Segregation at three loci explains familial and population risk in Hirschsprung disease.
Hirschsprung disease (HSCR), the most common hereditary cause of intestinal obstruction, shows considerable variation and complex inheritance. Coding sequence mutations in RET, GDNF, EDNRB, EDN3 and SOX10 lead to long-segment (L-HSCR) and syndromic HSCR but fail to explain the transmission of the much more common short-segment form (S-HSCR). We conducted a genome scan in families with S-HSCR and identified susceptibility loci at 3p21, 10q11 and 19q12 that seem to be necessary and sufficient to explain recurrence risk and population incidence. The gene at 10q11 is probably RET, supporting its crucial role in all forms of HSCR; however, coding sequence mutations are present in only 40% of linked families, suggesting the importance of noncoding variation. Here we show oligogenic inheritance of S-HSCR, the 3p21 and 19q12 loci as RET-dependent modifiers, and a parent-of-origin effect at RET. This study demonstrates by a complete genetic dissection why the inheritance pattern of S-HSCR is nonmendelian.
Gabriel
Stacey B
SB
Department of Genetics and Center for Human Genetics, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA.
Salomon
Rémi
R
Pelet
Anna
A
Angrist
Misha
M
Amiel
Jeanne
J
Fornage
Myriam
M
Attié-Bitach
Tania
T
Olson
Jane M
JM
Hofstra
Robert
R
Buys
Charles
C
Steffann
Julie
J
Munnich
Arnold
A
Lyonnet
Stanislas
S
Chakravarti
Aravinda
A
D000483:Alleles; D002879:Chromosomes, Human, Pair 10 / Q000235:genetics; D002888:Chromosomes, Human, Pair 19 / Q000235:genetics; D002893:Chromosomes, Human, Pair 3 / Q000235:genetics; D029721:Drosophila Proteins; D005260:Female; D005819:Genetic Markers; D051097:Glial Cell Line-Derived Neurotrophic Factor Receptors; D006627:Hirschsprung Disease / Q000235:genetics*; D006801:Humans; D008297:Male; D008957:Models, Genetic; D011518:Proto-Oncogene Proteins / Q000235:genetics*; D051096:Proto-Oncogene Proteins c-ret; D020794:Receptor Protein-Tyrosine Kinases / Q000235:genetics*; D012307:Risk Factors
D029721:Drosophila Proteins; D005819:Genetic Markers; D051097:Glial Cell Line-Derived Neurotrophic Factor Receptors; D011518:Proto-Oncogene Proteins; D051096:Proto-Oncogene Proteins c-ret; D020794:Receptor Protein-Tyrosine Kinases; C416649:Ret protein, Drosophila