A coding variant in RARG confers susceptibility to anthracycline-induced cardiotoxicity in childhood cancer

作者：Aminkeng Folefac; Bhavsar Amit P; Visscher Henk; Rassekh Shahrad R; Li Yuling; Lee Jong W; Brunham Liam R; Caron Huib N; van Dalen Elvira C; Kremer Leontien C; van der Pal Helena J; Amstutz Ursula; Rieder Michael J; Bernstein Daniel; Carleton Bruce C; Hayden Michael R; Ross Colin J D^*

来源：Nature Genetics, 2015, 47(9): 1079-+.

DOI：10.1038/ng.3374

Anthracyclines are used in over 50% of childhood cancer treatment protocols(1), but their clinical usefulness is limited by anthracycline-induced cardiotoxicity (ACT) manifesting as asymptomatic cardiac dysfunction and congestive heart failure in up to 57% and 16% of patients, respectively(2,3). Candidate gene studies have reported genetic associations with ACT(4-22), but these studies have in general lacked robust patient numbers, independent replication or functional validation. Thus, the individual variability in ACT susceptibility remains largely unexplained(12,13). We performed a genome-wide association study in 280 patients of European ancestry treated for childhood cancer, with independent replication in similarly treated cohorts of 96 European and 80 non-European patients. We identified a nonsynonymous variant (rs2229774, p.Ser427Leu) in RARG highly associated with ACT (P = 5.9 x 10(-8), odds ratio (95% confidence interval) = 4.7 (2.7-8.3)). This variant alters RARG function, leading to derepression of the key ACT genetic determinant Top2b, and provides new insight into the pathophysiology of this severe adverse drug reaction.

• 出版日期2015-9