1
|
Stevelink R, Campbell C, Chen S, Abou-Khalil B, Adesoji OM, Afawi Z, Amadori E, Anderson A, Anderson J, Andrade DM, Annesi G, Auce P, Avbersek A, Bahlo M, Baker MD, Balagura G, Balestrini S, Barba C, Barboza K, Bartolomei F, Bast T, Baum L, Baumgartner T, Baykan B, Bebek N, Becker AJ, Becker F, Bennett CA, Berghuis B, Berkovic SF, Beydoun A, Bianchini C, Bisulli F, Blatt I, Bobbili DR, Borggraefe I, Bosselmann C, Braatz V, Bradfield JP, Brockmann K, Brody LC, Buono RJ, Busch RM, Caglayan H, Campbell E, Canafoglia L, Canavati C, Cascino GD, Castellotti B, Catarino CB, Cavalleri GL, Cerrato F, Chassoux F, Cherny SS, Cheung CL, Chinthapalli K, Chou IJ, Chung SK, Churchhouse C, Clark PO, Cole AJ, Compston A, Coppola A, Cosico M, Cossette P, Craig JJ, Cusick C, Daly MJ, Davis LK, de Haan GJ, Delanty N, Depondt C, Derambure P, Devinsky O, Di Vito L, Dlugos DJ, Doccini V, Doherty CP, El-Naggar H, Elger CE, Ellis CA, Eriksson JG, Faucon A, Feng YCA, Ferguson L, Ferraro TN, Ferri L, Feucht M, Fitzgerald M, Fonferko-Shadrach B, Fortunato F, Franceschetti S, Franke A, French JA, Freri E, Gagliardi M, Gambardella A, Geller EB, Giangregorio T, Gjerstad L, Glauser T, Goldberg E, Goldman A, Granata T, Greenberg DA, Guerrini R, Gupta N, Haas KF, Hakonarson H, Hallmann K, Hassanin E, Hegde M, Heinzen EL, Helbig I, Hengsbach C, Heyne HO, Hirose S, Hirsch E, Hjalgrim H, Howrigan DP, Hucks D, Hung PC, Iacomino M, Imbach LL, Inoue Y, Ishii A, Jamnadas-Khoda J, Jehi L, Johnson MR, Kälviäinen R, Kamatani Y, Kanaan M, Kanai M, Kantanen AM, Kara B, Kariuki SM, Kasperavičiūte D, Kasteleijn-Nolst Trenite D, Kato M, Kegele J, Kesim Y, Khoueiry-Zgheib N, King C, Kirsch HE, Klein KM, Kluger G, Knake S, Knowlton RC, Koeleman BPC, Korczyn AD, Koupparis A, Kousiappa I, Krause R, Krenn M, Krestel H, Krey I, Kunz WS, Kurki MI, Kurlemann G, Kuzniecky R, Kwan P, Labate A, Lacey A, Lal D, Landoulsi Z, Lau YL, Lauxmann S, Leech SL, Lehesjoki AE, Lemke JR, Lerche H, Lesca G, Leu C, Lewin N, Lewis-Smith D, Li GHY, Li QS, Licchetta L, Lin KL, Lindhout D, Linnankivi T, Lopes-Cendes I, Lowenstein DH, Lui CHT, Madia F, Magnusson S, Marson AG, May P, McGraw CM, Mei D, Mills JL, Minardi R, Mirza N, Møller RS, Molloy AM, Montomoli M, Mostacci B, Muccioli L, Muhle H, Müller-Schlüter K, Najm IM, Nasreddine W, Neale BM, Neubauer B, Newton CRJC, Nöthen MM, Nothnagel M, Nürnberg P, O’Brien TJ, Okada Y, Ólafsson E, Oliver KL, Özkara C, Palotie A, Pangilinan F, Papacostas SS, Parrini E, Pato CN, Pato MT, Pendziwiat M, Petrovski S, Pickrell WO, Pinsky R, Pippucci T, Poduri A, Pondrelli F, Powell RHW, Privitera M, Rademacher A, Radtke R, Ragona F, Rau S, Rees MI, Regan BM, Reif PS, Rhelms S, Riva A, Rosenow F, Ryvlin P, Saarela A, Sadleir LG, Sander JW, Sander T, Scala M, Scattergood T, Schachter SC, Schankin CJ, Scheffer IE, Schmitz B, Schoch S, Schubert-Bast S, Schulze-Bonhage A, Scudieri P, Sham P, Sheidley BR, Shih JJ, Sills GJ, Sisodiya SM, Smith MC, Smith PE, Sonsma ACM, Speed D, Sperling MR, Stefansson H, Stefansson K, Steinhoff BJ, Stephani U, Stewart WC, Stipa C, Striano P, Stroink H, Strzelczyk A, Surges R, Suzuki T, Tan KM, Taneja RS, Tanteles GA, Taubøll E, Thio LL, Thomas GN, Thomas RH, Timonen O, Tinuper P, Todaro M, Topaloğlu P, Tozzi R, Tsai MH, Tumiene B, Turkdogan D, Unnsteinsdóttir U, Utkus A, Vaidiswaran P, Valton L, van Baalen A, Vetro A, Vining EPG, Visscher F, von Brauchitsch S, von Wrede R, Wagner RG, Weber YG, Weckhuysen S, Weisenberg J, Weller M, Widdess-Walsh P, Wolff M, Wolking S, Wu D, Yamakawa K, Yang W, Yapıcı Z, Yücesan E, Zagaglia S, Zahnert F, Zara F, Zhou W, Zimprich F, Zsurka G, Zulfiqar Ali Q. GWAS meta-analysis of over 29,000 people with epilepsy identifies 26 risk loci and subtype-specific genetic architecture. Nat Genet 2023; 55:1471-1482. [PMID: 37653029 PMCID: PMC10484785 DOI: 10.1038/s41588-023-01485-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/21/2023] [Indexed: 09/02/2023]
Abstract
Epilepsy is a highly heritable disorder affecting over 50 million people worldwide, of which about one-third are resistant to current treatments. Here we report a multi-ancestry genome-wide association study including 29,944 cases, stratified into three broad categories and seven subtypes of epilepsy, and 52,538 controls. We identify 26 genome-wide significant loci, 19 of which are specific to genetic generalized epilepsy (GGE). We implicate 29 likely causal genes underlying these 26 loci. SNP-based heritability analyses show that common variants explain between 39.6% and 90% of genetic risk for GGE and its subtypes. Subtype analysis revealed markedly different genetic architectures between focal and generalized epilepsies. Gene-set analyses of GGE signals implicate synaptic processes in both excitatory and inhibitory neurons in the brain. Prioritized candidate genes overlap with monogenic epilepsy genes and with targets of current antiseizure medications. Finally, we leverage our results to identify alternate drugs with predicted efficacy if repurposed for epilepsy treatment.
Collapse
|
2
|
Motelow JE, Povysil G, Dhindsa RS, Stanley KE, Allen AS, Feng YCA, Howrigan DP, Abbott LE, Tashman K, Cerrato F, Cusick C, Singh T, Heyne H, Byrnes AE, Churchhouse C, Watts N, Solomonson M, Lal D, Gupta N, Neale BM, Cavalleri GL, Cossette P, Cotsapas C, De Jonghe P, Dixon-Salazar T, Guerrini R, Hakonarson H, Heinzen EL, Helbig I, Kwan P, Marson AG, Petrovski S, Kamalakaran S, Sisodiya SM, Stewart R, Weckhuysen S, Depondt C, Dlugos DJ, Scheffer IE, Striano P, Freyer C, Krause R, May P, McKenna K, Regan BM, Bennett CA, Leu C, Leech SL, O’Brien TJ, Todaro M, Stamberger H, Andrade DM, Ali QZ, Sadoway TR, Krestel H, Schaller A, Papacostas SS, Kousiappa I, Tanteles GA, Christou Y, Štěrbová K, Vlčková M, Sedláčková L, Laššuthová P, Klein KM, Rosenow F, Reif PS, Knake S, Neubauer BA, Zimprich F, Feucht M, Reinthaler EM, Kunz WS, Zsurka G, Surges R, Baumgartner T, von Wrede R, Pendziwiat M, Muhle H, Rademacher A, van Baalen A, von Spiczak S, Stephani U, Afawi Z, Korczyn AD, Kanaan M, Canavati C, Kurlemann G, Müller-Schlüter K, Kluger G, Häusler M, Blatt I, Lemke JR, Krey I, Weber YG, Wolking S, Becker F, Lauxmann S, Boßelmann C, Kegele J, Hengsbach C, Rau S, Steinhoff BJ, Schulze-Bonhage A, Borggräfe I, Schankin CJ, Schubert-Bast S, Schreiber H, Mayer T, Korinthenberg R, Brockmann K, Wolff M, Dennig D, Madeleyn R, Kälviäinen R, Saarela A, Timonen O, Linnankivi T, Lehesjoki AE, Rheims S, Lesca G, Ryvlin P, Maillard L, Valton L, Derambure P, Bartolomei F, Hirsch E, Michel V, Chassoux F, Rees MI, Chung SK, Pickrell WO, Powell R, Baker MD, Fonferko-Shadrach B, Lawthom C, Anderson J, Schneider N, Balestrini S, Zagaglia S, Braatz V, Johnson MR, Auce P, Sills GJ, Baum LW, Sham PC, Cherny SS, Lui CH, Delanty N, Doherty CP, Shukralla A, El-Naggar H, Widdess-Walsh P, Barišić N, Canafoglia L, Franceschetti S, Castellotti B, Granata T, Ragona F, Zara F, Iacomino M, Riva A, Madia F, Vari MS, Salpietro V, Scala M, Mancardi MM, Nobili L, Amadori E, Giacomini T, Bisulli F, Pippucci T, Licchetta L, Minardi R, Tinuper P, Muccioli L, Mostacci B, Gambardella A, Labate A, Annesi G, Manna L, Gagliardi M, Parrini E, Mei D, Vetro A, Bianchini C, Montomoli M, Doccini V, Barba C, Hirose S, Ishii A, Suzuki T, Inoue Y, Yamakawa K, Beydoun A, Nasreddine W, Khoueiry Zgheib N, Tumiene B, Utkus A, Sadleir LG, King C, Caglayan SH, Arslan M, Yapıcı Z, Topaloglu P, Kara B, Yis U, Turkdogan D, Gundogdu-Eken A, Bebek N, Uğur-İşeri S, Baykan B, Salman B, Haryanyan G, Yücesan E, Kesim Y, Özkara Ç, Tsai MH, Ho CJ, Lin CH, Lin KL, Chou IJ, Poduri A, Shiedley BR, Shain C, Noebels JL, Goldman A, Busch RM, Jehi L, Najm IM, Ferguson L, Khoury J, Glauser TA, Clark PO, Buono RJ, Ferraro TN, Sperling MR, Lo W, Privitera M, French JA, Schachter S, Kuzniecky RI, Devinsky O, Hegde M, Greenberg DA, Ellis CA, Goldberg E, Helbig KL, Cosico M, Vaidiswaran P, Fitch E, Berkovic SF, Lerche H, Lowenstein DH, Goldstein DB. Sub-genic intolerance, ClinVar, and the epilepsies: A whole-exome sequencing study of 29,165 individuals. Am J Hum Genet 2021; 108:2024. [PMID: 34626584 DOI: 10.1016/j.ajhg.2021.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
3
|
Wolking S, Schulz H, Nies AT, McCormack M, Schaeffeler E, Auce P, Avbersek A, Becker F, Klein KM, Krenn M, Møller RS, Nikanorova M, Weckhuysen S, Consortium E, Cavalleri GL, Delanty N, Depondt C, Johnson MR, Koeleman BPC, Kunz WS, Marson AG, Sander JW, Sills GJ, Striano P, Zara F, Zimprich F, Weber YG, Krause R, Sisodiya S, Schwab M, Sander T, Lerche H. Pharmacoresponse in genetic generalized epilepsy: a genome-wide association study. Pharmacogenomics 2020; 21:325-335. [DOI: 10.2217/pgs-2019-0179] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Aim: Pharmacoresistance is a major burden in epilepsy treatment. We aimed to identify genetic biomarkers in response to specific antiepileptic drugs (AEDs) in genetic generalized epilepsies (GGE). Materials & methods: We conducted a genome-wide association study (GWAS) of 3.3 million autosomal SNPs in 893 European subjects with GGE – responsive or nonresponsive to lamotrigine, levetiracetam and valproic acid. Results: Our GWAS of AED response revealed suggestive evidence for association at 29 genomic loci (p <10-5) but no significant association reflecting its limited power. The suggestive associations highlight candidate genes that are implicated in epileptogenesis and neurodevelopment. Conclusion: This first GWAS of AED response in GGE provides a comprehensive reference of SNP associations for hypothesis-driven candidate gene analyses in upcoming pharmacogenetic studies.
Collapse
Affiliation(s)
- Stefan Wolking
- Department of Neurology & Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
- Department of Neurosciences, CHUM Research Center, University of Montreal, Montreal, H2X 0A9, Canada
| | - Herbert Schulz
- Cologne Center for Genomics, University of Cologne, 50931 Cologne, Germany
| | - Anne T Nies
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, 70376 Stuttgart, Germany
- University of Tübingen, 72076 Tübingen, Germany
| | - Mark McCormack
- Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, D02 YN77, Ireland
| | - Elke Schaeffeler
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, 70376 Stuttgart, Germany
- University of Tübingen, 72076 Tübingen, Germany
| | - Pauls Auce
- Walton Centre NHS Foundation Trust, Liverpool, L33 4YD, UK
| | - Andreja Avbersek
- Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, London & Chalfont Centre for Epilepsy, London, SL9 0RJ, UK
| | - Felicitas Becker
- Department of Neurology & Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
| | - Karl M Klein
- Epilepsy Center Frankfurt Rhine-Main, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt, Germany
| | - Martin Krenn
- Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria
| | - Rikke S Møller
- Danish Epilepsy Centre – Filadelfia, 4293 Dianalund, Denmark
- Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
| | | | - Sarah Weckhuysen
- Neurogenetics Group, Center for Molecular Neurology, VIB-University of Antwerp, 2650 Edegem, Belgium
- Laboratory of Neurogenetics, Institute Born-Bunge, University of Antwerp, 2650 Edegem, Belgium
- Department of Neurology, Antwerp University Hospital, 2650 Edegem, Belgium
| | | | - Gianpiero L Cavalleri
- Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, D02 YN77, Ireland
- Division of Brain Sciences, Imperial College Faculty of Medicine, London, SW2 2AZ, UK
| | - Norman Delanty
- Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, D02 YN77, Ireland
- Division of Neurology, Beaumont Hospital, Dublin 9, Ireland
- The FutureNeuro Research Centre, Royal College of Surgeons in Ireland, Dublin, D02 YN77, Ireland
| | - Chantal Depondt
- Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles, 1070 Brussels, Belgium
| | - Michael R Johnson
- Division of Brain Sciences, Imperial College Faculty of Medicine, London, SW2 2AZ, UK
| | - Bobby PC Koeleman
- Department of Genetics, University Medical Center Utrecht, 3584 Utrecht, The Netherlands
| | - Wolfram S Kunz
- Institute of Experimental Epileptology & Cognition Research & Department of Epileptology, University of Bonn, 53127 Bonn, Germany
| | - Anthony G Marson
- Department of Molecular & Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, L69 7ZB, UK
| | - Josemir W Sander
- Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, London & Chalfont Centre for Epilepsy, London, SL9 0RJ, UK
- Stichting Epilepsie Instellingen Nederland (SEIN), 2103 Heemstede, The Netherlands
| | - Graeme J Sills
- Department of Molecular & Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, L69 7ZB, UK
| | - Pasquale Striano
- Pediatric Neurology & Muscular Diseases Unit, IRCCS ‘G. Gaslini’ Institute, 16147 Genova, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal & Child Health, University of Genova, 16147 Genova, Italy
| | - Federico Zara
- Laboratory of Neurogenetics and Neuroscience, IRCCS ‘G. Gaslini’ Institute, 16147 Genova, Italy
| | - Fritz Zimprich
- Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria
| | - Yvonne G Weber
- Department of Neurology & Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
| | - Roland Krause
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, 4362 Esch-sur-Alzette, Luxembourg
| | - Sanjay Sisodiya
- Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, London & Chalfont Centre for Epilepsy, London, SL9 0RJ, UK
| | - Matthias Schwab
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, 70376 Stuttgart, Germany
- Department of Clinical Pharmacology, University Hospital Tübingen, 72076 Tübingen, Germany
- Department of Pharmacy & Biochemistry, University Tübingen, 72076 Tübingen, Germany
| | - Thomas Sander
- Cologne Center for Genomics, University of Cologne, 50931 Cologne, Germany
| | - Holger Lerche
- Department of Neurology & Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
| |
Collapse
|
4
|
Wolking S, Moreau C, Nies AT, Schaeffeler E, McCormack M, Auce P, Avbersek A, Becker F, Krenn M, Møller RS, Nikanorova M, Weber YG, Weckhuysen S, Cavalleri GL, Delanty N, Depondt C, Johnson MR, Koeleman BP, Kunz WS, Marson AG, Sander JW, Sills GJ, Striano P, Zara F, Zimprich F, Schwab M, Krause R, Sisodiya SM, Cossette P, Girard SL, Lerche H. Testing association of rare genetic variants with resistance to three common antiseizure medications. Epilepsia 2020; 61:657-666. [DOI: 10.1111/epi.16467] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/13/2020] [Accepted: 02/13/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Stefan Wolking
- Neurology and Epileptology Hertie Institute for Clinical Brain Research University of Tübingen Tübingen Germany
- Department of Neurosciences, Research Center of the University of Montreal Hospital Center (CRCHUM) University of MontrealMontreal Canada
| | - Claudia Moreau
- Department of Applied Sciences University of Quebec in Chicoutimi Saguenay Canada
| | - Anne T. Nies
- Dr. Margarete Fischer‐Bosch Institute of Clinical Pharmacology Stuttgart Germany
- University of Tübingen Tübingen Germany
| | - Elke Schaeffeler
- Dr. Margarete Fischer‐Bosch Institute of Clinical Pharmacology Stuttgart Germany
- University of Tübingen Tübingen Germany
| | - Mark McCormack
- Molecular and Cellular Therapeutics Royal College of Surgeons in Ireland Dublin Ireland
| | - Pauls Auce
- Walton Centre NHS Foundation Trust Liverpool UK
| | - Andreja Avbersek
- Department of Clinical and Experimental Epilepsy UCL Queen Square Institute of Neurology London UK
- Chalfont Centre for Epilepsy London UK
| | - Felicitas Becker
- Neurology and Epileptology Hertie Institute for Clinical Brain Research University of Tübingen Tübingen Germany
| | - Martin Krenn
- Department of Neurology Medical University of Vienna Vienna Austria
| | - Rikke S. Møller
- Danish Epilepsy Centre ‐ Filadelfia Dianalund Denmark
- Department of Regional Health Research University of Southern Denmark Odense Denmark
| | - Marina Nikanorova
- Department of Regional Health Research University of Southern Denmark Odense Denmark
| | - Yvonne G. Weber
- Neurology and Epileptology Hertie Institute for Clinical Brain Research University of Tübingen Tübingen Germany
- Department of Epileptology and Neurology University of Aachen Aachen Germany
| | - Sarah Weckhuysen
- Neurogenetics Group VIB‐UAntwerp Center for Molecular NeurologyAntwerp Belgium
- Laboratory of Neurogenetics Institute Born‐Bunge University of Antwerp Antwerp Belgium
- Department of Neurology Antwerp University Hospital Antwerp Belgium
| | - Gianpiero L. Cavalleri
- Molecular and Cellular Therapeutics Royal College of Surgeons in Ireland Dublin Ireland
- Division of Brain Sciences Imperial College Faculty of Medicine London UK
| | - Norman Delanty
- Molecular and Cellular Therapeutics Royal College of Surgeons in Ireland Dublin Ireland
- Division of Neurology Beaumont Hospital Dublin Ireland
- The FutureNeuro Research Centre Royal College of Surgeons in Ireland Dublin Ireland
| | - Chantal Depondt
- Department of Neurology Hôpital Erasme Université Libre de Bruxelles Brussels Belgium
| | - Michael R. Johnson
- Division of Brain Sciences Imperial College Faculty of Medicine London UK
| | - Bobby P.C. Koeleman
- Department of Genetics University Medical Center Utrecht Utrecht Netherlands
| | - Wolfram S. Kunz
- Institute of Experimental Epileptology and Cognition Research and Department of Epileptology University of Bonn Bonn Germany
| | - Anthony G. Marson
- Department of Molecular and Clinical Pharmacology Institute of Translational Medicine University of Liverpool Liverpool UK
| | - Josemir W. Sander
- Department of Clinical and Experimental Epilepsy UCL Queen Square Institute of Neurology London UK
- Chalfont Centre for Epilepsy London UK
- Stichting Epilepsie Instellingen Nederland (SEIN) Heemstede Netherlands
| | - Graeme J. Sills
- Department of Molecular and Clinical Pharmacology Institute of Translational Medicine University of Liverpool Liverpool UK
| | - Pasquale Striano
- IRCCS "G. Gaslini" Institute Genova Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health University of Genova Genova Italy
| | - Federico Zara
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health University of Genova Genova Italy
| | - Fritz Zimprich
- Department of Neurology Medical University of Vienna Vienna Austria
| | - Matthias Schwab
- Dr. Margarete Fischer‐Bosch Institute of Clinical Pharmacology Stuttgart Germany
- University of Tübingen Tübingen Germany
- Department of Clinical Pharmacology, Pharmacy and Biochemistry University Tübingen Tübingen Germany
| | - Roland Krause
- Luxembourg Centre for Systems Biomedicine University of Luxembourg Esch‐sur‐Alzette Luxembourg
| | - Sanjay M. Sisodiya
- Department of Clinical and Experimental Epilepsy UCL Queen Square Institute of Neurology London UK
- Chalfont Centre for Epilepsy London UK
| | - Patrick Cossette
- Department of Neurosciences, Research Center of the University of Montreal Hospital Center (CRCHUM) University of MontrealMontreal Canada
| | - Simon L. Girard
- Department of Applied Sciences University of Quebec in Chicoutimi Saguenay Canada
| | - Holger Lerche
- Neurology and Epileptology Hertie Institute for Clinical Brain Research University of Tübingen Tübingen Germany
| | | |
Collapse
|
5
|
Heavin SB, McCormack M, Wolking S, Slattery L, Walley N, Avbersek A, Novy J, Sinha SR, Radtke R, Doherty C, Auce P, Craig J, Johnson MR, Koeleman BPC, Krause R, Kunz WS, Marson AG, O'Brien TJ, Sander JW, Sills GJ, Stefansson H, Striano P, Zara F, Depondt C, Sisodiya S, Goldstein D, Lerche H, Cavalleri GL, Delanty N. Genomic and clinical predictors of lacosamide response in refractory epilepsies. Epilepsia Open 2019; 4:563-571. [PMID: 31819912 PMCID: PMC6885661 DOI: 10.1002/epi4.12360] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 08/21/2019] [Accepted: 08/29/2019] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Clinical and genetic predictors of response to antiepileptic drugs (AEDs) are largely unknown. We examined predictors of lacosamide response in a real-world clinical setting. METHODS We tested the association of clinical predictors with treatment response using regression modeling in a cohort of people with refractory epilepsy. Genetic assessment for lacosamide response was conducted via genome-wide association studies and exome studies, comprising 281 candidate genes. RESULTS Most patients (479/483) were treated with LCM in addition to other AEDs. Our results corroborate previous findings that patients with refractory genetic generalized epilepsy (GGE) may respond to treatment with LCM. No clear clinical predictors were identified. We then compared 73 lacosamide responders, defined as those experiencing greater than 75% seizure reduction or seizure freedom, to 495 nonresponders (<25% seizure reduction). No variants reached the genome-wide significance threshold in our case-control analysis. SIGNIFICANCE No genetic predictor of lacosamide response was identified. Patients with refractory GGE might benefit from treatment with lacosamide.
Collapse
Affiliation(s)
- Sinéad B. Heavin
- School of Pharmacy and Biomolecular SciencesRoyal College of SurgeonsDublinIreland
| | - Mark McCormack
- School of Pharmacy and Biomolecular SciencesRoyal College of SurgeonsDublinIreland
- Luxembourg Centre for Systems BiomedicineUniversity of LuxembourgEsch‐sur‐AlzetteLuxembourg
| | - Stefan Wolking
- Department of Neurology and EpileptologyHertie Institute for Clinical Brain ResearchUniversity of TübingenTübingenGermany
| | - Lisa Slattery
- School of Pharmacy and Biomolecular SciencesRoyal College of SurgeonsDublinIreland
| | - Nicole Walley
- Centre for Human Genome VariationDuke UniversityDurhamNCUSA
| | - Andreja Avbersek
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- Chalfont Centre for EpilepsyBuckinghamshireUK
| | - Jan Novy
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- Chalfont Centre for EpilepsyBuckinghamshireUK
| | | | - Rod Radtke
- Centre for Human Genome VariationDuke UniversityDurhamNCUSA
| | - Colin Doherty
- School of MedicineTrinity College DublinDublinIreland
- Department of NeurologySt James's HospitalDublinIreland
| | - Pauls Auce
- Department of Molecular and Clinical PharmacologyInstitute of Translational MedicineUniversity of LiverpoolLiverpoolUK
| | - John Craig
- Department of NeurosciencesBelfast Health and Social Care TrustBelfastUK
| | | | - Bobby P. C. Koeleman
- Center of Molecular MedicineUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Roland Krause
- Luxembourg Centre for Systems BiomedicineUniversity of LuxembourgEsch‐sur‐AlzetteLuxembourg
| | - Wolfram S. Kunz
- Institute of Experimental Epileptology and Cognition Research and Department of EpileptologyUniversity of BonnBonnGermany
| | - Anthony G. Marson
- Department of Molecular and Clinical PharmacologyInstitute of Translational MedicineUniversity of LiverpoolLiverpoolUK
| | - Terence J. O'Brien
- The Departments of Neuroscience and NeurologyThe Alfred HospitalMonash UniversityVictoriaAustralia
| | - Josemir W. Sander
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- Chalfont Centre for EpilepsyBuckinghamshireUK
- Stichting Epilepsie Instellingen Nederland (SEIN)HeemstedeThe Netherlands
| | - Graeme J. Sills
- Department of Molecular and Clinical PharmacologyInstitute of Translational MedicineUniversity of LiverpoolLiverpoolUK
| | | | - Pasquale Striano
- Pediatric Neurology and Muscular Diseases UnitDINOGMI‐Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child HealthInstitute "G. Gaslini"University of GenovaGenovaItaly
| | - Federico Zara
- Laboratory of Neurogenetics and NeuroscienceInstitute G. GasliniGenovaItaly
| | | | | | - Chantal Depondt
- Department of NeurologyHôpital ErasmeUniversité Libre de BruxellesBrusselsBelgium
| | - Sanjay Sisodiya
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- Chalfont Centre for EpilepsyBuckinghamshireUK
| | - David Goldstein
- Institute for Genomic MedicineColumbia UniversityNew YorkNYUSA
| | - Holger Lerche
- Department of Neurology and EpileptologyHertie Institute for Clinical Brain ResearchUniversity of TübingenTübingenGermany
| | - Gianpiero L. Cavalleri
- School of Pharmacy and Biomolecular SciencesRoyal College of SurgeonsDublinIreland
- Division of Brain SciencesImperial College Faculty of MedicineLondonUK
| | - Norman Delanty
- School of Pharmacy and Biomolecular SciencesRoyal College of SurgeonsDublinIreland
- The FutureNeuro SFI Research CentreRoyal College of Surgeons in IrelandDublinIreland
- Division of NeurologyBeaumont HospitalDublinIreland
| |
Collapse
|
6
|
Silvennoinen K, de Lange N, Zagaglia S, Balestrini S, Androsova G, Wassenaar M, Auce P, Avbersek A, Becker F, Berghuis B, Campbell E, Coppola A, Francis B, Wolking S, Cavalleri GL, Craig J, Delanty N, Johnson MR, Koeleman BPC, Kunz WS, Lerche H, Marson AG, O’Brien TJ, Sander JW, Sills GJ, Striano P, Zara F, van der Palen J, Krause R, Depondt C, Sisodiya SM. Comparative effectiveness of antiepileptic drugs in juvenile myoclonic epilepsy. Epilepsia Open 2019; 4:420-430. [PMID: 31440723 PMCID: PMC6698679 DOI: 10.1002/epi4.12349] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 06/11/2019] [Accepted: 06/22/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To study the effectiveness and tolerability of antiepileptic drugs (AEDs) commonly used in juvenile myoclonic epilepsy (JME). METHODS People with JME were identified from a large database of individuals with epilepsy, which includes detailed retrospective information on AED use. We assessed secular changes in AED use and calculated rates of response (12-month seizure freedom) and adverse drug reactions (ADRs) for the five most common AEDs. Retention was modeled with a Cox proportional hazards model. We compared valproate use between males and females. RESULTS We included 305 people with 688 AED trials of valproate, lamotrigine, levetiracetam, carbamazepine, and topiramate. Valproate and carbamazepine were most often prescribed as the first AED. The response rate to valproate was highest among the five AEDs (42.7%), and significantly higher than response rates for lamotrigine, carbamazepine, and topiramate; the difference to the response rate to levetiracetam (37.1%) was not significant. The rates of ADRs were highest for topiramate (45.5%) and valproate (37.5%). Commonest ADRs included weight change, lethargy, and tremor. In the Cox proportional hazards model, later start year (1.10 [1.08-1.13], P < 0.001) and female sex (1.41 [1.07-1.85], P = 0.02) were associated with shorter trial duration. Valproate was associated with the longest treatment duration; trials with carbamazepine and topiramate were significantly shorter (HR [CI]: 3.29 [2.15-5.02], P < 0.001 and 1.93 [1.31-2.86], P < 0.001). The relative frequency of valproate trials shows a decreasing trend since 2003 while there is an increasing trend for levetiracetam. Fewer females than males received valproate (76.2% vs 92.6%, P = 0.001). SIGNIFICANCE In people with JME, valproate is an effective AED; levetiracetam emerged as an alternative. Valproate is now contraindicated in women of childbearing potential without special precautions. With appropriate selection and safeguards in place, valproate should remain available as a therapy, including as an alternative for women of childbearing potential whose seizures are resistant to other treatments.
Collapse
Affiliation(s)
- Katri Silvennoinen
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- Chalfont Centre for EpilepsyChalfont St. PeterUK
| | - Nikola de Lange
- Luxembourg Centre for Systems BiomedicineUniversity of LuxembourgBelvauxLuxembourg
| | - Sara Zagaglia
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- Chalfont Centre for EpilepsyChalfont St. PeterUK
- Department of Experimental and Clinical MedicinePolytechnic University of MarcheAnconaItaly
| | - Simona Balestrini
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- Chalfont Centre for EpilepsyChalfont St. PeterUK
- Department of Experimental and Clinical MedicinePolytechnic University of MarcheAnconaItaly
| | - Ganna Androsova
- Luxembourg Centre for Systems BiomedicineUniversity of LuxembourgBelvauxLuxembourg
| | - Merel Wassenaar
- Stichting Epilepsie Instellingen Nederland (SEIN)HeemstedeThe Netherlands
| | - Pauls Auce
- Department of Molecular and Clinical Pharmacology, Institute of Translational MedicineUniversity of LiverpoolLiverpoolUK
- The Walton Centre NHS Foundation TrustLiverpoolUK
| | - Andreja Avbersek
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
| | - Felicitas Becker
- Hertie Institute for Clinical Brain ResearchUniversity of TübingenTübingenGermany
| | - Bianca Berghuis
- Stichting Epilepsie Instellingen Nederland (SEIN)HeemstedeThe Netherlands
| | | | - Antonietta Coppola
- Pediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child HealthUniversity of GenoaGenoaItaly
- Department of Neuroscience, Reproductive and Odontostomatological SciencesFederico II UniversityNaplesItaly
| | - Ben Francis
- Department of BiostatisticsUniversity of LiverpoolLiverpoolUK
| | - Stefan Wolking
- Hertie Institute for Clinical Brain ResearchUniversity of TübingenTübingenGermany
| | | | - John Craig
- Belfast Health and Social Care TrustBelfastUK
| | - Norman Delanty
- Molecular and Cellular TherapeuticsRoyal College of Surgeons in IrelandDublinIreland
- Department of NeurologyBeaumont HospitalDublinIreland
| | | | | | | | - Holger Lerche
- Hertie Institute for Clinical Brain ResearchUniversity of TübingenTübingenGermany
| | - Anthony G. Marson
- Department of Molecular and Clinical Pharmacology, Institute of Translational MedicineUniversity of LiverpoolLiverpoolUK
- The Walton Centre NHS Foundation TrustLiverpoolUK
| | - Terence J. O’Brien
- Departments of Neuroscience and Neurology, Central Clinical SchoolMonash University, The Alfred HospitalMelbourneVic.Australia
| | - Josemir W. Sander
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- Chalfont Centre for EpilepsyChalfont St. PeterUK
- Stichting Epilepsie Instellingen Nederland (SEIN)HeemstedeThe Netherlands
| | - Graeme J. Sills
- Department of Molecular and Clinical Pharmacology, Institute of Translational MedicineUniversity of LiverpoolLiverpoolUK
| | - Pasquale Striano
- Pediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child HealthUniversity of GenoaGenoaItaly
- Pediatric Neurology and Muscular Diseases UnitIRCCS Istituto G. GasliniGenovaItaly
| | - Federico Zara
- Laboratory of Neurogenetics and NeuroscienceIRCCS Istituto G. GasliniGenovaItaly
| | | | - Roland Krause
- Luxembourg Centre for Systems BiomedicineUniversity of LuxembourgBelvauxLuxembourg
| | - Chantal Depondt
- Department of NeurologyHôpital Erasme, Université Libre de BruxellesBrusselsBelgium
| | - Sanjay M. Sisodiya
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- Chalfont Centre for EpilepsyChalfont St. PeterUK
| |
Collapse
|
7
|
Feng YCA, Howrigan DP, Abbott LE, Tashman K, Cerrato F, Singh T, Heyne H, Byrnes A, Churchhouse C, Watts N, Solomonson M, Lal D, Heinzen EL, Dhindsa RS, Stanley KE, Cavalleri GL, Hakonarson H, Helbig I, Krause R, May P, Weckhuysen S, Petrovski S, Kamalakaran S, Sisodiya SM, Cossette P, Cotsapas C, De Jonghe P, Dixon-Salazar T, Guerrini R, Kwan P, Marson AG, Stewart R, Depondt C, Dlugos DJ, Scheffer IE, Striano P, Freyer C, McKenna K, Regan BM, Bellows ST, Leu C, Bennett CA, Johns EM, Macdonald A, Shilling H, Burgess R, Weckhuysen D, Bahlo M, O’Brien TJ, Todaro M, Stamberger H, Andrade DM, Sadoway TR, Mo K, Krestel H, Gallati S, Papacostas SS, Kousiappa I, Tanteles GA, Štěrbová K, Vlčková M, Sedláčková L, Laššuthová P, Klein KM, Rosenow F, Reif PS, Knake S, Kunz WS, Zsurka G, Elger CE, Bauer J, Rademacher M, Pendziwiat M, Muhle H, Rademacher A, van Baalen A, von Spiczak S, Stephani U, Afawi Z, Korczyn AD, Kanaan M, Canavati C, Kurlemann G, Müller-Schlüter K, Kluger G, Häusler M, Blatt I, Lemke JR, Krey I, Weber YG, Wolking S, Becker F, Hengsbach C, Rau S, Maisch AF, Steinhoff BJ, Schulze-Bonhage A, Schubert-Bast S, Schreiber H, Borggräfe I, Schankin CJ, Mayer T, Korinthenberg R, Brockmann K, Kurlemann G, Dennig D, Madeleyn R, Kälviäinen R, Auvinen P, Saarela A, Linnankivi T, Lehesjoki AE, Rees MI, Chung SK, Pickrell WO, Powell R, Schneider N, Balestrini S, Zagaglia S, Braatz V, Johnson MR, Auce P, Sills GJ, Baum LW, Sham PC, Cherny SS, Lui CH, Barišić N, Delanty N, Doherty CP, Shukralla A, McCormack M, El-Naggar H, Canafoglia L, Franceschetti S, Castellotti B, Granata T, Zara F, Iacomino M, Madia F, Vari MS, Mancardi MM, Salpietro V, Bisulli F, Tinuper P, Licchetta L, Pippucci T, Stipa C, Minardi R, Gambardella A, Labate A, Annesi G, Manna L, Gagliardi M, Parrini E, Mei D, Vetro A, Bianchini C, Montomoli M, Doccini V, Marini C, Suzuki T, Inoue Y, Yamakawa K, Tumiene B, Sadleir LG, King C, Mountier E, Caglayan SH, Arslan M, Yapıcı Z, Yis U, Topaloglu P, Kara B, Turkdogan D, Gundogdu-Eken A, Bebek N, Uğur-İşeri S, Baykan B, Salman B, Haryanyan G, Yücesan E, Kesim Y, Özkara Ç, Poduri A, Shiedley BR, Shain C, Buono RJ, Ferraro TN, Sperling MR, Lo W, Privitera M, French JA, Schachter S, Kuzniecky RI, Devinsky O, Hegde M, Khankhanian P, Helbig KL, Ellis CA, Spalletta G, Piras F, Piras F, Gili T, Ciullo V, Reif A, McQuillin A, Bass N, McIntosh A, Blackwood D, Johnstone M, Palotie A, Pato MT, Pato CN, Bromet EJ, Carvalho CB, Achtyes ED, Azevedo MH, Kotov R, Lehrer DS, Malaspina D, Marder SR, Medeiros H, Morley CP, Perkins DO, Sobell JL, Buckley PF, Macciardi F, Rapaport MH, Knowles JA, Fanous AH, McCarroll SA, Gupta N, Gabriel SB, Daly MJ, Lander ES, Lowenstein DH, Goldstein DB, Lerche H, Berkovic SF, Neale BM. Ultra-Rare Genetic Variation in the Epilepsies: A Whole-Exome Sequencing Study of 17,606 Individuals. Am J Hum Genet 2019; 105:267-282. [PMID: 31327507 PMCID: PMC6698801 DOI: 10.1016/j.ajhg.2019.05.020] [Citation(s) in RCA: 168] [Impact Index Per Article: 33.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 05/29/2019] [Indexed: 12/20/2022] Open
Abstract
Sequencing-based studies have identified novel risk genes associated with severe epilepsies and revealed an excess of rare deleterious variation in less-severe forms of epilepsy. To identify the shared and distinct ultra-rare genetic risk factors for different types of epilepsies, we performed a whole-exome sequencing (WES) analysis of 9,170 epilepsy-affected individuals and 8,436 controls of European ancestry. We focused on three phenotypic groups: severe developmental and epileptic encephalopathies (DEEs), genetic generalized epilepsy (GGE), and non-acquired focal epilepsy (NAFE). We observed that compared to controls, individuals with any type of epilepsy carried an excess of ultra-rare, deleterious variants in constrained genes and in genes previously associated with epilepsy; we saw the strongest enrichment in individuals with DEEs and the least strong in individuals with NAFE. Moreover, we found that inhibitory GABAA receptor genes were enriched for missense variants across all three classes of epilepsy, whereas no enrichment was seen in excitatory receptor genes. The larger gene groups for the GABAergic pathway or cation channels also showed a significant mutational burden in DEEs and GGE. Although no single gene surpassed exome-wide significance among individuals with GGE or NAFE, highly constrained genes and genes encoding ion channels were among the lead associations; such genes included CACNA1G, EEF1A2, and GABRG2 for GGE and LGI1, TRIM3, and GABRG2 for NAFE. Our study, the largest epilepsy WES study to date, confirms a convergence in the genetics of severe and less-severe epilepsies associated with ultra-rare coding variation, and it highlights a ubiquitous role for GABAergic inhibition in epilepsy etiology.
Collapse
|
8
|
Berghuis B, Stapleton C, Sonsma ACM, Hulst J, de Haan G, Lindhout D, Demurtas R, Krause R, Depondt C, Kunz WS, Zara F, Striano P, Craig J, Auce P, Marson AG, Stefansson H, O'Brien TJ, Johnson MR, Sills GJ, Wolking S, Lerche H, Sisodiya SM, Sander JW, Cavalleri GL, Koeleman BPC, McCormack M. A genome-wide association study of sodium levels and drug metabolism in an epilepsy cohort treated with carbamazepine and oxcarbazepine. Epilepsia Open 2019; 4:102-109. [PMID: 30868120 PMCID: PMC6398103 DOI: 10.1002/epi4.12297] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 12/02/2018] [Accepted: 12/06/2018] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To ascertain the clinical and genetic factors contributing to carbamazepine- and oxcarbazepine-induced hyponatremia (COIH), and to carbamazepine (CBZ) metabolism, in a retrospectively collected, cross-sectional cohort of people with epilepsy. METHODS We collected data on serum sodium levels and antiepileptic drug levels in people with epilepsy attending a tertiary epilepsy center while on treatment with CBZ or OXC. We defined hyponatremia as Na+ ≤134 mEq/L. We estimated the CBZ metabolic ratio defined as the log transformation of the ratio of metabolite CBZ-diol to unchanged drug precursor substrate as measured in serum. RESULTS Clinical and genetic data relating to carbamazepine and oxcarbazepine trials were collected in 1141 patients. We did not observe any genome-wide significant associations with sodium level in a linear trend or hyponatremia as a dichotomous trait. Age, sex, number of comedications, phenytoin use, phenobarbital use, and sodium valproate use were significant predictors of CBZ metabolic ratio. No genome-wide significant associations with CBZ metabolic ratio were found. SIGNIFICANCE Although we did not detect a genetic predictor of hyponatremia or CBZ metabolism in our cohort, our findings suggest that the determinants of CBZ metabolism are multifactorial.
Collapse
Affiliation(s)
- Bianca Berghuis
- Stichting Epilepsie Instellingen Nederland (SEIN)ZwolleThe Netherlands
| | - Caragh Stapleton
- Molecular and Cellular TherapeuticsRoyal College of Surgeons in IrelandDublinIreland
| | - Anja C. M. Sonsma
- Department of GeneticsUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Janic Hulst
- Stichting Epilepsie Instellingen Nederland (SEIN)ZwolleThe Netherlands
| | | | - Dick Lindhout
- Stichting Epilepsie Instellingen Nederland (SEIN)ZwolleThe Netherlands
- Department of GeneticsUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Rita Demurtas
- Department of Clinical and Experimental EpilepsyInstitute of NeurologyUniversity College LondonLondonUK
| | - Roland Krause
- Luxembourg Centre for Systems BiomedicineUniversity of LuxembourgEsch‐sur‐AlzetteLuxembourg
| | - Chantal Depondt
- Laboratory of Experimental NeurologyHôpital ErasmeUniversité Libre de BruxellesBrusselsBelgium
| | - Wolfram S. Kunz
- Institute of Experimental Epileptology and Cognition Research and Department of EpileptologyUniversity of BonnBonnGermany
| | - Federico Zara
- Laboratory of Neurogenetics and NeuroscienceInstitute G. GasliniGenovaItaly
| | - Pasquale Striano
- Pediatric Neurology and Muscular Diseases UnitDINOGMI‐Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child HealthUniversity of GenovaInstitute “G. Gaslini”GenovaItaly
| | - John Craig
- Department of NeurosciencesBelfast Health and Social Care TrustBelfastUK
| | - Pauls Auce
- Department of Molecular and Clinical PharmacologyInstitute of Translational MedicineUniversity of LiverpoolLiverpoolUK
| | - Anthony G. Marson
- Department of Molecular and Clinical PharmacologyInstitute of Translational MedicineUniversity of LiverpoolLiverpoolUK
| | | | - Terence J. O'Brien
- The Departments of Medicine and NeurologyThe Melbourne Brain CentreThe University of MelbourneThe Royal Melbourne HospitalMelbourneAustralia
| | | | - Graeme J. Sills
- Department of Molecular and Clinical PharmacologyInstitute of Translational MedicineUniversity of LiverpoolLiverpoolUK
| | - Stefan Wolking
- Department of Neurology and EpileptologyUniversity of TübingenHertie Institute for Clinical Brain ResearchTübingenGermany
| | - Holger Lerche
- Department of Neurology and EpileptologyUniversity of TübingenHertie Institute for Clinical Brain ResearchTübingenGermany
| | - Sanjay M. Sisodiya
- Department of Clinical and Experimental EpilepsyInstitute of NeurologyUniversity College LondonLondonUK
- Chalfont Centre for EpilepsyChalfont St. PeterUK
| | - Josemir W. Sander
- Stichting Epilepsie Instellingen Nederland (SEIN)ZwolleThe Netherlands
- Department of Clinical and Experimental EpilepsyInstitute of NeurologyUniversity College LondonLondonUK
- Chalfont Centre for EpilepsyChalfont St. PeterUK
| | - Gianpiero L. Cavalleri
- Molecular and Cellular TherapeuticsRoyal College of Surgeons in IrelandDublinIreland
- The FutureNeuro Research CentreRoyal College of Surgeons in IrelandDublinIreland
| | | | - Mark McCormack
- Molecular and Cellular TherapeuticsRoyal College of Surgeons in IrelandDublinIreland
- Department of GeneticsUniversity Medical Center UtrechtUtrechtThe Netherlands
| |
Collapse
|
9
|
McCormack M, Gui H, Ingason A, Speed D, Wright GEB, Zhang EJ, Secolin R, Yasuda C, Kwok M, Wolking S, Becker F, Rau S, Avbersek A, Heggeli K, Leu C, Depondt C, Sills GJ, Marson AG, Auce P, Brodie MJ, Francis B, Johnson MR, Koeleman BPC, Striano P, Coppola A, Zara F, Kunz WS, Sander JW, Lerche H, Klein KM, Weckhuysen S, Krenn M, Gudmundsson LJ, Stefánsson K, Krause R, Shear N, Ross CJD, Delanty N, Pirmohamed M, Carleton BC, Cendes F, Lopes-Cendes I, Liao WP, O'Brien TJ, Sisodiya SM, Cherny S, Kwan P, Baum L, Cavalleri GL. Genetic variation in CFH predicts phenytoin-induced maculopapular exanthema in European-descent patients. Neurology 2018; 90:e332-e341. [PMID: 29288229 PMCID: PMC5798660 DOI: 10.1212/wnl.0000000000004853] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [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: 02/27/2017] [Accepted: 10/02/2017] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To characterize, among European and Han Chinese populations, the genetic predictors of maculopapular exanthema (MPE), a cutaneous adverse drug reaction common to antiepileptic drugs. METHODS We conducted a case-control genome-wide association study of autosomal genotypes, including Class I and II human leukocyte antigen (HLA) alleles, in 323 cases and 1,321 drug-tolerant controls from epilepsy cohorts of northern European and Han Chinese descent. Results from each cohort were meta-analyzed. RESULTS We report an association between a rare variant in the complement factor H-related 4 (CFHR4) gene and phenytoin-induced MPE in Europeans (p = 4.5 × 10-11; odds ratio [95% confidence interval] 7 [3.2-16]). This variant is in complete linkage disequilibrium with a missense variant (N1050Y) in the complement factor H (CFH) gene. In addition, our results reinforce the association between HLA-A*31:01 and carbamazepine hypersensitivity. We did not identify significant genetic associations with MPE among Han Chinese patients. CONCLUSIONS The identification of genetic predictors of MPE in CFHR4 and CFH, members of the complement factor H-related protein family, suggest a new link between regulation of the complement system alternative pathway and phenytoin-induced hypersensitivity in European-ancestral patients.
Collapse
Affiliation(s)
- Mark McCormack
- Author affiliations are provided at the end of the article
| | - Hongsheng Gui
- Author affiliations are provided at the end of the article
| | - Andrés Ingason
- Author affiliations are provided at the end of the article
| | - Doug Speed
- Author affiliations are provided at the end of the article
| | | | - Eunice J Zhang
- Author affiliations are provided at the end of the article
| | | | | | - Maxwell Kwok
- Author affiliations are provided at the end of the article
| | - Stefan Wolking
- Author affiliations are provided at the end of the article
| | | | - Sarah Rau
- Author affiliations are provided at the end of the article
| | | | | | - Costin Leu
- Author affiliations are provided at the end of the article
| | | | - Graeme J Sills
- Author affiliations are provided at the end of the article
| | | | - Pauls Auce
- Author affiliations are provided at the end of the article
| | | | - Ben Francis
- Author affiliations are provided at the end of the article
| | | | | | | | | | - Federico Zara
- Author affiliations are provided at the end of the article
| | - Wolfram S Kunz
- Author affiliations are provided at the end of the article
| | | | - Holger Lerche
- Author affiliations are provided at the end of the article
| | | | | | - Martin Krenn
- Author affiliations are provided at the end of the article
| | | | | | - Roland Krause
- Author affiliations are provided at the end of the article
| | - Neil Shear
- Author affiliations are provided at the end of the article
| | - Colin J D Ross
- Author affiliations are provided at the end of the article
| | - Norman Delanty
- Author affiliations are provided at the end of the article
| | | | | | | | | | - Wei-Ping Liao
- Author affiliations are provided at the end of the article
| | | | | | - Stacey Cherny
- Author affiliations are provided at the end of the article
| | - Patrick Kwan
- Author affiliations are provided at the end of the article
| | - Larry Baum
- Author affiliations are provided at the end of the article
| | | |
Collapse
|
10
|
Auce P, Francis B, Langley SR, Jorgensen A, Marson AG, Sills GJ. PO039 Gwas for early remission in newly diagnosed focal epilepsy. J Neurol Psychiatry 2017. [DOI: 10.1136/jnnp-2017-abn.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
11
|
Androsova G, Krause R, Borghei M, Wassenaar M, Auce P, Avbersek A, Becker F, Berghuis B, Campbell E, Coppola A, Francis B, Wolking S, Cavalleri GL, Craig J, Delanty N, Koeleman BPC, Kunz WS, Lerche H, Marson AG, Sander JW, Sills GJ, Striano P, Zara F, Sisodiya SM, Depondt C. Comparative effectiveness of antiepileptic drugs in patients with mesial temporal lobe epilepsy with hippocampal sclerosis. Epilepsia 2017; 58:1734-1741. [DOI: 10.1111/epi.13871] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Ganna Androsova
- Luxembourg Center for Systems Biomedicine; University of Luxembourg; Esch-sur-Alzette Luxembourg
| | - Roland Krause
- Luxembourg Center for Systems Biomedicine; University of Luxembourg; Esch-sur-Alzette Luxembourg
| | - Mojgansadat Borghei
- Laboratory of Experimental Neurology; Université Libre de Bruxelles; Brussels Belgium
| | - Merel Wassenaar
- Stichting Epilepsie Instellingen Nederland (SEIN); Heemstede The Netherlands
| | - Pauls Auce
- Department of Molecular and Clinical Pharmacology; Institute of Translational Medicine; University of Liverpool; Liverpool United Kingdom
- The Walton Centre NHS Foundation Trust; Liverpool United Kingdom
| | - Andreja Avbersek
- Department of Clinical and Experimental Epilepsy; UCL Institute of Neurology; London United Kingdom
| | - Felicitas Becker
- Hertie Institute for Clinical Brain Research; University of Tübingen; Tübingen Germany
| | - Bianca Berghuis
- Stichting Epilepsie Instellingen Nederland (SEIN); Heemstede The Netherlands
| | - Ellen Campbell
- Belfast Health and Social Care Trust; Belfast United Kingdom
| | - Antonietta Coppola
- Pediatric Neurology and Muscular Diseases Unit; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health; University of Genoa; Genoa Italy
| | - Ben Francis
- Department of Biostatistics; University of Liverpool; Liverpool United Kingdom
| | - Stefan Wolking
- Hertie Institute for Clinical Brain Research; University of Tübingen; Tübingen Germany
| | - Gianpiero L. Cavalleri
- Molecular and Cellular Therapeutics; Royal College of Surgeons in Ireland; Dublin Ireland
| | - John Craig
- Belfast Health and Social Care Trust; Belfast United Kingdom
| | - Norman Delanty
- Molecular and Cellular Therapeutics; Royal College of Surgeons in Ireland; Dublin Ireland
- Department of Neurology; Beaumont Hospital; Dublin Ireland
| | - Bobby P. C. Koeleman
- Department of Genetics; University Medical Center Utrecht; Utrecht The Netherlands
| | - Wolfram S. Kunz
- Department of Epileptology; University of Bonn; Bonn Germany
| | - Holger Lerche
- Hertie Institute for Clinical Brain Research; University of Tübingen; Tübingen Germany
| | - Anthony G. Marson
- Department of Molecular and Clinical Pharmacology; Institute of Translational Medicine; University of Liverpool; Liverpool United Kingdom
- The Walton Centre NHS Foundation Trust; Liverpool United Kingdom
| | - Josemir W. Sander
- Stichting Epilepsie Instellingen Nederland (SEIN); Heemstede The Netherlands
- NIHR University College London Hospitals Biomedical Research Centre; UCL Institute of Neurology; London United Kingdom
- The Chalfont Centre for Epilepsy; Chalfont St. Peters United Kingdom
| | - Graeme J. Sills
- Department of Molecular and Clinical Pharmacology; Institute of Translational Medicine; University of Liverpool; Liverpool United Kingdom
| | - Pasquale Striano
- Pediatric Neurology and Muscular Diseases Unit; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health; University of Genoa; Genoa Italy
| | - Federico Zara
- Laboratory of Neurogenetics and Neuroscience; Institute G. Gaslini; Genoa Italy
| | - Sanjay M. Sisodiya
- Department of Clinical and Experimental Epilepsy; UCL Institute of Neurology; London United Kingdom
- The Chalfont Centre for Epilepsy; Chalfont St. Peters United Kingdom
| | - Chantal Depondt
- Laboratory of Experimental Neurology; Université Libre de Bruxelles; Brussels Belgium
- Department of Neurology; Hôpital Erasme; Université Libre de Bruxelles; Brussels Belgium
| | | |
Collapse
|
12
|
Auce P, Rajakulendran S, Nesbitt A, Chinn R, Kennedy A. Neurological picture. Internuclear ophthalmoplegia following African tick bite fever. J Neurol Neurosurg Psychiatry 2011; 82:681. [PMID: 21421770 DOI: 10.1136/jnnp.2010.236216] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Pauls Auce
- Department of Neurology, Chelsea and Westminster Hospital, London, UK
| | | | | | | | | |
Collapse
|
13
|
Kēniņa V, Auce P, Millers A. The relationship between seropositivity against Chlamydia pneumoniae and stroke and its subtypes in a Latvian population. Medicina (Kaunas) 2011; 47:657-660. [PMID: 22370464] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND AND OBJECTIVE Serological evidence of infection with Chlamydia pneumoniae has been associated with cardiovascular diseases, but the relationship with stroke and its risk factors remains not completely understood. The aim of this study was to determine whether serological evidence of infection with Chlamydia pneumoniae was associated with the risk of ischemic stroke and any of investigated stroke subtypes. MATERIAL AND METHODS Confirmed stroke cases (n=102) were compared with gender- and age-matched control patients (n=48). The patients with stroke were divided into 3 groups according to the TOAST criteria: atherothrombotic (n=36), cardioembolic (n=47), and of undetermined etiology (n=19). Plasma levels of IgG antibodies to Chlamydia pneumoniae were measured by enzyme-linked immunosorbent assay. RESULTS There was a significant association between seropositivity to Chlamydia pneumoniae and stroke. Anti-Chlamydia pneumoniae IgG antibodies were detected in 64 case patients (62.7%) and 17 control patients (35.4%) (χ(2)=9.8; df=1; P=0.002). IgG seropositivity to Chlamydia pneumoniae was linked to all the analyzed etiological subtypes of stroke. CONCLUSION This study showed that IgG seropositivity to Chlamydia pneumoniae was associated with stroke and all the analyzed etiological subtypes of stroke.
Collapse
Affiliation(s)
- Viktorija Kēniņa
- Department of Neurology, Riga Stradins University, Riga, Latvia.
| | | | | |
Collapse
|