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Kjaersgaard Andersen R, Clemmensen SB, Larsen LA, Hjelmborg JVB, Ødum N, Jemec GBE, Christensen K. Evidence of gene-gene interaction in Hidradenitis suppurativa - A nationwide register study of Danish twins. Br J Dermatol 2021; 186:78-85. [PMID: 34289077 DOI: 10.1111/bjd.20654] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a recurrent inflammatory skin disease that, apart from rare causative loss-of-function mutations, has a widely unknown genetic aetiology. Our objective was to estimate the relative importance of genetic and environmental factors underlying HS susceptibility. METHODS Through the Danish Twin Registry and the Danish National Patient Registry we joined information on zygosity with that of HS status. HS cases were identified by International Code of Diseases 8 (705.91) and 10 (L73.2). Heritability was assessed by the classic biometric model and the possibility of gene-gene interaction through the multi-locus modeling approach. RESULTS Amongst 100,044 registered twins, we found 170 twins (from 163 pairs) diagnosed with HS. The seven concordant pairs were all monozygotic, and monozygotic twins had a casewise concordance rate of 28% (95% CI: 7%; 49%), corresponding to a familial risk of 73 (95% CI 13; 133) times that of the background population. The biometrical modelling suggested a heritability of 0.80 (95% CI 0.67; 0.93), and the multilocus index estimate was 230 (95% CI: 60; 400). This is highly indicative of gene-gene interactions, with the possibility of up to six interacting loci. CONCLUSION This twin study is substantially larger, and employs a more valid phenotype than prior studies. Genetics account for the majority of the HS susceptibility, and HS is most likely caused by gene-gene interactions rather than monogenetic mutations or solely additive genetic factors. New approaches aimed at assessing potential interactions at a SNP-SNP level should be implemented in future HS genome-wide association studies.
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Affiliation(s)
| | - S B Clemmensen
- Danish Twin Registry, Department of Epidemiology, Biostatistics and Biodemography, University of southern Denmark, Odense, Denmark
| | - L A Larsen
- Danish Twin Registry, Department of Epidemiology, Biostatistics and Biodemography, University of southern Denmark, Odense, Denmark
| | - J V B Hjelmborg
- Danish Twin Registry, Department of Epidemiology, Biostatistics and Biodemography, University of southern Denmark, Odense, Denmark
| | - N Ødum
- LEO Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - G B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde
| | - K Christensen
- Danish Twin Registry, Department of Epidemiology, Biostatistics and Biodemography, University of southern Denmark, Odense, Denmark
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Abstract
The Danish Twin Registry (DTR) was established in the 1950s, when twins born from 1870 to 1910 were ascertained, and has since been extended to include twins from birth cohorts until 2009. The DTR currently comprises of more than 175,000 twins from the 140 birth cohorts. This makes the DTR the oldest nationwide twin register and among the largest in the world. The combination of data from several surveys, including biological samples and repeated measurements on the same individuals, and data from Danish national registers provides a unique resource for a wide range of twin studies. This article provides an updated overview of the data in the DTR: First, we provide a summary of the establishment of the register, the different ascertainment methods and the twins included; then follows an overview of major surveys conducted in the DTR since 1994 and a description of the DTR biobank, including a description of the molecular data created so far; finally, a short description is given of the linkage to Danish national registers at Statistics Denmark and some recent examples of studies using the various data resources in the DTR are highlighted.
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Abstract
Nordic twin studies have played a critical role in understanding cancer etiology and elucidating the nature of familial effects on site-specific cancers. The NorTwinCan consortium is a collaborative effort that capitalizes on unique research advantages made possible through the Nordic system of registries. It was constructed by linking the population-based twin registries of Denmark, Finland, Norway and Sweden to their country-specific national cancer and cause-of-death registries. These linkages enable the twins to be followed many decades for cancer incidence and mortality. To date, two major linkages have been conducted: NorTwinCan I in 2011-2012 and NorTwinCan II in 2018. Overall, there are 315,413 eligible twins, 57,236 incident cancer cases and 58 years of follow-up, on average. In the initial phases of our work, NorTwinCan established the world's most comprehensive twin database for studying cancer, developed novel analytical approaches tailored to address specific research considerations within the context of the Nordic data and leveraged these models and data in research publications that provide the most accurate estimates of heritability and familial risk of cancers reported in the literature to date. Our findings indicate an excess familial risk for nearly all cancers and demonstrate that the incidence of cancer among twins mirrors the rate in the general population. They also revealed that twin concordance for cancer most often manifests across, rather than within, cancer sites, and we are currently focusing on the analysis of these cross-cancer associations.
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Maas IL, Brüggemann P, Requena T, Bulla J, Edvall NK, Hjelmborg JV, Szczepek AJ, Canlon B, Mazurek B, Lopez-Escamez JA, Cederroth CR. Genetic susceptibility to bilateral tinnitus in a Swedish twin cohort. Genet Med 2017; 19:1007-1012. [PMID: 28333916 PMCID: PMC5589979 DOI: 10.1038/gim.2017.4] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 01/09/2017] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Genetic contributions to tinnitus have been difficult to determine due to the heterogeneity of the condition and its broad etiology. Here, we evaluated the genetic and nongenetic influences on self-reported tinnitus from the Swedish Twin Registry (STR). METHODS Cross-sectional data from the STR was obtained. Casewise concordance rates (the risk of one twin being affected given that his/her twin partner has tinnitus) were compared for monozygotic (MZ) and dizygotic (DZ) twin pairs (N = 10,464 concordant and discordant twin pairs) and heritability coefficients (the proportion of the total variance attributable to genetic factors) were calculated using biometrical model fitting procedures. RESULTS Stratification of tinnitus cases into subtypes according to laterality (unilateral versus bilateral) revealed that heritability of bilateral tinnitus was 0.56; however, it was 0.27 for unilateral tinnitus. Heritability was greater in men (0.68) than in women (0.41). However, when female pairs younger than 40 years of age were selected, heritability of 0.62 was achieved with negligible effects of shared environment. CONCLUSION Unlike unilateral tinnitus, bilateral tinnitus is influenced by genetic factors and might constitute a genetic subtype. Overall, our study provides the initial evidence for a tinnitus phenotype with a genetic influence.Genet Med advance online publication 23 March 2017.
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Affiliation(s)
- Iris Lianne Maas
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Petra Brüggemann
- Tinnitus Center, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Teresa Requena
- Otology & Neurotology Group CTS495, Department of Genomic Medicine, GENYO – Center for Genomics and Oncological Research–Pfizer, University of Granada, Junta de Andalucía, PTS, Granada, Spain
| | - Jan Bulla
- Department of Mathematics, University of Bergen, Bergen, Norway
| | - Niklas K. Edvall
- Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Jacob v.B. Hjelmborg
- Department of Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, Odense, Denmark
| | - Agnieszka J. Szczepek
- Department of ORL, Head and Neck Surgery, Research Laboratory, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Barbara Canlon
- Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Birgit Mazurek
- Tinnitus Center, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Jose A. Lopez-Escamez
- Otology & Neurotology Group CTS495, Department of Genomic Medicine, GENYO – Center for Genomics and Oncological Research–Pfizer, University of Granada, Junta de Andalucía, PTS, Granada, Spain
- Department of Otolaryngology, Complejo Hospitalario Universidad de Granada (CHUGRA), ibs.granada, Granada, Spain
| | - Christopher R. Cederroth
- Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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Cederkvist L, Holst KK, Andersen KK, Glidden DV, Frederiksen K, Kjaer SK, Scheike TH. Incorporation of the time aspect into the liability-threshold model for case-control-family data. Stat Med 2017; 36:1599-1618. [PMID: 28114748 DOI: 10.1002/sim.7229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 12/16/2016] [Accepted: 01/03/2017] [Indexed: 11/11/2022]
Abstract
Familial aggregation and the role of genetic and environmental factors can be investigated through family studies analysed using the liability-threshold model. The liability-threshold model ignores the timing of events including the age of disease onset and right censoring, which can lead to estimates that are difficult to interpret and are potentially biased. We incorporate the time aspect into the liability-threshold model for case-control-family data following the same approach that has been applied in the twin setting. Thus, the data are considered as arising from a competing risks setting and inverse probability of censoring weights are used to adjust for right censoring. In the case-control-family setting, recognising the existence of competing events is highly relevant to the sampling of control probands. Because of the presence of multiple family members who may be censored at different ages, the estimation of inverse probability of censoring weights is not as straightforward as in the twin setting but requires consideration. We propose to employ a composite likelihood conditioning on proband status that markedly simplifies adjustment for right censoring. We assess the proposed approach using simulation studies and apply it in the analysis of two Danish register-based case-control-family studies: one on cancer diagnosed in childhood and adolescence, and one on early-onset breast cancer. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Luise Cederkvist
- Section of Biostatistics, University of Copenhagen, Øster Farimagsgade 5, POB 2099, Copenhagen K, DK-1014, Denmark.,Unit of Statistics, Bioinformatics and Registry, Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen Ø, DK-2100, Denmark
| | - Klaus K Holst
- Section of Biostatistics, University of Copenhagen, Øster Farimagsgade 5, POB 2099, Copenhagen K, DK-1014, Denmark
| | - Klaus K Andersen
- Unit of Statistics, Bioinformatics and Registry, Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen Ø, DK-2100, Denmark
| | - David V Glidden
- Department of Epidemiology and Biostatistics, University of California, 550 16th Street, 2nd floor, San Francisco, CA, 94158, U.S.A
| | - Kirsten Frederiksen
- Unit of Statistics, Bioinformatics and Registry, Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen Ø, DK-2100, Denmark
| | - Susanne K Kjaer
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen Ø, DK-2100, Denmark.,Department of Gynecology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen Ø, DK-2100, Denmark
| | - Thomas H Scheike
- Section of Biostatistics, University of Copenhagen, Øster Farimagsgade 5, POB 2099, Copenhagen K, DK-1014, Denmark
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