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1.
Cell ; 182(5): 1198-1213.e14, 2020 09 03.
Artículo en Inglés | MEDLINE | ID: mdl-32888493

RESUMEN

Most loci identified by GWASs have been found in populations of European ancestry (EUR). In trans-ethnic meta-analyses for 15 hematological traits in 746,667 participants, including 184,535 non-EUR individuals, we identified 5,552 trait-variant associations at p < 5 × 10-9, including 71 novel associations not found in EUR populations. We also identified 28 additional novel variants in ancestry-specific, non-EUR meta-analyses, including an IL7 missense variant in South Asians associated with lymphocyte count in vivo and IL-7 secretion levels in vitro. Fine-mapping prioritized variants annotated as functional and generated 95% credible sets that were 30% smaller when using the trans-ethnic as opposed to the EUR-only results. We explored the clinical significance and predictive value of trans-ethnic variants in multiple populations and compared genetic architecture and the effect of natural selection on these blood phenotypes between populations. Altogether, our results for hematological traits highlight the value of a more global representation of populations in genetic studies.


Asunto(s)
Pueblo Asiatico/genética , Mutación Missense/genética , Polimorfismo de Nucleótido Simple/genética , Población Blanca/genética , Genética , Estudio de Asociación del Genoma Completo/métodos , Células HEK293 , Humanos , Interleucina-7/genética , Fenotipo
2.
Nature ; 600(7890): 675-679, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34887591

RESUMEN

Increased blood lipid levels are heritable risk factors of cardiovascular disease with varied prevalence worldwide owing to different dietary patterns and medication use1. Despite advances in prevention and treatment, in particular through reducing low-density lipoprotein cholesterol levels2, heart disease remains the leading cause of death worldwide3. Genome-wideassociation studies (GWAS) of blood lipid levels have led to important biological and clinical insights, as well as new drug targets, for cardiovascular disease. However, most previous GWAS4-23 have been conducted in European ancestry populations and may have missed genetic variants that contribute to lipid-level variation in other ancestry groups. These include differences in allele frequencies, effect sizes and linkage-disequilibrium patterns24. Here we conduct a multi-ancestry, genome-wide genetic discovery meta-analysis of lipid levels in approximately 1.65 million individuals, including 350,000 of non-European ancestries. We quantify the gain in studying non-European ancestries and provide evidence to support the expansion of recruitment of additional ancestries, even with relatively small sample sizes. We find that increasing diversity rather than studying additional individuals of European ancestry results in substantial improvements in fine-mapping functional variants and portability of polygenic prediction (evaluated in approximately 295,000 individuals from 7 ancestry groupings). Modest gains in the number of discovered loci and ancestry-specific variants were also achieved. As GWAS expand emphasis beyond the identification of genes and fundamental biology towards the use of genetic variants for preventive and precision medicine25, we anticipate that increased diversity of participants will lead to more accurate and equitable26 application of polygenic scores in clinical practice.


Asunto(s)
Enfermedades Cardiovasculares , Estudio de Asociación del Genoma Completo , Enfermedades Cardiovasculares/genética , Predisposición Genética a la Enfermedad/genética , Estudio de Asociación del Genoma Completo/métodos , Humanos , Desequilibrio de Ligamiento , Herencia Multifactorial , Polimorfismo de Nucleótido Simple/genética , Grupos de Población
3.
Am J Hum Genet ; 109(8): 1366-1387, 2022 08 04.
Artículo en Inglés | MEDLINE | ID: mdl-35931049

RESUMEN

A major challenge of genome-wide association studies (GWASs) is to translate phenotypic associations into biological insights. Here, we integrate a large GWAS on blood lipids involving 1.6 million individuals from five ancestries with a wide array of functional genomic datasets to discover regulatory mechanisms underlying lipid associations. We first prioritize lipid-associated genes with expression quantitative trait locus (eQTL) colocalizations and then add chromatin interaction data to narrow the search for functional genes. Polygenic enrichment analysis across 697 annotations from a host of tissues and cell types confirms the central role of the liver in lipid levels and highlights the selective enrichment of adipose-specific chromatin marks in high-density lipoprotein cholesterol and triglycerides. Overlapping transcription factor (TF) binding sites with lipid-associated loci identifies TFs relevant in lipid biology. In addition, we present an integrative framework to prioritize causal variants at GWAS loci, producing a comprehensive list of candidate causal genes and variants with multiple layers of functional evidence. We highlight two of the prioritized genes, CREBRF and RRBP1, which show convergent evidence across functional datasets supporting their roles in lipid biology.


Asunto(s)
Estudio de Asociación del Genoma Completo , Polimorfismo de Nucleótido Simple , Cromatina/genética , Genómica , Humanos , Lípidos/genética , Polimorfismo de Nucleótido Simple/genética
5.
Nature ; 498(7453): 232-5, 2013 Jun 13.
Artículo en Inglés | MEDLINE | ID: mdl-23698362

RESUMEN

Genome-wide association studies (GWAS) have identified common variants of modest-effect size at hundreds of loci for common autoimmune diseases; however, a substantial fraction of heritability remains unexplained, to which rare variants may contribute. To discover rare variants and test them for association with a phenotype, most studies re-sequence a small initial sample size and then genotype the discovered variants in a larger sample set. This approach fails to analyse a large fraction of the rare variants present in the entire sample set. Here we perform simultaneous amplicon-sequencing-based variant discovery and genotyping for coding exons of 25 GWAS risk genes in 41,911 UK residents of white European origin, comprising 24,892 subjects with six autoimmune disease phenotypes and 17,019 controls, and show that rare coding-region variants at known loci have a negligible role in common autoimmune disease susceptibility. These results do not support the rare-variant synthetic genome-wide-association hypothesis (in which unobserved rare causal variants lead to association detected at common tag variants). Many known autoimmune disease risk loci contain multiple, independently associated, common and low-frequency variants, and so genes at these loci are a priori stronger candidates for harbouring rare coding-region variants than other genes. Our data indicate that the missing heritability for common autoimmune diseases may not be attributable to the rare coding-region variant portion of the allelic spectrum, but perhaps, as others have proposed, may be a result of many common-variant loci of weak effect.


Asunto(s)
Enfermedades Autoinmunes/genética , Predisposición Genética a la Enfermedad/genética , Variación Genética/genética , Sistemas de Lectura Abierta/genética , Exones/genética , Frecuencia de los Genes , Estudio de Asociación del Genoma Completo , Humanos , Modelos Genéticos , Mutación/genética , Fenotipo , Tamaño de la Muestra , Reino Unido , Población Blanca/genética
6.
Nat Genet ; 39(7): 827-9, 2007 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-17558408

RESUMEN

We tested 310,605 SNPs for association in 778 individuals with celiac disease and 1,422 controls. Outside the HLA region, the most significant finding (rs13119723; P = 2.0 x 10(-7)) was in the KIAA1109-TENR-IL2-IL21 linkage disequilibrium block. We independently confirmed association in two further collections (strongest association at rs6822844, 24 kb 5' of IL21; meta-analysis P = 1.3 x 10(-14), odds ratio = 0.63), suggesting that genetic variation in this region predisposes to celiac disease.


Asunto(s)
Enfermedad Celíaca/genética , Predisposición Genética a la Enfermedad , Variación Genética , Genoma Humano , Interleucina-2/genética , Interleucinas/genética , Animales , Cromosomas Humanos Par 4/genética , Humanos , Desequilibrio de Ligamiento , Ratones , Polimorfismo de Nucleótido Simple , Factores de Riesgo
7.
Hum Mol Genet ; 19(1): 122-34, 2010 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-19825846

RESUMEN

Many disease-associated variants identified by genome-wide association (GWA) studies are expected to regulate gene expression. Allele-specific expression (ASE) quantifies transcription from both haplotypes using individuals heterozygous at tested SNPs. We performed deep human transcriptome-wide resequencing (RNA-seq) for ASE analysis and expression quantitative trait locus discovery. We resequenced double poly(A)-selected RNA from primary CD4(+) T cells (n = 4 individuals, both activated and untreated conditions) and developed tools for paired-end RNA-seq alignment and ASE analysis. We generated an average of 20 million uniquely mapping 45 base reads per sample. We obtained sufficient read depth to test 1371 unique transcripts for ASE. Multiple biases inflate the false discovery rate which we estimate to be approximately 50% for random SNPs. However, after controlling for these biases and considering the subset of SNPs that pass HapMap QC, 4.6% of heterozygous SNP-sample pairs show evidence of imbalance (P < 0.001). We validated four findings by both bacterial cloning and Sanger sequencing assays. We also found convincing evidence for allelic imbalance at multiple reporter exonic SNPs in CD6 for two samples heterozygous at the multiple sclerosis-associated variant rs17824933, linking GWA findings with variation in gene expression. Finally, we show in CD4(+) T cells from a further individual that high-throughput sequencing of genomic DNA and RNA-seq following enrichment for targeted gene sequences by sequence capture methods offers an unbiased means to increase the read depth for transcripts of interest, and therefore a method to investigate the regulatory role of many disease-associated genetic variants.


Asunto(s)
Desequilibrio Alélico/genética , Perfilación de la Expresión Génica/métodos , Estudio de Asociación del Genoma Completo , Ensayos Analíticos de Alto Rendimiento/métodos , Análisis de Secuencia de ADN/métodos , Alelos , Emparejamiento Base/genética , Sesgo , Células Cultivadas , Biología Computacional , Enfermedad/genética , Epigénesis Genética , Reacciones Falso Positivas , Sitios Genéticos/genética , Heterocigoto , Humanos , Polimorfismo de Nucleótido Simple/genética , ARN Mensajero/genética , ARN Mensajero/metabolismo , Reproducibilidad de los Resultados
8.
Nat Commun ; 13(1): 4664, 2022 08 09.
Artículo en Inglés | MEDLINE | ID: mdl-35945198

RESUMEN

Individuals with South Asian ancestry have a higher risk of heart disease than other groups but have been largely excluded from genetic research. Using data from 22,000 British Pakistani and Bangladeshi individuals with linked electronic health records from the Genes & Health cohort, we conducted genome-wide association studies of coronary artery disease and its key risk factors. Using power-adjusted transferability ratios, we found evidence for transferability for the majority of cardiometabolic loci powered to replicate. The performance of polygenic scores was high for lipids and blood pressure, but lower for BMI and coronary artery disease. Adding a polygenic score for coronary artery disease to clinical risk factors showed significant improvement in reclassification. In Mendelian randomisation using transferable loci as instruments, our findings were consistent with results in European-ancestry individuals. Taken together, trait-specific transferability of trait loci between populations is an important consideration with implications for risk prediction and causal inference.


Asunto(s)
Enfermedad de la Arteria Coronaria , Estudio de Asociación del Genoma Completo , Pueblo Asiatico/genética , Enfermedad de la Arteria Coronaria/epidemiología , Enfermedad de la Arteria Coronaria/genética , Sitios Genéticos , Humanos , Pakistán , Polimorfismo de Nucleótido Simple
9.
Genome Biol ; 23(1): 268, 2022 12 27.
Artículo en Inglés | MEDLINE | ID: mdl-36575460

RESUMEN

BACKGROUND: Genetic variants within nearly 1000 loci are known to contribute to modulation of blood lipid levels. However, the biological pathways underlying these associations are frequently unknown, limiting understanding of these findings and hindering downstream translational efforts such as drug target discovery. RESULTS: To expand our understanding of the underlying biological pathways and mechanisms controlling blood lipid levels, we leverage a large multi-ancestry meta-analysis (N = 1,654,960) of blood lipids to prioritize putative causal genes for 2286 lipid associations using six gene prediction approaches. Using phenome-wide association (PheWAS) scans, we identify relationships of genetically predicted lipid levels to other diseases and conditions. We confirm known pleiotropic associations with cardiovascular phenotypes and determine novel associations, notably with cholelithiasis risk. We perform sex-stratified GWAS meta-analysis of lipid levels and show that 3-5% of autosomal lipid-associated loci demonstrate sex-biased effects. Finally, we report 21 novel lipid loci identified on the X chromosome. Many of the sex-biased autosomal and X chromosome lipid loci show pleiotropic associations with sex hormones, emphasizing the role of hormone regulation in lipid metabolism. CONCLUSIONS: Taken together, our findings provide insights into the biological mechanisms through which associated variants lead to altered lipid levels and potentially cardiovascular disease risk.


Asunto(s)
Predisposición Genética a la Enfermedad , Estudio de Asociación del Genoma Completo , Humanos , Caracteres Sexuales , Fenotipo , Lípidos/genética , Polimorfismo de Nucleótido Simple , Pleiotropía Genética
10.
Am J Hum Genet ; 82(6): 1316-33, 2008 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-18519066

RESUMEN

Copy-number variation (CNV) is a major contributor to human genetic variation. Recently, CNV associations with human disease have been reported. Many genome-wide association (GWA) studies in complex diseases have been performed with sets of biallelic single-nucleotide polymorphisms (SNPs), but the available CNV methods are still limited. We present a new method (TriTyper) that can infer genotypes in case-control data sets for deletion CNVs, or SNPs with an extra, untyped allele at a high-resolution single SNP level. By accounting for linkage disequilibrium (LD), as well as intensity data, calling accuracy is improved. Analysis of 3102 unrelated individuals with European descent, genotyped with Illumina Infinium BeadChips, resulted in the identification of 1880 SNPs with a common untyped allele, and these SNPs are in strong LD with neighboring biallelic SNPs. Simulations indicate our method has superior power to detect associations compared to biallelic SNPs that are in LD with these SNPs, yet without increasing type I errors, as shown in a GWA analysis in celiac disease. Genotypes for 1204 triallelic SNPs could be fully imputed, with only biallelic-genotype calls, permitting association analysis of these SNPs in many published data sets. We estimate that 682 of the 1655 unique loci reflect deletions; this is on average 99 deletions per individual, four times greater than those detected by other methods. Whereas the identified loci are strongly enriched for known deletions, 61% have not been reported before. Genes overlapping with these loci more often have paralogs (p = 0.006) and biologically interact with fewer genes than expected (p = 0.004).


Asunto(s)
Eliminación de Gen , Dosificación de Gen , Análisis de Secuencia por Matrices de Oligonucleótidos/métodos , Algoritmos , Alelos , Estudios de Casos y Controles , Enfermedad Celíaca/genética , Bases de Datos Genéticas , Variación Genética , Humanos , Desequilibrio de Ligamiento , Polimorfismo de Nucleótido Simple
11.
N Engl J Med ; 359(26): 2767-77, 2008 Dec 25.
Artículo en Inglés | MEDLINE | ID: mdl-19073967

RESUMEN

BACKGROUND: Two inflammatory disorders, type 1 diabetes and celiac disease, cosegregate in populations, suggesting a common genetic origin. Since both diseases are associated with the HLA class II genes on chromosome 6p21, we tested whether non-HLA loci are shared. METHODS: We evaluated the association between type 1 diabetes and eight loci related to the risk of celiac disease by genotyping and statistical analyses of DNA samples from 8064 patients with type 1 diabetes, 9339 control subjects, and 2828 families providing 3064 parent-child trios (consisting of an affected child and both biologic parents). We also investigated 18 loci associated with type 1 diabetes in 2560 patients with celiac disease and 9339 control subjects. RESULTS: Three celiac disease loci--RGS1 on chromosome 1q31, IL18RAP on chromosome 2q12, and TAGAP on chromosome 6q25--were associated with type 1 diabetes (P<1.00x10(-4)). The 32-bp insertion-deletion variant on chromosome 3p21 was newly identified as a type 1 diabetes locus (P=1.81x10(-8)) and was also associated with celiac disease, along with PTPN2 on chromosome 18p11 and CTLA4 on chromosome 2q33, bringing the total number of loci with evidence of a shared association to seven, including SH2B3 on chromosome 12q24. The effects of the IL18RAP and TAGAP alleles confer protection in type 1 diabetes and susceptibility in celiac disease. Loci with distinct effects in the two diseases included INS on chromosome 11p15, IL2RA on chromosome 10p15, and PTPN22 on chromosome 1p13 in type 1 diabetes and IL12A on 3q25 and LPP on 3q28 in celiac disease. CONCLUSIONS: A genetic susceptibility to both type 1 diabetes and celiac disease shares common alleles. These data suggest that common biologic mechanisms, such as autoimmunity-related tissue damage and intolerance to dietary antigens, may be etiologic features of both diseases.


Asunto(s)
Autoinmunidad/genética , Enfermedad Celíaca/genética , Diabetes Mellitus Tipo 1/genética , Proteínas Adaptadoras Transductoras de Señales , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antígenos CD/genética , Antígeno CTLA-4 , Enfermedad Celíaca/inmunología , Niño , Preescolar , Proteínas del Citoesqueleto/genética , Diabetes Mellitus Tipo 1/inmunología , Femenino , Ligamiento Genético , Predisposición Genética a la Enfermedad , Humanos , Lactante , Subunidad p35 de la Interleucina-12/genética , Subunidad beta del Receptor de Interleucina-18/genética , Subunidad alfa del Receptor de Interleucina-2/genética , Péptidos y Proteínas de Señalización Intracelular , Proteínas con Dominio LIM , Masculino , Persona de Mediana Edad , Polimorfismo de Nucleótido Simple , Proteína Tirosina Fosfatasa no Receptora Tipo 2/genética , Proteína Tirosina Fosfatasa no Receptora Tipo 22/genética , Proteínas/genética , Proteínas RGS/genética , Receptores CCR5/genética , Adulto Joven
12.
Nat Commun ; 12(1): 7189, 2021 12 10.
Artículo en Inglés | MEDLINE | ID: mdl-34893604

RESUMEN

Previous genetic and public health research in the Pakistani population has focused on the role of consanguinity in increasing recessive disease risk, but little is known about its recent population history or the effects of endogamy. Here, we investigate fine-scale population structure, history and consanguinity patterns using genotype chip data from 2,200 British Pakistanis. We reveal strong recent population structure driven by the biraderi social stratification system. We find that all subgroups have had low recent effective population sizes (Ne), with some showing a decrease 15‒20 generations ago that has resulted in extensive identity-by-descent sharing and homozygosity, increasing the risk of recessive disorders. Our results from two orthogonal methods (one using machine learning and the other coalescent-based) suggest that the detailed reporting of parental relatedness for mothers in the cohort under-represents the true levels of consanguinity. These results demonstrate the impact of cultural practices on population structure and genomic diversity in Pakistanis, and have important implications for medical genetic studies.


Asunto(s)
Pueblo Asiatico/genética , Consanguinidad , Genética de Población , Población Blanca/genética , Estudios de Cohortes , Demografía , Genotipo , Homocigoto , Humanos , Matrimonio , Modelos Genéticos , Pakistán , Padres , Densidad de Población , Estatus Social
13.
Elife ; 92020 03 24.
Artículo en Inglés | MEDLINE | ID: mdl-32207686

RESUMEN

By sequencing autozygous human populations, we identified a healthy adult woman with lifelong complete knockout of HAO1 (expected ~1 in 30 million outbred people). HAO1 (glycolate oxidase) silencing is the mechanism of lumasiran, an investigational RNA interference therapeutic for primary hyperoxaluria type 1. Her plasma glycolate levels were 12 times, and urinary glycolate 6 times, the upper limit of normal observed in healthy reference individuals (n = 67). Plasma metabolomics and lipidomics (1871 biochemicals) revealed 18 markedly elevated biochemicals (>5 sd outliers versus n = 25 controls) suggesting additional HAO1 effects. Comparison with lumasiran preclinical and clinical trial data suggested she has <2% residual glycolate oxidase activity. Cell line p.Leu333SerfsTer4 expression showed markedly reduced HAO1 protein levels and cellular protein mis-localisation. In this woman, lifelong HAO1 knockout is safe and without clinical phenotype, de-risking a therapeutic approach and informing therapeutic mechanisms. Unlocking evidence from the diversity of human genetic variation can facilitate drug development.


Asunto(s)
Oxidorreductasas de Alcohol/genética , Hiperoxaluria Primaria/terapia , Tratamiento con ARN de Interferencia , Adulto , Oxidorreductasas de Alcohol/antagonistas & inhibidores , Animales , Células CHO , Cricetulus , Femenino , Glicolatos/metabolismo , Humanos , Hiperoxaluria Primaria/metabolismo
14.
Radiology ; 249(2): 463-70, 2008 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-18936310

RESUMEN

PURPOSE: To assess the diagnostic performance of various Doppler ultrasonographic (US) vascularity measures in conjunction with grayscale (GS) criteria in differentiating benign from malignant breast masses, by using histologic findings as the reference standard. MATERIALS AND METHODS: Institutional Review Board and HIPAA standards were followed. Seventy-eight women (average age, 49 years; range, 26-70 years) scheduled for breast biopsy were included. Thirty-eight patient scans were partially analyzed and published previously, and 40 additional scans were used as a test set to evaluate previously determined classification indexes. In each patient, a series of color Doppler images was acquired and reconstructed into a volume encompassing a suspicious mass, identified by a radiologist-defined ellipsoid, in which six Doppler vascularity measures were calculated. Radiologist GS ratings and patient age were also recorded. Multivariable discrimination indexes derived from the learning set were applied blindly to the test set. Overall performance was also confirmed by using a fourfold cross-validation scheme on the entire population. RESULTS: By using all cases (46 benign, 32 malignant), the area under the receiver operating characteristic curve (A(z)) values confirmed results of previous analyses: Speed-weighted pixel density (SWPD) performed the best as a diagnostic index, although statistical significance (P = .01) was demonstrated only with respect to the normalized power-weighted pixel density. In both learning and test sets, the three-variable index (SWPD-age-GS) displayed significantly better diagnostic performance (A(z) = 0.97) than did any single index or the one two-variable index (age-GS) that could be obtained without the data from the Doppler scan. Results of the cross validation confirmed the trends in the two data sets. CONCLUSION: Quantitative Doppler US vascularity measurements considerably contribute to malignant breast tissue identification beyond subjective GS evaluation alone. The SWPD-age-GS index has high performance (A(z) = 0.97), regardless of incidental performance variations in its single variable components.


Asunto(s)
Neoplasias de la Mama/diagnóstico por imagen , Imagenología Tridimensional , Ultrasonografía Doppler en Color , Ultrasonografía Mamaria/métodos , Adulto , Anciano , Biopsia , Neoplasias de la Mama/patología , Diagnóstico Diferencial , Análisis Discriminante , Femenino , Humanos , Persona de Mediana Edad , Curva ROC , Sensibilidad y Especificidad
15.
AJR Am J Roentgenol ; 189(1): 140-4, 2007 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-17579163

RESUMEN

OBJECTIVE: The purpose of our study was to determine the mammographic appearance, detection method, and stage of ipsilateral breast tumor recurrence in women treated with breast-conserving surgery and whole-breast radiation therapy for ductal carcinoma in situ (DCIS). MATERIALS AND METHODS: Following institutional review board approval, records of women treated with breast-conserving surgery and radiation therapy for DCIS who developed an ipsilateral breast tumor recurrence from 1981 to 2003 were reviewed retrospectively. Multiinstitutional database records showed 513 women were treated, of whom 42 (8.2%) developed local recurrence. Study criteria were fulfilled and complete records were available for 32 women. Mean age at initial diagnosis was 49 years (range, 26-73 years). RESULTS: Of the 32 patients included in our study, 31 (97%) recurrences were mammographically apparent. Twenty-nine (91%) of 32 were diagnosed exclusively by mammography. Mammographic findings at recurrence were calcifications in 24 (75%) of 32, mass in six (19%) of 32, and distortion in one (3%) of 32. The mean time to recurrence was 4.5 years. Twelve (40%) of 30 had the recurrence in a remote quadrant from the original cancer. Recurrences were DCIS in 17 (53%) of 32, DCIS with microinvasion in six (19%) of 32, invasive ductal cancer in three (9%) of 32, invasive lobular cancer in two (6%) of 32, and mixed DCIS and invasive cancer in four (13%) of 32. Six (67%) of nine patients with invasive cancer (excluding microinvasion) had tumors smaller than 1 cm. Ninety-one percent of recurrences were minimal cancers. All recurrences were stage 0 or 1. CONCLUSION: Mammography successfully detected ipsilateral breast tumor recurrence, predominantly as calcifications or masses, after breast-conserving surgery with radiation therapy for DCIS in 97% of cases. The recurrences were located at variable distances from the lumpectomy site. Ninety-one percent of recurrences were minimal cancers and all were early stage, connoting excellent prognosis.


Asunto(s)
Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/terapia , Carcinoma Ductal/diagnóstico por imagen , Carcinoma Ductal/terapia , Mamografía/métodos , Recurrencia Local de Neoplasia/diagnóstico por imagen , Adulto , Anciano , Femenino , Humanos , Mastectomía Segmentaria , Persona de Mediana Edad , Recurrencia Local de Neoplasia/prevención & control , Estadificación de Neoplasias , Radioterapia , Resultado del Tratamiento
16.
Lancet ; 365(9473): 1794-6, 2005.
Artículo en Inglés | MEDLINE | ID: mdl-15910952

RESUMEN

Both NOD2 (CARD15) alleles are mutated in roughly 15% of patients with Crohn's disease, but functional effects are unclear. We analysed the cytokine response of peripheral blood mononuclear cells to muramyl dipeptide (MDP), the ligand for NOD2. MDP induced little TNFalpha or interleukin 1beta, but strong interleukin-8 secretion. MDP also substantially upregulated secretion of TNFalpha and interleukin 1beta induced by toll-like receptor ligands. These effects were abolished by the most common Crohn's NOD2 double mutant genotypes at low nanomolar MDP concentrations, and provide the basis to develop a test of NOD2 functional deficiency. In Crohn's disease, there are defects in neutrophil recruitment driven by NOD2 and interleukin 8 and in cross talk between the NOD2 and toll-like receptor pathways, which suggests that the immune system fails to receive an early priming signal.


Asunto(s)
Acetilmuramil-Alanil-Isoglutamina/farmacología , Enfermedad de Crohn/inmunología , Péptidos y Proteínas de Señalización Intracelular/metabolismo , Glicoproteínas de Membrana/metabolismo , Receptores de Superficie Celular/metabolismo , Transducción de Señal , Acetilmuramil-Alanil-Isoglutamina/metabolismo , Enfermedad de Crohn/genética , Enfermedad de Crohn/metabolismo , Genotipo , Humanos , Inmunidad Innata , Técnicas In Vitro , Interleucina-1/biosíntesis , Interleucina-1/metabolismo , Interleucina-8/biosíntesis , Interleucina-8/metabolismo , Péptidos y Proteínas de Señalización Intracelular/genética , Leucocitos Mononucleares/metabolismo , Mutación , Proteína Adaptadora de Señalización NOD2 , Receptor Cross-Talk , Receptores Toll-Like , Factor de Necrosis Tumoral alfa/biosíntesis , Factor de Necrosis Tumoral alfa/metabolismo , Regulación hacia Arriba
17.
Inflamm Bowel Dis ; 12(7): 598-605, 2006 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-16804397

RESUMEN

BACKGROUND AND AIMS: Crohn's disease is strongly associated with double mutations in NOD2/CARD15. Three common mutations (Arg702Trp, Gly908Arg, Leu1007fs) impair innate immune responses to bacterial muramyl dipeptide. Rare NOD2 variants occur, but it is difficult to both identify them and assess their functional effect. We assessed the true frequency of defective muramyl dipeptide sensing in Crohn's disease and developed a rapid diagnostic assay. MATERIALS AND METHODS: An ex vivo assay was established and validated based on muramyl dipeptide stimulation of peripheral blood mononuclear cell cytokine production. Muramyl dipeptide-induced enhancement of interleukin (IL)-8 secretion and synergistic increase in lipopolysaccharide-induced IL-1beta secretion were studied. Assay results were compared with NOD2 genotype status (3 common mutations and rare variants) in 91 individuals including a prospective cohort of 49 patients with Crohn's disease. RESULTS: The assay was highly sensitive and specific for detection of profound defects in muramyl dipeptide sensing caused by double NOD2 mutations (IL-8 P = 0.0002; IL-1beta P = 0.0002). Disease state, active inflammation, or concurrent use of immunosuppressive medication did not influence results. Healthy NOD2 heterozygotes had modest impairment of muramyl dipeptide induced IL-8 secretion (P = 0.003). Only 1 of 7 patients with Crohn's disease with both a common mutation and a rare variant had a profound muramyl dipeptide-sensing defect. CONCLUSIONS: Profound defects in muramyl dipeptide sensing were found in 10% of patients with Crohn's disease. Defects were caused exclusively by inherited mutations in NOD2. The ex vivo assay has multiple potential applications as a clinical diagnostic tool to distinguish patients with muramyl dipeptide-sensing defects and for research investigation.


Asunto(s)
Acetilmuramil-Alanil-Isoglutamina/química , Enfermedad de Crohn/genética , Genotipo , Acetilmuramil-Alanil-Isoglutamina/sangre , Enfermedad de Crohn/sangre , Enfermedad de Crohn/metabolismo , Citocinas/metabolismo , Ensayo de Inmunoadsorción Enzimática , Heterocigoto , Humanos , Inmunosupresores/farmacología , Inflamación , Interleucina-1beta/metabolismo , Interleucina-8/metabolismo , Lipopolisacáridos/metabolismo , Monocitos/metabolismo , Mutación , Sensibilidad y Especificidad
18.
Science ; 352(6284): 474-7, 2016 Apr 22.
Artículo en Inglés | MEDLINE | ID: mdl-26940866

RESUMEN

Examining complete gene knockouts within a viable organism can inform on gene function. We sequenced the exomes of 3222 British adults of Pakistani heritage with high parental relatedness, discovering 1111 rare-variant homozygous genotypes with predicted loss of function (knockouts) in 781 genes. We observed 13.7% fewer homozygous knockout genotypes than we expected, implying an average load of 1.6 recessive-lethal-equivalent loss-of-function (LOF) variants per adult. When genetic data were linked to the individuals' lifelong health records, we observed no significant relationship between gene knockouts and clinical consultation or prescription rate. In this data set, we identified a healthy PRDM9-knockout mother and performed phased genome sequencing on her, her child, and control individuals. Our results show that meiotic recombination sites are localized away from PRDM9-dependent hotspots. Thus, natural LOF variants inform on essential genetic loci and demonstrate PRDM9 redundancy in humans.


Asunto(s)
Consanguinidad , Salud , N-Metiltransferasa de Histona-Lisina/genética , Adulto , Análisis Mutacional de ADN , Prescripciones de Medicamentos , Exoma/genética , Femenino , Fertilidad , Técnicas de Inactivación de Genes , Genes Letales , Sitios Genéticos , Genoma Humano , Recombinación Homóloga , Homocigoto , Humanos , Masculino , Madres , Pakistán/etnología , Fenotipo , Reino Unido
19.
Eur J Hum Genet ; 13(4): 440-4, 2005 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-15657618

RESUMEN

Coeliac disease is a common enteropathy with a strong inherited risk characterised by dietary wheat, rye and barley induced T-cell activation. Although there is replicated linkage to 2q33, results are inconsistent from association studies of the most promising candidate genes: the CD28/CTLA4/ICOS cluster. CTLA4 plays a key role in regulating T lymphocyte mediated inflammatory responses, and variants in the 3' region influence development of diabetes and thyroid disease. We genotyped CTLA4 variants (-1722 C/T, -658 T/C, -318 C/T, +49 A/G, +1822 C/T, CT60 A/G) to tag all common haplotypes (>5% frequency) and an ICOS variant (IVS+173 C/T) in 340 white UK Caucasian coeliac disease cases. Strict ascertainment criteria for coeliac cases required both villous atrophy at diagnosis and positive serology. In total, 973 healthy controls were available for SNP, and 705 for CTLA4 haplotype, based association analyses. Coeliac disease showed weak association with the CTLA4 +1822T (P=0.019) and CT60 G (P=0.047) alleles. Strong association was seen with a common CTLA4 haplotype (P=0.00067, odds ratio 1.41) of frequency 32.7% in coeliac disease and 25.5% in healthy controls. A common CTLA4 haplotype shows strong association with coeliac disease, and contains multiple alleles reported to affect immunological function. Loss of tolerance to dietary antigens in coeliac disease may be mediated in part by heritable variants in co-signalling genes regulating T-cell responses.


Asunto(s)
Antígenos de Diferenciación/genética , Enfermedad Celíaca/genética , Predisposición Genética a la Enfermedad , Haplotipos/genética , Polimorfismo de Nucleótido Simple/genética , Antígenos CD , Antígeno CTLA-4 , Estudios de Casos y Controles , Enfermedad Celíaca/epidemiología , Estudios de Cohortes , Genotipo , Humanos , Fragmentos Fc de Inmunoglobulinas/genética , Inmunosupresores , Reino Unido/epidemiología
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