Genetics Variants associated with Anterior Cruciate Ligament injury in Australia, South Africa, and Japan

Abstract

Previous small-scale studies have shown an association between the COL5A1 gene and anterior cruciate ligament (ACL) injury risk. In this larger study, the genotype and allele frequency distributions of the COL5A1 rs12722 C/T and rs10628678 AGGG/deletion (AGGG/-) indel variants were compared between: i) participants with ACL injury in independent and combined cohorts from South-Africa (SA) and Australia (AUS) vs controls (CON), and ii) participants with any ligament or only ACL injury in a Japanese (JPN) cohort vs CON. Samples were collected from SA (n=467; n=235 cases; n=232 controls), AUS (n=442; n=362 cases; n=80 controls) and JPN (n=1,903; cases n=500; n=1,403 controls). Genomic DNA was extracted and genotyped. Distributions were compared, and inferred haplotype analyses performed. No independent associations were noted for rs12722 or rs10628678 when the combined SA and AUS cohort was analysed. However, the rs12722-rs10628678 C- inferred haplotype was over-represented in the female SA + AUS CON vs ACL (p=0.040, OR=0.15, CI=0.04-0.56), whereas T- inferred haplotype was over-represented in the ACL SA+AUS participants in female participants (p<0.001, OR=4.74, CI=1.66-13.55). Moreover, the rs12722 C/C genotype was over-represented in JPN ACL vs CON (p=0.039, OR=0.52, 0.27-1.00), and the rs10628678 -/- genotype over-represented with increased risk of ligament injuries (p=0.035, OR=1.31, CI=1.02-1.68) in the JPN cohort. Collectively, these results highlight that a region within the COL5A1 3’-UTR is associated with ligament susceptibility. This must be evaluated in larger cohorts and functional contribution to ligament and knee joint biomechanics further explored. Highlights▪The rs12722 rs10628678 T- inferred haplotype was over-represented with increased risk of ACL rupture in the combined SA and AUS female participants.▪The rs12722 rs10628678 C- inferred haplotype was over-represented with decreased risk of ACL rupture in the combined SA and AUS female participants.▪The rs12722 C/C genotype and rs10628678 -/- genotype was associated with increased risk of ACL rupture and ligament injuries in JPN, respectively.▪A region within the COL5A1 3’-UTR is associated with susceptibility to ligament injuries, ACL rupture in particular, and must be investigated further as it may have a bearing on functional capacity of ligaments or joint biomechanics. Conflict of interest statement: My co-authors and I acknowledge that we have no conflict of interest of relevance to the submission of the abstract entitled "COL5A1 Gene variants and ligament injuries in Australian, South African, and Japanese populations" to be presented in the SMA conference in 2021.