Lee Jin Hwa, McDonald Merry-Lynn N, Cho Michael H, Wan Emily S, Castaldi Peter J, Hunninghake Gary M, Marchetti Nathaniel, Lynch David A, Crapo James D, Lomas David A, Coxson Harvey O, Bakke Per S, Silverman Edwin K, Hersh Craig P
Channing Division of Network Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston 02115, MA, USA.
Respir Res. 2014 Aug 20;15(1):97. doi: 10.1186/s12931-014-0097-y.
Chronic obstructive pulmonary disease (COPD) is characterized by expiratory flow limitation, causing air trapping and lung hyperinflation. Hyperinflation leads to reduced exercise tolerance and poor quality of life in COPD patients. Total lung capacity (TLC) is an indicator of hyperinflation particularly in subjects with moderate-to-severe airflow obstruction. The aim of our study was to identify genetic variants associated with TLC in COPD.
We performed genome-wide association studies (GWASs) in white subjects from three cohorts: the COPDGene Study; the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE); and GenKOLS (Bergen, Norway). All subjects were current or ex-smokers with at least moderate airflow obstruction, defined by a ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) <0.7 and FEV1 < 80% predicted on post-bronchodilator spirometry. TLC was calculated by using volumetric computed tomography scans at full inspiration (TLCCT). Genotyping in each cohort was completed, with statistical imputation of additional markers. To find genetic variants associated with TLCCT, linear regression models were used, with adjustment for age, sex, pack-years of smoking, height, and principal components for genetic ancestry. Results were summarized using fixed-effect meta-analysis.
Analysis of a total of 4,543 COPD subjects identified one genome-wide significant locus on chromosome 5p15.2 (rs114929486, β = 0.42L, P = 4.66 × 10-8).
In COPD, TLCCT was associated with a SNP in dynein, axonemal, heavy chain 5 (DNAH5), a gene in which genetic variants can cause primary ciliary dyskinesia. DNAH5 could have an effect on hyperinflation in COPD.
慢性阻塞性肺疾病(COPD)的特征是呼气气流受限,导致气体潴留和肺过度充气。肺过度充气会导致COPD患者运动耐力下降和生活质量降低。肺总量(TLC)是肺过度充气的一个指标,尤其在中重度气流受限的患者中。我们研究的目的是确定与COPD患者TLC相关的基因变异。
我们在来自三个队列的白人受试者中进行了全基因组关联研究(GWAS):COPDGene研究;纵向评估COPD以确定预测替代终点(ECLIPSE);以及GenKOLS(挪威卑尔根)。所有受试者均为现吸烟者或曾经吸烟者,至少有中度气流受限,定义为支气管扩张剂后肺功能检查中1秒用力呼气容积与用力肺活量之比(FEV1/FVC)<0.7且FEV1<预测值的80%。通过全吸气时的容积计算机断层扫描(TLCCT)计算TLC。每个队列完成基因分型,并对其他标记进行统计推断。为了找到与TLCCT相关的基因变异,使用线性回归模型,并对年龄、性别、吸烟包年数、身高和遗传血统的主成分进行调整。结果使用固定效应荟萃分析进行总结。
对总共4543名COPD受试者的分析确定了5号染色体p15.2上的一个全基因组显著位点(rs114929486,β = 0.42L,P = 4.66×10-8)。
在COPD中,TLCCT与动力蛋白轴丝重链5(DNAH5)中的一个单核苷酸多态性相关,该基因中的基因变异可导致原发性纤毛运动障碍。DNAH5可能对COPD中的肺过度充气有影响。