Published July 13, 2021 | Version v1
Journal article Open

Search for AL amyloidosis risk factors using Mendelian randomization

Authors/Creators

  • 1. Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom.
  • 2. Department of Clinical Genetics, Lund University, Lund, Sweden.
  • 3. Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany.
  • 4. Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany.. Department of Biomedicine, University of Basel, Basel, Switzerland.
  • 5. Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany.
  • 6. Institute for Medical Informatics, Biometry, and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
  • 7. Department of Biology, University of Pisa, Pisa, Italy.
  • 8. Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany. National Centre of Tumor Diseases, Heidelberg, Germany.
  • 9. Amyloidosis Research and Treatment Center, Foundation "Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo" and Department of Molecular Medicine, University of Pavia, Pavia, Italy.
  • 10. National Amyloidosis Centre, University College London Medical School, Royal Free Hospital Campus, London, United Kingdom.
  • 11. Hopp Children's Cancer Center, Heidelberg, Germany. Division of Pediatric Neuro-oncology, German Cancer Research Center, German Cancer Consortium, Heidelberg, Germany.
  • 12. Biomedical Center, Faculty of Medicine and Biomedical Center in Pilsen, Charles University in Prague, Pilsen, Czech Republic. Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany.

Description

In amyloid light chain (AL) amyloidosis, amyloid fibrils derived from immunoglobulin light chain are deposited in many organs, interfering with their function. The etiology of AL amyloidosis is poorly understood. Summary data from genome-wide association studies (GWASs) of multiple phenotypes can be exploited by Mendelian randomization (MR) methodology to search for factors influencing AL amyloidosis risk. We performed a 2-sample MR analyzing 72 phenotypes, proxied by 3461 genetic variants, and summary genetic data from a GWAS of 1129 AL amyloidosis cases and 7589 controls. Associations with a Bonferroni-defined significance level were observed for genetically predicted increased monocyte counts (P = 3.8 x 10(-4)) and the tumor necrosis factor receptor superfamily member 17 (TNFRSF17) gene (P = 3.4 x 10(-5)). Two other associations with the TNFRSF (members 6 and 19L) reached a nominal significance level. The association between genetically predicted decreased fibrinogen levels may be related to roles of fibrinogen other than blood clotting. be related to its nonhemostatic role. It is plausible that a causal relationship with monocyte concentration could be explained by selection of a light chain-producing clone during progression of monoclonal gammopathy of unknown significance toward AL amyloidosis. Because TNFRSF proteins have key functions in lymphocyte biology, it is entirely plausible that they offer a potential link to AL amyloidosis pathophysiology. Our study provides insight into AL amyloidosis etiology, suggesting high circulating levels of monocytes and TNFRSF proteins as risk factors.

Notes

This work was supported by the European Union's Horizon 2020 research and innovation programme, grant 856620 (Chaperon), the Harald Huppert Foundation, the Heinz Nixdorf Foundation (Germany), the Ministerium f€ur Innovation, Wissenschaft und Forschung des Landes Nordrhein-Westfalen and the Faculty of Medicine University Duisburg-Essen, Myeloma UK, and Cancer Research UK (C1298/A8362).

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Additional details

Funding

European Commission
Chaperon - ERA Chair Position for Excellent Research in Oncology 856620