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10. A genomic approach to therapeutic target validation identifies a glucose-lowering GLP1R variant protective for coronary heart disease

Author

Scott, RA, Freitag, DF, Li, L, Chu, AY, Surendran, P, Young, R, Grarup, N, Stancáková, A, Chen, Y, Varga, TV, Yaghootkar, H, Luan, J, Zhao, JH, Willems, SM, Wessel, J, Wang, S, Maruthur, N, Michailidou, K, Pirie, A, Van Der Lee, SJ, Gillson, C, Al Olama, AA, Amouyel, P, Arriola, L, Arveiler, D, Aviles-Olmos, I, Balkau, B, Barricarte, A, Barroso, I, Garcia, SB, Bis, JC, Blankenberg, S, Boehnke, M, Boeing, H, Boerwinkle, E, Borecki, IB, Bork-Jensen, J, Bowden, S, Caldas, C, Caslake, M, Cupples, LA, Cruchaga, C, Czajkowski, J, Den Hoed, M, Dunn, JA, Earl, HM, Ehret, GB, Ferrannini, E, Ferrieres, J, Foltynie, T, Ford, I, Forouhi, NG, Gianfagna, F, Gonzalez, C, Grioni, S, Hiller, L, Jansson, JH, Jørgensen, ME, Jukema, JW, Kaaks, R, Kee, F, Kerrison, ND, Key, TJ, Kontto, J, Kote-Jarai, Z, Kraja, AT, Kuulasmaa, K, Kuusisto, J, Linneberg, A, Liu, C, Marenne, G, Mohlke, KL, Morris, AP, Muir, K, Müller-Nurasyid, M, Munroe, PB, and Navarro, C

Abstract

Copyright 2016 by the American Association for the Advancement of Science; all rights reserved. Regulatory authorities have indicated that new drugs to treat type 2 diabetes (T2D) should not be associated with an unacceptable increase in cardiovascular risk. Human genetics may be able to guide development of antidiabetic therapies by predicting cardiovascular and other health endpoints. We therefore investigated the association of variants in six genes that encode drug targets for obesity or T2D with a range of metabolic traits in up to 11, 806 individuals by targeted exome sequencing and follow-up in 39, 979 individuals by targeted genotyping, with additional in silico follow-up in consortia. We used these data to first compare associations of variants in genes encoding drug targets with the effects of pharmacological manipulation of those targets in clinical trials. We then tested the association of those variants with disease outcomes, including coronary heart disease, to predict cardiovascular safety of these agents. A low-frequency missense variant (Ala316Thr; rs10305492) in the gene encoding glucagon-like peptide-1 receptor (GLP1R), the target of GLP1R agonists, was associated with lower fasting glucose and T2D risk, consistent with GLP1R agonist therapies. The minor allele was also associated with protection against heart disease, thus providing evidence that GLP1R agonists are not likely to be associated with an unacceptable increase in cardiovascular risk. Our results provide an encouraging signal that these agents may be associated with benefit, a question currently being addressed in randomized controlled trials. Genetic variants associated with metabolic traits and multiple disease outcomes can be used to validate therapeutic targets at an early stage in the drug development process.

Published
2016

13. Replication of LDL GWAs hits in PROSPER/PHASE as validation for future (pharmaco)genetic analyses

Author

Trompet, S., Craen, A.J.M. de, Postmus, I., Ford, I., Sattar, N., Caslake, M., Stott, D.J., Buckley, B.M., Sacks, F., Devlin, J.J., Slagboom, P.E., Westendorp, R.G.J., Jukema, J.W., and PROSPER Study Grp

Subjects
lcsh:Internal medicine, lcsh:QH426-470, Single-nucleotide polymorphism, Genome-wide association study, 030204 cardiovascular system & hematology, Biology, Population stratification, Polymorphism, Single Nucleotide, Pharmacogenetic Study, Placebos, 03 medical and health sciences, 0302 clinical medicine, Genetic variation, Genetics, Humans, Genetics(clinical), Prospective Studies, International HapMap Project, lcsh:RC31-1245, Genetics (clinical), Aged, Pravastatin, 030304 developmental biology, 0303 health sciences, 3. Good health, Lipoproteins, LDL, lcsh:Genetics, Pharmacogenetics, lipids (amino acids, peptides, and proteins), Hydroxymethylglutaryl-CoA Reductase Inhibitors, Imputation (genetics), Genome-Wide Association Study, Research Article
Abstract

Background The PHArmacogenetic study of Statins in the Elderly at risk (PHASE) is a genome wide association study in the PROspective Study of Pravastatin in the Elderly at risk for vascular disease (PROSPER) that investigates the genetic variation responsible for the individual variation in drug response to pravastatin. Statins lower LDL-cholesterol in general by 30%, however not in all subjects. Moreover, clinical response is highly variable and adverse effects occur in a minority of patients. In this report we first describe the rationale of the PROSPER/PHASE project and second show that the PROSPER/PHASE study can be used to study pharmacogenetics in the elderly. Methods The genome wide association study (GWAS) was conducted using the Illumina 660K-Quad beadchips following manufacturer's instructions. After a stringent quality control 557,192 SNPs in 5,244 subjects were available for analysis. To maximize the availability of genetic data and coverage of the genome, imputation up to 2.5 million autosomal CEPH HapMap SNPs was performed with MACH imputation software. The GWAS for LDL-cholesterol is assessed with an additive linear regression model in PROBABEL software, adjusted for age, sex, and country of origin to account for population stratification. Results Forty-two SNPs reached the GWAS significant threshold of p = 5.0e-08 in 5 genomic loci (APOE/APOC1; LDLR; FADS2/FEN1; HMGCR; PSRC1/CELSR5). The top SNP (rs445925, chromosome 19) with a p-value of p = 2.8e-30 is located within the APOC1 gene and near the APOE gene. The second top SNP (rs6511720, chromosome 19) with a p-value of p = 5.22e-15 is located within the LDLR gene. All 5 genomic loci were previously associated with LDL-cholesterol levels, no novel loci were identified. Replication in WOSCOPS and CARE confirmed our results. Conclusion With the GWAS in the PROSPER/PHASE study we confirm the previously found genetic associations with LDL-cholesterol levels. With this proof-of-principle study we show that the PROSPER/PHASE study can be used to investigate genetic associations in a similar way to population based studies. The next step of the PROSPER/PHASE study is to identify the genetic variation responsible for the variation in LDL-cholesterol lowering in response to statin treatment in collaboration with other large trials.

Published
2011

14. Replication of LDL SWAs hits in PROSPER/PHASE as validation for future (pharmaco)genetic analyses

Author

Trompet, S., de Craen, A.J.M., Postmus, I., Ford, I., Sattar, N., Caslake, M., Stott, D.J., Buckley, B.M., Sacks, F., Devlin, J.J., Slagboom, P.E., Westendorp, R.G.J., and Jukema, J.W.

Subjects
lipids (amino acids, peptides, and proteins)
Abstract

Background: The PHArmacogenetic study of Statins in the Elderly at risk (PHASE) is a genome wide association study in the PROspective Study of Pravastatin in the Elderly at risk for vascular disease (PROSPER) that investigates the genetic variation responsible for the individual variation in drug response to pravastatin. Statins lower LDL-cholesterol in general by 30%, however not in all subjects. Moreover, clinical response is highly variable and adverse effects occur in a minority of patients. In this report we first describe the rationale of the PROSPER/PHASE project and second show that the PROSPER/PHASE study can be used to study pharmacogenetics in the elderly.\ud \ud Methods: The genome wide association study (GWAS) was conducted using the Illumina 660K-Quad beadchips following manufacturer's instructions. After a stringent quality control 557,192 SNPs in 5,244 subjects were available for analysis. To maximize the availability of genetic data and coverage of the genome, imputation up to 2.5 million autosomal CEPH HapMap SNPs was performed with MACH imputation software. The GWAS for LDL-cholesterol is assessed with an additive linear regression model in PROBABEL software, adjusted for age, sex, and country of origin to account for population stratification.\ud \ud Results: Forty-two SNPs reached the GWAS significant threshold of p = 5.0e-08 in 5 genomic loci (APOE/APOC1; LDLR; FADS2/FEN1; HMGCR; PSRC1/CELSR5). The top SNP (rs445925, chromosome 19) with a p-value of p = 2.8e-30 is located within the APOC1 gene and near the APOE gene. The second top SNP (rs6511720, chromosome 19) with a p-value of p = 5.22e-15 is located within the LDLR gene. All 5 genomic loci were previously associated with LDL-cholesterol levels, no novel loci were identified. Replication in WOSCOPS and CARE confirmed our results.\ud \ud Conclusion: With the GWAS in the PROSPER/PHASE study we confirm the previously found genetic associations with LDL-cholesterol levels. With this proof-of-principle study we show that the PROSPER/PHASE study can be used to investigate genetic associations in a similar way to population based studies. The next step of the PROSPER/PHASE study is to identify the genetic variation responsible for the variation in LDL-cholesterol lowering in response to statin treatment in collaboration with other large trials.

Published
2011

46. Probucol reduces plasma lipid peroxides in man

Author

PATERSON, J, primary, RUMLEY, A, additional, OLDROYD, K, additional, TAIT, G, additional, SMELLIE, W, additional, GRIFFIN, B, additional, CASLAKE, M, additional, PACKARD, C, additional, SHEPHERD, J, additional, and LORIMER, A, additional

Published
1991
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47. Acute suppression of VLDL1 secretion rate by insulin is associated with hepatic fat content and insulin resistance.

Author

Adiels, M., Westerbacka, J., Soro-Paavonen, A., Häkkinen, A., Vehkavaara, S., Caslake, M., Packard, C., Olofsson, S., Yki-Järvinen, H., Taskinen, M., and Borén, J.

Abstract

Overproduction of VLDL1 seems to be the central pathophysiological feature of the dyslipidaemia associated with type 2 diabetes. We explored the relationship between liver fat and suppression of VLDL1 production by insulin in participants with a broad range of liver fat content. A multicompartmental model was used to determine the kinetic parameters of apolipoprotein B and TG in VLDL1 and VLDL2 after a bolus of [2H3]leucine and [2H5]glycerol during a hyperinsulinaemic–euglycaemic clamp in 20 male participants: eight with type 2 diabetes and 12 control volunteers. The participants were divided into two groups with low or high liver fat. All participants with diabetes were in the high liver-fat group. The results showed a rapid drop in VLDL1-apolipoprotein B and -triacylglycerol secretion in participants with low liver fat during the insulin infusion. In contrast, participants with high liver fat showed no significant change in VLDL1 secretion. The VLDL1 suppression following insulin infusion correlated with the suppression of NEFA, and the ability of insulin to suppress the plasma NEFA was impaired in participants with high liver fat. A novel finding was an inverse response between VLDL1 and VLDL2 secretion in participants with low liver fat: VLDL1 secretion decreased acutely after insulin infusion whereas VLDL2 secretion increased. Insulin downregulates VLDL1 secretion and increases VLDL2 secretion in participants with low liver fat but fails to suppress VLDL1 secretion in participants with high liver fat, resulting in overproduction of VLDL1. Thus, liver fat is associated with lack of VLDL1 suppression in response to insulin. [ABSTRACT FROM AUTHOR]

Published
2007
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50. Protease inhibitor related type III hyperlipoproteinaemia is common and not associated with apolipoprotein-E E2/E2 phenotype.

Author

Shahmanesh, Mohsen, Jaleel, Henna, DeSilva, Yassus, Ross, Jonathan D. C., Caslake, Muriel, Cramb, Robert, Shahmanesh, M, Jaleel, H, DeSilva, Y, Ross, J D, Caslake, M, and Cramb, R

Subjects
HYPERLIPOPROTEINEMIA, PROTEASE inhibitors, APOLIPOPROTEIN E, PHENOTYPES, HIV-positive persons, TRIGLYCERIDES, ELECTROPHORESIS
Abstract

Objective: To determine the prevalence of type III hyperlipoproteinaemia in a cohort of HIV infected patients taking protease inhibitors and its correlation with the apolipoprotein-E2 isoform.Design: Cross sectional study of 57 consecutive HIV infected subjects taking protease inhibitor therapy for a median of 12.5 (1-29) months, seen in an outpatient HIV clinic. Controls were 17 patients on non-nucleoside reverse transcriptor inhibitor therapy (NNRTI) for 9 (1-19) months and 50 antiviral naive patients.Methods: Fasting cholesterol, triglyceride, HDL cholesterol, lipoprotein (a), and glucose were measured. Lipoprotein electrophoresis was performed on patients with a cholesterol >6.5 mmol/l and a triglyceride concentration of >4.5 mmol/l. Apolipoprotein-E phenotype was determined in serum.Results: Dyslipidaemia was found in 43 (75%) PI treated patients-37 with triglyceride >2.3 mmol/l, 30 with cholesterol >6.5 mmol/l, and nine with HDL cholesterol <0.9 mmol/l. 38% had a lipoprotein (a) >300 mg/l. 11 patients (19.3%) had a type III hyperlipoproteinaemia pattern. Only one was homozygous for the E2 phenotype and none had clinical diabetes. An additional patient had a serum lipid profile compatible with type III hyperlipoproteinaemia and an E3/E2 phenotype in whom electrophoresis was not carried out before treatment. Six (35%) of the NNRTI and 16 (32%) of the antiviral naive patients had dyslipidaemia. 18 (31.6%) of the PI and none of the control patients had a cholesterol and/or triglyceride >8 mmol/l.Conclusion: Type III hyperlipoproteinaemia is common in this group of patients and need not be associated with the apolipoprotein-E2/E2 isoform. HIV protease inhibitors may interfere with lipoprotein receptor related protein. [ABSTRACT FROM AUTHOR]

Published
2001
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