scholarly journals Complement System and Age-Related Macular Degeneration: Implications of Gene-Environment Interaction for Preventive and Personalized Medicine

2018 ◽  
Vol 2018 ◽  
pp. 1-13 ◽  
Author(s):  
Andrea Maugeri ◽  
Martina Barchitta ◽  
Maria Grazia Mazzone ◽  
Francesco Giuliano ◽  
Antonella Agodi

Age-related macular degeneration (AMD) is the most common cause of visual loss in developed countries, with a significant economic and social burden on public health. Although genome-wide and gene-candidate studies have been enabled to identify genetic variants in the complement system associated with AMD pathogenesis, the effect of gene-environment interaction is still under debate. In this review we provide an overview of the role of complement system and its genetic variants in AMD, summarizing the consequences of the interaction between genetic and environmental risk factors on AMD onset, progression, and therapeutic response. Finally, we discuss the perspectives of current evidence in the field of genomics driven personalized medicine and public health.

2021 ◽  
Vol 11 (12) ◽  
pp. 1256
Author(s):  
I. Erkin Acar ◽  
Esther Willems ◽  
Eveline Kersten ◽  
Jenneke Keizer-Garritsen ◽  
Else Kragt ◽  
...  

Age-related macular degeneration (AMD) is a major cause of vision loss among the elderly in the Western world. The complement system has been identified as one of the main AMD disease pathways. We performed a comprehensive expression analysis of 32 complement proteins in plasma samples of 255 AMD patients and 221 control individuals using mass spectrometry-based semi-quantitative multiplex profiling. We detected significant associations of complement protein levels with age, sex and body-mass index (BMI), and potential associations of C-reactive protein, factor H related-2 (FHR-2) and collectin-11 with AMD. In addition, we confirmed previously described associations and identified new associations of AMD variants with complement levels. New associations include increased C4 levels for rs181705462 at the C2/CFB locus, decreased vitronectin (VTN) levels for rs11080055 at the TMEM97/VTN locus and decreased factor I levels for rs10033900 at the CFI locus. Finally, we detected significant associations between AMD-associated metabolites and complement proteins in plasma. The most significant complement-metabolite associations included increased high density lipoprotein (HDL) subparticle levels with decreased C3, factor H (FH) and VTN levels. The results of our study indicate that demographic factors, genetic variants and circulating metabolites are associated with complement protein components. We suggest that these factors should be considered to design personalized treatment approaches and to increase the success of clinical trials targeting the complement system.


2014 ◽  
Vol 61 (2) ◽  
pp. 118-125 ◽  
Author(s):  
Elizabeth C. Schramm ◽  
Simon J. Clark ◽  
Michael P. Triebwasser ◽  
Soumya Raychaudhuri ◽  
Johanna M. Seddon ◽  
...  

2019 ◽  
Vol 19 (10) ◽  
pp. 705-718 ◽  
Author(s):  
Naima Mansoor ◽  
Fazli Wahid ◽  
Maleeha Azam ◽  
Khadim Shah ◽  
Anneke I. den Hollander ◽  
...  

: Age-related macular degeneration (AMD) is an eye disorder affecting predominantly the older people above the age of 50 years in which the macular region of the retina deteriorates, resulting in the loss of central vision. The key factors associated with the pathogenesis of AMD are age, smoking, dietary, and genetic risk factors. There are few associated and plausible genes involved in AMD pathogenesis. Common genetic variants (with a minor allele frequency of >5% in the population) near the complement genes explain 40–60% of the heritability of AMD. The complement system is a group of proteins that work together to destroy foreign invaders, trigger inflammation, and remove debris from cells and tissues. Genetic changes in and around several complement system genes, including the CFH, contribute to the formation of drusen and progression of AMD. Similarly, Matrix metalloproteinases (MMPs) that are normally involved in tissue remodeling also play a critical role in the pathogenesis of AMD. MMPs are involved in the degradation of cell debris and lipid deposits beneath retina but with age their functions get affected and result in the drusen formation, succeeding to macular degeneration. In this review, AMD pathology, existing knowledge about the normal and pathological role of complement system proteins and MMPs in the eye is reviewed. The scattered data of complement system proteins, MMPs, drusenogenesis, and lipofusogenesis have been gathered and discussed in detail. This might add new dimensions to the understanding of molecular mechanisms of AMD pathophysiology and might help in finding new therapeutic options for AMD.


Life ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 635
Author(s):  
Monica L. Hu ◽  
Joel Quinn ◽  
Kanmin Xue

Age-related macular degeneration (AMD) is a multifactorial retinal disorder that is a major global cause of severe visual impairment. The development of an effective therapy to treat geographic atrophy, the predominant form of AMD, remains elusive due to the incomplete understanding of its pathogenesis. Central to AMD diagnosis and pathology are the hallmark lipid and proteinaceous deposits, drusen and reticular pseudodrusen, that accumulate in the subretinal pigment epithelium and subretinal spaces, respectively. Age-related changes and environmental stressors, such as smoking and a high-fat diet, are believed to interact with the many genetic risk variants that have been identified in several major biochemical pathways, including lipoprotein metabolism and the complement system. The APOE gene, encoding apolipoprotein E (APOE), is a major genetic risk factor for AMD, with the APOE2 allele conferring increased risk and APOE4 conferring reduced risk, in comparison to the wildtype APOE3. Paradoxically, APOE4 is the main genetic risk factor in Alzheimer's disease, a disease with features of neuroinflammation and amyloid-beta deposition in common with AMD. The potential interactions of APOE with the complement system and amyloid-beta are discussed here to shed light on their roles in AMD pathogenesis, including in drusen biogenesis, immune cell activation and recruitment, and retinal inflammation.


Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Kenneth E Westerman

Background: Gene-environment interaction (GEI) analysis enables us to understand how genetic variants modify the effects of environmental exposures on cardiometabolic risk factors, providing a foundation for genome-based precision medicine. Ideally, these interactions could be mapped comprehensively across all measured genetic variants, exposures, and outcomes, but this approach is computationally intensive and statistically underpowered. Recent studies have shown that variance-quantitative trait loci (vQTLs), or genetic variants that associate with differential variance of an outcome, are substantially enriched for underlying GEIs. Here, we sought to first identify vQTLs for cardiometabolic traits, then use this smaller genetic search space to uncover novel gene-environment interactions across thousands of environmental exposures. Methods: A two-stage, multi-ancestry analysis was conducted in 355,790 unrelated participants from the UK Biobank. First, we performed a genome-wide vQTL scan for each of 20 serum metabolic biomarkers, including but not limited to lipids, lipoproteins, and glycemic measures. This scan used Levene’s test to identify genetic markers whose genotypes are associated with the variance, rather than the mean, of the biomarker. Next, we collected over 2000 variables corresponding to socioeconomic, dietary, lifestyle, and clinical exposures, and conducted an interaction analysis for each combination of exposure and vQTL-biomarker pair. For each stage, the analysis was initially stratified by ancestry then meta-analyzed to generate the primary set of results. Results: vQTLs were identified at 514 independent regions in the genome, with most of these genetic variants already known to affect the mean biomarker level. In the subsequent gene-environment interaction analysis, we found 2,162 significant interactions passing a stringent significance threshold adjusted for multiple testing ( p < 0.05 / 578 vQTL-biomarker pairs / 2140 exposures = 4х10 -8 ). Some of these expanded on existing findings; for example, genetic marker rs2393775 in the HNF1A gene interacted with education level (as a proxy for socioeconomic status) to influence hsCRP ( p = 1.3х10 -10 ), building on a previous finding that HNF1A variants modify the effect of perceived stress on cardiovascular outcomes. Others highlighted novel biology, such as an interaction between variants near the fatty liver-associated gene TM6SF2 and oily fish intake on total and LDL-cholesterol levels ( p = 6.6х10 -9 ). Conclusions: Our systematic GEI discovery effort identified thousands of interactions that may impact cardiometabolic risk, both expanding on previous research and identifying novel biological mechanisms. This catalog of vQTLs and interactions can inform future mechanistic studies and provides a knowledge base for genome-centered precision approaches to cardiometabolic health.


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