Quantifying the Genetic Basis of Marfan Syndrome Clinical Variability
Thomas Grange1, Mélodie Aubart1,2, Maud Langeois3,4
1INSERM U1148, 75018 Paris, France.
Abstract:
Marfan syndrome (MFS) is an autosomal dominant connective tissue disorder with considerable inter- and intra-familial clinical variability. The contribution of inherited modifiers to variability has not been quantified. We analyzed the distribution of 23 clinical features in 1306 well-phenotyped MFS patients carrying FBN1 mutations. We found strong correlations between features within the same system (i.e., ophthalmology vs. skeletal vs. cardiovascular) suggesting common underlying determinants, while features belonging to different systems were largely uncorrelated. We adapted a classical quantitative genetics model to estimate the heritability of each clinical feature from phenotypic correlations between relatives. Most clinical features showed strong familial aggregation and high heritability. We found a significant contribution by the major locus on the phenotypic variance only for ectopia lentis using a new strategy. Finally, we found evidence for the "Carter effect" in the MFS cardiovascular phenotype, which supports a polygenic model for MFS cardiovascular variability and indicates additional risk for children of MFS mothers with an aortic event. Our results demonstrate that an important part of the phenotypic variability in MFS is under the control of inherited modifiers, widely shared between features within the same system, but not among different systems. Further research must be performed to identify genetic modifiers of MFS severity.
Insights
Inherited genetic factors significantly influence Marfan syndrome (MFS) variability, particularly within specific organ systems. This study quantifies the heritability of MFS clinical features, revealing shared modifiers across related traits.
Area of Science:
- Genetics
- Medical Genetics
- Quantitative Genetics
Background:
- Marfan syndrome (MFS) is an inherited connective tissue disorder characterized by significant clinical variability.
- The role of inherited genetic modifiers in this variability remains largely unquantified.
Purpose of the Study:
- To quantify the contribution of inherited modifiers to the clinical variability observed in Marfan syndrome.
- To analyze the distribution and heritability of 23 distinct clinical features in MFS patients with FBN1 mutations.
Main Methods:
- Analysis of phenotypic correlations among 1306 well-phenotyped MFS patients carrying FBN1 mutations.
- Application of a quantitative genetics model to estimate heritability of clinical features.
- Investigation of major locus contribution and the 'Carter effect' for cardiovascular phenotypes.
Main Results:
- Strong correlations observed between clinical features within the same organ system (ophthalmologic, skeletal, cardiovascular), suggesting shared genetic determinants.
- Most MFS clinical features demonstrated significant familial aggregation and high heritability.
- The major locus significantly influenced only ectopia lentis; evidence for a polygenic model in cardiovascular variability was found, including the 'Carter effect'.
Conclusions:
- A substantial portion of Marfan syndrome phenotypic variability is attributable to inherited genetic modifiers.
- These modifiers appear to be shared among features within the same organ system but not across different systems.
- Further research is needed to identify specific genetic modifiers influencing MFS severity.
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