A Rare Truncating Mutation in ADH1C (G78stop) Shows Significant Association with Parkinson Disease in a Large International Sample
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ORIGINAL CONTRIBUTION A Rare Truncating Mutation in ADH1C (G78Stop) Shows Significant Association With Parkinson Disease in a Large International Sample Silvia Buervenich, PhD; Andrea Carmine, PhD; Dagmar Galter, PhD; Haydeh N. Shahabi, MS; Bo Johnels, MD, PhD; Björn Holmberg, MD, PhD; Jarl Ahlberg, MD; Hans Nissbrandt, MD, PhD; Johanna Eerola, MD; Olli Hellström, MD; Pentti J. Tienari, MD, PhD; Tohru Matsuura, MD; Tetsuo Ashizawa, MD; Ullrich Wüllner, MD; Thomas Klockgether, MD; Alexander Zimprich, MD; Thomas Gasser, MD; Melissa Hanson, MS; Shamaila Waseem, MD; Andrew Singleton, PhD; Francis J. McMahon, MD; Maria Anvret, PhD; Olof Sydow, MD, PhD; Lars Olson, PhD Background: Alcohol dehydrogenases (ADHs) may be 1076 PD patients of European ancestry and 940 involved in the pathogenesis of neurodegenerative dis- matched controls. orders because of their multiple roles in detoxification pathways and retinoic acid synthesis. In a previous Results: The previously identified association with an ADH study, significant association of an ADH class IV allele class IV allele remained significant (PϽ.02) in the ex- with Parkinson disease (PD) was found in a Swedish tended Swedish study. Furthermore, in the international sample. collaboration, the G78stop mutation in ADH1C was found in 22 (2.0%) of the PD patients but only in 6 controls (0.6%). 2 Patients: The previously associated single-nucleotide This association was statistically significant ( 1=7.5; 2-sided polymorphism plus 12 further polymorphisms in the P=.007; odds ratio, 3.25 [95% confidence interval, 1.31- ADH cluster on human chromosome 4q23 were 8.05]). In addition, the G78stop mutation was identified screened for association in an extension of the original in 4 (10.0%) of 40 Caucasian index cases with PD with sample that now included 123 Swedish PD patients and mainly hereditary forms of the disorder. 127 geographically matched control subjects. A rare nonsense single-nucleotide polymorphism in ADH1C Conclusion: Findings presented herein provide further (G78stop, rs283413) was identified in 3 of these evidence for mutations in genes encoding ADHs as ge- patients but in no controls. To obtain sufficient power netic risk factors for PD. to detect a possible association of this rare variant with disease, we screened a large international sample of Arch Neurol. 2005;62:74-78 HE ETIOLOGY OF PARKIN- rahydroisoquinolines similar to MPTP son disease (PD) remains (N-methyl-4-phenyl-1,2,3,6-tetrahy- largely a mystery despite dropyridine).6 In addition, proper devel- considerable research ef- opment and maintenance of the dopamin- forts in the fields of epide- ergic system may be strongly dependent on miology, genetics, biochemistry, and cel- the supply of retinoic acid,7 which needs T1 8 lular biology. Neurodegeneration in PD is to be synthesized from retinol. most prominent in the dopaminergic cell Alcohol dehydrogenase (ADH) en- population,2 but is by no means confined zymes of classes I and IV are mainly ex- to this anatomical site,3 suggesting a more pressed in the lining of the digestive tract widespread metabolic deficiency and/or and in the liver.9 They are thought to play toxic event in the pathogenesis of the dis- important roles in the metabolism of etha- order. Epidemiological data suggest that en- nol and in the synthesis of retinoic acid, and vironmental factors are likely to play a role may also be important in the detoxifica- in PD pathogenesis,4 although the exact na- tion of reactive substances such as 4-hy- ture of such agents remains to be identi- droxynonenal. The dehydrogenases may, fied. Among candidate environmental risk therefore, constitute a first line of defense substances for PD are substances leading in the gastrointestinal tract against exog- to enhanced oxidative stress and lipid per- enous toxic agents, and genetic defects in oxidation products, such as reactive alde- these enzymes may lead to increased up- hydes.5 Mesencephalic dopamine neu- take of potentially harmful substances that rons may be especially vulnerable to reactive may eventually reach the dopamine sys- Author Affiliations are listed at substances because aldehydes may react tem of the brain. Proper function of these the end of this article. with dopamine in vivo, forming toxic tet- enzymes may also be required during pe- (REPRINTED) ARCH NEUROL / VOL 62, JAN 2005 WWW.ARCHNEUROL.COM 74 ©2005 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/27/2021 riods of reduced access to retinol or, conversely, during dietary overload of retinoids.10 Studying genetic variation Table 1. SNPs Across the ADH Cluster in genes encoding ADH enzymes may, thus, offer links be- at 4q23 Selected for This Study tween nature and nurture in the pathogenesis of the dif- Location and ferent manifestations of PD. Location Polymorphism, Characterization of In a sample of Swedish patients, association with PD of SNP Reference Allele 1/Allele 2 the Sequence Change was previously identified for a haplotype at the ADH4 gene ADH1B (also known as ADH7; the present study uses the more I rs1041969 C/A Exon 3, N57K 11 recent class-based nomenclature ), encoding a class IV II rs17033 T/C Exon 9, UTR ADH, µ or subunit.12 This finding, however, could not ADH1C be reproduced in a US sample of unrelated PD pa- I rs283413 G/T Exon 3, G78Stop tients.13 We selected the previously associated single- II rs1693482 A/G Exon 5, Q272R nucleotide polymorphism (SNP) plus 12 further SNPs III rs1042758 G/A Exon 7, V350I 14 ADH3 from the literature and the public SNP database. These I Reference 14 C/T Promoter, C+9/T+9 SNPs are located in 2 class I genes, class III ADH, and II Reference 14 G/A Promoter, G−79/A−79 class IV ADH (Table 1). One of the nucleotide varia- III Reference 14 GG/AA Exon 1, silent, GG−197, tions (rs283413) led to a predicted early truncation of GG−196/AA−197, AA−196 the protein chain at residue 78 of the ADH1C protein se- IV rs13832 T/G Exon 9, UTR quence (Figure). Nonsense mutations have been shown ADH4 I rs1573496 and G/C Exon 3, G92A, P5 to be 9 times more likely to lead to a phenotype than mu- reference 12 15 tations leading to amino acid substitutions, and de- II Reference 12 A/G Promoter, P1 serve special attention in sequence-based association stud- III Reference 12 T/C Promoter, P2 ies such as this one. Possible association of this variant IV rs971074 and G/A Exon 6, silent, P7 with PD was, therefore, tested in a further international reference 12 extension of the study by obtaining DNA from 1076 PD Abbreviations: ADH, alcohol dehydrogenase; SNP, single-nucleotide patients and 940 control subjects. polymorphism; UTR, untranslated region. METHODS set of the material described herein, no significant asso- Approval for this study was obtained from the local ethical com- ciation of the investigated SNPs with PD was found. mittees by each recruiting site, and samples were drawn after A SNP retrieved from a public database, rs283413, lead- informed consent. Seven collections of samples from PD pa- tients and geographically matched controls were combined for ing to an early truncation of the ADH1C protein chain, was case-control analysis (Table 2 provides the diagnostic crite- identified in 3 patients, but was absent from control samples. ria and demographic details). To establish case-control DNA We screened for the presence or absence of this ADH1C material for the London Brain Bank collection, tissue samples nonsense variant in a large collaborative sample of 1076 were supplied by the Queen Square Brain Bank for Neurologi- PD patients of European ancestry and 940 matched con- cal Disorders, London, England. DNA was extracted from tis- trols. There was a significant association with PD in the total 2 sue blocks using a standard kit (Qiagen; VWR International AB, sample (Table 4)( 1=7.5; 2-sided P=.007; odds ratio, Stockholm). DNA samples from 129 unrelated CEPH (Centre 3.25 [95% confidence interval, 1.31-8.05]). The ADH1C d’Etude du Polymorphisme Humain) founders from the French nonsense mutation was also found in an additional 4 of 40 and Utah pedigrees were purchased from Coriell Cell Reposi- tested Caucasian patients with PD, 3 having a strong fam- tories, Camden, Pa. An eighth collection sample (not in- cluded in the case-control study because of variable ascertain- ily history of the disorder and 1 being a sporadic case. No ment and lack of controls for this sample) contained DNA from DNA was available from further affected or unaffected fam- 40 Caucasian PD patients with mainly hereditary types of PD. ily members of these mutation carriers. Genotyping was performed by pyrosequencing, as described Previous studies performed by other investigators have in detail elsewhere.18 Sequences of primers, magnesium con- suggested large regions of linkage disequilibrium (LD) centrations, and nucleotide dispensation orders are available within the ADH cluster.19 Herein, we studied LD in the from us on request. The presence of the ADH1C nonsense mu- Swedish case-control material for the 13 SNPs listed in tation was confirmed by automated capillary sequencing or re- Table 1. The results indicate that there is extensive LD within striction fragment length polymorphism analysis using the BsaXI the ADH cluster in the Swedish population (data available 2 restriction enzyme. Tests were performed for association test- from us on request). In addition, to determine how far LD ing of all variants identified. P values and significance values given in the text are nominal values without correction for mul- extended between the identified truncating mutation in tiple testing. ADH1C and other SNPs within the cluster or at its border, we studied 40 SNPs in a 4.8-megabase region around the ADH gene cluster in 3 Swedish and 2 English mutation car- RESULTS riers.