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      GATA2 Is Associated with Familial Early-Onset Coronary Artery Disease

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          Abstract

          The transcription factor GATA2 plays an essential role in the establishment and maintenance of adult hematopoiesis. It is expressed in hematopoietic stem cells, as well as the cells that make up the aortic vasculature, namely aortic endothelial cells and smooth muscle cells. We have shown that GATA2 expression is predictive of location within the thoracic aorta; location is suggested to be a surrogate for disease susceptibility. The GATA2 gene maps beneath the Chromosome 3q linkage peak from our family-based sample set (GENECARD) study of early-onset coronary artery disease. Given these observations, we investigated the relationship of several known and novel polymorphisms within GATA2 to coronary artery disease. We identified five single nucleotide polymorphisms that were significantly associated with early-onset coronary artery disease in GENECARD. These results were validated by identifying significant association of two of these single nucleotide polymorphisms in an independent case-control sample set that was phenotypically similar to the GENECARD families. These observations identify GATA2 as a novel susceptibility gene for coronary artery disease and suggest that the study of this transcription factor and its downstream targets may uncover a regulatory network important for coronary artery disease inheritance.

          Synopsis

          Coronary artery disease (CAD) is the most common form of heart disease in the Western world and is one of the leading causes of death in the United States. CAD is inherited and is a complex genetic disease because it results from changes to multiple genes acting in concert with one another and the environment. The authors locate CAD susceptibility genes by convergence of techniques and identify variation within a gene of interest in an early-onset CAD population. If a specific variant is found more often in affected individuals or families than in controls, this can suggest that this gene variant is associated with disease. The authors have identified a gene, GATA2, which is located in a genomic region suspected to contain genes for CAD and displays expression patterns predictive of location of disease within human donor aortas. They have identified several GATA2 variants that segregate with CAD in a family-based early-onset CAD population and have further validated two of these associations in a separate young case-control sample affected with CAD. These data imply that the transcription factor GATA2 may play a role in CAD susceptibility and suggest that the study of GATA2 targets may uncover a set of GATA2-regulated genes important to CAD inheritance.

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          Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing

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            Number and migratory activity of circulating endothelial progenitor cells inversely correlate with risk factors for coronary artery disease.

            Recent studies provide increasing evidence that postnatal neovascularization involves bone marrow-derived circulating endothelial progenitor cells (EPCs). The regulation of EPCs in patients with coronary artery disease (CAD) is unclear at present. Therefore, we determined the number and functional activity of EPCs in 45 patients with CAD and 15 healthy volunteers. The numbers of isolated EPCs and circulating CD34/kinase insert domain receptor (KDR)-positive precursor cells were significantly reduced in patients with CAD by approximately 40% and 48%, respectively. To determine the influence of atherosclerotic risk factors, a risk factor score including age, sex, hypertension, diabetes, smoking, positive family history of CAD, and LDL cholesterol levels was used. The number of risk factors was significantly correlated with a reduction of EPC levels (R=-0.394, P=0.002) and CD34-/KDR-positive cells (R=-0.537, P<0.001). Analysis of the individual risk factors demonstrated that smokers had significantly reduced levels of EPCs (P<0.001) and CD34-/KDR-positive cells (P=0.003). Moreover, a positive family history of CAD was associated with reduced CD34-/KDR-positive cells (P=0.011). Most importantly, EPCs isolated from patients with CAD also revealed an impaired migratory response, which was inversely correlated with the number of risk factors (R=-0.484, P=0.002). By multivariate analysis, hypertension was identified as a major independent predictor for impaired EPC migration (P=0.043). The present study demonstrates that patients with CAD revealed reduced levels and functional impairment of EPCs, which correlated with risk factors for CAD. Given the important role of EPCs for neovascularization of ischemic tissue, the decrease of EPC numbers and activity may contribute to impaired vascularization in patients with CAD. The full text of this article is available at http://www.circresaha.org.
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              Score tests for association between traits and haplotypes when linkage phase is ambiguous.

              A key step toward the discovery of a gene related to a trait is the finding of an association between the trait and one or more haplotypes. Haplotype analyses can also provide critical information regarding the function of a gene; however, when unrelated subjects are sampled, haplotypes are often ambiguous because of unknown linkage phase of the measured sites along a chromosome. A popular method of accounting for this ambiguity in case-control studies uses a likelihood that depends on haplotype frequencies, so that the haplotype frequencies can be compared between the cases and controls; however, this traditional method is limited to a binary trait (case vs. control), and it does not provide a method of testing the statistical significance of specific haplotypes. To address these limitations, we developed new methods of testing the statistical association between haplotypes and a wide variety of traits, including binary, ordinal, and quantitative traits. Our methods allow adjustment for nongenetic covariates, which may be critical when analyzing genetically complex traits. Furthermore, our methods provide several different global tests for association, as well as haplotype-specific tests, which give a meaningful advantage in attempts to understand the roles of many different haplotypes. The statistics can be computed rapidly, making it feasible to evaluate the associations between many haplotypes and a trait. To illustrate the use of our new methods, they are applied to a study of the association of haplotypes (composed of genes from the human-leukocyte-antigen complex) with humoral immune response to measles vaccination. Limited simulations are also presented to demonstrate the validity of our methods, as well as to provide guidelines on how our methods could be used.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS Genet
                pgen
                PLoS Genetics
                Public Library of Science (San Francisco, USA )
                1553-7390
                1553-7404
                August 2006
                25 August 2006
                20 July 2006
                : 2
                : 8
                : e139
                Affiliations
                [1 ]Department of Medicine and Center for Human Genetics, Duke University Medical Center, Durham, North Carolina, United States
                [2 ]Department of Medicine and Division of Cardiology, Duke University Medical Center, Durham, North Carolina, United States
                [3 ]Cardiovascular Research Group, Northern General Hospital, University of Sheffield, Sheffield, United Kingdom
                [4 ]Center for Human Genetics Research and Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee, United States
                [5 ]University of Wales College of Medicine, Cardiff, United Kingdom
                [6 ]Miller School of Medicine, University of Miami, Miami, Florida, United States
                University of Oxford, United Kingdom
                Author notes
                * To whom correspondence should be addressed. E-mail: simon.gregory@ 123456duke.edu
                Article
                06-PLGE-RA-0224R2 e139 plge-02-08-13
                10.1371/journal.pgen.0020139
                1557786
                16934006
                bc654fc5-e1d9-42dc-b543-108a56948649
                Copyright: © 2006 Connelly et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                : 9 June 2006
                : 20 July 2006
                Page count
                Pages: 9
                Categories
                Research Article
                Cardiology - Cardiac Surgery
                Genetics/Complex Traits
                Homo (Human)
                Custom metadata
                Connelly JJ, Wang T, Cox JE, Haynes C, Wang L, et al. (2006) GATA2 is associated with familial early-onset coronary artery disease. PLoS Genet 2(8): e139. DOI: 10.1371/journal.pgen.0020139

                Genetics
                Genetics

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