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Gallego-Fabrega C, Temprano-Sagrera G, Cárcel-Márquez J, Muiño E, Cullell N, Lledós M, Llucià-Carol L, Martin-Campos JM, Sobrino T, Castillo J, Millán M, Muñoz-Narbona L, López-Cancio E, Ribó M, Alvarez-Sabin J, Jiménez-Conde J, Roquer J, Tur S, Obach V, Arenillas JF, Segura T, Serrano-Heras G, Marti-Fabregas J, Freijo-Guerrero M, Moniche F, Castellanos MDM, Morrison AC, Smith NL, de Vries PS, Fernández-Cadenas I, Sabater-Lleal M. A multitrait genetic study of hemostatic factors and hemorrhagic transformation after stroke treatment. J Thromb Haemost 2024; 22:936-950. [PMID: 38103737 PMCID: PMC11103592 DOI: 10.1016/j.jtha.2023.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/08/2023] [Accepted: 11/27/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Thrombolytic recombinant tissue plasminogen activator (r-tPA) treatment is the only pharmacologic intervention available in the ischemic stroke acute phase. This treatment is associated with an increased risk of intracerebral hemorrhages, known as hemorrhagic transformations (HTs), which worsen the patient's prognosis. OBJECTIVES To investigate the association between genetically determined natural hemostatic factors' levels and increased risk of HT after r-tPA treatment. METHODS Using data from genome-wide association studies on the risk of HT after r-tPA treatment and data on 7 hemostatic factors (factor [F]VII, FVIII, von Willebrand factor [VWF], FXI, fibrinogen, plasminogen activator inhibitor-1, and tissue plasminogen activator), we performed local and global genetic correlation estimation multitrait analyses and colocalization and 2-sample Mendelian randomization analyses between hemostatic factors and HT. RESULTS Local correlations identified a genomic region on chromosome 16 with shared covariance: fibrinogen-HT, P = 2.45 × 10-11. Multitrait analysis between fibrinogen-HT revealed 3 loci that simultaneously regulate circulating levels of fibrinogen and risk of HT: rs56026866 (PLXND1), P = 8.80 × 10-10; rs1421067 (CHD9), P = 1.81 × 10-14; and rs34780449, near ROBO1 gene, P = 1.64 × 10-8. Multitrait analysis between VWF-HT showed a novel common association regulating VWF and risk of HT after r-tPA at rs10942300 (ZNF366), P = 1.81 × 10-14. Mendelian randomization analysis did not find significant causal associations, although a nominal association was observed for FXI-HT (inverse-variance weighted estimate [SE], 0.07 [-0.29 to 0.00]; odds ratio, 0.87; 95% CI, 0.75-1.00; raw P = .05). CONCLUSION We identified 4 shared loci between hemostatic factors and HT after r-tPA treatment, suggesting common regulatory mechanisms between fibrinogen and VWF levels and HT. Further research to determine a possible mediating effect of fibrinogen on HT risk is needed.
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Affiliation(s)
- Cristina Gallego-Fabrega
- Stroke Pharmacogenomics and Genetics Group, Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain. https://twitter.com/FabregaGallego
| | - Gerard Temprano-Sagrera
- Genomics of Complex Disease Group, Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
| | - Jara Cárcel-Márquez
- Stroke Pharmacogenomics and Genetics Group, Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
| | - Elena Muiño
- Stroke Pharmacogenomics and Genetics Group, Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
| | - Natalia Cullell
- Stroke Pharmacogenomics and Genetics Group, Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain; Neurology Unit, Hospital Universitari MútuaTerrassa, Terrassa, Spain
| | - Miquel Lledós
- Stroke Pharmacogenomics and Genetics Group, Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
| | - Laia Llucià-Carol
- Stroke Pharmacogenomics and Genetics Group, Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
| | - Jesús M Martin-Campos
- Stroke Pharmacogenomics and Genetics Group, Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
| | - Tomás Sobrino
- Clinical Neurosciences Research Laboratories, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - José Castillo
- Department of Neurology, Hospital Clínico Universitario de Santiago (CHUS), Santiago de Compostela, Spain
| | - Mònica Millán
- Department of Neuroscience, Hospital Universitario Hermanos Trias y Pujol (HUGTP), Badalona, Spain
| | - Lucía Muñoz-Narbona
- Department of Neuroscience, Hospital Universitario Hermanos Trias y Pujol (HUGTP), Badalona, Spain
| | - Elena López-Cancio
- Stroke Unit, Neurology Department, Hospital Universitario Central de Asturias (HUCA), Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Marc Ribó
- Stroke Unit, Hospital Universitario Valle de Hebrón (HUVH), Barcelona, Spain
| | - Jose Alvarez-Sabin
- Department of Neurology, Hospital Universitario Valle de Hebrón (HUVH), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Jordi Jiménez-Conde
- Department of Neurology, Neurovascular Research Group, Instituto de investigaciones médicas Hospital del Mar (IMIM) Hospital del Mar, Barcelona, Spain
| | - Jaume Roquer
- Department of Neurology, Neurovascular Research Group, Instituto de investigaciones médicas Hospital del Mar (IMIM) Hospital del Mar, Barcelona, Spain
| | - Silvia Tur
- Department of Neurology, Hospital Universitario Son Espases (HUSE), Mallorca, Spain
| | - Victor Obach
- Department of Neurology, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain
| | - Juan F Arenillas
- Department of Neurology, Hospital Clínico Universitario, University of Valladolid, Valladolid, Spain
| | - Tomas Segura
- Department of Neurology, Complejo Hospitalario Universitario de Albacete (CHUA), Universidad de Castilla-La Mancha (UCLM), Albacete, Spain
| | - Gemma Serrano-Heras
- Research Unit, Complejo Hospital Universitario de Albacete (CHUA), Albacete, Spain
| | - Joan Marti-Fabregas
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
| | | | - Francisco Moniche
- Department of Neurology, Hospital Universitario Virgen del Rocio, Instituto de Biomedicina de Sevilla (IBIS), Seville, Spain
| | - Maria Del Mar Castellanos
- Department of Neurology, Hospital Universitario de A Coruña (CHUAC), Biomedical Research Institute, A Coruña, Spain
| | - Alanna C Morrison
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, the University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Nicholas L Smith
- Department of Epidemiology, University of Washington, Seattle, Washington, USA; Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, Washington, USA; Department of Veterans Affairs Office of Research and Development, Seattle Epidemiologic Research and Information Center, Seattle, Washington, USA
| | - Paul S de Vries
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, the University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Israel Fernández-Cadenas
- Stroke Pharmacogenomics and Genetics Group, Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain.
| | - Maria Sabater-Lleal
- Genomics of Complex Disease Group, Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain; Cardiovascular Medicine Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
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Dusanovic Pjevic M, Vojvodic L, Grk M, Todorovic J, Maksimovic N, Rasic M, Perovic D, Damnjanovic T, Trickovic J, Kacar K, Jekic B. Association of IL-6 rs1800795, but not TNF-α rs1800629, and IL-1β rs16944 polymorphisms' genotypes with recovery of ischemic stroke patients following thrombolysis. Neurol Res 2024; 46:157-164. [PMID: 37853768 DOI: 10.1080/01616412.2023.2258042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/04/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVES Inflammatory cytokines like tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, and IL-6 can cause brain injury, slow recovery, and adverse effects (ADEs) in ischemic stroke (IS) patients treated with recombinant tissue plasminogen activator (rtPA). We explored the relationship between selected polymorphisms within TNF-α, IL-1β and IL-6 genes, and post-IS outcome and ADEs in patients treated with rtPA. METHODS One hundred and sixty-six patients with IS treated with rtPA were included in this study. The modified Rankin Scale (mRS) was used to assess functional recovery 3 months after IS likewise thrombolytic therapy efficacy. Patients were classified into groups with favorable (0-1) or poor recovery based on their mRS score at the ninetieth day post-IS. During hospitalization, ADEs following rtPA were monitored. TNF-α-308 G/A (rs1800629), IL-1β-511 G/A (rs16944), and IL-6-174 G/C (rs1800795) polymorphisms were genotyped using Real-Time PCR. SPSS software version 22.0 was used for statistical analyses. RESULTS Patients with the TNF-α-308 G/A GG genotype had a higher mean NIHSS value at admission (12.75 ± 5.176) than those carrying A-allele (10.56 ± 3.979;p = 0.016). Individuals with the CC genotype of the IL-6-174 G/C polymorphism had significantly lower NIHSS scores (8.79 ± 5.053) than those with G-allele (12.06 ± 6.562) 24 hours after rtPA (p = 0.050). Patients with the GG genotype of the IL-6-174 G/C polymorphism had a significantly poorer outcome (p = 0.024; OR = 2.339; 95%CI 1.121-4.880), while patients who were G-allele carriers of the Il-6-174 G/C polymorphism and had the AA genotype of the IL-1β-511 G/A polymorphism were statistically significantly more likely to experience hemorrhagic transformation (p = 0.046; OR = 2.7273; 95%CI 1.0414-7.1426). CONCLUSION GG genotype of the IL-6-174 G/C polymorphism is associated with poor recovery after IS treated with rtPA therapy.
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Affiliation(s)
| | | | - Milka Grk
- Faculty of Medicine, Institute of Human Genetics, University of Belgrade, Belgrade, Serbia
| | - Jovana Todorovic
- Faculty of Medicine, Institute of Social Medicine, University of Belgrade, Belgrade, Serbia
| | - Nela Maksimovic
- Faculty of Medicine, Institute of Human Genetics, University of Belgrade, Belgrade, Serbia
| | - Milica Rasic
- Faculty of Medicine, Institute of Human Genetics, University of Belgrade, Belgrade, Serbia
| | - Dijana Perovic
- Faculty of Medicine, Institute of Human Genetics, University of Belgrade, Belgrade, Serbia
| | - Tatjana Damnjanovic
- Faculty of Medicine, Institute of Human Genetics, University of Belgrade, Belgrade, Serbia
| | | | | | - Biljana Jekic
- Faculty of Medicine, Institute of Human Genetics, University of Belgrade, Belgrade, Serbia
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3
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Ge H, Ma X, Wang J, Zhang X, Zhang Y, Zhang Q, Li W, Liu J, Duan J, Shi W, Tian Y. A potential relationship between MMP-9 rs2250889 and ischemic stroke susceptibility. Front Neurol 2023; 14:1178642. [PMID: 37475739 PMCID: PMC10354235 DOI: 10.3389/fneur.2023.1178642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/12/2023] [Indexed: 07/22/2023] Open
Abstract
Purpose Ischemic stroke (IS), a serious cerebrovascular disease, greatly affects people's health and life. Genetic factors are indispensable for the occurrence of IS. As a biomarker for IS, the MMP-9 gene is widely involved in the pathophysiological process of IS. This study attempts to find out the relationship between MMP-9 polymorphisms and IS susceptibility. Methods A total of 700 IS patients and 700 healthy controls were recruited. The single nucleotide polymorphism (SNP) markers of the MMP-9 gene were genotyped by the MassARRAY analyzer. Multifactor dimensionality reduction (MDR) was applied to generate SNP-SNP interaction. Furthermore, the relationship between genetic variations (allele and genotype) of the MMP-9 gene and IS susceptibility was analyzed by calculating odds ratios (ORs) and 95% confidence intervals (CIs). Results Our results demonstrated that rs2250889 could significantly increase the susceptibility to IS in the codominant, dominant, overdominant, and log-additive models (p < 0.05). Further stratification analysis showed that compared with the control group, rs2250889 was associated with IS risk in different case groups (age, female, smoking, and non-drinking) (p < 0.05). Based on MDR analysis, rs2250889 was the best model for predicting IS risk (cross-validation consistency: 10/10, OR = 1.56 (1.26-1.94), p < 0.001). Conclusion Our study preliminarily confirmed that SNP rs2250889 was significantly associated with susceptibility to IS.
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Affiliation(s)
- Hanming Ge
- Department of Neurology, Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, Xi'an No. 3 Hospital, The Affiliated Hospital of Northwest University, Xi'an, Shaanxi, China
| | - Xiaojuan Ma
- Medical Research Center, Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, Xi'an No. 3 Hospital, The Affiliated Hospital of Northwest University, Xi'an, Shaanxi, China
| | - Jiachen Wang
- The College of Life Sciences, Northwest University, Xi'an, Shaanxi, China
| | - Xiaobo Zhang
- The College of Life Sciences, Northwest University, Xi'an, Shaanxi, China
| | - Yu Zhang
- The College of Life Sciences, Northwest University, Xi'an, Shaanxi, China
| | - Qi Zhang
- The College of Life Sciences, Northwest University, Xi'an, Shaanxi, China
| | - Wu Li
- Medical Research Center, Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, Xi'an No. 3 Hospital, The Affiliated Hospital of Northwest University, Xi'an, Shaanxi, China
| | - Jie Liu
- Medical Research Center, Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, Xi'an No. 3 Hospital, The Affiliated Hospital of Northwest University, Xi'an, Shaanxi, China
| | - Jinwei Duan
- Medical Research Center, Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, Xi'an No. 3 Hospital, The Affiliated Hospital of Northwest University, Xi'an, Shaanxi, China
| | - Wenzhen Shi
- Medical Research Center, Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, Xi'an No. 3 Hospital, The Affiliated Hospital of Northwest University, Xi'an, Shaanxi, China
| | - Ye Tian
- Department of Neurology, Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, Xi'an No. 3 Hospital, The Affiliated Hospital of Northwest University, Xi'an, Shaanxi, China
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Dichgans M, Meschia JF. Advances in Stroke: Genetics, Genomics, Precision Medicine. Stroke 2022; 53:3211-3213. [DOI: 10.1161/strokeaha.122.039305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Germany (M.D.)
- Munich Cluster for Systems Neurology (SyNergy), Germany (M.D.)
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Genome-Wide Studies in Ischaemic Stroke: Are Genetics Only Useful for Finding Genes? Int J Mol Sci 2022; 23:ijms23126840. [PMID: 35743317 PMCID: PMC9224543 DOI: 10.3390/ijms23126840] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 02/07/2023] Open
Abstract
Ischaemic stroke is a complex disease with some degree of heritability. This means that heritability factors, such as genetics, could be risk factors for ischaemic stroke. The era of genome-wide studies has revealed some of these heritable risk factors, although the data generated by these studies may also be useful in other disciplines. Analysis of these data can be used to understand the biological mechanisms associated with stroke risk and stroke outcome, to determine the causality between stroke and other diseases without the need for expensive clinical trials, or to find potential drug targets with higher success rates than other strategies. In this review we will discuss several of the most relevant studies regarding the genetics of ischaemic stroke and the potential use of the data generated.
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Llucià-Carol L, Muiño E, Gallego-Fabrega C, Cárcel-Márquez J, Martín-Campos J, Lledós M, Cullell N, Fernández-Cadenas I. Pharmacogenetics studies in stroke patients treated with rtPA: a review of the most interesting findings. Pharmacogenomics 2021; 22:1091-1097. [PMID: 34698533 DOI: 10.2217/pgs-2021-0100] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Recombinant tissue-plasminogen activator (rtPA) is the only drug used during the acute phase of stroke. Despite its important benefits, a percentage of patients suffer symptomatic hemorrhagic transformations or a lack of early recanalization rates. These undesirable effects are associated with acute neurological and long-term functional deterioration. For the past 20 years, pharmacogenetic studies have tried to find the genetic risk factors associated with rtPA response. Most of these studies have used a gene-candidate strategy; however, recent genome-wide association studies have emerged indicating that genetic predisposition could modulate rtPA response. This review summarizes the most interesting findings in this field, including which genes and genetic variations are associated with hemorrhagic transformations and recanalization rates after thrombolytic therapy.
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Affiliation(s)
- Laia Llucià-Carol
- Institute for Biomedical Research of Barcelona (IIBB), National Spanish Research Council (CSIC), Barcelona, Spain.,Stroke Pharmacogenomics & Genetics, Biomedical Research Institute Sant Pau, Sant Pau Hospital, Barcelona, Spain
| | - Elena Muiño
- Stroke Pharmacogenomics & Genetics, Biomedical Research Institute Sant Pau, Sant Pau Hospital, Barcelona, Spain
| | - Cristina Gallego-Fabrega
- Stroke Pharmacogenomics & Genetics, Biomedical Research Institute Sant Pau, Sant Pau Hospital, Barcelona, Spain
| | - Jara Cárcel-Márquez
- Stroke Pharmacogenomics & Genetics, Biomedical Research Institute Sant Pau, Sant Pau Hospital, Barcelona, Spain
| | - Jesus Martín-Campos
- Stroke Pharmacogenomics & Genetics, Biomedical Research Institute Sant Pau, Sant Pau Hospital, Barcelona, Spain
| | - Miquel Lledós
- Stroke Pharmacogenomics & Genetics, Biomedical Research Institute Sant Pau, Sant Pau Hospital, Barcelona, Spain
| | - Natalia Cullell
- Stroke Pharmacogenomics & Genetics, Biomedical Research Institute Sant Pau, Sant Pau Hospital, Barcelona, Spain.,Neurology Unit, Hospital Universitari Mútua Terrassa, Terrassa, Spain
| | - Israel Fernández-Cadenas
- Stroke Pharmacogenomics & Genetics, Biomedical Research Institute Sant Pau, Sant Pau Hospital, Barcelona, Spain
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Abstract
The field of medical and population genetics in stroke is moving at a rapid pace and has led to unanticipated opportunities for discovery and clinical applications. Genome-wide association studies have highlighted the role of specific pathways relevant to etiologically defined subtypes of stroke and to stroke as a whole. They have further offered starting points for the exploration of novel pathways and pharmacological strategies in experimental systems. Mendelian randomization studies continue to provide insights in the causal relationships between exposures and outcomes and have become a useful tool for predicting the efficacy and side effects of drugs. Additional applications that have emerged from recent discoveries include risk prediction based on polygenic risk scores and pharmacogenomics. Among the topics currently moving into focus is the genetics of stroke outcome. While still at its infancy, this field is expected to boost the development of neuroprotective agents. We provide a brief overview on recent progress in these areas.
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Affiliation(s)
- Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Nathalie Beaufort
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Stephanie Debette
- University of Bordeaux, INSERM, Bordeaux Population Health Center, UMR1219, Team VINTAGE, F-33000 Bordeaux, France
- Bordeaux University Hospital, Department of Neurology, Institute of Neurodegenerative Diseases, F-33000 Bordeaux, France
| | - Christopher D. Anderson
- Department of Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
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8
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Muiño E, Cárcel-Márquez J, Carrera C, Llucià-Carol L, Gallego-Fabrega C, Cullell N, Lledós M, Castillo J, Sobrino T, Campos F, Rodríguez-Castro E, Millán M, Muñoz-Narbona L, Bustamante A, López-Cancio E, Ribó M, Álvarez-Sabín J, Jiménez-Conde J, Roquer J, Giralt-Steinhauer E, Soriano-Tárraga C, Vives-Bauza C, Navarro RD, Tur S, Obach V, Arenillas JF, Segura T, Serrano-Heras G, Martí-Fàbregas J, Delgado-Mederos R, Camps-Renom P, Prats-Sánchez L, Guisado D, Guasch M, Marin R, Martínez-Domeño A, Freijo-Guerrero MDM, Moniche F, Cabezas JA, Castellanos M, Krupinsky J, Strbian D, Tatlisumak T, Thijs V, Lemmens R, Slowik A, Pera J, Heitsch L, Ibañez L, Cruchaga C, Dhar R, Lee JM, Montaner J, Fernández-Cadenas I. RP11-362K2.2:RP11-767I20.1 Genetic Variation Is Associated with Post-Reperfusion Therapy Parenchymal Hematoma. A GWAS Meta-Analysis. J Clin Med 2021; 10:jcm10143137. [PMID: 34300314 PMCID: PMC8305811 DOI: 10.3390/jcm10143137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/05/2021] [Accepted: 07/14/2021] [Indexed: 12/12/2022] Open
Abstract
Stroke is one of the most common causes of death and disability. Reperfusion therapies are the only treatment available during the acute phase of stroke. Due to recent clinical trials, these therapies may increase their frequency of use by extending the time-window administration, which may lead to an increase in complications such as hemorrhagic transformation, with parenchymal hematoma (PH) being the more severe subtype, associated with higher mortality and disability rates. Our aim was to find genetic risk factors associated with PH, as that could provide molecular targets/pathways for their prevention/treatment and study its genetic correlations to find traits sharing genetic background. We performed a GWAS and meta-analysis, following standard quality controls and association analysis (fastGWAS), adjusting age, NIHSS, and principal components. FUMA was used to annotate, prioritize, visualize, and interpret the meta-analysis results. The total number of patients in the meta-analysis was 2034 (216 cases and 1818 controls). We found rs79770152 having a genome-wide significant association (beta 0.09, p-value 3.90 × 10−8) located in the RP11-362K2.2:RP11-767I20.1 gene and a suggestive variant (rs13297983: beta 0.07, p-value 6.10 × 10−8) located in PCSK5 associated with PH occurrence. The genetic correlation showed a shared genetic background of PH with Alzheimer’s disease and white matter hyperintensities. In addition, genes containing the ten most significant associations have been related to aggregated amyloid-β, tau protein, white matter microstructure, inflammation, and matrix metalloproteinases.
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Affiliation(s)
- Elena Muiño
- Stroke Pharmacogenomics and Genetics Group, Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (E.M.); (J.C.-M.); (L.L.-C.); (C.G.-F.); (N.C.); (M.L.)
| | - Jara Cárcel-Márquez
- Stroke Pharmacogenomics and Genetics Group, Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (E.M.); (J.C.-M.); (L.L.-C.); (C.G.-F.); (N.C.); (M.L.)
| | - Caty Carrera
- Neurovascular Research Laboratory, Vall d’Hebron Institut de Recerca, Universitat Autònoma de Barcelona, 08025 Barcelona, Spain;
| | - Laia Llucià-Carol
- Stroke Pharmacogenomics and Genetics Group, Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (E.M.); (J.C.-M.); (L.L.-C.); (C.G.-F.); (N.C.); (M.L.)
| | - Cristina Gallego-Fabrega
- Stroke Pharmacogenomics and Genetics Group, Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (E.M.); (J.C.-M.); (L.L.-C.); (C.G.-F.); (N.C.); (M.L.)
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, 08025 Barcelona, Spain; (J.M.-F.); (R.D.-M.); (P.C.-R.); (L.P.-S.); (D.G.); (M.G.); (R.M.); (A.M.-D.)
| | - Natalia Cullell
- Stroke Pharmacogenomics and Genetics Group, Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (E.M.); (J.C.-M.); (L.L.-C.); (C.G.-F.); (N.C.); (M.L.)
- Stroke Pharmacogenomics and Genetics, Fundació MútuaTerrassa per la Docència i la Recerca, 08221 Terrassa, Spain
| | - Miquel Lledós
- Stroke Pharmacogenomics and Genetics Group, Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (E.M.); (J.C.-M.); (L.L.-C.); (C.G.-F.); (N.C.); (M.L.)
| | - José Castillo
- Clinical Neurosciences Research Laboratories, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (J.C.); (T.S.); (F.C.)
| | - Tomás Sobrino
- Clinical Neurosciences Research Laboratories, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (J.C.); (T.S.); (F.C.)
| | - Francisco Campos
- Clinical Neurosciences Research Laboratories, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (J.C.); (T.S.); (F.C.)
| | - Emilio Rodríguez-Castro
- Department of Neurology, Hospital Clínico Universitario de Santiago, 15706 Santiago de Compostela, Spain;
| | - Mònica Millán
- Department of Neuroscience, Hospital Germans Trias i Pujol, 08025 Badalona, Spain; (M.M.); (L.M.-N.); (A.B.)
| | - Lucía Muñoz-Narbona
- Department of Neuroscience, Hospital Germans Trias i Pujol, 08025 Badalona, Spain; (M.M.); (L.M.-N.); (A.B.)
| | - Alejandro Bustamante
- Department of Neuroscience, Hospital Germans Trias i Pujol, 08025 Badalona, Spain; (M.M.); (L.M.-N.); (A.B.)
| | - Elena López-Cancio
- Stroke Unit, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain;
| | - Marc Ribó
- Stroke Unit, Hospital Universitario Valle de Hebrón, 08025 Barcelona, Spain;
| | - José Álvarez-Sabín
- Department of Neurology, Hospital Universitario Valle de Hebrón, Universidad Autónoma de Barcelona, 08025 Barcelona, Spain;
| | - Jordi Jiménez-Conde
- Department of Neurology, Neurovascular Research Group, Instituto de Investigaciones Médicas Hospital del Mar-Hospital del Mar, 08025 Barcelona, Spain; (J.J.-C.); (J.R.); (E.G.-S.); (C.S.-T.)
| | - Jaume Roquer
- Department of Neurology, Neurovascular Research Group, Instituto de Investigaciones Médicas Hospital del Mar-Hospital del Mar, 08025 Barcelona, Spain; (J.J.-C.); (J.R.); (E.G.-S.); (C.S.-T.)
| | - Eva Giralt-Steinhauer
- Department of Neurology, Neurovascular Research Group, Instituto de Investigaciones Médicas Hospital del Mar-Hospital del Mar, 08025 Barcelona, Spain; (J.J.-C.); (J.R.); (E.G.-S.); (C.S.-T.)
| | - Carolina Soriano-Tárraga
- Department of Neurology, Neurovascular Research Group, Instituto de Investigaciones Médicas Hospital del Mar-Hospital del Mar, 08025 Barcelona, Spain; (J.J.-C.); (J.R.); (E.G.-S.); (C.S.-T.)
| | - Cristófol Vives-Bauza
- Neurobiology Laboratory, Instituto de Investigación Sanitaria de Palma, 07120 Mallorca, Spain;
| | - Rosa Díaz Navarro
- Department of Neurology, Hospital Universitari Son Espases, 07120 Mallorca, Spain; (R.D.N.); (S.T.)
| | - Silvia Tur
- Department of Neurology, Hospital Universitari Son Espases, 07120 Mallorca, Spain; (R.D.N.); (S.T.)
| | - Victor Obach
- Department of Neurology, Hospital Clínic i Provincial de Barcelona, 08025 Barcelona, Spain;
| | - Juan F. Arenillas
- Department of Neurology, Hospital Clínico Universitario, University of Valladolid, 47003 Valladolid, Spain;
| | - Tomás Segura
- Department of Neurology, Complejo Hospitalario Universitario de Albacete, 02006 Albacete, Spain;
| | - Gemma Serrano-Heras
- Experimental Research Unit, Complejo Hospitalario Universitario de Albacete, 02006 Albacete, Spain;
| | - Joan Martí-Fàbregas
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, 08025 Barcelona, Spain; (J.M.-F.); (R.D.-M.); (P.C.-R.); (L.P.-S.); (D.G.); (M.G.); (R.M.); (A.M.-D.)
| | - Raquel Delgado-Mederos
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, 08025 Barcelona, Spain; (J.M.-F.); (R.D.-M.); (P.C.-R.); (L.P.-S.); (D.G.); (M.G.); (R.M.); (A.M.-D.)
| | - Pol Camps-Renom
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, 08025 Barcelona, Spain; (J.M.-F.); (R.D.-M.); (P.C.-R.); (L.P.-S.); (D.G.); (M.G.); (R.M.); (A.M.-D.)
| | - Luis Prats-Sánchez
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, 08025 Barcelona, Spain; (J.M.-F.); (R.D.-M.); (P.C.-R.); (L.P.-S.); (D.G.); (M.G.); (R.M.); (A.M.-D.)
| | - Daniel Guisado
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, 08025 Barcelona, Spain; (J.M.-F.); (R.D.-M.); (P.C.-R.); (L.P.-S.); (D.G.); (M.G.); (R.M.); (A.M.-D.)
| | - Marina Guasch
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, 08025 Barcelona, Spain; (J.M.-F.); (R.D.-M.); (P.C.-R.); (L.P.-S.); (D.G.); (M.G.); (R.M.); (A.M.-D.)
| | - Rebeca Marin
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, 08025 Barcelona, Spain; (J.M.-F.); (R.D.-M.); (P.C.-R.); (L.P.-S.); (D.G.); (M.G.); (R.M.); (A.M.-D.)
| | - Alejandro Martínez-Domeño
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, 08025 Barcelona, Spain; (J.M.-F.); (R.D.-M.); (P.C.-R.); (L.P.-S.); (D.G.); (M.G.); (R.M.); (A.M.-D.)
| | | | - Francisco Moniche
- Department of Neurology, Virgen del Rocío, Instituto de Biomedicina de Sevilla, 41013 Seville, Spain; (F.M.); (J.A.C.); (J.M.)
| | - Juan Antonio Cabezas
- Department of Neurology, Virgen del Rocío, Instituto de Biomedicina de Sevilla, 41013 Seville, Spain; (F.M.); (J.A.C.); (J.M.)
| | - Mar Castellanos
- Department of Neurology, Complejo Hospitalario Universitario A Coruña, 15006 A Coruña, Spain;
| | - Jerzy Krupinsky
- School of Healthcare Science, Manchester Metropolitan University, Manchester M15 6BH, UK;
- Neurology Unit, Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain
| | - Daniel Strbian
- Department of Neurology, Helsinki University Hospital, FI-00029 Helsinki, Finland;
| | - Turgut Tatlisumak
- Department of Clinical Neuroscience, Institute of Neurosciences and Physiology, Sahlgrenska Academy at University of Gothenburg, 41345 Gothenburg, Sweden;
- Department of Neurology, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden
| | - Vincent Thijs
- Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg VIC 3072, Australia;
- Department of Neurology, Austin Health, Heidelberg VIC 3072, Australia
| | - Robin Lemmens
- Department of Neurology, University Hospitals Leuven, Campus Gasthuisberg, 3000 Leuven, Belgium;
| | - Agnieszka Slowik
- Department of Neurology, Jagiellonian University Medical College, 31-007 Kraków, Poland; (A.S.); (J.P.)
| | - Joanna Pera
- Department of Neurology, Jagiellonian University Medical College, 31-007 Kraków, Poland; (A.S.); (J.P.)
| | - Laura Heitsch
- Division of Emergency Medicine, Washington University School of Medicine, St. Louis, MO 63110-1010, USA;
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110-1010, USA; (R.D.); (J.-M.L.)
| | - Laura Ibañez
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110-1010, USA; (L.I.); (C.C.)
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110-1010, USA; (L.I.); (C.C.)
| | - Rajat Dhar
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110-1010, USA; (R.D.); (J.-M.L.)
| | - Jin-Moo Lee
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110-1010, USA; (R.D.); (J.-M.L.)
| | - Joan Montaner
- Department of Neurology, Virgen del Rocío, Instituto de Biomedicina de Sevilla, 41013 Seville, Spain; (F.M.); (J.A.C.); (J.M.)
| | - Israel Fernández-Cadenas
- Stroke Pharmacogenomics and Genetics Group, Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (E.M.); (J.C.-M.); (L.L.-C.); (C.G.-F.); (N.C.); (M.L.)
- Correspondence:
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