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Giudicessi JR, Ackerman MJ. Calcium Revisited: New Insights Into the Molecular Basis of Long-QT Syndrome. Circ Arrhythm Electrophysiol 2018; 9:CIRCEP.116.002480. [PMID: 27390209 DOI: 10.1161/circep.116.002480] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 05/27/2016] [Indexed: 12/12/2022]
Affiliation(s)
- John R Giudicessi
- From the Internal Medicine Residency and Clinician-Investigator Programs, Department of Medicine (J.R.G.) and Departments of Cardiovascular Diseases, Pediatrics (Division of Pediatric Cardiology), and Molecular Pharmacology & Experimental Therapeutics (M.J.A.), Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, MN
| | - Michael J Ackerman
- From the Internal Medicine Residency and Clinician-Investigator Programs, Department of Medicine (J.R.G.) and Departments of Cardiovascular Diseases, Pediatrics (Division of Pediatric Cardiology), and Molecular Pharmacology & Experimental Therapeutics (M.J.A.), Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, MN.
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52
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Genomic approaches for the elucidation of genes and gene networks underlying cardiovascular traits. Biophys Rev 2018; 10:1053-1060. [PMID: 29934864 PMCID: PMC6082306 DOI: 10.1007/s12551-018-0435-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 06/13/2018] [Indexed: 12/31/2022] Open
Abstract
Genome-wide association studies have shed light on the association between natural genetic variation and cardiovascular traits. However, linking a cardiovascular trait associated locus to a candidate gene or set of candidate genes for prioritization for follow-up mechanistic studies is all but straightforward. Genomic technologies based on next-generation sequencing technology nowadays offer multiple opportunities to dissect gene regulatory networks underlying genetic cardiovascular trait associations, thereby aiding in the identification of candidate genes at unprecedented scale. RNA sequencing in particular becomes a powerful tool when combined with genotyping to identify loci that modulate transcript abundance, known as expression quantitative trait loci (eQTL), or loci modulating transcript splicing known as splicing quantitative trait loci (sQTL). Additionally, the allele-specific resolution of RNA-sequencing technology enables estimation of allelic imbalance, a state where the two alleles of a gene are expressed at a ratio differing from the expected 1:1 ratio. When multiple high-throughput approaches are combined with deep phenotyping in a single study, a comprehensive elucidation of the relationship between genotype and phenotype comes into view, an approach known as systems genetics. In this review, we cover key applications of systems genetics in the broad cardiovascular field.
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Giudicessi JR, Ackerman MJ, Camilleri M. Cardiovascular safety of prokinetic agents: A focus on drug-induced arrhythmias. Neurogastroenterol Motil 2018; 30:e13302. [PMID: 29441683 PMCID: PMC6364982 DOI: 10.1111/nmo.13302] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 01/08/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Gastrointestinal sensorimotor dysfunction underlies a wide range of esophageal, gastric, and intestinal motility and functional disorders that collectively constitute nearly half of all referrals to gastroenterologists. As a result, substantial effort has been dedicated toward the development of prokinetic agents intended to augment or restore normal gastrointestinal motility. However, the use of several clinically efficacious gastroprokinetic agents, such as cisapride, domperidone, erythromycin, and tegaserod, is associated with unfavorable cardiovascular safety profiles, leading to restrictions in their use. PURPOSE The purpose of this review is to detail the cellular and molecular mechanisms that lead commonly to drug-induced cardiac arrhythmias, specifically drug-induced long QT syndrome, torsades de pointes, and ventricular fibrillation, to examine the cardiovascular safety profiles of several classes of prokinetic agents currently in clinical use, and to explore potential strategies by which the risk of drug-induced cardiac arrhythmia associated with prokinetic agents and other QT interval prolonging medications can be mitigated successfully.
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Affiliation(s)
- J. R. Giudicessi
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - M. J. Ackerman
- Departments of Cardiovascular Medicine, Pediatrics, and Molecular Pharmacology & Experimental Therapeutics, Mayo Clinic, Rochester, MN, USA
| | - M. Camilleri
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Mayo Clinic, Rochester, MN, USA
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QTc prolongation in short-term treatment of schizophrenia patients: effects of different antipsychotics and genetic factors. Eur Arch Psychiatry Clin Neurosci 2018; 268:383-390. [PMID: 29429138 DOI: 10.1007/s00406-018-0880-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 02/04/2018] [Indexed: 02/04/2023]
Abstract
Antipsychotics are effective in treating schizophrenia but may lead to a higher cardiovascular risk due to QTc prolongation. Besides drugs, genetic and clinical factors may contribute to QTc prolongation. The aim of this study is to examine the effect of candidate genes known for QTc prolongation and their interaction with common antipsychotics. Thus, 199 patients were genotyped for nine polymorphisms in KCNQ1, KCNH2, SCN5A, LOC10537879, LOC101927066, NOS1AP and NUBPL. QTc interval duration was measured before treatment and weekly for 5 weeks while being treated with risperidone, quetiapine, olanzapine, amisulpride, aripiprazole and haloperidol in monotherapy. Antipsychotics used in this study showed a different potential to affect the QTc interval. We found no association between KCNH2, KCNQ1, LOC10537879, LOC101927066, NOS1AP and NUBPL polymorphisms and QTc duration at baseline and during antipsychotic treatment. Mixed general models showed a significant overall influence of SCN5A (H558R) on QTc duration but no significant interaction with antipsychotic treatment. Our results do not provide evidence for an involvement of candidate genes for QTc duration in the pathophysiology of QTc prolongation by antipsychotics during short-term treatment. Further association studies are needed to confirm our findings. With a better understanding of these interactions the cardiovascular risk of patients may be decreased.
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55
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Rosenberg MA, Lubitz SA, Lin H, Kosova G, Castro VM, Huang P, Ellinor PT, Perlis RH, Newton-Cheh C. Validation of Polygenic Scores for QT Interval in Clinical Populations. ACTA ACUST UNITED AC 2018; 10:CIRCGENETICS.117.001724. [PMID: 28986454 DOI: 10.1161/circgenetics.117.001724] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 08/28/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND Polygenic risk scores (PGS) enable rapid estimation of genome-wide susceptibility for traits, which may be useful in clinical settings, such as prediction of QT interval. In this study, we sought to validate PGS for QT interval in 2 real-world cohorts of European ancestry (EA) and African ancestry (AA). METHODS AND RESULTS Two thousand nine hundred and fifteen participants of EA and 366 of AA in the MGH CAMP study (Cardiology and Metabolic Patient) were genotyped on a genome-wide array and imputed to the 1000 Genomes reference panel. An additional 820 EA and 57 AA participants in the Partners Biobank were genotyped and used for validation. PGS were created for each individual using effect estimates from association tests with QT interval obtained from prior genome-wide association studies, with variants selected based from multiple significance thresholds in the original study. In regression models, clinical variables explained ≈9% to 10% of total variation in resting QTc in EA individuals and ≈12% to 18% in AA individuals. The PGS significantly increased variation explained at most significance thresholds (P<0.001), with a trend toward increased variation explained at more stringent P value cut points in the CAMP EA cohort (P<0.05). In AA individuals, PGS provided no improvement in variation explained at any significance threshold. CONCLUSIONS For individuals of European descent, PGS provided a significant increase in variation in QT interval explained compared with a model with only nongenetic factors at nearly every significance level. There was no apparent benefit gained by relaxing the significance threshold from conventional genome-wide significance (P<5×10-8).
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Affiliation(s)
- Michael A Rosenberg
- From the University of Colorado School of Medicine, Aurora (M.A.R.); Massachusetts General Hospital, Boston (S.A.L., G.K., V.M.C., P.H., P.T.E., R.H.P., C.N.-C.); and Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, MA (H.L.).
| | - Steven A Lubitz
- From the University of Colorado School of Medicine, Aurora (M.A.R.); Massachusetts General Hospital, Boston (S.A.L., G.K., V.M.C., P.H., P.T.E., R.H.P., C.N.-C.); and Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, MA (H.L.)
| | - Honghuang Lin
- From the University of Colorado School of Medicine, Aurora (M.A.R.); Massachusetts General Hospital, Boston (S.A.L., G.K., V.M.C., P.H., P.T.E., R.H.P., C.N.-C.); and Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, MA (H.L.)
| | - Gulum Kosova
- From the University of Colorado School of Medicine, Aurora (M.A.R.); Massachusetts General Hospital, Boston (S.A.L., G.K., V.M.C., P.H., P.T.E., R.H.P., C.N.-C.); and Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, MA (H.L.)
| | - Victor M Castro
- From the University of Colorado School of Medicine, Aurora (M.A.R.); Massachusetts General Hospital, Boston (S.A.L., G.K., V.M.C., P.H., P.T.E., R.H.P., C.N.-C.); and Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, MA (H.L.)
| | - Paul Huang
- From the University of Colorado School of Medicine, Aurora (M.A.R.); Massachusetts General Hospital, Boston (S.A.L., G.K., V.M.C., P.H., P.T.E., R.H.P., C.N.-C.); and Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, MA (H.L.)
| | - Patrick T Ellinor
- From the University of Colorado School of Medicine, Aurora (M.A.R.); Massachusetts General Hospital, Boston (S.A.L., G.K., V.M.C., P.H., P.T.E., R.H.P., C.N.-C.); and Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, MA (H.L.)
| | - Roy H Perlis
- From the University of Colorado School of Medicine, Aurora (M.A.R.); Massachusetts General Hospital, Boston (S.A.L., G.K., V.M.C., P.H., P.T.E., R.H.P., C.N.-C.); and Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, MA (H.L.)
| | - Christopher Newton-Cheh
- From the University of Colorado School of Medicine, Aurora (M.A.R.); Massachusetts General Hospital, Boston (S.A.L., G.K., V.M.C., P.H., P.T.E., R.H.P., C.N.-C.); and Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, MA (H.L.)
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56
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Pott A, Bock S, Berger IM, Frese K, Dahme T, Keßler M, Rinné S, Decher N, Just S, Rottbauer W. Mutation of the Na +/K +-ATPase Atp1a1a.1 causes QT interval prolongation and bradycardia in zebrafish. J Mol Cell Cardiol 2018; 120:42-52. [PMID: 29750993 DOI: 10.1016/j.yjmcc.2018.05.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 04/24/2018] [Accepted: 05/07/2018] [Indexed: 02/01/2023]
Abstract
The genetic underpinnings that orchestrate the vertebrate heart rate are not fully understood yet, but of high clinical importance, since diseases of cardiac impulse formation and propagation are common and severe human arrhythmias. To identify novel regulators of the vertebrate heart rate, we deciphered the pathogenesis of the bradycardia in the homozygous zebrafish mutant hiphop (hip) and identified a missense-mutation (N851K) in Na+/K+-ATPase α1-subunit (atp1a1a.1). N851K affects zebrafish Na+/K+-ATPase ion transport capacity, as revealed by in vitro pump current measurements. Inhibition of the Na+/K+-ATPase in vivo indicates that hip rather acts as a hypomorph than being a null allele. Consequently, reduced Na+/K+-ATPase function leads to prolonged QT interval and refractoriness in the hip mutant heart, as shown by electrocardiogram and in vivo electrical stimulation experiments. We here demonstrate for the first time that Na+/K+-ATPase plays an essential role in heart rate regulation by prolonging myocardial repolarization.
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Affiliation(s)
- Alexander Pott
- Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany
| | - Sarah Bock
- Molecular Cardiology, Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany
| | - Ina M Berger
- Molecular Cardiology, Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany
| | - Karen Frese
- Department of Internal Medicine III, Heidelberg University Medical Center, Heidelberg, Germany
| | - Tillman Dahme
- Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany
| | - Mirjam Keßler
- Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany
| | - Susanne Rinné
- Institute for Physiology and Pathophysiology, AG Vegetative Physiology, Philipps-University of Marburg, Marburg, Germany
| | - Niels Decher
- Institute for Physiology and Pathophysiology, AG Vegetative Physiology, Philipps-University of Marburg, Marburg, Germany
| | - Steffen Just
- Molecular Cardiology, Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany.
| | - Wolfgang Rottbauer
- Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany.
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57
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El-Sherif N, Turitto G, Boutjdir M. Acquired long QT syndrome and torsade de pointes. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2018; 41:414-421. [PMID: 29405316 DOI: 10.1111/pace.13296] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 12/13/2017] [Accepted: 12/22/2017] [Indexed: 01/08/2023]
Abstract
Since its initial description by Jervell and Lange-Nielsen in 1957, the congenital long QT syndrome (LQTS) has been the most investigated cardiac ion channelopathy. Although congenital LQTS continues to remain the domain of cardiologists, cardiac electrophysiologists, and specialized centers, the by far more frequent acquired drug-induced LQTS is the domain of all physicians and other members of the health care team who are required to make therapeutic decisions. This report will review the electrophysiological mechanisms of LQTS and torsade de pointes, electrocardiographic characteristics of acquired LQTS, its clinical presentation, management, and future directions in the field.
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Affiliation(s)
- Nabil El-Sherif
- Downstate Medical Center, State University of New York, New York, NY, USA.,VA NY Harbor Healthcare System, New York, NY, USA
| | - Gioia Turitto
- New York-Presbyterian Brooklyn Methodist Hospital, New York, NY, USA
| | - Mohamed Boutjdir
- Downstate Medical Center, State University of New York, New York, NY, USA.,VA NY Harbor Healthcare System, New York, NY, USA.,NYU School of Medicine, New York, NY, USA
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58
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Giudicessi JR, Wilde AAM, Ackerman MJ. The genetic architecture of long QT syndrome: A critical reappraisal. Trends Cardiovasc Med 2018; 28:453-464. [PMID: 29661707 DOI: 10.1016/j.tcm.2018.03.003] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 03/19/2018] [Accepted: 03/21/2018] [Indexed: 12/19/2022]
Abstract
Collectively, the completion of the Human Genome Project and subsequent development of high-throughput next-generation sequencing methodologies have revolutionized genomic research. However, the rapid sequencing and analysis of thousands upon thousands of human exomes and genomes has taught us that most genes, including those known to cause heritable cardiovascular disorders such as long QT syndrome, harbor an unexpected background rate of rare, and presumably innocuous, non-synonymous genetic variation. In this Review, we aim to reappraise the genetic architecture underlying both the acquired and congenital forms of long QT syndrome by examining how the clinical phenotype associated with and background genetic variation in long QT syndrome-susceptibility genes impacts the clinical validity of existing gene-disease associations and the variant classification and reporting strategies that serve as the foundation for diagnostic long QT syndrome genetic testing.
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Affiliation(s)
- John R Giudicessi
- Department of Cardiovascular Medicine (Cardiovascular Diseases Fellowship and Clinician-Investigator Training Programs), Mayo Clinic, Rochester, MN, United States
| | - Arthur A M Wilde
- Department of Medicine (Division of Cardiology), Columbia University Irving Medical Center, New York, NY, United States; Department of Clinical & Experimental Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Michael J Ackerman
- Departments of Cardiovascular Medicine (Division of Heart Rhythm Services), Pediatrics (Division of Pediatric Cardiology), and Molecular Pharmacology & Experimental Therapeutics (Windland Smith Rice Sudden Death Genomics Laboratory), Mayo Clinic, Rochester, MN, United States.
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59
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Chen X, Yang Y, Liu J, Li B, Xu Y, Li C, Xu Q, Liu G, Chen Y, Ying J, Duan S. NDRG4 hypermethylation is a potential biomarker for diagnosis and prognosis of gastric cancer in Chinese population. Oncotarget 2018; 8:8105-8119. [PMID: 28042954 PMCID: PMC5352386 DOI: 10.18632/oncotarget.14099] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 11/23/2016] [Indexed: 12/19/2022] Open
Abstract
In order to assess whether N-Myc downstream regulated gene 4 (NDRG4) methylation was associated with the diagnosis and prognosis of gastric cancer, we measured the methylation of NDRG4 promoter and gene body regions among 110 gastric cancer patients using quantitative methods (MethyLight and pyrosequencing). Both NDRG4 promoter and gene body methylation levels were increased in tumor tissues than paired adjacent normal tissues (P < 0.001). NDRG4 gene body methylation was found to be significantly associated with age and tumor differentiation. NDRG4 promoter hypermethylation was proved to be a predictor of poor overall survival. However, opposite result was observed among The Cancer Genome Atlas (TCGA) cohort. The findings from gastric cell lines and public databases have suggested that NDRG4 methylation level was inversely associated with NDRG4 transcription level. Subsequent luciferase reporter gene assay showed that promoter CpG island but not gene body CpG island was able to upregulate gene expression. Collectively, NDRG4 promoter hypermethylation contributed to the risk of gastric cancer and predicted a poor prognosis in Chinese gastric cancer patients. Moreover, the combined methylation levels of NDRG4 promoter and gene body served as diagnostic biomarkers in gastric cancer.
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Affiliation(s)
- Xiaoying Chen
- Medical Genetics Center, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China
| | - Yong Yang
- Medical Genetics Center, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China
| | - Jing Liu
- Medical Genetics Center, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China
| | - Bin Li
- Medical Genetics Center, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China
| | - Yan Xu
- Medical Genetics Center, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China
| | - Cong Li
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, China
| | - Qi Xu
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, China
| | - Guili Liu
- Medical Genetics Center, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China
| | - Yingmin Chen
- Medical Genetics Center, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China
| | - Jieer Ying
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, China
| | - Shiwei Duan
- Medical Genetics Center, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China
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60
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Zhang X, Yoon JY, Morley M, McLendon JM, Mapuskar KA, Gutmann R, Mehdi H, Bloom HL, Dudley SC, Ellinor PT, Shalaby AA, Weiss R, Tang WHW, Moravec CS, Singh M, Taylor AL, Yancy CW, Feldman AM, McNamara DM, Irani K, Spitz DR, Breheny P, Margulies KB, London B, Boudreau RL. A common variant alters SCN5A-miR-24 interaction and associates with heart failure mortality. J Clin Invest 2018; 128:1154-1163. [PMID: 29457789 DOI: 10.1172/jci95710] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 12/12/2017] [Indexed: 12/19/2022] Open
Abstract
SCN5A encodes the voltage-gated Na+ channel NaV1.5 that is responsible for depolarization of the cardiac action potential and rapid intercellular conduction. Mutations disrupting the SCN5A coding sequence cause inherited arrhythmias and cardiomyopathy, and single-nucleotide polymorphisms (SNPs) linked to SCN5A splicing, localization, and function associate with heart failure-related sudden cardiac death. However, the clinical relevance of SNPs that modulate SCN5A expression levels remains understudied. We recently generated a transcriptome-wide map of microRNA (miR) binding sites in human heart, evaluated their overlap with common SNPs, and identified a synonymous SNP (rs1805126) adjacent to a miR-24 site within the SCN5A coding sequence. This SNP was previously shown to reproducibly associate with cardiac electrophysiological parameters, but was not considered to be causal. Here, we show that miR-24 potently suppresses SCN5A expression and that rs1805126 modulates this regulation. We found that the rs1805126 minor allele associates with decreased cardiac SCN5A expression and that heart failure subjects homozygous for the minor allele have decreased ejection fraction and increased mortality, but not increased ventricular tachyarrhythmias. In mice, we identified a potential basis for this in discovering that decreased Scn5a expression leads to accumulation of myocardial reactive oxygen species. Together, these data reiterate the importance of considering the mechanistic significance of synonymous SNPs as they relate to miRs and disease, and highlight a surprising link between SCN5A expression and nonarrhythmic death in heart failure.
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Affiliation(s)
- Xiaoming Zhang
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Jin-Young Yoon
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Michael Morley
- Department of Internal Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jared M McLendon
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Kranti A Mapuskar
- Department of Radiation Oncology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Rebecca Gutmann
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Haider Mehdi
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Heather L Bloom
- Department of Medicine, Emory University Medical Center, Atlanta, Georgia, USA
| | - Samuel C Dudley
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Patrick T Ellinor
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Alaa A Shalaby
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Raul Weiss
- Department of Internal Medicine, The Ohio State University Medical Center, Columbus, Ohio, USA
| | - W H Wilson Tang
- Department of Cardiovascular Medicine, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA
| | - Christine S Moravec
- Department of Molecular Cardiology, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA
| | - Madhurmeet Singh
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Anne L Taylor
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA
| | - Clyde W Yancy
- Division of Cardiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Arthur M Feldman
- Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania, USA
| | - Dennis M McNamara
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Kaikobad Irani
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Douglas R Spitz
- Department of Radiation Oncology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Patrick Breheny
- Department of Biostatistics, University of Iowa College of Public Heath, Iowa City, Iowa, USA
| | - Kenneth B Margulies
- Department of Internal Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Barry London
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Ryan L Boudreau
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
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61
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Chai S, Wan X, Ramirez-Navarro A, Tesar PJ, Kaufman ES, Ficker E, George AL, Deschênes I. Physiological genomics identifies genetic modifiers of long QT syndrome type 2 severity. J Clin Invest 2018; 128:1043-1056. [PMID: 29431731 DOI: 10.1172/jci94996] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 01/02/2018] [Indexed: 12/11/2022] Open
Abstract
Congenital long QT syndrome (LQTS) is an inherited channelopathy associated with life-threatening arrhythmias. LQTS type 2 (LQT2) is caused by mutations in KCNH2, which encodes the potassium channel hERG. We hypothesized that modifier genes are partly responsible for the variable phenotype severity observed in some LQT2 families. Here, we identified contributors to variable expressivity in an LQT2 family by using induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) and whole exome sequencing in a synergistic manner. We found that iPSC-CMs recapitulated the clinical genotype-phenotype discordance in vitro. Importantly, iPSC-CMs derived from the severely affected LQT2 patients displayed prolonged action potentials compared with cells from mildly affected first-degree relatives. The iPSC-CMs derived from all patients with hERG R752W mutation displayed lower IKr amplitude. Interestingly, iPSC-CMs from severely affected mutation-positive individuals exhibited greater L-type Ca2+ current. Whole exome sequencing identified variants of KCNK17 and the GTP-binding protein REM2, providing biologically plausible explanations for this variable expressivity. Genome editing to correct a REM2 variant reversed the enhanced L-type Ca2+ current and prolonged action potential observed in iPSC-CMs from severely affected individuals. Thus, our findings showcase the power of combining complementary physiological and genomic analyses to identify genetic modifiers and potential therapeutic targets of a monogenic disorder. Furthermore, we propose that this strategy can be deployed to unravel myriad confounding pathologies displaying variable expressivity.
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Affiliation(s)
- Sam Chai
- Department of Physiology and Biophysics.,Heart and Vascular Research Center, Department of Medicine, and
| | - Xiaoping Wan
- Heart and Vascular Research Center, Department of Medicine, and
| | | | - Paul J Tesar
- Department of Genetics, Case Western Reserve University, Cleveland, Ohio, USA
| | | | - Eckhard Ficker
- Heart and Vascular Research Center, Department of Medicine, and
| | - Alfred L George
- Department of Pharmacology, Northwestern University, Chicago, Illinois, USA
| | - Isabelle Deschênes
- Department of Physiology and Biophysics.,Heart and Vascular Research Center, Department of Medicine, and
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Yamaguchi T, Suzuki T, Sato T, Takahashi A, Watanabe H, Kadowaki A, Natsui M, Inagaki H, Arakawa S, Nakaoka S, Koizumi Y, Seki S, Adachi S, Fukao A, Fujiwara T, Natsume T, Kimura A, Komatsu M, Shimizu S, Ito H, Suzuki Y, Penninger JM, Yamamoto T, Imai Y, Kuba K. The CCR4-NOT deadenylase complex controls Atg7-dependent cell death and heart function. Sci Signal 2018; 11:11/516/eaan3638. [PMID: 29438013 DOI: 10.1126/scisignal.aan3638] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Shortening and removal of the polyadenylate [poly(A)] tail of mRNA, a process called deadenylation, is a key step in mRNA decay that is mediated through the CCR4-NOT (carbon catabolite repression 4-negative on TATA-less) complex. In our investigation of the regulation of mRNA deadenylation in the heart, we found that this complex was required to prevent cell death. Conditional deletion of the CCR4-NOT complex components Cnot1 or Cnot3 resulted in the formation of autophagic vacuoles and cardiomyocyte death, leading to lethal heart failure accompanied by long QT intervals. Cnot3 bound to and shortened the poly(A) tail of the mRNA encoding the key autophagy regulator Atg7. In Cnot3-depleted hearts, Atg7 expression was posttranscriptionally increased. Genetic ablation of Atg7, but not Atg5, increased survival and partially restored cardiac function of Cnot1 or Cnot3 knockout mice. We further showed that in Cnot3-depleted hearts, Atg7 interacted with p53 and modulated p53 activity to induce the expression of genes encoding cell death-promoting factors in cardiomyocytes, indicating that defects in deadenylation in the heart aberrantly activated Atg7 and p53 to promote cell death. Thus, mRNA deadenylation mediated by the CCR4-NOT complex is crucial to prevent Atg7-induced cell death and heart failure, suggesting a role for mRNA deadenylation in targeting autophagy genes to maintain normal cardiac homeostasis.
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Affiliation(s)
- Tomokazu Yamaguchi
- Department of Biochemistry and Metabolic Science, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan
| | - Takashi Suzuki
- Department of Biochemistry and Metabolic Science, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan
| | - Teruki Sato
- Department of Cardiovascular and Respiratory Medicine, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Akinori Takahashi
- Okinawa Institute of Science and Technology Graduate University, Okinawa 904-0495, Japan
| | - Hiroyuki Watanabe
- Department of Cardiovascular and Respiratory Medicine, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Ayumi Kadowaki
- Department of Biochemistry and Metabolic Science, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan
| | - Miyuki Natsui
- Department of Biochemistry and Metabolic Science, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan
| | - Hideaki Inagaki
- Bioscience Education and Research Support Center, Akita University, Akita 010-8543, Japan
| | - Satoko Arakawa
- Department of Pathological Cell Biology, Medical Research Institute, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Shinji Nakaoka
- Institute of Industrial Science, The University of Tokyo, Tokyo 153-8505, Japan.,Laboratory for Regulation of Intractable Infectious Diseases, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki, Osaka 567-0085, Japan
| | - Yukio Koizumi
- Department of Biochemistry and Metabolic Science, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan
| | - Shinsuke Seki
- Bioscience Education and Research Support Center, Akita University, Akita 010-8543, Japan
| | - Shungo Adachi
- Molecular Profiling Research Center for Drug Discovery, National Institute of Advanced Industrial Science and Technology, Tokyo 135-0064, Japan
| | - Akira Fukao
- Molecular Laboratory of Biochemistry, Department of Pharmacy, Kindai University, Higashi-Osaka 577-8502, Japan
| | - Toshinobu Fujiwara
- Molecular Laboratory of Biochemistry, Department of Pharmacy, Kindai University, Higashi-Osaka 577-8502, Japan
| | - Tohru Natsume
- Molecular Profiling Research Center for Drug Discovery, National Institute of Advanced Industrial Science and Technology, Tokyo 135-0064, Japan
| | - Akinori Kimura
- Department of Molecular Pathogenesis, Medical Research Institute, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Masaaki Komatsu
- Department of Biochemistry, School of Medicine, Niigata University, Niigata 951-8510, Japan
| | - Shigeomi Shimizu
- Department of Pathological Cell Biology, Medical Research Institute, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Hiroshi Ito
- Department of Cardiovascular and Respiratory Medicine, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Yutaka Suzuki
- Department of Medical Genome Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Chiba 277-8562, Japan
| | - Josef M Penninger
- Institute of Molecular Biotechnology of the Austrian Academy of Sciences, Campus Vienna BioCenter, Vienna 1030, Austria
| | - Tadashi Yamamoto
- Okinawa Institute of Science and Technology Graduate University, Okinawa 904-0495, Japan
| | - Yumiko Imai
- Laboratory for Regulation of Intractable Infectious Diseases, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki, Osaka 567-0085, Japan
| | - Keiji Kuba
- Department of Biochemistry and Metabolic Science, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan. .,Precursory Research for Embryonic Science and Technology (PRESTO), Japan Science and Technology Agency, Tokyo 102-0076, Japan
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Abstract
Nitric oxide (NO) signalling has pleiotropic roles in biology and a crucial function in cardiovascular homeostasis. Tremendous knowledge has been accumulated on the mechanisms of the nitric oxide synthase (NOS)-NO pathway, but how this highly reactive, free radical gas signals to specific targets for precise regulation of cardiovascular function remains the focus of much intense research. In this Review, we summarize the updated paradigms on NOS regulation, NO interaction with reactive oxidant species in specific subcellular compartments, and downstream effects of NO in target cardiovascular tissues, while emphasizing the latest developments of molecular tools and biomarkers to modulate and monitor NO production and bioavailability.
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Affiliation(s)
- Charlotte Farah
- Pole of Pharmacology and Therapeutics (FATH), Institut de Recherche Experimentale et Clinique (IREC) and Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, UCL-FATH Tour Vésale 5th Floor, 52 Avenue Mounier B1.53.09, 1200 Brussels, Belgium
| | - Lauriane Y M Michel
- Pole of Pharmacology and Therapeutics (FATH), Institut de Recherche Experimentale et Clinique (IREC) and Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, UCL-FATH Tour Vésale 5th Floor, 52 Avenue Mounier B1.53.09, 1200 Brussels, Belgium
| | - Jean-Luc Balligand
- Pole of Pharmacology and Therapeutics (FATH), Institut de Recherche Experimentale et Clinique (IREC) and Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, UCL-FATH Tour Vésale 5th Floor, 52 Avenue Mounier B1.53.09, 1200 Brussels, Belgium
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Munroe PB, Addison S, Abrams DJ, Sebire NJ, Cartwright J, Donaldson I, Cohen MM, Mein C, Tinker A, Harmer SC, Aziz Q, Terry A, Struebig M, Warren HR, Vadgama B, Fowler DJ, Peebles D, Taylor AM, Lally PJ, Thayyil S. Postmortem Genetic Testing for Cardiac Ion Channelopathies in Stillbirths. CIRCULATION-GENOMIC AND PRECISION MEDICINE 2018; 11:e001817. [PMID: 29874177 DOI: 10.1161/circgen.117.001817] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 11/07/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although stillbirth is a significant health problem worldwide, the definitive cause of death remains elusive in many cases, despite detailed autopsy. In this study of partly explained and unexplained stillbirths, we used next-generation sequencing to examine an extended panel of 35 candidate genes known to be associated with ion channel disorders and sudden cardiac death. METHODS AND RESULTS We examined tissue from 242 stillbirths (≥22 weeks), including those where no definite cause of death could be confirmed after a full autopsy. We obtained high-quality DNA from 70 cases, which were then sequenced for a custom panel of 35 genes, 12 for inherited long- and short-QT syndrome genes (LQT1-LQT12 and SQT1-3), and 23 additional candidate genes derived from genome-wide association studies. We examined the functional significance of a selected variant by patch-clamp electrophysiological recording. No predicted damaging variants were identified in KCNQ1 (LQT1) or KCNH2 (LQT2). A rare putative pathogenic variant was found in KCNJ2(LQT7) in 1 case, and several novel variants of uncertain significance were observed. The KCNJ2 variant (p. R40Q), when assessed by whole-cell patch clamp, affected the function of the channel. There was no significant evidence of enrichment of rare predicted damaging variants within any of the candidate genes. CONCLUSIONS Although a causative link is unclear, 1 putative pathogenic and variants of uncertain significance variant resulting in cardiac channelopathies was identified in some cases of otherwise unexplained stillbirth, and these variants may have a role in fetal demise. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifier: NCT01120886.
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Affiliation(s)
- Patricia B Munroe
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.).
| | - Shea Addison
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Dominic J Abrams
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Neil J Sebire
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - James Cartwright
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Ian Donaldson
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Marta M Cohen
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Charles Mein
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Andrew Tinker
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Stephen C Harmer
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Qadeer Aziz
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Anna Terry
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Monika Struebig
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Helen R Warren
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Bhumita Vadgama
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Darren J Fowler
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Donald Peebles
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Andrew M Taylor
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Peter J Lally
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Sudhin Thayyil
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.).
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Savio-Galimberti E, Argenziano M, Antzelevitch C. Cardiac Arrhythmias Related to Sodium Channel Dysfunction. Handb Exp Pharmacol 2018; 246:331-354. [PMID: 28965168 DOI: 10.1007/164_2017_43] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The voltage-gated cardiac sodium channel (Nav1.5) is a mega-complex comprised of a pore-forming α subunit and 4 ancillary β-subunits together with numerous protein partners. Genetic defects in the form of rare variants in one or more sodium channel-related genes can cause a loss- or gain-of-function of sodium channel current (INa) leading to the manifestation of various disease phenotypes, including Brugada syndrome, long QT syndrome, progressive cardiac conduction disease, sick sinus syndrome, multifocal ectopic Purkinje-related premature contractions, and atrial fibrillation. Some sodium channelopathies have also been shown to be responsible for sudden infant death syndrome (SIDS). Although these genetic defects often present as pure electrical diseases, recent studies point to a contribution of structural abnormalities to the electrocardiographic and arrhythmic manifestation in some cases, such as dilated cardiomyopathy. The same rare variants in SCN5A or related genes may present with different clinical phenotypes in different individuals and sometimes in members of the same family. Genetic background and epigenetic and environmental factors contribute to the expression of these overlap syndromes. Our goal in this chapter is to review and discuss what is known about the clinical phenotype and genotype of each cardiac sodium channelopathy, and to briefly discuss the underlying mechanisms.
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Affiliation(s)
| | - Mariana Argenziano
- Lankenau Institute for Medical Research, 100 E. Lancaster Avenue, Wynnewood, PA, 19096, USA
| | - Charles Antzelevitch
- Lankenau Institute for Medical Research, 100 E. Lancaster Avenue, Wynnewood, PA, 19096, USA.
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66
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GAREM1 regulates the PR interval on electrocardiograms. J Hum Genet 2017; 63:297-307. [PMID: 29273731 DOI: 10.1038/s10038-017-0367-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/22/2017] [Accepted: 09/06/2017] [Indexed: 11/09/2022]
Abstract
PR interval is the period from the onset of P wave to the start of the QRS complex on electrocardiograms. A recent genomewide association study (GWAS) suggested that GAREM1 was linked to the PR interval on electrocardiograms. This study was designed to validate this correlation using additional subjects and examined the function of Garem1 in a mouse model. We analyzed the association of rs17744182, a variant in the GAREM1 locus, with the PR interval in 5646 subjects who were recruited from 2 Korean replication sets, Yangpyeong (n = 2471) and Yonsei (n = 3175), and noted a significant genomewide association by meta-analysis (P = 2.39 × 10-8). To confirm the function of Garem1 in mice, Garem1 siRNA was injected into mouse tail veins to reduce the expression of Garem1. Garem1 transcript levels declined by 53% in the atrium of the heart (P = 0.029), and Garem1-siRNA injected mice experienced a significant decrease in PR interval (43.27 ms vs. 44.89 ms in control, P = 0.007). We analyzed the expression pattern of Garem1 in the heart by immunohistology and observed specific expression of Garem1 in intracardiac ganglia. Garem1 was expressed in most neurons of the ganglion, including cholinergic and adrenergic cells. We have provided evidence that GAREM1 is involved in the PR interval of ECGs. These findings increase our understanding of the regulatory signals of heart rhythm through intracardiac ganglia of the autonomic nervous system and can be used to guide the development of a therapeutic target for heart conditions, such as atrial fibrillation.
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A Comparison of Heritability Estimates by Classical Twin Modeling and Based on Genome-Wide Genetic Relatedness for Cardiac Conduction Traits. Twin Res Hum Genet 2017; 20:489-498. [PMID: 29039294 DOI: 10.1017/thg.2017.55] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Twin studies have found that ~50% of variance in electrocardiogram (ECG) traits can be explained by genetic factors. However, genetic variants identified through genome-wide association studies explain less than 10% of the total trait variability. Some have argued that the equal environment assumption for the classical twin model might be invalid, resulting in inflated narrow-sense heritability (h 2) estimates, thus explaining part of the 'missing h 2'. Genomic relatedness restricted maximum likelihood (GREML) estimation overcomes this issue. This method uses both family data and genome-wide coverage of common SNPs to determine the degree of relatedness between individuals to estimate both h 2 explained by common SNPs and total h 2. The aim of the current study is to characterize more reliably than previously possible ECG trait h 2 using GREML estimation, and to compare these outcomes to those of the classical twin model. We analyzed ECG traits (heart rate, PR interval, QRS duration, RV5+SV1, QTc interval, Sokolow-Lyon product, and Cornell product) in up to 3,133 twins from the TwinsUK cohort and derived h 2 estimates by both methods. GREML yielded h 2 estimates between 47% and 68%. Classical twin modeling provided similar h 2 estimates, except for the Cornell product, for which the best fit included no genetic factors. We found no evidence that the classical twin model leads to inflated h 2 estimates. Therefore, our study confirms the validity of the equal environment assumption for monozygotic and dizygotic twins and supports the robust basis for future studies exploring genetic variants responsible for the variance of ECG traits.
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Ghouse J, Skov MW, Bigseth RS, Ahlberg G, Kanters JK, Olesen MS. Distinguishing pathogenic mutations from background genetic noise in cardiology: The use of large genome databases for genetic interpretation. Clin Genet 2017; 93:459-466. [PMID: 28589536 DOI: 10.1111/cge.13066] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 05/31/2017] [Accepted: 06/01/2017] [Indexed: 12/15/2022]
Abstract
Advances in clinical genetic testing have led to increased insight into the human genome, including how challenging it is to interpret rare genetic variation. In some cases, the ability to detect genetic mutations exceeds the ability to understand their clinical impact, limiting the advantage of these technologies. Obstacles in genomic medicine are many and include: understanding the level of certainty/uncertainty behind pathogenicity determination, the numerous different variant interpretation-guidelines used by clinical laboratories, delivering the certain or uncertain result to the patient, helping patients evaluate medical decisions in light of uncertainty regarding the consequence of the findings. Through publication of large publicly available exome/genome databases, researchers and physicians are now able to highlight dubious variants previously associated with different cardiac traits. Also, continuous efforts through data sharing, international collaborative efforts to develop disease-gene-specific guidelines, and computational analyses using large data, will indubitably assist in better variant interpretation and classification. This article discusses the current, and quickly changing, state of variant interpretation resources within cardiovascular genetic research, e.g., publicly available databases and ways of how cardiovascular genetic counselors and geneticists can aid in improving variant interpretation in cardiology.
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Affiliation(s)
- J Ghouse
- Laboratory of Molecular Cardiology, Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - M W Skov
- Laboratory of Molecular Cardiology, Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - R S Bigseth
- Laboratory of Molecular Cardiology, Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - G Ahlberg
- Laboratory of Molecular Cardiology, Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - J K Kanters
- Laboratory of Experimental Cardiology, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - M S Olesen
- Laboratory of Molecular Cardiology, Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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The genetic variation rs12143842 in NOS1AP increases idiopathic ventricular tachycardia risk in Chinese Han populations. Sci Rep 2017; 7:8356. [PMID: 28827735 PMCID: PMC5567283 DOI: 10.1038/s41598-017-08548-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 07/14/2017] [Indexed: 11/30/2022] Open
Abstract
Genome-wide association studies identified that the common T of rs12143842 in NOS1AP is associated with a QT/QTc interval in European populations. In this study, we test the association between the variation rs12143842 in NOS1AP and idiopathic ventricular tachycardia (IVT). A case-control association study examining rs12143842 was performed in two independent cohorts. The Northern cohort enrolled 277 IVT patients and 728 controls from a Chinese Gene ID population. The Central cohort enrolled 301 IVT patients and 803 matched controls. Genotyping was performed using high-resolution melt analysis. The minor T allele of the rs12143842 SNP was significantly associated with decreased IVT risk in the Northern cohort (adjusted P = 0.024, OR 0.71(0.52~0.96)), and this association was replicated in an independent Central Gene ID cohort (adjusted P = 0.029, OR 0.78 (0.62~0.97)). The association was more significant in the combined population (adjusted P = 0.001, OR 0.76 (0.64~0.90)). The P values for the genotypic association were significant for the dominant (P < 0.001) and additive (P = 0.001) models. The minor T allele for the SNP rs12143842 in NOS1AP is significantly associated with IVT. NOS1AP might be a novel gene affecting IVT, and further functional studies should be performed.
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Wichmann HE. Epidemiology in Germany-general development and personal experience. Eur J Epidemiol 2017; 32:635-656. [PMID: 28815360 DOI: 10.1007/s10654-017-0290-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 07/27/2017] [Indexed: 12/19/2022]
Abstract
Did you ever hear about epidemiology in Germany? Starting from an epidemiological desert the discipline has grown remarkably, especially during the last 10-15 years: research institutes have been established, research funding has improved, multiple curriculae in Epidemiology and Public Health are offered. This increase has been quite steep, and now the epidemiological infrastructure is much better. Several medium-sized and even big population cohorts are ongoing, and the number and quality of publications from German epidemiologists has reached a respectable level. My own career in epidemiology started in the field of environmental health. After German reunification I concentrated for many years on environmental problems in East Germany and observed the health benefits after improvement of the situation. Later, I concentrated on population-based cohorts in newborns (GINI/LISA) and adults (KORA, German National Cohort), and on biobanking. This Essay describes the development in Germany after worldwar 2, illustrated by examples of research results and build-up of epidemiological infractructures worth mentioning.
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Affiliation(s)
- Heinz-Erich Wichmann
- Institute of Epidemiology, 2, Helmholtz Center Munich, Munich, Germany. .,Chair of Epidemiology, University of Munich, Munich, Germany.
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Effect of GWAS-Identified Genetic Variants on Maximum QT Interval in Patients With Schizophrenia Receiving Antipsychotic Agents: A 24-Hour Holter ECG Study. J Clin Psychopharmacol 2017; 37:452-455. [PMID: 28590366 DOI: 10.1097/jcp.0000000000000724] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Users of antipsychotics (APs) have a risk of sudden cardiac death (SCD). Sudden cardiac death in such patients is thought to be largely due to drug-induced QT prolongation. It has been reported that many subjects with drug-induced torsades de pointes (TdP) have risk alleles associated with subclinical congenital long QT syndrome. METHODS We investigated the effects of the risk alleles associated with long QT on the QT interval in patients receiving APs using 24-hour Holter electrocardiograms to take into account the circadian fluctuation of QT intervals. We investigated 8 single-nucleotide polymorphisms identified on a GWAS. RESULTS We found that increased numbers of risk alleles at rs7188697 in NDRG4 and rs11970286 in PLN were the major predictors of an increased maximum QT interval over 24 hours in users of APs. CONCLUSIONS It could be useful to perform a DNA-based analysis before the initiation of APs to reduce the risk of drug-induced torsades de pointes and SCD.
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72
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Winbo A, Stattin EL, Westin IM, Norberg A, Persson J, Jensen SM, Rydberg A. Sex is a moderator of the association between NOS1AP sequence variants and QTc in two long QT syndrome founder populations: a pedigree-based measured genotype association analysis. BMC MEDICAL GENETICS 2017; 18:74. [PMID: 28720088 PMCID: PMC5516337 DOI: 10.1186/s12881-017-0435-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 07/06/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND Sequence variants in the NOS1AP gene have repeatedly been reported to influence QTc, albeit with moderate effect sizes. In the long QT syndrome (LQTS), this may contribute to the substantial QTc variance seen among carriers of identical pathogenic sequence variants. Here we assess three non-coding NOS1AP sequence variants, chosen for their previously reported strong association with QTc in normal and LQTS populations, for association with QTc in two Swedish LQT1 founder populations. METHODS This study included 312 individuals (58% females) from two LQT1 founder populations, whereof 227 genotype positive segregating either Y111C (n = 148) or R518* (n = 79) pathogenic sequence variants in the KCNQ1 gene, and 85 genotype negatives. All were genotyped for NOS1AP sequence variants rs12143842, rs16847548 and rs4657139, and tested for association with QTc length (effect size presented as mean difference between derived and wildtype, in ms), using a pedigree-based measured genotype association analysis. Mean QTc was obtained by repeated manual measurement (preferably in lead II) by one observer using coded 50 mm/s standard 12-lead ECGs. RESULTS A substantial variance in mean QTc was seen in genotype positives 476 ± 36 ms (Y111C 483 ± 34 ms; R518* 462 ± 34 ms) and genotype negatives 433 ± 24 ms. Female sex was significantly associated with QTc prolongation in all genotype groups (p < 0.001). In a multivariable analysis including the entire study population and adjusted for KCNQ1 genotype, sex and age, NOS1AP sequence variants rs12143842 and rs16847548 (but not rs4657139) were significantly associated with QT prolongation, +18 ms (p = 0.0007) and +17 ms (p = 0.006), respectively. Significant sex-interactions were detected for both sequent variants (interaction term r = 0.892, p < 0.001 and r = 0.944, p < 0.001, respectively). Notably, across the genotype groups, when stratified by sex neither rs12143842 nor rs16847548 were significantly associated with QTc in females (both p = 0.16) while in males, a prolongation of +19 ms and +8 ms (p = 0.002 and p = 0.02) was seen in multivariable analysis, explaining up to 23% of QTc variance in all males. CONCLUSIONS Sex was identified as a moderator of the association between NOS1AP sequence variants and QTc in two LQT1 founder populations. This finding may contribute to QTc sex differences and affect the usefulness of NOS1AP as a marker for clinical risk stratification in LQTS.
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Affiliation(s)
- Annika Winbo
- Department of Clinical Sciences, Pediatrics, Umeå University, 90187, Umeå, Sweden. .,Department of Physiology, University of Auckland, Auckland, New Zealand.
| | - Eva-Lena Stattin
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Ida Maria Westin
- Department of Medical Biosciences, Medical and Clinical Genetics, Umeå University, Umeå, 90185, Sweden
| | - Anna Norberg
- Department of Medical Biosciences, Medical and Clinical Genetics, Umeå University, Umeå, 90185, Sweden
| | - Johan Persson
- Department of Clinical Sciences, Pediatrics, Umeå University, 90187, Umeå, Sweden
| | - Steen M Jensen
- Department of Public Health and Clinical Medicine, Heart Centre, Umeå University, Umeå, 90185, Sweden
| | - Annika Rydberg
- Department of Clinical Sciences, Pediatrics, Umeå University, 90187, Umeå, Sweden
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73
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Harmer SC, Tinker A. The impact of recent advances in genetics in understanding disease mechanisms underlying the long QT syndromes. Biol Chem 2017; 397:679-93. [PMID: 26910742 DOI: 10.1515/hsz-2015-0306] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 02/18/2016] [Indexed: 11/15/2022]
Abstract
Long QT syndrome refers to a characteristic abnormality of the electrocardiogram and it is associated with a form of ventricular tachycardia known as torsade-de-pointes and sudden arrhythmic death. It can occur as part of a hereditary syndrome or can be acquired usually because of drug administration. Here we review recent genetic, molecular and cellular discoveries and outline how they have furthered our understanding of this disease. Specifically we focus on compound mutations, genome wide association studies of QT interval, modifier genes and the therapeutic implications of this recent work.
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74
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El-Sherif N, Turitto G, Boutjdir M. Congenital Long QT syndrome and torsade de pointes. Ann Noninvasive Electrocardiol 2017; 22. [PMID: 28670758 DOI: 10.1111/anec.12481] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 05/19/2017] [Indexed: 12/19/2022] Open
Abstract
Since its initial description by Jervell and Lange-Nielsen in 1957, the congenital long QT syndrome (LQTS) has been the most investigated cardiac ion channelopathy. A prolonged QT interval in the surface electrocardiogram is the sine qua non of the LQTS and is a surrogate measure of the ventricular action potential duration (APD). Congenital as well as acquired alterations in certain cardiac ion channels can affect their currents in such a way as to increase the APD and hence the QT interval. The inhomogeneous lengthening of the APD across the ventricular wall results in dispersion of APD. This together with the tendency of prolonged APD to be associated with oscillations at the plateau level, termed early afterdepolarizations (EADs), provides the substrate of ventricular tachyarrhythmia associated with LQTS, usually referred to as torsade de pointes (TdP) VT. This review will discuss the genetic, molecular, and phenotype characteristics of congenital LQTS as well as current management strategies and future directions in the field.
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Affiliation(s)
- Nabil El-Sherif
- Downstate Medical Center, State University of New York, Brooklyn, NY, USA.,VA NY Harbor Healthcare System, Brooklyn, NY, USA
| | - Gioia Turitto
- NewYork-Presbyterian Brooklyn Methodist Hospital, New York, NY, USA
| | - Mohamed Boutjdir
- Downstate Medical Center, State University of New York, Brooklyn, NY, USA.,VA NY Harbor Healthcare System, Brooklyn, NY, USA.,NYU School of Medicine, New York, NY, USA
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Traeger LL, Sabat G, Barrett-Wilt GA, Wells GB, Sussman MR. A tail of two voltages: Proteomic comparison of the three electric organs of the electric eel. SCIENCE ADVANCES 2017; 3:e1700523. [PMID: 28695212 PMCID: PMC5498108 DOI: 10.1126/sciadv.1700523] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 05/19/2017] [Indexed: 05/22/2023]
Abstract
The electric eel (Electrophorus electricus) is unusual among electric fishes because it has three pairs of electric organs that serve multiple biological functions: For navigation and communication, it emits continuous pulses of weak electric discharge (<1 V), but for predation and defense, it intermittently emits lethal strong electric discharges (10 to 600 V). We hypothesized that these two electrogenic outputs have different energetic demands reflected by differences in their proteome and phosphoproteome. We report the use of isotope-assisted quantitative mass spectrometry to test this hypothesis. We observed novel phosphorylation sites in sodium transporters and identified a potassium channel with unique differences in protein concentration among the electric organs. In addition, we found transcription factors and protein kinases that show differential abundance in the strong versus weak electric organs. Our findings support the hypothesis that proteomic differences among electric organs underlie differences in energetic needs, reflecting a trade-off between generating weak voltages continuously and strong voltages intermittently.
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Affiliation(s)
- Lindsay L. Traeger
- Department of Genetics, University of Wisconsin-Madison, Madison, WI 53706, USA
- Biotechnology Center, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Grzegorz Sabat
- Biotechnology Center, University of Wisconsin-Madison, Madison, WI 53706, USA
| | | | - Gregg B. Wells
- Department of Molecular and Cellular Medicine, Texas A&M University, College Station, TX 77843, USA
| | - Michael R. Sussman
- Biotechnology Center, University of Wisconsin-Madison, Madison, WI 53706, USA
- Department of Biochemistry, University of Wisconsin-Madison, Madison, WI 53706, USA
- Corresponding author.
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76
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Gregers E, Ahlberg G, Christensen T, Jabbari J, Larsen KO, Herfelt CB, Henningsen KM, Andreasen L, Thiis JJ, Lund J, Holme S, Haunsø S, Bentzen BH, Schmitt N, Svendsen JH, Olesen MS. Deep sequencing of atrial fibrillation patients with mitral valve regurgitation shows no evidence of mosaicism but reveals novel rare germline variants. Heart Rhythm 2017; 14:1531-1538. [PMID: 28549997 DOI: 10.1016/j.hrthm.2017.05.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Atrial fibrillation (AF) is the most common cardiac arrhythmia. Valvular heart disease is a strong predictor, yet the underlying molecular mechanisms are unknown. OBJECTIVE The purpose of this study was to investigate the prevalence of somatic variants in AF candidate genes in an AF patient population undergoing surgery for mitral valve regurgitation (MVR) to determine whether these patients are genetically predisposed to AF. METHODS DNA was extracted from blood and left atrial tissue from 44 AF patients with MVR. Using next-generation sequencing, we investigated 110 genes using the HaloPlex Target Enrichment System. MuTect software was used for identification of somatic point variants. We functionally characterized selected variants using electrophysiologic techniques. RESULTS No somatic variants were identified in the cardiac tissue. Thirty-three patients (75%) had a rare germline variation in ≥1 candidate genes. Fourteen variants were novel. Fifteen variants were predicted damaging or likely damaging in ≥6 in silico predictions. We identified rare variants in genes never directly associated with AF: KCNE4, SCN4B, NEURL1, and CAND2. Interestingly, 7 patients (16%) had variants in genes involved in cellular potassium handling. The variants KCNQ1 (p.G272S) and KCNH2 (p.A913V) resulted in gain of function due to faster activation (KCNQ1) and slowed deactivation kinetics (KCNQ1, KCNH2). CONCLUSION We did not find any somatic variants in patients with AF and MVR. Surprisingly, we found that our cohort of non-lone AF patients might, like lone AF patients, be predisposed to AF by rare germline variants. Our findings emphasize the extent of still unknown factors in the pathogenesis of AF.
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Affiliation(s)
- Emilie Gregers
- Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Copenhagen, Denmark; Laboratory for Molecular Cardiology, Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Gustav Ahlberg
- Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Copenhagen, Denmark; Laboratory for Molecular Cardiology, Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Thea Christensen
- Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Copenhagen, Denmark; Department of Biomedical Science, University of Copenhagen, Copenhagen, Denmark
| | - Javad Jabbari
- Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Copenhagen, Denmark; Laboratory for Molecular Cardiology, Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kirstine O Larsen
- Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Copenhagen, Denmark; Department of Biomedical Science, University of Copenhagen, Copenhagen, Denmark
| | - Cecilie B Herfelt
- Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Copenhagen, Denmark; Laboratory for Molecular Cardiology, Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kristoffer M Henningsen
- Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Copenhagen, Denmark; Laboratory for Molecular Cardiology, Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Laura Andreasen
- Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Copenhagen, Denmark; Laboratory for Molecular Cardiology, Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens J Thiis
- Department of Cardiothoracic Surgery, Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jens Lund
- Department of Cardiothoracic Surgery, Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Holme
- Department of Cardiothoracic Surgery, Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Stig Haunsø
- Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Copenhagen, Denmark; Laboratory for Molecular Cardiology, Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bo H Bentzen
- Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Copenhagen, Denmark; Department of Biomedical Science, University of Copenhagen, Copenhagen, Denmark
| | - Nicole Schmitt
- Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Copenhagen, Denmark; Department of Biomedical Science, University of Copenhagen, Copenhagen, Denmark
| | - Jesper H Svendsen
- Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Copenhagen, Denmark; Laboratory for Molecular Cardiology, Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Morten S Olesen
- Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Copenhagen, Denmark; Laboratory for Molecular Cardiology, Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Avery CL, Wassel CL, Richard MA, Highland HM, Bien S, Zubair N, Soliman EZ, Fornage M, Bielinski SJ, Tao R, Seyerle AA, Shah SJ, Lloyd-Jones DM, Buyske S, Rotter JI, Post WS, Rich SS, Hindorff LA, Jeff JM, Shohet RV, Sotoodehnia N, Lin DY, Whitsel EA, Peters U, Haiman CA, Crawford DC, Kooperberg C, North KE. Fine mapping of QT interval regions in global populations refines previously identified QT interval loci and identifies signals unique to African and Hispanic descent populations. Heart Rhythm 2017; 14:572-580. [PMID: 27988371 PMCID: PMC5448160 DOI: 10.1016/j.hrthm.2016.12.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND The electrocardiographically measured QT interval (QT) is heritable and its prolongation is an established risk factor for several cardiovascular diseases. Yet, most QT genetic studies have been performed in European ancestral populations, possibly reducing their global relevance. OBJECTIVE To leverage diversity and improve biological insight, we fine mapped 16 of the 35 previously identified QT loci (46%) in populations of African American (n = 12,410) and Hispanic/Latino (n = 14,837) ancestry. METHODS Racial/ethnic-specific multiple linear regression analyses adjusted for heart rate and clinical covariates were examined separately and in combination after inverse-variance weighted trans-ethnic meta-analysis. RESULTS The 16 fine-mapped QT loci included on the Illumina Metabochip represented 21 independent signals, of which 16 (76%) were significantly (P-value≤9.1×10-5) associated with QT. Through sequential conditional analysis we also identified three trans-ethnic novel SNPs at ATP1B1, SCN5A-SCN10A, and KCNQ1 and three Hispanic/Latino-specific novel SNPs at NOS1AP and SCN5A-SCN10A (two novel SNPs) with evidence of associations with QT independent of previous identified GWAS lead SNPs. Linkage disequilibrium patterns helped to narrow the region likely to contain the functional variants at several loci, including NOS1AP, USP50-TRPM7, and PRKCA, although intervals surrounding SLC35F1-PLN and CNOT1 remained broad in size (>100 kb). Finally, bioinformatics-based functional characterization suggested a regulatory function in cardiac tissues for the majority of independent signals that generalized and the novel SNPs. CONCLUSION Our findings suggest that a majority of identified SNPs implicate gene regulatory dysfunction in QT prolongation, that the same loci influence variation in QT across global populations, and that additional, novel, population-specific QT signals exist.
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Affiliation(s)
| | - Christina L Wassel
- Department of Pathology and Laboratory Medicine, College of Medicine, University of Vermont, Burlington, Vermont
| | - Melissa A Richard
- Institute of Molecular Medicine and; Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas
| | | | - Stephanie Bien
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Niha Zubair
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Elsayed Z Soliman
- Department of Epidemiology and Prevention, Epidemiological Cardiology Research Center and; Department of Internal Medicine, Section on Cardiology, Wake Forest School of Medicine, Winston Salem, North Carolina
| | - Myriam Fornage
- Institute of Molecular Medicine and; Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas
| | - Suzette J Bielinski
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | | | | | - Sanjiv J Shah
- Department of Preventive Medicine and; Department of Medicine, Northwestern University Feinberg School of Medicine and
| | - Donald M Lloyd-Jones
- Department of Preventive Medicine and; Department of Medicine, Northwestern University Feinberg School of Medicine and
| | - Steven Buyske
- Department of Statistics and Biostatistics and; Department of Genetics, Rutgers University, Piscataway, New Jersey
| | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and; Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, California
| | - Wendy S Post
- Department of Medicine and; Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland
| | - Stephen S Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia
| | - Lucia A Hindorff
- National Institutes of Health, National Human Genome Research Institute, Office of Population Genomics, Bethesda, Maryland
| | - Janina M Jeff
- Genetics and Genomic Sciences, The Charles Bronfman Institute for Personalized Medicine, The Center for Statistical Genetics, and The Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Ralph V Shohet
- Center for Cardiovascular Research, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
| | - Nona Sotoodehnia
- Cardiovascular Health Research Unit, Division of Cardiology, University of Washington, Seattle, Washington
| | | | | | - Ulrike Peters
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine and; Norris Comprehensive Cancer Center, University of Southern California, Pasadena, California
| | - Dana C Crawford
- Department of Epidemiology and Biostatistics, Institute for Computational Biology, Case Western Reserve University, Cleveland, Ohio
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Kari E North
- Department of Epidemiology; Carolina Center for Genome Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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78
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Association of SCN10A Polymorphisms with the Recurrence of Atrial Fibrillation after Catheter Ablation in a Chinese Han Population. Sci Rep 2017; 7:44003. [PMID: 28281580 PMCID: PMC5345091 DOI: 10.1038/srep44003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 02/02/2017] [Indexed: 11/08/2022] Open
Abstract
The nonsynonymous SCN10A single nucleotide polymorphism (SNP) rs6795970 has been reported to associate with PR interval and atrial fibrillation (AF) and in strong linkage disequilibrium (LD) with the AF-associated SNP rs6800541. In this study, we investigated whether rs6795970 polymorphisms are associated with AF recurrence after catheter ablation. A total of 502 consecutive patients with AF who underwent catheter ablation were included. AF recurrence was defined as a documented episode of any atrial arrhythmias lasting ≥30 s after a blanking period of 3 months. AF recurrence was observed between 3 and 12 months after catheter ablation in 24.5% of the patients. There was a significant difference in the allele distribution (p = 7.86 × 10−5) and genotype distribution (p = 1.42 × 10−5) of rs6795970 between the AF recurrence and no recurrence groups. In a multivariate analysis, we identified the following independent predictors of AF recurrence: the rs6795970 genotypes in an additive model (OR 0.36, 95%CI 0.22~0.60, p = 7.04 × 10−5), a history of AF ≥36 months (OR 3.57, 95%CI 2.26~5.63, p = 4.33 × 10−8) and left atrial diameter (LAD) ≥40 mm (OR 1.85, 95%CI 1.08~3.19, p = 0.026). These data suggest that genetic variation in SCN10A may play an important role in predicting AF recurrence after catheter ablation in the Chinese Han population.
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79
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Kapplinger JD, Erickson A, Asuri S, Tester DJ, McIntosh S, Kerr CR, Morrison J, Tang A, Sanatani S, Arbour L, Ackerman MJ. KCNQ1 p.L353L affects splicing and modifies the phenotype in a founder population with long QT syndrome type 1. J Med Genet 2017; 54:390-398. [PMID: 28264985 PMCID: PMC5502312 DOI: 10.1136/jmedgenet-2016-104153] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 11/30/2016] [Accepted: 12/19/2016] [Indexed: 12/23/2022]
Abstract
Background Variable expressivity and incomplete penetrance between individuals with identical long QT syndrome (LQTS) causative mutations largely remain unexplained. Founder populations provide a unique opportunity to explore modifying genetic effects. We examined the role of a novel synonymous KCNQ1 p.L353L variant on the splicing of exon 8 and on heart rate corrected QT interval (QTc) in a population known to have a pathogenic LQTS type 1 (LQTS1) causative mutation, p.V205M, in KCNQ1-encoded Kv7.1. Methods 419 adults were genotyped for p.V205M, p.L353L and a previously described QTc modifier (KCNH2-p.K897T). Adjusted linear regression determined the effect of each variant on QTc, alone and in combination. In addition, peripheral blood RNA was extracted from three controls and three p.L353L-positive individuals. The mutant transcript levels were assessed via qPCR and normalised to overall KCNQ1 transcript levels to assess the effect on splicing. Results For women and men, respectively, p.L353L alone conferred a 10.0 (p=0.064) ms and 14.0 (p=0.014) ms increase in QTc and in men only a significant interaction effect in combination with the p.V205M (34.6 ms, p=0.003) resulting in a QTc of ∼500 ms. The mechanism of p.L353L's effect was attributed to approximately threefold increase in exon 8 exclusion resulting in ∼25% mutant transcripts of the total KCNQ1 transcript levels. Conclusions Our results provide the first evidence that synonymous variants outside the canonical splice sites in KCNQ1 can alter splicing and clinically impact phenotype. Through this mechanism, we identified that p.L353L can precipitate QT prolongation by itself and produce a clinically relevant interactive effect in conjunction with other LQTS variants.
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Affiliation(s)
- Jamie D Kapplinger
- Mayo Medical School, Mayo Clinic, Rochester, Minnesota, USA.,Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, Minnesota, USA
| | - Anders Erickson
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - Sirisha Asuri
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - David J Tester
- Division of Heart Rhythm Services, Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Sarah McIntosh
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Charles R Kerr
- Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Julie Morrison
- Gitxsan Health Society, Hazelton, British Columbia, Canada
| | - Anthony Tang
- Department of Medicine, University of Western Ontario, London, Ontario, Canada
| | - Shubhayan Sanatani
- Division of Cardiology, Department of Pediatrics, University of British Columbia, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Laura Arbour
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada.,Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael J Ackerman
- Mayo Medical School, Mayo Clinic, Rochester, Minnesota, USA.,Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, Minnesota, USA.,Division of Heart Rhythm Services, Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.,Division of Pediatric Cardiology, Department of Pediatrics, Mayo Clinic, Rochester, Minnesota, USA
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80
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Strauss DG, Vicente J, Johannesen L, Blinova K, Mason JW, Weeke P, Behr ER, Roden DM, Woosley R, Kosova G, Rosenberg MA, Newton-Cheh C. Common Genetic Variant Risk Score Is Associated With Drug-Induced QT Prolongation and Torsade de Pointes Risk: A Pilot Study. Circulation 2017; 135:1300-1310. [PMID: 28213480 DOI: 10.1161/circulationaha.116.023980] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 01/26/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Drug-induced QT interval prolongation, a risk factor for life-threatening ventricular arrhythmias, is a potential side effect of many marketed and withdrawn medications. The contribution of common genetic variants previously associated with baseline QT interval to drug-induced QT prolongation and arrhythmias is not known. METHODS We tested the hypothesis that a weighted combination of common genetic variants contributing to QT interval at baseline, identified through genome-wide association studies, can predict individual response to multiple QT-prolonging drugs. Genetic analysis of 22 subjects was performed in a secondary analysis of a randomized, double-blind, placebo-controlled, crossover trial of 3 QT-prolonging drugs with 15 time-matched QT and plasma drug concentration measurements. Subjects received single doses of dofetilide, quinidine, ranolazine, and placebo. The outcome was the correlation between a genetic QT score comprising 61 common genetic variants and the slope of an individual subject's drug-induced increase in heart rate-corrected QT (QTc) versus drug concentration. RESULTS The genetic QT score was correlated with drug-induced QTc prolongation. Among white subjects, genetic QT score explained 30% of the variability in response to dofetilide (r=0.55; 95% confidence interval, 0.09-0.81; P=0.02), 23% in response to quinidine (r=0.48; 95% confidence interval, -0.03 to 0.79; P=0.06), and 27% in response to ranolazine (r=0.52; 95% confidence interval, 0.05-0.80; P=0.03). Furthermore, the genetic QT score was a significant predictor of drug-induced torsade de pointes in an independent sample of 216 cases compared with 771 controls (r2=12%, P=1×10-7). CONCLUSIONS We demonstrate that a genetic QT score comprising 61 common genetic variants explains a significant proportion of the variability in drug-induced QT prolongation and is a significant predictor of drug-induced torsade de pointes. These findings highlight an opportunity for recent genetic discoveries to improve individualized risk-benefit assessment for pharmacological therapies. Replication of these findings in larger samples is needed to more precisely estimate variance explained and to establish the individual variants that drive these effects. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT01873950.
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Affiliation(s)
- David G Strauss
- From Office of Clinical Pharmacology, Center for Drug Evaluation and Research (D.G.S., J.V., L.J.) and Office of Science and Engineering Laboratories, Center for Devices and Radiological Health (D.G.S., J.V., L.J., K.B.), US Food and Drug Administration, Silver Spring, MD; BSICoS Group, Aragón Institute for Engineering Research (I3A), IIS Aragón, University of Zaragoza, Spain (J.V.); Department of Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden (L.J.); Division of Cardiology, University of Utah, Salt Lake City (J.W.M.); Spaulding Clinical Research, West Bend, WI (J.W.M.); Departments of Medicine (P.W., D.R.), Pharmacology (D.R.), and Biomedical Informatics (D.R.), Vanderbilt University Medical Center, Nashville, TN; Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (P.W.); Cardiology Clinical Academic Group, St. George's University of London, London, UK (E.R.B.); AZCERT, Inc, Oro Valley, AZ (R.W.); Center for Genomic Medicine and Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA (G.K., M.A.R., C.N.-C.); Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge (G.K., M.A.R., C.N.-C.); and Division of Cardiac Electrophysiology, Veterans Administration Hospital System of Boston, Harvard Medical School, West Roxbury, MA (M.A.R.).
| | - Jose Vicente
- From Office of Clinical Pharmacology, Center for Drug Evaluation and Research (D.G.S., J.V., L.J.) and Office of Science and Engineering Laboratories, Center for Devices and Radiological Health (D.G.S., J.V., L.J., K.B.), US Food and Drug Administration, Silver Spring, MD; BSICoS Group, Aragón Institute for Engineering Research (I3A), IIS Aragón, University of Zaragoza, Spain (J.V.); Department of Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden (L.J.); Division of Cardiology, University of Utah, Salt Lake City (J.W.M.); Spaulding Clinical Research, West Bend, WI (J.W.M.); Departments of Medicine (P.W., D.R.), Pharmacology (D.R.), and Biomedical Informatics (D.R.), Vanderbilt University Medical Center, Nashville, TN; Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (P.W.); Cardiology Clinical Academic Group, St. George's University of London, London, UK (E.R.B.); AZCERT, Inc, Oro Valley, AZ (R.W.); Center for Genomic Medicine and Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA (G.K., M.A.R., C.N.-C.); Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge (G.K., M.A.R., C.N.-C.); and Division of Cardiac Electrophysiology, Veterans Administration Hospital System of Boston, Harvard Medical School, West Roxbury, MA (M.A.R.)
| | - Lars Johannesen
- From Office of Clinical Pharmacology, Center for Drug Evaluation and Research (D.G.S., J.V., L.J.) and Office of Science and Engineering Laboratories, Center for Devices and Radiological Health (D.G.S., J.V., L.J., K.B.), US Food and Drug Administration, Silver Spring, MD; BSICoS Group, Aragón Institute for Engineering Research (I3A), IIS Aragón, University of Zaragoza, Spain (J.V.); Department of Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden (L.J.); Division of Cardiology, University of Utah, Salt Lake City (J.W.M.); Spaulding Clinical Research, West Bend, WI (J.W.M.); Departments of Medicine (P.W., D.R.), Pharmacology (D.R.), and Biomedical Informatics (D.R.), Vanderbilt University Medical Center, Nashville, TN; Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (P.W.); Cardiology Clinical Academic Group, St. George's University of London, London, UK (E.R.B.); AZCERT, Inc, Oro Valley, AZ (R.W.); Center for Genomic Medicine and Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA (G.K., M.A.R., C.N.-C.); Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge (G.K., M.A.R., C.N.-C.); and Division of Cardiac Electrophysiology, Veterans Administration Hospital System of Boston, Harvard Medical School, West Roxbury, MA (M.A.R.)
| | - Ksenia Blinova
- From Office of Clinical Pharmacology, Center for Drug Evaluation and Research (D.G.S., J.V., L.J.) and Office of Science and Engineering Laboratories, Center for Devices and Radiological Health (D.G.S., J.V., L.J., K.B.), US Food and Drug Administration, Silver Spring, MD; BSICoS Group, Aragón Institute for Engineering Research (I3A), IIS Aragón, University of Zaragoza, Spain (J.V.); Department of Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden (L.J.); Division of Cardiology, University of Utah, Salt Lake City (J.W.M.); Spaulding Clinical Research, West Bend, WI (J.W.M.); Departments of Medicine (P.W., D.R.), Pharmacology (D.R.), and Biomedical Informatics (D.R.), Vanderbilt University Medical Center, Nashville, TN; Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (P.W.); Cardiology Clinical Academic Group, St. George's University of London, London, UK (E.R.B.); AZCERT, Inc, Oro Valley, AZ (R.W.); Center for Genomic Medicine and Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA (G.K., M.A.R., C.N.-C.); Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge (G.K., M.A.R., C.N.-C.); and Division of Cardiac Electrophysiology, Veterans Administration Hospital System of Boston, Harvard Medical School, West Roxbury, MA (M.A.R.)
| | - Jay W Mason
- From Office of Clinical Pharmacology, Center for Drug Evaluation and Research (D.G.S., J.V., L.J.) and Office of Science and Engineering Laboratories, Center for Devices and Radiological Health (D.G.S., J.V., L.J., K.B.), US Food and Drug Administration, Silver Spring, MD; BSICoS Group, Aragón Institute for Engineering Research (I3A), IIS Aragón, University of Zaragoza, Spain (J.V.); Department of Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden (L.J.); Division of Cardiology, University of Utah, Salt Lake City (J.W.M.); Spaulding Clinical Research, West Bend, WI (J.W.M.); Departments of Medicine (P.W., D.R.), Pharmacology (D.R.), and Biomedical Informatics (D.R.), Vanderbilt University Medical Center, Nashville, TN; Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (P.W.); Cardiology Clinical Academic Group, St. George's University of London, London, UK (E.R.B.); AZCERT, Inc, Oro Valley, AZ (R.W.); Center for Genomic Medicine and Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA (G.K., M.A.R., C.N.-C.); Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge (G.K., M.A.R., C.N.-C.); and Division of Cardiac Electrophysiology, Veterans Administration Hospital System of Boston, Harvard Medical School, West Roxbury, MA (M.A.R.)
| | - Peter Weeke
- From Office of Clinical Pharmacology, Center for Drug Evaluation and Research (D.G.S., J.V., L.J.) and Office of Science and Engineering Laboratories, Center for Devices and Radiological Health (D.G.S., J.V., L.J., K.B.), US Food and Drug Administration, Silver Spring, MD; BSICoS Group, Aragón Institute for Engineering Research (I3A), IIS Aragón, University of Zaragoza, Spain (J.V.); Department of Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden (L.J.); Division of Cardiology, University of Utah, Salt Lake City (J.W.M.); Spaulding Clinical Research, West Bend, WI (J.W.M.); Departments of Medicine (P.W., D.R.), Pharmacology (D.R.), and Biomedical Informatics (D.R.), Vanderbilt University Medical Center, Nashville, TN; Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (P.W.); Cardiology Clinical Academic Group, St. George's University of London, London, UK (E.R.B.); AZCERT, Inc, Oro Valley, AZ (R.W.); Center for Genomic Medicine and Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA (G.K., M.A.R., C.N.-C.); Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge (G.K., M.A.R., C.N.-C.); and Division of Cardiac Electrophysiology, Veterans Administration Hospital System of Boston, Harvard Medical School, West Roxbury, MA (M.A.R.)
| | - Elijah R Behr
- From Office of Clinical Pharmacology, Center for Drug Evaluation and Research (D.G.S., J.V., L.J.) and Office of Science and Engineering Laboratories, Center for Devices and Radiological Health (D.G.S., J.V., L.J., K.B.), US Food and Drug Administration, Silver Spring, MD; BSICoS Group, Aragón Institute for Engineering Research (I3A), IIS Aragón, University of Zaragoza, Spain (J.V.); Department of Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden (L.J.); Division of Cardiology, University of Utah, Salt Lake City (J.W.M.); Spaulding Clinical Research, West Bend, WI (J.W.M.); Departments of Medicine (P.W., D.R.), Pharmacology (D.R.), and Biomedical Informatics (D.R.), Vanderbilt University Medical Center, Nashville, TN; Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (P.W.); Cardiology Clinical Academic Group, St. George's University of London, London, UK (E.R.B.); AZCERT, Inc, Oro Valley, AZ (R.W.); Center for Genomic Medicine and Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA (G.K., M.A.R., C.N.-C.); Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge (G.K., M.A.R., C.N.-C.); and Division of Cardiac Electrophysiology, Veterans Administration Hospital System of Boston, Harvard Medical School, West Roxbury, MA (M.A.R.)
| | - Dan M Roden
- From Office of Clinical Pharmacology, Center for Drug Evaluation and Research (D.G.S., J.V., L.J.) and Office of Science and Engineering Laboratories, Center for Devices and Radiological Health (D.G.S., J.V., L.J., K.B.), US Food and Drug Administration, Silver Spring, MD; BSICoS Group, Aragón Institute for Engineering Research (I3A), IIS Aragón, University of Zaragoza, Spain (J.V.); Department of Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden (L.J.); Division of Cardiology, University of Utah, Salt Lake City (J.W.M.); Spaulding Clinical Research, West Bend, WI (J.W.M.); Departments of Medicine (P.W., D.R.), Pharmacology (D.R.), and Biomedical Informatics (D.R.), Vanderbilt University Medical Center, Nashville, TN; Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (P.W.); Cardiology Clinical Academic Group, St. George's University of London, London, UK (E.R.B.); AZCERT, Inc, Oro Valley, AZ (R.W.); Center for Genomic Medicine and Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA (G.K., M.A.R., C.N.-C.); Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge (G.K., M.A.R., C.N.-C.); and Division of Cardiac Electrophysiology, Veterans Administration Hospital System of Boston, Harvard Medical School, West Roxbury, MA (M.A.R.)
| | - Ray Woosley
- From Office of Clinical Pharmacology, Center for Drug Evaluation and Research (D.G.S., J.V., L.J.) and Office of Science and Engineering Laboratories, Center for Devices and Radiological Health (D.G.S., J.V., L.J., K.B.), US Food and Drug Administration, Silver Spring, MD; BSICoS Group, Aragón Institute for Engineering Research (I3A), IIS Aragón, University of Zaragoza, Spain (J.V.); Department of Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden (L.J.); Division of Cardiology, University of Utah, Salt Lake City (J.W.M.); Spaulding Clinical Research, West Bend, WI (J.W.M.); Departments of Medicine (P.W., D.R.), Pharmacology (D.R.), and Biomedical Informatics (D.R.), Vanderbilt University Medical Center, Nashville, TN; Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (P.W.); Cardiology Clinical Academic Group, St. George's University of London, London, UK (E.R.B.); AZCERT, Inc, Oro Valley, AZ (R.W.); Center for Genomic Medicine and Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA (G.K., M.A.R., C.N.-C.); Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge (G.K., M.A.R., C.N.-C.); and Division of Cardiac Electrophysiology, Veterans Administration Hospital System of Boston, Harvard Medical School, West Roxbury, MA (M.A.R.)
| | - Gulum Kosova
- From Office of Clinical Pharmacology, Center for Drug Evaluation and Research (D.G.S., J.V., L.J.) and Office of Science and Engineering Laboratories, Center for Devices and Radiological Health (D.G.S., J.V., L.J., K.B.), US Food and Drug Administration, Silver Spring, MD; BSICoS Group, Aragón Institute for Engineering Research (I3A), IIS Aragón, University of Zaragoza, Spain (J.V.); Department of Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden (L.J.); Division of Cardiology, University of Utah, Salt Lake City (J.W.M.); Spaulding Clinical Research, West Bend, WI (J.W.M.); Departments of Medicine (P.W., D.R.), Pharmacology (D.R.), and Biomedical Informatics (D.R.), Vanderbilt University Medical Center, Nashville, TN; Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (P.W.); Cardiology Clinical Academic Group, St. George's University of London, London, UK (E.R.B.); AZCERT, Inc, Oro Valley, AZ (R.W.); Center for Genomic Medicine and Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA (G.K., M.A.R., C.N.-C.); Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge (G.K., M.A.R., C.N.-C.); and Division of Cardiac Electrophysiology, Veterans Administration Hospital System of Boston, Harvard Medical School, West Roxbury, MA (M.A.R.)
| | - Michael A Rosenberg
- From Office of Clinical Pharmacology, Center for Drug Evaluation and Research (D.G.S., J.V., L.J.) and Office of Science and Engineering Laboratories, Center for Devices and Radiological Health (D.G.S., J.V., L.J., K.B.), US Food and Drug Administration, Silver Spring, MD; BSICoS Group, Aragón Institute for Engineering Research (I3A), IIS Aragón, University of Zaragoza, Spain (J.V.); Department of Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden (L.J.); Division of Cardiology, University of Utah, Salt Lake City (J.W.M.); Spaulding Clinical Research, West Bend, WI (J.W.M.); Departments of Medicine (P.W., D.R.), Pharmacology (D.R.), and Biomedical Informatics (D.R.), Vanderbilt University Medical Center, Nashville, TN; Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (P.W.); Cardiology Clinical Academic Group, St. George's University of London, London, UK (E.R.B.); AZCERT, Inc, Oro Valley, AZ (R.W.); Center for Genomic Medicine and Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA (G.K., M.A.R., C.N.-C.); Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge (G.K., M.A.R., C.N.-C.); and Division of Cardiac Electrophysiology, Veterans Administration Hospital System of Boston, Harvard Medical School, West Roxbury, MA (M.A.R.)
| | - Christopher Newton-Cheh
- From Office of Clinical Pharmacology, Center for Drug Evaluation and Research (D.G.S., J.V., L.J.) and Office of Science and Engineering Laboratories, Center for Devices and Radiological Health (D.G.S., J.V., L.J., K.B.), US Food and Drug Administration, Silver Spring, MD; BSICoS Group, Aragón Institute for Engineering Research (I3A), IIS Aragón, University of Zaragoza, Spain (J.V.); Department of Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden (L.J.); Division of Cardiology, University of Utah, Salt Lake City (J.W.M.); Spaulding Clinical Research, West Bend, WI (J.W.M.); Departments of Medicine (P.W., D.R.), Pharmacology (D.R.), and Biomedical Informatics (D.R.), Vanderbilt University Medical Center, Nashville, TN; Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (P.W.); Cardiology Clinical Academic Group, St. George's University of London, London, UK (E.R.B.); AZCERT, Inc, Oro Valley, AZ (R.W.); Center for Genomic Medicine and Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA (G.K., M.A.R., C.N.-C.); Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge (G.K., M.A.R., C.N.-C.); and Division of Cardiac Electrophysiology, Veterans Administration Hospital System of Boston, Harvard Medical School, West Roxbury, MA (M.A.R.).
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81
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Stillitano F, Hansen J, Kong CW, Karakikes I, Funck-Brentano C, Geng L, Scott S, Reynier S, Wu M, Valogne Y, Desseaux C, Salem JE, Jeziorowska D, Zahr N, Li R, Iyengar R, Hajjar RJ, Hulot JS. Modeling susceptibility to drug-induced long QT with a panel of subject-specific induced pluripotent stem cells. eLife 2017; 6:e19406. [PMID: 28134617 PMCID: PMC5279943 DOI: 10.7554/elife.19406] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 12/08/2016] [Indexed: 12/18/2022] Open
Abstract
A large number of drugs can induce prolongation of cardiac repolarization and life-threatening cardiac arrhythmias. The prediction of this side effect is however challenging as it usually develops in some genetically predisposed individuals with normal cardiac repolarization at baseline. Here, we describe a platform based on a genetically diverse panel of induced pluripotent stem cells (iPSCs) that reproduces susceptibility to develop a cardiotoxic drug response. We generated iPSC-derived cardiomyocytes from patients presenting in vivo with extremely low or high changes in cardiac repolarization in response to a pharmacological challenge with sotalol. In vitro, the responses to sotalol were highly variable but strongly correlated to the inter-individual differences observed in vivo. Transcriptomic profiling identified dysregulation of genes (DLG2, KCNE4, PTRF, HTR2C, CAMKV) involved in downstream regulation of cardiac repolarization machinery as underlying high sensitivity to sotalol. Our findings offer novel insights for the development of iPSC-based screening assays for testing individual drug reactions.
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Affiliation(s)
- Francesca Stillitano
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, United States
| | - Jens Hansen
- Department of Pharmacology and Systems Therapeutics, Systems Biology Center, Icahn School of Medicine at Mount Sinai, New York, United States
| | - Chi-Wing Kong
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, United States
| | - Ioannis Karakikes
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, United States
| | - Christian Funck-Brentano
- Sorbonne Universités, UPMC Univ Paris 06, AP-HP, INSERM, CIC-1421, Institute of Cardiometabolism and Nutrition, Paris, France
| | - Lin Geng
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, United States
| | - Stuart Scott
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States
| | | | - Ma Wu
- Cellectis Stem Cells, Paris, France
| | | | | | - Joe-Elie Salem
- Sorbonne Universités, UPMC Univ Paris 06, AP-HP, INSERM, CIC-1421, Institute of Cardiometabolism and Nutrition, Paris, France
| | - Dorota Jeziorowska
- Sorbonne Universités, UPMC Univ Paris 06, AP-HP, INSERM, CIC-1421, Institute of Cardiometabolism and Nutrition, Paris, France
| | - Noël Zahr
- Sorbonne Universités, UPMC Univ Paris 06, AP-HP, INSERM, CIC-1421, Institute of Cardiometabolism and Nutrition, Paris, France
| | - Ronald Li
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, United States
- Ming Wai Lau Centre for Reparative Medicine, Karolinska Institutet, Stockholm, Sweden
- Dr. Li Dak-Sum Centre, The University of Hong Kong – Karolinska Institutet Collaboration in Regenerative Medicine, Pokfulam, Hong Kong
| | - Ravi Iyengar
- Department of Pharmacology and Systems Therapeutics, Systems Biology Center, Icahn School of Medicine at Mount Sinai, New York, United States
| | - Roger J Hajjar
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, United States
| | - Jean-Sébastien Hulot
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, United States
- Sorbonne Universités, UPMC Univ Paris 06, AP-HP, INSERM, CIC-1421, Institute of Cardiometabolism and Nutrition, Paris, France
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82
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Zheng J, Rodriguez S, Laurin C, Baird D, Trela-Larsen L, Erzurumluoglu MA, Zheng Y, White J, Giambartolomei C, Zabaneh D, Morris R, Kumari M, Casas JP, Hingorani AD, Evans DM, Gaunt TR, Day INM. HAPRAP: a haplotype-based iterative method for statistical fine mapping using GWAS summary statistics. Bioinformatics 2017; 33:79-86. [PMID: 27591082 PMCID: PMC5544112 DOI: 10.1093/bioinformatics/btw565] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 04/29/2016] [Accepted: 08/26/2016] [Indexed: 11/21/2022] Open
Abstract
MOTIVATION Fine mapping is a widely used approach for identifying the causal variant(s) at disease-associated loci. Standard methods (e.g. multiple regression) require individual level genotypes. Recent fine mapping methods using summary-level data require the pairwise correlation coefficients ([Formula: see text]) of the variants. However, haplotypes rather than pairwise [Formula: see text], are the true biological representation of linkage disequilibrium (LD) among multiple loci. In this article, we present an empirical iterative method, HAPlotype Regional Association analysis Program (HAPRAP), that enables fine mapping using summary statistics and haplotype information from an individual-level reference panel. RESULTS Simulations with individual-level genotypes show that the results of HAPRAP and multiple regression are highly consistent. In simulation with summary-level data, we demonstrate that HAPRAP is less sensitive to poor LD estimates. In a parametric simulation using Genetic Investigation of ANthropometric Traits height data, HAPRAP performs well with a small training sample size (N < 2000) while other methods become suboptimal. Moreover, HAPRAP's performance is not affected substantially by single nucleotide polymorphisms (SNPs) with low minor allele frequencies. We applied the method to existing quantitative trait and binary outcome meta-analyses (human height, QTc interval and gallbladder disease); all previous reported association signals were replicated and two additional variants were independently associated with human height. Due to the growing availability of summary level data, the value of HAPRAP is likely to increase markedly for future analyses (e.g. functional prediction and identification of instruments for Mendelian randomization). AVAILABILITY AND IMPLEMENTATION The HAPRAP package and documentation are available at http://apps.biocompute.org.uk/haprap/ CONTACT: : jie.zheng@bristol.ac.uk or tom.gaunt@bristol.ac.ukSupplementary information: Supplementary data are available at Bioinformatics online.
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Affiliation(s)
- Jie Zheng
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, Bristol, UK
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Santiago Rodriguez
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, Bristol, UK
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Charles Laurin
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, Bristol, UK
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Denis Baird
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, Bristol, UK
| | - Lea Trela-Larsen
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Mesut A Erzurumluoglu
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- Department of Health Sciences, Genetic Epidemiology Group, University of Leicester, Leicester, UK
| | - Yi Zheng
- Dedman College of Humanities and Sciences, Southern Methodist University, Dallas, TX, USA
| | - Jon White
- Department of Genetics, Environment and Evolution, University College London Genetics Institute, London, UK
| | - Claudia Giambartolomei
- Department of Genetics, Environment and Evolution, University College London Genetics Institute, London, UK
| | - Delilah Zabaneh
- Department of Genetics, Environment and Evolution, University College London Genetics Institute, London, UK
| | - Richard Morris
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Meena Kumari
- Department of Genetics, Environment and Evolution, University College London Genetics Institute, London, UK
| | - Juan P Casas
- Department of Genetics, Environment and Evolution, University College London Genetics Institute, London, UK
- Department of Primary Care & Population Health, University College London, Royal Free Campus, London, UK
| | - Aroon D Hingorani
- Department of Genetics, Environment and Evolution, University College London Genetics Institute, London, UK
- Centre for Clinical Pharmacology, University College London, London, UK, Division of Medicine
| | | | - David M Evans
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, Bristol, UK
- University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia, QLD
| | - Tom R Gaunt
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, Bristol, UK
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Ian N M Day
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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83
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Abstract
It is well established that variations in genes can alter the pharmacokinetic and pharmacodynamic profile of a drug and immunological responses to it. Early advances in pharmacogenetics were made with traditional genetic techniques such as functional cloning of genes using knowledge gained from purified proteins, and candidate gene analysis. Over the past decade, techniques for analysing the human genome have accelerated greatly as knowledge and technological capabilities have grown. These techniques were initially focussed on understanding genetic factors of disease, but increasingly they are helping to clarify the genetic basis of variable drug responses and adverse drug reactions (ADRs). We examine genetic methods that have been applied to the understanding of ADRs, review the current state of knowledge of genetic factors that influence ADR development, and discuss how the application of genome-wide association studies and next-generation sequencing approaches is supporting and extending existing knowledge of pharmacogenetic processes leading to ADRs. Such approaches have identified single genes that are major contributing genetic risk factors for an ADR, (such as flucloxacillin and drug-induced liver disease), making pre-treatment testing a possibility. They have contributed to the identification of multiple genetic determinants of a single ADR, some involving both pharmacologic and immunological processes (such as phenytoin and severe cutaneous adverse reactions). They have indicated that rare genetic variants, often not previously reported, are likely to have more influence on the phenotype than common variants that have been traditionally tested for. The problem of genotype/phenotype discordance affecting the interpretation of pharmacogenetic screening and the future of genome-based testing applied to ADRs are also discussed.
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84
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Omar A, Zhou M, Berman A, Sorrentino RA, Yar N, Weintraub NL, Kim IM, Lei W, Tang Y. Genomic-based diagnosis of arrhythmia disease in a personalized medicine era. EXPERT REVIEW OF PRECISION MEDICINE AND DRUG DEVELOPMENT 2016; 1:497-504. [PMID: 28944294 PMCID: PMC5606339 DOI: 10.1080/23808993.2016.1264258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Although thousands of potentially disease-causing mutations have been identified in a handful of genes, the genetic heterogeneity has led to diagnostic confusions, stemming directly from the limitations in our arsenal of genetic tools. AREAS COVERED We discuss the genetic basis of cardiac ion channelopathies, the gaps in our knowledge and how Next-generation sequencing technology (NGS) and can be used to bridge them, and how induced pluripotent stem cell (iPSC) derived-cardiomyocytes can be used for drug discovery. EXPERT COMMENTARY Univariate, arrhythmogenic arrhythmias can explain some congenital arrhythmias, however, it is far from a comprehensive understanding of the complexity of many arrhythmias. Mutational screening is a critical step in personalized medicine and is critical to the management of patients with arrhythmias. The success of personalized medicine requires a more efficient way to identify a high number of genetic variants potentially implicated in cardiac arrhythmogenic diseases than traditional sequencing methods (eg, Sanger sequencing). Next-generation sequencing technology provides us with unprecedented opportunities to achieve high-throughput, rapid, and cost-effective detection of congenital arrhythmias in patients. Moreover, in personalized medicine era, IPSC derived-cardiomyocytes can be used as 'cardiac arrhythmia in a dish' model for drug discovery, and help us improve management of arrhythmias in patients by developing patient-specific drug therapies with target specificity.
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Affiliation(s)
- Abdullah Omar
- Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Mi Zhou
- Cardiac Surgery department, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Adam Berman
- Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Robert A. Sorrentino
- Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Neela Yar
- Purdue University, West Lafayette, IN, USA
| | - Neal L. Weintraub
- Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Il-man Kim
- Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Wei Lei
- Cardiovascular Medicine Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Yaoliang Tang
- Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
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85
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Walsh R, Cook SA. Issues and Challenges in Diagnostic Sequencing for Inherited Cardiac Conditions. Clin Chem 2016; 63:116-128. [PMID: 27879323 DOI: 10.1373/clinchem.2016.254698] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 10/24/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Inherited cardiac conditions are a relatively common group of Mendelian diseases associated with ill health and death, often in the young. Research into the genetic causes of these conditions has enabled confirmatory and predictive diagnostic sequencing to become an integral part of the clinical management of inherited cardiomyopathies, arrhythmias, aortopathies, and dyslipidemias. CONTENT Currently, the principle benefit of clinical genetic testing is the cascade screening of family members of patients with a pathogenic variant, enabling targeted follow up of presymptomatic genotype-positive individuals and discharge of genotype-negative individuals to health. For the affected proband, diagnostic sequencing can also be useful in discriminating inherited disease from alternative diagnoses, directing treatment, and for molecular autopsy in cases of sudden unexplained death. Advances in sequencing technology have expanded testing panels for inherited cardiac conditions and driven down costs, further improving the cost-effectiveness of genetic testing. However, this expanded testing requires great rigor in the identification of pathogenic variants, with domain-specific knowledge required for variant interpretation. SUMMARY Diagnostic sequencing has the potential to become an integral part of the clinical management of patients with inherited cardiac conditions. However, to move beyond just confirmatory and predictive testing, a much greater understanding is needed of the genetic basis of these conditions, the role of the environment, and the underlying disease mechanisms. With this additional information it is likely that genetic testing will increasingly be used for stratified and preventative strategies in the era of genomic medicine.
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Affiliation(s)
- Roddy Walsh
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College London, London, UK.,National Heart and Lung Institute, Imperial College London, London, UK
| | - Stuart A Cook
- National Heart and Lung Institute, Imperial College London, London, UK; .,National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore.,MRC Clinical Sciences Centre, Imperial College London, London, UK.,Division of Cardiovascular & Metabolic Disorders, Duke-National University of Singapore, Singapore
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86
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Silva CT, Zorkoltseva IV, Amin N, Demirkan A, van Leeuwen EM, Kors JA, van den Berg M, Stricker BH, Uitterlinden AG, Kirichenko AV, Witteman JCM, Willemsen R, Oostra BA, Axenovich TI, van Duijn CM, Isaacs A. A Combined Linkage and Exome Sequencing Analysis for Electrocardiogram Parameters in the Erasmus Rucphen Family Study. Front Genet 2016; 7:190. [PMID: 27877193 PMCID: PMC5099142 DOI: 10.3389/fgene.2016.00190] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 10/11/2016] [Indexed: 12/30/2022] Open
Abstract
Electrocardiogram (ECG) measurements play a key role in the diagnosis and prediction of cardiac arrhythmias and sudden cardiac death. ECG parameters, such as the PR, QRS, and QT intervals, are known to be heritable and genome-wide association studies of these phenotypes have been successful in identifying common variants; however, a large proportion of the genetic variability of these traits remains to be elucidated. The aim of this study was to discover loci potentially harboring rare variants utilizing variance component linkage analysis in 1547 individuals from a large family-based study, the Erasmus Rucphen Family Study (ERF). Linked regions were further explored using exome sequencing. Five suggestive linkage peaks were identified: two for QT interval (1q24, LOD = 2.63; 2q34, LOD = 2.05), one for QRS interval (1p35, LOD = 2.52) and two for PR interval (9p22, LOD = 2.20; 14q11, LOD = 2.29). Fine-mapping using exome sequence data identified a C > G missense variant (c.713C > G, p.Ser238Cys) in the FCRL2 gene associated with QT (rs74608430; P = 2.8 × 10-4, minor allele frequency = 0.019). Heritability analysis demonstrated that the SNP explained 2.42% of the trait’s genetic variability in ERF (P = 0.02). Pathway analysis suggested that the gene is involved in cytosolic Ca2+ levels (P = 3.3 × 10-3) and AMPK stimulated fatty acid oxidation in muscle (P = 4.1 × 10-3). Look-ups in bioinformatics resources showed that expression of FCRL2 is associated with ARHGAP24 and SETBP1 expression. This finding was not replicated in the Rotterdam study. Combining the bioinformatics information with the association and linkage analyses, FCRL2 emerges as a strong candidate gene for QT interval.
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Affiliation(s)
- Claudia T Silva
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical CenterRotterdam, Netherlands; Doctoral Program in Biomedical Sciences, Universidad del RosarioBogotá, Colombia; GENIUROS Group, Genetics and Genomics Research Center CIGGUR, School of Medicine and Health Sciences, Universidad del RosarioBogotá, Colombia
| | - Irina V Zorkoltseva
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences Novosibirsk, Russia
| | - Najaf Amin
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center Rotterdam, Netherlands
| | - Ayşe Demirkan
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical CenterRotterdam, Netherlands; Department of Human Genetics, Leiden University Medical CenterLeiden, Netherlands
| | - Elisabeth M van Leeuwen
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center Rotterdam, Netherlands
| | - Jan A Kors
- Department of Medical Informatics, Erasmus University Medical Center Rotterdam, Netherlands
| | - Marten van den Berg
- Department of Medical Informatics, Erasmus University Medical Center Rotterdam, Netherlands
| | - Bruno H Stricker
- Department of Epidemiology, Erasmus University Medical CenterRotterdam, Netherlands; Department of Internal Medicine, Erasmus University Medical CenterRotterdam, Netherlands; Inspectorate of Health CareThe Hague, Netherlands
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus University Medical Center Rotterdam, Netherlands
| | - Anatoly V Kirichenko
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences Novosibirsk, Russia
| | | | - Rob Willemsen
- Department of Clinical Genetics, Erasmus University Medical Center Rotterdam, Netherlands
| | - Ben A Oostra
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical CenterRotterdam, Netherlands; Center for Medical Systems BiologyLeiden, Netherlands
| | - Tatiana I Axenovich
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences Novosibirsk, Russia
| | - Cornelia M van Duijn
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical CenterRotterdam, Netherlands; Center for Medical Systems BiologyLeiden, Netherlands
| | - Aaron Isaacs
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical CenterRotterdam, Netherlands; Center for Medical Systems BiologyLeiden, Netherlands
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87
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The novel heart-specific RING finger protein 207 is involved in energy metabolism in cardiomyocytes. J Mol Cell Cardiol 2016; 100:43-53. [DOI: 10.1016/j.yjmcc.2016.09.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 09/20/2016] [Accepted: 09/23/2016] [Indexed: 11/22/2022]
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88
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Spengler RM, Zhang X, Cheng C, McLendon JM, Skeie JM, Johnson FL, Davidson BL, Boudreau RL. Elucidation of transcriptome-wide microRNA binding sites in human cardiac tissues by Ago2 HITS-CLIP. Nucleic Acids Res 2016; 44:7120-31. [PMID: 27418678 PMCID: PMC5009757 DOI: 10.1093/nar/gkw640] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 07/07/2016] [Indexed: 12/14/2022] Open
Abstract
MicroRNAs (miRs) have emerged as key biological effectors in human health and disease. These small noncoding RNAs are incorporated into Argonaute (Ago) proteins, where they direct post-transcriptional gene silencing via base-pairing with target transcripts. Although miRs have become intriguing biological entities and attractive therapeutic targets, the translational impacts of miR research remain limited by a paucity of empirical miR targeting data, particularly in human primary tissues. Here, to improve our understanding of the diverse roles miRs play in cardiovascular function and disease, we applied high-throughput methods to globally profile miR:target interactions in human heart tissues. We deciphered Ago2:RNA interactions using crosslinking immunoprecipitation coupled with high-throughput sequencing (HITS-CLIP) to generate the first transcriptome-wide map of miR targeting events in human myocardium, detecting 4000 cardiac Ago2 binding sites across >2200 target transcripts. Our initial exploration of this interactome revealed an abundance of miR target sites in gene coding regions, including several sites pointing to new miR-29 functions in regulating cardiomyocyte calcium, growth and metabolism. Also, we uncovered several clinically-relevant interactions involving common genetic variants that alter miR targeting events in cardiomyopathy-associated genes. Overall, these data provide a critical resource for bolstering translational miR research in heart, and likely beyond.
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Affiliation(s)
- Ryan M Spengler
- Department of Internal Medicine, Carver College of Medicine; Abboud Cardiovascular Research Center, University of Iowa, Iowa City, IA 52242, USA
| | - Xiaoming Zhang
- Department of Internal Medicine, Carver College of Medicine; Abboud Cardiovascular Research Center, University of Iowa, Iowa City, IA 52242, USA
| | - Congsheng Cheng
- The Raymond G. Perelman Center for Cellular and Molecular Therapeutics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jared M McLendon
- Department of Internal Medicine, Carver College of Medicine; Abboud Cardiovascular Research Center, University of Iowa, Iowa City, IA 52242, USA
| | - Jessica M Skeie
- Department of Internal Medicine, Carver College of Medicine; Abboud Cardiovascular Research Center, University of Iowa, Iowa City, IA 52242, USA
| | - Frances L Johnson
- Department of Internal Medicine, Carver College of Medicine; Abboud Cardiovascular Research Center, University of Iowa, Iowa City, IA 52242, USA
| | - Beverly L Davidson
- The Raymond G. Perelman Center for Cellular and Molecular Therapeutics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA Department of Pathology and Laboratory Medicine, the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ryan L Boudreau
- Department of Internal Medicine, Carver College of Medicine; Abboud Cardiovascular Research Center, University of Iowa, Iowa City, IA 52242, USA
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89
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Abstract
A prolonged QT interval is an important risk factor for ventricular arrhythmias and sudden cardiac death. QT prolongation can be caused by drugs. There are multiple risk factors for drug-induced QT prolongation, including genetic variation. QT prolongation is one of the most common reasons for withdrawal of drugs from the market, despite the fact that these drugs may be beneficial for certain patients and not harmful in every patient. Identifying genetic variants associated with drug-induced QT prolongation might add to tailored pharmacotherapy and prevent beneficial drugs from being withdrawn unnecessarily. In this review, our objective was to provide an overview of the genetic background of drug-induced QT prolongation, distinguishing pharmacokinetic and pharmacodynamic pathways. Pharmacokinetic-mediated genetic susceptibility is mainly characterized by variation in genes encoding drug-metabolizing cytochrome P450 enzymes or drug transporters. For instance, the P-glycoprotein drug transporter plays a role in the pharmacokinetic susceptibility of drug-induced QT prolongation. The pharmacodynamic component of genetic susceptibility is mainly characterized by genes known to be associated with QT interval duration in the general population and genes in which the causal mutations of congenital long QT syndromes are located. Ethnicity influences susceptibility to drug-induced QT interval prolongation, with Caucasians being more sensitive than other ethnicities. Research on the association between pharmacogenetic interactions and clinical endpoints such as sudden cardiac death is still limited. Future studies in this area could enable us to determine the risk of arrhythmias more adequately in clinical practice.
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90
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Kapoor A, Bakshy K, Xu L, Nandakumar P, Lee D, Boerwinkle E, Grove ML, Arking DE, Chakravarti A. Rare coding TTN variants are associated with electrocardiographic QT interval in the general population. Sci Rep 2016; 6:28356. [PMID: 27321809 PMCID: PMC4913250 DOI: 10.1038/srep28356] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 06/01/2016] [Indexed: 12/31/2022] Open
Abstract
We have shown previously that noncoding variants mapping around a specific set of 170 genes encoding cardiomyocyte intercalated disc (ID) proteins are more enriched for associations with QT interval than observed for genome-wide comparisons. At a false discovery rate (FDR) of 5%, we had identified 28 such ID protein-encoding genes. Here, we assessed whether coding variants at these 28 genes affect QT interval in the general population as well. We used exome sequencing in 4,469 European American (EA) and 1,880 African American (AA) ancestry individuals from the population-based ARIC (Atherosclerosis Risk In Communities) Study cohort to focus on rare (allele frequency <1%) potentially deleterious (nonsynonymous, stop-gain, splice) variants (n = 2,398 for EA; n = 1,693 for AA) and tested their effects on standardized QT interval residuals. We identified 27 nonsynonymous variants associated with QT interval (FDR 5%), 22 of which were in TTN. Taken together with the mapping of a QT interval GWAS locus near TTN, our observation of rare deleterious coding variants in TTN associated with QT interval show that TTN plays a role in regulation of cardiac electrical conductance and coupling, and is a risk factor for cardiac arrhythmias and sudden cardiac death.
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Affiliation(s)
- Ashish Kapoor
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, 21205, USA
| | - Kiranmayee Bakshy
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, 21205, USA
| | - Linda Xu
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, 21205, USA
| | - Priyanka Nandakumar
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, 21205, USA
| | - Dongwon Lee
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, 21205, USA
| | - Eric Boerwinkle
- Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center, Houston, Texas, 77030, USA
| | - Megan L. Grove
- Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center, Houston, Texas, 77030, USA
| | - Dan E. Arking
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, 21205, USA
| | - Aravinda Chakravarti
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, 21205, USA
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91
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Musa H, Murphy NP, Curran J, Higgins JD, Webb TR, Makara MA, Wright P, Lancione PJ, Lubbers ER, Healy JA, Smith SA, Bennett V, Hund TJ, Kline CF, Mohler PJ. Common human ANK2 variant confers in vivo arrhythmia phenotypes. Heart Rhythm 2016; 13:1932-40. [PMID: 27298202 DOI: 10.1016/j.hrthm.2016.06.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND Human ANK2 (ankyrin-B) loss-of-function variants are directly linked with arrhythmia phenotypes. However, in atypical non-ion channel arrhythmia genes such as ANK2 that lack the same degree of robust structure/function and clinical data, it may be more difficult to assign variant disease risk based simply on variant location, minor allele frequency, and/or predictive structural algorithms. The human ankyrin-B p.L1622I variant found in arrhythmia probands displays significant diversity in minor allele frequency across populations. OBJECTIVE The objective of this study was to directly test the in vivo impact of ankyrin-B p.L1622I on cardiac electrical phenotypes and arrhythmia risk using a new animal model. METHODS We tested arrhythmia phenotypes in a new "knock-in" animal model harboring the human ankyrin-B p.L1622I variant. RESULTS Ankyrin-B p.L1622I displays reduced posttranslational expression in vivo, resulting in reduced cardiac ankyrin-B expression and reduced association with binding-partner Na/Ca exchanger. Ankyrin-B(L1622I/L1622I) mice display changes in heart rate, atrioventricular and intraventricular conduction, and alterations in repolarization. Furthermore, ankyrin-B(L1622I/L1622I) mice display catecholamine-dependent arrhythmias. At the cellular level, ankyrin-B(L1622I/L1622I) myocytes display increased action potential duration and severe arrhythmogenic afterdepolarizations that provide a mechanistic rationale for the arrhythmias. CONCLUSION Our findings support in vivo arrhythmogenic phenotypes of an ANK2 variant with unusual frequency in select populations. On the basis of our findings and current clinical data, we support classification of p.L1622I as a "mild" loss-of-function variant that may confer arrhythmia susceptibility in the context of secondary risk factors including environment, medication, and/or additional genetic variation.
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Affiliation(s)
- Hassan Musa
- Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH; Department of Physiology & Cell Biology College of Medicine, The Ohio State University, Columbus, OH
| | - Nathaniel P Murphy
- Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH; Department of Physiology & Cell Biology College of Medicine, The Ohio State University, Columbus, OH
| | - Jerry Curran
- Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH; Department of Physiology & Cell Biology College of Medicine, The Ohio State University, Columbus, OH
| | - John D Higgins
- Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH; Department of Physiology & Cell Biology College of Medicine, The Ohio State University, Columbus, OH
| | - Tyler R Webb
- Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH; Department of Physiology & Cell Biology College of Medicine, The Ohio State University, Columbus, OH
| | - Michael A Makara
- Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH; Department of Physiology & Cell Biology College of Medicine, The Ohio State University, Columbus, OH
| | - Patrick Wright
- Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Peter J Lancione
- Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH; Department of Physiology & Cell Biology College of Medicine, The Ohio State University, Columbus, OH
| | - Ellen R Lubbers
- Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH; Department of Physiology & Cell Biology College of Medicine, The Ohio State University, Columbus, OH
| | - Jane A Healy
- Department of Biochemistry and Howard Hughes Medical Institute, Duke University Medical Center, Durham, NC
| | - Sakima A Smith
- Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH; Department of Internal Medicine, Division of Cardiovascular Medicine
| | - Vann Bennett
- Department of Biochemistry and Howard Hughes Medical Institute, Duke University Medical Center, Durham, NC
| | - Thomas J Hund
- Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH; Department of Internal Medicine, Division of Cardiovascular Medicine,; Department of Biomedical Engineering, College of Engineering, The Ohio State University, Columbus, OH
| | - Crystal F Kline
- Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH; Department of Physiology & Cell Biology College of Medicine, The Ohio State University, Columbus, OH
| | - Peter J Mohler
- Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH; Department of Physiology & Cell Biology College of Medicine, The Ohio State University, Columbus, OH; Department of Internal Medicine, Division of Cardiovascular Medicine,.
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92
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Malovini A, Bellazzi R, Napolitano C, Guffanti G. Multivariate Methods for Genetic Variants Selection and Risk Prediction in Cardiovascular Diseases. Front Cardiovasc Med 2016; 3:17. [PMID: 27376073 PMCID: PMC4896915 DOI: 10.3389/fcvm.2016.00017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 05/23/2016] [Indexed: 01/06/2023] Open
Abstract
Over the last decade, high-throughput genotyping and sequencing technologies have contributed to major advancements in genetics research, as these technologies now facilitate affordable mapping of the entire genome for large sets of individuals. Given this, genome-wide association studies are proving to be powerful tools in identifying genetic variants that have the capacity to modify the probability of developing a disease or trait of interest. However, when the study’s goal is to evaluate the effect of the presence of genetic variants mapping to specific chromosomes regions on a specific phenotype, the candidate loci approach is still preferred. Regardless of which approach is taken, such a large data set calls for the establishment and development of appropriate analytical methods in order to translate such knowledge into biological or clinical findings. Standard univariate tests often fail to identify informative genetic variants, especially when dealing with complex traits, which are more likely to result from a combination of rare and common variants and non-genetic determinants. These limitations can partially be overcome by multivariate methods, which allow for the identification of informative combinations of genetic variants and non-genetic features. Furthermore, such methods can help to generate additive genetic scores and risk stratification algorithms that, once extensively validated in independent cohorts, could serve as useful tools to assist clinicians in decision-making. This review aims to provide readers with an overview of the main multivariate methods for genetic data analysis that could be applied to the analysis of cardiovascular traits.
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Affiliation(s)
- Alberto Malovini
- Laboratory of Informatics and Systems Engineering for Clinical Research, IRCCS Fondazione Salvatore Maugeri , Pavia , Italy
| | - Riccardo Bellazzi
- Laboratory of Informatics and Systems Engineering for Clinical Research, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy; Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Carlo Napolitano
- Molecular Cardiology Laboratories, IRCCS Fondazione Salvatore Maugeri , Pavia , Italy
| | - Guia Guffanti
- Department of Psychiatry, McLean Hospital, Harvard Medical School , Belmont, MA , USA
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93
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Abstract
Approximately 80 genes in the human genome code for pore-forming subunits of potassium (K(+)) channels. Rare variants (mutations) in K(+) channel-encoding genes may cause heritable arrhythmia syndromes. Not all rare variants in K(+) channel-encoding genes are necessarily disease-causing mutations. Common variants in K(+) channel-encoding genes are increasingly recognized as modifiers of phenotype in heritable arrhythmia syndromes and in the general population. Although difficult, distinguishing pathogenic variants from benign variants is of utmost importance to avoid false designations of genetic variants as disease-causing mutations.
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Affiliation(s)
- Ahmad S Amin
- Department of Clinical and Experimental Cardiology, Heart Centre, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
| | - Arthur A M Wilde
- Department of Clinical and Experimental Cardiology, Heart Centre, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands; King Abdulaziz University, Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders, PO Box 80200, Jeddah 21589, Kingdom of Saudi Arabia.
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94
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van Weerd JH, Christoffels VM. The formation and function of the cardiac conduction system. Development 2016; 143:197-210. [PMID: 26786210 DOI: 10.1242/dev.124883] [Citation(s) in RCA: 135] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The cardiac conduction system (CCS) consists of distinctive components that initiate and conduct the electrical impulse required for the coordinated contraction of the cardiac chambers. CCS development involves complex regulatory networks that act in stage-, tissue- and dose-dependent manners, and recent findings indicate that the activity of these networks is sensitive to common genetic variants associated with cardiac arrhythmias. Here, we review how these findings have provided novel insights into the regulatory mechanisms and transcriptional networks underlying CCS formation and function.
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Affiliation(s)
- Jan Hendrik van Weerd
- Department of Anatomy, Embryology & Physiology, Academic Medical Center, Amsterdam 1105 AZ, The Netherlands
| | - Vincent M Christoffels
- Department of Anatomy, Embryology & Physiology, Academic Medical Center, Amsterdam 1105 AZ, The Netherlands
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95
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Sugiyama K, Sasano T, Kurokawa J, Takahashi K, Okamura T, Kato N, Isobe M, Furukawa T. Oxidative Stress Induced Ventricular Arrhythmia and Impairment of Cardiac Function in Nos1ap Deleted Mice. Int Heart J 2016; 57:341-9. [PMID: 27170476 DOI: 10.1536/ihj.15-471] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Genome-wide association study has identified that the genetic variations at NOS1AP (neuronal nitric oxide synthase-1 adaptor protein) were associated with QT interval and sudden cardiac death (SCD). However, the mechanism linking a genetic variant of NOS1AP and SCD is poorly understood. We used Nos1ap knockout mice (Nos1ap(-/-)) to determine the involvement of Nos1ap in SCD, paying special attention to oxidative stress.At baseline, a surface electrocardiogram (ECG) and ultrasound echocardiography (UCG) showed no difference between Nos1ap(-/-) and wild-type (WT) mice. Oxidative stress was induced by a single injection of doxorubicin (Dox, 25 mg/kg). After Dox injection, Nos1ap(-/-) showed significantly higher mortality than WT (93.3 versus 16.0% at day 14, P < 0.01). ECG showed significantly longer QTc in Nos1ap(-/-) than WT, and UCG revealed significant reduction of fractional shortening (%FS) only in Nos1ap(-/-) after Dox injection. Spontaneous ventricular tachyarrhythmias were documented by telemetry recording after Dox injection only in Nos1ap(-/-). Ex vivo optical mapping revealed that the action potential duration (APD)90 was prolonged at baseline in Nos1ap(-/-), and administration of Dox lengthened APD90 more in Nos1ap(-/-) than in WT. The expression of Bnp and the H2O2 level were higher in Nos1ap(-/-) after Dox injection. Nos1ap(-/-) showed a reduced amplitude of calcium transient in isolated cardiomyocytes after Dox injection. Administration of the antioxidant N-acetyl-L-cysteine significantly reduced mortality of Nos1ap(-/-) by Dox injection, accompanied by prevention of QT prolongation and a reduction in %FS.Although Nos1ap(-/-) mice have apparently normal hearts, oxidative stress evokes ventricular tachyarrhythmia and heart failure, which may cause sudden cardiac death.
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Affiliation(s)
- Koji Sugiyama
- Department of Bio-informational Pharmacology, Medical Research Institute, Tokyo Medical and Dental University
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96
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Abstract
Cardiac delayed rectifier potassium channels conduct outward potassium currents during the plateau phase of action potentials and play pivotal roles in cardiac repolarization. These include IKs, IKr and the atrial specific IKur channels. In this article, we will review their molecular identities and biophysical properties. Mutations in the genes encoding delayed rectifiers lead to loss- or gain-of-function phenotypes, disrupt normal cardiac repolarization and result in various cardiac rhythm disorders, including congenital Long QT Syndrome, Short QT Syndrome and familial atrial fibrillation. We will also discuss the prospect of using delayed rectifier channels as therapeutic targets to manage cardiac arrhythmia.
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Affiliation(s)
- Lei Chen
- Department of Pharmacology, College of Physicians & Surgeons of Columbia University, 630 West 168th Street, New York, NY 10032, USA
| | - Kevin J Sampson
- Department of Pharmacology, College of Physicians & Surgeons of Columbia University, 630 West 168th Street, New York, NY 10032, USA
| | - Robert S Kass
- Department of Pharmacology, College of Physicians & Surgeons of Columbia University, 630 West 168th Street, New York, NY 10032, USA.
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97
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Franco D, Lozano-Velasco E, Aranega A. Gene regulatory networks in atrial fibrillation. World J Med Genet 2016; 6:1-16. [DOI: 10.5496/wjmg.v6.i1.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 12/15/2015] [Accepted: 02/17/2016] [Indexed: 02/06/2023] Open
Abstract
Atrial fibrillation (AF) is the most frequent arrhythmogenic syndrome in humans. With an estimate incidence of 1%-2% in the general population, AF raises up to almost 10%-12% in 80+ years. Thus, AF represents nowadays a highly prevalent medical problem generating a large economic burden. At the electrophysiological level, distinct mechanisms have been elucidated. Yet, despite its prevalence, the genetic and molecular culprits of this pandemic cardiac electrophysiological abnormality have remained largely obscure. Molecular genetics of AF familiar cases have demonstrated that single nucleotide mutations in distinct genes encoding for ion channels underlie the onset of AF, albeit such alterations only explain a minor subset of patients with AF. In recent years, analyses by means of genome-wide association studies have unraveled a more complex picture of the etiology of AF, pointing out to distinct cardiac-enriched transcription factors, as well as to other regulatory genes. Furthermore a new layer of regulatory mechanisms have emerged, i.e., post-transcriptional regulation mediated by non-coding RNA, which have been demonstrated to exert pivotal roles in cardiac electrophysiology. In this manuscript, we aim to provide a comprehensive review of the genetic regulatory networks that if impaired exert electrophysiological abnormalities that contribute to the onset, and subsequently, on self-perpetuation of AF.
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98
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Interleukin-1β gene variants are associated with QTc interval prolongation following cardiac surgery: a prospective observational study. Can J Anaesth 2016; 63:397-410. [PMID: 26858093 DOI: 10.1007/s12630-015-0576-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 10/13/2015] [Accepted: 12/21/2015] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND We characterized cardiac surgery-induced dynamic changes of the corrected QT (QTc) interval and tested the hypothesis that genetic factors are associated with perioperative QTc prolongation independent of clinical and procedural factors. METHODS All study subjects were ascertained from a prospective study of patients who underwent elective cardiac surgery during August 1999 to April 2002. We defined a prolonged QTc interval as > 440 msec, measured from 24-hr pre- and postoperative 12-lead electrocardiograms. The association of 37 single nucleotide polymorphisms (SNPs) in 21 candidate genes -involved in modulating arrhythmia susceptibility pathways with postoperative QTc changes- was investigated in a two-stage design with a stage I cohort (n = 497) nested within a stage II cohort (n = 957). Empirical P values (Pemp) were obtained by permutation tests with 10,000 repeats. RESULTS After adjusting for clinical and procedural risk factors, we selected four SNPs (P value range, 0.03-0.1) in stage I, which we then tested in the stage II cohort. Two functional SNPs in the pro-inflammatory cytokine interleukin-1β (IL1β), rs1143633 (odds ratio [OR], 0.71; 95% confidence interval [CI], 0.53 to 0.95; Pemp = 0.02) and rs16944 (OR, 1.31; 95% CI, 1.01 to 1.70; Pemp = 0.04), remained independent predictors of postoperative QTc prolongation. The ability of a clinico-genetic model incorporating the two IL1B polymorphisms to classify patients at risk for developing prolonged postoperative QTc was superior to a clinical model alone, with a net reclassification improvement of 0.308 (P = 0.0003) and an integrated discrimination improvement of 0.02 (P = 0.000024). CONCLUSION The results suggest a contribution of IL1β in modulating susceptibility to postoperative QTc prolongation after cardiac surgery.
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99
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Dumitrescu L, Restrepo NA, Goodloe R, Boston J, Farber-Eger E, Pendergrass SA, Bush WS, Crawford DC. Towards a phenome-wide catalog of human clinical traits impacted by genetic ancestry. BioData Min 2015; 8:35. [PMID: 26566401 PMCID: PMC4642611 DOI: 10.1186/s13040-015-0068-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 11/02/2015] [Indexed: 01/13/2023] Open
Abstract
Background Racial/ethnic differences for commonly measured clinical variables are well documented, and it has been postulated that population-specific genetic factors may play a role. The genetic heterogeneity of admixed populations, such as African Americans, provides a unique opportunity to identify genomic regions and variants associated with the clinical variability observed for diseases and traits across populations. Method To begin a systematic search for these population-specific genomic regions at the phenome-wide scale, we determined the relationship between global genetic ancestry, specifically European and African ancestry, and clinical variables measured in a population of African Americans from BioVU, Vanderbilt University’s biorepository linked to de-identified electronic medical records (EMRs) as part of the Epidemiologic Architecture using Genomics and Epidemiology (EAGLE) study. Through billing (ICD-9) codes, procedure codes, labs, and clinical notes, 36 common clinical and laboratory variables were mined from the EMR, including body mass index (BMI), kidney traits, lipid levels, blood pressure, and electrocardiographic measurements. A total of 15,863 DNA samples from non-European Americans were genotyped on the Illumina Metabochip containing ~200,000 variants, of which 11,166 were from African Americans. Tests of association were performed to examine associations between global ancestry and the phenotype of interest. Results Increased European ancestry, and conversely decreased African ancestry, was most strongly correlated with an increase in QRS duration, consistent with previous observations that African Americans tend to have shorter a QRS duration compared with European Americans. Despite known racial/ethnic disparities in blood pressure, European and African ancestry was neither associated with diastolic nor systolic blood pressure measurements. Conclusion Collectively, these results suggest that this clinical population can be used to identify traits in which population differences may be due, in part, to population-specific genetics. Electronic supplementary material The online version of this article (doi:10.1186/s13040-015-0068-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Logan Dumitrescu
- Center for Human Genetics Research, Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN 37232 USA
| | - Nicole A Restrepo
- Center for Human Genetics Research, Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN 37232 USA
| | - Robert Goodloe
- Center for Human Genetics Research, Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN 37232 USA
| | - Jonathan Boston
- Center for Human Genetics Research, Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN 37232 USA
| | - Eric Farber-Eger
- Center for Human Genetics Research, Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN 37232 USA
| | - Sarah A Pendergrass
- Center for Systems Genomics, Department of Biochemistry and Molecular Biology, The Pennsylvania State University, University Park, PA 16802 USA
| | - William S Bush
- Institute for Computational Biology, Department of Epidemiology and Biostatistics, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Suite 2527, Cleveland, OH 44106 USA
| | - Dana C Crawford
- Institute for Computational Biology, Department of Epidemiology and Biostatistics, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Suite 2527, Cleveland, OH 44106 USA
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Kim MJ, Lim JE, Oh B. Validation of Non-invasive Method for Electrocardiogram Recording in Mouse using Lead II. ACTA ACUST UNITED AC 2015. [DOI: 10.15616/bsl.2015.21.3.135] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Myung Jun Kim
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul 02447, Korea
| | - Ji Eun Lim
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul 02447, Korea
| | - Bermseok Oh
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul 02447, Korea
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul 02447, Korea
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