Genetic alterations and pathways in patients with Hereditary Angioedema of Unknown Cause (U-HAE)

Objective: Hereditary angioedema ( HAE) with normal C1 inhibitor (HAE-nC1-INH), is a genetically complex, rare disease andmutations in F12, ANGPT1, PLG, MYOF genes are found in some families with HAE-nC1-INH. However, often a specific mutationcannot be identified and this type is called as hereditary angioedema of unknown cause (U-HAE). Our aim was to identify putativecausative genetic alterations and/or pathways by whole exome sequencing in patients with U-HAE.Patients and Methods: Nine patients from 8 families between the ages of 3 to 63 years with U-HAE and 6 controls were enrolled forthe study and whole exome sequencing were performed.Results: No significant difference was found between the case and control group for the a priori suspected set of genes. Variants in thegenes; RAMP2, IL6, GP1BA, C1QBP were significantly different between U-HAE and control group. Downstream functional analysisfound that blood coagulation pathways were enriched in these genes.Conclusion: Proteins that are not involved in contact pathways may also play a role in U-HAE. These variants need to be replicated inlarger cohorts and studied at the functional level to verify our findings.

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  • [1] Cicardi M, Aberer W, Banerji A et al. HAWK under the patronage of EAACI (European Academy of Allergy and Clinical Immunology). Classification, diagnosis, and approach to treatment for angioedema: consensus report from the Hereditary Angioedema International Working Group. Allergy 2014;69:602-16. doi: 10.1111/all.12380.
  • [2] Bork K, Barnstedt SE, Koch P, Traupe H. Hereditary angioedema with normal C1-inhibitor activity in women. Lancet 2000;356(9225):213-7. doi: 10.1016/S0140- 6736(00)02483-1.
  • [3] Dewald G, Bork K. Missense mutations in the coagulation factor XII (Hageman factor) gene in hereditary angioedema with normal C1 inhibitor. Biochem Biophys Res Commun 2006 May 19;343(4):1286-9. doi: 10.1016/j.bbrc.2006.03.092.
  • [4] Cichon S, Martin L, Hennies HC et al. Increased activity of coagulation factor XII (Hageman factor) causes hereditary angioedema type III. Am J Hum Genet 2006 Dec;79(6):1098- 104. doi: 10.1086/509899.
  • [5] Bodian DL, Vilboux T, Hauser NS. Genotype-first analysis of a generally healthy population cohort supports genetic testing for diagnosis of hereditary angioedema of unknown cause. Allergy Asthma Clin Immunol 2019; 16:15:32. doi: 10.1186/ s13223.019.0346-1.
  • [6] Hieter P, Boguski M. Functional genomics: it’s all how you read it. Science 1997; 24:278(5338):601-2. doi: 10.1126/ science.278.5338.601.
  • [7] Langmead B, Salzberg SL. Fast gapped-read alignment with Bowtie 2. Nat Methods 2012;9:357-9.
  • [8] Li H, Durbin R. Fast and accurate short read alignment with Burrows-Wheeler transform. Bioinformatics 2009; 25:1754- 60. doi: 10.1093/bioinformatics/btp324
  • [9] Li H, Handsaker B, Wysoker A, et al. 1000 Genome Project Data Processing Subgroup. The Sequence Alignment/Map format and SAMtools. Bioinformatics 2009; 15:25:2078-9. doi: 10.1093/bioinformatics/btp352.
  • [10] Van der Auwera GA, Carneiro MO, Hartl C, et al. From FastQ data to high confidence variant calls: the Genome Analysis Toolkit best practices pipeline. Curr Protoc Bioinformatics 2013;43(1110):11.10.1-11.10.33. doi:10.1002/047.125.0953. bi1110s43.
  • [11] Adzhubei IA, Schmidt S, Peshkin L, et al. A method and server for predicting damaging missense mutations. Nat Methods. 2010;7:248-9. doi: 10.1038/nmeth0410-248.
  • [12] Sim NL, Kumar P, Hu J, et al. SIFT web server: predicting effects of amino acid substitutions on proteins. Nucleic Acids Res 2012;40 (Web Server issue):W452-7. doi: 10.1093/nar/ gks539
  • [13] Tate JG, Bamford S, Jubb H, et al. COSMIC: the Catalogue of Somatic Mutations in Cancer. Nucleic Acids Res. 2019;47(D1):D941-D947. doi: 10.1093/nar/gky1015.
  • [14] Wang MH, Cordell HJ, Van Steen K. Statistical methods for genome-wide association studies. Semin Cancer Biol 2019;55:53-60. doi: 10.1016/j.semcancer.2018.04.008.
  • [15] Szklarczyk D, Gable AL, Lyon D, et al. STRING v11: proteinprotein association networks with increased coverage, supporting functional discovery in genome-wide experimental datasets. Nucleic Acids Res 2019; 8;47(D1):D607-D613. doi: 10.1093/nar/gky1131.
  • [16] Huang da W, Sherman BT, Lempicki RA. Bioinformatics enrichment tools: paths toward the comprehensive functional analysis of large gene lists. Nucleic Acids Res 2009;37:1-13. doi: 10.1093/nar/gkn923.
  • [17] Huang da W, Sherman BT, Lempicki RA. Systematic and integrative analysis of large gene lists using DAVID bioinformatics resources. Nat Protoc 2009;4:44-57. doi: 10.1038/nprot.2008.211
  • [18] The Gene Ontology Consortium. The Gene Ontology Resource: 20 years and still GOing strong. Nucleic Acids Res 2019;47(D1):D330-D338. doi: 10.1093/nar/gky1055.
  • [19] Kajdácsi E, Jani PK, Csuka D, et al. J Clin Immunol 2016;36:160-70. doi: 10.1007/s10875.016.0239-8
  • [20] Cicardi M, Zuraw BL. Angioedema due to bradykinin dysregulation. J Allergy Clin Immunol Pract 2018;6:1132-41. doi: 10.1016/j.jaip.2018.04.022.
  • [21] Arcoleo F, Lo Pizzo M, Misiano G, et al. The complex alteration in the network of IL-17-type cytokines in patients with hereditary angioedema. Clin Exp Med. 2018;18:355-361. doi:10.1007/s10238.018.0499-022.
  • [22] López JA, Andrews RK, Afshar-Kharghan V, et al. BernardSoulier syndrome. Blood 1998;91:4397-418. doi: 10.1182/ blood.V91.12.4397
  • [23] Peerschke EI, Ghebrehiwet B. The contribution of gC1qR/p33 in infection and inflammation. Immunobiology 2007;212:333- 42. doi: 10.1016/j.imbio.2006.11.011.