ITM2A Expands Evidence for Genetic and Environmental Interaction in Graves Disease Pathogenesis.
Graves disease (GD) is a common autoimmune disease triggered by genetic predisposition and environmental factors. However, the mechanisms of interaction between genetic and environmental factors contributing to the development of GD remain unknown.



We aimed to identify GD susceptibility variants and genes on Xq21.1 locus and interpret the contribution of interaction between genetic predisposition on Xq21.1 and environmental factors to GD.



We performed refining study on Xq21.1 in a 2-stage study and carried out expression quantitative trait locus analysis of the best association signal with GD.



A total of 4316 GD patients and 4374 sex-matched controls were collected from the Chinese Han population by cooperation with multiple hospitals.



We identified that rs3827440 or its linkage single nucleotide polymorphisms (SNPs) were probably the causal variant in the Xq21.1 locus, with the most substantial association with GD in our combined cohorts (P = 2.45 × 10-15). The genotypes of rs3827440 were correlated with the expression of ITM2A in monocytes and peripheral blood mononuclear cells (PBMCs) from healthy volunteers. Notably, the expression of ITM2A in monocytes after lipopolysaccharide (LPS) and interferon-γ (INF-γ) stimulation showed substantial difference among the volunteers that carried different genotypes of rs3827440 (P = 9.40 × 10-7 and P = 1.26 × 10-5 for 24 hours' LPS and INF-γ stimulation, respectively). Moreover, ITM2A expression was significantly decreased in PBMCs from untreated GD patients than that from controls.



The results suggest that ITM2A might be a susceptibility gene for GD in the Xq21.1 locus, and environmental factors, such as viral and bacterial infections, probably contribute to GD pathogenesis by interacting with the risk SNP rs3827440 mediating the regulation of ITM2A expression.
State Key Laboratory of Medical Genomics, Shanghai Institute of Endocrinology and Metabolism, Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.|Research Center for Clinical Medicine, Department of Respiration and Endocrinology, The Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200011, China.
Xiao-Ping
XP
Ye
State Key Laboratory of Medical Genomics, Shanghai Institute of Endocrinology and Metabolism, Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.|Research Center for Clinical Medicine, Department of Respiration and Endocrinology, The Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200011, China.
Fei-Fei
FF
Yuan
Research Center for Clinical Medicine, Department of Respiration and Endocrinology, The Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200011, China.
Le-Le
LL
Zhang
Research Center for Clinical Medicine, Department of Respiration and Endocrinology, The Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200011, China.
Yu-Ru
YR
Ma
Research Center for Clinical Medicine, Department of Respiration and Endocrinology, The Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200011, China.
Man-Man
MM
Zhang
Research Center for Clinical Medicine, Department of Respiration and Endocrinology, The Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200011, China.
Wei
W
Liu
Research Center for Clinical Medicine, Department of Respiration and Endocrinology, The Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200011, China.
Feng
F
Sun
Research Center for Clinical Medicine, Department of Respiration and Endocrinology, The Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200011, China.
Jing
J
Wu
Research Center for Clinical Medicine, Department of Respiration and Endocrinology, The Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200011, China.
Meng
M
Lu
Research Center for Clinical Medicine, Department of Respiration and Endocrinology, The Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200011, China.
Li-Qiong
LQ
Xue
State Key Laboratory of Medical Genomics, Shanghai Institute of Endocrinology and Metabolism, Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
Jing-Yi
JY
Shi
Research Center for Clinical Medicine, Department of Respiration and Endocrinology, The Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200011, China.
Shuang-Xia
SX
Zhao
State Key Laboratory of Medical Genomics, Shanghai Institute of Endocrinology and Metabolism, Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.|Research Center for Clinical Medicine, Department of Respiration and Endocrinology, The Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200011, China.
Huai-Dong
HD
Song
Department of Endocrinology, The Central Hospital of Xuzhou Affiliated to Xuzhou Medical College, Xuzhou, Jiangsu Province 221109, China; and.|Xuzhou Clinical School of Xuzhou Medical College, The Affiliated XuZhou Hospital of Medical College of Southeast University, Xuzhou, Jiangsu Province 221009, China.
Jun
J
Liang
Research Center for Clinical Medicine, Department of Respiration and Endocrinology, The Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200011, China.
Cui-Xia
CX
Zheng
D001424:Bacterial Infections / Q000150:complications*; D002681:China; D059647:Gene-Environment Interaction; D020022:Genetic Predisposition to Disease; D055106:Genome-Wide Association Study; D006111:Graves Disease / Q000097:blood / Q000209:etiology* / Q000235:genetics*; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000378:metabolism*; D008565:Membrane Proteins / Q000235:genetics*; D020641:Polymorphism, Single Nucleotide; D040641:Quantitative Trait Loci; D014777:Virus Diseases / Q000150:complications*
C485527:ITM2A protein, human; D008565:Membrane Proteins