title: Whole exome sequencing in the Framingham Heart Study identifies rare variation in HYAL2 that influences platelet aggregation.
abstract: Inhibition of platelet reactivity is a common therapeutic strategy in secondary prevention of cardiovascular disease. Genetic and environmental factors influence inter-individual variation in platelet reactivity. Identifying genes that contribute to platelet reactivity can reveal new biological mechanisms and possible therapeutic targets. Here, we examined rare coding variation to identify genes associated with platelet reactivity in a population-based cohort. To do so, we performed whole exome sequencing in the Framingham Heart Study and conducted single variant and gene-based association tests against platelet reactivity to collagen, adenosine diphosphate (ADP), and epinephrine agonists in up to 1,211 individuals. Single variant tests revealed no significant associations (p<1.44×10-7), though we observed a suggestive association with previously implicated MRVI1 (rs11042902, p = 1.95×10-7). Using gene-based association tests of rare and low-frequency variants, we found significant associations of HYAL2 with increased ADP-induced aggregation (p = 1.07×10-7) and GSTZ1 with increased epinephrine-induced aggregation (p = 1.62×10-6). HYAL2 also showed suggestive associations with epinephrine-induced aggregation (p = 2.64×10-5). The rare variants in the HYAL2 gene-based association included a missense variant (N357S) at a known N-glycosylation site and a nonsense variant (Q406*) that removes a glycophosphatidylinositol (GPI) anchor from the resulting protein. These variants suggest that improper membrane trafficking of HYAL2 influences platelet reactivity. We also observed suggestive associations of AR (p = 7.39×10-6) and MAPRE1 (p = 7.26×10-6) with ADP-induced reactivity. Our study demonstrates that gene-based tests and other grouping strategies of rare variants are powerful approaches to detect associations in population-based analyses of complex traits not detected by single variant tests and possible new genetic influences on platelet reactivity.
authors.forename: John D
authors.initials: JD
authors.lastname: Eicher
authors.forename: Ming-Huei
authors.initials: MH
authors.lastname: Chen
authors.forename: Achilleas N
authors.initials: AN
authors.lastname: Pitsillides
authors.forename: Honghuang
authors.initials: H
authors.lastname: Lin
authors.forename: Narayanan
authors.initials: N
authors.lastname: Veeraraghavan
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Brody
authors.forename: Ginger A
authors.initials: GA
authors.lastname: Metcalf
authors.forename: Donna M
authors.initials: DM
authors.lastname: Muzny
authors.forename: Richard A
authors.initials: RA
authors.lastname: Gibbs
authors.forename: Diane M
authors.initials: DM
authors.lastname: Becker
authors.forename: Lewis C
authors.initials: LC
authors.lastname: Becker
authors.forename: Nauder
authors.initials: N
authors.lastname: Faraday
authors.forename: Rasika A
authors.initials: RA
authors.lastname: Mathias
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Yanek
authors.forename: Eric
authors.initials: E
authors.lastname: Boerwinkle
authors.forename: L Adrienne
authors.initials: LA
authors.lastname: Cupples
authors.affiliation: Andrew D. Johnson, Tenure Track Investigator, Population Sciences Branch, National Heart, Lung, and Blood Institute, The Framingham Heart Study, 73 Mt. Wayte Ave. Suite #2, Framingham, MA 01702, USA, Tel.: +1 508 663 4082, E-mail: johnsonad2@nhlbi.nih.gov.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Johnson
mesh_terms: D000244:Adenosine Diphosphate / Q000378:metabolism; D000328:Adult; D000483:Alleles; D001792:Blood Platelets / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000235:genetics*; D015815:Cell Adhesion Molecules / Q000235:genetics*; D015331:Cohort Studies; D004837:Epinephrine / Q000378:metabolism; D059472:Exome / Q000235:genetics*; D005260:Female; D058851:GPI-Linked Proteins / Q000235:genetics; D005838:Genotype; D006801:Humans; D006821:Hyaluronoglucosaminidase / Q000235:genetics*; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008565:Membrane Proteins / Q000235:genetics; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D010750:Phosphoproteins / Q000235:genetics; D010974:Platelet Aggregation / Q000235:genetics*; D011110:Polymorphism, Genetic; D044382:Population Groups; D021381:Protein Transport / Q000235:genetics; D000073359:Exome Sequencing
chemical_list: D015815:Cell Adhesion Molecules; D058851:GPI-Linked Proteins; C485784:IRAG1 protein, human; D008565:Membrane Proteins; D010750:Phosphoproteins; D000244:Adenosine Diphosphate; C473096:Hyal2 protein, human; D006821:Hyaluronoglucosaminidase; D004837:Epinephrine
keywords: Epidemiological studies; gene mutations; platelet physiology; polymorphisms; thrombosis