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ABSTRACT: Background
Primary membranoproliferative GN, including complement 3 (C3) glomerulopathy, is a rare, untreatable kidney disease characterized by glomerular complement deposition. Complement gene mutations can cause familial C3 glomerulopathy, and studies have reported rare variants in complement genes in nonfamilial primary membranoproliferative GN.Methods
We analyzed whole-genome sequence data from 165 primary membranoproliferative GN cases and 10,250 individuals without the condition (controls) as part of the National Institutes of Health Research BioResource-Rare Diseases Study. We examined copy number, rare, and common variants.Results
Our analysis included 146 primary membranoproliferative GN cases and 6442 controls who were unrelated and of European ancestry. We observed no significant enrichment of rare variants in candidate genes (genes encoding components of the complement alternative pathway and other genes associated with the related disease atypical hemolytic uremic syndrome; 6.8% in cases versus 5.9% in controls) or exome-wide. However, a significant common variant locus was identified at 6p21.32 (rs35406322) (P=3.29×10-8; odds ratio [OR], 1.93; 95% confidence interval [95% CI], 1.53 to 2.44), overlapping the HLA locus. Imputation of HLA types mapped this signal to a haplotype incorporating DQA1*05:01, DQB1*02:01, and DRB1*03:01 (P=1.21×10-8; OR, 2.19; 95% CI, 1.66 to 2.89). This finding was replicated by analysis of HLA serotypes in 338 individuals with membranoproliferative GN and 15,614 individuals with nonimmune renal failure.Conclusions
We found that HLA type, but not rare complement gene variation, is associated with primary membranoproliferative GN. These findings challenge the paradigm of complement gene mutations typically causing primary membranoproliferative GN and implicate an underlying autoimmune mechanism in most cases.
SUBMITTER: Levine AP
PROVIDER: S-EPMC7003307 | biostudies-literature | 2020 Feb
REPOSITORIES: biostudies-literature
Levine Adam P AP Chan Melanie M Y MMY Sadeghi-Alavijeh Omid O Wong Edwin K S EKS Cook H Terence HT Ashford Sofie S Carss Keren K Christian Martin T MT Hall Matthew M Harris Claire Louise CL McAlinden Paul P Marchbank Kevin J KJ Marks Stephen D SD Maxwell Heather H Megy Karyn K Penkett Christopher J CJ Mozere Monika M Stirrups Kathleen E KE Tuna Salih S Wessels Julie J Whitehorn Deborah D Johnson Sally A SA Gale Daniel P DP
Journal of the American Society of Nephrology : JASN 20200109 2
<h4>Background</h4>Primary membranoproliferative GN, including complement 3 (C3) glomerulopathy, is a rare, untreatable kidney disease characterized by glomerular complement deposition. Complement gene mutations can cause familial C3 glomerulopathy, and studies have reported rare variants in complement genes in nonfamilial primary membranoproliferative GN.<h4>Methods</h4>We analyzed whole-genome sequence data from 165 primary membranoproliferative GN cases and 10,250 individuals without the cond ...[more]