A meta-analysis of genome-wide association studies of childhood wheezing phenotypes identifies ANXA1 as a susceptibility locus for persistent wheezing.

Background: Many genes associated with asthma explain only a fraction of its heritability. Most genome-wide association studies (GWASs) used a broad definition of 'doctor-diagnosed asthma', thereby diluting genetic signals by not considering asthma heterogeneity. The objective of our study was to identify genetic associates of childhood wheezing phenotypes.
Methods: We conducted a novel multivariate GWAS meta-analysis of wheezing phenotypes jointly derived using unbiased analysis of data collected from birth to 18 years in 9568 individuals from five UK birth cohorts.
Results: Forty-four independent SNPs were associated with early-onset persistent, 25 with pre-school remitting, 33 with mid-childhood remitting, and 32 with late-onset wheeze. We identified a novel locus on chr9q21.13 (close to annexin 1 [ ANXA1 ], p<6.7 × 10 ^-9 ), associated exclusively with early-onset persistent wheeze. We identified rs75260654 as the most likely causative single nucleotide polymorphism (SNP) using Promoter Capture Hi-C loops, and then showed that the risk allele (T) confers a reduction in ANXA1 expression. Finally, in a murine model of house dust mite (HDM)-induced allergic airway disease, we demonstrated that anxa1 protein expression increased and anxa1 mRNA was significantly induced in lung tissue following HDM exposure. Using anxa1 ^-/- deficient mice, we showed that loss of anxa1 results in heightened airway hyperreactivity and Th2 inflammation upon allergen challenge.
Conclusions: Targeting this pathway in persistent disease may represent an exciting therapeutic prospect.
Funding: UK Medical Research Council Programme Grant MR/S025340/1 and the Wellcome Trust Strategic Award (108818/15/Z) provided most of the funding for this study.
Competing Interests: RG, JC, SH, NK, SM, LG, LY, MT, JH, MP, JV, HA, PC, SF, ST No competing interests declared, GR MRC grant to my institution; President of the British Society of Allergy and Clinical Immunology, GK Dutch Lung Foundation, Ubbo Emmius Foundation (Money to insititution); Dutch Lung Foundation, Vertex, TEVA the Netherlands, GSK, ZON-MW (VICI grant), European Union (Money to institution); Astra Zeneca, Pure IMS, GSK (Money to institution); Sanofi, Boehringer Ingelheim (Money to institution), AS Medical research council Research grant; JP Moulton Charitable Foundation Research grant; Asthma UK Research grant, CM has received grants from Asthma Uk, the National Institute for Health Research, the Moulton Charitable Foundation and the North West Lung Centre Charity (to the Institution). They received lecture fees from GSK and Novartis, and received a travel grant from Sanofi. The authors has no other competing interests to declare, CL Wellcome Trust 107059/Z/15/Z, JH Medial Research Council grant MR/S025340/1 (to institution); American Academy of Allergy Asthma and Immunology (AAAI) (Support for speaker travel to AAAAI annual congress), AC MRC (research grants); EPSRC (research grant); Wellcome Trust (research grant); Worg Pharmaceoticals (Personal payment)
(© 2023, Granell et al.)