1. Rare protein-altering variants in ANGPTL7 lower intraocular pressure and protect against glaucoma.
- Author
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Tanigawa Y, Wainberg M, Karjalainen J, Kiiskinen T, Venkataraman G, Lemmelä S, Turunen JA, Graham RR, Havulinna AS, Perola M, Palotie A, Daly MJ, and Rivas MA
- Subjects
- Adult, Aged, Aged, 80 and over, Angiopoietin-Like Protein 7, Biological Specimen Banks statistics & numerical data, Case-Control Studies, Cohort Studies, Female, Finland epidemiology, Gene Frequency, Genetic Predisposition to Disease, Genetics, Population, Genome-Wide Association Study, Glaucoma epidemiology, Humans, Loss of Function Mutation genetics, Male, Middle Aged, Mutation, Missense, United Kingdom epidemiology, Angiopoietin-like Proteins genetics, Glaucoma genetics, Glaucoma prevention & control, Intraocular Pressure genetics, Polymorphism, Single Nucleotide
- Abstract
Protein-altering variants that are protective against human disease provide in vivo validation of therapeutic targets. Here we use genotyping data from UK Biobank (n = 337,151 unrelated White British individuals) and FinnGen (n = 176,899) to conduct a search for protein-altering variants conferring lower intraocular pressure (IOP) and protection against glaucoma. Through rare protein-altering variant association analysis, we find a missense variant in ANGPTL7 in UK Biobank (rs28991009, p.Gln175His, MAF = 0.8%, genotyped in 82,253 individuals with measured IOP and an independent set of 4,238 glaucoma patients and 250,660 controls) that significantly lowers IOP (β = -0.53 and -0.67 mmHg for heterozygotes, -3.40 and -2.37 mmHg for homozygotes, P = 5.96 x 10-9 and 1.07 x 10-13 for corneal compensated and Goldman-correlated IOP, respectively) and is associated with 34% reduced risk of glaucoma (P = 0.0062). In FinnGen, we identify an ANGPTL7 missense variant at a greater than 50-fold increased frequency in Finland compared with other populations (rs147660927, p.Arg220Cys, MAF Finland = 4.3%), which was genotyped in 6,537 glaucoma patients and 170,362 controls and is associated with a 29% lower glaucoma risk (P = 1.9 x 10-12 for all glaucoma types and also protection against its subtypes including exfoliation, primary open-angle, and primary angle-closure). We further find three rarer variants in UK Biobank, including a protein-truncating variant, which confer a strong composite lowering of IOP (P = 0.0012 and 0.24 for Goldman-correlated and corneal compensated IOP, respectively), suggesting the protective mechanism likely resides in the loss of interaction or function. Our results support inhibition or down-regulation of ANGPTL7 as a therapeutic strategy for glaucoma., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: Robert Graham is an employee of MazeTx. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
- Published
- 2020
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