Genome-wide linkage and association mapping identify susceptibility alleles in ABCC4 for Kawasaki disease

Division of Infectious Diseases, Genome Institute of Singapore, Singapore.
Journal of Medical Genetics (Impact Factor: 6.34). 07/2011; 48(7):467-72. DOI: 10.1136/jmg.2010.086611
Source: PubMed


Kawasaki disease (KD) is a self limited vasculitis in which host genetics plays a prominent role. To further the understanding of the role of host genetics in KD, a three-stage genetic study was conducted that began with a family linkage study and ultimately involved more than 3000 individuals to identify new genetic contributions to KD susceptibility.
A 26-family linkage study followed by fine mapping was performed in a cohort of 1284 KD subjects and their family members (total 3248 individuals). Suggestive evidence of disease linkage (logarithm of odds (LOD) ≥3.0, p<1.00×10(-4)) was found for five genomic locations (Chr 3q, 4q, 10p, 13q, 21q). Two of these loci (Chr 4q and Chr 13q) overlapped with validated findings from a recent KD genome-wide association study. Fine mapping analysis revealed three single nucleotide polymorphisms (SNPs) in ATP-binding cassette, subfamily C, member 4 (ABCC4) underlying the Chr 13q linkage peak showing evidence of association to KD (lowest p=8.82×10(-5); combined OR 2.00, 95% CI 1.41 to 2.83). ABCC4 is a multifunctional cyclic nucleotide transporter that stimulates the migratory capacity of dendritic cells. It is also a mediator of prostaglandin efflux from human cells and is inhibited by non-steroidal anti-inflammatory medications such as aspirin.
These genetic data suggest that ABCC4 could play a fundamental role in KD pathogenesis with effects on immune activation and vascular response to injury.

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    • "By contrast with the candidate gene approach, genome-wide association studies (GWAS) have the advantage of identifying disease-associated genes without requiring prior knowledge of the mechanisms involved.32 A number of GWAS of KD have been published so far.33–39 From these studies, several single nucleotide polymorphisms (SNPs) associated with susceptibility to KD, including ITPKC, ABCC4 and FCGR2A, CD40 and a gene region near FAM167A-BLK (table 1). "
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