Publications by authors named "Claudia P Cabrera"

36 Publications

Somatic mutations of GNA11 and GNAQ in CTNNB1-mutant aldosterone-producing adenomas presenting in puberty, pregnancy or menopause.

Nat Genet 2021 09 12;53(9):1360-1372. Epub 2021 Aug 12.

Department of Surgery, St Bartholomew's Hospital, London, UK.

Most aldosterone-producing adenomas (APAs) have gain-of-function somatic mutations of ion channels or transporters. However, their frequency in aldosterone-producing cell clusters of normal adrenal gland suggests a requirement for codriver mutations in APAs. Here we identified gain-of-function mutations in both CTNNB1 and GNA11 by whole-exome sequencing of 3/41 APAs. Further sequencing of known CTNNB1-mutant APAs led to a total of 16 of 27 (59%) with a somatic p.Gln209His, p.Gln209Pro or p.Gln209Leu mutation of GNA11 or GNAQ. Solitary GNA11 mutations were found in hyperplastic zona glomerulosa adjacent to double-mutant APAs. Nine of ten patients in our UK/Irish cohort presented in puberty, pregnancy or menopause. Among multiple transcripts upregulated more than tenfold in double-mutant APAs was LHCGR, the receptor for luteinizing or pregnancy hormone (human chorionic gonadotropin). Transfections of adrenocortical cells demonstrated additive effects of GNA11 and CTNNB1 mutations on aldosterone secretion and expression of genes upregulated in double-mutant APAs. In adrenal cortex, GNA11/Q mutations appear clinically silent without a codriver mutation of CTNNB1.
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http://dx.doi.org/10.1038/s41588-021-00906-yDOI Listing
September 2021

Hypertension genetics past, present and future applications.

J Intern Med 2021 Jun 24. Epub 2021 Jun 24.

Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

Essential hypertension is a complex trait where the underlying aetiology is not completely understood. Left untreated it increases the risk of severe health complications including cardiovascular and renal disease. It is almost 15 years since the first genome-wide association study for hypertension, and after a slow start there are now over 1000 blood pressure (BP) loci explaining ∼6% of the single nucleotide polymorphism-based heritability. Success in discovery of hypertension genes has provided new pathological insights and drug discovery opportunities and translated to the development of BP genetic risk scores (GRSs), facilitating population disease risk stratification. Comparing highest and lowest risk groups shows differences of 12.9 mm Hg in systolic-BP with significant differences in risk of hypertension, stroke, cardiovascular disease and myocardial infarction. GRSs are also being trialled in antihypertensive-drug responses. Drug targets identified include NPR1, for which an agonist drug is currently in clinical trials. Identification of variants at the PHACTR1 locus provided insights into regulation of EDN1 in the endothelin pathway, which is aiding the development of endothelin receptor EDNRA antagonists. Drug re-purposing opportunities, including SLC5A1 and canagliflozin (a type-2 diabetes drug), are also being identified. In this review, we present key studies from the past, highlight current avenues of research and look to the future focusing on gene discovery, epigenetics, gene-environment interactions, GRSs and drug discovery. We evaluate limitations affecting BP genetics, including ancestry bias and discuss streamlining of drug target discovery and applications for treating and preventing hypertension, which will contribute to tailored precision medicine for patients.
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http://dx.doi.org/10.1111/joim.13352DOI Listing
June 2021

The trans-ancestral genomic architecture of glycemic traits.

Nat Genet 2021 06 31;53(6):840-860. Epub 2021 May 31.

Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.

Glycemic traits are used to diagnose and monitor type 2 diabetes and cardiometabolic health. To date, most genetic studies of glycemic traits have focused on individuals of European ancestry. Here we aggregated genome-wide association studies comprising up to 281,416 individuals without diabetes (30% non-European ancestry) for whom fasting glucose, 2-h glucose after an oral glucose challenge, glycated hemoglobin and fasting insulin data were available. Trans-ancestry and single-ancestry meta-analyses identified 242 loci (99 novel; P < 5 × 10), 80% of which had no significant evidence of between-ancestry heterogeneity. Analyses restricted to individuals of European ancestry with equivalent sample size would have led to 24 fewer new loci. Compared with single-ancestry analyses, equivalent-sized trans-ancestry fine-mapping reduced the number of estimated variants in 99% credible sets by a median of 37.5%. Genomic-feature, gene-expression and gene-set analyses revealed distinct biological signatures for each trait, highlighting different underlying biological pathways. Our results increase our understanding of diabetes pathophysiology by using trans-ancestry studies for improved power and resolution.
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http://dx.doi.org/10.1038/s41588-021-00852-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7610958PMC
June 2021

An Academic Clinician's Road Map to Hypertension Genomics: Recent Advances and Future Directions MMXX.

Hypertension 2021 02 4;77(2):284-295. Epub 2021 Jan 4.

From the William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom.

At the dawn of the new decade, it is judicious to reflect on the boom of knowledge about polygenic risk for essential hypertension supplied by the wealth of genome-wide association studies. Hypertension continues to account for significant cardiovascular morbidity and mortality, with increasing prevalence anticipated. Here, we overview recent advances in the use of big data to understand polygenic hypertension, as well as opportunities for future innovation to translate this windfall of knowledge into clinical benefit.
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http://dx.doi.org/10.1161/HYPERTENSIONAHA.120.14535DOI Listing
February 2021

Discovery of rare variants associated with blood pressure regulation through meta-analysis of 1.3 million individuals.

Nat Genet 2020 12 23;52(12):1314-1332. Epub 2020 Nov 23.

Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.

Genetic studies of blood pressure (BP) to date have mainly analyzed common variants (minor allele frequency > 0.05). In a meta-analysis of up to ~1.3 million participants, we discovered 106 new BP-associated genomic regions and 87 rare (minor allele frequency ≤ 0.01) variant BP associations (P < 5 × 10), of which 32 were in new BP-associated loci and 55 were independent BP-associated single-nucleotide variants within known BP-associated regions. Average effects of rare variants (44% coding) were ~8 times larger than common variant effects and indicate potential candidate causal genes at new and known loci (for example, GATA5 and PLCB3). BP-associated variants (including rare and common) were enriched in regions of active chromatin in fetal tissues, potentially linking fetal development with BP regulation in later life. Multivariable Mendelian randomization suggested possible inverse effects of elevated systolic and diastolic BP on large artery stroke. Our study demonstrates the utility of rare-variant analyses for identifying candidate genes and the results highlight potential therapeutic targets.
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http://dx.doi.org/10.1038/s41588-020-00713-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7610439PMC
December 2020

Rare CNVs provide novel insights into the molecular basis of GH and IGF-1 insensitivity.

Eur J Endocrinol 2020 Dec;183(6):581-595

Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK.

Objective: Copy number variation (CNV) has been associated with idiopathic short stature, small for gestational age and Silver-Russell syndrome (SRS). It has not been extensively investigated in growth hormone insensitivity (GHI; short stature, IGF-1 deficiency and normal/high GH) or previously in IGF-1 insensitivity (short stature, high/normal GH and IGF-1).

Design And Methods: Array comparative genomic hybridisation was performed with ~60 000 probe oligonucleotide array in GHI (n = 53) and IGF-1 insensitivity (n = 10) subjects. Published literature, mouse models, DECIPHER CNV tracks, growth associated GWAS loci and pathway enrichment analyses were used to identify key biological pathways/novel candidate growth genes within the CNV regions.

Results: Both cohorts were enriched for class 3-5 CNVs (7/53 (13%) GHI and 3/10 (30%) IGF-1 insensitivity patients). Interestingly, 6/10 (60%) CNV subjects had diagnostic/associated clinical features of SRS. 5/10 subjects (50%) had CNVs previously reported in suspected SRS: 1q21 (n = 2), 12q14 (n = 1) deletions and Xp22 (n = 1), Xq26 (n = 1) duplications. A novel 15q11 deletion, previously associated with growth failure but not SRS/GHI was identified. Bioinformatic analysis identified 45 novel candidate growth genes, 15 being associated with growth in GWAS. The WNT canonical pathway was enriched in the GHI cohort and CLOCK was identified as an upstream regulator in the IGF-1 insensitivity cohorts.

Conclusions: Our cohort was enriched for low frequency CNVs. Our study emphasises the importance of CNV testing in GHI and IGF-1 insensitivity patients, particularly GHI subjects with SRS features. Functional experimental evidence is now required to validate the novel candidate growth genes, interactions and biological pathways identified.
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http://dx.doi.org/10.1530/EJE-20-0474DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7592635PMC
December 2020

Enzymatic degradation of RNA causes widespread protein aggregation in cell and tissue lysates.

EMBO Rep 2020 10 18;21(10):e49585. Epub 2020 Sep 18.

Barts and The London School of Medicine and Dentistry, Blizard Institute, Queen Mary University of London, London, UK.

Most proteins in cell and tissue lysates are soluble. We show here that in lysate from human neurons, more than 1,300 proteins are maintained in a soluble and functional state by association with endogenous RNA, as degradation of RNA invariably leads to protein aggregation. The majority of these proteins lack conventional RNA-binding domains. Using synthetic oligonucleotides, we identify the importance of nucleic acid structure, with single-stranded pyrimidine-rich bulges or loops surrounded by double-stranded regions being particularly efficient in the maintenance of protein solubility. These experiments also identify an apparent one-to-one protein-nucleic acid stoichiometry. Furthermore, we show that protein aggregates isolated from brain tissue from Amyotrophic Lateral Sclerosis patients can be rendered soluble after refolding by both RNA and synthetic oligonucleotides. Together, these findings open new avenues for understanding the mechanism behind protein aggregation and shed light on how certain proteins remain soluble.
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http://dx.doi.org/10.15252/embr.201949585DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7534620PMC
October 2020

LGR4 deficiency results in delayed puberty through impaired Wnt/β-catenin signaling.

JCI Insight 2020 06 4;5(11). Epub 2020 Jun 4.

Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.

The initiation of puberty is driven by an upsurge in hypothalamic gonadotropin-releasing hormone (GnRH) secretion. In turn, GnRH secretion upsurge depends on the development of a complex GnRH neuroendocrine network during embryonic life. Although delayed puberty (DP) affects up to 2% of the population, is highly heritable, and is associated with adverse health outcomes, the genes underlying DP remain largely unknown. We aimed to discover regulators by whole-exome sequencing of 160 individuals of 67 multigenerational families in our large, accurately phenotyped DP cohort. LGR4 was the only gene remaining after analysis that was significantly enriched for potentially pathogenic, rare variants in 6 probands. Expression analysis identified specific Lgr4 expression at the site of GnRH neuron development. LGR4 mutant proteins showed impaired Wnt/β-catenin signaling, owing to defective protein expression, trafficking, and degradation. Mice deficient in Lgr4 had significantly delayed onset of puberty and fewer GnRH neurons compared with WT, whereas lgr4 knockdown in zebrafish embryos prevented formation and migration of GnRH neurons. Further, genetic lineage tracing showed strong Lgr4-mediated Wnt/β-catenin signaling pathway activation during GnRH neuron development. In conclusion, our results show that LGR4 deficiency impairs Wnt/β-catenin signaling with observed defects in GnRH neuron development, resulting in a DP phenotype.
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http://dx.doi.org/10.1172/jci.insight.133434DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7308048PMC
June 2020

Gene-educational attainment interactions in a multi-ancestry genome-wide meta-analysis identify novel blood pressure loci.

Mol Psychiatry 2021 06 5;26(6):2111-2125. Epub 2020 May 5.

Health Disparities Research Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD, 21224, USA.

Educational attainment is widely used as a surrogate for socioeconomic status (SES). Low SES is a risk factor for hypertension and high blood pressure (BP). To identify novel BP loci, we performed multi-ancestry meta-analyses accounting for gene-educational attainment interactions using two variables, "Some College" (yes/no) and "Graduated College" (yes/no). Interactions were evaluated using both a 1 degree of freedom (DF) interaction term and a 2DF joint test of genetic and interaction effects. Analyses were performed for systolic BP, diastolic BP, mean arterial pressure, and pulse pressure. We pursued genome-wide interrogation in Stage 1 studies (N = 117 438) and follow-up on promising variants in Stage 2 studies (N = 293 787) in five ancestry groups. Through combined meta-analyses of Stages 1 and 2, we identified 84 known and 18 novel BP loci at genome-wide significance level (P < 5 × 10). Two novel loci were identified based on the 1DF test of interaction with educational attainment, while the remaining 16 loci were identified through the 2DF joint test of genetic and interaction effects. Ten novel loci were identified in individuals of African ancestry. Several novel loci show strong biological plausibility since they involve physiologic systems implicated in BP regulation. They include genes involved in the central nervous system-adrenal signaling axis (ZDHHC17, CADPS, PIK3C2G), vascular structure and function (GNB3, CDON), and renal function (HAS2 and HAS2-AS1, SLIT3). Collectively, these findings suggest a role of educational attainment or SES in further dissection of the genetic architecture of BP.
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http://dx.doi.org/10.1038/s41380-020-0719-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7641978PMC
June 2021

Reaching the End-Game for GWAS: Machine Learning Approaches for the Prioritization of Complex Disease Loci.

Front Genet 2020 15;11:350. Epub 2020 Apr 15.

Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.

Genome-wide association studies (GWAS) have revealed thousands of genetic loci that underpin the complex biology of many human traits. However, the strength of GWAS - the ability to detect genetic association by linkage disequilibrium (LD) - is also its limitation. Whilst the ever-increasing study size and improved design have augmented the power of GWAS to detect effects, differentiation of causal variants or genes from other highly correlated genes associated by LD remains the real challenge. This has severely hindered the biological insights and clinical translation of GWAS findings. Although thousands of disease susceptibility loci have been reported, causal genes at these loci remain elusive. Machine learning (ML) techniques offer an opportunity to dissect the heterogeneity of variant and gene signals in the post-GWAS analysis phase. ML models for GWAS prioritization vary greatly in their complexity, ranging from relatively simple logistic regression approaches to more complex ensemble models such as random forests and gradient boosting, as well as deep learning models, i.e., neural networks. Paired with functional validation, these methods show important promise for clinical translation, providing a strong evidence-based approach to direct post-GWAS research. However, as ML approaches continue to evolve to meet the challenge of causal gene identification, a critical assessment of the underlying methodologies and their applicability to the GWAS prioritization problem is needed. This review investigates the landscape of ML applications in three parts: selected models, input features, and output model performance, with a focus on prioritizations of complex disease associated loci. Overall, we explore the contributions ML has made towards reaching the GWAS end-game with consequent wide-ranging translational impact.
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http://dx.doi.org/10.3389/fgene.2020.00350DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7174742PMC
April 2020

Genome-Wide Analysis of Left Ventricular Image-Derived Phenotypes Identifies Fourteen Loci Associated With Cardiac Morphogenesis and Heart Failure Development.

Circulation 2019 10 25;140(16):1318-1330. Epub 2019 Sep 25.

William Harvey Research Institute, Barts and The London School of Medicine and Dentistry (N.A., H.R.W., K.F., P.B.M., S.E.P.), Queen Mary University of London, United Kingdom.

Background: The genetic basis of left ventricular (LV) image-derived phenotypes, which play a vital role in the diagnosis, management, and risk stratification of cardiovascular diseases, is unclear at present.

Methods: The LV parameters were measured from the cardiovascular magnetic resonance studies of the UK Biobank. Genotyping was done using Affymetrix arrays, augmented by imputation. We performed genome-wide association studies of 6 LV traits-LV end-diastolic volume, LV end-systolic volume, LV stroke volume, LV ejection fraction, LV mass, and LV mass to end-diastolic volume ratio. The replication analysis was performed in the MESA study (Multi-Ethnic Study of Atherosclerosis). We identified the candidate genes at genome-wide significant loci based on the evidence from extensive bioinformatic analyses. Polygenic risk scores were constructed from the summary statistics of LV genome-wide association studies to predict the heart failure events.

Results: The study comprised 16 923 European UK Biobank participants (mean age 62.5 years; 45.8% men) without prevalent myocardial infarction or heart failure. We discovered 14 genome-wide significant loci (3 loci each for LV end-diastolic volume, LV end-systolic volume, and LV mass to end-diastolic volume ratio; 4 loci for LV ejection fraction, and 1 locus for LV mass) at a stringent <1×10. Three loci were replicated at Bonferroni significance and 7 loci at nominal significance (<0.05 with concordant direction of effect) in the MESA study (n=4383). Follow-up bioinformatic analyses identified 28 candidate genes that were enriched in the cardiac developmental pathways and regulation of the LV contractile mechanism. Eight genes (, and ) supported by at least 2 independent lines of in silico evidence were implicated in the cardiac morphogenesis and heart failure development. The polygenic risk scores of LV phenotypes were predictive of heart failure in a holdout UK Biobank sample of 3106 cases and 224 134 controls (odds ratio 1.41, 95% CI 1.26 - 1.58, for the top quintile versus the bottom quintile of the LV end-systolic volume risk score).

Conclusions: We report 14 genetic loci and indicate several candidate genes that not only enhance our understanding of the genetic architecture of prognostically important LV phenotypes but also shed light on potential novel therapeutic targets for LV remodeling.
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http://dx.doi.org/10.1161/CIRCULATIONAHA.119.041161DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6791514PMC
October 2019

Over 1000 genetic loci influencing blood pressure with multiple systems and tissues implicated.

Hum Mol Genet 2019 11;28(R2):R151-R161

Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, EC1M 6BQ, UK.

High blood pressure (BP) remains the major heritable and modifiable risk factor for cardiovascular disease. Persistent high BP, or hypertension, is a complex trait with both genetic and environmental interactions. Despite swift advances in genomics, translating new discoveries to further our understanding of the underlying molecular mechanisms remains a challenge. More than 500 loci implicated in the regulation of BP have been revealed by genome-wide association studies (GWAS) in 2018 alone, taking the total number of BP genetic loci to over 1000. Even with the large number of loci now associated to BP, the genetic variance explained by all loci together remains low (~5.7%). These genetic associations have elucidated mechanisms and pathways regulating BP, highlighting potential new therapeutic and drug repurposing targets. A large proportion of the BP loci were discovered and reported simultaneously by multiple research groups, creating a knowledge gap, where the reported loci to date have not been investigated in a harmonious way. Here, we review the BP-associated genetic variants reported across GWAS studies and investigate their potential impact on the biological systems using in silico enrichment analyses for pathways, tissues, gene ontology and genetic pleiotropy.
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http://dx.doi.org/10.1093/hmg/ddz197DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6872427PMC
November 2019

Differentially expressed genes for atrial fibrillation identified by RNA sequencing from paired human left and right atrial appendages.

Physiol Genomics 2019 08 7;51(8):323-332. Epub 2019 Jun 7.

Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.

Atrial fibrillation is a significant worldwide contributor to cardiovascular morbidity and mortality. Few studies have investigated the differences in gene expression between the left and right atrial appendages, leaving their characterization largely unexplored. In this study, differential gene expression was investigated in atrial fibrillation and sinus rhythm using left and right atrial appendages from the same patients. RNA sequencing was performed on the left and right atrial appendages from five sinus rhythm (SR) control patients and five permanent AF case patients. Differential gene expression in both the left and right atrial appendages was analyzed using the Bioconductor package edgeR. A selection of differentially expressed genes, with relevance to atrial fibrillation, were further validated using quantitative RT-PCR. The distribution of the samples assessed through principal component analysis showed distinct grouping between left and right atrial appendages and between SR controls and AF cases. Overall 157 differentially expressed genes were identified to be downregulated and 90 genes upregulated in AF. Pathway enrichment analysis indicated a greater involvement of left atrial genes in the Wnt signaling pathway whereas right atrial genes were involved in clathrin-coated vesicle and collagen formation. The differing expression of genes in both left and right atrial appendages indicate that there are different mechanisms for development, support and remodeling of AF within the left and right atria.
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http://dx.doi.org/10.1152/physiolgenomics.00012.2019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6732415PMC
August 2019

EAP1 regulation of GnRH promoter activity is important for human pubertal timing.

Hum Mol Genet 2019 04;28(8):1357-1368

Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

The initiation of puberty is orchestrated by an augmentation of gonadotropin-releasing hormone (GnRH) secretion from a few thousand hypothalamic neurons. Recent findings have indicated that the neuroendocrine control of puberty may be regulated by a hierarchically organized network of transcriptional factors acting upstream of GnRH. These include enhanced at puberty 1 (EAP1), which contributes to the initiation of female puberty through transactivation of the GnRH promoter. However, no EAP1 mutations have been found in humans with disorders of pubertal timing. We performed whole-exome sequencing in 67 probands and 93 relatives from a large cohort of familial self-limited delayed puberty (DP). Variants were analyzed for rare, potentially pathogenic variants enriched in case versus controls and relevant to the biological control of puberty. We identified one in-frame deletion (Ala221del) and one rare missense variant (Asn770His) in EAP1 in two unrelated families; these variants were highly conserved and potentially pathogenic. Expression studies revealed Eap1 mRNA abundance in peri-pubertal mouse hypothalamus. EAP1 binding to the GnRH1 promoter increased in monkey hypothalamus at the onset of puberty as determined by chromatin immunoprecipitation. Using a luciferase reporter assay, EAP1 mutants showed a reduced ability to trans-activate the GnRH promoter compared to wild-type EAP1, due to reduced protein levels caused by the Ala221del mutation and subcellular mislocation caused by the Asn770His mutation, as revealed by western blot and immunofluorescence, respectively. In conclusion, we have identified the first EAP1 mutations leading to reduced GnRH transcriptional activity resulting in a phenotype of self-limited DP.
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http://dx.doi.org/10.1093/hmg/ddy451DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6452208PMC
April 2019

Trans-ethnic association study of blood pressure determinants in over 750,000 individuals.

Nat Genet 2019 01 21;51(1):51-62. Epub 2018 Dec 21.

MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.

In this trans-ethnic multi-omic study, we reinterpret the genetic architecture of blood pressure to identify genes, tissues, phenomes and medication contexts of blood pressure homeostasis. We discovered 208 novel common blood pressure SNPs and 53 rare variants in genome-wide association studies of systolic, diastolic and pulse pressure in up to 776,078 participants from the Million Veteran Program (MVP) and collaborating studies, with analysis of the blood pressure clinical phenome in MVP. Our transcriptome-wide association study detected 4,043 blood pressure associations with genetically predicted gene expression of 840 genes in 45 tissues, and mouse renal single-cell RNA sequencing identified upregulated blood pressure genes in kidney tubule cells.
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http://dx.doi.org/10.1038/s41588-018-0303-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365102PMC
January 2019

Genetic analysis of over 1 million people identifies 535 new loci associated with blood pressure traits.

Nat Genet 2018 10 17;50(10):1412-1425. Epub 2018 Sep 17.

Laboratory of Genetics and Genomics, NIA/NIH, Baltimore, MD, USA.

High blood pressure is a highly heritable and modifiable risk factor for cardiovascular disease. We report the largest genetic association study of blood pressure traits (systolic, diastolic and pulse pressure) to date in over 1 million people of European ancestry. We identify 535 novel blood pressure loci that not only offer new biological insights into blood pressure regulation but also highlight shared genetic architecture between blood pressure and lifestyle exposures. Our findings identify new biological pathways for blood pressure regulation with potential for improved cardiovascular disease prevention in the future.
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http://dx.doi.org/10.1038/s41588-018-0205-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6284793PMC
October 2018

HS6ST1 Insufficiency Causes Self-Limited Delayed Puberty in Contrast With Other GnRH Deficiency Genes.

J Clin Endocrinol Metab 2018 09;103(9):3420-3429

Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.

Context: Self-limited delayed puberty (DP) segregates in an autosomal-dominant pattern, but the genetic basis is largely unknown. Although DP is sometimes seen in relatives of patients with hypogonadotropic hypogonadism (HH), mutations in genes known to cause HH that segregate with the trait of familial self-limited DP have not yet been identified.

Objective: To assess the contribution of mutations in genes known to cause HH to the phenotype of self-limited DP.

Design, Patients, And Setting: We performed whole-exome sequencing in 67 probands and 93 relatives from a large cohort of familial self-limited DP, validated the pathogenicity of the identified gene variant in vitro, and examined the tissue expression and functional requirement of the mouse homolog in vivo.

Results: A potentially pathogenic gene variant segregating with DP was identified in 1 of 28 known HH genes examined. This pathogenic variant occurred in HS6ST1 in one pedigree and segregated with the trait in the six affected members with heterozygous transmission (P = 3.01 × 10-5). Biochemical analysis showed that this mutation reduced sulfotransferase activity in vitro. Hs6st1 mRNA was expressed in peripubertal wild-type mouse hypothalamus. GnRH neuron counts were similar in Hs6st1+/- and Hs6st1+/+ mice, but vaginal opening was delayed in Hs6st1+/- mice despite normal postnatal growth.

Conclusions: We have linked a deleterious mutation in HS6ST1 to familial self-limited DP and show that heterozygous Hs6st1 loss causes DP in mice. In this study, the observed overlap in potentially pathogenic mutations contributing to the phenotypes of self-limited DP and HH was limited to this one gene.
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http://dx.doi.org/10.1210/jc.2018-00646DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6126894PMC
September 2018

A Large-Scale Multi-ancestry Genome-wide Study Accounting for Smoking Behavior Identifies Multiple Significant Loci for Blood Pressure.

Am J Hum Genet 2018 03 15;102(3):375-400. Epub 2018 Feb 15.

Health Disparities Research Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Baltimore, MD 21224, USA.

Genome-wide association analysis advanced understanding of blood pressure (BP), a major risk factor for vascular conditions such as coronary heart disease and stroke. Accounting for smoking behavior may help identify BP loci and extend our knowledge of its genetic architecture. We performed genome-wide association meta-analyses of systolic and diastolic BP incorporating gene-smoking interactions in 610,091 individuals. Stage 1 analysis examined ∼18.8 million SNPs and small insertion/deletion variants in 129,913 individuals from four ancestries (European, African, Asian, and Hispanic) with follow-up analysis of promising variants in 480,178 additional individuals from five ancestries. We identified 15 loci that were genome-wide significant (p < 5 × 10) in stage 1 and formally replicated in stage 2. A combined stage 1 and 2 meta-analysis identified 66 additional genome-wide significant loci (13, 35, and 18 loci in European, African, and trans-ancestry, respectively). A total of 56 known BP loci were also identified by our results (p < 5 × 10). Of the newly identified loci, ten showed significant interaction with smoking status, but none of them were replicated in stage 2. Several loci were identified in African ancestry, highlighting the importance of genetic studies in diverse populations. The identified loci show strong evidence for regulatory features and support shared pathophysiology with cardiometabolic and addiction traits. They also highlight a role in BP regulation for biological candidates such as modulators of vascular structure and function (CDKN1B, BCAR1-CFDP1, PXDN, EEA1), ciliopathies (SDCCAG8, RPGRIP1L), telomere maintenance (TNKS, PINX1, AKTIP), and central dopaminergic signaling (MSRA, EBF2).
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http://dx.doi.org/10.1016/j.ajhg.2018.01.015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5985266PMC
March 2018

Contributions of Function-Altering Variants in Genes Implicated in Pubertal Timing and Body Mass for Self-Limited Delayed Puberty.

J Clin Endocrinol Metab 2018 02;103(2):649-659

Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.

Context: Self-limited delayed puberty (DP) is often associated with a delay in physical maturation, but although highly heritable the causal genetic factors remain elusive. Genome-wide association studies of the timing of puberty have identified multiple loci for age at menarche in females and voice break in males, particularly in pathways controlling energy balance.

Objective/main Outcome Measures: We sought to assess the contribution of rare variants in such genes to the phenotype of familial DP.

Design/patients: We performed whole-exome sequencing in 67 pedigrees (125 individuals with DP and 35 unaffected controls) from our unique cohort of familial self-limited DP. Using a whole-exome sequencing filtering pipeline one candidate gene [fat mass and obesity-associated gene (FTO)] was identified. In silico, in vitro, and mouse model studies were performed to investigate the pathogenicity of FTO variants and timing of puberty in FTO+/- mice.

Results: We identified potentially pathogenic, rare variants in genes in linkage disequilibrium with genome-wide association studies of age at menarche loci in 283 genes. Of these, five genes were implicated in the control of body mass. After filtering for segregation with trait, one candidate, FTO, was retained. Two FTO variants, found in 14 affected individuals from three families, were also associated with leanness in these patients with DP. One variant (p.Leu44Val) demonstrated altered demethylation activity of the mutant protein in vitro. Fto+/- mice displayed a significantly delayed timing of pubertal onset (P < 0.05).

Conclusions: Mutations in genes implicated in body mass and timing of puberty in the general population may contribute to the pathogenesis of self-limited DP.
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http://dx.doi.org/10.1210/jc.2017-02147DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800831PMC
February 2018

New Blood Pressure-Associated Loci Identified in Meta-Analyses of 475 000 Individuals.

Circ Cardiovasc Genet 2017 Oct;10(5)

Background: Genome-wide association studies have recently identified >400 loci that harbor DNA sequence variants that influence blood pressure (BP). Our earlier studies identified and validated 56 single nucleotide variants (SNVs) associated with BP from meta-analyses of exome chip genotype data. An additional 100 variants yielded suggestive evidence of association.

Methods And Results: Here, we augment the sample with 140 886 European individuals from the UK Biobank, in whom 77 of the 100 suggestive SNVs were available for association analysis with systolic BP or diastolic BP or pulse pressure. We performed 2 meta-analyses, one in individuals of European, South Asian, African, and Hispanic descent (pan-ancestry, ≈475 000), and the other in the subset of individuals of European descent (≈423 000). Twenty-one SNVs were genome-wide significant (<5×10) for BP, of which 4 are new BP loci: rs9678851 (missense, ), rs7437940 (), rs13303 (missense, ), and rs1055144 (). In addition, we identified a potentially independent novel BP-associated SNV, rs3416322 (missense, ) at a known locus, uncorrelated with the previously reported SNVs. Two SNVs are associated with expression levels of nearby genes, and SNVs at 3 loci are associated with other traits. One SNV with a minor allele frequency <0.01, (rs3025380 at ) was genome-wide significant.

Conclusions: We report 4 novel loci associated with BP regulation, and 1 independent variant at an established BP locus. This analysis highlights several candidate genes with variation that alter protein function or gene expression for potential follow-up.
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http://dx.doi.org/10.1161/CIRCGENETICS.117.001778DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5776077PMC
October 2017

Genome-Wide Association Study of Blood Pressure Traits by Hispanic/Latino Background: the Hispanic Community Health Study/Study of Latinos.

Sci Rep 2017 09 4;7(1):10348. Epub 2017 Sep 4.

Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA.

Hypertension prevalence varies between ethnic groups, possibly due to differences in genetic, environmental, and cultural determinants. Hispanic/Latino Americans are a diverse and understudied population. We performed a genome-wide association study (GWAS) of blood pressure (BP) traits in 12,278 participants from the Hispanics Community Health Study/Study of Latinos (HCHS/SOL). In the discovery phase we identified eight previously unreported BP loci. In the replication stage, we tested these loci in the 1982 Pelotas Birth Cohort Study of admixed Southern Brazilians, the COGENT-BP study of African descent, women of European descent from the Women Health Initiative (WHI), and a sample of European descent from the UK Biobank. No loci met the Bonferroni-adjusted level of statistical significance (0.0024). Two loci had marginal evidence of replication: rs78701042 (NGF) with diastolic BP (P = 0.008 in the 1982 Pelotas Birth Cohort Study), and rs7315692 (SLC5A8) with systolic BP (P = 0.007 in European ancestry replication). We investigated whether previously reported loci associated with BP in studies of European, African, and Asian ancestry generalize to Hispanics/Latinos. Overall, 26% of the known associations in studies of individuals of European and Chinese ancestries generalized, while only a single association previously discovered in a people of African descent generalized.
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http://dx.doi.org/10.1038/s41598-017-09019-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5583292PMC
September 2017

Novel Blood Pressure Locus and Gene Discovery Using Genome-Wide Association Study and Expression Data Sets From Blood and the Kidney.

Hypertension 2017 Jul 24. Epub 2017 Jul 24.

From the Department of Health Sciences (L.V.W., A.M.E., N. Shrine, C.B., T.B., M.D.T.), and Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre (C.P.N., P.S.B., N.J.S.), University of Leicester, United Kingdom; Department of Epidemiology (A.V., P.J.v.d.M., I.M.N., H. Snieder), Division of Nephrology, Department of Internal Medicine (M.H.d.B., M.A.S.), Interdisciplinary Center Psychopathology and Emotion Regulation (IPCE) (A.J.O., H.R., C.A.H.), Department of Genetics, (M.S.), and Department of Cardiology (P.v.d.H.), University of Groningen, University Medical Center Groningen, The Netherlands; Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Iran (A.V.); Department of Psychiatry, VU University Medical Center, Neuroscience Campus Amsterdam, The Netherlands (R. Jansen); Hebrew SeniorLife, Harvard Medical School, Boston, MA (R. Joehanes); National Heart, Lung and Blood Institute's Framingham Heart Study, MA (R. Joehanes, A.D.J., M. Larson); Institute of Psychiatry, Psychology and Neuroscience (P.F.O.), and Department of Twin Research and Genetic Epidemiology (M.M., C. Menni, T.D.S.), King's College London, United Kingdom; Clinical Pharmacology, William Harvey Research Institute (C.P.C., H.R.W., M.R.B., M. Brown, B.M., M.R., P.B.M., M.J.C.) and NIHR Barts Cardiovascular Biomedical Research Unit (C.P.C., H.R.W., M.R.B., M. Brown, P.B.M., M.J.C.), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom; Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (L.M.R., F.G., P.M.R., D.I.C.); Department of Epidemiology (G.C.V., A. Hofman, A.G.U., O.H.F.), Genetic Epidemiology Unit, Department of Epidemiology (N.A., B.A.O., C.M.v.D.), and Department of Internal Medicine (A.G.U.), Erasmus MC, Rotterdam, The Netherlands; Department of Biological Psychology, Vrije Universiteit, Amsterdam, EMGO+ Institute, VU University Medical Center, The Netherlands (J.-J.H., E.J.d.G., G.W., D.I.B.); Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (R.J.S., M. Frånberg, A. Hamsten); Centre for Molecular Medicine, Karolinska Universitetsjukhuset, Solna, Sweden (R.J.S., M. Frånberg, A. Hamsten); Estonian Genome Center (T.E., E.O., A. Metspalu), Institute of Biomedicine and Translational Medicine (S.S., M. Laan), and Estonian Genome Center (M.P.), University of Tartu, Estonia; Divisions of Endocrinology/Children's Hospital, Boston, MA (T.E.); Broad Institute of Harvard and MIT, Cambridge, MA (T.E., C.M.L., C.N.-C.); Center for Complex Disease Genomics, McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (D.E.A., P.N., A. Chakravarti, G.B.E.); The Population Science Branch, Division of Intramural Research, National Heart Lung and Blood Institute (S.-J.H., D.L.), Laboratory of Neurogenetics, National Institute on Aging (M.A.N.), Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute (F.C.), and Center for Information Technology (Y.D., P.J.M., Q.T.N.), National Institutes of Health, Bethesda, MD; The Framingham Heart Study, Framingham, MA (S.-J.H., D.L.); The Institute for Translational Genomics and Population Sciences, Department of Pediatrics (X.G., J.Y.), and The Institute for Translational Genomics and Population Sciences, Departments of Pediatrics and Medicine (J.I.R.), LABioMed at Harbor-UCLA Medical Center, Torrance, CA; Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland (Z.K., M. Bochud); Swiss Institute of Bioinformatics, Lausanne, Switzerland (Z.K.); Department of Cardiology (S. Trompet, J.W.J.) Department of Gerontology and Geriatrics (S. Trompet), Department of Clinical Epidemiology (R.L.-G., R.d.M., D.O.M.-K.), Department of Molecular Epidemiology (J.D.), and Department of Public Health and Primary Care (D.O.M.-K.), Leiden University Medical Center, The Netherlands; Institute for Community Medicine (A.T.), Department of Internal Medicine B (M.D.), and Interfaculty Institute for Genetics and Functional Genomics (U.V.), University Medicine Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Germany (A.T., M.D., U.V.); Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Germany (J.S.R., A. Peters); Cardiovascular Health Research Unit, Department of Medicine (J.C.B., B.M.P.) and Departments of Biostatistics (K.R.), Epidemiology (B.M.P.), and Health Services (B.M.P.), University of Washington, Seattle; Icelandic Heart Association, Kopavogur, Iceland (A.V.S., V. Gudnason); Faculty of Medicine, University of Iceland, Reykjavik, Iceland (A.V.S., V. Gudnason); Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland (L.-P.L., T.L.); Department of Clinical Chemistry, Faculty of Medicine and Life Sciences, University of Tampere, Finland (L.-P.L., T.L.); Wellcome Trust Centre for Human Genetics (A. Mahajan, A.G., M. Farrall, T.F., C.M.L., H.W., A.P.M.), and Division of Cardiovascular Medicine, Radcliffe Department of Medicine (A.G., M. Farrall, H.W.), University of Oxford, United Kingdom; MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, United Kingdom (N.J.W., J.L., C.L., R.J.F.L., R.A.S., J.H.Z.); Clinical Division of Neurogeriatrics, Department of Neurology (E.H., R. Schmidt), Institute of Medical Informatics, Statistics and Documentation (E.H.), and Department of Neurology (H. Schmidt), Medical University Graz, Austria; Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics (P.K.J., H.C., I.R., S.W., J.F.W.), Centre for Cognitive Ageing and Cognitive Epidemiology (L.M.L., S.E.H., G.D., A.J.G., D.C.M.L., J.M.S., I.J.D.), Medical Genetics Section, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine (A. Campbell), Generation Scotland, Centre for Genomic and Experimental Medicine (A. Campbell, S.P., C.H.), Department of Psychology (G.D., D.C.M.L., A. Pattie, I.J.D.), Alzheimer Scotland Dementia Research Centre (J.M.S.), and Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine (C.H.), University of Edinburgh, Scotland, United Kingdom; Department of Health (K.K., A.S.H., T. Niiranen, P.J., A.J., S. Koskinen, P.K., V.S., M.P.), and Chronic Disease Prevention Unit (J.T.), National Institute for Health and Welfare (THL), Helsinki, Finland; Division of Genetics and Cell Biology, San Raffaele Scientific Institute, Milano, Italy (M.T., C.M.B., C.F.S., D.T.); Data Tecnica International, Glen Echo, MD (M.A.N.); Medical Genetics, IRCCS-Burlo Garofolo Children Hospital, Trieste, Italy (D.V., G.G., P.G.); Department of Medical, Surgical and Health Sciences, University of Trieste, Italy (D.V., I.G., M. Brumat, M. Cocca, A. Morgan, G.G., P.G.); Institute for Biomedicine, Eurac Research, Affiliated Institute of the University of Lübeck, Bolzano, Italy (F.D.G.M., P.P.P., A.S.P., A.A.H.); Department of Genetics and Genomic Sciences (K.L.A.), The Charles Bronfman Institute for Personalized Medicine (Y.L., E.P.B., R.J.F.L.), and Mindich Child health Development Institute (R.J.F.L.), Icahn School of Medicine at Mount Sinai, New York; Cardiovascular Epidemiology and Genetics, IMIM, and CIBERCV, Barcelona, Spain (J. Marrugat, R.E.); Institute of Genetics and Biophysics A. Buzzati-Traverso, CNR, Napoli, Italy (D.R., T. Nutile, R. Sorice, M. Ciullo); Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin (L.M.L.); UCD Conway Institute, Centre for Proteome Research (L.M.L.), and School of Medicine, Conway Institute (D.C.S.), University College Dublin, Belfield, Ireland; Department of Immunology, Genetics and Pathology, Uppsala Universitet, Science for Life Laboratory, Sweden (S.E., Å. Johansson, U.G.); Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor (A.U.J., M. Boehnke); NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester United Kingdom (C.P.N., P.S.B., N.J.S.); MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine (J.E.H., V.V., J. Marten, A.F.W., J.F.W.), and Medical Genetics Section, Centre for Genomic and Experimental Medicine and MRC Institute of Genetics and Molecular Medicine (S.E.H.), University of Edinburgh, Western General Hospital, Scotland, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health (W.Z., E.E., J.C.C., H.G., B.L., I.T., A.-C.V.), MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health (M.-R.J., P.E.), School of Public Health (N.P.), International Centre for Circulatory Health (S. Thom), and National Heart and Lung Institute (P.S.), Imperial College London, United Kingdom; Department of Cardiology, Ealing Hospital, London North West Healthcare NHS Trust, Southall, United Kingdom (W.Z., J.C.C., J.S.K.); Department of Medical Biology, Faculty of Medicine, University of Split, Croatia (T.Z.); Department of Hygiene and Epidemiology, University of Ioannina Medical School, Greece (E.E.); Medical Research Institute, University of Dundee, Ninewells Hospital and Medical School, Scotland, United Kingdom (N. Shah, A.S.F.D., C.N.A.P.); Department of Pharmacy, COMSATS Institute of Information Technology, Abbottabad, Pakistan (N. Shah); National Institute for Health Research Biomedical Research Centre, London, United Kingdom (M.M.); Department of Human Genetics, Wellcome Trust Sanger Institute, United Kingdom (B.P.P., E.Z.); INSERM U 1219, Bordeaux Population Health Center, France (G.C., C.T., S.D.); Bordeaux University, France (G.C., C.T., S.D.); Hunter Medical Research Institute, New Lambton, NSW, Australia (C.O., E.G.H., R. Scott, J.A.); Center for Statistical Genetics, Department of Biostatistics, Ann Arbor, MI (G.A.); Department of Genetics and Molecular Biology, Isfahan University of Medical Sciences, Iran (M.A.); Busselton Population Medical Research Institute, Western Australia (J.B., J.H.); PathWest Laboratory Medicine of Western Australia, Nedlands (J.B., J.H.); School of Pathology and Laboratory Medicine (J.B., J.H.), School of Population and Global Health (J.H.), and School of Medicine and Pharmacology (A. James), The University of Western Australia, Nedlands; Imperial College Healthcare NHS Trust, London, United Kingdom (J.C.C., J.S.K.); University of Dundee, Ninewells Hospital & Medical School, United Kingdom (J.C.); Institute of Genetic Medicine (H.J.C.), and Institute of Health and Society (C. Mamasoula), Newcastle University, Newcastle upon Tyne, United Kingdom; Department of Pathology, Amsterdam Medical Center, The Netherlands (J.J.D.); Department of Numerical Analysis and Computer Science, Stockholm University, Sweden (M. Frånberg); Department of Public Health and Caring Sciences, Geriatrics, Uppsala, Sweden (V. Giedraitis); Helmholtz Zentrum Muenchen, Deutsches Forschungszentrum fuer Gesundheit und Umwelt (GmbH), Neuherberg, Germany (C.G.); Department of Psychology, School of Social Sciences, Heriot-Watt University, Edinburgh, United Kingdom (A.J.G.); Intramural Research Program, Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging (T.B.H., L.J.L.); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A. Hofman); Center For Life-Course Health Research (M.-R.J.), and Biocenter Oulu (M.-R.J.), University of Oulu, Finland; Unit of Primary Care, Oulu University Hospital, Finland (M.-R.J.); National Heart, Lung and Blood Institute, Cardiovascular Epidemiology and Human Genomics Branch, Bethesda, MD (A.D.J.); Department of Clinical Physiology, Tampere University Hospital, Finland (M.K.); Department of Clinical Physiology, Faculty of Medicine and Life Sciences, University of Tampere, Finland (M.K.); Cardiovascular Research Center (S. Kathiresan, C.N.-C.); Center for Human Genetics (S. Kathiresan), and Center for Human Genetic Research (C.N.-C.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA (S. Kathiresan, C.N.-C.); Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, United Kingdom (K.-T.K.); Department of Public Health, Faculty of Medicine, University of Split, Croatia (I.K., O.P.); Cardiology, Department of Specialties of Medicine, Geneva University Hospital, Switzerland (L. Lin, F.M., G.B.E.); Department of Medical Sciences, Cardiovascular Epidemiology (L. Lind, J.S.), and Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory (E.I.), Uppsala University, Sweden; Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands (Y.M., B.W.J.H.P.); School of Molecular, Genetic and Population Health Sciences, University of Edinburgh, Medical School, Teviot Place, Scotland, United Kingdom (A.D.M.); Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston (A.C.M.); British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (S.P.), and Institute of Cardiovascular and Medical Sciences, Faculty of Medicine (D.J.S.), University of Glasgow, United Kingdom; Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Finland (A. Palotie, S.R., A.-P.S., M.P.); Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Canada (G.P., S. Thériault); Department of Neurology, General Central Hospital, Bolzano, Italy (P.P.P.); Department of Neurology, University of Lübeck, Germany (P.P.P.); Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Finland (O.T.R.); Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland (O.T.R.); Department of Cardiology, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China (M.R.); Harvard Medical School, Boston, MA (P.M.R., D.I.C.); Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy (A.R.); Institute of Molecular Biology and Biochemistry, Centre for Molecular Medicine, Medical University of Graz, Austria (Y.S., H. Schmidt); INSERM U1078, Etablissement Français du Sang, Brest Cedex, France (A.S.P.); Faculty of Health, University of Newcastle, Callaghan, NSW, Australia (R. Scott, J.A.); John Hunter Hospital, New Lambton, NSW, Australia (R. Scott, J.A.); The New York Academy of Medicine, New York (D.S.); IRCCS Neuromed, Pozzilli, Isernia, Italy (R. Sorice, M. Ciullo); Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin 2, Ireland (A.S.); Institute for Translational Genomics and Population Sciences, Los Angeles BioMedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA (K.D.T.); Division of Genetic Outcomes, Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA (K.D.T.); Department of Public Health (C.T.), and Department of Neurology (S.D.), Bordeaux University Hospital, France; Department of Internal Medicine, Lausanne University Hospital, CHUV, Switzerland (P.V.); Population Health Research Institute, McMaster University, Hamilton Ontario, Canada (D.C.); National Heart and Lung Institute, Imperial College London, Hammersmith Hospital Campus, United Kingdom (J.S.K.); Dasman Diabetes Institute, Kuwait (J.T.); Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia (J.T.); Department of Neurosciences and Preventive Medicine, Danube-University Krems, Austria (J.T.); Division of Cardiovascular Sciences, The University of Manchester and Central Manchester University Hospitals NHS Foundation Trust, United Kingdom (B.D.K.); Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem (Y.M.L.); Kaiser Permanent Washington Health Research Institute, Seattle, WA (B.M.P.); Institute of Physiology, University Medicine Greifswald, Karlsburg, Germany (R.R); Department of Pulmonary Physiology and Sleep, Sir Charles Gairdner Hospital, Nedlands, Western Australia (A. James); Population Health Research Institute, St George's, University of London, United Kingdom (D.P.S.); Department of Medicine, Columbia University Medical Center, New York (W.P.); Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, CA (E.I.); Data Science Institute and Lancaster Medical School, Lancaster University, United Kingdom (J.K.); and Department of Biostatistics, University of Liverpool, United Kingdom (A.P.M.).

Elevated blood pressure is a major risk factor for cardiovascular disease and has a substantial genetic contribution. Genetic variation influencing blood pressure has the potential to identify new pharmacological targets for the treatment of hypertension. To discover additional novel blood pressure loci, we used 1000 Genomes Project-based imputation in 150 134 European ancestry individuals and sought significant evidence for independent replication in a further 228 245 individuals. We report 6 new signals of association in or near , , , , , and , and provide new replication evidence for a further 2 signals in and Combining large whole-blood gene expression resources totaling 12 607 individuals, we investigated all novel and previously reported signals and identified 48 genes with evidence for involvement in blood pressure regulation that are significant in multiple resources. Three novel kidney-specific signals were also detected. These robustly implicated genes may provide new leads for therapeutic innovation.
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http://dx.doi.org/10.1161/HYPERTENSIONAHA.117.09438DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5783787PMC
July 2017

Enhanced Energetic State and Protection from Oxidative Stress in Human Myoblasts Overexpressing BMI1.

Stem Cell Reports 2017 08 20;9(2):528-542. Epub 2017 Jul 20.

Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark Street, London E1 2AT, UK. Electronic address:

The Polycomb group gene BMI1 is essential for efficient muscle regeneration in a mouse model of Duchenne muscular dystrophy, and its enhanced expression in adult skeletal muscle satellite cells ameliorates the muscle strength in this model. Here, we show that the impact of mild BMI1 overexpression observed in mouse models is translatable to human cells. In human myoblasts, BMI1 overexpression increases mitochondrial activity, leading to an enhanced energetic state with increased ATP production and concomitant protection against DNA damage both in vitro and upon xenografting in a severe dystrophic mouse model. These preclinical data in mouse models and human cells provide a strong rationale for the development of pharmacological approaches to target BMI1-mediated mitochondrial regulation and protection from DNA damage to sustain the regenerative potential of the skeletal muscle in conditions of chronic muscle wasting.
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http://dx.doi.org/10.1016/j.stemcr.2017.06.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5549966PMC
August 2017

Signatures of inflammation and impending multiple organ dysfunction in the hyperacute phase of trauma: A prospective cohort study.

PLoS Med 2017 Jul 17;14(7):e1002352. Epub 2017 Jul 17.

Centre for Trauma Sciences, The Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.

Background: Severe trauma induces a widespread response of the immune system. This "genomic storm" can lead to poor outcomes, including Multiple Organ Dysfunction Syndrome (MODS). MODS carries a high mortality and morbidity rate and adversely affects long-term health outcomes. Contemporary management of MODS is entirely supportive, and no specific therapeutics have been shown to be effective in reducing incidence or severity. The pathogenesis of MODS remains unclear, and several models are proposed, such as excessive inflammation, a second-hit insult, or an imbalance between pro- and anti-inflammatory pathways. We postulated that the hyperacute window after trauma may hold the key to understanding how the genomic storm is initiated and may lead to a new understanding of the pathogenesis of MODS.

Methods And Findings: We performed whole blood transcriptome and flow cytometry analyses on a total of 70 critically injured patients (Injury Severity Score [ISS] ≥ 25) at The Royal London Hospital in the hyperacute time period within 2 hours of injury. We compared transcriptome findings in 36 critically injured patients with those of 6 patients with minor injuries (ISS ≤ 4). We then performed flow cytometry analyses in 34 critically injured patients and compared findings with those of 9 healthy volunteers. Immediately after injury, only 1,239 gene transcripts (4%) were differentially expressed in critically injured patients. By 24 hours after injury, 6,294 transcripts (21%) were differentially expressed compared to the hyperacute window. Only 202 (16%) genes differentially expressed in the hyperacute window were still expressed in the same direction at 24 hours postinjury. Pathway analysis showed principally up-regulation of pattern recognition and innate inflammatory pathways, with down-regulation of adaptive responses. Immune deconvolution, flow cytometry, and modular analysis suggested a central role for neutrophils and Natural Killer (NK) cells, with underexpression of T- and B cell responses. In the transcriptome cohort, 20 critically injured patients later developed MODS. Compared with the 16 patients who did not develop MODS (NoMODS), maximal differential expression was seen within the hyperacute window. In MODS versus NoMODS, 363 genes were differentially expressed on admission, compared to only 33 at 24 hours postinjury. MODS transcripts differentially expressed in the hyperacute window showed enrichment among diseases and biological functions associated with cell survival and organismal death rather than inflammatory pathways. There was differential up-regulation of NK cell signalling pathways and markers in patients who would later develop MODS, with down-regulation of neutrophil deconvolution markers. This study is limited by its sample size, precluding more detailed analyses of drivers of the hyperacute response and different MODS phenotypes, and requires validation in other critically injured cohorts.

Conclusions: In this study, we showed how the hyperacute postinjury time window contained a focused, specific signature of the response to critical injury that led to widespread genomic activation. A transcriptomic signature for later development of MODS was present in this hyperacute window; it showed a strong signal for cell death and survival pathways and implicated NK cells and neutrophil populations in this differential response.
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http://dx.doi.org/10.1371/journal.pmed.1002352DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513400PMC
July 2017

Discovery of novel heart rate-associated loci using the Exome Chip.

Hum Mol Genet 2017 06;26(12):2346-2363

Genetic Epidemiology Unit, Dept. of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, NL.

Resting heart rate is a heritable trait, and an increase in heart rate is associated with increased mortality risk. Genome-wide association study analyses have found loci associated with resting heart rate, at the time of our study these loci explained 0.9% of the variation. This study aims to discover new genetic loci associated with heart rate from Exome Chip meta-analyses.Heart rate was measured from either elecrtrocardiograms or pulse recordings. We meta-analysed heart rate association results from 104 452 European-ancestry individuals from 30 cohorts, genotyped using the Exome Chip. Twenty-four variants were selected for follow-up in an independent dataset (UK Biobank, N = 134 251). Conditional and gene-based testing was undertaken, and variants were investigated with bioinformatics methods.We discovered five novel heart rate loci, and one new independent low-frequency non-synonymous variant in an established heart rate locus (KIAA1755). Lead variants in four of the novel loci are non-synonymous variants in the genes C10orf71, DALDR3, TESK2 and SEC31B. The variant at SEC31B is significantly associated with SEC31B expression in heart and tibial nerve tissue. Further candidate genes were detected from long-range regulatory chromatin interactions in heart tissue (SCD, SLF2 and MAPK8). We observed significant enrichment in DNase I hypersensitive sites in fetal heart and lung. Moreover, enrichment was seen for the first time in human neuronal progenitor cells (derived from embryonic stem cells) and fetal muscle samples by including our novel variants.Our findings advance the knowledge of the genetic architecture of heart rate, and indicate new candidate genes for follow-up functional studies.
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http://dx.doi.org/10.1093/hmg/ddx113DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5458336PMC
June 2017

Genome-wide association analysis identifies novel blood pressure loci and offers biological insights into cardiovascular risk.

Nat Genet 2017 Mar 30;49(3):403-415. Epub 2017 Jan 30.

Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.

Elevated blood pressure is the leading heritable risk factor for cardiovascular disease worldwide. We report genetic association of blood pressure (systolic, diastolic, pulse pressure) among UK Biobank participants of European ancestry with independent replication in other cohorts, and robust validation of 107 independent loci. We also identify new independent variants at 11 previously reported blood pressure loci. In combination with results from a range of in silico functional analyses and wet bench experiments, our findings highlight new biological pathways for blood pressure regulation enriched for genes expressed in vascular tissues and identify potential therapeutic targets for hypertension. Results from genetic risk score models raise the possibility of a precision medicine approach through early lifestyle intervention to offset the impact of blood pressure-raising genetic variants on future cardiovascular disease risk.
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http://dx.doi.org/10.1038/ng.3768DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5972004PMC
March 2017
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