Weber S, Grünhage F, Hall R, Lammert F
Klinik für Innere Medizin II, Universitätsklinikum des Saarlandes, Universität des Saarlandes, Homburg.
Z Gastroenterol. 2010 Jan;48(1):56-64. doi: 10.1055/s-0028-1109982. Epub 2010 Jan 13.
Genomewide association studies (GWAS) are being reported for an increasing number of common diseases, including first reports on GWAS for hepatobiliary diseases. Most common liver diseases are multifactorial (complex) diseases that are modified by higher-order interactions between multiple genetic and environmental risk factors. The aim of GWAS is to identify the genetic risk factors contributing to disease susceptibility and/or progression. In GWAS, large patient cohorts are genotyped for genetic markers that cover the whole genome, and genotypes are associated with phenotypes by contingency tests and regression analyses. Recent GWAS have identified "risk genes" for gallstones, fatty liver, primary cholestatic liver diseases and chronic hepatitis C virus (HCV) infection as well as fibrosis progression in HCV-infected patients. For the latter patients, "gene signatures" were developed that are composed of multiple risk variants and are associated with progressive liver fibrosis. Furthermore, mouse models are an important tool to identify novel genetic determinants of complex liver diseases. In large experimental crosses of susceptible and resistant inbred mouse strains, phenotypes are correlated with genome-wide markers by genetic linkage analyses. The findings from genome-wide studies in mice and men may contribute to a better understanding of the pathogenesis of complex liver diseases and provide a framework for the development of "personalised" strategies for prediction, early prevention and therapy.
全基因组关联研究(GWAS)正被报道用于越来越多的常见疾病,包括关于肝胆疾病GWAS的首次报告。大多数常见肝脏疾病是多因素(复杂)疾病,由多种遗传和环境风险因素之间的高阶相互作用所修饰。GWAS的目的是识别导致疾病易感性和/或进展的遗传风险因素。在GWAS中,对覆盖整个基因组的遗传标记对大量患者队列进行基因分型,并通过列联检验和回归分析将基因型与表型相关联。最近的GWAS已经确定了胆结石、脂肪肝、原发性胆汁性肝病和慢性丙型肝炎病毒(HCV)感染以及HCV感染患者纤维化进展的“风险基因”。对于后一类患者,开发了由多个风险变异组成且与进行性肝纤维化相关的“基因特征”。此外,小鼠模型是识别复杂肝脏疾病新遗传决定因素的重要工具。在易感和抗性近交小鼠品系的大型实验杂交中,通过遗传连锁分析将表型与全基因组标记相关联。小鼠和人类全基因组研究的结果可能有助于更好地理解复杂肝脏疾病的发病机制,并为开发预测、早期预防和治疗的“个性化”策略提供框架。