Rare variant analyses validate known ALS genes in a multi-ethnic population and identifies ANTXR2 as a candidate in PLS

• Published in: BMC genomics Vol. 25; no. 1; pp. 651 - 11
• Main Authors: Pottinger, Tess D, Motelow, Joshua E, Povysil, Gundula, Moreno, Cristiane A Martins, Ren, Zhong, Phatnani, Hemali, Aitman, Timothy J, Santoyo-Lopez, Javier, Mitsumoto, Hiroshi, Goldstein, David B, Harms, Matthew B
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 29-06-2024; BioMed Central; BMC
• Subjects: ALS; Amyotrophic lateral sclerosis; Amyotrophic Lateral Sclerosis - genetics; Analysis; Antisense oligonucleotides; Antisense therapy; Burden testing; Care and treatment; Diagnosis; Disease; Ethnicity - genetics; Family medical history; Female; Genealogy; Genes; Genetic aspects; Genetic diversity; Genetic Predisposition to Disease; Genetic variance; Genetic Variation; Genomes; Humans; Male; Medical treatment; Minority & ethnic groups; Motor neurons; Muscles; Mutation; Nervous system; Neurodegenerative diseases; Oligonucleotides; Peripheral lateral sclerosis; PLS; Primary lateral sclerosis; Rare-variant analyses; Signs and symptoms; Superoxide dismutase; United States; New York; United States > US; ALS; Burden testing; Amyotrophic lateral sclerosis; Rare-variant analyses; PLS; Peripheral lateral sclerosis
• ISSN: 1471-2164; 1471-2164
• DOI: 10.1186/s12864-024-10538-1

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease affecting over 300,000 people worldwide. It is characterized by the progressive decline of the nervous system that leads to the weakening of muscles which impacts physical function. Approximately, 15% of individuals diagnosed with ALS have a known genetic variant that contributes to their disease. As therapies that slow or prevent symptoms continue to develop, such as antisense oligonucleotides, it is important to discover novel genes that could be targets for treatment. Additionally, as cohorts continue to grow, performing analyses in ALS subtypes, such as primary lateral sclerosis (PLS), becomes possible due to an increase in power. These analyses could highlight novel pathways in disease manifestation.
Building on our previous discoveries using rare variant association analyses, we conducted rare variant burden testing on a substantially larger multi-ethnic cohort of 6,970 ALS patients, 166 PLS patients, and 22,524 controls. We used intolerant domain percentiles based on sub-region Residual Variation Intolerance Score (subRVIS) that have been described previously in conjunction with gene based collapsing approaches to conduct burden testing to identify genes that associate with ALS and PLS.
A gene based collapsing model showed significant associations with SOD1, TARDBP, and TBK1 (OR = 19.18, p = 3.67 × 10
; OR = 4.73, p = 2 × 10
; OR = 2.3, p = 7.49 × 10
, respectively). These genes have been previously associated with ALS. Additionally, a significant novel control enriched gene, ALKBH3 (p = 4.88 × 10
), was protective for ALS in this model. An intolerant domain-based collapsing model showed a significant improvement in identifying regions in TARDBP that associated with ALS (OR = 10.08, p = 3.62 × 10
). Our PLS protein truncating variant collapsing analysis demonstrated significant case enrichment in ANTXR2 (p = 8.38 × 10
).
In a large multi-ethnic cohort of 6,970 ALS patients, collapsing analyses validated known ALS genes and identified a novel potentially protective gene, ALKBH3. A first-ever analysis in 166 patients with PLS found a candidate association with loss-of-function mutations in ANTXR2.