The role of genetics in the pathogenesis and diagnosis of type 1 Von Willebrand disease
CURRENT OPINION IN HEMATOLOGY
Authors: Flood, Veronica H.; Garcia, Jessica; Haberichter, Sandra L.
Abstract
Purpose of review Von Willebrand disease (VWD) is a common bleeding disorder, but diagnosis of VWD is challenging, particularly with type 1 VWD. Although most clinicians use specific tests of von Willebrand factor (VWF) activity to classify patients with VWD, genetic testing for VWF defects is another potential method of diagnosis. Recent findings Studies of patients with type 1 VWD report consistently that many, but not all, study participants have VWF gene defects. Certain populations, including those with VWF levels less than 30 IU/dl and those with clearance defects, are more likely to have a VWF sequence variant. In addition, a number of loci outside the VWF gene have been shown to affect VWF levels, including ABO, CLEC4M, STXBP5, and STAB2. Genetic defects in VWF are common, but not all defects lead to disease. Type 1 VWD in particular does not always have an associated VWF sequence variant. New data stemming from genome-wide association studies on modifier genes suggest that the etiology of type 1 VWD is multifactorial.
Genetics of Venous Thrombosis: Insights from a New Genome Wide Association Study
PLOS ONE
Authors: Germain, Marine; Saut, Noemie; Greliche, Nicolas; Dina, Christian; Lambert, Jean-Charles; Perret, Claire; Cohen, William; Oudot-Mellakh, Tiphaine; Antoni, Guillemette; Alessi, Marie-Christine; Zelenika, Diana; Cambien, Francois; Tiret, Laurence; Bertrand, Marion; Dupuy, Anne-Marie; Letenneur, Luc; Lathrop, Mark; Emmerich, Joseph; Amouyel, Philippe; Tregouet, David-Alexandre; Morange, Pierre-Emmanuel
Abstract
Background: Venous Thrombosis (VT) is a common multifactorial disease associated with a major public health burden. Genetics factors are known to contribute to the susceptibility of the disease but how many genes are involved and their contribution to VT risk still remain obscure. We aimed to identify genetic variants associated with VT risk. Methodology/Principal Findings: We conducted a genome-wide association study (GWAS) based on 551,141 SNPs genotyped in 1,542 cases and 1,110 controls. Twelve SNPs reached the genome-wide significance level of 2.0x10(-8) and encompassed four known VT-associated loci, ABO, F5, F11 and FGG. By means of haplotype analyses, we also provided novel arguments in favor of a role of HIVEP1, PROCR and STAB2, three loci recently hypothesized to participate in the susceptibility to VT. However, no novel VT-associated loci came out of our GWAS. Using a recently proposed statistical methodology, we also showed that common variants could explain about 35% of the genetic variance underlying VT susceptibility among which 3% could be attributable to the main identified VT loci. This analysis additionally suggested that the common variants left to be identified are not uniformly distributed across the genome and that chromosome 20, itself, could contribute to similar to 7% of the total genetic variance. Conclusions/Significance: This study might also provide a valuable source of information to expand our understanding of biological mechanisms regulating quantitative biomarkers for VT.