The genetic landscape of pediatric postural orthostatic tachycardia syndrome.

IF 3.9 3区 医学 Q1 CLINICAL NEUROLOGY
Huiqi Qu, Jingchun Qu, Xiao Chang, Nolan Williams, Frank Mentch, James Snyder, Maria Lemma, Kenny Nguyen, Meckenzie Behr, Michael March, John Connolly, Joseph Glessner, Jeffrey R Boris, Hakon Hakonarson
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Abstract

Background: Postural orthostatic tachycardia syndrome (POTS) is a complex disorder with serious health consequences, while its etiology remains largely elusive.

Objective: The purpose of this study was to investigate the genetic landscape of POTS using genomic approaches in a unique pediatric cohort.

Methods: We conducted a combined genome wide genotyping and whole exome sequencing (WES) study to systemically examine the molecular mechanisms of POTS pathogenesis. The patients were genotyped as two independent cohorts: a family cohort of 100 complete families and a case-control cohort of 207 unrelated European cases and 4063 ethnicity-matched control subjects. The WES component consisted of a subset of the genotyped subjects, including 87 unrelated European cases and 2719 unrelated European control subjects.

Results: The heterogeneous phenotype of POTS made achieving genome-wide significance improbable. Instead, 5670 SNPs with nominal significance (P < 0.05) were identified in both the family and case-control cohorts, with effects in the same direction. We conducted an over-representation analysis (ORA) by considering all genes that showed nominal significance. The ORA identified gene sets linked to cell-cell junction, early estrogen response, and substance-related disorders with statistical significance. Moreover, WES revealed 55 genes with genome-wide significance through rare variant burden analysis, harboring 92 variants classified as pathogenic or likely pathogenic by ClinVar.

Conclusions: This study showcases the complex interplay between common and rare genetic variants in POTS development, marking a pioneering step forward in deciphering its complex etiologies. The insights from this research enrich our understanding of POTS, offering new avenues for precise treatment strategies and highlighting areas for further research.

儿童体位性心动过速综合征的遗传景观。
背景:体位性体位性心动过速综合征(POTS)是一种复杂的疾病,具有严重的健康后果,而其病因在很大程度上仍然难以捉摸。目的:本研究的目的是在一个独特的儿科队列中使用基因组方法研究POTS的遗传景观。方法:采用全基因组分型和全外显子组测序(WES)相结合的方法,对POTS发病的分子机制进行系统研究。将患者分为两个独立的队列进行基因分型:一个由100个完整家庭组成的家庭队列和一个由207个不相关的欧洲病例和4063个种族匹配的对照受试者组成的病例-对照队列。WES成分由基因分型受试者组成,包括87例无血缘关系的欧洲病例和2719例无血缘关系的欧洲对照受试者。结果:POTS的异质性表型使得实现全基因组意义是不可能的。结论:该研究展示了POTS发育中常见和罕见遗传变异之间的复杂相互作用,标志着在破译其复杂病因方面迈出了开创性的一步。本研究的见解丰富了我们对POTS的理解,为精确治疗策略提供了新的途径,并突出了进一步研究的领域。
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来源期刊
Clinical Autonomic Research
Clinical Autonomic Research 医学-临床神经学
CiteScore
7.40
自引率
6.90%
发文量
65
审稿时长
>12 weeks
期刊介绍: Clinical Autonomic Research aims to draw together and disseminate research work from various disciplines and specialties dealing with clinical problems resulting from autonomic dysfunction. Areas to be covered include: cardiovascular system, neurology, diabetes, endocrinology, urology, pain disorders, ophthalmology, gastroenterology, toxicology and clinical pharmacology, skin infectious diseases, renal disease. This journal is an essential source of new information for everyone working in areas involving the autonomic nervous system. A major feature of Clinical Autonomic Research is its speed of publication coupled with the highest refereeing standards.
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