From the Stroke Pharmacogenomics and Genetics Group (E.M., J.C.-M., L.L.-C., C.G.-F., N.C., M.L.L., J.M.M.-C., P.V.-G., I.F.-C.), Biomedical Research Institute Sant Pau (IIB SANT PAU); Epilepsy Unit (E.M., A.S.-M., V.R.-C.), Neurology Service, Hospital de la Santa Creu i Sant Pau, Barcelona; Stroke Pharmacogenomics and Genetics (N.C.), Fundació MútuaTerrassa per la Docència i la Recerca; and Department of Neurology (C.G.-F., A.A.-S., J.M.-F.), Hospital de la Santa Creu i Sant Pau, IIB SANT PAU, Barcelona, Spain.
Neurology. 2024 Oct 22;103(8):e209666. doi: 10.1212/WNL.0000000000209666. Epub 2024 Sep 19.
BACKGROUND AND OBJECTIVES: Genome-wide association studies (GWASs) have only 2 loci associated with spontaneous intracerebral hemorrhage (ICH): for lobar and 1q22 for nonlobar ICH. We aimed to discover new loci through an analysis that combines correlated traits (multi-trait analysis of GWAS [MTAG]) and explore a gene-based analysis, transcriptome-wide association study (TWAS), and proteome-wide association study (PWAS) to understand the biological mechanisms of spontaneous ICH providing potential therapeutic targets. METHODS: We use the published MTAG of ICH (patients with spontaneous intraparenchymal bleeding) and small-vessel ischemic stroke. For all ICH, lobar ICH, and nonlobar ICH, a pairwise MTAG combined ICH with traits related to cardiovascular risk factors, cerebrovascular diseases, or Alzheimer disease (AD). For the analysis, we assembled those traits with a genetic correlation ≥0.3. A new MTAG combining multiple traits was performed with those traits whose pairwise MTAG yielded new GWAS-significant single nucleotide polymorphisms (SNPs), with a posterior-probability of model 3 (GWAS-pairwise) ≥0.6. We perform TWAS and PWAS that correlate the genetic component of expression or protein levels with the genetic component of a trait. We use the ICH cohort from UK Biobank as replication. RESULTS: For all ICH (1,543 ICH, 1,711 controls), the mean age was 72 ± 2 in cases and 70 ± 2 in controls, and half of them were women. Replication cohort: 700 ICH and 399,717 controls. Novel loci were found only for all ICH (the trait containing lobar and nonlobar ICH), combining data of ICH and small vessel stroke, white matter hyperintensities volume, fractional anisotropy, mean diffusivity, and AD. We replicated 6 SNPs belonging to 2q33.2 (, β = 0.20, SE = 0.03, value = 8.91 × 10), 10q24.33 (, β = -0.12, SE = 0.02, value = 1.67 × 10), 13q34 (, β = 0.02, SE = 0.02, value = 2.34 × 10), and 19q13.32 (, β = -0.19, SE = 0.03, value = 1.38 × 10; , β = 0.21, SE = 0.03, value = 2.70 × 10; , β = 0.15, SE = 0.03, value = 1.38 × 10); 2 genes (, -score = 4.83, value = 6.67 × 10; and , -score: = 5.11, value = 1.60 × 10); and transcript (-score = 6.8, value = 9.1 × 10) and protein levels (-score = -5.8, value = 6.7 × 10). DISCUSSION: Our results reinforce the role of in ICH risk, replicate previous ICH-associated loci (2q33 and 13q34), and point to new ICH associations with , , , and . Our study used data from European subjects, our main limitation. These molecules could be potential targets for future studies for modulating ICH risk.
背景与目的:全基因组关联研究(GWAS)仅发现了与自发性脑出血(ICH)相关的 2 个基因座: 与脑叶 ICH 相关,1q22 与非脑叶 ICH 相关。我们旨在通过分析发现新的基因座,该分析结合了相关的特征(GWAS 的多特征分析[MTAG]),并探讨了基于基因的分析、转录组全关联研究(TWAS)和蛋白质组全关联研究(PWAS),以了解自发性 ICH 的生物学机制,提供潜在的治疗靶点。
方法:我们使用已发表的 ICH(自发性脑实质出血)和小血管缺血性卒中的 MTAG。对于所有 ICH、脑叶 ICH 和非脑叶 ICH,将 ICH 与与心血管危险因素、脑血管疾病或阿尔茨海默病(AD)相关的特征进行成对的 MTAG 组合。对于分析,我们将那些遗传相关性≥0.3 的特征组合在一起。对于那些通过成对的 MTAG 产生新的 GWAS 显著单核苷酸多态性(SNP)的特征,我们进行了新的 MTAG 组合,模型 3(GWAS 成对)的后验概率≥0.6。我们进行了 TWAS 和 PWAS,将表达或蛋白质水平的遗传成分与特征的遗传成分相关联。我们使用 UK Biobank 的 ICH 队列进行复制。
结果:对于所有 ICH(1543 例 ICH,1711 例对照),病例的平均年龄为 72±2 岁,对照组为 70±2 岁,其中一半为女性。复制队列:700 例 ICH 和 399717 例对照。仅在所有 ICH(包含脑叶和非脑叶 ICH 的特征)中发现了新的基因座,该特征结合了 ICH 和小血管卒中、白质高信号体积、分数各向异性、平均扩散率和 AD 的数据。我们复制了属于 2q33.2(β=0.20,SE=0.03, 值=8.91×10)、10q24.33(β=-0.12,SE=0.02, 值=1.67×10)、13q34(β=0.02,SE=0.02, 值=2.34×10)和 19q13.32(β=-0.19,SE=0.03, 值=1.38×10;β=0.21,SE=0.03, 值=2.70×10;β=0.15,SE=0.03, 值=1.38×10);2 个基因(β=-score=4.83, 值=6.67×10;β=-score=5.11, 值=1.60×10)和 1 个转录本(-score=6.8, 值=9.1×10)和蛋白质水平(-score=-5.8, 值=6.7×10)的 SNP。
讨论:我们的研究结果强化了 在 ICH 风险中的作用,复制了之前与 ICH 相关的基因座(2q33 和 13q34),并指出了与 、 、 和 相关的新的 ICH 关联。我们的研究使用了来自欧洲人群的数据,这是我们的主要局限性。这些分子可能是未来研究调节 ICH 风险的潜在靶点。
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