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贝叶斯推理将罕见变异与肺动脉高压的特定表型相关联。

Bayesian Inference Associates Rare Variants with Specific Phenotypes in Pulmonary Arterial Hypertension.

作者信息

Swietlik Emilia M, Greene Daniel, Zhu Na, Megy Karyn, Cogliano Marcella, Rajaram Smitha, Pandya Divya, Tilly Tobias, Lutz Katie A, Welch Carrie C L, Pauciulo Michael W, Southgate Laura, Martin Jennifer M, Treacy Carmen M, Penkett Christopher J, Stephens Jonathan C, Bogaard Harm J, Church Colin, Coghlan Gerry, Coleman Anna W, Condliffe Robin, Eichstaedt Christina A, Eyries Mélanie, Gall Henning, Ghio Stefano, Girerd Barbara, Grünig Ekkehard, Holden Simon, Howard Luke, Humbert Marc, Kiely David G, Kovacs Gabor, Lordan Jim, Machado Rajiv D, Mackenzie Ross Robert V, McCabe Colm, Moledina Shahin, Montani David, Olschewski Horst, Pepke-Zaba Joanna, Price Laura, Rhodes Christopher J, Seeger Werner, Soubrier Florent, Suntharalingam Jay, Toshner Mark R, Vonk Noordegraaf Anton, Wharton John, Wild James M, Wort Stephen John, Lawrie Allan, Wilkins Martin R, Trembath Richard C, Shen Yufeng, Chung Wendy K, Swift Andrew J, Nichols William C, Morrell Nicholas W, Gräf Stefan

机构信息

Department of Medicine, University of Cambridge, Cambridge, United Kingdom.

Department of Haematology, University of Cambridge & NIHR BioResource for Translational Research, Cambridge, United Kingdom.

出版信息

Circ Genom Precis Med. 2020 Dec 15;14(1):e003155. doi: 10.1161/CIRCGEN.120.003155.

Abstract
  • Approximately 25% of patients with pulmonary arterial hypertension (PAH) have been found to harbor rare mutations in disease-causing genes. To identify missing heritability in PAH we integrated deep phenotyping with whole-genome sequencing data using Bayesian statistics. - We analyzed 13,037 participants enrolled in the NIHR BioResource - Rare Diseases (NBR) study, of which 1,148 were recruited to the PAH domain. To test for genetic associations between genes and selected phenotypes of pulmonary hypertension (PH), we used the Bayesian rare-variant association method BeviMed. - Heterozygous, high impact, likely loss-of-function variants in the Kinase Insert Domain Receptor () gene were strongly associated with significantly reduced transfer coefficient for carbon monoxide (KCO, posterior probability (PP)=0.989) and older age at diagnosis (PP=0.912). We also provide evidence for familial segregation of a rare nonsense variant with these phenotypes. On computed tomographic imaging of the lungs, a range of parenchymal abnormalities were observed in the five patients harboring these predicted deleterious variants in . Four additional PAH cases with rare likely loss-of-function variants in were independently identified in the US PAH Biobank cohort with similar phenotypic characteristics. - The Bayesian inference approach allowed us to independently validate , which encodes for the Vascular Endothelial Growth Factor Receptor 2 (VEGFR2), as a novel PAH candidate gene. Furthermore, this approach specifically associated high impact likely loss-of-function variants in the genetically constrained gene with distinct phenotypes. These findings provide evidence for being a clinically actionable PAH gene and further support the central role of the vascular endothelium in the pathobiology of PAH.
摘要
  • 已发现约25%的肺动脉高压(PAH)患者在致病基因中存在罕见突变。为了确定PAH中缺失的遗传力,我们使用贝叶斯统计方法将深度表型分析与全基因组测序数据相结合。

  • 我们分析了参与英国国家卫生研究院生物资源 - 罕见病(NBR)研究的13037名参与者,其中1148人被纳入PAH领域研究。为了测试基因与肺动脉高压(PH)选定表型之间的遗传关联,我们使用了贝叶斯罕见变异关联方法BeviMed。

  • 激酶插入结构域受体()基因中的杂合、高影响、可能功能丧失的变异与一氧化碳转运系数显著降低(KCO,后验概率(PP)=0.989)和诊断时年龄较大(PP=0.912)密切相关。我们还提供了一种罕见的无义变异与这些表型的家族分离证据。在肺部计算机断层扫描成像中,在携带这些预测有害变异的5名患者中观察到一系列实质异常。在美国PAH生物样本队列中独立鉴定出另外4例在中具有罕见的可能功能丧失变异的PAH病例,其具有相似的表型特征。

  • 贝叶斯推理方法使我们能够独立验证编码血管内皮生长因子受体2(VEGFR2)的作为一个新的PAH候选基因。此外,这种方法特别将遗传受限基因中高影响的可能功能丧失变异与不同表型相关联。这些发现为是一个具有临床可操作性的PAH基因提供了证据,并进一步支持了血管内皮在PAH病理生物学中的核心作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17f0/7892262/07f651d99a17/hcg-14-e003155-g001.jpg

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