Departamento de Moléstias Infecciosas e Parasitárias, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
Laboratório de Parasitologia Médica (LIM-46), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
PLoS Negl Trop Dis. 2022 Oct 10;16(10):e0010725. doi: 10.1371/journal.pntd.0010725. eCollection 2022 Oct.
Chronic Chagas Cardiomyopathy (CCC) usually develops between 10 and 20 years after the first parasitic infection and is one of the leading causes of end-stage heart failure in Latin America. Despite the great inter-individual variability in CCC susceptibility (only 30% of infected individuals ever present CCC), there are no known predictors for disease development in those chronically infected.
METHODOLOGY/PRINCIPAL FINDINGS: We describe a new susceptibility locus for CCC through a GWAS analysis in the SaMi-Trop cohort, a population-based study conducted in a Chagas endemic region from Brazil. This locus was also associated with CCC in the REDS II Study. The newly identified locus (rs34238187, OR 0.73, p-value 2.03 x 10-9) spans a haplotype of approximately 30Kb on chromosome 18 (chr18: 5028302-5057621) and is also associated with 80 different traits, most of them blood protein traits significantly enriched for immune-related biological pathways. Hi-C data show that the newly associated locus is able to interact with chromatin sites as far as 10Mb on chromosome 18 in a number of different cell types and tissues. Finally, we were able to confirm, at the tissue transcriptional level, the immune-associated blood protein signature using a multi-tissue differential gene expression and enrichment analysis.
CONCLUSIONS/SIGNIFICANCE: We suggest that the newly identified locus impacts CCC risk among T cruzi infected individuals through the modulation of a downstream transcriptional and protein signature associated with host-parasite immune response. Functional characterization of the novel risk locus is warranted.
慢性恰加斯心肌病(CCC)通常在初次寄生虫感染后 10 至 20 年内发展,是拉丁美洲导致终末期心力衰竭的主要原因之一。尽管 CCC 的个体易感性存在很大差异(只有 30%的感染个体出现 CCC),但在那些慢性感染的人中,目前还没有已知的疾病发展预测因子。
方法/主要发现:我们通过在巴西恰加斯病流行地区进行的一项基于人群的 SaMi-Trop 队列的 GWAS 分析,描述了 CCC 的一个新易感性位点。该位点也与 REDS II 研究中的 CCC 相关。新确定的位点(rs34238187,OR0.73,p 值 2.03x10-9)跨越染色体 18 上大约 30Kb 的单倍型(chr18:5028302-5057621),并且还与 80 种不同的特征相关,其中大多数是与免疫相关的生物学途径显著富集的血液蛋白特征。Hi-C 数据表明,新关联的位点能够在多种不同的细胞类型和组织中与染色体 18 上多达 10Mb 的染色质位点相互作用。最后,我们能够在组织转录水平上使用多组织差异基因表达和富集分析,确认与免疫相关的血液蛋白特征。
结论/意义:我们认为,新确定的位点通过调节与宿主-寄生虫免疫反应相关的下游转录和蛋白质特征,影响 T cruzi 感染个体的 CCC 风险。有必要对新的风险位点进行功能特征分析。