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      A genome-wide association study links small-vessel ischemic stroke to autophagy

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          Abstract

          Genome-wide association studies (GWAS) can serve as strong evidence in correlating biological pathways with human diseases. Although ischemic stroke has been found to be associated with many biological pathways, the genetic mechanism of ischemic stroke is still unclear. Here, we performed GWAS for a major subtype of stroke—small-vessel occlusion (SVO)—to identify potential genetic factors contributing to ischemic stroke. GWAS were conducted on 342 individuals with SVO stroke and 1,731 controls from a Han Chinese population residing in Taiwan. The study was replicated in an independent Han Chinese population comprising an additional 188 SVO stroke cases and 1,265 controls. Three SNPs (rs2594966, rs2594973, rs4684776) clustered at 3p25.3 in ATG7 (encoding Autophagy Related 7), with P values between 2.52 × 10 −6 and 3.59 × 10 −6, were identified. Imputation analysis also supported the association between ATG7 and SVO stroke. To our knowledge, this is the first GWAS to link stroke and autophagy. ATG7, which has been implicated in autophagy, could provide novel insights into the genetic basis of ischemic stroke.

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          Ischemic stroke subtype incidence among whites, blacks, and Hispanics: the Northern Manhattan Study.

          Stroke incidence is greater in blacks than in whites; data on Hispanics are limited. Comparing subtype-specific ischemic stroke incidence rates may help to explain race-ethnic differences in stroke risk. The aim of this population-based study was to determine ischemic stroke subtype incidence rates for whites, blacks, and Hispanics living in one community. A comprehensive stroke surveillance system incorporating multiple overlapping strategies was used to identify all cases of first ischemic stroke occurring between July 1, 1993, and June 30, 1997, in northern Manhattan. Ischemic stroke subtypes were determined according to a modified NINDS scheme, and age-adjusted, race-specific incidence rates calculated. The annual age-adjusted incidence of first ischemic stroke per 100,000 was 88 (95% CI, 75 to 101) in whites, 149 (95% CI, 132 to 165) in Hispanics, and 191 (95% CI, 160 to 221) in blacks. Among blacks compared with whites, the relative rate of intracranial atherosclerotic stroke was 5.85 (95% CI, 1.82 to 18.73); extracranial atherosclerotic stroke, 3.18 (95% CI, 1.42 to 7.13); lacunar stroke, 3.09 (95% CI, 1.86 to 5.11); and cardioembolic stroke, 1.58 (95% CI, 0.99 to 2.52). Among Hispanics compared with whites, the relative rate of intracranial atherosclerotic stroke was 5.00 (95% CI, 1.69 to 14.76); extracranial atherosclerotic stroke, 1.71 (95% CI, 0.80 to 3.63); lacunar stroke, 2.32 (95% CI, 1.48 to 3.63); and cardioembolic stroke, 1.42 (95% CI, 0.97 to 2.09). The high ischemic stroke incidence among blacks and Hispanics compared with whites is due to higher rates of all ischemic stroke subtypes.
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            Loci associated with ischaemic stroke and its subtypes (SiGN): a genome-wide association study

            (2016)
            The discovery of disease-associated loci through genome-wide association studies (GWAS) is the leading genetic approach to the identification of novel biological pathways underlying diseases in humans. Until recently, GWAS in ischaemic stroke have been limited by small sample sizes and have yielded few loci associated with ischaemic stroke. We did a large-scale GWAS to identify additional susceptibility genes for stroke and its subtypes.
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              Neuroprotection by selective neuronal deletion of Atg7 in neonatal brain injury

              ABSTRACT Perinatal asphyxia induces neuronal cell death and brain injury, and is often associated with irreversible neurological deficits in children. There is an urgent need to elucidate the neuronal death mechanisms occurring after neonatal hypoxia-ischemia (HI). We here investigated the selective neuronal deletion of the Atg7 (autophagy related 7) gene on neuronal cell death and brain injury in a mouse model of severe neonatal hypoxia-ischemia. Neuronal deletion of Atg7 prevented HI-induced autophagy, resulted in 42% decrease of tissue loss compared to wild-type mice after the insult, and reduced cell death in multiple brain regions, including apoptosis, as shown by decreased caspase-dependent and -independent cell death. Moreover, we investigated the lentiform nucleus of human newborns who died after severe perinatal asphyxia and found increased neuronal autophagy after severe hypoxic-ischemic encephalopathy compared to control uninjured brains, as indicated by the numbers of MAP1LC3B/LC3B (microtubule-associated protein 1 light chain 3)-, LAMP1 (lysosomal-associated membrane protein 1)-, and CTSD (cathepsin D)-positive cells. These findings reveal that selective neuronal deletion of Atg7 is strongly protective against neuronal death and overall brain injury occurring after HI and suggest that inhibition of HI-enhanced autophagy should be considered as a potential therapeutic target for the treatment of human newborns developing severe hypoxic-ischemic encephalopathy.
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                Author and article information

                Contributors
                chen0010@ibms.sinica.edu.tw
                jywu@ibms.sinica.edu.tw
                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                9 November 2017
                9 November 2017
                2017
                : 7
                : 15229
                Affiliations
                [1 ]Chang Gung Memorial Hospital, Linkou Medical Center, and Chang Gung University College of Medicine, Taoyuan, Taiwan
                [2 ]ISNI 0000 0004 0633 7958, GRID grid.482251.8, Institute of Biomedical Sciences, Academia Sinica, ; Taipei, Taiwan
                [3 ]ISNI 0000 0001 0083 6092, GRID grid.254145.3, Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, ; Taichung, Taiwan
                [4 ]ISNI 0000 0001 0083 6092, GRID grid.254145.3, School of Chinese Medicine, China Medical University, ; Taichung, Taiwan
                [5 ]Chang Gung Memorial Hospital, Chiayi Branch, and Chang Gung University College of Medicine, Chiayi, Taiwan
                [6 ]Chang Gung Memorial Hospital, Kaohsiung Medical Center, and Chang Gung University College of Medicine, Kaohsiung, Taiwan
                [7 ]ISNI 0000 0004 0394 1447, GRID grid.280776.c, Genomic Medicine Institute, Geisinger Health System, ; Danville, Pennsylvania USA
                [8 ]ISNI 0000000100241216, GRID grid.189509.c, Department of Pediatrics, , Duke University Medical Center, ; Durham, North Carolina USA
                Author information
                http://orcid.org/0000-0003-2510-8977
                Article
                14355
                10.1038/s41598-017-14355-3
                5680343
                29123153
                b13ecd03-0bb0-4068-8f7f-8b942320402d
                © The Author(s) 2017

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 19 May 2017
                : 9 October 2017
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