Cheng Yu-Ching, Stanne Tara M, Giese Anne-Katrin, Ho Weang Kee, Traylor Matthew, Amouyel Philippe, Holliday Elizabeth G, Malik Rainer, Xu Huichun, Kittner Steven J, Cole John W, O'Connell Jeffrey R, Danesh John, Rasheed Asif, Zhao Wei, Engelter Stefan, Grond-Ginsbach Caspar, Kamatani Yoichiro, Lathrop Mark, Leys Didier, Thijs Vincent, Metso Tiina M, Tatlisumak Turgut, Pezzini Alessandro, Parati Eugenio A, Norrving Bo, Bevan Steve, Rothwell Peter M, Sudlow Cathie, Slowik Agnieszka, Lindgren Arne, Walters Matthew R, Jannes Jim, Shen Jess, Crosslin David, Doheny Kimberly, Laurie Cathy C, Kanse Sandip M, Bis Joshua C, Fornage Myriam, Mosley Thomas H, Hopewell Jemma C, Strauch Konstantin, Müller-Nurasyid Martina, Gieger Christian, Waldenberger Melanie, Peters Annette, Meisinger Christine, Ikram M Arfan, Longstreth W T, Meschia James F, Seshadri Sudha, Sharma Pankaj, Worrall Bradford, Jern Christina, Levi Christopher, Dichgans Martin, Boncoraglio Giorgio B, Markus Hugh S, Debette Stephanie, Rolfs Arndt, Saleheen Danish, Mitchell Braxton D
From the Veterans Affairs Maryland Health Care System, Baltimore, MD (Y.-C.C., S.J.K., J.W.C., B.D.M.); University of Maryland School of Medicine, Baltimore (Y.-C.C., H.X., S.J.K., J.W.C., J.R.O., B.D.M.); The University of Gothenburg, Gothenburg, Sweden (T.M.S., C.J.); University of Rostock, Rostock, Germany (A.-K.G., A. Rolfs); University of Nottingham Malaysia Campus, Selangor Darul Ehsa, Malaysia (W.K.H.); University of Cambridge, Cambridge, UK (M.T., J.D., S.B., H.S.M., S.D., D.S.); Institut Pasteur de Lille, F-59000 Lille, France (P.A.); University of Newcastle, Australia (E.G.H.); Ludwig-Maximilians-Universität, Munich, Germany (R.M., K.S., M.D.); Wellcome Trust Sanger Institute, Cambridge, UK (J.D.); Center for Non-Communicable Diseases, Karachi, Pakistan (A. Rasheed, D.S.); University of Pennsylvania (W.Z., D.S.); Basel University Hospital, Switzerland (S.E.); Heidelberg University Hospital, Germany (C.G.-G.); Centre d'Étude du Polymorphisme Humain, Paris, France (Y.K.); RIKEN Center for Integrative Medical Sciences, Yokohama, Japan (Y.K.); National Genotyping Center, Evry, France (M.L.); Genome Quebec, McGill University, Montreal, Canada (M.L.); Lille University Hospital, France (D.L., S.D.); KU Leuven - University of Leuven, Leuven, Belgium (V.T.); Vesalius Research Center, VIB, Leuven, Belgium (V.T.); University Hospitals Leuven, Leuven, Belgium (V.T.); Helsinki University Central Hospital, Helsinki, Finland (T.M.M., T.T.); Università degli Studi di Brescia, Brescia, Italy (A. Pezzini); Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy (E.A.P., G.B.B.); University of Lund, Sweden (B.N.); University of Oxford, John Radcliffe Hospital (P.M.R.); University of Edinburgh, Edinburgh, UK (C.S.); Jagiellonian University Medical College, Krakow, Poland (A.S.); Lund University, Lund, Sweden (A.L.); Skåne University Hospital, Lund, Sweden (A.L.); University of Glasgow, Glasgow, UK (M.R.W.); University of Adelaide, Australia (J.J.); Mount Sinai Hos
Stroke. 2016 Feb;47(2):307-16. doi: 10.1161/STROKEAHA.115.011328. Epub 2016 Jan 5.
Although a genetic contribution to ischemic stroke is well recognized, only a handful of stroke loci have been identified by large-scale genetic association studies to date. Hypothesizing that genetic effects might be stronger for early- versus late-onset stroke, we conducted a 2-stage meta-analysis of genome-wide association studies, focusing on stroke cases with an age of onset <60 years.
The discovery stage of our genome-wide association studies included 4505 cases and 21 968 controls of European, South-Asian, and African ancestry, drawn from 6 studies. In Stage 2, we selected the lead genetic variants at loci with association P<5×10(-6) and performed in silico association analyses in an independent sample of ≤1003 cases and 7745 controls.
One stroke susceptibility locus at 10q25 reached genome-wide significance in the combined analysis of all samples from the discovery and follow-up stages (rs11196288; odds ratio =1.41; P=9.5×10(-9)). The associated locus is in an intergenic region between TCF7L2 and HABP2. In a further analysis in an independent sample, we found that 2 single nucleotide polymorphisms in high linkage disequilibrium with rs11196288 were significantly associated with total plasma factor VII-activating protease levels, a product of HABP2.
HABP2, which encodes an extracellular serine protease involved in coagulation, fibrinolysis, and inflammatory pathways, may be a genetic susceptibility locus for early-onset stroke.
虽然遗传因素对缺血性卒中的影响已得到充分认识,但迄今为止,大规模基因关联研究仅鉴定出少数几个卒中相关基因座。鉴于早期与晚期发病的卒中可能存在更强的遗传效应,我们开展了一项两阶段的全基因组关联研究荟萃分析,重点关注发病年龄小于60岁的卒中病例。
我们全基因组关联研究的发现阶段纳入了来自6项研究的4505例病例以及21968例欧洲、南亚和非洲血统的对照。在第二阶段,我们选择了关联P值<5×10⁻⁶的基因座上的主要遗传变异,并在一个独立样本(≤1003例病例和7745例对照)中进行了电子关联分析。
在发现阶段和随访阶段的所有样本的联合分析中,位于10q25的一个卒中易感基因座达到全基因组显著性水平(rs11196288;比值比=1.41;P=9.5×10⁻⁹)。相关基因座位于TCF7L2和HABP2之间的基因间区域。在对一个独立样本的进一步分析中,我们发现与rs11196288处于高度连锁不平衡状态的2个单核苷酸多态性与血浆总因子VII激活蛋白酶水平显著相关,该蛋白酶是HABP2的产物。
HABP2编码一种参与凝血、纤维蛋白溶解和炎症途径的细胞外丝氨酸蛋白酶,可能是早发性卒中的一个遗传易感基因座。