Genetic Analysis of Corneal Dystrophies

Corneal disease is a major cause of global blindness accounting for around 2% of severe visual impairment in the UK. Corneal dystrophies are a group of rare, bilateral conditions with a genetic basis. In conjunction with the British Ophthalmic Surveillance Unit (BOSU), a national incidence for new cases of corneal dystrophy in patients aged below 40 years was identified. 73 cases were reported to BOSU with 27 cases (42%) returned by questionnaire. There was a positive family history in 48% of cases. A minimum UK incidence for new cases per annum of 6.7 cases per 10 000 000 population was calculated. To investigate the link between Congenital Hereditary Endothelial Dystrophy (CHED), Harboyan syndrome and Fuchs Endothelial Corneal Dystrophy (FECD), a longitudinal observational study was performed. CHED and Harboyan syndrome (CHED with sensorineural hearing loss) are both caused by biallelic mutations in SLC4A11. All four of the CHED patients examined had varying degrees of hearing loss at high frequencies, suggesting that CHED and Harboyan syndrome are the same condition at different developmental stages. In addition, two of the four parents of CHED patients examined had guttata, suggesting that the parents are at risk of developing FECD. FECD is a common, complex corneal endothelial disease. The relative contributions of the TCF4 SNP rs613872, the intronic TCF4 CTG18.1 trinucleotide expansion and LOXHD1 variants in a UK Caucasian FECD cohort ethnically-matched controls were compared. The results of segregation of the CTG18.1 expansion and whole exome sequencing in three local FECD families indicated that the CTG18.1 expansion was causative for the FECD in two of the three families. This indicated that the TCF4 expansion is a major contributor to the pathogenesis of FECD. Whole exome sequencing in the third family revealed some good gene candidates, which were considered for further screening in the FECD cohort

A multi-ethnic genome-wide association study implicates collagen matrix integrity and cell differentiation pathways in keratoconus

Keratoconus is characterised by reduced rigidity of the cornea with distortion and focal thinning that causes blurred vision, however, the pathogenetic mechanisms are unknown. It can lead to severe visual morbidity in children and young adults and is a common indication for corneal transplantation worldwide. Here we report the first large scale genome-wide association study of keratoconus including 4,669 cases and 116,547 controls. We have identified significant association with 36 genomic loci that, for the first time, implicate both dysregulation of corneal collagen matrix integrity and cell differentiation pathways as primary disease-causing mechanisms. The results also suggest pleiotropy, with some disease mechanisms shared with other corneal diseases, such as Fuchs endothelial corneal dystrophy. The common variants associated with keratoconus explain 12.5% of the genetic variance, which shows potential for the future development of a diagnostic test to detect susceptibility to disease

Identification of 12 new susceptibility loci for different histotypes of epithelial ovarian cancer.

To identify common alleles associated with different histotypes of epithelial ovarian cancer (EOC), we pooled data from multiple genome-wide genotyping projects totaling 25,509 EOC cases and 40,941 controls. We identified nine new susceptibility loci for different EOC histotypes: six for serous EOC histotypes (3q28, 4q32.3, 8q21.11, 10q24.33, 18q11.2 and 22q12.1), two for mucinous EOC (3q22.3 and 9q31.1) and one for endometrioid EOC (5q12.3). We then performed meta-analysis on the results for high-grade serous ovarian cancer with the results from analysis of 31,448 BRCA1 and BRCA2 mutation carriers, including 3,887 mutation carriers with EOC. This identified three additional susceptibility loci at 2q13, 8q24.1 and 12q24.31. Integrated analyses of genes and regulatory biofeatures at each locus predicted candidate susceptibility genes, including OBFC1, a new candidate susceptibility gene for low-grade and borderline serous EOC

Mutational Analysis of MIR184 in Sporadic Keratoconus and Myopia

Author version made available in accordance with the publisher's policy.A mutation miR-184(+57C>T) in the seed region of miR-184 (encoded by MIR184 [MIM*613146]) results in familial severe keratoconus combined with early-onset anterior polar cataract and endothelial dystrophy, iris hypoplasia, congenital cataract, and stromal thinning (EDICT) syndrome (MIM#614303). In order to investigate the phenotypic spectrum resulting from MIR184 mutation, MIR184 was sequenced in a keratoconus cohort of mixed ethnicity and a Chinese axial myopia cohort. Sequencing of MIR184 was performed in 780 unrelated keratoconus patients and 96 unrelated Han southern Chinese subjects with axial myopia. Effects of identified mutations on RNA secondary structure were predicted computationally using mFold and RNAFold algorithms. MIR184 amplicons from patients harboring mutations were cloned and transfected into human embryonic kidney 293T (HEK293T) cells, and mature mutant miR-184 expression was analyzed by stem-loop real-time quantitative PCR (RT-qPCR). Two novel heterozygous substitution mutations in MIR184 were identified in the two patients with isolated keratoconus: miR-184(+8C>A) and miR-184(+3A>G). Computational modeling predicted that these mutations would alter the miR-184 stem-loop stability and secondary structure. Ex vivo miR-184 expression analysis demonstrated that miR-184(+8C>A) almost completely repressed the expression of miR-184 (P = 0.022), and miR-184(+3A>G) reduced the expression of miR-184 by approximately 40% (P = 0.002). There was no significant association of rs41280052, which lies within the stem-loop of miR-184, with keratoconus. No MIR184 mutations were detected in the axial myopia cohort. Two novel heterozygous substitution mutations in MIR184 were identified in two patients with isolated keratoconus: miR-184(+8C>A) and miR-184(+3A>G). Mutations in MIR184 are a rare cause of keratoconus and were found in 2 of 780 (0.25%) cases.Supported by Fight for Sight (United Kingdom; JL, CEW); The Research and Development Office, Northern Ireland (RRG Grant 4.46; CEW); Biotechnology and Biological Sciences Research Council, United Kingdom (Grant BB/H005498/1; JG-F, DAS); National Health and Medical Research Council of Australia (KPB, JEC); ALCON India (GG, MD, PS); and The Aravind Eye Care System (GG, MD, PS). JL is a Fight for Sight PhD student

Genetic Heterogeneity for Recessively Inherited Congenital Cataract Microcornea with Corneal Opacity

The authors describe a new ocular phenotype, congenital cataract microcornea with corneal opacity, which is recessively inherited. This phenotype is genetically heterogeneous in the Pakistani population

A multi-ethnic genome-wide association study implicates collagen matrix integrity and cell differentiation pathways in keratoconus

Keratoconus is characterised by reduced rigidity of the cornea with distortion and focal thinning that causes blurred vision, however, the pathogenetic mechanisms are unknown. It can lead to severe visual morbidity in children and young adults and is a common indication for corneal transplantation worldwide. Here we report the first large scale genome-wide association study of keratoconus including 4,669 cases and 116,547 controls. We have identified significant association with 36 genomic loci that, for the first time, implicate both dysregulation of corneal collagen matrix integrity and cell differentiation pathways as primary disease-causing mechanisms. The results also suggest pleiotropy, with some disease mechanisms shared with other corneal diseases, such as Fuchs endothelial corneal dystrophy. The common variants associated with keratoconus explain 12.5% of the genetic variance, which shows potential for the future development of a diagnostic test to detect susceptibility to disease. Alison Hardcastle et al. report a genome-wide meta-analysis of keratoconus, a condition affecting the cornea that causes blurred vision and often leads to blindness. They identify 36 genomic regions associated with keratoconus, 31 of which are novel, and show that the genes in these regions implicate genetic pathways involved in collagen matrix integrity and cell differentiation.</p

A multi-ethnic genome-wide association study implicates collagen matrix integrity and cell differentiation pathways in keratoconus.

Keratoconus is characterised by reduced rigidity of the cornea with distortion and focal thinning that causes blurred vision, however, the pathogenetic mechanisms are unknown. It can lead to severe visual morbidity in children and young adults and is a common indication for corneal transplantation worldwide. Here we report the first large scale genome-wide association study of keratoconus including 4,669 cases and 116,547 controls. We have identified significant association with 36 genomic loci that, for the first time, implicate both dysregulation of corneal collagen matrix integrity and cell differentiation pathways as primary disease-causing mechanisms. The results also suggest pleiotropy, with some disease mechanisms shared with other corneal diseases, such as Fuchs endothelial corneal dystrophy. The common variants associated with keratoconus explain 12.5% of the genetic variance, which shows potential for the future development of a diagnostic test to detect susceptibility to disease