Department of Genetic Medicine, Johns Hopkins University (JHU), Baltimore, MD, 21205, USA.
University of North Carolina at Chapel Hill (UNC), Chapel Hill, NC, 27599, USA.
J Cyst Fibros. 2021 Sep;20(5):851-856. doi: 10.1016/j.jcf.2021.02.007. Epub 2021 Mar 2.
The CFTR modulator ivacaftor has been variably effective in treating individuals with cystic fibrosis (CF) who harbor CFTR gating variants such as G551D, as well as other classes of CFTR variants when used with other modulators. Because CFTR genotype does not fully explain this variability, defining genetic modifiers of response to modulator therapy is of particular interest to the field of individualized CF drug therapy. Previous studies have proposed that a variant in SLC26A9 (rs7512462) is associated with lung disease severity and with response to treatment with ivacaftor in individuals with CF who carry G551D or gating variants.
Given the implications for CF treatment, we re-examined the reported associations in three cohorts; patients enrolled in the Twin and Siblings study at Johns Hopkins University, the CF modifier study at the University of North Carolina at Chapel Hill, and the prospective G551D Observational (GOAL) study. The GOAL study was specifically designed to measure lung function response to ivacaftor.
We find no association between SLC26A9 (rs7512462) genotype and lung disease severity (n = 272) or change in lung function at one-, three-, and six-month intervals following ivacaftor treatment(n = 141) in individuals with CF who carry at least one G551D variant.
Our inability to replicate this association indicates that rs7512462 genotype should not be used in treatment decisions.
CFTR 调节剂 ivacaftor 治疗携带 CFTR 门控变异(如 G551D)的囊性纤维化(CF)个体以及与其他调节剂联合使用时的其他 CFTR 变异的效果存在差异。由于 CFTR 基因型不能完全解释这种变异性,因此确定对调节剂治疗反应的遗传修饰因子是个体化 CF 药物治疗领域特别关注的问题。先前的研究表明,SLC26A9(rs7512462)中的变异与 CF 个体的肺部疾病严重程度以及携带 G551D 或门控变异的个体对 ivacaftor 治疗的反应有关。
鉴于其对 CF 治疗的影响,我们在三个队列中重新检查了报告的关联;约翰霍普金斯大学双胞胎和兄弟姐妹研究中的患者、北卡罗来纳大学教堂山分校的 CF 调节剂研究中的患者以及前瞻性 G551D 观察(GOAL)研究中的患者。GOAL 研究专门设计用于测量肺功能对 ivacaftor 的反应。
我们未发现 SLC26A9(rs7512462)基因型与携带至少一种 G551D 变异的 CF 个体的肺部疾病严重程度(n=272)或 ivacaftor 治疗后一个月、三个月和六个月时肺功能变化之间存在关联(n=141)。
我们无法复制这种关联表明,rs7512462 基因型不应用于治疗决策。