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. 2015 Apr;47(4):387-92.
doi: 10.1038/ng.3226. Epub 2015 Feb 23.

A common variant mapping to CACNA1A is associated with susceptibility to exfoliation syndrome

Tin Aung  1 Mineo Ozaki  2 Takanori Mizoguchi  3 R Rand Allingham  4 Zheng Li  5 Aravind Haripriya  6 Satoko Nakano  7 Steffen Uebe  8 Jeffrey M Harder  9 Anita S Y Chan  10 Mei Chin Lee  11 Kathryn P Burdon  12 Yury S Astakhov  13 Khaled K Abu-Amero  14 Juan C Zenteno  15 Yildirim Nilgün  16 Tomasz Zarnowski  17 Mohammad Pakravan  18 Leen Abu Safieh  19 Liyun Jia  20 Ya Xing Wang  21 Susan Williams  22 Daniela Paoli  23 Patricio G Schlottmann  24 Lulin Huang  25 Kar Seng Sim  5 Jia Nee Foo  5 Masakazu Nakano  26 Yoko Ikeda  27 Rajesh S Kumar  28 Morio Ueno  27 Shin-ichi Manabe  29 Ken Hayashi  29 Shigeyasu Kazama  30 Ryuichi Ideta  31 Yosai Mori  32 Kazunori Miyata  33 Kazuhisa Sugiyama  34 Tomomi Higashide  34 Etsuo Chihara  35 Kenji Inoue  36 Satoshi Ishiko  37 Akitoshi Yoshida  38 Masahide Yanagi  39 Yoshiaki Kiuchi  39 Makoto Aihara  40 Tsutomu Ohashi  41 Toshiya Sakurai  42 Takako Sugimoto  43 Hideki Chuman  43 Fumihiko Matsuda  44 Kenji Yamashiro  45 Norimoto Gotoh  45 Masahiro Miyake  46 Sergei Y Astakhov  13 Essam A Osman  47 Saleh A Al-Obeidan  47 Ohoud Owaidhah  18 Leyla Al-Jasim  18 Sami Al Shahwan  18 Rhys A Fogarty  48 Paul Leo  49 Yaz Yetkin  16 Çilingir Oğuz  16 Mozhgan Rezaei Kanavi  18 Afsaneh Nederi Beni  18 Shahin Yazdani  18 Evgeny L Akopov  13 Kai-Yee Toh  5 Gareth R Howell  9 Andrew C Orr  50 Yufen Goh  5 Wee Yang Meah  5 Su Qin Peh  5 Ewa Kosior-Jarecka  17 Urszula Lukasik  17 Mandy Krumbiegel  8 Eranga N Vithana  11 Tien Yin Wong  51 Yutao Liu  52 Allison E Ashley Koch  53 Pratap Challa  4 Robyn M Rautenbach  54 David A Mackey  55 Alex W Hewitt  56 Paul Mitchell  57 Jie Jin Wang  57 Ari Ziskind  54 Trevor Carmichael  22 Rangappa Ramakrishnan  6 Kalpana Narendran  6 Rangaraj Venkatesh  6 Saravanan Vijayan  58 Peiquan Zhao  59 Xueyi Chen  60 Dalia Guadarrama-Vallejo  15 Ching Yu Cheng  61 Shamira A Perera  10 Rahat Husain  10 Su-Ling Ho  62 Ulrich-Christoph Welge-Luessen  63 Christian Mardin  63 Ursula Schloetzer-Schrehardt  63 Axel M Hillmer  64 Stefan Herms  65 Susanne Moebus  66 Markus M Nöthen  67 Nicole Weisschuh  68 Rohit Shetty  28 Arkasubhra Ghosh  69 Yik Ying Teo  70 Matthew A Brown  49 Ignacio Lischinsky  71 Blue Mountains Eye Study GWAS TeamWellcome Trust Case Control Consortium 2Jonathan G Crowston  72 Michael Coote  72 Bowen Zhao  19 Jinghong Sang  20 Nihong Zhang  20 Qisheng You  21 Vera Vysochinskaya  73 Panayiota Founti  74 Anthoula Chatzikyriakidou  75 Alexandros Lambropoulos  75 Eleftherios Anastasopoulos  74 Anne L Coleman  76 M Roy Wilson  77 Douglas J Rhee  78 Jae Hee Kang  79 Inna May-Bolchakova  80 Steffen Heegaard  81 Kazuhiko Mori  26 Wallace L M Alward  82 Jost B Jonas  83 Liang Xu  21 Jeffrey M Liebmann  84 Balram Chowbay  85 Elke Schaeffeler  86 Matthias Schwab  87 Fabian Lerner  88 Ningli Wang  20 Zhenglin Yang  25 Paolo Frezzotti  89 Shigeru Kinoshita  27 John H Fingert  82 Masaru Inatani  90 Kei Tashiro  26 André Reis  8 Deepak P Edward  91 Louis R Pasquale  92 Toshiaki Kubota  7 Janey L Wiggs  78 Francesca Pasutto  8 Fotis Topouzis  74 Michael Dubina  93 Jamie E Craig  48 Nagahisa Yoshimura  45 Periasamy Sundaresan  58 Simon W M John  9 Robert Ritch  94 Michael A Hauser  95 Chiea-Chuen Khor  96
Collaborators, Affiliations

A common variant mapping to CACNA1A is associated with susceptibility to exfoliation syndrome

Tin Aung et al. Nat Genet. 2015 Apr.

Erratum in

  • Corrigendum: a common variant mapping to CACNA1A is associated with susceptibility to exfoliation syndrome.
    Aung T, Ozaki M, Mizoguchi T, Allingham RR, Li Z, Haripriya A, Nakano S, Uebe S, Harder JM, Chan AS, Lee MC, Burdon KP, Astakhov YS, Abu-Amero KK, Zenteno JC, Nilgün Y, Zarnowski T, Pakravan M, Safieh LA, Jia L, Wang YX, Williams S, Paoli D, Schlottmann PG, Huang L, Sim KS, Foo JN, Nakano M, Ikeda Y, Kumar RS, Ueno M, Manabe S, Hayashi K, Kazama S, Ideta R, Mori Y, Miyata K, Sugiyama K, Higashide T, Chihara E, Inoue K, Ishiko S, Yoshida A, Yanagi M, Kiuchi Y, Aihara M, Ohashi T, Sakurai T, Sugimoto T, Chuman H, Matsuda F, Yamashiro K, Gotoh N, Miyake M, Astakhov SY, Osman EA, Al-Obeidan SA, Owaidhah O, Al-Jasim L, Shahwan SA, Fogarty RA, Leo P, Yetkin Y, Oğuz Ç, Kanavi MR, Beni AN, Yazdani S, Akopov EL, Toh KY, Howell GR, Orr AC, Goh Y, Meah WY, Peh SQ, Kosior-Jarecka E, Lukasik U, Krumbiegel M, Vithana EN, Wong TY, Liu Y, Koch AE, Challa P, Rautenbach RM, Mackey DA, Hewitt AW, Mitchell P, Wang JJ, Ziskind A, Carmichael T, Ramakrishnan R, Narendran K, Venkatesh R, Vijayan S, Zhao P, Chen X, Guadarrama-Vallejo D, Cheng CY, Perera SA, Husain R, Ho SL, Welge-Luessen UC, Mardin C, Schloetzer-Schrehardt U, Hillmer AM, Herms S, Moebus S, Nöthen MM, Weisschuh N, Shetty R, Ghosh A, Teo YY… See abstract for full author list ➔ Aung T, et al. Nat Genet. 2015 Jun;47(6):689. doi: 10.1038/ng0615-689c. Nat Genet. 2015. PMID: 26018902 No abstract available.

Abstract

Exfoliation syndrome (XFS) is the most common recognizable cause of open-angle glaucoma worldwide. To better understand the etiology of XFS, we conducted a genome-wide association study (GWAS) of 1,484 cases and 1,188 controls from Japan and followed up the most significant findings in a further 6,901 cases and 20,727 controls from 17 countries across 6 continents. We discovered a genome-wide significant association between a new locus (CACNA1A rs4926244) and increased susceptibility to XFS (odds ratio (OR) = 1.16, P = 3.36 × 10(-11)). Although we also confirmed overwhelming association at the LOXL1 locus, the key SNP marker (LOXL1 rs4886776) demonstrated allelic reversal depending on the ancestry group (Japanese: OR(A allele) = 9.87, P = 2.13 × 10(-217); non-Japanese: OR(A allele) = 0.49, P = 2.35 × 10(-31)). Our findings represent the first genetic locus outside of LOXL1 surpassing genome-wide significance for XFS and provide insight into the biology and pathogenesis of the disease.

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Conflict of interest statement

COMPETING FINANCIAL INTERESTS

The authors declare no competing financial interests.

Figures

Figure 1
Figure 1
Forest plot for the associations between CACNA1A rs4926244 and Exfoliation syndrome in discovery and follow up case-control collections. The black lines denote the 95% confidence intervals of the odds ratio for each collection. The diamonds denote summary results for the GWAS, Validation and Replication stages (blue), as well as the GWAS and Validation meta-analysis, and meta-analysis of data from all collections (red). Asian and European ethnic summaries are in black diamonds.
Figure 2
Figure 2
Regional association and recombination rate plot for the CACNA1A rs4926244 locus. The left y axis represents –log10 P values for association with exfoliation syndrome and the right y axis represents the recombination rate. The x axis represents base-pair positions along the chromosome (human genome Build 37). The diamonds denote the summary of each experimental stage, a) for the GWAS discovery, b) for the meta-analysis between GWAS discovery and validation stages, and c) for the meta-analysis between GWAS discovery, validation, and replication stages.
Figure 3
Figure 3
CACNA1A and LOXL1 protein expression and light microscopic analysis in XFS and non-XFS control eyes. Immunolocalisation of CACNA1A in human non-XFS and XFS globes show CACNA1A positive immunoreactivity in the smooth musculature of the ciliary body (CB) and pigmented and non-pigmented ciliary process (CP) epithelium with variable staining in the zonules (Panels a to c: CACNA1A immunofluorescence (IF) panel; CACNA1A immunohistochemical (IHC) panel, 40x; zonules, white and black arrows; exfoliated material, green asterix). In contrast, LOXL1 immunoreactivity is present only in the exfoliated material and the CP epithelium, (LOXL1 IF panel; zonules, white arrows). Double immunofluorecence analysis shows colocalisation of CACNA1A and LOXL1 within the non-pigmented and pigmented epithelium of the CP but not in the CB smooth muscles or the zonules (IF overlay panel; zonules, white arrows). Light microscopy comparison of non-XFS and XFS irides show the typical XFS findings of exfoliated material (green asterix) on the posterior iris and atrophic iris pigment epithelium with possible atrophy of the iris dilator muscle (blue arrowheads) in XFS irides. The sphincter pupillae in both non-XFS and XFS shows negligible differences (H&E panels). CACNA1A positive immunoreactivity is also seen in the anterior iris border, iris stromal cells, the iris dilator (blue arrowheads, H&E and IHC panels) and sphincter muscles as well as the iris pigmented epithelium in both XFS and Non-XFS irides (Panel d & e: CACNA1A IF and CACNA1A IHC panels). Stromal cells are highlighted by the blue circles. For CACNA1A, LOXL1, and overlay panels a) through to d), each unit on the scale bar represents 100 μm. For CACNA1A IHC panels a) to d), each unit on the scale bar represents 50 μm. For panel e) hematoxylin & eosin non-XFS as well as hematoxylin & eosin XFS1, each unit on the scale bar represents 200 μm. For panel e) CACNA1A IHC XFS2 as well as CACNA1A IHC non-XFS, each unit on the scale bar represents 25 μm.

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