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      Rare Variants in MYD88, IRAK4 and IKBKG and Susceptibility to Invasive Pneumococcal Disease: A Population-Based Case-Control Study

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          Abstract

          Although rare variants within the Toll-like receptor signalling pathway genes have been found to underlie human primary immunodeficiencies associated with selective predisposition to invasive pneumococcal disease (IPD), the contribution of variants in these genes to IPD susceptibility at the population level remains unknown. Complete re-sequencing of IRAK4, MYD88 and IKBKG genes was undertaken in 164 IPD cases from the UK and 164 geographically-matched population-based controls. 233 single-nucleotide variants (SNVs) were identified, of which ten were in coding regions. Four rare coding variants were predicted to be deleterious, two variants in MYD88 and two in IRAK4. The predicted deleterious variants in MYD88 were observed as two heterozygote cases but not seen in controls. Frequencies of predicted deleterious IRAK4 SNVs were the same in cases and controls. Our findings suggest that rare, functional variants in MYD88, IRAK4 or IKBKG do not significantly contribute to IPD susceptibility in adults at the population level.

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          Most cited references20

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          Deep resequencing of GWAS loci identifies independent rare variants associated with inflammatory bowel disease

          More than a thousand disease susceptibility loci have been identified via genome-wide association studies (GWAS) of common variants; however, the specific genes and full allelic spectrum of causal variants underlying these findings generally remain to be defined. We utilize pooled next-generation sequencing to study 56 genes in regions associated to Crohn’s Disease in 350 cases and 350 controls. Follow up genotyping of 70 rare and low-frequency protein-altering variants (MAF ~ .001-.05) in nine independent case-control series (16054 CD patients, 12153 UC patients, 17575 healthy controls) identifies four additional independent risk factors in NOD2, two additional protective variants in IL23R, a highly significant association to a novel, protective splice variant in CARD9 (p < 1e-16, OR ~ 0.29), as well as additional associations to coding variants in IL18RAP, CUL2, C1orf106, PTPN22 and MUC19. We extend the results of successful GWAS by providing novel, rare, and likely functional variants that will empower functional experiments and predictive models.
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            Pyogenic bacterial infections in humans with MyD88 deficiency.

            MyD88 is a key downstream adapter for most Toll-like receptors (TLRs) and interleukin-1 receptors (IL-1Rs). MyD88 deficiency in mice leads to susceptibility to a broad range of pathogens in experimental settings of infection. We describe a distinct situation in a natural setting of human infection. Nine children with autosomal recessive MyD88 deficiency suffered from life-threatening, often recurrent pyogenic bacterial infections, including invasive pneumococcal disease. However, these patients were otherwise healthy, with normal resistance to other microbes. Their clinical status improved with age, but not due to any cellular leakiness in MyD88 deficiency. The MyD88-dependent TLRs and IL-1Rs are therefore essential for protective immunity to a small number of pyogenic bacteria, but redundant for host defense to most natural infections.
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              Human genetic susceptibility to infectious disease.

              Recent genome-wide studies have reported novel associations between common polymorphisms and susceptibility to many major infectious diseases in humans. In parallel, an increasing number of rare mutations underlying susceptibility to specific phenotypes of infectious disease have been described. Together, these developments have highlighted a key role for host genetic variation in determining the susceptibility to infectious disease. They have also provided insights into the genetic architecture of infectious disease susceptibility and identified immune molecules and pathways that are directly relevant to the human host defence.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                17 April 2015
                2015
                : 10
                : 4
                : e0123532
                Affiliations
                [1 ]Wellcome Trust Centre for Human Genetics, University of Oxford, United Kingdom
                [2 ]Queensland Institute of Medical Research, Brisbane, Australia
                [3 ]Centenary Institute and Sydney Medical School, University of Sydney, Sydney Australia
                [4 ]Department of Microbiology, John Radcliffe Hospital, Oxford, United Kingdom
                [5 ]Oxford Centre for Respiratory Medicine, Churchill Hospital Site, Oxford University Hospitals, Oxford, United Kingdom
                University of Cambridge, UNITED KINGDOM
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: MKE AVSH SJC. Performed the experiments: MKE. Analyzed the data: MKE KSE. Contributed reagents/materials/analysis tools: DWC AVSH SJC. Wrote the paper: MKE KSE AR AVSH SJC.

                Article
                PONE-D-14-47270
                10.1371/journal.pone.0123532
                4401548
                25886387
                f52c14e6-64c8-466b-b7ea-d8246977c7c0
                Copyright @ 2015

                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
                : 29 October 2014
                : 19 February 2015
                Page count
                Figures: 0, Tables: 2, Pages: 9
                Funding
                This study was supported by the Medical Research Council, UK ( www.mrc.ac.uk)and the Wellcome Trust Centre for Human Genetics core grant 090532/Z/09/Z ( www.well.ox.ac.uk). SJC is supported by the NIHR Biomedical Research Centre, Oxford ( oxcam.gpp.nih.gov). MKE is supported by an NHMRC Training Fellowship GNT0552496, Australia ( www.nhmrc.gov.au). We acknowledge the use of DNA from The UK Blood Services collection of Common Controls (UKBS collection), funded by the Wellcome Trust grant 076113/C/04/Z, by the Juvenile Diabetes Research Foundation grant WT061858 ( www.jdrf.org.uk), and by the National Institute of Health Research of England ( www.nihr.ac.uk). The collection was established as part of the Wellcome Trust Case-Control Consortium. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Custom metadata
                The supplementary data table 1 provided as a Supporting Information file contains the output with all variants identified from the syzygy algorithm for IKBKG, IRAK4 and MYD88.

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