A genome-wide association study identifies new loci for factor VII and implicates factor VII in ischemic stroke etiology.

Paul S de Vries, Maria Sabater-Lleal, Jennifer E Huffman, Jonathan Marten, Ci Song, Nathan Pankratz, Traci M Bartz, Hugoline G de Haan, Graciela E Delgado, John D Eicher, Angel Martinez-Perez, Cavin K Ward-Caviness, Jennifer A Brody, Ming-Huei Chen, Moniek P M de Maat, Mattias Frånberg, Dipender Gill, Marcus E Kleber, Fernando Rivadeneira, José Manuel Soria, Weihong Tang, Geoffrey H Tofler, André G Uitterlinden, Astrid van Hylckama Vlieg, Sudha Seshadri, Eric Boerwinkle, Neil M Davies, Anne-Katrin Giese, M Kamran Ikram, Steven J Kittner, Barbara McKnight, Bruce M Psaty, Alex P Reiner, Muralidharan Sargurupremraj, Kent D Taylor, Myriam Fornage, Anders Hamsten, Winfried März, Frits R Rosendaal, Juan Carlos Souto, Abbas Dehghan, Andrew D Johnson, Alanna C Morrison, Christopher J O'Donnell, Nicholas L Smith

Journal: Blood 2019;133(9):967-977

PMID: 30642921

Abstract

Factor VII (FVII) is an important component of the coagulation cascade. Few genetic loci regulating FVII activity and/or levels have been discovered to date. We conducted a meta-analysis of 9 genome-wide association studies of plasma FVII levels (7 FVII activity and 2 FVII antigen) among 27 495 participants of European and African ancestry. Each study performed ancestry-specific association analyses. Inverse variance weighted meta-analysis was performed within each ancestry group and then combined for a -ancestry meta-analysis. Our primary analysis included the 7 studies that measured FVII activity, and a secondary analysis included all 9 studies. We provided functional genomic validation for newly identified significant loci by silencing candidate genes in a human liver cell line (HuH7) using small-interfering RNA and then measuring messenger RNA and FVII protein expression. Lastly, we used meta-analysis results to perform Mendelian randomization analysis to estimate the causal effect of FVII activity on coronary artery disease, ischemic stroke (IS), and venous thromboembolism. We identified 2 novel ( and ) and 6 known loci associated with FVII activity, explaining 19.0% of the phenotypic variance. Adding FVII antigen data to the meta-analysis did not result in the discovery of further loci. Silencing in HuH7 cells upregulated FVII, whereas silencing downregulated FVII. Mendelian randomization analyses suggest that FVII activity has a positive causal effect on the risk of IS. Variants at and contribute to FVII activity by regulating expression levels. FVII activity appears to contribute to the etiology of IS in the general population.

Address: Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX.; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.; Unit of Genomics of Complex Diseases, Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Barcelona, Spain.; Cardiovascular Medicine Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.; Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.; Population Sciences Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Framingham, MA.; The Framingham Heart Study, Framingham, MA.; Center for Population Genomics, Veterans Affairs (VA) Boston Healthcare System, Jamaica Plain, MA.; Medical Research Council (MRC) Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom.; Population Sciences Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Framingham, MA.; The Framingham Heart Study, Framingham, MA.; Department of Medical Sciences and.; Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.; Department of Laboratory Medicine and Pathology, School of Medicine, University of Minnesota, Minneapolis, MN.; Department of Biostatistics, University of Washington, Seattle, WA.; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.; Vth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.; Population Sciences Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Framingham, MA.; The Framingham Heart Study, Framingham, MA.; Unit of Genomics of Complex Diseases, Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Barcelona, Spain.; National Health and Environmental Effects Research Laboratory, US Environmental Protection Agency, Chapel Hill, NC.; Department of Medicine, University of Washington, Seattle, WA.; Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands.; Cardiovascular Medicine Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.; Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.; Department of Epidemiology and Biostatistics and.; Department of Stroke Medicine, Imperial College London, London, United Kingdom.; Vth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.; Institute of Nutrition, Friedrich Schiller University Jena, Mannheim, Germany.; Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.; Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN.; Royal North Shore Hospital, University of Sydney, Sydney, Australia.; The Framingham Heart Study, Framingham, MA.; Department of Neurology, Boston University, Boston, MA.; Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX.; Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX.; Human Genome Sequencing Center, College of Medicine, Baylor University, Houston, TX.; MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, United Kingdom.; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.; Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands.; Department of Neurology, School of Medicine, University of Maryland, Baltimore, MD.; Baltimore VA Medical Center, Baltimore, MD.; Department of Medicine.; Department of Epidemiology, and.; Department of Health Services, University of Washington, Seattle, WA.; Kaiser Permanente Washington Research Institute, Kaiser Permanente Washington, Seattle, WA.; Fred Hutchinson Cancer Research Center, Seattle, WA.; Department of Epidemiology, University of Washington, Seattle, WA.; INSERM U1219, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France.; The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA.; Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX.; Brown Foundation Institute of Molecular Medicine, The University of Texas Health Science Center at Houston, Houston, TX.; Vth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.; Synlab Academy, Synlab Holding Deutschland GmbH, Mannheim, Germany.; Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University Graz, Graz, Austria.; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.; Einthoven Laboratory of Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands.; Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands.; Unitat d'Hemostasia i Trombosi, Hospital de la Sant Creu i Sant Pau, Barcelona, Spain.; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.; Department of Epidemiology and Biostatistics and.; MRC-Public Health England Centre for Environment and Health, School of Public Health and.; UK Dementia Research Institute, Imperial College London, London, United Kingdom.; Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX.; Population Sciences Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Framingham, MA.; Cardiology Section, VA Boston Healthcare System, West Roxbury, MA; and.; Kaiser Permanente Washington Research Institute, Kaiser Permanente Washington, Seattle, WA.; Department of Epidemiology, University of Washington, Seattle, WA.; Seattle Epidemiologic Research and Information Center, Office of Research and Development, Department of Veteran Affairs, Seattle, WA.
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