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Radder JE, Shapiro SD, Berndt A. Personalized medicine for chronic, complex diseases: chronic obstructive pulmonary disease as an example. Per Med 2014; 11:669-679. [PMID: 29764057 DOI: 10.2217/pme.14.51] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Chronic, complex diseases represent the majority of healthcare utilization and spending in the USA today. Despite this, therapeutics that account for the heterogeneity of these diseases are lacking, begging for more personalized approaches. Improving our understanding of disease phenotypes through retrospective trials of electronic health record data will enable us to better categorize patients. Increased usage of next-generation sequencing will further our understanding of the genetic variants involved in chronic disease. Utilization of data warehousing will be necessary in order to securely handle, integrate and analyze the large sets of data produced with these methods. Finally, increased use of clinical decision support will enable the return of clinically actionable results that physicians can use to apply these personalized approaches.
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Affiliation(s)
- Josiah E Radder
- Division of Pulmonary, Allergy & Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Steven D Shapiro
- Division of Pulmonary, Allergy & Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Annerose Berndt
- Division of Pulmonary, Allergy & Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Smolonska J, Koppelman GH, Wijmenga C, Vonk JM, Zanen P, Bruinenberg M, Curjuric I, Imboden M, Thun GA, Franke L, Probst-Hensch NM, Nürnberg P, Riemersma RA, van Schayck CP, Loth DW, Brusselle GG, Stricker BH, Hofman A, Uitterlinden AG, Lahousse L, London SJ, Loehr LR, Manichaikul A, Barr RG, Donohue KM, Rich SS, Pare P, Bossé Y, Hao K, van den Berge M, Groen HJM, Lammers JWJ, Mali W, Boezen HM, Postma DS. Common genes underlying asthma and COPD? Genome-wide analysis on the Dutch hypothesis. Eur Respir J 2014; 44:860-72. [PMID: 24993907 DOI: 10.1183/09031936.00001914] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Asthma and chronic obstructive pulmonary disease (COPD) are thought to share a genetic background ("Dutch hypothesis"). We investigated whether asthma and COPD have common underlying genetic factors, performing genome-wide association studies for both asthma and COPD and combining the results in meta-analyses. Three loci showed potential involvement in both diseases: chr2p24.3, chr5q23.1 and chr13q14.2, containing DDX1, COMMD10 (both participating in the nuclear factor (NF) κβ pathway) and GNG5P5, respectively. Single nucleotide polymorphisms (SNPs) rs9534578 in GNG5P5 reached genome-wide significance after first replication phase (p=9.96×10(-9)). The second replication phase, in seven independent cohorts, provided no significant replication. Expression quantitative trait loci (eQTL) analysis in blood cells and lung tissue on the top 20 associated SNPs identified two SNPs in COMMD10 that influenced gene expression. Inflammatory processes differ in asthma and COPD and are mediated by NF-κβ, which could be driven by the same underlying genes, COMMD10 and DDX1. None of the SNPs reached genome-wide significance. Our eQTL studies support a functional role for two COMMD10 SNPs, since they influence gene expression in both blood cells and lung tissue. Our findings suggest that there is either no common genetic component in asthma and COPD or, alternatively, different environmental factors, e.g. lifestyle and occupation in different countries and continents, which may have obscured the genetic common contribution.
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Affiliation(s)
- Joanna Smolonska
- Dept of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands Dept of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands GRIAC Research Institute, Groningen University Medical Center, University of Groningen, Groningen, The Netherlands
| | - Gerard H Koppelman
- GRIAC Research Institute, Groningen University Medical Center, University of Groningen, Groningen, The Netherlands Dept of Paediatric Pulmonology and Paediatric Allergology, Beatrix Children's Hospital, University Medical Center, University of Groningen, Groningen, The Netherlands
| | - Cisca Wijmenga
- Dept of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Judith M Vonk
- Dept of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands GRIAC Research Institute, Groningen University Medical Center, University of Groningen, Groningen, The Netherlands
| | - Pieter Zanen
- Dept of Pulmonology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marcel Bruinenberg
- Dept of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ivan Curjuric
- Dept of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland University of Basel, Basel, Switzerland
| | - Medea Imboden
- Dept of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland University of Basel, Basel, Switzerland
| | - Gian-Andri Thun
- Dept of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland University of Basel, Basel, Switzerland
| | - Lude Franke
- Dept of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Nicole M Probst-Hensch
- Dept of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland University of Basel, Basel, Switzerland
| | - Peter Nürnberg
- Cologne Center for Genomics, University of Cologne, Cologne, Germany
| | - Roland A Riemersma
- GRIAC Research Institute, Groningen University Medical Center, University of Groningen, Groningen, The Netherlands Dept of Pulmonology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Daan W Loth
- Dept of Epidemiology, Erasmus MC, Rotterdam, The Netherlands Netherlands Healthcare Inspectorate, The Hague, The Netherlands
| | - Guy G Brusselle
- Dept of Epidemiology, Erasmus MC, Rotterdam, The Netherlands Dept of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium Dept of Respiratory Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Bruno H Stricker
- Dept of Epidemiology, Erasmus MC, Rotterdam, The Netherlands Netherlands Healthcare Inspectorate, The Hague, The Netherlands Netherlands Consortium for Healthy Aging (NCHA), Rotterdam, The Netherlands
| | - Albert Hofman
- Dept of Epidemiology, Erasmus MC, Rotterdam, The Netherlands Netherlands Consortium for Healthy Aging (NCHA), Rotterdam, The Netherlands
| | - André G Uitterlinden
- Netherlands Consortium for Healthy Aging (NCHA), Rotterdam, The Netherlands Dept of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Lies Lahousse
- Dept of Epidemiology, Erasmus MC, Rotterdam, The Netherlands Dept of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Stephanie J London
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Dept of Health and Human Services, Research Triangle Park, NC, USA
| | | | - Ani Manichaikul
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA Dept of Public Health Sciences, Division of Biostatistics and Epidemiology, University of Virginia, Charlottesville, VA, USA
| | - R Graham Barr
- Dept of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Kathleen M Donohue
- Dept of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Stephen S Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
| | - Peter Pare
- Respiratory Division, Dept of Medicine, University of British Columbia James Hogg Research Centre, St Paul's Hospital, Vancouver, BC, Canada
| | - Yohan Bossé
- Institut Universitaire De Cardiologie Et De Pneumologie De Québec, Dept of Molecular Medicine, Laval University, Québec, QC, Canada
| | - Ke Hao
- Dept of Genetics and Genomics Sciences, Mount Sinai School of Medicine, New York, NY, USA
| | - Maarten van den Berge
- GRIAC Research Institute, Groningen University Medical Center, University of Groningen, Groningen, The Netherlands Dept of Pulmonology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Harry J M Groen
- Dept of Pulmonology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jan-Willem J Lammers
- Dept of Pulmonology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Willem Mali
- Dept of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - H Marike Boezen
- Dept of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands GRIAC Research Institute, Groningen University Medical Center, University of Groningen, Groningen, The Netherlands
| | - Dirkje S Postma
- GRIAC Research Institute, Groningen University Medical Center, University of Groningen, Groningen, The Netherlands Dept of Pulmonology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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