1. Beyond factor H: The impact of genetic-risk variants for age-related macular degeneration on circulating factor-H-like 1 and factor-H-related protein concentrations
- Author
-
Cipriani, Valentina, Tierney, Anna, Griffiths, John R, Zuber, Verena, Sergouniotis, Panagiotis I, Yates, John RW, Moore, Anthony T, Bishop, Paul N, Clark, Simon J, and Unwin, Richard D
- Subjects
Aging ,Macular Degeneration ,Neurodegenerative ,Eye Disease and Disorders of Vision ,Genetics ,2.1 Biological and endogenous factors ,Aetiology ,Aged ,Case-Control Studies ,Complement C3b Inactivator Proteins ,Complement Factor H ,Female ,Genetic Predisposition to Disease ,Humans ,Male ,Polymorphism ,Single Nucleotide ,Risk Factors ,Mendelian randomization ,age-related macular degeneration ,complement factor H ,factor H-related ,mass spectrometry ,Biological Sciences ,Medical and Health Sciences ,Genetics & Heredity - Abstract
Age-related macular degeneration (AMD) is a leading cause of vision loss; there is strong genetic susceptibility at the complement factor H (CFH) locus. This locus encodes a series of complement regulators: factor H (FH), a splice variant factor-H-like 1 (FHL-1), and five factor-H-related proteins (FHR-1 to FHR-5), all involved in the regulation of complement factor C3b turnover. Little is known about how AMD-associated variants at this locus might influence FHL-1 and FHR protein concentrations. We have used a bespoke targeted mass-spectrometry assay to measure the circulating concentrations of all seven complement regulators and demonstrated elevated concentrations in 352 advanced AMD-affected individuals for all FHR proteins (FHR-1, p = 2.4 × 10-10; FHR-2, p = 6.0 × 10-10; FHR-3, p = 1.5 × 10-5; FHR-4, p = 1.3 × 10-3; FHR-5, p = 1.9 × 10-4) and FHL-1 (p = 4.9 × 10-4) when these individuals were compared to 252 controls, whereas no difference was seen for FH (p = 0.94). Genome-wide association analyses in controls revealed genome-wide-significant signals at the CFH locus for all five FHR proteins, and univariate Mendelian-randomization analyses strongly supported the association of FHR-1, FHR-2, FHR-4, and FHR-5 with AMD susceptibility. These findings provide a strong biochemical explanation for how genetically driven alterations in circulating FHR proteins could be major drivers of AMD and highlight the need for research into FHR protein modulation as a viable therapeutic avenue for AMD.
- Published
- 2021