Rare damaging CCR2 variants are associated with lower lifetime cardiovascular risk.

Marios K Georgakis, Rainer Malik, Omar El Bounkari, Natalie R Hasbani, Jiang Li, Jennifer E Huffman, Gabrielle Shakt, Reinier W P Tack, Tamara N Kimball, Yaw Asare, Alanna C Morrison, Noah L Tsao, Renae Judy, Braxton D Mitchell, Huichun Xu, May E Montasser, Ron Do, Eimear E Kenny, Ruth J F Loos, James G Terry, John Jeffrey Carr, Joshua C Bis, Bruce M Psaty, W T Longstreth, Kendra A Young, Sharon M Lutz, Michael H Cho, Jai Broome, Alyna T Khan, Fei Fei Wang, Nancy Heard-Costa, Sudha Seshadri, Ramachandran S Vasan, Nicholette D Palmer, Barry I Freedman, Donald W Bowden, Lisa R Yanek, Brian G Kral, Lewis C Becker, Patricia A Peyser, Lawrence F Bielak, Farah Ammous, April P Carson, Michael E Hall, Laura M Raffield, Stephen S Rich, Wendy S Post, Russel P Tracy, Kent D Taylor, Xiuqing Guo, Michael C Mahaney, Joanne E Curran, John Blangero, Shoa L Clarke, Jeffrey W Haessler, Yao Hu, Themistocles L Assimes, Charles Kooperberg, Jürgen Bernhagen, Christopher D Anderson, Scott M Damrauer, Ramin Zand, Jerome I Rotter, Paul S de Vries, Martin Dichgans
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Abstract

Background: Previous work has shown a role of CCL2, a key chemokine governing monocyte trafficking, in atherosclerosis. However, it remains unknown whether targeting CCR2, the cognate receptor of CCL2, provides protection against human atherosclerotic cardiovascular disease.

Methods: Computationally predicted damaging or loss-of-function (REVEL>0.5) variants within CCR2 were detected in whole-exome-sequencing data from 454,775 UK Biobank participants and tested for association with cardiovascular endpoints in gene-burden tests. Given the key role of CCR2 in monocyte mobilization, variants associated with lower monocyte count were prioritized for experimental validation. The response to CCL2 of human cells transfected with these variants was tested in migration and cAMP assays. Validated damaging variants were tested for association with cardiovascular endpoints, atherosclerosis burden, and vascular risk factors. Significant associations were replicated in six independent datasets (n=1,062,595).

Results: Carriers of 45 predicted damaging or loss-of-function CCR2 variants (n=787 individuals) were at lower risk of myocardial infarction and coronary artery disease. One of these variants (M249K, n=585, 0.15% of European ancestry individuals) was associated with lower monocyte count and with both decreased downstream signaling and chemoattraction in response to CCL2. While M249K showed no association with conventional vascular risk factors, it was consistently associated with a lower risk of myocardial infarction (Odds Ratio [OR]: 0.66 95% Confidence Interval [CI]: 0.54-0.81, p=6.1×10-5) and coronary artery disease (OR: 0.74 95%CI: 0.63-0.87, p=2.9×10-4) in the UK Biobank and in six replication cohorts. In a phenome-wide association study, there was no evidence of a higher risk of infections among M249K carriers.

Conclusions: Carriers of an experimentally confirmed damaging CCR2 variant are at a lower lifetime risk of myocardial infarction and coronary artery disease without carrying a higher risk of infections. Our findings provide genetic support for the translational potential of CCR2-targeting as an atheroprotective approach.

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携带罕见破坏性CCR2基因变异的人患动脉粥样硬化疾病的风险较低。
背景:CCL2/CCR2轴支配单核细胞向动脉粥样硬化病变的运输和募集。人类基因分析和基于人群的研究支持循环CCL2水平与动脉粥样硬化之间的联系。尽管如此,对CCL2(主要的CCL2受体)的药理学靶向是否能提供对人类动脉粥样硬化疾病的保护仍然未知。方法:在来自454775名英国生物银行参与者(40-69岁)的全外显子组测序数据中,我们确定了CCR2基因中的预测功能丧失(LoF)或损伤性错义(REVEL评分>0.5)变体。我们优先考虑与低单核细胞计数相关的变异(p结果:在CCR2基因中共鉴定出45种预测的LoF或破坏性错义变体,其中4种也与较低的单核细胞计数显著相关,但与其他白细胞计数无关。这些变体的杂合携带者出现综合动脉粥样硬化结果的风险较低,在四个血管床上显示出较低的动脉粥样硬化负担冠状动脉疾病和心肌梗死的终生风险较低。没有证据表明与低密度脂蛋白胆固醇、血压、血糖状况或C反应蛋白等血管风险因素有关。使用cAMP测定,我们发现用最常见的CCR2损伤变体(3:46358273:T:a,M249K,547个载体,频率:0.14%)转染的细胞显示出对CCL2的信号传导减少。M249K变异株与心肌梗死的相关性在各队列中是一致的(ORUKB:0.62 95%CI:0.39-0.96;ORexternal:0.64 95%CI:0.34-1.19;ORpooled:0.64 95%CI:0.450.90)。在一项现象广泛的相关性研究中,我们没有发现破坏性CCR2变异株携带者常见感染或死亡风险更高的证据。结论:破坏性CCR2变异体的杂合携带者动脉粥样硬化负担较低,心肌梗死的终生风险较低。结合先前实验和流行病学研究的证据,我们的发现强调了CCR2靶向作为动脉粥样硬化保护方法的转化潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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