019; 68:1508-1522. [PMID: 31010960 PMCID: PMC6609988 DOI: 10.2337/db18-1229] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 04/03/2019] [Indexed: 12/17/2022]
Abstract
Insulin resistance (IR) is a harbinger of type 2 diabetes (T2D) and partly determined by genetic factors. However, genetically regulated mechanisms of IR remain poorly understood. Using gene expression, genotype, and insulin sensitivity data from the African American Genetics of Metabolism and Expression (AAGMEx) cohort, we performed transcript-wide correlation and expression quantitative trait loci (eQTL) analyses to identify IR-correlated cis-regulated transcripts (cis-eGenes) in adipose tissue. These IR-correlated cis-eGenes were tested in the European ancestry individuals in the Metabolic Syndrome in Men (METSIM) cohort for trans-ethnic replication. Comparison of Matsuda index-correlated transcripts in AAGMEx with the METSIM study identified significant correlation of 3,849 transcripts, with concordant direction of effect for 97.5% of the transcripts. cis-eQTL for 587 Matsuda index-correlated genes were identified in both cohorts. Enoyl-CoA hydratase domain-containing 3 (ECHDC3) was the top-ranked Matsuda index-correlated cis-eGene. Expression levels of ECHDC3 were positively correlated with Matsuda index, and regulated by cis-eQTL, rs34844369 being the top cis-eSNP in AAGMEx. Silencing of ECHDC3 in adipocytes significantly reduced insulin-stimulated glucose uptake and Akt Ser473 phosphorylation. RNA sequencing analysis identified 691 differentially expressed genes in ECHDC3-knockdown adipocytes, which were enriched in γ-linolenate biosynthesis, and known IR genes. Thus, our studies elucidated genetic regulatory mechanisms of IR and identified genes and pathways in adipose tissue that are mechanistically involved in IR.
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Affiliation(s)
- Neeraj K Sharma
- Section of Endocrinology and Metabolism, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Chia-Chi Chuang Key
- Section of Molecular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Mete Civelek
- Center for Public Health Genomics, Department of Biomedical Engineering, University of Virginia, Charlottesville, VA
| | - Martin Wabitsch
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - Mary E Comeau
- Division of Public Health Sciences, Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC
| | - Carl D Langefeld
- Division of Public Health Sciences, Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC
| | - John S Parks
- Section of Molecular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Swapan K Das
- Section of Endocrinology and Metabolism, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC
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16
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McClain DA, Sharma NK, Jain S, Harrison A, Salaye LN, Comeau ME, Langefeld CD, Lorenzo FR, Das SK. Adipose Tissue Transferrin and Insulin Resistance. J Clin Endocrinol Metab 2018; 103:4197-4208. [PMID: 30099506 PMCID: PMC6194856 DOI: 10.1210/jc.2018-00770] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 08/01/2018] [Indexed: 12/27/2022]
Abstract
Context Excessive body iron stores are a risk factor for decreased insulin sensitivity (SI) and diabetes. We hypothesized that transcriptional dysregulation of genes involved in iron metabolism in adipocytes causes insulin resistance. Objective and Design To define the genetic regulation of iron metabolism and its role in SI, we used gene expression, genotype, and SI data from an African American cohort (N = 256). Replication studies were performed in independent European ancestry cohorts. In vitro studies in human adipocytes were performed to define the role of a selected gene in causing insulin resistance. Results Among 62 transcripts representing iron homeostasis genes, expression of 30 in adipose tissue were correlated with SI. Transferrin (TF) and ferritin heavy polypeptide were most positively and negatively associated with SI, respectively. These observations were replicated in two independent European ancestry adipose data sets. The strongest cis-regulatory variant for TF expression (rs6785596; P = 7.84 × 10-18) was identified in adipose but not muscle or liver tissue. Variants significantly affected the normal relationship of serum ferritin to insulin resistance. Knockdown of TF in differentiated Simpson-Golabi-Behmel syndrome adipocytes by short hairpin RNA decreased intracellular iron, reduced maximal insulin-stimulated glucose uptake, and reduced Akt phosphorylation. Knockdown of TF caused differential expression of 465 genes, including genes involved in glucose transport, mitochondrial function, Wnt-pathway/ SI, chemokine activity, and obesity. Iron chelation recapitulated key changes in the expression profile induced by TF knockdown. Conclusion Genetic regulation of TF expression in adipose tissue plays a novel role in regulating SI.
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Affiliation(s)
- Donald A McClain
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
- W. G. (Bill) Hefner VA Medical Center - Salisbury, Salisbury, North Carolina
| | - Neeraj K Sharma
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Shalini Jain
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Alexandria Harrison
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Lipika N Salaye
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Mary E Comeau
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Carl D Langefeld
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Felipe R Lorenzo
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
- W. G. (Bill) Hefner VA Medical Center - Salisbury, Salisbury, North Carolina
| | - Swapan K Das
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
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17
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Martínez-Bueno M, Oparina N, Dozmorov MG, Marion MC, Comeau ME, Gilkeson G, Kamen D, Weisman M, Salmon J, McCune JW, Harley JB, Kimberly R, James JA, Merrill J, Montgomery C, Langefeld CD, Alarcón-Riquelme ME. Trans-Ethnic Mapping of BANK1 Identifies Two Independent SLE-Risk Linkage Groups Enriched for Co-Transcriptional Splicing Marks. Int J Mol Sci 2018; 19:ijms19082331. [PMID: 30096841 PMCID: PMC6121630 DOI: 10.3390/ijms19082331] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 07/31/2018] [Accepted: 08/06/2018] [Indexed: 11/17/2022] Open
Abstract
BANK1 is a susceptibility gene for several systemic autoimmune diseases in several populations. Using the genome-wide association study (GWAS) data from Europeans (EUR) and African Americans (AA), we performed an extensive fine mapping of ankyrin repeats 1 (BANK1). To increase the SNP density, we used imputation followed by univariate and conditional analysis, combined with a haplotypic and expression quantitative trait locus (eQTL) analysis. The data from Europeans showed that the associated region was restricted to a minimal and dependent set of SNPs covering introns two and three, and exon two. In AA, the signal found in the Europeans was split into two independent effects. All of the major risk associated SNPs were eQTLs, and the risks were associated with an increased BANK1 gene expression. Functional annotation analysis revealed the enrichment of repressive B cell epigenomic marks (EZH2 and H3K27me3) and a strong enrichment of splice junctions. Furthermore, one eQTL located in intron two, rs13106926, was found within the binding site for RUNX3, a transcriptional activator. These results connect the local genome topography, chromatin structure, and the regulatory landscape of BANK1 with co-transcriptional splicing of exon two. Our data defines a minimal set of risk associated eQTLs predicted to be involved in the expression of BANK1 modulated through epigenetic regulation and splicing. These findings allow us to suggest that the increased expression of BANK1 will have an impact on B-cell mediated disease pathways.
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Affiliation(s)
- Manuel Martínez-Bueno
- GENYO, Centre for Genomics and Oncological Research: Pfizer, University of Granada, Andalusian Government, PTS, 18016 Granada, Spain.
| | - Nina Oparina
- Unit of Chronic Inflammatory Diseases, Institute for Environmental Medicine, Karolinska Institutet, 171 67 Solna, Sweden.
| | - Mikhail G Dozmorov
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA 23284, USA.
| | - Miranda C Marion
- Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Mary E Comeau
- Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Gary Gilkeson
- Division of Rheumatology, Medical University of South Carolina, Charleston, SC 29425, USA.
| | - Diane Kamen
- Division of Rheumatology, Medical University of South Carolina, Charleston, SC 29425, USA.
| | - Michael Weisman
- Division of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
| | - Jane Salmon
- Hospital for Special Surgery, New York, NY 10021, USA.
| | - Joseph W McCune
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA.
| | - John B Harley
- Cincinnati Children's Hospital Medical Center, OH and US Department of Veterans Affairs Medical Center, Cincinnati, OH 45229, USA.
| | - Robert Kimberly
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35205, USA.
| | - Judith A James
- Arthritis and Clinical Immunology and Clinical Pharmacology Programs, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA.
| | - Joan Merrill
- Arthritis and Clinical Immunology and Clinical Pharmacology Programs, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA.
| | - Courtney Montgomery
- Arthritis and Clinical Immunology and Clinical Pharmacology Programs, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA.
| | - Carl D Langefeld
- Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Marta E Alarcón-Riquelme
- GENYO, Centre for Genomics and Oncological Research: Pfizer, University of Granada, Andalusian Government, PTS, 18016 Granada, Spain.
- Unit of Chronic Inflammatory Diseases, Institute for Environmental Medicine, Karolinska Institutet, 171 67 Solna, Sweden.
- Arthritis and Clinical Immunology and Clinical Pharmacology Programs, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA.
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18
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Ding D, Sekar P, Moomaw CJ, Comeau ME, James ML, Testai F, Flaherty ML, Vashkevich A, Worrall BB, Woo D, Osborne J. Venous Thromboembolism in Patients With Spontaneous Intracerebral Hemorrhage: A Multicenter Study. Neurosurgery 2018; 84:E304-E310. [DOI: 10.1093/neuros/nyy333] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 06/19/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Dale Ding
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona
| | - Padmini Sekar
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Charles J Moomaw
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Mary E Comeau
- Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, North Carolina
| | - Michael L James
- Departments of Anesthesiology and Neurology, Duke University, Durham, North Carolina
| | - Fernando Testai
- Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, Illinois
| | - Matthew L Flaherty
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio
| | | | - Bradford B Worrall
- Department of Neurology, University of Virginia, Charlottesville, Virginia
| | - Daniel Woo
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Jennifer Osborne
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio
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19
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Patel ZH, Lu X, Miller D, Forney CR, Lee J, Lynch A, Schroeder C, Parks L, Magnusen AF, Chen X, Pujato M, Maddox A, Zoller EE, Namjou B, Brunner HI, Henrickson M, Huggins JL, Williams AH, Ziegler JT, Comeau ME, Marion MC, Glenn SB, Adler A, Shen N, Nath SK, Stevens AM, Freedman BI, Pons-Estel BA, Tsao BP, Jacob CO, Kamen DL, Brown EE, Gilkeson GS, Alarcón GS, Martin J, Reveille JD, Anaya JM, James JA, Sivils KL, Criswell LA, Vilá LM, Petri M, Scofield RH, Kimberly RP, Edberg JC, Ramsey-Goldman R, Bang SY, Lee HS, Bae SC, Boackle SA, Cunninghame Graham D, Vyse TJ, Merrill JT, Niewold TB, Ainsworth HC, Silverman ED, Weisman MH, Wallace DJ, Raj P, Guthridge JM, Gaffney PM, Kelly JA, Alarcón-Riquelme ME, Langefeld CD, Wakeland EK, Kaufman KM, Weirauch MT, Harley JB, Kottyan LC. A plausibly causal functional lupus-associated risk variant in the STAT1-STAT4 locus. Hum Mol Genet 2018; 27:2392-2404. [PMID: 29912393 PMCID: PMC6005081 DOI: 10.1093/hmg/ddy140] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 03/21/2018] [Accepted: 04/13/2018] [Indexed: 01/01/2023] Open
Abstract
Systemic lupus erythematosus (SLE or lupus) (OMIM: 152700) is a chronic autoimmune disease with debilitating inflammation that affects multiple organ systems. The STAT1-STAT4 locus is one of the first and most highly replicated genetic loci associated with lupus risk. We performed a fine-mapping study to identify plausible causal variants within the STAT1-STAT4 locus associated with increased lupus disease risk. Using complementary frequentist and Bayesian approaches in trans-ancestral Discovery and Replication cohorts, we found one variant whose association with lupus risk is supported across ancestries in both the Discovery and Replication cohorts: rs11889341. In B cell lines from patients with lupus and healthy controls, the lupus risk allele of rs11889341 was associated with increased STAT1 expression. We demonstrated that the transcription factor HMGA1, a member of the HMG transcription factor family with an AT-hook DNA-binding domain, has enriched binding to the risk allele compared with the non-risk allele of rs11889341. We identified a genotype-dependent repressive element in the DNA within the intron of STAT4 surrounding rs11889341. Consistent with expression quantitative trait locus (eQTL) analysis, the lupus risk allele of rs11889341 decreased the activity of this putative repressor. Altogether, we present a plausible molecular mechanism for increased lupus risk at the STAT1-STAT4 locus in which the risk allele of rs11889341, the most probable causal variant, leads to elevated STAT1 expression in B cells due to decreased repressor activity mediated by increased binding of HMGA1.
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Affiliation(s)
- Zubin H Patel
- Immunology Graduate Program, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA
- Center for Autoimmune Genomics and Etiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Medical Scientist Training Program, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Xiaoming Lu
- Immunology Graduate Program, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA
- Center for Autoimmune Genomics and Etiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Daniel Miller
- Center for Autoimmune Genomics and Etiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Carmy R Forney
- Center for Autoimmune Genomics and Etiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Joshua Lee
- Center for Autoimmune Genomics and Etiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Arthur Lynch
- Center for Autoimmune Genomics and Etiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Connor Schroeder
- Center for Autoimmune Genomics and Etiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Lois Parks
- Center for Autoimmune Genomics and Etiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Albert F Magnusen
- Center for Autoimmune Genomics and Etiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Xiaoting Chen
- Center for Autoimmune Genomics and Etiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Mario Pujato
- Center for Autoimmune Genomics and Etiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Avery Maddox
- Center for Autoimmune Genomics and Etiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Erin E Zoller
- Center for Autoimmune Genomics and Etiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Bahram Namjou
- Center for Autoimmune Genomics and Etiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45220, USA
| | - Hermine I Brunner
- Division of Rheumatology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Michael Henrickson
- Division of Rheumatology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Jennifer L Huggins
- Division of Rheumatology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Adrienne H Williams
- Center for Public Health Genomics and the Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Julie T Ziegler
- Center for Public Health Genomics and the Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Mary E Comeau
- Center for Public Health Genomics and the Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Miranda C Marion
- Center for Public Health Genomics and the Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Stuart B Glenn
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
| | - Adam Adler
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
| | - Nan Shen
- Center for Autoimmune Genomics and Etiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Shanghai Institute of Rheumatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, P.R. China
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45220, USA
| | - Swapan K Nath
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
| | - Anne M Stevens
- Center for Immunity and Immunotherapies, Seattle Children’s Research Institute, Seattle, WA 98101, USA
- Division of Rheumatology, Department of Pediatrics, University of Washington, Seattle, WA 98195, USA
| | - Barry I Freedman
- Section on Nephrology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | | | - Betty P Tsao
- Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Chaim O Jacob
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Diane L Kamen
- Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Elizabeth E Brown
- Division of Molecular and Cellular Pathology, Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, 35294, United States of America
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Gary S Gilkeson
- Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Graciela S Alarcón
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Javier Martin
- Instituto de Parasitologia y Biomedicina Lopez-Neyra, CSIC, Granada 18001-18016, Spain
| | - John D Reveille
- Rheumatology and Clinical Immunogenetics, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Juan-Manuel Anaya
- Center for Autoimmune Diseases Research (CREA), Universidad del Rosario, Bogota 111711, Colombia
| | - Judith A James
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
- Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, United States of America
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Kathy L Sivils
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
| | - Lindsey A Criswell
- Department of Medicine, Rosalind Russell/Ephraim P Engleman Rheumatology Research Center, University of California San Francisco, San Francisco, CA 94143-0500, USA
| | - Luis M Vilá
- Division of Rheumatology, Department of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, PR 00936, USA
| | - Michelle Petri
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA
| | - R Hal Scofield
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
- Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, United States of America
- United States Department of Veterans Affairs Medical Center, Oklahoma City, OK 73104, USA
| | - Robert P Kimberly
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Jeffrey C Edberg
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Rosalind Ramsey-Goldman
- Division of Rheumatology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - So-Young Bang
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul 04763, Korea
| | - Hye-Soon Lee
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul 04763, Korea
| | - Sang-Cheol Bae
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul 04763, Korea
| | - Susan A Boackle
- Division of Rheumatology, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Deborah Cunninghame Graham
- Divisions of Genetics/Molecular Medicine and Immunology, King’s College London, Guy’s Hospital, London SE1 9RT, UK
| | - Timothy J Vyse
- Divisions of Genetics/Molecular Medicine and Immunology, King’s College London, Guy’s Hospital, London SE1 9RT, UK
| | - Joan T Merrill
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
- Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, United States of America
| | - Timothy B Niewold
- Division of Rheumatology, Department of Pathology, New York University, New York, NY 10016, USA
| | - Hannah C Ainsworth
- Center for Public Health Genomics and the Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Earl D Silverman
- Division of Rheumatology, The Hospital for Sick Children, Hospital for Sick Research Institute, University of Toronto, Toronto, ON M5G 1X8, Canada
| | - Michael H Weisman
- Division of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Daniel J Wallace
- Division of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Prithvi Raj
- Department of Immunology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Joel M Guthridge
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
- Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, United States of America
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Patrick M Gaffney
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
| | - Jennifer A Kelly
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
| | - Marta E Alarcón-Riquelme
- Unit of Chronic Inflammatory Diseases, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 17167, Sweden
- Center for Genomics and Oncological Research, Pfizer-University of Granada-Junta de Andalucia, Parque Tecnológica de la Salud, Granada 18016, Spain
| | - Carl D Langefeld
- Center for Public Health Genomics and the Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Edward K Wakeland
- Department of Immunology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Kenneth M Kaufman
- Center for Autoimmune Genomics and Etiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- United States Department of Veterans Affairs Medical Center, Cincinnati, OH 45220, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45220, USA
- Divisions of Biomedical Informatics and Developmental Biology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Matthew T Weirauch
- Center for Autoimmune Genomics and Etiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45220, USA
- Divisions of Biomedical Informatics and Developmental Biology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - John B Harley
- Center for Autoimmune Genomics and Etiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- United States Department of Veterans Affairs Medical Center, Cincinnati, OH 45220, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45220, USA
| | - Leah C Kottyan
- Center for Autoimmune Genomics and Etiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45220, USA
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Langefeld CD, Comeau ME, Ng MCY, Guan M, Dimitrov L, Mudgal P, Spainhour MH, Julian BA, Edberg JC, Croker JA, Divers J, Hicks PJ, Bowden DW, Chan GC, Ma L, Palmer ND, Kimberly RP, Freedman BI. Genome-wide association studies suggest that APOL1-environment interactions more likely trigger kidney disease in African Americans with nondiabetic nephropathy than strong APOL1-second gene interactions. Kidney Int 2018; 94:599-607. [PMID: 29885931 DOI: 10.1016/j.kint.2018.03.017] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 03/01/2018] [Accepted: 03/22/2018] [Indexed: 12/25/2022]
Abstract
African Americans carrying two apolipoprotein L1 gene (APOL1) renal risk variants have a high risk for nephropathy. However, only a minority develops end-stage renal disease (ESRD). Hence, modifying factors likely contribute to initiation of kidney disease such as endogenous (HIV infection) or exogenous (interferon treatment) environmental modifiers. In this report, genome-wide association studies and a meta-analysis were performed to identify novel loci for nondiabetic ESRD in African Americans and to detect genetic modifiers in APOL1-associated nephropathy. Two African American cohorts were analyzed, 1749 nondiabetic ESRD cases and 1136 controls from Wake Forest and 901 lupus nephritis (LN)-ESRD cases and 520 controls with systemic lupus erythematosus but lacking nephropathy from the LN-ESRD Consortium. Association analyses adjusting for APOL1 G1/G2 renal-risk variants were completed and stratified by APOL1 risk genotype status. Individual genome-wide association studies and meta-analysis results of all 2650 ESRD cases and 1656 controls did not detect significant genome-wide associations with ESRD beyond APOL1. Similarly, no single nucleotide polymorphism showed significant genome-wide evidence of an interaction with APOL1 risk variants. Thus, although variants with small individual effects cannot be ruled out and are likely to exist, our results suggest that APOL1-environment interactions may be of greater clinical importance in triggering nephropathy in African Americans than APOL1 interactions with other single nucleotide polymorphisms.
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Affiliation(s)
- Carl D Langefeld
- Division of Public Health Sciences, Department of Biostatistical Sciences; Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; Center for Public Health Genomics; Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Mary E Comeau
- Division of Public Health Sciences, Department of Biostatistical Sciences; Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; Center for Public Health Genomics; Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Maggie C Y Ng
- Department of Biochemistry; Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; Center for Diabetes Research; Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Meijian Guan
- Center for Diabetes Research; Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Latchezar Dimitrov
- Center for Diabetes Research; Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Poorva Mudgal
- Center for Diabetes Research; Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Mitzie H Spainhour
- Department of Internal Medicine, Section on Nephrology; Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Bruce A Julian
- Department of Medicine, Division of Nephrology; University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Jeffrey C Edberg
- Department of Medicine, Division of Clinical Immunology and Rheumatology; University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Jennifer A Croker
- Department of Medicine, Division of Clinical Immunology and Rheumatology; University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Jasmin Divers
- Division of Public Health Sciences, Department of Biostatistical Sciences; Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; Center for Public Health Genomics; Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Pamela J Hicks
- Department of Biochemistry; Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; Center for Diabetes Research; Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Donald W Bowden
- Department of Biochemistry; Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; Center for Diabetes Research; Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Gary C Chan
- Department of Internal Medicine, Section on Nephrology; Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Lijun Ma
- Department of Internal Medicine, Section on Nephrology; Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Nicholette D Palmer
- Department of Biochemistry; Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; Center for Diabetes Research; Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Robert P Kimberly
- Department of Medicine, Division of Clinical Immunology and Rheumatology; University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Barry I Freedman
- Center for Public Health Genomics; Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; Center for Diabetes Research; Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; Department of Internal Medicine, Section on Nephrology; Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
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21
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Hinks A, Marion MC, Cobb J, Comeau ME, Sudman M, Ainsworth HC, Bowes J, Becker ML, Bohnsack JF, Haas JP, Lovell DJ, Mellins ED, Nelson JL, Nordal E, Punaro M, Reed AM, Rose CD, Rosenberg AM, Rygg M, Smith SL, Stevens AM, Videm V, Wallace CA, Wedderburn LR, Yarwood A, Yeung RSM, Langefeld CD, Thompson SD, Thomson W, Prahalad S. Brief Report: The Genetic Profile of Rheumatoid Factor-Positive Polyarticular Juvenile Idiopathic Arthritis Resembles That of Adult Rheumatoid Arthritis. Arthritis Rheumatol 2018; 70:957-962. [PMID: 29426059 PMCID: PMC5984672 DOI: 10.1002/art.40443] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 02/01/2018] [Indexed: 02/03/2023]
Abstract
Objective Juvenile idiopathic arthritis (JIA) comprises 7 heterogeneous categories of chronic childhood arthritides. Approximately 5% of children with JIA have rheumatoid factor (RF)–positive arthritis, which phenotypically resembles adult rheumatoid arthritis (RA). Our objective was to compare and contrast the genetics of RF‐positive polyarticular JIA with those of RA and selected other JIA categories, to more fully understand the pathophysiologic relationships of inflammatory arthropathies. Methods Patients with RF‐positive polyarticular JIA (n = 340) and controls (n = 14,412) were genotyped using the Immunochip array. Single‐nucleotide polymorphisms were tested for association using a logistic regression model adjusting for admixture proportions. We calculated weighted genetic risk scores (wGRS) of reported RA and JIA risk loci, and we compared the ability of these wGRS to predict RF‐positive polyarticular JIA. Results As expected, the HLA region was strongly associated with RF‐positive polyarticular JIA (P = 5.51 × 10−31). Nineteen of 44 RA risk loci and 6 of 27 oligoarticular/RF‐negative polyarticular JIA risk loci were associated with RF‐positive polyarticular JIA (P < 0.05). The RA wGRS predicted RF‐positive polyarticular JIA (area under the curve [AUC] 0.71) better than did the oligoarticular/RF‐negative polyarticular JIA wGRS (AUC 0.59). The genetic profile of patients with RF‐positive polyarticular JIA was more similar to that of RA patients with age at onset 16–29 years than to that of RA patients with age at onset ≥70 years. Conclusion RF‐positive polyarticular JIA is genetically more similar to adult RA than to the most common JIA categories and thus appears to be a childhood‐onset presentation of autoantibody‐positive RA. These findings suggest common disease mechanisms, which could lead to novel therapeutic targets and shared treatment strategies.
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Affiliation(s)
- Anne Hinks
- University of Manchester, Manchester, UK
| | - Miranda C Marion
- Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Joanna Cobb
- University of Manchester and Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Mary E Comeau
- Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Marc Sudman
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Hannah C Ainsworth
- Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - John Bowes
- University of Manchester, Manchester, UK
| | | | | | | | - Johannes-Peter Haas
- German Centre for Pediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany
| | - Daniel J Lovell
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | - J Lee Nelson
- Fred Hutchinson Cancer Research Center and University of Washington, Seattle
| | - Ellen Nordal
- University Hospital of North Norway and UIT The Arctic University of Norway, Tromsø, Norway
| | - Marilynn Punaro
- Arthritis Clinic Texas Scottish Rite Hospital for Children and University of Texas Southwestern Medical Center, Dallas
| | - Ann M Reed
- Duke University School of Medicine, Durham, North Carolina
| | | | | | - Marite Rygg
- Norwegian University of Science and Technology and St. Olav's University Hospital, Trondheim, Norway
| | | | - Anne M Stevens
- Seattle Children's Research Institute and University of Washington, Seattle
| | - Vibeke Videm
- Norwegian University of Science and Technology and St. Olav's University Hospital, Trondheim, Norway
| | - Carol A Wallace
- Seattle Children's Hospital and Research Institute, Seattle, Washington
| | - Lucy R Wedderburn
- University College London and NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | | | - Rae S M Yeung
- The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Carl D Langefeld
- Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | | | - Wendy Thomson
- University of Manchester and Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Sampath Prahalad
- Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia
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Langefeld CD, Comeau ME, Sharma NK, Bowden DW, Freedman BI, Das SK. Transcriptional Regulatory Mechanisms in Adipose and Muscle Tissue Associated with Composite Glucometabolic Phenotypes. Obesity (Silver Spring) 2018; 26:559-569. [PMID: 29377571 PMCID: PMC5821540 DOI: 10.1002/oby.22113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 10/27/2017] [Accepted: 12/08/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Tissue-specific gene expression is associated with individual metabolic measures. However, these measures may not reflect the true but latent underlying biological phenotype. This study reports gene expression associations with multidimensional glucometabolic characterizations of obesity, glucose homeostasis, and lipid traits. METHODS Factor analysis was computed by using orthogonal rotation to construct composite phenotypes (CPs) from 23 traits in 256 African Americans without diabetes. Genome-wide transcript expression data from adipose and muscle were tested for association with CPs, and expression quantitative trait loci (eQTLs) were identified by associations between cis-acting single-nucleotide polymorphisms (SNPs) and gene expression. RESULTS The factor analysis identified six CPs. CPs 1 through 6 individually explained 34%, 12%, 9%, 8%, 6%, and 5% of the variation in 23 glucometabolic traits studied. There were 3,994 and 929 CP-associated transcripts identified in adipose and muscle tissue, respectively; CP2 had the largest number of associated transcripts. Pathway analysis identified multiple canonical pathways from the CP-associated transcripts. In adipose and muscle, significant cis-eQTLs were identified for 558 and 164 CP-associated transcripts (q-value < 0.01), respectively. CONCLUSIONS Adipose and muscle transcripts comprehensively define pathways involved in regulating glucometabolic disorders. Cis-eQTLs for CP-associated genes may act as primary causal determinants of glucometabolic phenotypes by regulating transcription of key genes.
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Affiliation(s)
- Carl D. Langefeld
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157
| | - Mary E. Comeau
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157
| | - Neeraj K. Sharma
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157
| | - Donald W. Bowden
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC 27157
| | - Barry I. Freedman
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157
| | - Swapan K. Das
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157
- Corresponding author and person to whom reprint requests should be addressed: Swapan K. Das, Ph.D., Section on Endocrinology and Metabolism, Department of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina 27157, , Telephone: 336-713-6057; Fax: 336-713-7200
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23
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Boehme AK, Comeau ME, Langefeld CD, Lord A, Moomaw CJ, Osborne J, James ML, Martini S, Testai FD, Woo D, Elkind MSV. Systemic inflammatory response syndrome, infection, and outcome in intracerebral hemorrhage. Neurol Neuroimmunol Neuroinflamm 2017; 5:e428. [PMID: 29318180 PMCID: PMC5745360 DOI: 10.1212/nxi.0000000000000428] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 11/06/2017] [Indexed: 01/09/2023]
Abstract
Objective: Systemic inflammatory response syndrome (SIRS) may be related to poor outcomes after intracerebral hemorrhage (ICH). Methods: The Ethnic/Racial Variations of Intracerebral Hemorrhage study is an observational study of ICH in whites, blacks, and Hispanics throughout the United Sates. SIRS was defined by standard criteria as 2 or more of the following on admission: (1) body temperature <36°C or >38°C, (2) heart rate >90 beats per minute, (3) respiratory rate >20 breaths per minute, or (4) white blood cell count <4,000/mm3 or >12,000/mm3. The relationship among SIRS, infection, and poor outcome (modified Rankin Scale [mRS] 3–6) at discharge and 3 months was assessed. Results: Of 2,441 patients included, 343 (14%) met SIRS criteria at admission. Patients with SIRS were younger (58.2 vs 62.7 years; p < 0.0001) and more likely to have intraventricular hemorrhage (IVH; 53.6% vs 36.7%; p < 0.0001), higher admission hematoma volume (25.4 vs 17.5 mL; p < 0.0001), and lower admission Glasgow Coma Scale (GCS; 10.7 vs 13.1; p < 0.0001). SIRS on admission was significantly related to infections during hospitalization (adjusted odds ratio [OR] 1.36, 95% confidence interval [CI] 1.04–1.78). In unadjusted analyses, SIRS was associated with poor outcomes at discharge (OR 1.96, 95% CI 1.42–2.70) and 3 months (OR 1.75, 95% CI 1.35–2.33) after ICH. In analyses adjusted for infection, age, IVH, hematoma location, admission GCS, and premorbid mRS, SIRS was no longer associated with poor outcomes. Conclusions: SIRS on admission is associated with ICH score on admission and infection, but it was not an independent predictor of poor functional outcomes after ICH.
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Affiliation(s)
- Amelia K Boehme
- Department of Neurology (A.K.B., M.S.V.E.), College of Physicians and Surgeons, Columbia University; Department of Epidemiology (A.K.B., M.S.V.E.), Mailman School of Public Health, Columbia University, New York, NY; Wake Forest University (M.E.C., C.D.L.), NC; Department of Neurology (A.L.), New York University School of Medicine; Department of Neurology and Rehabilitation Medicine (C.J.M., J.O., D.W.), University of Cincinnati, OH; Departments of Anesthesiology and Neurology (M.L.J.), Duke University, Durham, NC; Baylor University, Houston, TX (S.M.); and University of Illinois Chicago (F.D.T.)
| | - Mary E Comeau
- Department of Neurology (A.K.B., M.S.V.E.), College of Physicians and Surgeons, Columbia University; Department of Epidemiology (A.K.B., M.S.V.E.), Mailman School of Public Health, Columbia University, New York, NY; Wake Forest University (M.E.C., C.D.L.), NC; Department of Neurology (A.L.), New York University School of Medicine; Department of Neurology and Rehabilitation Medicine (C.J.M., J.O., D.W.), University of Cincinnati, OH; Departments of Anesthesiology and Neurology (M.L.J.), Duke University, Durham, NC; Baylor University, Houston, TX (S.M.); and University of Illinois Chicago (F.D.T.)
| | - Carl D Langefeld
- Department of Neurology (A.K.B., M.S.V.E.), College of Physicians and Surgeons, Columbia University; Department of Epidemiology (A.K.B., M.S.V.E.), Mailman School of Public Health, Columbia University, New York, NY; Wake Forest University (M.E.C., C.D.L.), NC; Department of Neurology (A.L.), New York University School of Medicine; Department of Neurology and Rehabilitation Medicine (C.J.M., J.O., D.W.), University of Cincinnati, OH; Departments of Anesthesiology and Neurology (M.L.J.), Duke University, Durham, NC; Baylor University, Houston, TX (S.M.); and University of Illinois Chicago (F.D.T.)
| | - Aaron Lord
- Department of Neurology (A.K.B., M.S.V.E.), College of Physicians and Surgeons, Columbia University; Department of Epidemiology (A.K.B., M.S.V.E.), Mailman School of Public Health, Columbia University, New York, NY; Wake Forest University (M.E.C., C.D.L.), NC; Department of Neurology (A.L.), New York University School of Medicine; Department of Neurology and Rehabilitation Medicine (C.J.M., J.O., D.W.), University of Cincinnati, OH; Departments of Anesthesiology and Neurology (M.L.J.), Duke University, Durham, NC; Baylor University, Houston, TX (S.M.); and University of Illinois Chicago (F.D.T.)
| | - Charles J Moomaw
- Department of Neurology (A.K.B., M.S.V.E.), College of Physicians and Surgeons, Columbia University; Department of Epidemiology (A.K.B., M.S.V.E.), Mailman School of Public Health, Columbia University, New York, NY; Wake Forest University (M.E.C., C.D.L.), NC; Department of Neurology (A.L.), New York University School of Medicine; Department of Neurology and Rehabilitation Medicine (C.J.M., J.O., D.W.), University of Cincinnati, OH; Departments of Anesthesiology and Neurology (M.L.J.), Duke University, Durham, NC; Baylor University, Houston, TX (S.M.); and University of Illinois Chicago (F.D.T.)
| | - Jennifer Osborne
- Department of Neurology (A.K.B., M.S.V.E.), College of Physicians and Surgeons, Columbia University; Department of Epidemiology (A.K.B., M.S.V.E.), Mailman School of Public Health, Columbia University, New York, NY; Wake Forest University (M.E.C., C.D.L.), NC; Department of Neurology (A.L.), New York University School of Medicine; Department of Neurology and Rehabilitation Medicine (C.J.M., J.O., D.W.), University of Cincinnati, OH; Departments of Anesthesiology and Neurology (M.L.J.), Duke University, Durham, NC; Baylor University, Houston, TX (S.M.); and University of Illinois Chicago (F.D.T.)
| | - Michael L James
- Department of Neurology (A.K.B., M.S.V.E.), College of Physicians and Surgeons, Columbia University; Department of Epidemiology (A.K.B., M.S.V.E.), Mailman School of Public Health, Columbia University, New York, NY; Wake Forest University (M.E.C., C.D.L.), NC; Department of Neurology (A.L.), New York University School of Medicine; Department of Neurology and Rehabilitation Medicine (C.J.M., J.O., D.W.), University of Cincinnati, OH; Departments of Anesthesiology and Neurology (M.L.J.), Duke University, Durham, NC; Baylor University, Houston, TX (S.M.); and University of Illinois Chicago (F.D.T.)
| | - Sharyl Martini
- Department of Neurology (A.K.B., M.S.V.E.), College of Physicians and Surgeons, Columbia University; Department of Epidemiology (A.K.B., M.S.V.E.), Mailman School of Public Health, Columbia University, New York, NY; Wake Forest University (M.E.C., C.D.L.), NC; Department of Neurology (A.L.), New York University School of Medicine; Department of Neurology and Rehabilitation Medicine (C.J.M., J.O., D.W.), University of Cincinnati, OH; Departments of Anesthesiology and Neurology (M.L.J.), Duke University, Durham, NC; Baylor University, Houston, TX (S.M.); and University of Illinois Chicago (F.D.T.)
| | - Fernando D Testai
- Department of Neurology (A.K.B., M.S.V.E.), College of Physicians and Surgeons, Columbia University; Department of Epidemiology (A.K.B., M.S.V.E.), Mailman School of Public Health, Columbia University, New York, NY; Wake Forest University (M.E.C., C.D.L.), NC; Department of Neurology (A.L.), New York University School of Medicine; Department of Neurology and Rehabilitation Medicine (C.J.M., J.O., D.W.), University of Cincinnati, OH; Departments of Anesthesiology and Neurology (M.L.J.), Duke University, Durham, NC; Baylor University, Houston, TX (S.M.); and University of Illinois Chicago (F.D.T.)
| | - Daniel Woo
- Department of Neurology (A.K.B., M.S.V.E.), College of Physicians and Surgeons, Columbia University; Department of Epidemiology (A.K.B., M.S.V.E.), Mailman School of Public Health, Columbia University, New York, NY; Wake Forest University (M.E.C., C.D.L.), NC; Department of Neurology (A.L.), New York University School of Medicine; Department of Neurology and Rehabilitation Medicine (C.J.M., J.O., D.W.), University of Cincinnati, OH; Departments of Anesthesiology and Neurology (M.L.J.), Duke University, Durham, NC; Baylor University, Houston, TX (S.M.); and University of Illinois Chicago (F.D.T.)
| | - Mitchell S V Elkind
- Department of Neurology (A.K.B., M.S.V.E.), College of Physicians and Surgeons, Columbia University; Department of Epidemiology (A.K.B., M.S.V.E.), Mailman School of Public Health, Columbia University, New York, NY; Wake Forest University (M.E.C., C.D.L.), NC; Department of Neurology (A.L.), New York University School of Medicine; Department of Neurology and Rehabilitation Medicine (C.J.M., J.O., D.W.), University of Cincinnati, OH; Departments of Anesthesiology and Neurology (M.L.J.), Duke University, Durham, NC; Baylor University, Houston, TX (S.M.); and University of Illinois Chicago (F.D.T.)
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Sajuthi SP, Sharma NK, Comeau ME, Chou JW, Bowden DW, Freedman BI, Langefeld CD, Parks JS, Das SK. Genetic regulation of adipose tissue transcript expression is involved in modulating serum triglyceride and HDL-cholesterol. Gene 2017; 632:50-58. [PMID: 28844666 DOI: 10.1016/j.gene.2017.08.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 07/06/2017] [Accepted: 08/23/2017] [Indexed: 10/19/2022]
Abstract
Dyslipidemia is a major contributor to the increased cardiovascular disease and mortality associated with obesity and type 2 diabetes. We hypothesized that variation in expression of adipose tissue transcripts is associated with serum lipid concentrations in African Americans (AAs), and common genetic variants regulate expression levels of these transcripts. Fasting serum lipid levels, genome-wide transcript expression profiles of subcutaneous adipose tissue, and genome-wide SNP genotypes were analyzed in a cohort of non-diabetic AAs (N=250). Serum triglyceride (TRIG) and high density lipoprotein-cholesterol (HDL-C) levels were associated (FDR<0.01) with expression level of 1021 and 1875 adipose tissue transcripts, respectively, but none associated with total cholesterol or LDL-C levels. Serum HDL-C-associated transcripts were enriched for salient biological pathways, including branched-chain amino acid degradation, and oxidative phosphorylation. Genes in immuno-inflammatory pathways were activated among individuals with higher serum TRIG levels. We identified significant cis-regulatory SNPs (cis-eSNPs) for 449 serum lipid-associated transcripts in adipose tissue. The cis-eSNPs of 12 genes were nominally associated (p<0.001) with serum lipid level in genome wide association studies in Global Lipids Genetics Consortium (GLGC) cohorts. Allelic effect direction of cis-eSNPs on expression of MARCH2, BEST1 and TMEM258 matched with effect direction of these SNP alleles on serum TRIG or HDL-C levels in GLGC cohorts. These data suggest that expressions of serum lipid-associated transcripts in adipose tissue are dependent on common cis-eSNPs in African Americans. Thus, genetically-mediated transcriptional regulation in adipose tissue may play a role in reducing HDL-C and increasing TRIG in serum.
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Affiliation(s)
- Satria P Sajuthi
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States
| | - Neeraj K Sharma
- Department of Internal Medicine, Section on Endocrinology and Metabolism, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States
| | - Mary E Comeau
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States
| | - Jeff W Chou
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States
| | - Donald W Bowden
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States
| | - Barry I Freedman
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States
| | - Carl D Langefeld
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States
| | - John S Parks
- Department of Internal Medicine, Section on Molecular Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States
| | - Swapan K Das
- Department of Internal Medicine, Section on Endocrinology and Metabolism, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States.
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McIntosh LA, Marion MC, Sudman M, Comeau ME, Becker ML, Bohnsack JF, Fingerlin TE, Griffin TA, Haas JP, Lovell DJ, Maier LA, Nigrovic PA, Prahalad S, Punaro M, Rosé CD, Wallace CA, Wise CA, Moncrieffe H, Howard TD, Langefeld CD, Thompson SD. Genome-Wide Association Meta-Analysis Reveals Novel Juvenile Idiopathic Arthritis Susceptibility Loci. Arthritis Rheumatol 2017; 69:2222-2232. [PMID: 28719732 DOI: 10.1002/art.40216] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 07/13/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Juvenile idiopathic arthritis (JIA) is the most common childhood rheumatic disease and has a strong genomic component. To date, JIA genetic association studies have had limited sample sizes, used heterogeneous patient populations, or included only candidate regions. The aim of this study was to identify new associations between JIA patients with oligoarticular disease and those with IgM rheumatoid factor (RF)-negative polyarticular disease, which are clinically similar and the most prevalent JIA disease subtypes. METHODS Three cohorts comprising 2,751 patients with oligoarticular or RF-negative polyarticular JIA were genotyped using the Affymetrix Genome-Wide SNP Array 6.0 or the Illumina HumanCoreExome-12+ Array. Overall, 15,886 local and out-of-study controls, typed on these platforms or the Illumina HumanOmni2.5, were used for association analyses. High-quality single-nucleotide polymorphisms (SNPs) were used for imputation to 1000 Genomes prior to SNP association analysis. RESULTS Meta-analysis showed evidence of association (P < 1 × 10-6 ) at 9 regions: PRR9_LOR (P = 5.12 × 10-8 ), ILDR1_CD86 (P = 6.73 × 10-8 ), WDFY4 (P = 1.79 × 10-7 ), PTH1R (P = 1.87 × 10-7 ), RNF215 (P = 3.09 × 10-7 ), AHI1_LINC00271 (P = 3.48 × 10-7 ), JAK1 (P = 4.18 × 10-7 ), LINC00951 (P = 5.80 × 10-7 ), and HBP1 (P = 7.29 × 10-7 ). Of these, PRR9_LOR, ILDR1_CD86, RNF215, LINC00951, and HBP1 were shown, for the first time, to be autoimmune disease susceptibility loci. Furthermore, associated SNPs included cis expression quantitative trait loci for WDFY4, CCDC12, MTP18, SF3A1, AHI1, COG5, HBP1, and GPR22. CONCLUSION This study provides evidence of both unique JIA risk loci and risk loci overlapping between JIA and other autoimmune diseases. These newly associated SNPs are shown to influence gene expression, and their bounding regions tie into molecular pathways of immunologic relevance. Thus, they likely represent regions that contribute to the pathology of oligoarticular JIA and RF-negative polyarticular JIA.
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Affiliation(s)
- Laura A McIntosh
- Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio
| | - Miranda C Marion
- Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Marc Sudman
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Mary E Comeau
- Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | | | | | | | | | - J Peter Haas
- German Center for Pediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany
| | - Daniel J Lovell
- Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio
| | - Lisa A Maier
- National Jewish Health and University of Colorado, Denver
| | - Peter A Nigrovic
- Boston Children's Hospital and Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | - Marilynn Punaro
- Texas Scottish Rite Hospital for Children and UT Southwestern Medical Center, Dallas, Texas
| | | | - Carol A Wallace
- Seattle Children's Hospital and Research Institute, Seattle, Washington
| | - Carol A Wise
- Texas Scottish Rite Hospital for Children, McDermott Center for Human Growth and Development, and UT Southwestern Medical Center, Dallas, Texas
| | - Halima Moncrieffe
- Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio
| | | | | | - Susan D Thompson
- Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio
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Siddiqui FM, Langefeld CD, Moomaw CJ, Comeau ME, Sekar P, Rosand J, Kidwell CS, Martini S, Osborne JL, Stutzman S, Hall C, Woo D. Use of Statins and Outcomes in Intracerebral Hemorrhage Patients. Stroke 2017; 48:2098-2104. [PMID: 28663510 DOI: 10.1161/strokeaha.117.017358] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 05/05/2017] [Accepted: 06/02/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE Statin use may be associated with improved outcome in intracerebral hemorrhage patients. However, the topic remains controversial. Our analysis examined the effect of prior, continued, or new statin use on intracerebral hemorrhage outcomes using the ERICH (Ethnic/Racial Variations of Intracerebral Hemorrhage) data set. METHODS We analyzed ERICH (a multicenter study designed to examine ethnic variations in the risk, presentation, and outcomes of intracerebral hemorrhage) to explore the association of statin use and hematoma growth, mortality, and 3-month disability. We computed subset analyses with respect to 3 statin categories (prior, continued, or new use). RESULTS Two thousand four hundred and fifty-seven enrolled cases (mean age, 62 years; 42% females) had complete data on mortality and 3-month disability (modified Rankin Scale). Among those, 1093 cases were on statins (prior, n=268; continued, n=423; new, n=402). Overall, statin use was associated with reduced mortality and disability without any effect on hematoma growth. This association was primarily driven by continued/new statin use. A multivariate analysis adjusted for age and major predictors for poor outcome showed that continued/new statins users had good outcomes compared with prior users. However, statins may have been continued/started more frequently among less severe patients. When a propensity score was developed based on factors that could influence a physician's decision in prescribing statins and used as a covariate, continued/new statin use was no longer a significant predictor of good outcome. CONCLUSIONS Although statin use, especially continued/new use, was associated with improved intracerebral hemorrhage outcomes, this effect may merely reflect the physician's view of a patient's prognosis rather than a predictor of survival.
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Affiliation(s)
- Fazeel M Siddiqui
- From the Department of Neurology, Southern Illinois University School of Medicine, Springfield (F.M.S.); Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, NC (C.D.L., M.E.C.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., P.S., J.L.O., D.W.); Center for Genomic Medicine, Massachusetts General Hospital, Boston (J.R.); Departments of Neurology and Medical Imaging, University of Arizona, Tucson (C.S.K.); Michael E. DeBakey VA Medical Center and Department of Neurology, Baylor College of Medicine, Houston, TX (S.M.); and Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas (S.S., C.H.).
| | - Carl D Langefeld
- From the Department of Neurology, Southern Illinois University School of Medicine, Springfield (F.M.S.); Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, NC (C.D.L., M.E.C.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., P.S., J.L.O., D.W.); Center for Genomic Medicine, Massachusetts General Hospital, Boston (J.R.); Departments of Neurology and Medical Imaging, University of Arizona, Tucson (C.S.K.); Michael E. DeBakey VA Medical Center and Department of Neurology, Baylor College of Medicine, Houston, TX (S.M.); and Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas (S.S., C.H.)
| | - Charles J Moomaw
- From the Department of Neurology, Southern Illinois University School of Medicine, Springfield (F.M.S.); Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, NC (C.D.L., M.E.C.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., P.S., J.L.O., D.W.); Center for Genomic Medicine, Massachusetts General Hospital, Boston (J.R.); Departments of Neurology and Medical Imaging, University of Arizona, Tucson (C.S.K.); Michael E. DeBakey VA Medical Center and Department of Neurology, Baylor College of Medicine, Houston, TX (S.M.); and Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas (S.S., C.H.)
| | - Mary E Comeau
- From the Department of Neurology, Southern Illinois University School of Medicine, Springfield (F.M.S.); Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, NC (C.D.L., M.E.C.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., P.S., J.L.O., D.W.); Center for Genomic Medicine, Massachusetts General Hospital, Boston (J.R.); Departments of Neurology and Medical Imaging, University of Arizona, Tucson (C.S.K.); Michael E. DeBakey VA Medical Center and Department of Neurology, Baylor College of Medicine, Houston, TX (S.M.); and Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas (S.S., C.H.)
| | - Padmini Sekar
- From the Department of Neurology, Southern Illinois University School of Medicine, Springfield (F.M.S.); Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, NC (C.D.L., M.E.C.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., P.S., J.L.O., D.W.); Center for Genomic Medicine, Massachusetts General Hospital, Boston (J.R.); Departments of Neurology and Medical Imaging, University of Arizona, Tucson (C.S.K.); Michael E. DeBakey VA Medical Center and Department of Neurology, Baylor College of Medicine, Houston, TX (S.M.); and Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas (S.S., C.H.)
| | - Jonathan Rosand
- From the Department of Neurology, Southern Illinois University School of Medicine, Springfield (F.M.S.); Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, NC (C.D.L., M.E.C.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., P.S., J.L.O., D.W.); Center for Genomic Medicine, Massachusetts General Hospital, Boston (J.R.); Departments of Neurology and Medical Imaging, University of Arizona, Tucson (C.S.K.); Michael E. DeBakey VA Medical Center and Department of Neurology, Baylor College of Medicine, Houston, TX (S.M.); and Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas (S.S., C.H.)
| | - Chelsea S Kidwell
- From the Department of Neurology, Southern Illinois University School of Medicine, Springfield (F.M.S.); Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, NC (C.D.L., M.E.C.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., P.S., J.L.O., D.W.); Center for Genomic Medicine, Massachusetts General Hospital, Boston (J.R.); Departments of Neurology and Medical Imaging, University of Arizona, Tucson (C.S.K.); Michael E. DeBakey VA Medical Center and Department of Neurology, Baylor College of Medicine, Houston, TX (S.M.); and Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas (S.S., C.H.)
| | - Sharyl Martini
- From the Department of Neurology, Southern Illinois University School of Medicine, Springfield (F.M.S.); Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, NC (C.D.L., M.E.C.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., P.S., J.L.O., D.W.); Center for Genomic Medicine, Massachusetts General Hospital, Boston (J.R.); Departments of Neurology and Medical Imaging, University of Arizona, Tucson (C.S.K.); Michael E. DeBakey VA Medical Center and Department of Neurology, Baylor College of Medicine, Houston, TX (S.M.); and Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas (S.S., C.H.)
| | - Jennifer L Osborne
- From the Department of Neurology, Southern Illinois University School of Medicine, Springfield (F.M.S.); Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, NC (C.D.L., M.E.C.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., P.S., J.L.O., D.W.); Center for Genomic Medicine, Massachusetts General Hospital, Boston (J.R.); Departments of Neurology and Medical Imaging, University of Arizona, Tucson (C.S.K.); Michael E. DeBakey VA Medical Center and Department of Neurology, Baylor College of Medicine, Houston, TX (S.M.); and Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas (S.S., C.H.)
| | - Sonja Stutzman
- From the Department of Neurology, Southern Illinois University School of Medicine, Springfield (F.M.S.); Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, NC (C.D.L., M.E.C.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., P.S., J.L.O., D.W.); Center for Genomic Medicine, Massachusetts General Hospital, Boston (J.R.); Departments of Neurology and Medical Imaging, University of Arizona, Tucson (C.S.K.); Michael E. DeBakey VA Medical Center and Department of Neurology, Baylor College of Medicine, Houston, TX (S.M.); and Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas (S.S., C.H.)
| | - Christiana Hall
- From the Department of Neurology, Southern Illinois University School of Medicine, Springfield (F.M.S.); Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, NC (C.D.L., M.E.C.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., P.S., J.L.O., D.W.); Center for Genomic Medicine, Massachusetts General Hospital, Boston (J.R.); Departments of Neurology and Medical Imaging, University of Arizona, Tucson (C.S.K.); Michael E. DeBakey VA Medical Center and Department of Neurology, Baylor College of Medicine, Houston, TX (S.M.); and Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas (S.S., C.H.)
| | - Daniel Woo
- From the Department of Neurology, Southern Illinois University School of Medicine, Springfield (F.M.S.); Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, NC (C.D.L., M.E.C.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., P.S., J.L.O., D.W.); Center for Genomic Medicine, Massachusetts General Hospital, Boston (J.R.); Departments of Neurology and Medical Imaging, University of Arizona, Tucson (C.S.K.); Michael E. DeBakey VA Medical Center and Department of Neurology, Baylor College of Medicine, Houston, TX (S.M.); and Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas (S.S., C.H.)
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Pirkle JL, Comeau ME, Langefeld CD, Russell GB, Balderston SS, Freedman BI, Burkart JM. Effects of weight-based ultrafiltration rate limits on intradialytic hypotension in hemodialysis. Hemodial Int 2017. [PMID: 28643378 DOI: 10.1111/hdi.12578] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 11/28/2022]
Abstract
INTRODUCTION High ultrafiltration (UF) rates can result in intradialytic hypotension and are associated with increased mortality. The effects of a weight-based UF rate limit on intradialytic hypotension and the potential for unwanted fluid weight gain and hospitalizations for volume overload are unknown. METHODS This retrospective cohort study examined 123 in-center hemodialysis patients at one facility who transitioned to 13 mL/kg/h maximum UF rates. Patients were studied for an 8 week UF rate limit exposure period and compared to the 8-week period immediately prior, during which the cohort served as its own historical control. The primary outcomes were frequency of intradialytic hypotension events and percentage of treatments with a hypotension event. FINDINGS The delivered UF rate was lower during the exposure compared to the baseline period (mean UF rate 7.90 ± 4.45 mL/kg/h vs. 8.92 ± 5.64 mL/kg/h; P = 0.0005). The risk of intradialytic hypotension was decreased during the exposure compared to baseline period (event rate per treatment 0.0569 vs. 0.0719, OR 0.78 [95% CI 0.62-1.00]; P = 0.0474), as was the risk of having a treatment with a hypotension event (percentage of treatments with event 5.2% vs. 6.8%, OR 0.75 [95% CI 0.58-0.96]; P = 0.0217). Subgroup analyses demonstrated that these findings were attributable to patients with high baseline UF rates. Statistically significant differences in all-cause or volume overload-related hospitalization were not observed during the exposure period. DISCUSSION A weight-based UF rate limit of 13 mL/kg/h was associated with a decrease in the rate of intradialytic hypotension events among in-center hemodialysis patients.
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Affiliation(s)
- James L Pirkle
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Mary E Comeau
- Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Carl D Langefeld
- Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Gregory B Russell
- Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | | | - Barry I Freedman
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - John M Burkart
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Haycock PC, Burgess S, Nounu A, Zheng J, Okoli GN, Bowden J, Wade KH, Timpson NJ, Evans DM, Willeit P, Aviv A, Gaunt TR, Hemani G, Mangino M, Ellis HP, Kurian KM, Pooley KA, Eeles RA, Lee JE, Fang S, Chen WV, Law MH, Bowdler LM, Iles MM, Yang Q, Worrall BB, Markus HS, Hung RJ, Amos CI, Spurdle AB, Thompson DJ, O'Mara TA, Wolpin B, Amundadottir L, Stolzenberg-Solomon R, Trichopoulou A, Onland-Moret NC, Lund E, Duell EJ, Canzian F, Severi G, Overvad K, Gunter MJ, Tumino R, Svenson U, van Rij A, Baas AF, Bown MJ, Samani NJ, van t'Hof FNG, Tromp G, Jones GT, Kuivaniemi H, Elmore JR, Johansson M, Mckay J, Scelo G, Carreras-Torres R, Gaborieau V, Brennan P, Bracci PM, Neale RE, Olson SH, Gallinger S, Li D, Petersen GM, Risch HA, Klein AP, Han J, Abnet CC, Freedman ND, Taylor PR, Maris JM, Aben KK, Kiemeney LA, Vermeulen SH, Wiencke JK, Walsh KM, Wrensch M, Rice T, Turnbull C, Litchfield K, Paternoster L, Standl M, Abecasis GR, SanGiovanni JP, Li Y, Mijatovic V, Sapkota Y, Low SK, Zondervan KT, Montgomery GW, Nyholt DR, van Heel DA, Hunt K, Arking DE, Ashar FN, Sotoodehnia N, Woo D, Rosand J, Comeau ME, Brown WM, Silverman EK, Hokanson JE, Cho MH, Hui J, Ferreira MA, Thompson PJ, Morrison AC, Felix JF, Smith NL, Christiano AM, Petukhova L, Betz RC, Fan X, Zhang X, Zhu C, Langefeld CD, Thompson SD, Wang F, Lin X, Schwartz DA, Fingerlin T, Rotter JI, Cotch MF, Jensen RA, Munz M, Dommisch H, Schaefer AS, Han F, Ollila HM, Hillary RP, Albagha O, Ralston SH, Zeng C, Zheng W, Shu XO, Reis A, Uebe S, Hüffmeier U, Kawamura Y, Otowa T, Sasaki T, Hibberd ML, Davila S, Xie G, Siminovitch K, Bei JX, Zeng YX, Försti A, Chen B, Landi S, Franke A, Fischer A, Ellinghaus D, Flores C, Noth I, Ma SF, Foo JN, Liu J, Kim JW, Cox DG, Delattre O, Mirabeau O, Skibola CF, Tang CS, Garcia-Barcelo M, Chang KP, Su WH, Chang YS, Martin NG, Gordon S, Wade TD, Lee C, Kubo M, Cha PC, Nakamura Y, Levy D, Kimura M, Hwang SJ, Hunt S, Spector T, Soranzo N, Manichaikul AW, Barr RG, Kahali B, Speliotes E, Yerges-Armstrong LM, Cheng CY, Jonas JB, Wong TY, Fogh I, Lin K, Powell JF, Rice K, Relton CL, Martin RM, Davey Smith G. Association Between Telomere Length and Risk of Cancer and Non-Neoplastic Diseases: A Mendelian Randomization Study. JAMA Oncol 2017; 3:636-651. [PMID: 28241208 PMCID: PMC5638008 DOI: 10.1001/jamaoncol.2016.5945] [Citation(s) in RCA: 287] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
IMPORTANCE The causal direction and magnitude of the association between telomere length and incidence of cancer and non-neoplastic diseases is uncertain owing to the susceptibility of observational studies to confounding and reverse causation. OBJECTIVE To conduct a Mendelian randomization study, using germline genetic variants as instrumental variables, to appraise the causal relevance of telomere length for risk of cancer and non-neoplastic diseases. DATA SOURCES Genomewide association studies (GWAS) published up to January 15, 2015. STUDY SELECTION GWAS of noncommunicable diseases that assayed germline genetic variation and did not select cohort or control participants on the basis of preexisting diseases. Of 163 GWAS of noncommunicable diseases identified, summary data from 103 were available. DATA EXTRACTION AND SYNTHESIS Summary association statistics for single nucleotide polymorphisms (SNPs) that are strongly associated with telomere length in the general population. MAIN OUTCOMES AND MEASURES Odds ratios (ORs) and 95% confidence intervals (CIs) for disease per standard deviation (SD) higher telomere length due to germline genetic variation. RESULTS Summary data were available for 35 cancers and 48 non-neoplastic diseases, corresponding to 420 081 cases (median cases, 2526 per disease) and 1 093 105 controls (median, 6789 per disease). Increased telomere length due to germline genetic variation was generally associated with increased risk for site-specific cancers. The strongest associations (ORs [95% CIs] per 1-SD change in genetically increased telomere length) were observed for glioma, 5.27 (3.15-8.81); serous low-malignant-potential ovarian cancer, 4.35 (2.39-7.94); lung adenocarcinoma, 3.19 (2.40-4.22); neuroblastoma, 2.98 (1.92-4.62); bladder cancer, 2.19 (1.32-3.66); melanoma, 1.87 (1.55-2.26); testicular cancer, 1.76 (1.02-3.04); kidney cancer, 1.55 (1.08-2.23); and endometrial cancer, 1.31 (1.07-1.61). Associations were stronger for rarer cancers and at tissue sites with lower rates of stem cell division. There was generally little evidence of association between genetically increased telomere length and risk of psychiatric, autoimmune, inflammatory, diabetic, and other non-neoplastic diseases, except for coronary heart disease (OR, 0.78 [95% CI, 0.67-0.90]), abdominal aortic aneurysm (OR, 0.63 [95% CI, 0.49-0.81]), celiac disease (OR, 0.42 [95% CI, 0.28-0.61]) and interstitial lung disease (OR, 0.09 [95% CI, 0.05-0.15]). CONCLUSIONS AND RELEVANCE It is likely that longer telomeres increase risk for several cancers but reduce risk for some non-neoplastic diseases, including cardiovascular diseases.
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Affiliation(s)
- Philip C Haycock
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, England2School of Social and Community Medicine, University of Bristol, Bristol, England
| | - Stephen Burgess
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| | - Aayah Nounu
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, England2School of Social and Community Medicine, University of Bristol, Bristol, England
| | - Jie Zheng
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, England2School of Social and Community Medicine, University of Bristol, Bristol, England
| | - George N Okoli
- School of Social and Community Medicine, University of Bristol, Bristol, England
| | - Jack Bowden
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, England2School of Social and Community Medicine, University of Bristol, Bristol, England
| | - Kaitlin Hazel Wade
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, England2School of Social and Community Medicine, University of Bristol, Bristol, England
| | - Nicholas J Timpson
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, England2School of Social and Community Medicine, University of Bristol, Bristol, England
| | - David M Evans
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, England2School of Social and Community Medicine, University of Bristol, Bristol, England4University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Queensland, Australia
| | - Peter Willeit
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, England5Department of Neurology, Innsbruck Medical University, Austria
| | - Abraham Aviv
- Center of Human Development and Aging, Department of Pediatrics, New Jersey Medical School, Rutgers, The State University of New Jersey
| | - Tom R Gaunt
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, England2School of Social and Community Medicine, University of Bristol, Bristol, England
| | - Gibran Hemani
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, England2School of Social and Community Medicine, University of Bristol, Bristol, England
| | - Massimo Mangino
- Department of Twin Research and Genetic Epidemiology, King's College London, London England8NIHR Biomedical Research Centre at Guy's and St Thomas' Foundation Trust, London, England
| | - Hayley Patricia Ellis
- Brain Tumour Research Group, Institute of Clinical Neuroscience, Learning and Research Building, Southmead Hospital, University of Bristol
| | - Kathreena M Kurian
- Brain Tumour Research Group, Institute of Clinical Neuroscience, Learning and Research Building, Southmead Hospital, University of Bristol
| | - Karen A Pooley
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| | - Rosalind A Eeles
- The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, England
| | - Jeffrey E Lee
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston
| | - Shenying Fang
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston
| | - Wei V Chen
- Department of Clinical Applications & Support, The University of Texas MD Anderson Cancer Center, Houston
| | - Matthew H Law
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Lisa M Bowdler
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Mark M Iles
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, England
| | - Qiong Yang
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Bradford B Worrall
- Departments of Neurology and Public Health Sciences, University of Virginia Charlottesville, Virginia
| | | | - Rayjean J Hung
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada21Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Chris I Amos
- Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| | - Amanda B Spurdle
- Genetics and Computational Biology Division, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Deborah J Thompson
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| | - Tracy A O'Mara
- Genetics and Computational Biology Division, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Brian Wolpin
- Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Laufey Amundadottir
- Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Rachael Stolzenberg-Solomon
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece28WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
| | - N Charlotte Onland-Moret
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands
| | - Eiliv Lund
- Institute of Community Medicine, UiT The Arctic University of Norway, Tromso, Norway
| | - Eric J Duell
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Gianluca Severi
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France34Institut Gustave Roussy, Villejuif, France35Human Genetics Foundation (HuGeF), Torino, Italy36Cancer Council Victoria and University of Melbourne, Melbourne, Australia
| | - Kim Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - Marc J Gunter
- School of Public Health, Imperial College London, London, England
| | - Rosario Tumino
- Cancer Registry, Azienda Ospedaliera "Civile M.P. Arezzo," Ragusa, Italy
| | - Ulrika Svenson
- Department of Medical Biosciences, Umea University, Umea, Sweden
| | - Andre van Rij
- Surgery Department, University of Otago, Dunedin, New Zealand
| | - Annette F Baas
- Department of Genetics, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Matthew J Bown
- Department of Cardiovascular Sciences and the NIHR Leicester, Cardiovascular Biomedical Research Unit, University of Leicester, Glenfield Hospital, Leicester, England
| | - Nilesh J Samani
- Department of Cardiovascular Sciences and the NIHR Leicester, Cardiovascular Biomedical Research Unit, University of Leicester, Glenfield Hospital, Leicester, England
| | - Femke N G van t'Hof
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands
| | - Gerard Tromp
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa46The Sigfried and Janet Weis Center for Research, Geisinger Health System, Danville, Pennsylvania
| | - Gregory T Jones
- Surgery Department, University of Otago, Dunedin, New Zealand
| | - Helena Kuivaniemi
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa46The Sigfried and Janet Weis Center for Research, Geisinger Health System, Danville, Pennsylvania
| | - James R Elmore
- Department of Vascular and Endovascular Surgery, Geisinger Health System, Danville, Pennsylvania
| | - Mattias Johansson
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - James Mckay
- Genetic Cancer Susceptibility Group, International Agency for Research on Cancer, Lyon, France
| | - Ghislaine Scelo
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | | | - Valerie Gaborieau
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - Paul Brennan
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - Paige M Bracci
- Department of Epidemiology and Biostatistics, University of California San Francisco
| | - Rachel E Neale
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Sara H Olson
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Steven Gallinger
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Donghui Li
- Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston
| | - Gloria M Petersen
- Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Harvey A Risch
- Yale School of Public Health, Yale School of Medicine, and Yale Cancer Center, New Haven, Connecticut
| | - Alison P Klein
- Departments of Oncology, Pathology and Epidemiology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Jiali Han
- Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Indianapolis57Indiana University Melvin and Bren Simon Cancer Center, Indianapolis
| | - Christian C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Philip R Taylor
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - John M Maris
- Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania
| | - Katja K Aben
- Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands61Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands
| | - Lambertus A Kiemeney
- Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Sita H Vermeulen
- Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - John K Wiencke
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California63Institute of Human Genetics, University of California, San Francisco, San Francisco, California
| | - Kyle M Walsh
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California63Institute of Human Genetics, University of California, San Francisco, San Francisco, California
| | - Margaret Wrensch
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California63Institute of Human Genetics, University of California, San Francisco, San Francisco, California
| | - Terri Rice
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California
| | - Clare Turnbull
- The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, England64William Harvey Research Institute, Queen Mary University, London, England
| | - Kevin Litchfield
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, England
| | - Lavinia Paternoster
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, England2School of Social and Community Medicine, University of Bristol, Bristol, England
| | - Marie Standl
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | | | - John Paul SanGiovanni
- National Institute of Alcohol Abuse and Alcoholism, Laboratory of Membrane Biophysics and Biochemistry, Section on Nutritional Neuroscience, Bethesda, Maryland69Department of Biochemistry and Molecular and Cellular Biology, Georgetown School of Medicine, Washington, DC
| | - Yong Li
- Division of Genetic Epidemiology, Institute for Medical Biometry and Statistics, Faculty of Medicine, and Medical Centre, University of Freiburg, Freiburg, Germany
| | - Vladan Mijatovic
- Department of Life and Reproduction Sciences, University of Verona, Verona, Italy
| | - Yadav Sapkota
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Siew-Kee Low
- Laboratory of Statistical Analysis, Centre for Integrative Medical Sciences, The Institute of Physical and Chemical Research (RIKEN), Yokohama, Japan
| | - Krina T Zondervan
- Genetic and Genomic Epidemiology Unit, Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, England74Nuffield Department of Obstetrics and Gynecology, University of Oxford, John Radcliffe Hospital, Oxford, England
| | | | - Dale R Nyholt
- QIMR Berghofer Medical Research Institute, Brisbane, Australia75Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - David A van Heel
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, England
| | - Karen Hunt
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, England
| | - Dan E Arking
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Foram N Ashar
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Nona Sotoodehnia
- Division of Cardiology and Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington
| | - Daniel Woo
- University of Cincinnati College of Medicine, Department of Neurology, Cincinnati, Ohio
| | - Jonathan Rosand
- Massachusetts General Hospital, Neurology, Center for Human Genetic Research, Boston, Massachusetts
| | - Mary E Comeau
- Center for Public Health Genomics, Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - W Mark Brown
- Center for Public Health Genomics, Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Edwin K Silverman
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - John E Hokanson
- Department of Epidemiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Michael H Cho
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Jennie Hui
- Busselton Population Medical Research Institute Inc, Sir Charles Gairdner Hospital, Perth, Australia85PathWest Laboratory Medicine of Western Australia, Perth, Australia86School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Australia87School of Population Health, University of WA, Perth, Australia
| | | | - Philip J Thompson
- The Lung Health Clinic and Institute for Respiratory Health, University of Western Australia, Perth, Australia
| | - Alanna C Morrison
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston, Houston
| | - Janine F Felix
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | | | - Angela M Christiano
- Departments of Dermatology and Genetics & Development, Columbia University, New York, New York
| | - Lynn Petukhova
- Departments of Dermatology and Epidemiology, Columbia University, New York, New York
| | - Regina C Betz
- Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - Xing Fan
- Institute of Dermatology & Department of Dermatology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xuejun Zhang
- Institute of Dermatology & Department of Dermatology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Caihong Zhu
- Institute of Dermatology & Department of Dermatology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Carl D Langefeld
- Center for Public Health Genomics, Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Susan D Thompson
- Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Feijie Wang
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, China
| | - Xu Lin
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, China
| | - David A Schwartz
- Department of Medicine, School of Medicine, University of Colorado, Aurora
| | - Tasha Fingerlin
- Department of Biomedical Research, National Jewish Health Hospital, Denver, Colorado
| | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California101Departments of Pediatrics and Medicine, Harbor-UCLA Medical Center, Torrance, California
| | - Mary Frances Cotch
- Epidemiology Branch, Division of Epidemiology and Clinical Applications, Intramural Research Program, National Eye Institute, National Institutes of Health, Clinical Research Center, Bethesda, Maryland
| | - Richard A Jensen
- Cardiovascular Health Research Unit, University of Washington, Seattle104Department of Medicine, University of Washington, Seattle
| | - Matthias Munz
- Department of Periodontology and Synoptic Dentistry, Center for Dental and Craniofacial Sciences, Charité - University Medicine Berlin, Berlin, Germany106Institute for Integrative and Experimental Genomics, University of Lübeck, Lübeck, Germany
| | - Henrik Dommisch
- Department of Periodontology and Synoptic Dentistry, Center for Dental and Craniofacial Sciences, Charité - University Medicine Berlin, Berlin, Germany
| | - Arne S Schaefer
- Department of Periodontology and Synoptic Dentistry, Center for Dental and Craniofacial Sciences, Charité - University Medicine Berlin, Berlin, Germany
| | - Fang Han
- Department of Pulmonary Medicine, Peking University People's Hospital, Beijing, China
| | - Hanna M Ollila
- Stanford University, Center for Sleep Sciences, Palo Alto, California
| | - Ryan P Hillary
- Stanford University, Center for Sleep Sciences, Palo Alto, California
| | - Omar Albagha
- Qatar Biomedical Research Institute, Hamad Bin Khalifa University, Doha, Qatar110Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, Scotland
| | - Stuart H Ralston
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, Scotland
| | - Chenjie Zeng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Andre Reis
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Steffen Uebe
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Ulrike Hüffmeier
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Yoshiya Kawamura
- Department of Psychiatry, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Takeshi Otowa
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan115Graduate School of Clinical Psychology, Teikyo Heisei University Major of Professional Clinical Psychology, Tokyo, Japan
| | - Tsukasa Sasaki
- Department of Physical and Health Education, Graduate School of Education, University of Tokyo, Tokyo, Japan
| | | | - Sonia Davila
- Human Genetics, Genome Institute of Singapore, Singapore
| | - Gang Xie
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada119Departments of Medicine, Immunology, Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Katherine Siminovitch
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada119Departments of Medicine, Immunology, Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Jin-Xin Bei
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Yi-Xin Zeng
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China121Peking Union Medical College, Beijing, China
| | - Asta Försti
- Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany123Center for Primary Health Care Research, Clinical Research Center, Lund University, Malmö, Sweden
| | - Bowang Chen
- Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Stefano Landi
- Department of Biology, University of Pisa, Pisa, Italy
| | - Andre Franke
- University Hospital Schleswig-Holstein, Kiel, Germany
| | - Annegret Fischer
- University Hospital Schleswig-Holstein, Kiel, Germany126Institute of Clinical Molecular Biology, Kiel University, Kiel, Germany
| | - David Ellinghaus
- Institute of Clinical Molecular Biology, Kiel University, Kiel, Germany
| | - Carlos Flores
- Research Unit, Hospital Universitario N.S. de Candelaria, Universidad de La Laguna, Tenerife, Spain128CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Imre Noth
- Section of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, Illinois
| | - Shwu-Fan Ma
- Section of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, Illinois
| | - Jia Nee Foo
- Human Genetics, Genome Institute of Singapore, A*STAR, Singapore
| | - Jianjun Liu
- Human Genetics, Genome Institute of Singapore, A*STAR, Singapore
| | - Jong-Won Kim
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan, University School of Medicine, Gangnam-gu, Seoul, South Korea
| | - David G Cox
- Cancer Research Center of Lyon, INSERM U1052, Lyon, France
| | | | | | | | - Clara S Tang
- Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Merce Garcia-Barcelo
- Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Kai-Ping Chang
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital at Lin-Kou, Taoyuan, Taiwan
| | - Wen-Hui Su
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital at Lin-Kou, Taoyuan, Taiwan137Department of Biomedical Sciences, Graduate Institute of Biomedical Sciences, College of Medicine, Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Sun Chang
- Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
| | | | - Scott Gordon
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Tracey D Wade
- School of Psychology, Flinders University, Adelaide, South Australia
| | - Chaeyoung Lee
- School of Systems Biomedical Science, Soongsil University, Dongjak-gu, Seoul, South Korea
| | - Michiaki Kubo
- RIKEN Center for Integrative Medical Science, Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa, Japan
| | - Pei-Chieng Cha
- Division of Molecular Brain Science, Kobe University Graduate School of Medicine, Kusunoki-chou, Chuo-ku, Kobe, Japan
| | - Yusuke Nakamura
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois
| | - Daniel Levy
- The NHLBI's Framingham Heart Study, Framingham, Massachusetts, Population Sciences Branch of the National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Masayuki Kimura
- Center of Human Development and Aging, Department of Pediatrics, New Jersey Medical School, Rutgers, The State University of New Jersey
| | - Shih-Jen Hwang
- The NHLBI's Framingham Heart Study, Framingham, Massachusetts, Population Sciences Branch of the National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Steven Hunt
- Department of Genetic Medicine, Weill Cornell Medicine in Qatar, Doha, Qatar
| | - Tim Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London England
| | - Nicole Soranzo
- Human Genetics, Wellcome Trust Sanger Institute, Genome Campus, Hinxton Cambridge, England
| | - Ani W Manichaikul
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia, Charlottesville
| | - R Graham Barr
- Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, New York
| | - Bratati Kahali
- Department of Internal Medicine, Division of Gastroenterology and Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor
| | - Elizabeth Speliotes
- Department of Internal Medicine, Division of Gastroenterology and Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor
| | | | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore152Department of Ophthalmology, National University of Singapore and National University Health System, Singapore153Duke-NUS Medical School, Singapore
| | - Jost B Jonas
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China155Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore152Department of Ophthalmology, National University of Singapore and National University Health System, Singapore153Duke-NUS Medical School, Singapore
| | - Isabella Fogh
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Kuang Lin
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - John F Powell
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Kenneth Rice
- Department of Biostatistics, University of Washington, Seattle
| | - Caroline L Relton
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, England2School of Social and Community Medicine, University of Bristol, Bristol, England
| | - Richard M Martin
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, England2School of Social and Community Medicine, University of Bristol, Bristol, England158University of Bristol/University Hospitals Bristol NHS Foundation Trust National Institute for Health Research Bristol Nutrition Biomedical Research Unit, Bristol, England
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, England2School of Social and Community Medicine, University of Bristol, Bristol, England
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Hinks A, Bowes J, Cobb J, Ainsworth HC, Marion MC, Comeau ME, Sudman M, Han B, Becker ML, Bohnsack JF, de Bakker PIW, Haas JP, Hazen M, Lovell DJ, Nigrovic PA, Nordal E, Punnaro M, Rosenberg AM, Rygg M, Smith SL, Wise CA, Videm V, Wedderburn LR, Yarwood A, Yeung RSM, Prahalad S, Langefeld CD, Raychaudhuri S, Thompson SD, Thomson W. Fine-mapping the MHC locus in juvenile idiopathic arthritis (JIA) reveals genetic heterogeneity corresponding to distinct adult inflammatory arthritic diseases. Ann Rheum Dis 2016; 76:765-772. [PMID: 27998952 PMCID: PMC5530326 DOI: 10.1136/annrheumdis-2016-210025] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 09/12/2016] [Accepted: 11/05/2016] [Indexed: 11/06/2022]
Abstract
Objectives Juvenile idiopathic arthritis (JIA) is a heterogeneous group of diseases, comprising seven categories. Genetic data could potentially be used to help redefine JIA categories and improve the current classification system. The human leucocyte antigen (HLA) region is strongly associated with JIA. Fine-mapping of the region was performed to look for similarities and differences in HLA associations between the JIA categories and define correspondences with adult inflammatory arthritides. Methods Dense genotype data from the HLA region, from the Immunochip array for 5043 JIA cases and 14 390 controls, were used to impute single-nucleotide polymorphisms, HLA classical alleles and amino acids. Bivariate analysis was performed to investigate genetic correlation between the JIA categories. Conditional analysis was used to identify additional effects within the region. Comparison of the findings with those in adult inflammatory arthritic diseases was performed. Results We identified category-specific associations and have demonstrated for the first time that rheumatoid factor (RF)-negative polyarticular JIA and oligoarticular JIA are genetically similar in their HLA associations. We also observe that each JIA category potentially has an adult counterpart. The RF-positive polyarthritis association at HLA-DRB1 amino acid at position 13 mirrors the association in adult seropositive rheumatoid arthritis (RA). Interestingly, the combined oligoarthritis and RF-negative polyarthritis dataset shares the same association with adult seronegative RA. Conclusions The findings suggest the value of using genetic data in helping to classify the categories of this heterogeneous disease. Mapping JIA categories to adult counterparts could enable shared knowledge of disease pathogenesis and aetiology and facilitate transition from paediatric to adult services.
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Affiliation(s)
- A Hinks
- Arthritis Research UK Centre for Genetics and Genomics, Manchester Academic Health Science Centre, University Of Manchester, Manchester, UK
| | - J Bowes
- Arthritis Research UK Centre for Genetics and Genomics, Manchester Academic Health Science Centre, University Of Manchester, Manchester, UK
| | - J Cobb
- Arthritis Research UK Centre for Genetics and Genomics, Manchester Academic Health Science Centre, University Of Manchester, Manchester, UK.,NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - H C Ainsworth
- Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - M C Marion
- Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - M E Comeau
- Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - M Sudman
- Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - B Han
- Divisions of Genetics and Rheumatology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.,Department of Convergence Medicine, University of Ulsan College of Medicine & Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | | | - M L Becker
- Division of Rheumatology and Division of Clinical Pharmacology, Toxicology, and Therapeutic Innovation, Children's Mercy-Kansas City, Kansas City, Missouri, USA
| | - J F Bohnsack
- Division of Allergy, Immunology and Paediatric Rheumatology, University of Utah, Salt Lake City, Utah, USA
| | - P I W de Bakker
- Department of Medical Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J P Haas
- German Center for Pediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany
| | - M Hazen
- Division of Immunology, Department of Rheumatology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - D J Lovell
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - P A Nigrovic
- Division of Immunology, Department of Rheumatology, Boston Children's Hospital, Boston, Massachusetts, USA.,Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA
| | - E Nordal
- Department of Paediatrics, University Hospital of North Norway, and UIT The Arctic University of Norway, Tromsø, Norway
| | - M Punnaro
- Arthritis Clinic Texas Scottish Rite Hospital for Children, Dallas, Texas, USA.,Department of Paediatrics, UT Southwestern Medical Center, Dallas, Texas, USA
| | - A M Rosenberg
- Division of Rheumatology, Department of Paediatrics, University of Saskatchewan, Saskatoon, Canada
| | - M Rygg
- Department of Laboratory Medicine, Children's and Women's Health, NTNU - Norwegian University of Science and Technology, and St. Olavs University Hospital, Trondheim, Norway
| | - S L Smith
- Arthritis Research UK Centre for Genetics and Genomics, Manchester Academic Health Science Centre, University Of Manchester, Manchester, UK
| | - C A Wise
- Sarah M. and Charles E. Seay Center for Musculoskeletal Research, Texas Scottish Rite Hospital for Children, Dallas, Texas, USA.,Department of Orthopaedic Surgery, Paediatrics, and McDermott Center for Human Growth and Development, UT Southwestern Medical Center, Dallas, Texas, USA
| | - V Videm
- Department of Laboratory Medicine, Children's and Women's Health, NTNU - Norwegian University of Science and Technology, and St. Olavs University Hospital, Trondheim, Norway
| | - L R Wedderburn
- Arthritis Research UK Centre for Adolescent Rheumatology, UCL GOS Institute of Child Health, University College London, London, UK.,NIHR-Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - A Yarwood
- Arthritis Research UK Centre for Genetics and Genomics, Manchester Academic Health Science Centre, University Of Manchester, Manchester, UK
| | - R S M Yeung
- The Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - S Prahalad
- Department of Paediatrics, Emory University School of Medicine, and Children's Healthcare of Atlanta, Atlanta, USA
| | - C D Langefeld
- Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - S Raychaudhuri
- Arthritis Research UK Centre for Genetics and Genomics, Manchester Academic Health Science Centre, University Of Manchester, Manchester, UK.,Divisions of Genetics and Rheumatology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.,Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, USA.,Department of Medicine, Karolinska Institutet and Karolinska University Hospital Solna, Stockholm, Sweden
| | - S D Thompson
- Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - W Thomson
- Arthritis Research UK Centre for Genetics and Genomics, Manchester Academic Health Science Centre, University Of Manchester, Manchester, UK.,NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
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Alarcón-Riquelme ME, Ziegler JT, Molineros J, Howard TD, Moreno-Estrada A, Sánchez-Rodríguez E, Ainsworth HC, Ortiz-Tello P, Comeau ME, Rasmussen A, Kelly JA, Adler A, Acevedo-Vázquez EM, Cucho-Venegas JM, García-De la Torre I, Cardiel MH, Miranda P, Catoggio LJ, Maradiaga-Ceceña M, Gaffney PM, Vyse TJ, Criswell LA, Tsao BP, Sivils KL, Bae SC, James JA, Kimberly RP, Kaufman KM, Harley JB, Esquivel-Valerio JA, Moctezuma JF, García MA, Berbotto GA, Babini AM, Scherbarth H, Toloza S, Baca V, Nath SK, Aguilar Salinas C, Orozco L, Tusié-Luna T, Zidovetzki R, Pons-Estel BA, Langefeld CD, Jacob CO. Genome-Wide Association Study in an Amerindian Ancestry Population Reveals Novel Systemic Lupus Erythematosus Risk Loci and the Role of European Admixture. Arthritis Rheumatol 2016; 68:932-43. [PMID: 26606652 DOI: 10.1002/art.39504] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 11/03/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a strong genetic component. We undertook the present work to perform the first genome-wide association study on individuals from the Americas who are enriched for Native American heritage. METHODS We analyzed 3,710 individuals from the US and 4 countries of Latin America who were diagnosed as having SLE, and healthy controls. Samples were genotyped with HumanOmni1 BeadChip. Data on out-of-study controls genotyped with HumanOmni2.5 were also included. Statistical analyses were performed using SNPtest and SNPGWA. Data were adjusted for genomic control and false discovery rate. Imputation was performed using Impute2 and, for classic HLA alleles, HiBag. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. RESULTS The IRF5-TNPO3 region showed the strongest association and largest OR for SLE (rs10488631: genomic control-adjusted P [Pgcadj ] = 2.61 × 10(-29), OR 2.12 [95% CI 1.88-2.39]), followed by HLA class II on the DQA2-DQB1 loci (rs9275572: Pgcadj = 1.11 × 10(-16), OR 1.62 [95% CI 1.46-1.80] and rs9271366: Pgcadj = 6.46 × 10(-12), OR 2.06 [95% CI 1.71-2.50]). Other known SLE loci found to be associated in this population were ITGAM, STAT4, TNIP1, NCF2, and IRAK1. We identified a novel locus on 10q24.33 (rs4917385: Pgcadj = 1.39 × 10(-8)) with an expression quantitative trait locus (eQTL) effect (Peqtl = 8.0 × 10(-37) at USMG5/miR1307), and several new suggestive loci. SLE risk loci previously identified in Europeans and Asians were corroborated. Local ancestry estimation showed that the HLA allele risk contribution is of European ancestral origin. Imputation of HLA alleles suggested that autochthonous Native American haplotypes provide protection against development of SLE. CONCLUSION Our results demonstrate that studying admixed populations provides new insights in the delineation of the genetic architecture that underlies autoimmune and complex diseases.
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Affiliation(s)
| | - Julie T Ziegler
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | | | - Andrés Moreno-Estrada
- Stanford University School of Medicine, Stanford, California, and Laboratorio Nacional de Genómica para la Biodiversidad, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Irapuato, Mexico
| | | | | | - Patricia Ortiz-Tello
- Stanford University School of Medicine, Stanford, California, and Laboratorio Nacional de Genómica para la Biodiversidad, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Irapuato, Mexico
| | - Mary E Comeau
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | | | - Adam Adler
- Oklahoma Medical Research Foundation, Oklahoma City
| | | | | | | | | | | | | | | | | | | | | | | | | | - Sang-Cheol Bae
- Hanyang University Hospital for Rheumatic Diseases, Seoul, Republic of Korea
| | - Judith A James
- Oklahoma Medical Research Foundation and University of Oklahoma Health Sciences Center, Oklahoma City
| | | | | | - John B Harley
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Jorge A Esquivel-Valerio
- Hospital Universitario Dr. José Eleuterio González Universidad Autonoma de Nuevo León, Monterrey, Mexico
| | | | - Mercedes A García
- Hospital Interzonal General de Agudos General San Martin, La Plata, Argentina
| | | | | | - Hugo Scherbarth
- Hospital Interzonal General de Agudos Oscar E. Alende, Mar del Plata, Argentina
| | - Sergio Toloza
- Hospital Interzonal San Juan Bautista, San Fernando del Valle de Catamarca, Argentina
| | - Vicente Baca
- Hospital de Peditaria, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | | | - Carlos Aguilar Salinas
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Lorena Orozco
- Instituto Nacional de Medicina Genómica, Mexico City, Mexico
| | - Teresa Tusié-Luna
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán and Instituto de Investigaciones Biomédicas de la Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | | | | | - Chaim O Jacob
- University of Southern California School of Medicine, Los Angeles
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31
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Yuan M, Hsu FC, Bowden DW, Xu J, Smith SC, Wagenknecht LE, Comeau ME, Divers J, Register TC, Carr JJ, Langefeld CD, Freedman BI. Relationships between measures of adiposity with subclinical atherosclerosis in patients with type 2 diabetes. Obesity (Silver Spring) 2016; 24:1810-8. [PMID: 27356020 PMCID: PMC4963287 DOI: 10.1002/oby.21540] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 04/06/2016] [Accepted: 04/06/2016] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Assess cross-sectional relationships between body mass index (BMI), waist circumference (WC), pericardial (PAT), visceral (VAT), and subcutaneous adipose tissue (SAT) volumes with calcified plaque (CP) in African Americans (AAs) and European Americans (EAs) with type 2 diabetes. METHODS Computed tomography measured PAT, VAT, SAT, and CP in coronary arteries (CAC), carotid arteries, and aorta. Generalized estimating equations models were fitted to test for associations between adiposity and CP, stratified by ethnicity while accounting for familial correlations. RESULTS AAs (N = 753) vs. EAs (N = 562) had significantly lower PAT and VAT, despite equal or higher BMI. In multivariable models adjusting for age, gender, education, HbA1c, statins, smoking, cardiovascular disease, hypertension, nephropathy, and C-reactive protein, PAT positively associated with presence of CAC in AAs (P < 0.001), not EAs (P = 0.68; ethnicity interaction P < 0.01). Inverse associations were detected between SAT and severity of aorta CP (P < 0.01) in AAs and between BMI, WC, and SAT with severity of aorta CP in all participants. CONCLUSIONS Ethnic- and gender-specific differences in BMI, WC, PAT, SAT, and VAT were present in AAs and EAs with diabetes. Only PAT was positively associated with CAC in AAs; paradoxical inverse associations were seen between several other adiposity measures and subclinical cardiovascular disease.
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Affiliation(s)
- Mingxia Yuan
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Centers for Genomics and Personalized Medicine Research & Diabetes Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Fang-Chi Hsu
- Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Donald W. Bowden
- Centers for Genomics and Personalized Medicine Research & Diabetes Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Jianzhao Xu
- Centers for Genomics and Personalized Medicine Research & Diabetes Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - S. Carrie Smith
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Lynne E. Wagenknecht
- Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Mary E. Comeau
- Centers for Genomics and Personalized Medicine Research & Diabetes Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Jasmin Divers
- Centers for Genomics and Personalized Medicine Research & Diabetes Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Thomas C. Register
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - J. Jeffrey Carr
- Department of Radiology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Carl D. Langefeld
- Centers for Genomics and Personalized Medicine Research & Diabetes Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Barry I. Freedman
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Centers for Genomics and Personalized Medicine Research & Diabetes Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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32
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Ma L, Langefeld CD, Comeau ME, Bonomo JA, Rocco MV, Burkart JM, Divers J, Palmer ND, Hicks PJ, Bowden DW, Lea JP, Krisher JO, Clay MJ, Freedman BI. APOL1 renal-risk genotypes associate with longer hemodialysis survival in prevalent nondiabetic African American patients with end-stage renal disease. Kidney Int 2016; 90:389-395. [PMID: 27157696 PMCID: PMC4946964 DOI: 10.1016/j.kint.2016.02.032] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 02/24/2016] [Accepted: 02/25/2016] [Indexed: 01/13/2023]
Abstract
Relative to European Americans, evidence supports that African Americans with end-stage renal disease (ESRD) survive longer on dialysis. Renal-risk variants in the apolipoprotein L1 gene (APOL1), associated with nondiabetic nephropathy and less subclinical atherosclerosis, may contribute to dialysis outcomes. Here, APOL1 renal-risk variants were assessed for association with dialytic survival in 450 diabetic and 275 nondiabetic African American hemodialysis patients from Wake Forest and Emory School of Medicine outpatient facilities. Outcomes were provided by the ESRD Network 6-Southeastern Kidney Council Standardized Information Management System. Dates of death, receipt of a kidney transplant, and loss to follow-up were recorded. Outcomes were censored at the date of transplantation or through 1 July 2015. Multivariable Cox proportional hazards models were computed separately in patients with nondiabetic and diabetic ESRD, adjusting for the covariates age, gender, comorbidities, ancestry, and presence of an arteriovenous fistula or graft at dialysis initiation. In nondiabetic ESRD, patients with 2 (vs. 0/1) APOL1 renal-risk variants had significantly longer dialysis survival (hazard ratio 0.57), a pattern not observed in patients with diabetes-associated ESRD (hazard ratio 1.29). Thus, 2 APOL1 renal-risk variants are associated with longer dialysis survival in African Americans without diabetes, potentially relating to presence of renal-limited disease or less atherosclerosis.
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Affiliation(s)
- Lijun Ma
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Carl D Langefeld
- Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Mary E Comeau
- Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Jason A Bonomo
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Michael V Rocco
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - John M Burkart
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Jasmin Divers
- Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Nicholette D Palmer
- Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; Center for Genomics and Personalized Medicine Research, Center for Diabetes Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Pamela J Hicks
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Donald W Bowden
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; Center for Genomics and Personalized Medicine Research, Center for Diabetes Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Janice P Lea
- Division of Renal Medicine, Department of Internal Medicine, Emory School of Medicine, Atlanta, Georgia, USA
| | - Jenna O Krisher
- Southeastern Kidney Council Inc.-ESRD Network 6, Raleigh, North Carolina, USA
| | - Margo J Clay
- Southeastern Kidney Council Inc.-ESRD Network 6, Raleigh, North Carolina, USA
| | - Barry I Freedman
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; Center for Genomics and Personalized Medicine Research, Center for Diabetes Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
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33
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Sharma NK, Sajuthi SP, Chou JW, Calles-Escandon J, Demons J, Rogers S, Ma L, Palmer ND, McWilliams DR, Beal J, Comeau ME, Cherry K, Hawkins GA, Menon L, Kouba E, Davis D, Burris M, Byerly SJ, Easter L, Bowden DW, Freedman BI, Langefeld CD, Das SK. Tissue-Specific and Genetic Regulation of Insulin Sensitivity-Associated Transcripts in African Americans. J Clin Endocrinol Metab 2016; 101:1455-68. [PMID: 26789776 PMCID: PMC4880154 DOI: 10.1210/jc.2015-3336] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Integrative multiomics analyses of adipose and muscle tissue transcripts, S, and genotypes revealed novel genetic regulatory mechanisms of insulin resistance in African Americans.
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Affiliation(s)
- Neeraj K Sharma
- Department of Internal Medicine (N.K.S., J.C.-E., J.D., S.R., L.Ma., K.C., L.Me., E.K., D.D., B.I.F., S.K.D.), Center for Public Health Genomics (N.K.S., S.P.S., J.W.C., L.Ma., N.D.P., D.R.M., M.C., G.A.H., B.I.F., C.D.L., S.K.D.), Department of Biostatistical Sciences, Division of Public Health Sciences (S.P.S., J.W.C., D.R.M., J.B., M.C., C.D.L.), Department of Biochemistry (N.D.P., D.W.B.), Center for Diabetes Research and Center for Genomics and Personalized Medicine Research (N.D.P., G.A.H., D.W.B., B.I.F.), and Clinical Research Unit, Biomedical Research Services and Administration (M.B., S.J.B., L.E.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Satria P Sajuthi
- Department of Internal Medicine (N.K.S., J.C.-E., J.D., S.R., L.Ma., K.C., L.Me., E.K., D.D., B.I.F., S.K.D.), Center for Public Health Genomics (N.K.S., S.P.S., J.W.C., L.Ma., N.D.P., D.R.M., M.C., G.A.H., B.I.F., C.D.L., S.K.D.), Department of Biostatistical Sciences, Division of Public Health Sciences (S.P.S., J.W.C., D.R.M., J.B., M.C., C.D.L.), Department of Biochemistry (N.D.P., D.W.B.), Center for Diabetes Research and Center for Genomics and Personalized Medicine Research (N.D.P., G.A.H., D.W.B., B.I.F.), and Clinical Research Unit, Biomedical Research Services and Administration (M.B., S.J.B., L.E.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Jeff W Chou
- Department of Internal Medicine (N.K.S., J.C.-E., J.D., S.R., L.Ma., K.C., L.Me., E.K., D.D., B.I.F., S.K.D.), Center for Public Health Genomics (N.K.S., S.P.S., J.W.C., L.Ma., N.D.P., D.R.M., M.C., G.A.H., B.I.F., C.D.L., S.K.D.), Department of Biostatistical Sciences, Division of Public Health Sciences (S.P.S., J.W.C., D.R.M., J.B., M.C., C.D.L.), Department of Biochemistry (N.D.P., D.W.B.), Center for Diabetes Research and Center for Genomics and Personalized Medicine Research (N.D.P., G.A.H., D.W.B., B.I.F.), and Clinical Research Unit, Biomedical Research Services and Administration (M.B., S.J.B., L.E.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Jorge Calles-Escandon
- Department of Internal Medicine (N.K.S., J.C.-E., J.D., S.R., L.Ma., K.C., L.Me., E.K., D.D., B.I.F., S.K.D.), Center for Public Health Genomics (N.K.S., S.P.S., J.W.C., L.Ma., N.D.P., D.R.M., M.C., G.A.H., B.I.F., C.D.L., S.K.D.), Department of Biostatistical Sciences, Division of Public Health Sciences (S.P.S., J.W.C., D.R.M., J.B., M.C., C.D.L.), Department of Biochemistry (N.D.P., D.W.B.), Center for Diabetes Research and Center for Genomics and Personalized Medicine Research (N.D.P., G.A.H., D.W.B., B.I.F.), and Clinical Research Unit, Biomedical Research Services and Administration (M.B., S.J.B., L.E.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Jamehl Demons
- Department of Internal Medicine (N.K.S., J.C.-E., J.D., S.R., L.Ma., K.C., L.Me., E.K., D.D., B.I.F., S.K.D.), Center for Public Health Genomics (N.K.S., S.P.S., J.W.C., L.Ma., N.D.P., D.R.M., M.C., G.A.H., B.I.F., C.D.L., S.K.D.), Department of Biostatistical Sciences, Division of Public Health Sciences (S.P.S., J.W.C., D.R.M., J.B., M.C., C.D.L.), Department of Biochemistry (N.D.P., D.W.B.), Center for Diabetes Research and Center for Genomics and Personalized Medicine Research (N.D.P., G.A.H., D.W.B., B.I.F.), and Clinical Research Unit, Biomedical Research Services and Administration (M.B., S.J.B., L.E.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Samantha Rogers
- Department of Internal Medicine (N.K.S., J.C.-E., J.D., S.R., L.Ma., K.C., L.Me., E.K., D.D., B.I.F., S.K.D.), Center for Public Health Genomics (N.K.S., S.P.S., J.W.C., L.Ma., N.D.P., D.R.M., M.C., G.A.H., B.I.F., C.D.L., S.K.D.), Department of Biostatistical Sciences, Division of Public Health Sciences (S.P.S., J.W.C., D.R.M., J.B., M.C., C.D.L.), Department of Biochemistry (N.D.P., D.W.B.), Center for Diabetes Research and Center for Genomics and Personalized Medicine Research (N.D.P., G.A.H., D.W.B., B.I.F.), and Clinical Research Unit, Biomedical Research Services and Administration (M.B., S.J.B., L.E.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Lijun Ma
- Department of Internal Medicine (N.K.S., J.C.-E., J.D., S.R., L.Ma., K.C., L.Me., E.K., D.D., B.I.F., S.K.D.), Center for Public Health Genomics (N.K.S., S.P.S., J.W.C., L.Ma., N.D.P., D.R.M., M.C., G.A.H., B.I.F., C.D.L., S.K.D.), Department of Biostatistical Sciences, Division of Public Health Sciences (S.P.S., J.W.C., D.R.M., J.B., M.C., C.D.L.), Department of Biochemistry (N.D.P., D.W.B.), Center for Diabetes Research and Center for Genomics and Personalized Medicine Research (N.D.P., G.A.H., D.W.B., B.I.F.), and Clinical Research Unit, Biomedical Research Services and Administration (M.B., S.J.B., L.E.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Nicholette D Palmer
- Department of Internal Medicine (N.K.S., J.C.-E., J.D., S.R., L.Ma., K.C., L.Me., E.K., D.D., B.I.F., S.K.D.), Center for Public Health Genomics (N.K.S., S.P.S., J.W.C., L.Ma., N.D.P., D.R.M., M.C., G.A.H., B.I.F., C.D.L., S.K.D.), Department of Biostatistical Sciences, Division of Public Health Sciences (S.P.S., J.W.C., D.R.M., J.B., M.C., C.D.L.), Department of Biochemistry (N.D.P., D.W.B.), Center for Diabetes Research and Center for Genomics and Personalized Medicine Research (N.D.P., G.A.H., D.W.B., B.I.F.), and Clinical Research Unit, Biomedical Research Services and Administration (M.B., S.J.B., L.E.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - David R McWilliams
- Department of Internal Medicine (N.K.S., J.C.-E., J.D., S.R., L.Ma., K.C., L.Me., E.K., D.D., B.I.F., S.K.D.), Center for Public Health Genomics (N.K.S., S.P.S., J.W.C., L.Ma., N.D.P., D.R.M., M.C., G.A.H., B.I.F., C.D.L., S.K.D.), Department of Biostatistical Sciences, Division of Public Health Sciences (S.P.S., J.W.C., D.R.M., J.B., M.C., C.D.L.), Department of Biochemistry (N.D.P., D.W.B.), Center for Diabetes Research and Center for Genomics and Personalized Medicine Research (N.D.P., G.A.H., D.W.B., B.I.F.), and Clinical Research Unit, Biomedical Research Services and Administration (M.B., S.J.B., L.E.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - John Beal
- Department of Internal Medicine (N.K.S., J.C.-E., J.D., S.R., L.Ma., K.C., L.Me., E.K., D.D., B.I.F., S.K.D.), Center for Public Health Genomics (N.K.S., S.P.S., J.W.C., L.Ma., N.D.P., D.R.M., M.C., G.A.H., B.I.F., C.D.L., S.K.D.), Department of Biostatistical Sciences, Division of Public Health Sciences (S.P.S., J.W.C., D.R.M., J.B., M.C., C.D.L.), Department of Biochemistry (N.D.P., D.W.B.), Center for Diabetes Research and Center for Genomics and Personalized Medicine Research (N.D.P., G.A.H., D.W.B., B.I.F.), and Clinical Research Unit, Biomedical Research Services and Administration (M.B., S.J.B., L.E.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Mary E Comeau
- Department of Internal Medicine (N.K.S., J.C.-E., J.D., S.R., L.Ma., K.C., L.Me., E.K., D.D., B.I.F., S.K.D.), Center for Public Health Genomics (N.K.S., S.P.S., J.W.C., L.Ma., N.D.P., D.R.M., M.C., G.A.H., B.I.F., C.D.L., S.K.D.), Department of Biostatistical Sciences, Division of Public Health Sciences (S.P.S., J.W.C., D.R.M., J.B., M.C., C.D.L.), Department of Biochemistry (N.D.P., D.W.B.), Center for Diabetes Research and Center for Genomics and Personalized Medicine Research (N.D.P., G.A.H., D.W.B., B.I.F.), and Clinical Research Unit, Biomedical Research Services and Administration (M.B., S.J.B., L.E.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Kristina Cherry
- Department of Internal Medicine (N.K.S., J.C.-E., J.D., S.R., L.Ma., K.C., L.Me., E.K., D.D., B.I.F., S.K.D.), Center for Public Health Genomics (N.K.S., S.P.S., J.W.C., L.Ma., N.D.P., D.R.M., M.C., G.A.H., B.I.F., C.D.L., S.K.D.), Department of Biostatistical Sciences, Division of Public Health Sciences (S.P.S., J.W.C., D.R.M., J.B., M.C., C.D.L.), Department of Biochemistry (N.D.P., D.W.B.), Center for Diabetes Research and Center for Genomics and Personalized Medicine Research (N.D.P., G.A.H., D.W.B., B.I.F.), and Clinical Research Unit, Biomedical Research Services and Administration (M.B., S.J.B., L.E.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Gregory A Hawkins
- Department of Internal Medicine (N.K.S., J.C.-E., J.D., S.R., L.Ma., K.C., L.Me., E.K., D.D., B.I.F., S.K.D.), Center for Public Health Genomics (N.K.S., S.P.S., J.W.C., L.Ma., N.D.P., D.R.M., M.C., G.A.H., B.I.F., C.D.L., S.K.D.), Department of Biostatistical Sciences, Division of Public Health Sciences (S.P.S., J.W.C., D.R.M., J.B., M.C., C.D.L.), Department of Biochemistry (N.D.P., D.W.B.), Center for Diabetes Research and Center for Genomics and Personalized Medicine Research (N.D.P., G.A.H., D.W.B., B.I.F.), and Clinical Research Unit, Biomedical Research Services and Administration (M.B., S.J.B., L.E.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Lata Menon
- Department of Internal Medicine (N.K.S., J.C.-E., J.D., S.R., L.Ma., K.C., L.Me., E.K., D.D., B.I.F., S.K.D.), Center for Public Health Genomics (N.K.S., S.P.S., J.W.C., L.Ma., N.D.P., D.R.M., M.C., G.A.H., B.I.F., C.D.L., S.K.D.), Department of Biostatistical Sciences, Division of Public Health Sciences (S.P.S., J.W.C., D.R.M., J.B., M.C., C.D.L.), Department of Biochemistry (N.D.P., D.W.B.), Center for Diabetes Research and Center for Genomics and Personalized Medicine Research (N.D.P., G.A.H., D.W.B., B.I.F.), and Clinical Research Unit, Biomedical Research Services and Administration (M.B., S.J.B., L.E.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Ethel Kouba
- Department of Internal Medicine (N.K.S., J.C.-E., J.D., S.R., L.Ma., K.C., L.Me., E.K., D.D., B.I.F., S.K.D.), Center for Public Health Genomics (N.K.S., S.P.S., J.W.C., L.Ma., N.D.P., D.R.M., M.C., G.A.H., B.I.F., C.D.L., S.K.D.), Department of Biostatistical Sciences, Division of Public Health Sciences (S.P.S., J.W.C., D.R.M., J.B., M.C., C.D.L.), Department of Biochemistry (N.D.P., D.W.B.), Center for Diabetes Research and Center for Genomics and Personalized Medicine Research (N.D.P., G.A.H., D.W.B., B.I.F.), and Clinical Research Unit, Biomedical Research Services and Administration (M.B., S.J.B., L.E.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Donna Davis
- Department of Internal Medicine (N.K.S., J.C.-E., J.D., S.R., L.Ma., K.C., L.Me., E.K., D.D., B.I.F., S.K.D.), Center for Public Health Genomics (N.K.S., S.P.S., J.W.C., L.Ma., N.D.P., D.R.M., M.C., G.A.H., B.I.F., C.D.L., S.K.D.), Department of Biostatistical Sciences, Division of Public Health Sciences (S.P.S., J.W.C., D.R.M., J.B., M.C., C.D.L.), Department of Biochemistry (N.D.P., D.W.B.), Center for Diabetes Research and Center for Genomics and Personalized Medicine Research (N.D.P., G.A.H., D.W.B., B.I.F.), and Clinical Research Unit, Biomedical Research Services and Administration (M.B., S.J.B., L.E.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Marcie Burris
- Department of Internal Medicine (N.K.S., J.C.-E., J.D., S.R., L.Ma., K.C., L.Me., E.K., D.D., B.I.F., S.K.D.), Center for Public Health Genomics (N.K.S., S.P.S., J.W.C., L.Ma., N.D.P., D.R.M., M.C., G.A.H., B.I.F., C.D.L., S.K.D.), Department of Biostatistical Sciences, Division of Public Health Sciences (S.P.S., J.W.C., D.R.M., J.B., M.C., C.D.L.), Department of Biochemistry (N.D.P., D.W.B.), Center for Diabetes Research and Center for Genomics and Personalized Medicine Research (N.D.P., G.A.H., D.W.B., B.I.F.), and Clinical Research Unit, Biomedical Research Services and Administration (M.B., S.J.B., L.E.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Sara J Byerly
- Department of Internal Medicine (N.K.S., J.C.-E., J.D., S.R., L.Ma., K.C., L.Me., E.K., D.D., B.I.F., S.K.D.), Center for Public Health Genomics (N.K.S., S.P.S., J.W.C., L.Ma., N.D.P., D.R.M., M.C., G.A.H., B.I.F., C.D.L., S.K.D.), Department of Biostatistical Sciences, Division of Public Health Sciences (S.P.S., J.W.C., D.R.M., J.B., M.C., C.D.L.), Department of Biochemistry (N.D.P., D.W.B.), Center for Diabetes Research and Center for Genomics and Personalized Medicine Research (N.D.P., G.A.H., D.W.B., B.I.F.), and Clinical Research Unit, Biomedical Research Services and Administration (M.B., S.J.B., L.E.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Linda Easter
- Department of Internal Medicine (N.K.S., J.C.-E., J.D., S.R., L.Ma., K.C., L.Me., E.K., D.D., B.I.F., S.K.D.), Center for Public Health Genomics (N.K.S., S.P.S., J.W.C., L.Ma., N.D.P., D.R.M., M.C., G.A.H., B.I.F., C.D.L., S.K.D.), Department of Biostatistical Sciences, Division of Public Health Sciences (S.P.S., J.W.C., D.R.M., J.B., M.C., C.D.L.), Department of Biochemistry (N.D.P., D.W.B.), Center for Diabetes Research and Center for Genomics and Personalized Medicine Research (N.D.P., G.A.H., D.W.B., B.I.F.), and Clinical Research Unit, Biomedical Research Services and Administration (M.B., S.J.B., L.E.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Donald W Bowden
- Department of Internal Medicine (N.K.S., J.C.-E., J.D., S.R., L.Ma., K.C., L.Me., E.K., D.D., B.I.F., S.K.D.), Center for Public Health Genomics (N.K.S., S.P.S., J.W.C., L.Ma., N.D.P., D.R.M., M.C., G.A.H., B.I.F., C.D.L., S.K.D.), Department of Biostatistical Sciences, Division of Public Health Sciences (S.P.S., J.W.C., D.R.M., J.B., M.C., C.D.L.), Department of Biochemistry (N.D.P., D.W.B.), Center for Diabetes Research and Center for Genomics and Personalized Medicine Research (N.D.P., G.A.H., D.W.B., B.I.F.), and Clinical Research Unit, Biomedical Research Services and Administration (M.B., S.J.B., L.E.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Barry I Freedman
- Department of Internal Medicine (N.K.S., J.C.-E., J.D., S.R., L.Ma., K.C., L.Me., E.K., D.D., B.I.F., S.K.D.), Center for Public Health Genomics (N.K.S., S.P.S., J.W.C., L.Ma., N.D.P., D.R.M., M.C., G.A.H., B.I.F., C.D.L., S.K.D.), Department of Biostatistical Sciences, Division of Public Health Sciences (S.P.S., J.W.C., D.R.M., J.B., M.C., C.D.L.), Department of Biochemistry (N.D.P., D.W.B.), Center for Diabetes Research and Center for Genomics and Personalized Medicine Research (N.D.P., G.A.H., D.W.B., B.I.F.), and Clinical Research Unit, Biomedical Research Services and Administration (M.B., S.J.B., L.E.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Carl D Langefeld
- Department of Internal Medicine (N.K.S., J.C.-E., J.D., S.R., L.Ma., K.C., L.Me., E.K., D.D., B.I.F., S.K.D.), Center for Public Health Genomics (N.K.S., S.P.S., J.W.C., L.Ma., N.D.P., D.R.M., M.C., G.A.H., B.I.F., C.D.L., S.K.D.), Department of Biostatistical Sciences, Division of Public Health Sciences (S.P.S., J.W.C., D.R.M., J.B., M.C., C.D.L.), Department of Biochemistry (N.D.P., D.W.B.), Center for Diabetes Research and Center for Genomics and Personalized Medicine Research (N.D.P., G.A.H., D.W.B., B.I.F.), and Clinical Research Unit, Biomedical Research Services and Administration (M.B., S.J.B., L.E.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
| | - Swapan K Das
- Department of Internal Medicine (N.K.S., J.C.-E., J.D., S.R., L.Ma., K.C., L.Me., E.K., D.D., B.I.F., S.K.D.), Center for Public Health Genomics (N.K.S., S.P.S., J.W.C., L.Ma., N.D.P., D.R.M., M.C., G.A.H., B.I.F., C.D.L., S.K.D.), Department of Biostatistical Sciences, Division of Public Health Sciences (S.P.S., J.W.C., D.R.M., J.B., M.C., C.D.L.), Department of Biochemistry (N.D.P., D.W.B.), Center for Diabetes Research and Center for Genomics and Personalized Medicine Research (N.D.P., G.A.H., D.W.B., B.I.F.), and Clinical Research Unit, Biomedical Research Services and Administration (M.B., S.J.B., L.E.), Wake Forest School of Medicine, Winston-Salem, North Carolina 27157
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Hwang DY, Dell CA, Sparks MJ, Watson TD, Langefeld CD, Comeau ME, Rosand J, Battey TWK, Koch S, Perez ML, James ML, McFarlin J, Osborne JL, Woo D, Kittner SJ, Sheth KN. Clinician judgment vs formal scales for predicting intracerebral hemorrhage outcomes. Neurology 2015; 86:126-33. [PMID: 26674335 DOI: 10.1212/wnl.0000000000002266] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 09/03/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To compare the performance of formal prognostic instruments vs subjective clinical judgment with regards to predicting functional outcome in patients with spontaneous intracerebral hemorrhage (ICH). METHODS This prospective observational study enrolled 121 ICH patients hospitalized at 5 US tertiary care centers. Within 24 hours of each patient's admission to the hospital, one physician and one nurse on each patient's clinical team were each asked to predict the patient's modified Rankin Scale (mRS) score at 3 months and to indicate whether he or she would recommend comfort measures. The admission ICH score and FUNC score, 2 prognostic scales selected for their common use in neurologic practice, were calculated for each patient. Spearman rank correlation coefficients (r) with respect to patients' actual 3-month mRS for the physician and nursing predictions were compared against the same correlation coefficients for the ICH score and FUNC score. RESULTS The absolute value of the correlation coefficient for physician predictions with respect to actual outcome (0.75) was higher than that of either the ICH score (0.62, p = 0.057) or the FUNC score (0.56, p = 0.01). The nursing predictions of outcome (r = 0.72) also trended towards an accuracy advantage over the ICH score (p = 0.09) and FUNC score (p = 0.03). In an analysis that excluded patients for whom comfort care was recommended, the 65 available attending physician predictions retained greater accuracy (r = 0.73) than either the ICH score (r = 0.50, p = 0.02) or the FUNC score (r = 0.42, p = 0.004). CONCLUSIONS Early subjective clinical judgment of physicians correlates more closely with 3-month outcome after ICH than prognostic scales.
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Affiliation(s)
- David Y Hwang
- From the Division of Neurocritical Care and Emergency Neurology (D.Y.H., K.N.S.), Department of Neurology, Yale School of Medicine, New Haven, CT; the Maryland Stroke Center (C.A.D., M.J.S., T.D.W.), Baltimore; the Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L., M.E.C.), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; the Center for Human Genetic Research (J.R., T.W.K.B.), Boston, MA; the University of Miami (S.K., M.L.P.), Miller School of Medicine, FL; Duke University Medical Center (M.L.J., J.M.), Durham, NC; the Department of Neurology (J.L.O., D.W.), University of Cincinnati College of Medicine, OH; and the Baltimore Veterans Administration Medical Center and University of Maryland School of Medicine (S.J.K.).
| | - Cameron A Dell
- From the Division of Neurocritical Care and Emergency Neurology (D.Y.H., K.N.S.), Department of Neurology, Yale School of Medicine, New Haven, CT; the Maryland Stroke Center (C.A.D., M.J.S., T.D.W.), Baltimore; the Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L., M.E.C.), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; the Center for Human Genetic Research (J.R., T.W.K.B.), Boston, MA; the University of Miami (S.K., M.L.P.), Miller School of Medicine, FL; Duke University Medical Center (M.L.J., J.M.), Durham, NC; the Department of Neurology (J.L.O., D.W.), University of Cincinnati College of Medicine, OH; and the Baltimore Veterans Administration Medical Center and University of Maryland School of Medicine (S.J.K.)
| | - Mary J Sparks
- From the Division of Neurocritical Care and Emergency Neurology (D.Y.H., K.N.S.), Department of Neurology, Yale School of Medicine, New Haven, CT; the Maryland Stroke Center (C.A.D., M.J.S., T.D.W.), Baltimore; the Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L., M.E.C.), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; the Center for Human Genetic Research (J.R., T.W.K.B.), Boston, MA; the University of Miami (S.K., M.L.P.), Miller School of Medicine, FL; Duke University Medical Center (M.L.J., J.M.), Durham, NC; the Department of Neurology (J.L.O., D.W.), University of Cincinnati College of Medicine, OH; and the Baltimore Veterans Administration Medical Center and University of Maryland School of Medicine (S.J.K.)
| | - Tiffany D Watson
- From the Division of Neurocritical Care and Emergency Neurology (D.Y.H., K.N.S.), Department of Neurology, Yale School of Medicine, New Haven, CT; the Maryland Stroke Center (C.A.D., M.J.S., T.D.W.), Baltimore; the Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L., M.E.C.), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; the Center for Human Genetic Research (J.R., T.W.K.B.), Boston, MA; the University of Miami (S.K., M.L.P.), Miller School of Medicine, FL; Duke University Medical Center (M.L.J., J.M.), Durham, NC; the Department of Neurology (J.L.O., D.W.), University of Cincinnati College of Medicine, OH; and the Baltimore Veterans Administration Medical Center and University of Maryland School of Medicine (S.J.K.)
| | - Carl D Langefeld
- From the Division of Neurocritical Care and Emergency Neurology (D.Y.H., K.N.S.), Department of Neurology, Yale School of Medicine, New Haven, CT; the Maryland Stroke Center (C.A.D., M.J.S., T.D.W.), Baltimore; the Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L., M.E.C.), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; the Center for Human Genetic Research (J.R., T.W.K.B.), Boston, MA; the University of Miami (S.K., M.L.P.), Miller School of Medicine, FL; Duke University Medical Center (M.L.J., J.M.), Durham, NC; the Department of Neurology (J.L.O., D.W.), University of Cincinnati College of Medicine, OH; and the Baltimore Veterans Administration Medical Center and University of Maryland School of Medicine (S.J.K.)
| | - Mary E Comeau
- From the Division of Neurocritical Care and Emergency Neurology (D.Y.H., K.N.S.), Department of Neurology, Yale School of Medicine, New Haven, CT; the Maryland Stroke Center (C.A.D., M.J.S., T.D.W.), Baltimore; the Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L., M.E.C.), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; the Center for Human Genetic Research (J.R., T.W.K.B.), Boston, MA; the University of Miami (S.K., M.L.P.), Miller School of Medicine, FL; Duke University Medical Center (M.L.J., J.M.), Durham, NC; the Department of Neurology (J.L.O., D.W.), University of Cincinnati College of Medicine, OH; and the Baltimore Veterans Administration Medical Center and University of Maryland School of Medicine (S.J.K.)
| | - Jonathan Rosand
- From the Division of Neurocritical Care and Emergency Neurology (D.Y.H., K.N.S.), Department of Neurology, Yale School of Medicine, New Haven, CT; the Maryland Stroke Center (C.A.D., M.J.S., T.D.W.), Baltimore; the Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L., M.E.C.), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; the Center for Human Genetic Research (J.R., T.W.K.B.), Boston, MA; the University of Miami (S.K., M.L.P.), Miller School of Medicine, FL; Duke University Medical Center (M.L.J., J.M.), Durham, NC; the Department of Neurology (J.L.O., D.W.), University of Cincinnati College of Medicine, OH; and the Baltimore Veterans Administration Medical Center and University of Maryland School of Medicine (S.J.K.)
| | - Thomas W K Battey
- From the Division of Neurocritical Care and Emergency Neurology (D.Y.H., K.N.S.), Department of Neurology, Yale School of Medicine, New Haven, CT; the Maryland Stroke Center (C.A.D., M.J.S., T.D.W.), Baltimore; the Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L., M.E.C.), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; the Center for Human Genetic Research (J.R., T.W.K.B.), Boston, MA; the University of Miami (S.K., M.L.P.), Miller School of Medicine, FL; Duke University Medical Center (M.L.J., J.M.), Durham, NC; the Department of Neurology (J.L.O., D.W.), University of Cincinnati College of Medicine, OH; and the Baltimore Veterans Administration Medical Center and University of Maryland School of Medicine (S.J.K.)
| | - Sebastian Koch
- From the Division of Neurocritical Care and Emergency Neurology (D.Y.H., K.N.S.), Department of Neurology, Yale School of Medicine, New Haven, CT; the Maryland Stroke Center (C.A.D., M.J.S., T.D.W.), Baltimore; the Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L., M.E.C.), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; the Center for Human Genetic Research (J.R., T.W.K.B.), Boston, MA; the University of Miami (S.K., M.L.P.), Miller School of Medicine, FL; Duke University Medical Center (M.L.J., J.M.), Durham, NC; the Department of Neurology (J.L.O., D.W.), University of Cincinnati College of Medicine, OH; and the Baltimore Veterans Administration Medical Center and University of Maryland School of Medicine (S.J.K.)
| | - Mario L Perez
- From the Division of Neurocritical Care and Emergency Neurology (D.Y.H., K.N.S.), Department of Neurology, Yale School of Medicine, New Haven, CT; the Maryland Stroke Center (C.A.D., M.J.S., T.D.W.), Baltimore; the Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L., M.E.C.), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; the Center for Human Genetic Research (J.R., T.W.K.B.), Boston, MA; the University of Miami (S.K., M.L.P.), Miller School of Medicine, FL; Duke University Medical Center (M.L.J., J.M.), Durham, NC; the Department of Neurology (J.L.O., D.W.), University of Cincinnati College of Medicine, OH; and the Baltimore Veterans Administration Medical Center and University of Maryland School of Medicine (S.J.K.)
| | - Michael L James
- From the Division of Neurocritical Care and Emergency Neurology (D.Y.H., K.N.S.), Department of Neurology, Yale School of Medicine, New Haven, CT; the Maryland Stroke Center (C.A.D., M.J.S., T.D.W.), Baltimore; the Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L., M.E.C.), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; the Center for Human Genetic Research (J.R., T.W.K.B.), Boston, MA; the University of Miami (S.K., M.L.P.), Miller School of Medicine, FL; Duke University Medical Center (M.L.J., J.M.), Durham, NC; the Department of Neurology (J.L.O., D.W.), University of Cincinnati College of Medicine, OH; and the Baltimore Veterans Administration Medical Center and University of Maryland School of Medicine (S.J.K.)
| | - Jessica McFarlin
- From the Division of Neurocritical Care and Emergency Neurology (D.Y.H., K.N.S.), Department of Neurology, Yale School of Medicine, New Haven, CT; the Maryland Stroke Center (C.A.D., M.J.S., T.D.W.), Baltimore; the Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L., M.E.C.), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; the Center for Human Genetic Research (J.R., T.W.K.B.), Boston, MA; the University of Miami (S.K., M.L.P.), Miller School of Medicine, FL; Duke University Medical Center (M.L.J., J.M.), Durham, NC; the Department of Neurology (J.L.O., D.W.), University of Cincinnati College of Medicine, OH; and the Baltimore Veterans Administration Medical Center and University of Maryland School of Medicine (S.J.K.)
| | - Jennifer L Osborne
- From the Division of Neurocritical Care and Emergency Neurology (D.Y.H., K.N.S.), Department of Neurology, Yale School of Medicine, New Haven, CT; the Maryland Stroke Center (C.A.D., M.J.S., T.D.W.), Baltimore; the Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L., M.E.C.), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; the Center for Human Genetic Research (J.R., T.W.K.B.), Boston, MA; the University of Miami (S.K., M.L.P.), Miller School of Medicine, FL; Duke University Medical Center (M.L.J., J.M.), Durham, NC; the Department of Neurology (J.L.O., D.W.), University of Cincinnati College of Medicine, OH; and the Baltimore Veterans Administration Medical Center and University of Maryland School of Medicine (S.J.K.)
| | - Daniel Woo
- From the Division of Neurocritical Care and Emergency Neurology (D.Y.H., K.N.S.), Department of Neurology, Yale School of Medicine, New Haven, CT; the Maryland Stroke Center (C.A.D., M.J.S., T.D.W.), Baltimore; the Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L., M.E.C.), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; the Center for Human Genetic Research (J.R., T.W.K.B.), Boston, MA; the University of Miami (S.K., M.L.P.), Miller School of Medicine, FL; Duke University Medical Center (M.L.J., J.M.), Durham, NC; the Department of Neurology (J.L.O., D.W.), University of Cincinnati College of Medicine, OH; and the Baltimore Veterans Administration Medical Center and University of Maryland School of Medicine (S.J.K.)
| | - Steven J Kittner
- From the Division of Neurocritical Care and Emergency Neurology (D.Y.H., K.N.S.), Department of Neurology, Yale School of Medicine, New Haven, CT; the Maryland Stroke Center (C.A.D., M.J.S., T.D.W.), Baltimore; the Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L., M.E.C.), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; the Center for Human Genetic Research (J.R., T.W.K.B.), Boston, MA; the University of Miami (S.K., M.L.P.), Miller School of Medicine, FL; Duke University Medical Center (M.L.J., J.M.), Durham, NC; the Department of Neurology (J.L.O., D.W.), University of Cincinnati College of Medicine, OH; and the Baltimore Veterans Administration Medical Center and University of Maryland School of Medicine (S.J.K.)
| | - Kevin N Sheth
- From the Division of Neurocritical Care and Emergency Neurology (D.Y.H., K.N.S.), Department of Neurology, Yale School of Medicine, New Haven, CT; the Maryland Stroke Center (C.A.D., M.J.S., T.D.W.), Baltimore; the Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L., M.E.C.), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; the Center for Human Genetic Research (J.R., T.W.K.B.), Boston, MA; the University of Miami (S.K., M.L.P.), Miller School of Medicine, FL; Duke University Medical Center (M.L.J., J.M.), Durham, NC; the Department of Neurology (J.L.O., D.W.), University of Cincinnati College of Medicine, OH; and the Baltimore Veterans Administration Medical Center and University of Maryland School of Medicine (S.J.K.)
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Sheth KN, Martini SR, Moomaw CJ, Koch S, Elkind MSV, Sung G, Kittner SJ, Frankel M, Rosand J, Langefeld CD, Comeau ME, Waddy SP, Osborne J, Woo D. Prophylactic Antiepileptic Drug Use and Outcome in the Ethnic/Racial Variations of Intracerebral Hemorrhage Study. Stroke 2015; 46:3532-5. [PMID: 26470777 DOI: 10.1161/strokeaha.115.010875] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 09/16/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The role of antiepileptic drug (AED) prophylaxis after intracerebral hemorrhage (ICH) remains unclear. This analysis describes prevalence of prophylactic AED use, as directed by treating clinicians, in a prospective ICH cohort and tests the hypothesis that it is associated with poor outcome. METHODS Analysis included 744 patients with ICH enrolled in the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study before November 2012. Baseline clinical characteristics and AED use were recorded in standardized fashion. ICH location and volume were recorded from baseline neuroimaging. We analyzed differences in patient characteristics by AED prophylaxis, and we used logistic regression to test whether AED prophylaxis was associated with poor outcome. The primary outcome was 3-month modified Rankin Scale score, with 4 to 6 considered poor outcome. RESULTS AEDs were used for prophylaxis in 289 (39%) of the 744 subjects; of these, levetiracetam was used in 89%. Patients with lobar ICH, craniotomy, or larger hematomas were more likely to receive prophlyaxis. Although prophylactic AED use was associated with poor outcome in an unadjusted model (odds ratio, 1.40; 95% confidence interval, 1.04-1.88; P=0.03), this association was no longer significant after adjusting for clinical and demographic characteristics (odds ratio, 1.11; 95% confidence interval, 0.74-1.65; P=0.62). CONCLUSIONS We found no evidence that AED use (predominantly levetiracetam) is independently associated with poor outcome. A prospective study is required to assess for a more modest effect of AED use on outcome after ICH.
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Affiliation(s)
- Kevin N Sheth
- From the Department of Neurology, Yale University School of Medicine, New Haven, CT (K.N.S.); Department of Neurology, Baylor College of Medicine, Houston, TX (S.R.M.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., J.O., D.W.); Department of Neurology, University of Miami School of Medicine, Miami, FL (S.K.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York (M.S.V.E.); Department of Neurology, University of Southern California, Los Angeles (G.S.); Department of Neurology, University of Maryland School of Medicine, Baltimore, MD (S.J.K.); Department of Neurology, Emory University School of Medicine, Atlanta, GA (M.F.); Department of Neurology, Massachusetts General Hospital, Boston, MA (J.R.); Department of Biostatistical Sciences and Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L., M.E.C.); and Office of Clinical Research, National Institute of Neurological Disorders and Stroke, Bethesda, MD (S.P.W.).
| | - Sharyl R Martini
- From the Department of Neurology, Yale University School of Medicine, New Haven, CT (K.N.S.); Department of Neurology, Baylor College of Medicine, Houston, TX (S.R.M.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., J.O., D.W.); Department of Neurology, University of Miami School of Medicine, Miami, FL (S.K.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York (M.S.V.E.); Department of Neurology, University of Southern California, Los Angeles (G.S.); Department of Neurology, University of Maryland School of Medicine, Baltimore, MD (S.J.K.); Department of Neurology, Emory University School of Medicine, Atlanta, GA (M.F.); Department of Neurology, Massachusetts General Hospital, Boston, MA (J.R.); Department of Biostatistical Sciences and Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L., M.E.C.); and Office of Clinical Research, National Institute of Neurological Disorders and Stroke, Bethesda, MD (S.P.W.)
| | - Charles J Moomaw
- From the Department of Neurology, Yale University School of Medicine, New Haven, CT (K.N.S.); Department of Neurology, Baylor College of Medicine, Houston, TX (S.R.M.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., J.O., D.W.); Department of Neurology, University of Miami School of Medicine, Miami, FL (S.K.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York (M.S.V.E.); Department of Neurology, University of Southern California, Los Angeles (G.S.); Department of Neurology, University of Maryland School of Medicine, Baltimore, MD (S.J.K.); Department of Neurology, Emory University School of Medicine, Atlanta, GA (M.F.); Department of Neurology, Massachusetts General Hospital, Boston, MA (J.R.); Department of Biostatistical Sciences and Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L., M.E.C.); and Office of Clinical Research, National Institute of Neurological Disorders and Stroke, Bethesda, MD (S.P.W.)
| | - Sebastian Koch
- From the Department of Neurology, Yale University School of Medicine, New Haven, CT (K.N.S.); Department of Neurology, Baylor College of Medicine, Houston, TX (S.R.M.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., J.O., D.W.); Department of Neurology, University of Miami School of Medicine, Miami, FL (S.K.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York (M.S.V.E.); Department of Neurology, University of Southern California, Los Angeles (G.S.); Department of Neurology, University of Maryland School of Medicine, Baltimore, MD (S.J.K.); Department of Neurology, Emory University School of Medicine, Atlanta, GA (M.F.); Department of Neurology, Massachusetts General Hospital, Boston, MA (J.R.); Department of Biostatistical Sciences and Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L., M.E.C.); and Office of Clinical Research, National Institute of Neurological Disorders and Stroke, Bethesda, MD (S.P.W.)
| | - Mitchell S V Elkind
- From the Department of Neurology, Yale University School of Medicine, New Haven, CT (K.N.S.); Department of Neurology, Baylor College of Medicine, Houston, TX (S.R.M.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., J.O., D.W.); Department of Neurology, University of Miami School of Medicine, Miami, FL (S.K.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York (M.S.V.E.); Department of Neurology, University of Southern California, Los Angeles (G.S.); Department of Neurology, University of Maryland School of Medicine, Baltimore, MD (S.J.K.); Department of Neurology, Emory University School of Medicine, Atlanta, GA (M.F.); Department of Neurology, Massachusetts General Hospital, Boston, MA (J.R.); Department of Biostatistical Sciences and Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L., M.E.C.); and Office of Clinical Research, National Institute of Neurological Disorders and Stroke, Bethesda, MD (S.P.W.)
| | - Gene Sung
- From the Department of Neurology, Yale University School of Medicine, New Haven, CT (K.N.S.); Department of Neurology, Baylor College of Medicine, Houston, TX (S.R.M.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., J.O., D.W.); Department of Neurology, University of Miami School of Medicine, Miami, FL (S.K.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York (M.S.V.E.); Department of Neurology, University of Southern California, Los Angeles (G.S.); Department of Neurology, University of Maryland School of Medicine, Baltimore, MD (S.J.K.); Department of Neurology, Emory University School of Medicine, Atlanta, GA (M.F.); Department of Neurology, Massachusetts General Hospital, Boston, MA (J.R.); Department of Biostatistical Sciences and Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L., M.E.C.); and Office of Clinical Research, National Institute of Neurological Disorders and Stroke, Bethesda, MD (S.P.W.)
| | - Steven J Kittner
- From the Department of Neurology, Yale University School of Medicine, New Haven, CT (K.N.S.); Department of Neurology, Baylor College of Medicine, Houston, TX (S.R.M.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., J.O., D.W.); Department of Neurology, University of Miami School of Medicine, Miami, FL (S.K.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York (M.S.V.E.); Department of Neurology, University of Southern California, Los Angeles (G.S.); Department of Neurology, University of Maryland School of Medicine, Baltimore, MD (S.J.K.); Department of Neurology, Emory University School of Medicine, Atlanta, GA (M.F.); Department of Neurology, Massachusetts General Hospital, Boston, MA (J.R.); Department of Biostatistical Sciences and Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L., M.E.C.); and Office of Clinical Research, National Institute of Neurological Disorders and Stroke, Bethesda, MD (S.P.W.)
| | - Michael Frankel
- From the Department of Neurology, Yale University School of Medicine, New Haven, CT (K.N.S.); Department of Neurology, Baylor College of Medicine, Houston, TX (S.R.M.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., J.O., D.W.); Department of Neurology, University of Miami School of Medicine, Miami, FL (S.K.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York (M.S.V.E.); Department of Neurology, University of Southern California, Los Angeles (G.S.); Department of Neurology, University of Maryland School of Medicine, Baltimore, MD (S.J.K.); Department of Neurology, Emory University School of Medicine, Atlanta, GA (M.F.); Department of Neurology, Massachusetts General Hospital, Boston, MA (J.R.); Department of Biostatistical Sciences and Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L., M.E.C.); and Office of Clinical Research, National Institute of Neurological Disorders and Stroke, Bethesda, MD (S.P.W.)
| | - Jonathan Rosand
- From the Department of Neurology, Yale University School of Medicine, New Haven, CT (K.N.S.); Department of Neurology, Baylor College of Medicine, Houston, TX (S.R.M.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., J.O., D.W.); Department of Neurology, University of Miami School of Medicine, Miami, FL (S.K.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York (M.S.V.E.); Department of Neurology, University of Southern California, Los Angeles (G.S.); Department of Neurology, University of Maryland School of Medicine, Baltimore, MD (S.J.K.); Department of Neurology, Emory University School of Medicine, Atlanta, GA (M.F.); Department of Neurology, Massachusetts General Hospital, Boston, MA (J.R.); Department of Biostatistical Sciences and Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L., M.E.C.); and Office of Clinical Research, National Institute of Neurological Disorders and Stroke, Bethesda, MD (S.P.W.)
| | - Carl D Langefeld
- From the Department of Neurology, Yale University School of Medicine, New Haven, CT (K.N.S.); Department of Neurology, Baylor College of Medicine, Houston, TX (S.R.M.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., J.O., D.W.); Department of Neurology, University of Miami School of Medicine, Miami, FL (S.K.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York (M.S.V.E.); Department of Neurology, University of Southern California, Los Angeles (G.S.); Department of Neurology, University of Maryland School of Medicine, Baltimore, MD (S.J.K.); Department of Neurology, Emory University School of Medicine, Atlanta, GA (M.F.); Department of Neurology, Massachusetts General Hospital, Boston, MA (J.R.); Department of Biostatistical Sciences and Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L., M.E.C.); and Office of Clinical Research, National Institute of Neurological Disorders and Stroke, Bethesda, MD (S.P.W.)
| | - Mary E Comeau
- From the Department of Neurology, Yale University School of Medicine, New Haven, CT (K.N.S.); Department of Neurology, Baylor College of Medicine, Houston, TX (S.R.M.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., J.O., D.W.); Department of Neurology, University of Miami School of Medicine, Miami, FL (S.K.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York (M.S.V.E.); Department of Neurology, University of Southern California, Los Angeles (G.S.); Department of Neurology, University of Maryland School of Medicine, Baltimore, MD (S.J.K.); Department of Neurology, Emory University School of Medicine, Atlanta, GA (M.F.); Department of Neurology, Massachusetts General Hospital, Boston, MA (J.R.); Department of Biostatistical Sciences and Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L., M.E.C.); and Office of Clinical Research, National Institute of Neurological Disorders and Stroke, Bethesda, MD (S.P.W.)
| | - Salina P Waddy
- From the Department of Neurology, Yale University School of Medicine, New Haven, CT (K.N.S.); Department of Neurology, Baylor College of Medicine, Houston, TX (S.R.M.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., J.O., D.W.); Department of Neurology, University of Miami School of Medicine, Miami, FL (S.K.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York (M.S.V.E.); Department of Neurology, University of Southern California, Los Angeles (G.S.); Department of Neurology, University of Maryland School of Medicine, Baltimore, MD (S.J.K.); Department of Neurology, Emory University School of Medicine, Atlanta, GA (M.F.); Department of Neurology, Massachusetts General Hospital, Boston, MA (J.R.); Department of Biostatistical Sciences and Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L., M.E.C.); and Office of Clinical Research, National Institute of Neurological Disorders and Stroke, Bethesda, MD (S.P.W.)
| | - Jennifer Osborne
- From the Department of Neurology, Yale University School of Medicine, New Haven, CT (K.N.S.); Department of Neurology, Baylor College of Medicine, Houston, TX (S.R.M.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., J.O., D.W.); Department of Neurology, University of Miami School of Medicine, Miami, FL (S.K.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York (M.S.V.E.); Department of Neurology, University of Southern California, Los Angeles (G.S.); Department of Neurology, University of Maryland School of Medicine, Baltimore, MD (S.J.K.); Department of Neurology, Emory University School of Medicine, Atlanta, GA (M.F.); Department of Neurology, Massachusetts General Hospital, Boston, MA (J.R.); Department of Biostatistical Sciences and Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L., M.E.C.); and Office of Clinical Research, National Institute of Neurological Disorders and Stroke, Bethesda, MD (S.P.W.)
| | - Daniel Woo
- From the Department of Neurology, Yale University School of Medicine, New Haven, CT (K.N.S.); Department of Neurology, Baylor College of Medicine, Houston, TX (S.R.M.); Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (C.J.M., J.O., D.W.); Department of Neurology, University of Miami School of Medicine, Miami, FL (S.K.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York (M.S.V.E.); Department of Neurology, University of Southern California, Los Angeles (G.S.); Department of Neurology, University of Maryland School of Medicine, Baltimore, MD (S.J.K.); Department of Neurology, Emory University School of Medicine, Atlanta, GA (M.F.); Department of Neurology, Massachusetts General Hospital, Boston, MA (J.R.); Department of Biostatistical Sciences and Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC (C.D.L., M.E.C.); and Office of Clinical Research, National Institute of Neurological Disorders and Stroke, Bethesda, MD (S.P.W.)
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36
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Iyengar SK, Sedor JR, Freedman BI, Kao WHL, Kretzler M, Keller BJ, Abboud HE, Adler SG, Best LG, Bowden DW, Burlock A, Chen YDI, Cole SA, Comeau ME, Curtis JM, Divers J, Drechsler C, Duggirala R, Elston RC, Guo X, Huang H, Hoffmann MM, Howard BV, Ipp E, Kimmel PL, Klag MJ, Knowler WC, Kohn OF, Leak TS, Leehey DJ, Li M, Malhotra A, März W, Nair V, Nelson RG, Nicholas SB, O’Brien SJ, Pahl MV, Parekh RS, Pezzolesi MG, Rasooly RS, Rotimi CN, Rotter JI, Schelling JR, Seldin MF, Shah VO, Smiles AM, Smith MW, Taylor KD, Thameem F, Thornley-Brown DP, Truitt BJ, Wanner C, Weil EJ, Winkler CA, Zager PG, Igo RP, Hanson RL, Langefeld CD. Genome-Wide Association and Trans-ethnic Meta-Analysis for Advanced Diabetic Kidney Disease: Family Investigation of Nephropathy and Diabetes (FIND). PLoS Genet 2015; 11:e1005352. [PMID: 26305897 PMCID: PMC4549309 DOI: 10.1371/journal.pgen.1005352] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 06/10/2015] [Indexed: 11/28/2022] Open
Abstract
Diabetic kidney disease (DKD) is the most common etiology of chronic kidney disease (CKD) in the industrialized world and accounts for much of the excess mortality in patients with diabetes mellitus. Approximately 45% of U.S. patients with incident end-stage kidney disease (ESKD) have DKD. Independent of glycemic control, DKD aggregates in families and has higher incidence rates in African, Mexican, and American Indian ancestral groups relative to European populations. The Family Investigation of Nephropathy and Diabetes (FIND) performed a genome-wide association study (GWAS) contrasting 6,197 unrelated individuals with advanced DKD with healthy and diabetic individuals lacking nephropathy of European American, African American, Mexican American, or American Indian ancestry. A large-scale replication and trans-ethnic meta-analysis included 7,539 additional European American, African American and American Indian DKD cases and non-nephropathy controls. Within ethnic group meta-analysis of discovery GWAS and replication set results identified genome-wide significant evidence for association between DKD and rs12523822 on chromosome 6q25.2 in American Indians (P = 5.74x10-9). The strongest signal of association in the trans-ethnic meta-analysis was with a SNP in strong linkage disequilibrium with rs12523822 (rs955333; P = 1.31x10-8), with directionally consistent results across ethnic groups. These 6q25.2 SNPs are located between the SCAF8 and CNKSR3 genes, a region with DKD relevant changes in gene expression and an eQTL with IPCEF1, a gene co-translated with CNKSR3. Several other SNPs demonstrated suggestive evidence of association with DKD, within and across populations. These data identify a novel DKD susceptibility locus with consistent directions of effect across diverse ancestral groups and provide insight into the genetic architecture of DKD. Type 2 diabetes is the most common cause of severe kidney disease worldwide and diabetic kidney disease (DKD) associates with premature death. Individuals of non-European ancestry have the highest burden of type 2 DKD; hence understanding the causes of DKD remains critical to reducing health disparities. Family studies demonstrate that genes regulate the onset and progression of DKD; however, identifying these genes has proven to be challenging. The Family Investigation of Diabetes and Nephropathy consortium (FIND) recruited a large multi-ethnic collection of individuals with type 2 diabetes with and without kidney disease in order to detect genes associated with DKD. FIND discovered and replicated a DKD-associated genetic locus on human chromosome 6q25.2 (rs955333) between the SCAF8 and CNKSR genes. Findings were supported by significantly different expression of genes in this region from kidney tissue of subjects with, versus without DKD. The present findings identify a novel kidney disease susceptibility locus in individuals with type 2 diabetes which is consistent across subjects of differing ancestries. In addition, FIND results provide a rich catalogue of genetic variation in DKD patients for future research on the genetic architecture regulating this common and devastating disease.
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Affiliation(s)
- Sudha K. Iyengar
- Department of Epidemiology & Biostatistics, Case Western Reserve University, Cleveland, Ohio, United States of America
- * E-mail: (SKI); (JRS); (BIF)
| | - John R. Sedor
- Departments of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
- Departments of Physiology and Biophysics, Case Western Reserve University, Cleveland, Ohio, United States of America
- * E-mail: (SKI); (JRS); (BIF)
| | - Barry I. Freedman
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
- * E-mail: (SKI); (JRS); (BIF)
| | - W. H. Linda Kao
- Department of Epidemiology and Medicine, John Hopkins University, Baltimore, Maryland, United States of America
| | - Matthias Kretzler
- Department of Internal Medicine/Nephrology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Benjamin J. Keller
- Department of Internal Medicine/Nephrology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Hanna E. Abboud
- Department of Medicine/Nephrology, The University of Texas Health Science Center, San Antonio, Texas, United States of America
| | - Sharon G. Adler
- Department of Medicine, Division of Nephrology and Hypertension, Harbor-UCLA Medical Center, Torrance, California, United States of America
| | - Lyle G. Best
- Missouri Breaks Industries Research, Timber Lake, South Dakota, United States of America
| | - Donald W. Bowden
- Department of Biochemistry, Center for Human Genomics, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Allison Burlock
- Department of Internal Medicine/Nephrology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Yii-Der Ida Chen
- The Institute for Translational Genomics and Population Sciences, Harbor-UCLA Medical Center, Torrance, California, United States of America
| | - Shelley A. Cole
- Department of Genetics, Texas Biomedical Research Institute, San Antonio, Texas, United States of America
| | - Mary E. Comeau
- Center for Public Health Genomics and Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, United States of America
| | - Jeffrey M. Curtis
- National Institutes of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, United States of America
| | - Jasmin Divers
- Center for Public Health Genomics and Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, United States of America
| | - Christiane Drechsler
- University Hospital Würzburg, Renal Division and Comprehensive Heart Failure Center, Würzburg, Germany
| | - Ravi Duggirala
- Department of Genetics, Texas Biomedical Research Institute, San Antonio, Texas, United States of America
| | - Robert C. Elston
- Department of Epidemiology & Biostatistics, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Xiuqing Guo
- The Institute for Translational Genomics and Population Sciences, Harbor-UCLA Medical Center, Torrance, California, United States of America
| | - Huateng Huang
- Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, Michigan, United States of America
| | | | - Barbara V. Howard
- MedStar Health Research Institute, Hyattsville, Maryland, United States of America
| | - Eli Ipp
- Department of Medicine, Section of Diabetes and Metabolism, Harbor-UCLA Medical Center, Torrance, California, United States of America
| | - Paul L. Kimmel
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, United States of America
| | - Michael J. Klag
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
| | - William C. Knowler
- National Institutes of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, United States of America
| | - Orly F. Kohn
- Department of Medicine, University of Chicago Medicine, Chicago, Illinois, United States of America
| | - Tennille S. Leak
- Department of Internal Medicine/Nephrology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - David J. Leehey
- Department of Medicine, Loyola School of Medicine, Maywood, Illinois, United States of America
| | - Man Li
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Alka Malhotra
- National Institutes of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, United States of America
| | - Winfried März
- Heidelberg University and Synlab Academy, University of Graz, Graz, Austria
| | - Viji Nair
- Department of Internal Medicine/Nephrology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Robert G. Nelson
- National Institutes of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, United States of America
| | - Susanne B. Nicholas
- Department of Medicine, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Stephen J. O’Brien
- Theodosius Dobzhansky Center for Genome Bioinformatics, St. Petersburg, Russia, and Oceanographic Center, Nova Southeastern University, Ft. Lauderdale, Florida, United States of America
| | - Madeleine V. Pahl
- Department of Medicine, University of California, Irvine, Irvine, California, United States of America
| | - Rulan S. Parekh
- Departments of Paediatrics and Medicine, Hospital for Sick Children, University Health Network and the University of Toronto, Toronto, Ontario, Canada
| | - Marcus G. Pezzolesi
- Department of Medicine, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Rebekah S. Rasooly
- National Institute of Diabetes and Digestive Disease, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Charles N. Rotimi
- Center for Research on Genomics and Global Health, Bethesda, Maryland, United States of America
| | - Jerome I. Rotter
- The Institute for Translational Genomics and Population Sciences, Harbor-UCLA Medical Center, Torrance, California, United States of America
| | - Jeffrey R. Schelling
- Departments of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Michael F. Seldin
- Department of Biochemistry and Molecular Medicine, UC Davis School of Medicine, Davis, California, United States of America
| | - Vallabh O. Shah
- Department of Biochemistry & Molecular Biology, University of New Mexico, Albuquerque, New Mexico, United States of America
| | - Adam M. Smiles
- Joslin Diabetes Center, Section on Genetics and Epidemiology, Boston, Massachusetts, United States of America
| | - Michael W. Smith
- National Human Genome Research Institute, Rockville, Maryland, United States of America
| | - Kent D. Taylor
- The Institute for Translational Genomics and Population Sciences, Harbor-UCLA Medical Center, Torrance, California, United States of America
| | - Farook Thameem
- Department of Medicine, The University of Texas Health Science Center, San Antonio, Texas, United States of America
| | | | - Barbara J. Truitt
- Department of Epidemiology & Biostatistics, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Christoph Wanner
- Department of Medicine, Division of Nephrology, University Hospital Würzburg, Würzburg, Germany
| | - E. Jennifer Weil
- National Institutes of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, United States of America
| | - Cheryl A. Winkler
- Center for Cancer Research, National Cancer Institute, Frederick, Maryland, United States of America
| | - Philip G. Zager
- Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, United States of America
| | - Robert P. Igo
- Department of Epidemiology & Biostatistics, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Robert L. Hanson
- National Institutes of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, United States of America
| | - Carl D. Langefeld
- The Institute for Translational Genomics and Population Sciences, Harbor-UCLA Medical Center, Torrance, California, United States of America
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Vaughn SE, Foley C, Lu X, Patel ZH, Zoller EE, Magnusen AF, Williams AH, Ziegler JT, Comeau ME, Marion MC, Glenn SB, Adler A, Shen N, Nath S, Stevens AM, Freedman BI, Tsao BP, Jacob CO, Kamen DL, Brown EE, Gilkeson GS, Alarcón GS, Reveille JD, Anaya JM, James JA, Moser KL, Criswell LA, Vilá LM, Alarcón-Riquelme ME, Petri M, Scofield RH, Kimberly RP, Ramsey-Goldman R, Binjoo Y, Choi J, Bae SC, Boackle SA, Vyse TJ, Guthridge JM, Namjou B, Gaffney PM, Langefeld CD, Kaufman KM, Kelly JA, Harley ITW, Harley JB, Kottyan LC. Lupus risk variants in the PXK locus alter B-cell receptor internalization. Front Genet 2015; 5:450. [PMID: 25620976 PMCID: PMC4288052 DOI: 10.3389/fgene.2014.00450] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 12/09/2014] [Indexed: 01/17/2023] Open
Abstract
Genome wide association studies have identified variants in PXK that confer risk for humoral autoimmune diseases, including systemic lupus erythematosus (SLE or lupus), rheumatoid arthritis and more recently systemic sclerosis. While PXK is involved in trafficking of epidermal growth factor Receptor (EGFR) in COS-7 cells, mechanisms linking PXK to lupus pathophysiology have remained undefined. In an effort to uncover the mechanism at this locus that increases lupus-risk, we undertook a fine-mapping analysis in a large multi-ancestral study of lupus patients and controls. We define a large (257kb) common haplotype marking a single causal variant that confers lupus risk detected only in European ancestral populations and spans the promoter through the 3′ UTR of PXK. The strongest association was found at rs6445972 with P < 4.62 × 10−10, OR 0.81 (0.75–0.86). Using stepwise logistic regression analysis, we demonstrate that one signal drives the genetic association in the region. Bayesian analysis confirms our results, identifying a 95% credible set consisting of 172 variants spanning 202 kb. Functionally, we found that PXK operates on the B-cell antigen receptor (BCR); we confirmed that PXK influenced the rate of BCR internalization. Furthermore, we demonstrate that individuals carrying the risk haplotype exhibited a decreased rate of BCR internalization, a process known to impact B cell survival and cell fate. Taken together, these data define a new candidate mechanism for the genetic association of variants around PXK with lupus risk and highlight the regulation of intracellular trafficking as a genetically regulated pathway mediating human autoimmunity.
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Affiliation(s)
- Samuel E Vaughn
- Immunology Graduate Program and Medical Scientist Training Program, University of Cincinnati College of Medicine Cincinnati, OH, USA ; Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center Cincinnati, OH, USA
| | | | - Xiaoming Lu
- Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center Cincinnati, OH, USA
| | - Zubin H Patel
- Immunology Graduate Program and Medical Scientist Training Program, University of Cincinnati College of Medicine Cincinnati, OH, USA ; Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center Cincinnati, OH, USA
| | - Erin E Zoller
- Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center Cincinnati, OH, USA
| | - Albert F Magnusen
- Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center Cincinnati, OH, USA
| | - Adrienne H Williams
- Center for Public Health Genomics and the Department of Biostatistical Sciences, Wake Forest School of Medicine Winston-Salem, NC, USA
| | - Julie T Ziegler
- Center for Public Health Genomics and the Department of Biostatistical Sciences, Wake Forest School of Medicine Winston-Salem, NC, USA
| | - Mary E Comeau
- Center for Public Health Genomics and the Department of Biostatistical Sciences, Wake Forest School of Medicine Winston-Salem, NC, USA
| | - Miranda C Marion
- Center for Public Health Genomics and the Department of Biostatistical Sciences, Wake Forest School of Medicine Winston-Salem, NC, USA
| | - Stuart B Glenn
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation Oklahoma City, OK, USA
| | - Adam Adler
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation Oklahoma City, OK, USA
| | - Nan Shen
- Immunology Graduate Program and Medical Scientist Training Program, University of Cincinnati College of Medicine Cincinnati, OH, USA ; Joint Molecular Rheumatology Laboratory of the Institute of Health Sciences and Shanghai Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institutes for Biological Sciences, and Chinese Academy of Sciences Shanghai, China
| | - Swapan Nath
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation Oklahoma City, OK, USA
| | - Anne M Stevens
- Center for Immunity and Immunotherapies, Seattle Children's Research Institute Seattle, WA, USA ; Division of Rheumatology, Department of Pediatrics, University of Washington Seattle, WA, USA
| | - Barry I Freedman
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine Winston-Salem, NC, USA
| | - Betty P Tsao
- Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles Los Angeles, CA, USA
| | - Chaim O Jacob
- Department of Medicine, Keck School of Medicine, University of Southern California Los Angeles, CA, USA
| | - Diane L Kamen
- Division of Rheumatology, Medical University of South Carolina Charleston, SC, USA
| | - Elizabeth E Brown
- Department of Epidemiology, University of Alabama at Birmingham Birmingham, AL, USA ; Department of Medicine, University of Alabama at Birmingham Birmingham, AL, USA
| | - Gary S Gilkeson
- Division of Rheumatology, Medical University of South Carolina Charleston, SC, USA
| | - Graciela S Alarcón
- Department of Medicine, University of Alabama at Birmingham Birmingham, AL, USA
| | - John D Reveille
- Rheumatology and Clinical Immunogenetics, University of Texas Health Science Center at Houston Houston, TX, USA
| | - Juan-Manuel Anaya
- Center for Autoimmune Disease Research, Universidad del Rosario Bogota, Colombia
| | - Judith A James
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation Oklahoma City, OK, USA ; Department of Medicine, University of Oklahoma Health Sciences Center Oklahoma City, OK, USA
| | - Kathy L Moser
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation Oklahoma City, OK, USA
| | - Lindsey A Criswell
- Rosalind Russell/Ephraim P Engleman Rheumatology Research Research Center, Department of Medicine, University of California, San Francisco San Francisco, CA, USA
| | - Luis M Vilá
- Division of Rheumatology, Department of Medicine, University of Puerto Rico Medical Sciences Campus San Juan, PR, USA
| | - Marta E Alarcón-Riquelme
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation Oklahoma City, OK, USA ; Center for Genomics and Oncological Research, Pfizer-University of Granada-Junta de Andalucia Granada, Spain
| | - Michelle Petri
- Department of Medicine, Johns Hopkins University School of Medicine Baltimore, MD, USA
| | - R Hal Scofield
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation Oklahoma City, OK, USA ; Department of Medicine, University of Oklahoma Health Sciences Center Oklahoma City, OK, USA ; United States Department of Veterans Affairs Medical Center Oklahoma City, OK, USA
| | - Robert P Kimberly
- Department of Medicine, University of Alabama at Birmingham Birmingham, AL, USA
| | - Rosalind Ramsey-Goldman
- Division of Rheumatology, Feinberg School of Medicine, Northwestern University Chicago, IL, USA
| | - Young Binjoo
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases Seoul, Korea
| | - Jeongim Choi
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases Seoul, Korea
| | - Sang-Cheol Bae
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases Seoul, Korea
| | - Susan A Boackle
- Division of Rheumatology, University of Colorado School of Medicine Aurora, CO, USA
| | - Timothy J Vyse
- Divisions of Genetics and Molecular Medicine and Immunology, King's College London London, UK
| | - Joel M Guthridge
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation Oklahoma City, OK, USA
| | - Bahram Namjou
- Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center Cincinnati, OH, USA
| | - Patrick M Gaffney
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation Oklahoma City, OK, USA
| | - Carl D Langefeld
- Center for Public Health Genomics and the Department of Biostatistical Sciences, Wake Forest School of Medicine Winston-Salem, NC, USA
| | - Kenneth M Kaufman
- Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center Cincinnati, OH, USA ; United States Department of Veterans Affairs Medical Center Cincinnati, OH, USA
| | - Jennifer A Kelly
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation Oklahoma City, OK, USA
| | - Isaac T W Harley
- Immunology Graduate Program and Medical Scientist Training Program, University of Cincinnati College of Medicine Cincinnati, OH, USA ; Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center Cincinnati, OH, USA
| | - John B Harley
- Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center Cincinnati, OH, USA ; United States Department of Veterans Affairs Medical Center Cincinnati, OH, USA
| | - Leah C Kottyan
- Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center Cincinnati, OH, USA ; United States Department of Veterans Affairs Medical Center Cincinnati, OH, USA
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38
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Zhao J, Giles BM, Taylor RL, Yette GA, Lough KM, Ng HL, Abraham LJ, Wu H, Kelly JA, Glenn SB, Adler AJ, Williams AH, Comeau ME, Ziegler JT, Marion M, Alarcón-Riquelme ME, Alarcón GS, Anaya JM, Bae SC, Kim D, Lee HS, Criswell LA, Freedman BI, Gilkeson GS, Guthridge JM, Jacob CO, James JA, Kamen DL, Merrill JT, Sivils KM, Niewold TB, Petri MA, Ramsey-Goldman R, Reveille JD, Scofield RH, Stevens AM, Vilá LM, Vyse TJ, Kaufman KM, Harley JB, Langefeld CD, Gaffney PM, Brown EE, Edberg JC, Kimberly RP, Ulgiati D, Tsao BP, Boackle SA. Preferential association of a functional variant in complement receptor 2 with antibodies to double-stranded DNA. Ann Rheum Dis 2014; 75:242-52. [PMID: 25180293 PMCID: PMC4717392 DOI: 10.1136/annrheumdis-2014-205584] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 08/02/2014] [Indexed: 02/03/2023]
Abstract
Objectives Systemic lupus erythematosus (SLE; OMIM 152700) is characterised by the production of antibodies to nuclear antigens. We previously identified variants in complement receptor 2 (CR2/CD21) that were associated with decreased risk of SLE. This study aimed to identify the causal variant for this association. Methods Genotyped and imputed genetic variants spanning CR2 were assessed for association with SLE in 15 750 case-control subjects from four ancestral groups. Allele-specific functional effects of associated variants were determined using quantitative real-time PCR, quantitative flow cytometry, electrophoretic mobility shift assay (EMSA) and chromatin immunoprecipitation (ChIP)-PCR. Results The strongest association signal was detected at rs1876453 in intron 1 of CR2 (pmeta=4.2×10−4, OR 0.85), specifically when subjects were stratified based on the presence of dsDNA autoantibodies (case-control pmeta=7.6×10−7, OR 0.71; case-only pmeta=1.9×10−4, OR 0.75). Although allele-specific effects on B cell CR2 mRNA or protein levels were not identified, levels of complement receptor 1 (CR1/CD35) mRNA and protein were significantly higher on B cells of subjects harbouring the minor allele (p=0.0248 and p=0.0006, respectively). The minor allele altered the formation of several DNA protein complexes by EMSA, including one containing CCCTC-binding factor (CTCF), an effect that was confirmed by ChIP-PCR. Conclusions These data suggest that rs1876453 in CR2 has long-range effects on gene regulation that decrease susceptibility to lupus. Since the minor allele at rs1876453 is preferentially associated with reduced risk of the highly specific dsDNA autoantibodies that are present in preclinical, active and severe lupus, understanding its mechanisms will have important therapeutic implications.
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Affiliation(s)
- Jian Zhao
- Division of Rheumatology, Department of Medicine, University of California at Los Angeles, Los Angeles, California, USA
| | - Brendan M Giles
- Division of Rheumatology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Rhonda L Taylor
- School of Pathology and Laboratory Medicine, Centre for Genetic Origins of Health and Disease, The University of Western Australia, Crawley, Western Australia, Australia
| | - Gabriel A Yette
- Division of Rheumatology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Kara M Lough
- Division of Rheumatology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Han Leng Ng
- School of Pathology and Laboratory Medicine, Centre for Genetic Origins of Health and Disease, The University of Western Australia, Crawley, Western Australia, Australia
| | - Lawrence J Abraham
- School of Pathology and Laboratory Medicine, Centre for Genetic Origins of Health and Disease, The University of Western Australia, Crawley, Western Australia, Australia
| | - Hui Wu
- Division of Rheumatology, Department of Medicine, University of California at Los Angeles, Los Angeles, California, USA
| | - Jennifer A Kelly
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
| | - Stuart B Glenn
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
| | - Adam J Adler
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
| | - Adrienne H Williams
- Department of Biostatistical Sciences and Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Mary E Comeau
- Department of Biostatistical Sciences and Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Julie T Ziegler
- Department of Biostatistical Sciences and Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Miranda Marion
- Department of Biostatistical Sciences and Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Marta E Alarcón-Riquelme
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA Pfizer-Universidad de Granada-Junta de Andalucía Center for Genomics and Oncological Research, Granada, Spain
| | | | - Graciela S Alarcón
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Juan-Manuel Anaya
- Center for Autoimmune Diseases Research (CREA), Universidad del Rosario, Bogotá, Colombia
| | - Sang-Cheol Bae
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea
| | - Dam Kim
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea
| | - Hye-Soon Lee
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea
| | - Lindsey A Criswell
- Rosalind Russell/Ephraim P. Engleman Rheumatology Research Center, University of California San Francisco, San Francisco, California, USA
| | - Barry I Freedman
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Gary S Gilkeson
- Division of Rheumatology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Joel M Guthridge
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
| | - Chaim O Jacob
- Department of Medicine, University of Southern California, Los Angeles, California, USA
| | - Judith A James
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Diane L Kamen
- Division of Rheumatology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Joan T Merrill
- Department of Clinical Pharmacology, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
| | - Kathy Moser Sivils
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Timothy B Niewold
- Division of Rheumatology and Department of Immunology, Mayo Clinic, Rochester, Minnesota, USA
| | - Michelle A Petri
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rosalind Ramsey-Goldman
- Division of Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - John D Reveille
- Department of Rheumatology and Clinical Immunogenetics, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - R Hal Scofield
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA US Department of Veterans Affairs Medical Center, Oklahoma City, Oklahoma, USA
| | - Anne M Stevens
- Division of Rheumatology, Department of Pediatrics, University of Washington, Seattle, Washington, USA Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Luis M Vilá
- Division of Rheumatology, Department of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Timothy J Vyse
- Division of Genetics and Molecular Medicine and Immunology, King's College London, London, UK
| | - Kenneth M Kaufman
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA US Department of Veterans Affairs Medical Center, Cincinnati, Ohio, USA
| | - John B Harley
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA US Department of Veterans Affairs Medical Center, Cincinnati, Ohio, USA
| | - Carl D Langefeld
- Department of Biostatistical Sciences and Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Patrick M Gaffney
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
| | - Elizabeth E Brown
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jeffrey C Edberg
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Robert P Kimberly
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Daniela Ulgiati
- School of Pathology and Laboratory Medicine, Centre for Genetic Origins of Health and Disease, The University of Western Australia, Crawley, Western Australia, Australia
| | - Betty P Tsao
- Division of Rheumatology, Department of Medicine, University of California at Los Angeles, Los Angeles, California, USA
| | - Susan A Boackle
- Division of Rheumatology, University of Colorado School of Medicine, Aurora, Colorado, USA Denver Veterans Affairs Medical Center, Denver, Colorado, USA
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Ng MCY, Shriner D, Chen BH, Li J, Chen WM, Guo X, Liu J, Bielinski SJ, Yanek LR, Nalls MA, Comeau ME, Rasmussen-Torvik LJ, Jensen RA, Evans DS, Sun YV, An P, Patel SR, Lu Y, Long J, Armstrong LL, Wagenknecht L, Yang L, Snively BM, Palmer ND, Mudgal P, Langefeld CD, Keene KL, Freedman BI, Mychaleckyj JC, Nayak U, Raffel LJ, Goodarzi MO, Chen YDI, Taylor HA, Correa A, Sims M, Couper D, Pankow JS, Boerwinkle E, Adeyemo A, Doumatey A, Chen G, Mathias RA, Vaidya D, Singleton AB, Zonderman AB, Igo RP, Sedor JR, Kabagambe EK, Siscovick DS, McKnight B, Rice K, Liu Y, Hsueh WC, Zhao W, Bielak LF, Kraja A, Province MA, Bottinger EP, Gottesman O, Cai Q, Zheng W, Blot WJ, Lowe WL, Pacheco JA, Crawford DC, Grundberg E, Rich SS, Hayes MG, Shu XO, Loos RJF, Borecki IB, Peyser PA, Cummings SR, Psaty BM, Fornage M, Iyengar SK, Evans MK, Becker DM, Kao WHL, Wilson JG, Rotter JI, Sale MM, Liu S, Rotimi CN, Bowden DW. Meta-analysis of genome-wide association studies in African Americans provides insights into the genetic architecture of type 2 diabetes. PLoS Genet 2014; 10:e1004517. [PMID: 25102180 PMCID: PMC4125087 DOI: 10.1371/journal.pgen.1004517] [Citation(s) in RCA: 150] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 06/05/2014] [Indexed: 12/11/2022] Open
Abstract
Type 2 diabetes (T2D) is more prevalent in African Americans than in Europeans. However, little is known about the genetic risk in African Americans despite the recent identification of more than 70 T2D loci primarily by genome-wide association studies (GWAS) in individuals of European ancestry. In order to investigate the genetic architecture of T2D in African Americans, the MEta-analysis of type 2 DIabetes in African Americans (MEDIA) Consortium examined 17 GWAS on T2D comprising 8,284 cases and 15,543 controls in African Americans in stage 1 analysis. Single nucleotide polymorphisms (SNPs) association analysis was conducted in each study under the additive model after adjustment for age, sex, study site, and principal components. Meta-analysis of approximately 2.6 million genotyped and imputed SNPs in all studies was conducted using an inverse variance-weighted fixed effect model. Replications were performed to follow up 21 loci in up to 6,061 cases and 5,483 controls in African Americans, and 8,130 cases and 38,987 controls of European ancestry. We identified three known loci (TCF7L2, HMGA2 and KCNQ1) and two novel loci (HLA-B and INS-IGF2) at genome-wide significance (4.15×10−94<P<5×10−8, odds ratio (OR) = 1.09 to 1.36). Fine-mapping revealed that 88 of 158 previously identified T2D or glucose homeostasis loci demonstrated nominal to highly significant association (2.2×10−23 < locus-wide P<0.05). These novel and previously identified loci yielded a sibling relative risk of 1.19, explaining 17.5% of the phenotypic variance of T2D on the liability scale in African Americans. Overall, this study identified two novel susceptibility loci for T2D in African Americans. A substantial number of previously reported loci are transferable to African Americans after accounting for linkage disequilibrium, enabling fine mapping of causal variants in trans-ethnic meta-analysis studies. Despite the higher prevalence of type 2 diabetes (T2D) in African Americans than in Europeans, recent genome-wide association studies (GWAS) were examined primarily in individuals of European ancestry. In this study, we performed meta-analysis of 17 GWAS in 8,284 cases and 15,543 controls to explore the genetic architecture of T2D in African Americans. Following replication in additional 6,061 cases and 5,483 controls in African Americans, and 8,130 cases and 38,987 controls of European ancestry, we identified two novel and three previous reported T2D loci reaching genome-wide significance. We also examined 158 loci previously reported to be associated with T2D or regulating glucose homeostasis. While 56% of these loci were shared between African Americans and the other populations, the strongest associations in African Americans are often found in nearby single nucleotide polymorphisms (SNPs) instead of the original SNPs reported in other populations due to differential genetic architecture across populations. Our results highlight the importance of performing genetic studies in non-European populations to fine map the causal genetic variants.
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Affiliation(s)
- Maggie C. Y. Ng
- Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
- Center for Diabetes Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Daniel Shriner
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, Bethesda, Maryland, United States of America
| | - Brian H. Chen
- Program on Genomics and Nutrition, School of Public Health, University of California Los Angeles, Los Angeles, California, United States of America
- Center for Metabolic Disease Prevention, School of Public Health, University of California Los Angeles, Los Angeles, California, United States of America
| | - Jiang Li
- Center for Diabetes Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Wei-Min Chen
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, United States of America
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, United States of America
| | - Xiuqing Guo
- Institute for Translational Genomics and Population Sciences, Los Angeles BioMedical Research Institute at Harbor-UCLA Medical Center, Torrance, California, United States of America
| | - Jiankang Liu
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
| | - Suzette J. Bielinski
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Lisa R. Yanek
- The GeneSTAR Research Program, Division of General Internal Medicine, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Michael A. Nalls
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Mary E. Comeau
- Center for Public Health Genomics, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Laura J. Rasmussen-Torvik
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Richard A. Jensen
- Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, United States of America
- Department of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Daniel S. Evans
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, United States of America
| | - Yan V. Sun
- Department of Epidemiology and Biomedical Informatics, Emory University, Atlanta, Georgia, United States of America
| | - Ping An
- Division of Statistical Genomics, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Sanjay R. Patel
- Division of Sleep Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
| | - Yingchang Lu
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- The Genetics of Obesity and Related Metabolic Traits Program, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Jirong Long
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Loren L. Armstrong
- Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Lynne Wagenknecht
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Lingyao Yang
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Beverly M. Snively
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Nicholette D. Palmer
- Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
- Center for Diabetes Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Poorva Mudgal
- Center for Diabetes Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Carl D. Langefeld
- Center for Public Health Genomics, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Keith L. Keene
- Department of Biology, Center for Health Disparities, East Carolina University, Greenville, North Carolina, United States of America
| | - Barry I. Freedman
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Josyf C. Mychaleckyj
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, United States of America
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, United States of America
| | - Uma Nayak
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, United States of America
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, United States of America
| | - Leslie J. Raffel
- Medical Genetics Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Mark O. Goodarzi
- Medical Genetics Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Y-D Ida Chen
- Institute for Translational Genomics and Population Sciences, Los Angeles BioMedical Research Institute at Harbor-UCLA Medical Center, Torrance, California, United States of America
| | - Herman A. Taylor
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
- Jackson State University, Tougaloo College, Jackson, Mississippi, United States of America
| | - Adolfo Correa
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
| | - David Couper
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - James S. Pankow
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Eric Boerwinkle
- Human Genetics Center, University of Texas Health Science Center at Houston, Houston, Texas, United States of America
| | - Adebowale Adeyemo
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, Bethesda, Maryland, United States of America
| | - Ayo Doumatey
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, Bethesda, Maryland, United States of America
| | - Guanjie Chen
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, Bethesda, Maryland, United States of America
| | - Rasika A. Mathias
- The GeneSTAR Research Program, Division of General Internal Medicine, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Division of Allergy and Clinical Immunology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Dhananjay Vaidya
- The GeneSTAR Research Program, Division of General Internal Medicine, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Andrew B. Singleton
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Alan B. Zonderman
- Laboratory of Personality and Cognition, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, United States of America
| | - Robert P. Igo
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - John R. Sedor
- Department of Medicine, Case Western Reserve University, MetroHealth System campus, Cleveland, Ohio, United States of America
- Department of Physiology and Biophysics, Case Western Reserve University, Cleveland, Ohio, United States of America
| | | | - Edmond K. Kabagambe
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - David S. Siscovick
- Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, United States of America
- Department of Medicine, University of Washington, Seattle, Washington, United States of America
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
| | - Barbara McKnight
- Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, United States of America
- Department of Biostatistics, University of Washington, Seattle, Washington, United States of America
| | - Kenneth Rice
- Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, United States of America
- Department of Biostatistics, University of Washington, Seattle, Washington, United States of America
| | - Yongmei Liu
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Wen-Chi Hsueh
- Department of Medicine, University of California, San Francisco, California, United States of America
| | - Wei Zhao
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Lawrence F. Bielak
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Aldi Kraja
- Division of Statistical Genomics, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Michael A. Province
- Division of Statistical Genomics, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Erwin P. Bottinger
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Omri Gottesman
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Qiuyin Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - William J. Blot
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee; International Epidemiology Institute, Rockville, Maryland, United States of America
| | - William L. Lowe
- Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Jennifer A. Pacheco
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Dana C. Crawford
- Center for Human Genetics Research and Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee, United States of America
| | | | | | - Elin Grundberg
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | | | - Stephen S. Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, United States of America
| | - M. Geoffrey Hayes
- Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Ruth J. F. Loos
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- The Genetics of Obesity and Related Metabolic Traits Program, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Ingrid B. Borecki
- Division of Statistical Genomics, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Patricia A. Peyser
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Steven R. Cummings
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, United States of America
| | - Bruce M. Psaty
- Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, United States of America
- Department of Medicine, University of Washington, Seattle, Washington, United States of America
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
- Department of Health Services, University of Washington, Seattle, Washington, United States of America
| | - Myriam Fornage
- Human Genetics Center, University of Texas Health Science Center at Houston, Houston, Texas, United States of America
| | - Sudha K. Iyengar
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Michele K. Evans
- Health Disparities Unit, National Institute on Aging, National Institutes of Health, Baltimore Maryland, United States of America
| | - Diane M. Becker
- The GeneSTAR Research Program, Division of General Internal Medicine, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - W. H. Linda Kao
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - James G. Wilson
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
| | - Jerome I. Rotter
- Institute for Translational Genomics and Population Sciences, Los Angeles BioMedical Research Institute at Harbor-UCLA Medical Center, Torrance, California, United States of America
| | - Michèle M. Sale
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, United States of America
- Department of Medicine, University of Virginia, Charlottesville, Virginia, United States of America
- Department of Biochemistry and Molecular Genetics, University of Virginia, Charlottesville, Virginia, United States of America
| | - Simin Liu
- Program on Genomics and Nutrition, School of Public Health, University of California Los Angeles, Los Angeles, California, United States of America
- Department of Epidemiology, University of California Los Angeles, Los Angeles, California, United States of America
- Departments of Epidemiology and Medicine, Brown University, Providence, Rhode Island, United States of America
- * E-mail: (SL); (CNR); (DWB)
| | - Charles N. Rotimi
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, Bethesda, Maryland, United States of America
- * E-mail: (SL); (CNR); (DWB)
| | - Donald W. Bowden
- Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
- Center for Diabetes Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
- * E-mail: (SL); (CNR); (DWB)
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Freedman BI, Langefeld CD, Andringa KK, Croker JA, Williams AH, Garner NE, Birmingham DJ, Hebert LA, Hicks PJ, Segal MS, Edberg JC, Brown EE, Alarcón GS, Costenbader KH, Comeau ME, Criswell LA, Harley JB, James JA, Kamen DL, Lim SS, Merrill JT, Sivils KL, Niewold TB, Patel NM, Petri M, Ramsey-Goldman R, Reveille JD, Salmon JE, Tsao BP, Gibson KL, Byers JR, Vinnikova AK, Lea JP, Julian BA, Kimberly RP. End-stage renal disease in African Americans with lupus nephritis is associated with APOL1. Arthritis Rheumatol 2014; 66:390-6. [PMID: 24504811 DOI: 10.1002/art.38220] [Citation(s) in RCA: 208] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2013] [Accepted: 10/01/2013] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Lupus nephritis (LN) is a severe manifestation of systemic lupus erythematosus (SLE) that exhibits familial aggregation and may progress to end-stage renal disease (ESRD). LN is more prevalent among African Americans than among European Americans. This study was undertaken to investigate the hypothesis that the apolipoprotein L1 gene (APOL1) nephropathy risk alleles G1/G2, common in African Americans and rare in European Americans, contribute to the ethnic disparity in risk. METHODS APOL1 G1 and G2 nephropathy alleles were genotyped in 855 African American SLE patients with LN-ESRD (cases) and 534 African American SLE patients without nephropathy (controls) and tested for association under a recessive genetic model, by logistic regression. RESULTS Ninety percent of the SLE patients were female. The mean ± SD age at SLE diagnosis was significantly lower in LN-ESRD cases than in SLE non-nephropathy controls (27.3 ± 10.9 years versus 39.5 ± 12.2 years). The mean ± SD time from SLE diagnosis to development of LN-ESRD in cases was 7.3 ± 7.2 years. The G1/G2 risk alleles were strongly associated with SLE-ESRD, with 25% of cases and 12% of controls having 2 nephropathy alleles (odds ratio [OR] 2.57, recessive model P = 1.49 × 10(-9)), and after adjustment for age, sex, and ancestry admixture (OR 2.72, P = 6.23 × 10(-6)). The age-, sex-, and admixture-adjusted population attributable risk for ESRD among patients with G1/G2 polymorphisms was 0.26, compared to 0.003 among European American patients. The mean time from SLE diagnosis to ESRD development was ∼2 years earlier among individuals with APOL1 risk genotypes (P = 0.01). CONCLUSION APOL1 G1/G2 alleles strongly impact the risk of LN-ESRD in African Americans, as well as the time to progression to ESRD. The high frequency of these alleles in African Americans with near absence in European Americans explains an important proportion of the increased risk of LN-ESRD in African Americans.
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Woo D, Falcone GJ, Devan WJ, Brown WM, Biffi A, Howard TD, Anderson CD, Brouwers HB, Valant V, Battey TWK, Radmanesh F, Raffeld MR, Baedorf-Kassis S, Deka R, Woo JG, Martin LJ, Haverbusch M, Moomaw CJ, Sun G, Broderick JP, Flaherty ML, Martini SR, Kleindorfer DO, Kissela B, Comeau ME, Jagiella JM, Schmidt H, Freudenberger P, Pichler A, Enzinger C, Hansen BM, Norrving B, Jimenez-Conde J, Giralt-Steinhauer E, Elosua R, Cuadrado-Godia E, Soriano C, Roquer J, Kraft P, Ayres AM, Schwab K, McCauley JL, Pera J, Urbanik A, Rost NS, Goldstein JN, Viswanathan A, Stögerer EM, Tirschwell DL, Selim M, Brown DL, Silliman SL, Worrall BB, Meschia JF, Kidwell CS, Montaner J, Fernandez-Cadenas I, Delgado P, Malik R, Dichgans M, Greenberg SM, Rothwell PM, Lindgren A, Slowik A, Schmidt R, Langefeld CD, Rosand J. Meta-analysis of genome-wide association studies identifies 1q22 as a susceptibility locus for intracerebral hemorrhage. Am J Hum Genet 2014; 94:511-21. [PMID: 24656865 PMCID: PMC3980413 DOI: 10.1016/j.ajhg.2014.02.012] [Citation(s) in RCA: 195] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 02/24/2014] [Indexed: 11/25/2022] Open
Abstract
Intracerebral hemorrhage (ICH) is the stroke subtype with the worst prognosis and has no established acute treatment. ICH is classified as lobar or nonlobar based on the location of ruptured blood vessels within the brain. These different locations also signal different underlying vascular pathologies. Heritability estimates indicate a substantial genetic contribution to risk of ICH in both locations. We report a genome-wide association study of this condition that meta-analyzed data from six studies that enrolled individuals of European ancestry. Case subjects were ascertained by neurologists blinded to genotype data and classified as lobar or nonlobar based on brain computed tomography. ICH-free control subjects were sampled from ambulatory clinics or random digit dialing. Replication of signals identified in the discovery cohort with p < 1 × 10(-6) was pursued in an independent multiethnic sample utilizing both direct and genome-wide genotyping. The discovery phase included a case cohort of 1,545 individuals (664 lobar and 881 nonlobar cases) and a control cohort of 1,481 individuals and identified two susceptibility loci: for lobar ICH, chromosomal region 12q21.1 (rs11179580, odds ratio [OR] = 1.56, p = 7.0 × 10(-8)); and for nonlobar ICH, chromosomal region 1q22 (rs2984613, OR = 1.44, p = 1.6 × 10(-8)). The replication included a case cohort of 1,681 individuals (484 lobar and 1,194 nonlobar cases) and a control cohort of 2,261 individuals and corroborated the association for 1q22 (p = 6.5 × 10(-4); meta-analysis p = 2.2 × 10(-10)) but not for 12q21.1 (p = 0.55; meta-analysis p = 2.6 × 10(-5)). These results demonstrate biological heterogeneity across ICH subtypes and highlight the importance of ascertaining ICH cases accordingly.
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Affiliation(s)
- Daniel Woo
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
| | - Guido J Falcone
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA; Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA
| | - William J Devan
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
| | - W Mark Brown
- Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, NC 27157, USA
| | - Alessandro Biffi
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
| | - Timothy D Howard
- Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, NC 27157, USA
| | - Christopher D Anderson
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
| | - H Bart Brouwers
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
| | - Valerie Valant
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
| | - Thomas W K Battey
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
| | - Farid Radmanesh
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
| | - Miriam R Raffeld
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
| | - Sylvia Baedorf-Kassis
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
| | - Ranjan Deka
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Jessica G Woo
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Lisa J Martin
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Mary Haverbusch
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Charles J Moomaw
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Guangyun Sun
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Joseph P Broderick
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Matthew L Flaherty
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Sharyl R Martini
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Dawn O Kleindorfer
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Brett Kissela
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Mary E Comeau
- Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, NC 27157, USA
| | - Jeremiasz M Jagiella
- Department of Neurology, Jagiellonian University Medical College, Krakow 31-008, Poland
| | - Helena Schmidt
- Institute of Molecular Biology and Medical Biochemistry, Medical University Graz, Graz 8010, Austria
| | - Paul Freudenberger
- Institute of Molecular Biology and Medical Biochemistry, Medical University Graz, Graz 8010, Austria
| | - Alexander Pichler
- Department of Neurology, Medical University of Graz, Graz 8036, Austria
| | - Christian Enzinger
- Department of Neurology, Medical University of Graz, Graz 8036, Austria; Division of Neuroradiology, Department of Radiology, Medical University of Graz, Graz 8036, Austria
| | - Björn M Hansen
- Department of Clinical Sciences Lund, Neurology, Lund University, Lund 221 85, Sweden; Department of Neurology, Skåne University Hospital, Lund 221 85, Sweden
| | - Bo Norrving
- Department of Clinical Sciences Lund, Neurology, Lund University, Lund 221 85, Sweden; Department of Neurology, Skåne University Hospital, Lund 221 85, Sweden
| | - Jordi Jimenez-Conde
- Department of Neurology, Neurovascular Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Autonoma de Barcelona/DCEXS-UPF, Barcelona 08003, Spain; Cardiovascular Epidemiology and Genetics Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona 08003, Spain
| | - Eva Giralt-Steinhauer
- Department of Neurology, Neurovascular Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Autonoma de Barcelona/DCEXS-UPF, Barcelona 08003, Spain; Cardiovascular Epidemiology and Genetics Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona 08003, Spain
| | - Roberto Elosua
- Department of Neurology, Neurovascular Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Autonoma de Barcelona/DCEXS-UPF, Barcelona 08003, Spain; Cardiovascular Epidemiology and Genetics Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona 08003, Spain
| | - Elisa Cuadrado-Godia
- Department of Neurology, Neurovascular Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Autonoma de Barcelona/DCEXS-UPF, Barcelona 08003, Spain; Cardiovascular Epidemiology and Genetics Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona 08003, Spain
| | - Carolina Soriano
- Department of Neurology, Neurovascular Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Autonoma de Barcelona/DCEXS-UPF, Barcelona 08003, Spain; Cardiovascular Epidemiology and Genetics Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona 08003, Spain
| | - Jaume Roquer
- Department of Neurology, Neurovascular Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Autonoma de Barcelona/DCEXS-UPF, Barcelona 08003, Spain; Cardiovascular Epidemiology and Genetics Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona 08003, Spain
| | - Peter Kraft
- Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA
| | - Alison M Ayres
- The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Kristin Schwab
- The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Jacob L McCauley
- John P. Hussman Institute for Human Genomics, University of Miami, Miller School of Medicine, Miami, FL 33136, USA
| | - Joanna Pera
- Department of Neurology, Jagiellonian University Medical College, Krakow 31-008, Poland
| | - Andrzej Urbanik
- Department of Radiology, Jagiellonian University Medical College, Krakow 31-008, Poland
| | - Natalia S Rost
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
| | - Joshua N Goldstein
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Anand Viswanathan
- The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | | | - David L Tirschwell
- Stroke Center, Harborview Medical Center, University of Washington, Seattle, WA 98104, USA
| | - Magdy Selim
- Department of Neurology, Stroke Division, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Devin L Brown
- Stroke Program, Department of Neurology, University of Michigan Health System, Ann Arbor, MI 48109, USA
| | - Scott L Silliman
- Department of Neurology, University of Florida College of Medicine, Jacksonville, FL 32209, USA
| | - Bradford B Worrall
- Department of Neurology and Public Health Sciences, University of Virginia Health System, Charlottesville, VA 22908, USA
| | - James F Meschia
- Department of Neurology, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Chelsea S Kidwell
- Department of Neurology, University of Arizona, Tucson, AZ 85724, USA
| | - Joan Montaner
- Neurovascular Research Laboratory and Neurovascular Unit, Institut de Recerca, Hospital Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona 08035, Spain
| | - Israel Fernandez-Cadenas
- Neurovascular Research Laboratory and Neurovascular Unit, Institut de Recerca, Hospital Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona 08035, Spain; Stroke Pharmacogenomics and Genetics, Fundació Docència i Recerca Mútuaterrassa, Barcelona 08010, Spain
| | - Pilar Delgado
- Neurovascular Research Laboratory and Neurovascular Unit, Institut de Recerca, Hospital Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona 08035, Spain
| | - Rainer Malik
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University, Munich 80539, Germany; Munich Cluster for Systems Neurology (Synergy), Munich 80539, Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University, Munich 80539, Germany; Munich Cluster for Systems Neurology (Synergy), Munich 80539, Germany
| | - Steven M Greenberg
- The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Peter M Rothwell
- Stroke Prevention Research Unit, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford OX3 9DU, UK
| | - Arne Lindgren
- Department of Clinical Sciences Lund, Neurology, Lund University, Lund 221 85, Sweden; Department of Neurology, Skåne University Hospital, Lund 221 85, Sweden
| | - Agnieszka Slowik
- Department of Neurology, Jagiellonian University Medical College, Krakow 31-008, Poland
| | - Reinhold Schmidt
- Department of Neurology, Medical University of Graz, Graz 8036, Austria
| | - Carl D Langefeld
- Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, NC 27157, USA
| | - Jonathan Rosand
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA.
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Hwang DY, Dell CA, Sparks MJ, Watson TD, Langefeld CD, Comeau ME, Rosand J, Battey TW, Koch S, Perez ML, James ML, McFarlin J, Osborne JL, Woo DL, Kittner SJ, Sheth KN. Abstract 211: Subjective Judgments of Physicians and Nurses Are More Accurate Than Formal Clinical Scales in Predicting Functional Outcome After Intracerebral Hemorrhage. Stroke 2014. [DOI: 10.1161/str.45.suppl_1.211] [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] [Indexed: 11/16/2022]
Abstract
Introduction:
Providing an accurate prognosis is a fundamental responsibility of care providers for patients with intracerebral hemorrhage (ICH). The ICH and FUNC Scores are common clinical scales designed to predict functional outcome and mortality for ICH patients.
Hypothesis:
The ICH Score and FUNC Score have superior accuracy, compared to the early clinical judgment of physicians and nurses, with regards to the prediction of the Modified Rankin Scale (mRS) achieved by ICH patients at 3 months.
Methods:
We conducted a prospective study at 5 centers. For each consecutive adult patient admitted with primary ICH, one physician and one nurse on the treatment team were asked for prediction of mRS at 3 months. All predictions were collected within 24 hours of admission. ICH and FUNC Scores on admission and blinded outcome at 3 months were obtained for each patient, in part using data collected for the ongoing Ethnic/Racial Variations with ICH (ERICH) project. Predictive ability was measured by Spearman’s rank correlation (r).
Results:
For a total of 100 patients, 100 physicians (75 attendings, 25 trainees) and 100 nurses gave predictions. In order of strength of association with actual 3-month mRS, correlations were attending physicians r = 0.81, nurses r = 0.72, and trainees r = 0.66. Although suggestive, none of these groups were statistically superior (p > 0.10). However, nurses (p = 0.015) and attending physicians (p = 0.002), but not trainees (p = 0.57), were superior in their predictive ability over ICH Score (r = 0.55). Similarly, nurses (p = 0.0003) and attending physicians (p < 0.0001), but not trainees (p = 0.27), were superior over FUNC Score (r = -0.46). This accuracy advantage remained when examining predictions for (1) only those patients alive at 3 months (n = 65), and (2) only those patients for whom providers indicated that they would not recommend comfort care within the first 24 hours (n = 82).
Conclusions:
The ICH Score and FUNC Score did not have superior accuracy, compared to subjective clinical judgment, with regards to prediction of 3-month ICH outcome.
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Sandholm N, McKnight AJ, Salem RM, Brennan EP, Forsblom C, Harjutsalo V, Mäkinen VP, McKay GJ, Sadlier DM, Williams WW, Martin F, Panduru NM, Tarnow L, Tuomilehto J, Tryggvason K, Zerbini G, Comeau ME, Langefeld CD, Godson C, Hirschhorn JN, Maxwell AP, Florez JC, Groop PH. Chromosome 2q31.1 associates with ESRD in women with type 1 diabetes. J Am Soc Nephrol 2013; 24:1537-43. [PMID: 24029427 DOI: 10.1681/asn.2012111122] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Sex and genetic variation influence the risk of developing diabetic nephropathy and ESRD in patients with type 1 diabetes. We performed a genome-wide association study in a cohort of 3652 patients from the Finnish Diabetic Nephropathy (FinnDiane) Study with type 1 diabetes to determine whether sex-specific genetic risk factors for ESRD exist. A common variant, rs4972593 on chromosome 2q31.1, was associated with ESRD in women (P<5×10(-8)) but not in men (P=0.77). This association was replicated in the meta-analysis of three independent type 1 diabetes cohorts (P=0.02) and remained significant for women (P<5×10(-8); odds ratio, 1.81 [95% confidence interval, 1.47 to 2.24]) upon combined meta-analysis of the discovery and replication cohorts. rs4972593 is located between the genes that code for the Sp3 transcription factor, which interacts directly with estrogen receptor α and regulates the expression of genes linked to glomerular function and the pathogenesis of nephropathy, and the CDCA7 transcription factor, which regulates cell proliferation. Further examination revealed potential transcription factor-binding sites within rs4972593 and predicted eight estrogen-responsive elements within 5 kb of this locus. Moreover, we found sex-specific differences in the glomerular expression levels of SP3 (P=0.004). Overall, these results suggest that rs4972593 is a sex-specific genetic variant associated with ESRD in patients with type 1 diabetes and may underlie the sex-specific protection against ESRD.
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Affiliation(s)
- Niina Sandholm
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
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Sánchez E, Comeau ME, Freedman BI, Kelly JA, Kaufman KM, Langefeld CD, Brown EE, Alarcón GS, Kimberly RP, Edberg JC, Ramsey-Goldman R, Petri M, Reveille JD, Vilá LM, Merrill JT, Tsao BP, Kamen DL, Gilkeson GS, James JA, Vyse TJ, Gaffney PM, Jacob CO, Niewold TB, Richardson BC, Harley JB, Alarcón-Riquelme ME, Sawalha AH. Identification of novel genetic susceptibility loci in African American lupus patients in a candidate gene association study. ACTA ACUST UNITED AC 2013; 63:3493-501. [PMID: 21792837 DOI: 10.1002/art.30563] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Candidate gene and genome-wide association studies have identified several disease susceptibility loci in lupus patients. These studies have largely been performed in lupus patients who are Asian or of European ancestry. This study was undertaken to examine whether some of these same susceptibility loci increase lupus risk in African American individuals. METHODS Single-nucleotide polymorphisms tagging 15 independent lupus susceptibility loci were genotyped in a set of 1,724 lupus patients and 2,024 healthy controls of African American descent. The loci examined included PTPN22, FCGR2A, TNFSF4, STAT4, CTLA4, PDCD1, PXK, BANK1, MSH5 (HLA region), CFB (HLA region), C8orf13-BLK region, MBL2, KIAA1542, ITGAM, and MECP2/IRAK1. RESULTS We found the first evidence of genetic association between lupus in African American patients and 5 susceptibility loci (C8orf13-BLK, BANK1, TNFSF4, KIAA1542, and CTLA4; P = 8.0 × 10⁻⁶, P = 1.9 × 10⁻⁵, P = 5.7 × 10⁻⁵, P = 0.00099, and P = 0.0045, respectively). Further, we confirmed the genetic association between lupus and 5 additional lupus susceptibility loci (ITGAM, MSH5, CFB, STAT4, and FCGR2A; P = 7.5 × 10⁻¹¹, P = 5.2 × 10⁻⁸, P = 8.7 × 10⁻⁷ , P = 0.0058, and P = 0.0070, respectively), and provided evidence, for the first time, of genome-wide significance for the association between lupus in African American patients and ITGAM and MSH5 (HLA region). CONCLUSION These findings provide evidence of novel genetic susceptibility loci for lupus in African Americans and demonstrate that the majority of lupus susceptibility loci examined confer lupus risk across multiple ethnicities.
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Affiliation(s)
- Elena Sánchez
- Oklahoma Medical Research Foundation, Oklahoma City, USA
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45
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Adrianto I, Wang S, Wiley GB, Lessard CJ, Kelly JA, Adler AJ, Glenn SB, Williams AH, Ziegler JT, Comeau ME, Marion MC, Wakeland BE, Liang C, Kaufman KM, Guthridge JM, Alarcón-Riquelme ME, Alarcón GS, Anaya JM, Bae SC, Kim JH, Joo YB, Boackle SA, Brown EE, Petri MA, Ramsey-Goldman R, Reveille JD, Vilá LM, Criswell LA, Edberg JC, Freedman BI, Gilkeson GS, Jacob CO, James JA, Kamen DL, Kimberly RP, Martín J, Merrill JT, Niewold TB, Pons-Estel BA, Scofield RH, Stevens AM, Tsao BP, Vyse TJ, Langefeld CD, Harley JB, Wakeland EK, Moser KL, Montgomery CG, Gaffney PM. Association of two independent functional risk haplotypes in TNIP1 with systemic lupus erythematosus. ACTA ACUST UNITED AC 2013; 64:3695-705. [PMID: 22833143 DOI: 10.1002/art.34642] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by autoantibody production and altered type I interferon expression. Genetic surveys and genome-wide association studies have identified >30 SLE susceptibility genes. One of these genes, TNIP1, encodes the ABIN1 protein. ABIN1 functions in the immune system by restricting NF-κB signaling. The present study was undertaken to investigate the genetic factors that influence association with SLE in genes that regulate the NF-κB pathway. METHODS We analyzed a dense set of genetic markers spanning TNIP1 and TAX1BP1, as well as the TNIP1 homolog TNIP2, in case-control populations of diverse ethnic origins. TNIP1, TNIP2, and TAX1BP1 were fine-mapped in a total of 8,372 SLE cases and 7,492 healthy controls from European-ancestry, African American, Hispanic, East Asian, and African American Gullah populations. Levels of TNIP1 messenger RNA (mRNA) and ABIN1 protein in Epstein-Barr virus-transformed human B cell lines were analyzed by quantitative reverse transcription-polymerase chain reaction and Western blotting, respectively. RESULTS We found significant associations between SLE and genetic variants within TNIP1, but not in TNIP2 or TAX1BP1. After resequencing and imputation, we identified 2 independent risk haplotypes within TNIP1 in individuals of European ancestry that were also present in African American and Hispanic populations. Levels of TNIP1 mRNA and ABIN1 protein were reduced among subjects with these haplotypes, suggesting that they harbor hypomorphic functional variants that influence susceptibility to SLE by restricting ABIN1 expression. CONCLUSION Our results confirm the association signals between SLE and TNIP1 variants in multiple populations and provide new insight into the mechanism by which TNIP1 variants may contribute to SLE pathogenesis.
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Affiliation(s)
- Indra Adrianto
- Oklahoma Medical Research Foundation, Oklahoma City, USA
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Sánchez E, Rasmussen A, Riba L, Acevedo-Vasquez E, Kelly JA, Langefeld CD, Williams AH, Ziegler JT, Comeau ME, Marion MC, García-De La Torre I, Maradiaga-Ceceña MA, Cardiel MH, Esquivel-Valerio JA, Rodriguez-Amado J, Moctezuma JF, Miranda P, Perandones CE, Castel C, Laborde HA, Alba P, Musuruana JL, Goecke IA, Anaya JM, Kaufman KM, Adler A, Glenn SB, Brown EE, Alarcón GS, Kimberly RP, Edberg JC, Vilá LM, Criswell LA, Gilkeson GS, Niewold TB, Martín J, Vyse TJ, Boackle SA, Ramsey-Goldman R, Scofield RH, Petri M, Merrill JT, Reveille JD, Tsao BP, Orozco L, Baca V, Moser KL, Gaffney PM, James JA, Harley JB, Tusié-Luna T, Pons-Estel BA, Jacob CO, Alarcón-Riquelme ME. Impact of genetic ancestry and sociodemographic status on the clinical expression of systemic lupus erythematosus in American Indian-European populations. ACTA ACUST UNITED AC 2013; 64:3687-94. [PMID: 22886787 DOI: 10.1002/art.34650] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE American Indian-Europeans, Asians, and African Americans have an excess morbidity from systemic lupus erythematosus (SLE) and a higher prevalence of lupus nephritis than do Caucasians. The aim of this study was to analyze the relationship between genetic ancestry and sociodemographic characteristics and clinical features in a large cohort of American Indian-European SLE patients. METHODS A total of 2,116 SLE patients of American Indian-European origin and 4,001 SLE patients of European descent for whom we had clinical data were included in the study. Genotyping of 253 continental ancestry-informative markers was performed on the Illumina platform. Structure and Admixture software were used to determine genetic ancestry proportions of each individual. Logistic regression was used to test the association between genetic ancestry and sociodemographic and clinical characteristics. Odds ratios (ORs) were calculated with 95% confidence intervals (95% CIs). RESULTS The average American Indian genetic ancestry of 2,116 SLE patients was 40.7%. American Indian genetic ancestry conferred increased risks of renal involvement (P < 0.0001, OR 3.50 [95% CI 2.63- 4.63]) and early age at onset (P < 0.0001). American Indian ancestry protected against photosensitivity (P < 0.0001, OR 0.58 [95% CI 0.44-0.76]), oral ulcers (P < 0.0001, OR 0.55 [95% CI 0.42-0.72]), and serositis (P < 0.0001, OR 0.56 [95% CI 0.41-0.75]) after adjustment for age, sex, and age at onset. However, age and sex had stronger effects than genetic ancestry on malar rash, discoid rash, arthritis, and neurologic involvement. CONCLUSION In general, American Indian genetic ancestry correlates with lower sociodemographic status and increases the risk of developing renal involvement and SLE at an earlier age.
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Affiliation(s)
- Elena Sánchez
- Oklahoma Medical Research Foundation, Oklahoma City, USA
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47
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Martini SR, Flaherty ML, Brown WM, Haverbusch M, Comeau ME, Sauerbeck LR, Kissela BM, Deka R, Kleindorfer DO, Moomaw CJ, Broderick JP, Langefeld CD, Woo D. Risk factors for intracerebral hemorrhage differ according to hemorrhage location. Neurology 2012; 79:2275-82. [PMID: 23175721 DOI: 10.1212/wnl.0b013e318276896f] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES Risk factors have been described for spontaneous intracerebral hemorrhage (ICH); their relative contribution to lobar vs nonlobar hemorrhage location is less clear. Our purpose here was to investigate risk factors by hemorrhage location. METHODS This case-control study prospectively enrolled subjects with first-ever spontaneous ICH and matched each with up to 3 controls by age, race, and gender. Conditional stepwise logistic regression modeling was used to determine significant independent risk factors for lobar and nonlobar ICH. RESULTS From December 1997 through December 2006, 597 cases and 1,548 controls qualified for the analysis. Hypertension, warfarin use, first-degree relative with ICH, personal history of ischemic stroke, less than a high school education, and APOE ε2 or ε4 genotype were more common in ICH cases. Hypercholesterolemia and moderate alcohol consumption (≤ 2 drinks per day) were less common in ICH cases. The associations of hypertension and hypercholesterolemia were specific for nonlobar ICH. Conversely, the association of APOE ε2 or ε4 genotype was specific for lobar ICH. CONCLUSIONS APOE ε2 or ε4 genotype was associated specifically with lobar ICH. Hypertension was associated specifically with nonlobar ICH. A protective association was seen between hypercholesterolemia and nonlobar ICH; no such association was identified for lobar ICH.
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Affiliation(s)
- Sharyl R Martini
- Department of Neurology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Kaufman KM, Zhao J, Kelly JA, Hughes T, Adler A, Sanchez E, Ojwang JO, Langefeld CD, Ziegler JT, Williams AH, Comeau ME, Marion MC, Glenn SB, Cantor RM, Grossman JM, Hahn BH, Song YW, Yu CY, James JA, Guthridge JM, Brown EE, Alarcón GS, Kimberly RP, Edberg JC, Ramsey-Goldman R, Petri MA, Reveille JD, Vilá LM, Anaya JM, Boackle SA, Stevens AM, Freedman BI, Criswell LA, Pons Estel BA, Lee JH, Lee JS, Chang DM, Scofield RHA, Gilkeson GS, Merrill JT, Niewold TB, Vyse TJ, Bae SC, Alarcón-Riquelme ME, Jacob CO, Moser Sivils K, Gaffney PM, Harley JB, Sawalha AH, Tsao BP. Fine mapping of Xq28: both MECP2 and IRAK1 contribute to risk for systemic lupus erythematosus in multiple ancestral groups. Ann Rheum Dis 2012; 72:437-44. [PMID: 22904263 DOI: 10.1136/annrheumdis-2012-201851] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The Xq28 region containing IRAK1 and MECP2 has been identified as a risk locus for systemic lupus erythematosus (SLE) in previous genetic association studies. However, due to the strong linkage disequilibrium between IRAK1 and MECP2, it remains unclear which gene is affected by the underlying causal variant(s) conferring risk of SLE. METHODS We fine-mapped ≥136 SNPs in a ∼227 kb region on Xq28, containing IRAK1, MECP2 and seven adjacent genes (L1CAM, AVPR2, ARHGAP4, NAA10, RENBP, HCFC1 and TMEM187), for association with SLE in 15 783 case-control subjects derived from four different ancestral groups. RESULTS Multiple SNPs showed strong association with SLE in European Americans, Asians and Hispanics at p<5×10(-8) with consistent association in subjects with African ancestry. Of these, six SNPs located in the TMEM187-IRAK1-MECP2 region captured the underlying causal variant(s) residing in a common risk haplotype shared by all four ancestral groups. Among them, rs1059702 best explained the Xq28 association signals in conditional testings and exhibited the strongest p value in transancestral meta-analysis (p(meta )= 1.3×10(-27), OR=1.43), and thus was considered to be the most likely causal variant. The risk allele of rs1059702 results in the amino acid substitution S196F in IRAK1 and had previously been shown to increase NF-κB activity in vitro. We also found that the homozygous risk genotype of rs1059702 was associated with lower mRNA levels of MECP2, but not IRAK1, in SLE patients (p=0.0012) and healthy controls (p=0.0064). CONCLUSIONS These data suggest contributions of both IRAK1 and MECP2 to SLE susceptibility.
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Affiliation(s)
- Kenneth M Kaufman
- Division of Rheumatology and The Center for Autoimmune Genomics & Etiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA.
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Martini SR, Brown WM, Comeau ME, Flaherty M, Haverbusch M, Moomaw C, Adeoye O, Kleindorfer D, Kissela B, Broderick J, Langefeld CD, Woo D. Abstract 3559: Differential Effect of High Cholesterol by Intracerebral Hemorrhage Location. Stroke 2012. [DOI: 10.1161/str.43.suppl_1.a3559] [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] [Indexed: 11/16/2022]
Abstract
Background:
High cholesterol has been associated with a reduced likelihood of intracerebral hemorrhage (ICH). Lobar ICHs that arise from brain parenchyma near the cortex are predominantly related to amyloid angiopathy and thus have a different risk factor profile than non-lobar ICHs for which the main risk factor is hypertension. We were interested in whether high cholesterol was associated with reduced likelihood of all ICH, or whether there was a differential effect by hemorrhage location.
Methods:
The Genetic and Environmental Risk Factors for Hemorrhagic Stroke Study is a prospective case-control study of hemorrhagic strokes in the Greater Cincinnati/Northern Kentucky region. Charts are abstracted by nurses and verified by physician review to identify cases. Controls selected by random-digit dialing are matched to each case by age (±5 years), race, and sex. Data is collected through structured interview by study nurses within 90 days of onset; history of high cholesterol is determined by self-report. Hemorrhage location is classified by physician review as either lobar or non-lobar (deep gray matter, brainstem, cerebellum, or pure intraventricular hemorrhage).
Results:
Of the 2,850 ICH cases identified from 5/98 to 11/06, 995 died prior to nurse contact, 396 declined interview, and 784 were not contacted within 90 days. To restrict the analysis to spontaneous, first-ever ICH cases among whites and blacks, 78 subjects were excluded due to prior ICH, structural cause of ICH, or “other” race. The remaining 597 subjects underwent direct interview and were matched to 1-3 controls base on ethnicity, age and gender. Frequency of high cholesterol history was 34% for all ICH cases vs. 43% in controls; 40% for lobar cases vs. 43% in their controls; and 31% in non-lobar cases vs. 42% in their controls. Multivariable logistic regression, controlling for hypertension, warfarin use, first-degree relative with ICH, education level, prior ischemic stroke, and Apolipoprotein E genotype, revealed odds ratios and 95% confidence intervals for high cholesterol of 0.57 (0.45-0.72) for all ICH, 0.45 (0.34-0.61) for non-lobar ICH, and 0.85 (0.57-1.26) for lobar ICH.
Conclusions:
High cholesterol is associated with a lower risk of ICH, and this appears to be driven primarily by its association with non-lobar ICHs. This novel finding suggests that hypercholesterolemia may be associated with reduced risk of hypertensive ICH.
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Namjou B, Choi CB, Harley ITW, Alarcón-Riquelme ME, Kelly JA, Glenn SB, Ojwang JO, Adler A, Kim K, Gallant CJ, Boackle SA, Criswell LA, Kimberly RP, Brown EE, Edberg J, Alarcón GS, Stevens AM, Jacob CO, Gilkeson GS, Kamen DL, Tsao BP, Anaya JM, Kim EM, Park SY, Sung YK, Guthridge JM, Merrill JT, Petri M, Ramsey-Goldman R, Vilá LM, Niewold TB, Martin J, Pons-Estel BA, Vyse TJ, Freedman BI, Moser KL, Gaffney PM, Williams AH, Comeau ME, Reveille JD, Kang C, James JA, Scofield RH, Langefeld CD, Kaufman KM, Harley JB, Bae SC. Evaluation of TRAF6 in a large multiancestral lupus cohort. ACTA ACUST UNITED AC 2012; 64:1960-9. [PMID: 22231568 DOI: 10.1002/art.34361] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease with significant immune system aberrations resulting from complex heritable genetics as well as environmental factors. We undertook to study the role of TRAF6 as a candidate gene for SLE, since it plays a major role in several signaling pathways that are important for immunity and organ development. METHODS Fifteen single-nucleotide polymorphisms (SNPs) across TRAF6 were evaluated in 7,490 SLE patients and 6,780 control subjects from different ancestries. Population-based case-control association analyses and meta-analyses were performed. P values, false discovery rate q values, and odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated. RESULTS Evidence of associations was detected in multiple SNPs. The best overall P values were obtained for SNPs rs5030437 and rs4755453 (P = 7.85 × 10(-5) and P = 4.73 × 10(-5) , respectively) without significant heterogeneity among populations (P = 0.67 and P = 0.50, respectively, in Q statistic). In addition, SNP rs540386, which was previously reported to be associated with rheumatoid arthritis (RA), was found to be in linkage disequilibrium with these 2 SNPs (r(2) = 0.95) and demonstrated evidence of association with SLE in the same direction (meta-analysis P = 9.15 × 10(-4) , OR 0.89 [95% CI 0.83-0.95]). The presence of thrombocytopenia improved the overall results in different populations (meta-analysis P = 1.99 × 10(-6) , OR 0.57 [95% CI 0.45-0.72], for rs5030470). Finally, evidence of family-based association in 34 African American pedigrees with the presence of thrombocytopenia was detected in 1 available SNP (rs5030437) with a Z score magnitude of 2.28 (P = 0.02) under a dominant model. CONCLUSION Our data indicate the presence of association of TRAF6 with SLE, consistent with the previous report of association with RA. These data provide further support for the involvement of TRAF6 in the pathogenesis of autoimmunity.
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Affiliation(s)
- Bahram Namjou
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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