Genetic Predisposition to Sarcoidosis

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Questions and Answers

Which of the following phenotypes is associated with the TLR-4 gene?

  • Advanced pulmonary sarcoidosis (scadding stage II-IV)
  • Progressive pulmonary sarcoidosis
  • European (German) (correct)
  • European (Dutch)

Which gene is associated with the phenotype of Asian (Chinese) individuals?

  • TLR-4
  • HLA-DRB1*07
  • ANXA11
  • PRSS3 (correct)

What is the main challenge in studying the association between phenotypes and genes?

  • The rarity of certain phenotypes (correct)
  • The lack of available genetic data
  • The complex interactions between genes and environmental factors
  • The difficulty in defining specific phenotypes

Which of the following genes is linked to Advanced pulmonary sarcoidosis (scadding stage II-IV)?

<p>HLA-DRB1*1101 (D)</p> Signup and view all the answers

Which of the following statements is TRUE about the genetic risks of sarcoidosis phenotypes?

<p>Research on genetic risks of sarcoidosis phenotypes is relatively recent (B)</p> Signup and view all the answers

How many SNPs on protein-coding genes were analyzed in the study?

<p>135 (D)</p> Signup and view all the answers

Which genes were found to have missense mutations associated with sarcoidosis in this study?

<p>PRSS3 and CNN2 (A)</p> Signup and view all the answers

Which of the following was NOT mentioned as a limitation of this study?

<p>Use of non-specific markers (C)</p> Signup and view all the answers

The study mentioned that several HLA variants were found in certain populations, which of the following is most likely a population in which the HLA-DQB1*0201 variant was found?

<p>Czech (A)</p> Signup and view all the answers

Which of these genes has associations with sarcoidosis that have been previously published, as indicated in the provided text?

<p>BTNL2 (C)</p> Signup and view all the answers

What initial approach is typically used to study genetic risk factors for a disease like sarcoidosis?

<p>Evaluating genetic risk among relatives through heritability and linkage studies. (A)</p> Signup and view all the answers

Which method is NOT mentioned as a way to identify genetic variants?

<p>Microarray analysis (D)</p> Signup and view all the answers

What does familial clustering of sarcoidosis cases suggest?

<p>It suggests a potential genetic predisposition to the disease. (B)</p> Signup and view all the answers

What do transcriptomic studies contribute to the understanding of sarcoidosis?

<p>They explain the functional impact of genetic variants through their effect on gene expression. (C)</p> Signup and view all the answers

What is the increased risk of sarcoidosis observed in siblings of affected individuals?

<p>A fivefold increased risk. (A)</p> Signup and view all the answers

Aside from genetic factors, what other kind of factor can contribute to familial aggregation of sarcoidosis?

<p>Shared environmental factors. (B)</p> Signup and view all the answers

What is the implication of finding an increased risk of sarcoidosis in first-degree relatives?

<p>It suggests a familial aggregation of the disease and a potential genetic predisposition. (C)</p> Signup and view all the answers

Which of the following best describes the evidence for a genetic component in sarcoidosis, according to the text?

<p>Studies on relatives, along with genetic variant identification, provide compelling evidence. (A)</p> Signup and view all the answers

Which genetic variant has been associated with a decreased risk of sarcoidosis?

<p>The T allele of ANXA11 SNP rs2789679 (B)</p> Signup and view all the answers

In a Chinese cohort study, how many protein-coding genes were found to be associated with sarcoidosis risk?

<p>439 (A)</p> Signup and view all the answers

Which of the following genes, identified in a WGS family study, has NOT been previously linked to autoimmune diseases?

<p>KIR2DL4 (C)</p> Signup and view all the answers

What was the total number of subjects evaluated in the WGS family study that included 13 individuals diagnosed with sarcoidosis?

<p>61 (D)</p> Signup and view all the answers

Which HLA gene was NOT identified in the Chinese family WES as linked to sarcoidosis?

<p>HLA-B*0801 (B)</p> Signup and view all the answers

What was suggested as a potential therapeutic approach based on findings from the WGS family study which included 13 individuals with sarcoidosis?

<p>Evaluation of JAK inhibitors (D)</p> Signup and view all the answers

The C allele of which SNP has been associated with an increased risk of sarcoidosis?

<p>rs1049550 (D)</p> Signup and view all the answers

In the Chinese cohort study, how were the sarcoidosis patients divided to evaluate genetic associations?

<p>Into acute and chronic groups (A)</p> Signup and view all the answers

Which HLA allele is associated with an increased risk of sarcoidosis?

<p>HLA-DRB1<em>1501 (A), HLA-DRB1</em>0402 (B)</p> Signup and view all the answers

What factor is increased in sarcoidosis patients and linked to disease severity?

<p>B-lymphocyte-activating factor (BAFF) (C)</p> Signup and view all the answers

Which HLA allele was associated with a reduced risk of sarcoidosis?

<p>HLA-DRB1*0401 (D)</p> Signup and view all the answers

What was identified as a tool to study ancestry-specific genetic variants in sarcoidosis research?

<p>Local ancestry (C)</p> Signup and view all the answers

In the context of sarcoidosis research, what does pleiotropy refer to?

<p>Genetic associations with multiple diseases (A)</p> Signup and view all the answers

Which of the following was associated with a link between cardiac sarcoidosis and other sarcoidosis types?

<p>Presence of specific genetic variants (D)</p> Signup and view all the answers

Which statement accurately reflects findings on HLA-DRB1*0301?

<p>Associated with increased risk of sarcoidosis in ED population. (A)</p> Signup and view all the answers

Which disease showed significant pleiotropy with sarcoidosis in the study?

<p>Asthma (C)</p> Signup and view all the answers

Which polymorphism is associated with increased risk of systemic lupus erythematosus?

<p>308 G/A polymorphism (B)</p> Signup and view all the answers

What role does TNF-alpha play in sarcoidosis according to the discussed findings?

<p>It is a prognostic marker. (C)</p> Signup and view all the answers

Which toll-like receptor polymorphism is NOT associated with disease course in sarcoidosis?

<p>TLR4 Asp299Gly (B)</p> Signup and view all the answers

Which TNF polymorphisms have shown associations with susceptibility to sarcoidosis?

<p>Both A and B (C)</p> Signup and view all the answers

What is the main inflammatory role of TNF-alpha in sarcoidosis?

<p>Regulating immune response. (C)</p> Signup and view all the answers

Which study design was primarily referenced for finding associations of TNF polymorphisms with sarcoidosis?

<p>Meta-analysis (B)</p> Signup and view all the answers

How does the TLR2 polymorphism relate to infection and sarcoidosis?

<p>It can enhance infection susceptibility. (D)</p> Signup and view all the answers

Which group was investigated for TNF-alpha and TNF-beta gene polymorphisms related to sarcoidosis?

<p>Both A and B (D)</p> Signup and view all the answers

Flashcards

Genetics

The study of inherited traits and how they are passed down through generations.

Genome

A collection of genes that are passed from parent to offspring.

Genetic Variant

A change in the sequence of DNA, which can cause variations in traits.

Genome-Wide Association Study (GWAS)

A research method used to find genetic variants associated with diseases.

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Whole Exome Sequencing (WES)

Sequencing the complete set of protein-coding genes in a genome.

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Whole-Genome Sequencing (WGS)

Sequencing the entire genome, including both protein-coding and non-coding regions.

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Familial Clustering

The accumulation of a disease in a family, suggesting a possible genetic component.

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Familial Heritability Study

A study that compares the incidence of a disease in relatives of affected individuals to the general population.

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SNP (Single Nucleotide Polymorphism)

A type of genetic variation where a single nucleotide (DNA building block) is altered. It can be associated with different diseases and traits.

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HLA Genes (Human Leukocyte Antigen)

A family of genes that code for proteins involved in immune responses, particularly in inflammation.

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ANXA11 (Annexin A11)

A gene that encodes an enzyme involved in the production of inflammatory mediators.

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Lofgren Syndrome

A specific type of sarcoidosis characterized by fever, joint pain, and swelling in the ankles and feet.

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JAK2 (Janus Kinase 2)

A protein involved in cell signaling and immune regulation, potentially linked to autoimmune diseases.

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WGS (Whole Genome Sequencing)

A method of genetic analysis that examines the entire genome (all genes) of an individual.

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WES (Whole Exome Sequencing)

A method of genetic analysis that focuses on specific protein-coding regions of the genome.

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Haplotype

A group of genetic variants (SNPs) that are inherited together and potentially linked to specific traits or diseases.

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HLA

A type of immune system protein involved in immune responses. They are crucial for recognizing foreign invaders (like bacteria or viruses) and triggering immune responses.

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MHC

A group of genes involved in the production of HLA proteins, which are critical for immune recognition and response.

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Missense Mutation

A specific mutation in a gene that alters the protein it codes for. These changes can sometimes lead to disease.

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Sarcoidosis

A condition where the body's immune system mistakenly attacks its own tissues. This can cause inflammation and damage to organs.

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SNPs

Variations in a gene's DNA sequence that can affect its function. These variations are common in the population and can contribute to susceptibility to disease.

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Underpowered study

A study with a sample size that is too small to detect statistically significant differences between groups.

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Power to detect association

In a study that compares different groups, the ability of the study to detect a true association between a variable and the outcome.

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Phenotype

A trait or characteristic of an individual that is determined by genes.

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Genetic risk

The study of genetic factors that contribute to the development of a disease or condition.

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Advanced pulmonary sarcoidosis

A stage of sarcoidosis that is characterized by more extensive lung involvement.

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BAFF (B-lymphocyte activating factor)

A protein belonging to the tumor necrosis family, found in increased levels in the blood and lungs of sarcoidosis patients, potentially linked to disease severity.

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HLA-DRB1*0402

A genetic variant associated with increased risk of sarcoidosis, particularly in those with European ancestry.

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HLA-DRB1*0401

A genetic variant associated with decreased risk of sarcoidosis, especially in those with European ancestry.

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DQB1*0602

A genetic variant found to increase sarcoidosis risk and contribute to disease progression, potentially through an inflammatory pathway.

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HLA-DRB1*0301

A genetic variant that can influence sarcoidosis risk, but its association with disease varies across different populations.

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Local ancestry

The concept of analyzing the origin of genetic material within individuals of mixed ancestry to understand how specific genes may influence disease risk, particularly when self-reported race is not enough.

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Genetic pleiotropy

The shared genetic contributions to multiple diseases, indicating that genes may influence risk for more than one disease.

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Genetic Polymorphism

A specific variation in the DNA sequence at a particular location in the genome, such as a single nucleotide polymorphism (SNP). These variations can influence how genes are expressed and contribute to an individual's risk of developing diseases.

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308 G/A Polymorphism

A type of genetic variation found in a population where a specific base pair in a gene is replaced with a different base pair (e.g., G replaced with A).

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Toll-like Receptor (TLR)

A family of proteins that play a crucial role in the immune system's recognition of pathogens (foreign invaders).

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Systemic Lupus Erythematosus (SLE)

A common autoimmune disorder characterized by inflammation of multiple organs and tissues. Symptoms can include fatigue, joint pain, and skin rashes.

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Prognostic Marker

A marker that indicates the presence or progression of a disease, often measured in blood or other bodily fluids. In the context of sarcoidosis, these markers can help clinicians assess the severity and track the course of the disease.

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Tumor Necrosis Factor-alpha (TNF-alpha)

An inflammatory protein that plays a critical role in the immune response. In the context of this study, TNF-alpha is associated with the development and progression of sarcoidosis.

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Lymphotoxin-alpha

A key player in the regulation of the immune system. It influences the development and activity of immune cells, and its dysregulation has been linked to several autoimmune disorders.

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Study Notes

Genetic Predisposition to Sarcoidosis

  • Sarcoidosis is a complex disease with heterogeneous phenotypes and variable natural history.
  • Genetic predisposition and environmental factors significantly contribute to disease pathogenesis.
  • The review assesses genetic variants impacting sarcoidosis susceptibility and phenotypes, including ancestry- and sex-specific variants.
  • It also examines shared genetic architecture with other diseases and gene-environment interactions.

Summary of Genetic Approaches

  • Early genetic studies evaluated familial clustering and heritability, showing increased risk in relatives of affected individuals.
  • Genome-wide association studies (GWAS) identify common genetic variants—single nucleotide polymorphisms (SNPs)—associated with disease risk.
  • Candidate gene studies examine specific genes potentially involved.
  • Whole-exome and whole-genome sequencing (WES/WGS) analyze rare variants, potentially explaining disease variability in specific individuals.

Genetic Variants in Sarcoidosis Susceptibility

  • Multiple gene regions are associated with sarcoidosis susceptibility, particularly across immune genes or those involved in immune pathways.
  • The HLA region shows consistent associations, with HLA-DRB1 alleles frequently implicated.
  • Other genes linked to cytokines, cell surface markers and signaling molecules also contribute.
  • Results vary among studies, suggesting disease complexity and varied clinical expression.

Genetic Variants in Sarcoidosis Phenotypes

  • Genetic predispositions may differ based on specific disease phenotypes.
  • Lofgren's syndrome (LS)—characterized by fever, erythema nodosum, and bilateral hilar adenopathy—presents specific HLA associations like HLA-DRB1*03.
  • Chronic sarcoidosis shows various gene associations, such as HLA-DRB1*14.
  • Variants related to specific outcomes like pulmonary fibrosis, are found. Also, ocular and neurological manifestations show specific genetic associations.

Genetic Architecture and Other Diseases

  • Sarcoidosis may share genetic pathways and features with other immune-mediated and autoimmune diseases.
  • Evidence suggests pleiotropy with asthma, celiac disease, and rheumatoid arthritis, involving interleukins and cell adhesion molecules.
  • Studies identify shared genetic regions with idiopathic pulmonary fibrosis (IPF), suggesting similar underlying mechanisms, especially those involving TGF-β pathways.

Gene-Environment Interactions

  • Studies demonstrate associations between sarcoidosis and environmental exposures (occupational and infectious agents).
  • Genetic risk factors interact with environmental exposures, possibly modifying disease risk.
  • Smoking may have a protective effect against sarcoidosis.
  • The precise mechanisms of these interactions require further investigation.

Unmet Needs and Future Directions

  • Large, diverse populations in GWAS are critical for validating findings across ancestries.
  • Investigating rare variants through comprehensive sequencing approaches is necessary.
  • Assessing gene-gene and gene-environment interactions contributes to a better understanding of disease mechanisms.
  • Developing multi-omics approaches (integrating genetic, epigenetic, transcriptomic, and proteomic data) can provide a deeper understanding of sarcoidosis.

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