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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Risk genes associated with pediatric-onset MS but not with monophasic acquired CNS demyelination
E Daniëlle van Pelt1, Julia Y Mescheriakova, Nalia Makhani
1From the Departments of Neurology (E.D.v.P., J.Y.M., I.A.K., R.F.N., C.E.C.-B., R.Q.H.) and Epidemiology (S.K., L.B., C.J., C.M.v.D.), Erasmus MC, Rotterdam, the Netherlands; the Departments of Pediatrics and Neurology (N.M.), Yale School of Medicine, New Haven, CT; the Department of Epidemiology (C.J.), Emory University, Atlanta, GA; the Department of Neurology (B.B.), Children's Hospital of Philadelphia, PA; the Division of Neurology (B.B.), Hospital for Sick Children and University of Toronto; and Montreal Neurological Institute (A.B.-O.), McGill University, Canada.
Insights
Genetic risk factors for adult multiple sclerosis (MS) also increase susceptibility in children with MS. These 57 genetic risk loci do not predict monophasic acquired demyelinating syndromes (ADS) in children.
Area of Science:
- Genetics
- Neurology
- Pediatrics
Background:
- Multiple sclerosis (MS) is a complex neurological disorder with a significant genetic component.
- Genome-wide association studies (GWAS) have identified numerous genetic risk loci associated with adult-onset MS.
- The genetic architecture of pediatric-onset MS (pMS) and its relationship with adult risk factors remain less understood.
Purpose of the Study:
- To determine if 57 genetic risk loci identified in adult MS are associated with pediatric-onset MS (pMS).
- To assess the predictive value of these genetic loci for MS diagnosis in children with acquired demyelinating syndromes (ADS).
Main Methods:
- A cohort study including 188 children with ADS (53 diagnosed with MS), 466 adult-onset MS patients, and 2,046 adult controls.
- Calculation of weighted genetic risk scores (wGRS) using 57 single nucleotide polymorphisms (SNPs) associated with adult MS.
- Analysis of wGRS, sex, and HLA-DRB1*15 for prediction of MS in pediatric and adult cohorts.
Main Results:
- Mean wGRS was significantly higher in pediatric-onset MS patients compared to monophasic ADS and controls.
- No significant difference in wGRS was observed between monophasic ADS and controls.
- The 57 SNPs showed moderate predictive ability for MS in children, improving with the addition of sex and HLA-DRB1*15 (AUC = 0.70).
- The combined effect of the 57 SNPs exceeded that of HLA-DRB1*15 alone in risk models for both pediatric and adult MS.
Conclusions:
- The 57 genetic risk loci identified for adult MS confer increased susceptibility to pediatric-onset MS.
- These genetic factors do not appear to increase susceptibility to monophasic ADS in children.
- Genetic risk profiling holds potential for improving MS diagnosis in pediatric populations.
Objective:
To investigate whether 57 genetic risk loci recently identified in a large-scale genome-wide association study in adult patients with multiple sclerosis (MS) are also associated with a risk for pediatric-onset MS and whether they can predict MS diagnosis in children presenting with acquired demyelinating syndromes (ADS).
Methods:
We included 188 children with ADS, of whom 53 were diagnosed with MS, 466 patients with adult-onset MS, and 2,046 adult controls in our cohort study. Weighted genetic risk scores (wGRS) were calculated to evaluate genetic effects.
Results:
Mean wGRS was significantly higher for patients with pediatric-onset MS (7.32 ± 0.53) as compared with patients with monophasic ADS (7.10 ± 0.47, p = 0.01) and controls (7.11 ± 0.53, p < 0.01). We found no difference in mean wGRS of participants with monophasic ADS (7.10 ± 0.47) and controls (7.11 ± 0.53). The ability of the wGRS for the 57 single nucleotide polymorphisms (SNPs) to discriminate between children with MS and those with monophasic ADS was moderate (area under the curve [AUC] = 0.64), but improved with the addition of sex and HLA-DRB1*15 (AUC = 0.70). The combined effect of 57 SNPs exceeded the effect of HLA-DRB1*15 alone in our risk models for pediatric- and adult-onset MS.
Conclusion:
The previously reported 57 SNPs for adult-onset MS also confer increased susceptibility to pediatric-onset MS, but not to monophasic ADS.
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