Publikation
Genome-wide association study of eosinophilic granulomatosis with polyangiitis reveals genomic loci stratified by ANCA status
Wissenschaftlicher Artikel/Review - 12.11.2019
Lyons Paul A, Moosig Frank, Neumann Thomas, Ohlsson Sophie, Quickert Stefanie, Ramirez Giuseppe A, Rewerska Barbara, Schett Georg, Sinico Renato A, Szczeklik Wojciech, Tesar Vladimir, Vukcevic Damjan, European Vasculitis Genetics Consortium, Terrier Benjamin, Watts Richard A, Vaglio Augusto, Holle Julia U, Wallace Chris, Martorana Davide, Little Mark A, Peters James E, Alberici Federico, Liley James, Coulson Richard M R, Astle William, Baldini Chiara, Francesco Bonatti, Cid María C, Elding Heather, Emmi Giacomo, Epplen Jörg, Guillevin Loic, Jayne David R W, Jiang Tao, Gunnarsson Iva, Lamprecht Peter, Leslie Stephen, Smith Kenneth G C
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Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare inflammatory disease of unknown cause. 30% of patients have anti-neutrophil cytoplasmic antibodies (ANCA) specific for myeloperoxidase (MPO). Here, we describe a genome-wide association study in 676 EGPA cases and 6809 controls, that identifies 4 EGPA-associated loci through conventional case-control analysis, and 4 additional associations through a conditional false discovery rate approach. Many variants are also associated with asthma and six are associated with eosinophil count in the general population. Through Mendelian randomisation, we show that a primary tendency to eosinophilia contributes to EGPA susceptibility. Stratification by ANCA reveals that EGPA comprises two genetically and clinically distinct syndromes. MPO+ ANCA EGPA is an eosinophilic autoimmune disease sharing certain clinical features and an HLA-DQ association with MPO+ ANCA-associated vasculitis, while ANCA-negative EGPA may instead have a mucosal/barrier dysfunction origin. Four candidate genes are targets of therapies in development, supporting their exploration in EGPA.