DNA Variants and AAA Disease

描述(申请人提供)：腹主动脉瘤(AAA)疾病是一种常见的、病态的和高度致命的疾病。先前的研究表明，这种疾病有很强的遗传成分，涉及多个基因位点。目前初步检测AAA的存在以及确定哪些病变有快速生长/破裂风险的模式并不是最理想的。因此，动脉瘤治疗的进一步进展将需要增强的风险分层工具。在我们目前在斯坦福大学的AAA疾病血管SCCOR中，我们采用了数据丰富的策略来识别在AAA疾病中有信息的生物相关血液蛋白。然而，在血液中发现的因子(由AAA病变分泌)不太可能捕捉到潜在病理生理过程的广度。我们建议利用腹主动脉瘤-简单治疗或预防(AAA-STOP)试验的病例和对照的仔细表型来识别与AAA相关的新的DNA序列变异。我们将利用下一代高通量测序技术对我们的实验策略确定的候选基因进行重新测序，包括全基因组转录图谱，以构建相关的表达网络。新的错义变异将在AAA-STOP的第二个亚队列中复制，以及在西澳大利亚筛查研究(WASS)的表型相同的AAA患者和对照的补充队列中复制。最后，验证的序列变体将与蛋白质生物标记物和临床数据相结合，以确定它们对疾病诊断和预后算法的相加价值。此外，已识别的罕见错义变体可能会增加对调节AAA形成的潜在生物学过程以及重要的基因-环境相互作用的洞察。因此，我们建议追求并完成以下具体目标：1.在AAA-STOP队列中的样本中鉴定与AAA病相关的罕见序列变异。2.对来自AAA-STOP的第二组样本和西澳大利亚筛查研究的一个子队列进行验证基因分型。为了确定稀有序列变异是否可以预测疾病进展，以及它们是否增加了表型数据、蛋白质生物标记物的值和相互作用项，以产生用于疾病监测的有用的诊断和预后算法。这一合作代表着一个独特的机会，可以进一步利用斯坦福大学AAA SCCOR和WASS临床试验的持续成功，为患有常见和危及生命的疾病的患者提供有意义的临床指南。此外，罕见的变异可能会为疾病病理生物学提供重要的洞察力，并指导疾病管理和未来的研究。公共卫生相关性：项目叙事腹主动脉瘤(AAA)是一种常见的、病态的、经常致命的美国老年人疾病。我们建议通过对我们NIH赞助的临床试验中登记的受试者的候选基因进行深度测序，来识别易患AAA的新的遗传因素。此外，我们将确定已识别的遗传标记是否会添加到已知的临床参数中，以帮助指导AAA的临床护理。(摘要结束)

DESCRIPTION (provided by applicant): Abdominal aortic aneurysm (AAA) disease is a common, morbid and highly lethal disease. Prior studies indicate a strong genetic component to the disease involving multiple loci. Present modes to initially detect the presence of AAA as well as determine which lesions are at risk for rapid growth/rupture are suboptimal. Thus, further advances in aneurysm care will require enhanced risk stratification tools. In our current Vascular SCCOR in AAA Disease at Stanford, we have employed a data-rich strategy to identify biologically relevant blood proteins that are informative in AAA disease. However, factors found in blood (secreted by AAA lesions) are unlikely to capture the breadth of the underlying pathophysiological processes. We propose to exploit the careful phenotyping of both cases and controls of the Abdominal Aortic Aneurysm-Simple Treatment or Prevention (AAA-STOP) trial to identify novel DNA sequence variants associated with AAA. We will take advantage of next-generation high-throughput sequencing technology to resequence candidate genes identified by our experimental strategy involving whole genome transcriptional profiling to build relevant expression networks. Novel missense variants will be replicated in a second subcohort of AAA-STOP as well as in a complementary cohort of equally well-phenotyped AAA patients and controls- participants of the Western Australia Screening Study (WASS). Finally, validated sequence variants will be combined with protein biomarker and clinical data to determine their additive value to disease algorithms of diagnosis and prognosis. In addition, identified rare missense variants are likely to add insight into the underlying biological processes regulating AAA formation as well as important gene-environment interactions. As such, we propose to pursue and complete the following Specific Aims: 1. to identify rare sequence variants associated with AAA disease in samples from the AAA-STOP cohort. 2. To perform validation genotyping in a second set of samples from AAA-STOP and a subcohort of the Western Australia Screening Study. To determine if rare sequence variants are predictive of disease progression and whether they add to phenotypic data, protein biomarker values, and interaction terms to produce useful diagnostic and prognostic algorithms for disease monitoring. This collaboration represents a unique opportunity to further leverage the ongoing success of the Stanford AAA SCCOR and WASS clinical trials into meaningful clinical guidelines for patients with a common and life threatening disease. In addition, rare variants will likely provide significant insight into disease pathobiology as well as guide disease management and future research. PUBLIC HEALTH RELEVANCE: Project Narrative Abdominal aortic aneurysm (AAA) is a common, morbid, and frequently lethal disease of older Americans. We propose to identify novel genetic factors that predispose individuals to develop AAA by deep sequencing of candidate genes in subjects enrolled in our NIH-sponsored clinical trial. In addition, we will determine if identified genetic markers add to known clinical parameters to help guide clinical care of AAAs. (End of Abstract)