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Highlight article: Whole-exome sequencing indicates FLG2 variant associated with leg ulcers in Brazilian sickle cell anemia patients

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Autor(es):
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de Carvalho-Siqueira, Gabriela Queila [1] ; Ananina, Galina [1] ; de Souza, Bruno Batista [1] ; Borges, Murilo Guimaraes [2] ; Ito, Mirta Tomie [1] ; da Silva-Costa, Sueli Matilde [1] ; Domingos, Igor de Farias [3] ; Falcao, Diego Arruda [3] ; Lopes-Cendes, Iscia [2] ; Cavalcanti Bezerra, Marcos Andre [3] ; Araujo, Aderson da Silva [4] ; Lucena-Araujo, Antonio Roberto [3] ; Goncalves, Marilda de Souza [5] ; Olalla Saad, Sara Teresinha [6] ; Costa, Fernando Ferreira [6] ; de Melo, Monica Barbosa [1]
Número total de Autores: 16
Afiliação do(s) autor(es):
[1] Univ Estadual Campinas, Ctr Mol Biol & Genet Engn CBMEG, BR-13083875 Campinas, SP - Brazil
[2] Univ Estadual Campinas, Fac Med Sci, Dept Med Genet & Genome Med, BR-13083887 Campinas, SP - Brazil
[3] Univ Fed Pernambuco, Genet Postgrad Program, BR-50670901 Recife, PE - Brazil
[4] Hematol & Hemotherapy Fdn Pernambuco, BR-52011000 Recife, PE - Brazil
[5] Fiocruz MS, Goncalo Moniz Inst, BR-40296710 Salvador, BA - Brazil
[6] Univ Estadual Campinas, Hematol & Hemotherapy Ctr, BR-13083878 Campinas, SP - Brazil
Número total de Afiliações: 6
Tipo de documento: Artigo Científico
Fonte: Experimental Biology and Medicine; v. 244, n. 11, p. 932-939, AUG 2019.
Citações Web of Science: 0
Resumo

Although sickle cell anemia results from homozygosity for a single mutation at position 7 of the beta-globin chain, the clinical aspects of this condition are very heterogeneous. Complications include leg ulcers, which have a negative impact on patients' quality of life and are related to the severity of the disease. Nevertheless, the complex pathogenesis of this complication has yet to be elucidated. To identify novel genes associated with leg ulcers in sickle cell anemia, we performed whole-exome sequencing of extreme phenotypes in a sample of Brazilian sickle cell anemia patients and validated our findings in another sample. Our discovery cohort consisted of 40 unrelated sickle cell anemia patients selected based on extreme phenotypes: 20 patients without leg ulcers, aged from 40 to 61 years, and 20 with chronic leg ulcers. DNA was extracted from peripheral blood leukocytes and used for whole-exome sequencing. After the bioinformatics analysis, eight variants were selected for validation by Sanger sequencing and TaqMan (R) genotyping in 293 sickle cell anemia patients (153 without leg ulcers) from two different locations in Brazil. After the validation, Fisher's exact test revealed a statistically significant difference in a stop codon variant (rs12568784 G/T) in the FLG2 gene between the GT and GG genotypes (P = 0.035). We highlight the importance of rs12568784 in leg ulcer development as this variant of the FLG2 gene results in impairment of the skin barrier, predisposing the individual to inflammation and infection. Additionally, we suggest that the remaining seven variants and the genes in which they occur could be strong candidates for leg ulcers in sickle cell anemia. Impact statement To our knowledge, the present study is the first to use whole-exome sequencing based on extreme phenotypes to identify new candidate genes associated with leg ulcers in sickle cell anemia patients. There are few studies about this complication; the pathogenesis remains complex and has yet to be fully elucidated. We identified interesting associations in genes never related with this complication to our knowledge, especially the variant in the FLG2 gene. The knowledge of variants related with leg ulcer in sickle cell anemia may lead to a better comprehension of the disease's etiology, allowing prevention and early treatment options in risk genotypes while improving quality of life for these patients. (AU)

Processo FAPESP: 15/24029-3 - Investigação de genes de suscetibilidade à úlcera de perna em pacientes com anemia falciforme
Beneficiário:Gabriela Queila de Carvalho Siqueira
Linha de fomento: Bolsas no Brasil - Doutorado Direto
Processo FAPESP: 14/00984-3 - Doenças dos glóbulos vermelhos: fisiopatologia e novas abordagens terapêuticas
Beneficiário:Fernando Ferreira Costa
Linha de fomento: Auxílio à Pesquisa - Temático