Computational Modeling of the Relationship Between Snps and Disease

Total Page:16

File Type:pdf, Size:1020Kb

Computational Modeling of the Relationship Between Snps and Disease ABSTRACT Title of Document: COMPUTATIONAL MODELING OF THE RELATIONSHIP BETWEEN SNPS AND DISEASE Peng Yue, Doctor of Philosophy, 2005 Directed By: Professor, John Moult, CARB/UMBI We have developed two models, the stability model and the profile model, to identify non-synonymous single base changes (the most common cause of monogenic disease) that have deleterious effects on protein function in vivo. The stability model analyzes the effect of the resulting amino acid change on protein stability by utilizing structural information such as reduction in hydrophobic area and loss of electrostatic interactions. The profile model makes use of the conservation and type of residues observed at a base change position within a protein family. In each model, a machine learning technique, the support vector machine (SVM) was trained on a set of mutations causative of disease, and a control set of non-disease causing mutations. In jack-knifed testing, the stability model identifies 74% of disease mutations, with a false positive rate of 15%; the profile model identifies 80% of disease mutations, with a false positive rate of 10%. Evaluation of a set of in vitro mutagenesis data with the stability model established that the majority of disease mutations affect protein stability by 1 to 3 Kcal/mol. The stability model’s effective distinction between disease and non-disease variants strongly supports the hypothesis that loss of protein stability is a major factor contributing to monogenic disease. Both models are used to identify deleterious SNPs in the human population. After carefully controlling of errors, we find that approximately one-fourth of the known non-synonymous SNPs are deleterious, thus providing a set of possible SNPs contributing to human complex disease traits. A web resource has been developed to provide information on disease/gene relationships at the molecular level. The resource has three primary modules. The first module is used to publish the deleterious SNPs identified by the two above- mentioned models. The second module identifies the candidate genes for a specific disease, and the third module provides information about the relationships between the sets of candidate genes. Disease/candidate gene relationships and gene-gene relationships are derived from the literature using a simple but effective text profiling method. COMPUTATIONAL MODELING OF THE RELATIONSHIP BETWEEN SNPS AND DISEASE By Peng Yue Dissertation submitted to the Faculty of the Graduate School of the University of Maryland, College Park, in partial fulfillment of the requirements for the degree of Doctor of Philosophy 2005 Advisory Committee: Professor John Moult, Chair Professor Michael Gilson Professor Richard Payne Associate Professor Stephen Mount Associate Professor Sarah Tishkoff Associate Professor Victor Muñoz, Dean’s representative © Copyright by Peng Yue 2005 Acknowledgements I want to thank Dr. John Moult, my mentor and supervisor, from whom I have learned so much over the years. Without his great insight, knowledge, patience and kindness, this dissertation could not have been written. I am also grateful to all my other committee members, Dr. Michael Gilson, Dr. Richard Payne, Dr. Sarah Tishkoff, and Dr. Stephen Mount. Their helpful advice and guidance have certainly played an essential role in improvement of this work. I would also like to thank Dr. Victor Muñoz for being Dean’s representative. I am thankful to Ms. Zhaolong Li, for her contribution in the stability model. My special thanks go to Mr. Eugene Melamud, with whom I have worked closely in the past six years and developed such deep friendship. His unselfish help have contributed tremendously to the success of this project. Last but not least, my deepest appreciation goes to my family, especially to my wife and my mother. Without their loving support, this long journey toward completion of my study and dissertation is doomed to be a lonely and more arduous one. ii Table of Contents Acknowledgements....................................................................................................... ii Table of Contents.........................................................................................................iii List of Tables ............................................................................................................... vi List of Figures............................................................................................................. vii Chapter 1: Introduction................................................................................................. 1 SNP in Populations and Human Disease .................................................................. 1 Two Types of Human Disease.................................................................................. 2 The Allelic Structure of Human Disease .................................................................. 3 Genetic Mapping of Human Disease ........................................................................ 4 Linkage Analysis .................................................................................................. 4 Association Studies............................................................................................... 4 Bioinformatics........................................................................................................... 6 Computational Modeling of SNPs: Overview ...................................................... 7 Computational Modeling of SNPs: Hypotheses ................................................. 10 SNPs3D: a resource for analysis of SNP, identification of candidate genes and construction of gene relationship networks ........................................................ 11 Technology overview.............................................................................................. 13 Classification....................................................................................................... 13 Comparative modeling........................................................................................ 14 Chapter 2: Loss of Protein Structure Stability as a Major Causative Factor in Monogenic Disease..................................................................................................... 18 Introduction............................................................................................................. 18 Results..................................................................................................................... 20 Selection of Data for Analysis ............................................................................ 20 Analysis of Factors Likely to Affect Protein Stability........................................ 20 Accuracy of the SVM Model.............................................................................. 26 Model Evaluation using in vitro Mutagenesis Stability Data ............................. 28 Alternative Test Sets........................................................................................... 32 Functional Analysis of Single Residue Mutations.............................................. 35 Investigation of the Role of Protein Structure Accuracy.................................... 37 Discussion and Conclusion..................................................................................... 39 Role of Protein Destabilization in Monogenic Disease ...................................... 39 Why does Protein Stability play a Prominent Role in Monogenic Disease?...... 41 Distinguishing Properties of Monogenic Disease Proteins................................. 42 Advantages and Disadvantages of a Protein Structure Based Approach............ 43 Methods................................................................................................................... 44 Identification of Single Residue Variants related to Monogenic Disease .......... 44 Identification of a Set of Single Residue Variants not related to Disease .......... 44 Selection of Sets of Mutants with Protein Structure........................................... 45 Support Vector Machine..................................................................................... 45 SVM Model Training and Testing...................................................................... 46 In-vitro Mutagenesis Data................................................................................... 46 iii Comparative Modeling of Protein Structure....................................................... 47 Modeling the Structure of Single Residue Mutants............................................ 48 Modeling the Stability Impact of a Single Residue Mutant................................ 48 Evaluation of Discrimination power of each Stability Factor ............................ 52 Identification of Residues with a Role in Molecular Function........................... 53 Chapter 3: Identification and Analysis of Deleterious Human SNPs......................... 54 Introduction............................................................................................................. 54 Results..................................................................................................................... 57 Training and Testing Data used for the Classification Methods......................... 57 Accuracy of the Classification Methods............................................................. 57 Sensitivity to the Number of Sequences in a Profile .........................................
Recommended publications
  • Genotype/Phenotype Analysis in a Male Patient with Partial Trisomy 4P and Monosomy 20Q Due to Maternal Reciprocal Translocation (4;20): a Case Report
    6222 MOLECULAR MEDICINE REPORTS 16: 6222-6227, 2017 Genotype/phenotype analysis in a male patient with partial trisomy 4p and monosomy 20q due to maternal reciprocal translocation (4;20): A case report DONG WU1-3, HUI ZHANG1-3, QIAOFANG HOU1-3, HONGDAN WANG1-3, TAO WANG1-3 and SHIXIU LIAO1-3 1Medical Genetics Institute of Henan; 2Medical Genetics Institute of Henan Provincial People's Hospital; 3Department of Medical Genetics, The Affiliated People's Hospital, Zhengzhou University, Zhengzhou, Henan 450003, P.R. China Received September 21, 2016; Accepted July 17, 2017 DOI: 10.3892/mmr.2017.7390 Abstract. Translocations are the most frequent structural aber- of balanced chromosome rearrangement exhibit an increased ration in the human genome. Carriers of balanced chromosome risk of abortion and/or a chromosomally unbalanced child (2). rearrangement exhibit an increased risk of abortion and/or a The type of unbalanced translocation is dependent upon the chromosomally-unbalanced child. The present study reported mode of segregation. A 2:2 segregation event may result in a clinical and cytogenetic analysis of a child who exhibited gametes with partial trisomy/monosomy of the chromosomes typical trisomy 4p and monosomy 20q features, including involved in the translocation (3). Conventional cytogenetic intellectual disability, delayed speech, tall stature, seizures analysis is unable to detect small rearrangements due to its and facial dysmorphism. The karyotype of the proband exhib- low resolution. The wide use of whole-genome array-based ited 46, XY, add(20) (q13.3). The karyotype of the mother comparative genomic hybridization (aCGH) techniques has indicated a balanced translocation karyotype: 46, XX, t(4;20) allowed for the detection of submicroscopic chromosomal (p15.2;q13.1).
    [Show full text]
  • The DNA Sequence and Comparative Analysis of Human Chromosome 20
    articles The DNA sequence and comparative analysis of human chromosome 20 P. Deloukas, L. H. Matthews, J. Ashurst, J. Burton, J. G. R. Gilbert, M. Jones, G. Stavrides, J. P. Almeida, A. K. Babbage, C. L. Bagguley, J. Bailey, K. F. Barlow, K. N. Bates, L. M. Beard, D. M. Beare, O. P. Beasley, C. P. Bird, S. E. Blakey, A. M. Bridgeman, A. J. Brown, D. Buck, W. Burrill, A. P. Butler, C. Carder, N. P. Carter, J. C. Chapman, M. Clamp, G. Clark, L. N. Clark, S. Y. Clark, C. M. Clee, S. Clegg, V. E. Cobley, R. E. Collier, R. Connor, N. R. Corby, A. Coulson, G. J. Coville, R. Deadman, P. Dhami, M. Dunn, A. G. Ellington, J. A. Frankland, A. Fraser, L. French, P. Garner, D. V. Grafham, C. Grif®ths, M. N. D. Grif®ths, R. Gwilliam, R. E. Hall, S. Hammond, J. L. Harley, P. D. Heath, S. Ho, J. L. Holden, P. J. Howden, E. Huckle, A. R. Hunt, S. E. Hunt, K. Jekosch, C. M. Johnson, D. Johnson, M. P. Kay, A. M. Kimberley, A. King, A. Knights, G. K. Laird, S. Lawlor, M. H. Lehvaslaiho, M. Leversha, C. Lloyd, D. M. Lloyd, J. D. Lovell, V. L. Marsh, S. L. Martin, L. J. McConnachie, K. McLay, A. A. McMurray, S. Milne, D. Mistry, M. J. F. Moore, J. C. Mullikin, T. Nickerson, K. Oliver, A. Parker, R. Patel, T. A. V. Pearce, A. I. Peck, B. J. C. T. Phillimore, S. R. Prathalingam, R. W. Plumb, H. Ramsay, C. M.
    [Show full text]
  • Mitochondrial Sequestration of GABA by Aralar in Drosophila Cyfip Haploinsufficiency Causes Deficits in Social Group Behavior
    Kanellopoulos et al. Main text Mitochondrial sequestration of GABA by Aralar in Drosophila Cyfip haploinsufficiency causes deficits in social group behavior Alexandros K. Kanellopoulos1, Vittoria Mariano1,2, Marco Spinazzi2,3, Young Jae Woo4,5, Colin McLean6, Ulrike Pech7, Ka Wan Li8, J. Douglas Armstrong6, Angela Giangrande9, Patrick Callaerts2, August B. Smit8, Brett S. Abrahams4,10, Andre Fiala7, Tilmann Achsel1 and Claudia Bagni1,11,* 1University of Lausanne, Department of Fundamental Neurosciences, Lausanne, Switzerland 2KU Leuven, Department of Neurosciences, Leuven, 3000, Belgium 3VIB Center for Brain & Disease Research, Leuven, 3000, Belgium 4Department of Genetics, Albert Einstein College of Medicine, Bronx, New York; 5Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, USA 6University of Edinburgh, School of Informatics, Edinburgh, UK 7Georg-August-University Göttingen, Department of Molecular Neurobiology of Behaviour, Göttingen, Germany 8Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, VU University Amsterdam, Amsterdam, The Netherlands 9Centre National de la Recherche Scientifique, UMR7104, Institut National de la Sante´ et de la Recherche Medicale, Universite´ de Strasbourg, Illkirch, France 10Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, Bronx, USA 11University of Rome Tor Vergata, Department of Biomedicine and Prevention, Rome, Italy *Corresponding author: Claudia Bagni, Ph.D. e-mail: [email protected]; [email protected]; Tel (1): +41-216925120; Tel (2): +39-0672596063 Running title: Mitochondria regulate GABA availability and behavior Keywords: Mitochondrial activity, mitochondrial membrane potential, GABA, social group behavior, Aralar, Drosophila, CYFIP1, autism, schizophrenia. SUMMARY Social impairment is frequently associated with mitochondrial dysfunction and altered neurotransmission.
    [Show full text]
  • Dissecting the Genetics of Human Communication
    DISSECTING THE GENETICS OF HUMAN COMMUNICATION: INSIGHTS INTO SPEECH, LANGUAGE, AND READING by HEATHER ASHLEY VOSS-HOYNES Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Epidemiology and Biostatistics CASE WESTERN RESERVE UNIVERSITY January 2017 CASE WESTERN RESERVE UNIVERSITY SCHOOL OF GRADUATE STUDIES We herby approve the dissertation of Heather Ashely Voss-Hoynes Candidate for the degree of Doctor of Philosophy*. Committee Chair Sudha K. Iyengar Committee Member William Bush Committee Member Barbara Lewis Committee Member Catherine Stein Date of Defense July 13, 2016 *We also certify that written approval has been obtained for any proprietary material contained therein Table of Contents List of Tables 3 List of Figures 5 Acknowledgements 7 List of Abbreviations 9 Abstract 10 CHAPTER 1: Introduction and Specific Aims 12 CHAPTER 2: Review of speech sound disorders: epidemiology, quantitative components, and genetics 15 1. Basic Epidemiology 15 2. Endophenotypes of Speech Sound Disorders 17 3. Evidence for Genetic Basis Of Speech Sound Disorders 22 4. Genetic Studies of Speech Sound Disorders 23 5. Limitations of Previous Studies 32 CHAPTER 3: Methods 33 1. Phenotype Data 33 2. Tests For Quantitative Traits 36 4. Analytical Methods 42 CHAPTER 4: Aim I- Genome Wide Association Study 49 1. Introduction 49 2. Methods 49 3. Sample 50 5. Statistical Procedures 53 6. Results 53 8. Discussion 71 CHAPTER 5: Accounting for comorbid conditions 84 1. Introduction 84 2. Methods 86 3. Results 87 4. Discussion 105 CHAPTER 6: Hypothesis driven pathway analysis 111 1. Introduction 111 2. Methods 112 3. Results 116 4.
    [Show full text]
  • Pankreas-Forschungslabor Chirurgische Klinik Und Poliklinik Klinikum Rechts Der Isar
    TECHNISCHE UNIVERSITÄT MÜNCHEN Pankreas-Forschungslabor Chirurgische Klinik und Poliklinik Klinikum rechts der Isar Identification and characterization of molecular subtypes of human pancreatic ductal adenocarcinoma Bo Kong Vollständiger Abdruck der von der Fakultät für Medizin der Technischen Universität München zur Erlangung des akademischen Grades eines Doctor of Philosophy genehmigten Dissertation Vorsitzender: Univ.-Prof. Dr. Florian R. Greten Prüfer der Dissertation: 1. Univ.-Prof. Dr. Bernhard Holzmann 2. apl. Prof. Dr. Achim Krüger 3. apl. Prof. Dr. Andreas Jung, Ludwig-Maximilians-Universität München Die Dissertation wurden am 05.02.2013 bei der Technischen Universität München eingereicht und durch die Fakultät für Medizin am 20.03.2013 angenommen. TABLE OF CONTENTS 1. INTRODUCTION .......................................................................................................... 5 1.1. PANCREATIC CANCER BIOLOGY .......................................................................... 5 1.2. MOLECULAR SUBTYPES AND TREATMENT RESPONSES IN HUMAN PDAC . .. 7 1.3. HNF1A/MIA2 AXIS AND ER STRESS/UPR SYSTEM IN PANCREATIC PHYSIOLOGY AND CANCER BIOLOGY ........................................................... 9 1.4. TSC1-TSC2 COMPLEX AND MTORC1 ARE COMMON GATEKEEPERS OF PANCREATIC MALIGNANCY ........................................................................... 11 2. AIMS OF THIS STUDY ...................................................................................... 17 3. MATERIALS AND METHODS .........................................................................
    [Show full text]
  • ACO2 Clinicobiological Dataset with Extensive Phenotype Ontology Annotation
    www.nature.com/scientificdata OPEN ACO2 clinicobiological dataset with Data DeSCriPtOr extensive phenotype ontology annotation Khadidja Guehlouz1, Thomas Foulonneau2, Patrizia Amati-Bonneau2,3, Majida Charif2,4, Estelle Colin2,3, Céline Bris2,3, Valérie Desquiret-Dumas2,3, Dan Milea5, Philippe Gohier1, Vincent Procaccio2,3, Dominique Bonneau2,3, Johan T. den Dunnen 6, Guy Lenaers 2, Pascal Reynier 2,3 & Marc Ferré 2 ✉ Pathogenic variants of the aconitase 2 gene (ACO2) are responsible for a broad clinical spectrum involving optic nerve degeneration, ranging from isolated optic neuropathy with recessive or dominant inheritance, to complex neurodegenerative syndromes with recessive transmission. We created the frst public locus-specifc database (LSDB) dedicated to ACO2 within the “Global Variome shared LOVD” using exclusively the Human Phenotype Ontology (HPO), a standard vocabulary for describing phenotypic abnormalities. All the variants and clinical cases listed in the literature were incorporated into the database, from which we produced a dataset. We followed a rational and comprehensive approach based on the HPO thesaurus, demonstrating that ACO2 patients should not be classifed separately between isolated and syndromic cases. Our data highlight that certain syndromic patients do not have optic neuropathy and provide support for the classifcation of the recurrent pathogenic variants c.220C>G and c.336C>G as likely pathogenic. Overall, our data records demonstrate that the clinical spectrum of ACO2 should be considered as a continuum of symptoms and refnes the classifcation of some common variants. Background & Summary Aconitate hydratase (ACO2; EC# 4.2.1.3) is a ubiquitous human mitochondrial monomeric enzyme composed of 780 amino acids. It catalyses the second reaction of the citric acid cycle by isomerising citrate to isocitrate1.
    [Show full text]
  • UC Davis UC Davis Previously Published Works
    UC Davis UC Davis Previously Published Works Title A comparative physical map reveals the pattern of chromosomal evolution between the turkey (Meleagris gallopavo) and chicken (Gallus gallus) genomes Permalink https://escholarship.org/uc/item/78d2v9m4 Journal BMC Genomics, 12(1) ISSN 1471-2164 Authors Zhang, Yang Zhang, Xiaojun O'Hare, Thomas H et al. Publication Date 2011-09-09 DOI http://dx.doi.org/10.1186/1471-2164-12-447 Supplemental Material https://escholarship.org/uc/item/78d2v9m4#supplemental Peer reviewed eScholarship.org Powered by the California Digital Library University of California Zhang et al. BMC Genomics 2011, 12:447 http://www.biomedcentral.com/1471-2164/12/447 RESEARCH ARTICLE Open Access A comparative physical map reveals the pattern of chromosomal evolution between the turkey (Meleagris gallopavo) and chicken (Gallus gallus) genomes Yang Zhang1, Xiaojun Zhang1, Thomas H O’Hare2, William S Payne3, Jennifer J Dong1, Chantel F Scheuring1, Meiping Zhang1, James J Huang1, Mi-Kyung Lee1, Mary E Delany2*, Hong-Bin Zhang1* and Jerry B Dodgson3* Abstract Background: A robust bacterial artificial chromosome (BAC)-based physical map is essential for many aspects of genomics research, including an understanding of chromosome evolution, high-resolution genome mapping, marker-assisted breeding, positional cloning of genes, and quantitative trait analysis. To facilitate turkey genetics research and better understand avian genome evolution, a BAC-based integrated physical, genetic, and comparative map was developed for this important agricultural species. Results: The turkey genome physical map was constructed based on 74,013 BAC fingerprints (11.9 × coverage) from two independent libraries, and it was integrated with the turkey genetic map and chicken genome sequence using over 41,400 BAC assignments identified by 3,499 overgo hybridization probes along with > 43,000 BAC end sequences.
    [Show full text]
  • The Role of Tks5 Sh3 Domains in Invadopodia Development and Activity
    THE ROLE OF TKS5 SH3 DOMAINS IN INVADOPODIA DEVELOPMENT AND ACTIVITY A Thesis by CHRISTINA ADELE DALY Submitted to the Graduate School at Appalachian State University in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE August 2016 Department of Biology THE ROLE OF TKS5 SH3 DOMAINS IN INVADOPODIA DEVELOPMENT AND ACTIVITY A Thesis by CHRISTINA ADELE DALY August 2016 APPROVED BY: Darren Seals, Ph.D. Chairperson, Thesis Committee Maryam Ahmed, Ph.D. Member, Thesis Committee Andrew Bellemer, Ph.D. Member, Thesis Committee Zack Murrell, Ph.D. Chairperson, Department of Biology Max C. Poole, Ph.D. Dean, Cratis D. Williams School of Graduate Studies Copyright by Christina Adele Daly 2016 All Rights Reserved Abstract THE ROLE OF TKS5 SH3 DOMAINS IN INVADOPODIA DEVELOPMENT AND ACTIVITY Christina Adele Daly B.S., Appalachian State University M.S., Appalachian State University Chairperson: Darren Seals, Ph.D. One mechanism by which cancer cells metastasize is through the formation of actin- rich structures called invadopodia. Tks5 is a Src tyrosine kinase substrate and scaffolding protein necessary for invadopodia formation and associated extracellular matrix-remodeling activity. The purpose of this study is to appreciate how the five, protein binding SH3 domains of Tks5 impact its function. SH3 domains are commonly found in adaptor/scaffolding proteins where they mediate binding to poly-proline-containing amino acid sequences. Some binding partners for Tks5 have been previously identified, but the functional implications for these interactions are not well understood in the context of cancer. Here, Tks5 constructs harboring point mutations in a key tryptophan residue involved in SH3 domain binding activity were introduced into cancer cells to study invadopodia development and activity.
    [Show full text]
  • Genetic Analysis on Familial Nonsyndromic Hearing Loss Using Next-Generation Sequencing
    저작자표시-비영리-변경금지 2.0 대한민국 이용자는 아래의 조건을 따르는 경우에 한하여 자유롭게 l 이 저작물을 복제, 배포, 전송, 전시, 공연 및 방송할 수 있습니다. 다음과 같은 조건을 따라야 합니다: 저작자표시. 귀하는 원저작자를 표시하여야 합니다. 비영리. 귀하는 이 저작물을 영리 목적으로 이용할 수 없습니다. 변경금지. 귀하는 이 저작물을 개작, 변형 또는 가공할 수 없습니다. l 귀하는, 이 저작물의 재이용이나 배포의 경우, 이 저작물에 적용된 이용허락조건 을 명확하게 나타내어야 합니다. l 저작권자로부터 별도의 허가를 받으면 이러한 조건들은 적용되지 않습니다. 저작권법에 따른 이용자의 권리는 위의 내용에 의하여 영향을 받지 않습니다. 이것은 이용허락규약(Legal Code)을 이해하기 쉽게 요약한 것입니다. Disclaimer 의학박사 학위논문 Genetic analysis on familial nonsyndromic hearing loss using next-generation sequencing 차세대 염기서열 분석을 이용한 가족성비증후군난청의 유전분석 2014 년 2 월 서울대학교 대학원 의과학과 박 기 범 A thesis of the Degree of Doctor of Philosophy 차세대 염기서열 분석을 이용한 가족성비증후군난청의 유전분석 Genetic analysis on familial nonsyndromic hearing loss using next-generation sequencing February 2014 The Department of Biomedical Sciences, Seoul National University Graduate School Gibeom Park Genetic analysis on familial nonsyndromic hearing loss using next-generation sequencing by Gibeom Park A thesis submitted to the Department of Biomedical Sciences in partial fulfillment of the requirements for the Degree of Doctor of Philosophy in Medical Science at Seoul National University Graduate School December 2013 Approved by Thesis Committee: Professor Chairman Professor Vice chairman Professor Professor Professor ABSTRACT Introduction: Hearing loss is a common sensorineural disorder and half of hearing loss is derived from genetic causes. Due to complexity of hearing mechanism, about 50 genes have been found to have genetic aberrations from previous studies.
    [Show full text]
  • A Multi-Factorial Analysis of Response to Warfarin in a UK Prospective Cohort Stephane Bourgeois1, Andrea Jorgensen2, Eunice J
    Bourgeois et al. Genome Medicine (2016) 8:2 DOI 10.1186/s13073-015-0255-y RESEARCH Open Access A multi-factorial analysis of response to warfarin in a UK prospective cohort Stephane Bourgeois1, Andrea Jorgensen2, Eunice J. Zhang2, Anita Hanson2, Matthew S. Gillman1, Suzannah Bumpstead1, Cheng Hock Toh2, Paula Williamson2, Ann K. Daly3, Farhad Kamali3, Panos Deloukas1,5* and Munir Pirmohamed2,4,6* Abstract Background: Warfarin is the most widely used oral anticoagulant worldwide, but it has a narrow therapeutic index which necessitates constant monitoring of anticoagulation response. Previous genome-wide studies have focused on identifying factors explaining variance in stable dose, but have not explored the initial patient response to warfarin, and a wider range of clinical and biochemical factors affecting both initial and stable dosing with warfarin. Methods: A prospective cohort of 711 patients starting warfarin was followed up for 6 months with analyses focusing on both non-genetic and genetic factors. The outcome measures used were mean weekly warfarin dose (MWD), stable mean weekly dose (SMWD) and international normalised ratio (INR) > 4 during the first week. Samples were genotyped on the Illumina Human610-Quad chip. Statistical analyses were performed using Plink and R. Results: VKORC1 and CYP2C9 were the major genetic determinants of warfarin MWD and SMWD, with CYP4F2 having a smaller effect. Age, height, weight, cigarette smoking and interacting medications accounted for less than 20 % of the variance. Our multifactorial analysis explained 57.89 % and 56.97 % of the variation for MWD and SMWD, respectively. Genotypes for VKORC1 and CYP2C9*3, age, height and weight, as well as other clinical factors such as alcohol consumption, loading dose and concomitant drugs were important for the initial INR response to warfarin.
    [Show full text]