DOI QR코드

DOI QR Code

Sex-Specific Susceptibility Loci Associated With Coronary Artery Aneurysms in Patients With Kawasaki Disease

  • Jae-Jung Kim (Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Young Mi Hong (Department of Pediatrics, Ewha Womans University Hospital) ;
  • Sin Weon Yun (Department of Pediatrics, Chung-Ang University Hospital) ;
  • Kyung-Yil Lee (Department of Pediatrics, Daejeon St. Mary's Hospital, The Catholic University of Korea) ;
  • Kyung Lim Yoon (Department of Pediatrics, Kyung Hee University Hospital at Gangdong) ;
  • Myung-Ki Han (Department of Pediatrics, Gangneung Asan Hospital, University of Ulsan) ;
  • Gi Beom Kim (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • Hong-Ryang Kil (Department of Pediatrics, Chungnam National University Hospital) ;
  • Min Seob Song (Department of Pediatrics, Inje University Paik Hospital) ;
  • Hyoung Doo Lee (Department of Pediatrics, Pusan National University Hospital) ;
  • Kee Soo Ha (Department of Pediatrics, Korea University Guro Hospital) ;
  • Hyun Ok Jun (Department of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine) ;
  • Jeong Jin Yu (Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Gi Young Jang (Department of Pediatrics, Korea University Ansan Hospital) ;
  • Jong-Keuk Lee (Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Korean Kawasaki Disease Genetics Consortium (Korean Kawasaki Disease Genetics Consortium)
  • 투고 : 2023.08.28
  • 심사 : 2024.02.26
  • 발행 : 2024.09.01

초록

Background and Objectives: Kawasaki disease (KD) is an acute vasculitis that primarily affects children under age 5 years. Approximately 20-25% of untreated children with KD and 3-5% of those treated with intravenous immunoglobulin therapy develop coronary artery aneurysms (CAAs). The prevalence of CAAs is much higher in male than in female patients with KD, but the underlying factors contributing to susceptibility to CAAs in patients with KD remain unclear. This study aimed to identify sex-specific susceptibility loci associated with CAAs in KD patients. Methods: A sex-stratified genome-wide association study (GWAS) was performed using previously obtained GWAS data from 296 KD patients and a new replication study in an independent set of 976 KD patients by comparing KD patients without CAA (controls) and KD patients with aneurysms (internal diameter ≥5 mm) (cases). Results: Six male-specific susceptibility loci, PDE1C, NOS3, DLG2, CPNE8, FUNDC1, and GABRQ (odds ratios [ORs], 2.25-9.98; p=0.00204-1.96×10-6), and 2 female-specific susceptibility loci, SMAD3 (OR, 4.59; p=0.00016) and IL1RAPL1 (OR, 4.35; p=0.00026), were significantly associated with CAAs in patients with KD. In addition, the numbers of CAA risk alleles additively contributed to the development of CAAs in patients with KD. Conclusions: A sex-stratified GWAS identified 6 male-specific (PDE1C, NOS3, DLG2, CPNE8, FUNDC1, and GABRQ) and 2 female-specific (SMAD3 and IL1RAPL1) CAA susceptibility loci in patients with KD.

키워드

과제정보

We thank all our patients and their families for participating in this study.

참고문헌

  1. McCrindle BW, Rowley AH, Newburger JW, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association. Circulation 2017;135:e927-99.
  2. Kato H, Sugimura T, Akagi T, et al. Long-term consequences of Kawasaki disease. A 10- to 21-year follow-up study of 594 patients. Circulation 1996;94:1379-85.
  3. Newburger JW, Takahashi M, Beiser AS, et al. A single intravenous infusion of gamma globulin as compared with four infusions in the treatment of acute Kawasaki syndrome. N Engl J Med 1991;324:1633-9.
  4. Newburger JW, Takahashi M, Gerber MA, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 2004;110:2747-71.
  5. Takahashi K, Oharaseki T, Naoe S, Wakayama M, Yokouchi Y. Neutrophilic involvement in the damage to coronary arteries in acute stage of Kawasaki disease. Pediatr Int 2005;47:305-10.
  6. Rowley AH, Shulman ST, Mask CA, et al. IgA plasma cell infiltration of proximal respiratory tract, pancreas, kidney, and coronary artery in acute Kawasaki disease. J Infect Dis 2000;182:1183-91.
  7. Ha KS, Jang G, Lee J, et al. Incomplete clinical manifestation as a risk factor for coronary artery abnormalities in Kawasaki disease: a meta-analysis. Eur J Pediatr 2013;172:343-9.
  8. Song D, Yeo Y, Ha K, et al. Risk factors for Kawasaki disease-associated coronary abnormalities differ depending on age. Eur J Pediatr 2009;168:1315-21.
  9. Muta H, Ishii M, Iemura M, Suda K, Nakamura Y, Matsuishi T. Effect of revision of Japanese diagnostic criterion for fever in Kawasaki disease on treatment and cardiovascular outcome. Circ J 2007;71:1791-3.
  10. Dietz SM, Kuipers IM, Tacke CE, Koole JC, Hutten BA, Kuijpers TW. Giant aneurysms: a gender-specific complication of Kawasaki disease? J Cardiol 2017;70:359-65.
  11. Lin YJ, Chang JS, Liu X, et al. Genetic variants in PLCB4/PLCB1 as susceptibility loci for coronary artery aneurysm formation in Kawasaki disease in Han Chinese in Taiwan. Sci Rep 2015;5:14762.
  12. Kuo HC, Li SC, Guo MM, et al. Genome-wide association study identifies novel susceptibility genes associated with coronary artery aneurysm formation in Kawasaki disease. PLoS One 2016;11:e0154943.
  13. Kim JJ, Park YM, Yoon D, et al. Identification of KCNN2 as a susceptibility locus for coronary artery aneurysms in Kawasaki disease using genome-wide association analysis. J Hum Genet 2013;58:521-5.
  14. Kwon YC, Kim JJ, Yu JJ, et al. Identification of the TIFAB gene as a susceptibility locus for coronary artery aneurysm in patients with Kawasaki disease. Pediatr Cardiol 2019;40:483-8.
  15. Kim JJ, Yun SW, Yu JJ, et al. A genome-wide association analysis identifies NMNAT2 and HCP5 as susceptibility loci for Kawasaki disease. J Hum Genet 2017;62:1023-9.
  16. Kim JJ, Yun SW, Yu JJ, et al. Identification of SAMD9L as a susceptibility locus for intravenous immunoglobulin resistance in Kawasaki disease by genome-wide association analysis. Pharmacogenomics J 2020;20:80-6.
  17. Purcell S, Neale B, Todd-Brown K, et al. PLINK: a tool set for whole-genome association and population-based linkage analyses. Am J Hum Genet 2007;81:559-75.
  18. Kim GB, Eun LY, Han JW, et al. Epidemiology of Kawasaki disease in South Korea: a nationwide survey 2015-2017. Pediatr Infect Dis J 2020;39:1012-6.
  19. Tsuda E, Tsujii N, Hayama Y. Cardiac events and the maximum diameter of coronary artery aneurysms in Kawasaki disease. J Pediatr 2017;188:70-74.e1.
  20. van de Laar IM, Oldenburg RA, Pals G, et al. Mutations in SMAD3 cause a syndromic form of aortic aneurysms and dissections with early-onset osteoarthritis. Nat Genet 2011;43:121-6.
  21. Regalado ES, Guo DC, Villamizar C, et al. Exome sequencing identifies SMAD3 mutations as a cause of familial thoracic aortic aneurysm and dissection with intracranial and other arterial aneurysms. Circ Res 2011;109:680-6.
  22. Abruzzo T, Kendler A, Apkarian R, Workman M, Khoury JC, Cloft HJ. Cerebral aneurysm formation in nitric oxide synthase-3 knockout mice. Curr Neurovasc Res 2007;4:161-9.
  23. Fatini C, Sofi F, Sticchi E, et al. eNOS G894T polymorphism as a mild predisposing factor for abdominal aortic aneurysm. J Vasc Surg 2005;42:415-9.
  24. Rybalkin SD, Rybalkina I, Beavo JA, Bornfeldt KE. Cyclic nucleotide phosphodiesterase 1C promotes human arterial smooth muscle cell proliferation. Circ Res 2002;90:151-7.
  25. Vandeput F, Wolda SL, Krall J, et al. Cyclic nucleotide phosphodiesterase PDE1C1 in human cardiac myocytes. J Biol Chem 2007;282:32749-57.
  26. Zhang C, Zhao H, Cai Y, et al. Cyclic nucleotide phosphodiesterase 1C contributes to abdominal aortic aneurysm. Proc Natl Acad Sci U S A 2021;118:e2107898118.
  27. Wang J, Kazmi MM, Huxley VH. Microvascular sex- and age- dependent phosphodiesterase expression. Front Aging 2021;2:719698.
  28. Cattaneo MG, Vanetti C, Decimo I, et al. Sex-specific eNOS activity and function in human endothelial cells. Sci Rep 2017;7:9612.
  29. Brandon-Warner E, Walling TL, Schrum LW, McKillop IH. Chronic ethanol feeding accelerates hepatocellular carcinoma progression in a sex-dependent manner in a mouse model of hepatocarcinogenesis. Alcohol Clin Exp Res 2012;36:641-53.
  30. Kumari R, Irudayam MJ, Al Abdallah Q, et al. SMAD2 and SMAD3 differentially regulate adiposity and the growth of subcutaneous white adipose tissue. FASEB J 2021;35:e22018.