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Identification of susceptibility genes to nonsyndromic cleft lip/palate: epidemiology and population stratification influences

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Luciano Abreu Brito
Total Authors: 1
Document type: Master's Dissertation
Press: São Paulo.
Institution: Universidade de São Paulo (USP). Instituto de Biociências (IBIOC/SB)
Defense date:
Examining board members:
Maria Rita dos Santos e Passos Bueno; Ricardo Della Coletta; David Schlesinger
Advisor: Maria Rita dos Santos e Passos Bueno

Nonsyndromic cleft lip with or without cleft palate (NS CL±P) is a complex disease with worldwide incidence estimated as 1:700. The multifactorial model of inheritance and the genetic heterogeneity difficult the search for the genetic causes of NS CL±P, and, of all loci, IRF6 gene and 8q24 gene desert are the two most associated. The population stratification constitutes an additional problem to be considered in case-control studies in Brazil. In order to identify the factors that may interfere in the hunting of risk factors, we carried out, in a first moment, an epidemiologic evaluation of patients from five locations in Brazil (Santarém-PA, Barbalha-CE, Fortaleza-CE, Maceió-AL and Rio de Janeiro-RJ). This study put Barbalha as the region where genetic factors play the more determinant role (heritability = 85%; recurrence risk = 2.2-2.8%); Maceió, on the other hand, was the region of less genetic contribution to the disease (heritability = 45%; recurrence risk = 0.6-0.7%). In addition, consanguinity did not appear to influence these results. In a second study, we characterized the sample ancestry, in order to establish parameters for future association studies in our population. To test our hypothesis, we carried out a case-control study with the SNPs which are the most corroborated in other populations: rs642961 (in an IRF6 enhancer), and rs987525 (in 8q24). We verified that, when a structured association test was performed, we obtained results that are consistent with heritability estimates, since Barbalha was the only region with positive association for both SNPs. This was the first time that a positive association for these markers was reported in a Brazilian population. In addition, the molecular analysis evidenced the importance of an individual characterization with ancestry informative markers when performing a case-control study in this population, since different results were obtained from the analyses assuming no stratification and correcting its effect. This study provides important bases for the identification of new susceptibility variants to NS CL±P in Brazilian population, since targeting in the populations of highest genetic contribution to the disease will be possible in the forthcoming studies, increasing the power of the study. (AU)

FAPESP's process: 09/04183-7 - Investigation of predisposition genes to cleft lip with or without cleft palate in Brazilian population.
Grantee:Luciano Abreu Brito
Support type: Scholarships in Brazil - Master