Genome Scan Studies Research Articles

Current topics in human SLE genetics

Susceptibility to systemic lupus erythematosus (SLE) depends on genetic and environmental factors. Genome scan studies have identified eight chromosomal regions with significant linkage to SLE that are confirmed by individual cohorts, suggesting that susceptibility genes may be identified within each of these loci. Linkage studies and single nucleotide polymorphisms (SNPs) have led to the identification of positional candidate genes, and their functional allelic variants have demonstrated molecular pathogenesis of the disease. The discovery of positional candidate genes that are associated with various autoimmune diseases signifies a common pathway in the mechanism of these diseases. Copy polymorphisms in susceptibility genes provide evidence in how genetic plasticity affects complex phenotypes as seen in SLE.

Osteoarthritis susceptibility loci defined by genome scan meta-analysis

Genome scans for osteoarthritis (OA) have yielded inconsistent results. The absence of replication of linkage might be due to lack of power of individual studies. A meta-analysis of the published data was performed to assess evidence for linkage of OA across genome scan studies. Three OA whole-genome scans including 893 families with 3,000 affected individuals were used for genome scan meta-analysis (GSMA). A total of 5 bins lie above 95% confidence level (P = 0.05) and 1 bin is above 99% confidence level (P = 0.01) in OA GSMA; bins 7.6 (7q34-7q36.3, Psumrnk = 0.0035), 11.3 (11p12-11q13.4), 6.3 (6p21.1-6q15), 2.8 (2q31.1-2q34) and 15.3 (15q21.3-15q26.1). The highest summed rank was observed at bin 7.6. In conclusion, the OA GSMA has shown chromosome 7q34-7q36.3 with the highest summed rank and four additional loci with significant summed ranks across studies.

An Empirical Bayes Method for Updating Inferences in Analysis of Quantitative Trait Loci Using Information From Related Genome Scans

Individual genome scans for quantitative trait loci (QTL) mapping often suffer from low statistical power and imprecise estimates of QTL location and effect. This lack of precision yields large confidence intervals for QTL location, which are problematic for subsequent fine mapping and positional cloning. In prioritizing areas for follow-up after an initial genome scan and in evaluating the credibility of apparent linkage signals, investigators typically examine the results of other genome scans of the same phenotype and informally update their beliefs about which linkage signals in their scan most merit confidence and follow-up via a subjective-intuitive integration approach. A method that acknowledges the wisdom of this general paradigm but formally borrows information from other scans to increase confidence in objectivity would be a benefit. We developed an empirical Bayes analytic method to integrate information from multiple genome scans. The linkage statistic obtained from a single genome scan study is updated by incorporating statistics from other genome scans as prior information. This technique does not require that all studies have an identical marker map or a common estimated QTL effect. The updated linkage statistic can then be used for the estimation of QTL location and effect. We evaluate the performance of our method by using extensive simulations based on actual marker spacing and allele frequencies from available data. Results indicate that the empirical Bayes method can account for between-study heterogeneity, estimate the QTL location and effect more precisely, and provide narrower confidence intervals than results from any single individual study. We also compared the empirical Bayes method with a method originally developed for meta-analysis (a closely related but distinct purpose). In the face of marked heterogeneity among studies, the empirical Bayes method outperforms the comparator.

Heterogeneous evolution of microsatellites revealed by reconstruction of recent mutation history in an invasive apomictic snail, Potamopyrgus antipodarum

Heterogeneous patterns of microsatellite evolution present a major challenge for the development of mutation models, and an improved understanding of the determinants of variation in mutation rates and patterns among loci, alleles and taxa is required. A 19th Century bottleneck associated with the introduction of clones of the snail Potamopyrgus antipodarum to Britain presented an opportunity to reconstruct recent microsatellite evolution within the most common apomictic lineage. There was significant variation in both the number and step size of mutations among the seven loci studied. Patterns of mutability were consistent with higher mutation rates for di- than trinucleotides and for longer alleles at a locus. Mutation size was influenced in a more complex way, decreasing with relative allele length much more strongly for tri-, than dinucleotides. We found support for this latter, highly novel result in the literature via reanalysis of data in a recent genome-scan study of human microsatellites, which showed a similarly disparate pattern of length-dependence between di- and trinucleotides. In spite of the apomictic form of reproduction and an unusually strong excess of microsatellite contractions in P. antipodarum, there were notable similarities with mutation processes of human microsatellites, supporting the wider taxonomic generality of such evolutionary mechanisms.

Osteoarthritis susceptibility loci defined by genome scan meta-analysis

Genome scans for osteoarthritis (OA) have yielded inconsistent results. The absence of replication of linkage might be due to the lack of power of individual studies. A meta-analysis of published data was performed to assess evidence for linkage of OA across genome scan studies. Three OA whole-genome scans including 893 families with 3,000 affected individuals were used for genome scan meta-analysis (GSMA). A total of five bins lie above 95% confidence level (P=0.05) and one bin is above 99% confidence level (P=0.01) in OA GSMA; bins 7.6 (7q34-7q36.3, P (sumrnk) =0.0035), 11.3 (11p12-11q13.4), 6.3 (6p21.1-6q15), 2.8 (2q31.1-2q34) and 15.3 (15q21.3-15q26.1). The highest summed bin was bins 7.6. In conclusion, the OA GSMA has shown that chromosome 7q34-7q36.3 have the highest summed rank and four additional loci with significant summed ranks across studies.

Meta-analysis of genome-wide linkage studies for bone mineral density

Genome-wide linkage studies have shown several chromosome loci that may harbor genes that regulate bone mineral density (BMD), but results have been inconsistent. A meta-analysis was performed to assess evidence for linkage of BMD across whole genome scan studies. Eleven whole-genome scans of BMD or osteoporosis containing 3,097 families with 12,685 individuals were included in this genome scan meta-analysis (GSMA). For each study, 120 genomic bins of approximately 30 cM were defined and ranked according to maximum evidence for linkage within each bin. Bin ranks were weighted and summed across all studies. The summed rank for each bin was assessed empirically for significance using permutation methods. A total of seven bins lie above the 95% confidence level (P=0.05) and one bin was above the 99% confidence level (P=0.01) in the GSMA of eleven linkage studies: bins 16.1 (16pter-16p12.3, Psumrnk <0.01), 3.3 (3p22.2-3p14.1), 1.1 (1pter-1p36.22), 18.2 (18p11.23-18q12.2), 6.3 (6p21.1-6q15), 20.1 (20pter-20p12.3), and 18.1 (18pter-18p11.23). GSMA was performed with seven studies with linkage scores of LOD >1-1.85 for sensitivity test, confirming the linkage on chromosome 16p and 3p and revealing evidence of new linkage in bins 10.2 (10p14-10q11.21) and 22.2 (22q12.3-22pter). In conclusion, the meta-analysis of whole-genome linkage studies of BMD has shown chromosome 16pter-16p12.3 to have the greatest evidence of linkage as well as revealing evidence of linkage in chromosomes 1p, 3p, 6, 10, 18, 20p, and 22q across studies. This data may provide a basis with which to carry out targeted linkage and candidate gene studies particularly in these regions.

Association of the phosphatase and tensin homolog gene (PTEN) with smoking initiation and nicotine dependence

Since PTEN (phosphatase and tensin homolog) has elevated expression in rat brain (amygdala) after chronic administration of nicotine and the PTEN gene is located in the vicinity of the chromosome 10q23 linkage peak in a genome-scan study of nicotine dependence, PTEN seems a plausible candidate gene for smoking behavior. To test this hypothesis, we use a three-group case-control design and genotype five SNPs in the PTEN gene. We compare allele and genotype frequencies between the smokers and nonsmokers and between the low nicotine dependent and high nicotine dependent subjects. Three SNPs in the PTEN gene are significantly associated with smoking initiation (rs1234221, P = 0.0311; rs1234213, P = 0.0002; and rs2735343, P = 0.0028). Rs1234213 also shows association with nicotine dependence (P = 0.0278). Haplotype analyses indicate that a major haplotype, 1-1-2-2-1 for rs1234221-rs2299939-rs1234213-rs2735343-rs70184, is associated with smoking initiation. A minor haplotype (about 3%), 1-2-2-2-1 for the same five SNPs, is observed only in the high nicotine dependence group. These results suggest that the PTEN gene may be involved in the etiology of both smoking initiation and nicotine dependence.

Response

Dear Madam: We thank Drs. Samaras and Campbell for their comments regarding our paper ((1)). We appreciate the opportunity to further discuss this interesting and important area of biomedical investigation. In our paper, we focused discussion on the measurements of both whole body and selected regional quantities of fat mass (FM) and lean mass (LM). We analyzed DXA measurements, including % FM, whole body FM, trunk FM, whole body LM, and appendicular LM. BMI was considered as an easily measured phenotype for comparison. We recognize that DXA can be used to estimate central abdominal fat, but central abdominal fat was not the focus of this paper. Rather, we chose to focus on body composition per se (i.e., absolute and relative quantities of adipose tissue and lean mass). Drs. Samaras and Campbell have published a series of papers using a twin study to study the genetic epidemiology of total and central obesity and metabolic syndrome. The Diabetes Heart Study (DHS), on the other hand, is a study of siblings concordant for type 2 diabetics and unaffected family members. It is interesting to note that the twin study provides heritability estimates of similar magnitude to those in our study. This similarity may suggest relatively little effect of non-additivity or gene-gene interaction on the variation in these adiposity phenotypes after adjusting for the covariates. The two study designs (twin and family) have their own advantages and disadvantages. Sampling on multiplex families (e.g., affected sibling pairs) reduces the likelihood of including non-genetic sources of variation. Thus, the sibling pair study design can be used to define the role of genetic factors in disease and, with inclusion of genetic markers, provide gene localization. One potential limitation of the family study is that the heritability estimates may not delineate shared genes from shared environment. The twin study, when including monozygotic (MZ) and dizygotic (DZ) twin pairs, provides an elegant way to delineate genetic from environmental factors; however, in the absence of twins reared apart, the twin design may overestimate heritability due to the inability to separate the effects of shared environment. Even in the absence of any genetic factor, the greater environmental similarity in MZ twins can result in a higher concordance rate in MZ twins than in DZ twins ((2)). The ability to generalize results of twin studies to the non-twin population remains controversial, as twins share environmental factors uniquely, and selection bias may minimize the environmental variation and, hence, inflate the role of genetic factors ((3)). The DHS has extensive data on cardiovascular phenotypes, bone mineral density, and body composition. While our paper focuses on DXA measures, quantitative computed tomography measures exist that further delineate components of body composition. Taking advantage of the family study design, a genome scan is being performed to identify quantitative trait loci that contribute to the observed variation in these phenotypes. The combination of genome scan, candidate gene, and family-based association studies should permit the identification of genes that may contribute to the expression of FM and LM.

Interval estimation of disease loci: development and applications of new linkage methods

Three variants of the confidence set inference (CSI) procedure were proposed and applied to both the simulated and the Collaborative Study on the Genetics of Alcoholism (COGA) data. For each of the two applications, we first performed a preliminary genome scan study based on the microsatellite markers using the GENEHUNTER+ software to identify regions that potentially harbor disease loci. For each such region, we estimated the sibling identity-by-descent sharing probability distribution at the putative disease locus. Based on these estimated probabilities, the CSI procedures were employed to further localize the disease loci using the single-nucleotide polymorphism markers, leading to confidence intervals/regions for their locations. For our analysis with the simulated data, we had knowledge of the simulating models at the time we performed the analysis.

Bone mass in young adults: relationship with gender, weight and genetic factors

To determine the relationship of the bone mass attained in young adults with anthropometric and genetic factors. Cross-sectional study of normal individuals. We studied 341 healthy subjects between 22 and 45 years of age. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DXA) and correlated with body weight, height and nine polymorphisms in six genes involved in sex steroid metabolism (17-hydroxylase, aromatase and 5-reductase) and activity (oestrogen receptors (ER)-alpha and -beta, and androgen receptor). The BMD was higher in men than in women (spine: 1.048 +/- 0.120 vs. 1.034 +/- 0.112; hip: 0.907 +/- 0.131 vs. 0.822 +/- 0.104 g cm(-2), P < 0.001). However, the difference was due, at least in part, to the larger body size in men and diminished markedly after height adjustment. There was a negative correlation between age and hip BMD. Body weight was the single most influential factor on spine and hip BMD in both sexes, explaining 8-9% of BMD variance. Amongst the genetic factors studied, a common CA repeat polymorphism in ER-beta showed a significant association with BMD in women (P = 0.03 at the spine, and 0.008 at the hip). The relationship between ER-beta genotype and BMD persisted after adjustment by body weight and age, explaining a further 2-3% of BMD variance. Allelic variants of other genes studied were not related with BMD. Body weight and allelic variants of ER-beta are associated with BMD in young adults.

Genome scan meta-analysis of rheumatoid arthritis

Genome scans for rheumatoid arthritis (RA) have yielded inconsistent results. The absence of replication of linkage might be due to lack of power of individual studies. We performed a genome scan meta-analysis of published data to increase statistical power and to assess evidence for linkage of RA across genome scan studies. Four RA whole-genome scans containing 767 families with 964 sibling pairs were included for the genome scan meta-analysis (GSMA). The GSMA method was applied to pool the results obtained from four genome scans. For each study, 120 genomic bins of approximately 30 centimorgans were defined and ranked according to maximum evidence for linkage within each bin. Bin ranks were weighted and summed across all studies. The summed rank for each bin was assessed empirically for significance using permutation methods. A total of nine bins lay above the 95% confidence level (P=0.05) and four bins were above the 99% confidence level (P=0.01) in the RA GSMA, suggesting that these bins contain RA-linked loci: bins 6.2, 6.4, 8.1, 18.3, 12.3, 12.2, 1.5, 6.3 and 16.2. The strongest evidence for linkage occurred on chromosome 6p22.3-6p21.1 (bin 6.2), containing the HLA region (P(sumrnk)=0.0000008). This RA GSMA confirmed the evidence for HLA loci as the greatest susceptibility factor to RA and showed evidence for linkage at non-HLA loci, such as chromosomes 1p, 6, 8p, 12, 16 and 18q, across studies. These data may provide a basis to carry out targeted linkage and candidate gene studies, particularly in the regions.

Linkage disequilibrium in aquaporin 4 gene and association study with schizophrenia

Aquaporin 4 (AQP4) has an important role in water homeostasis of human brain and a dysfunction of AQP4 could induce pathological conditions in neuronal activity. Several genome scan studies for schizophrenia found a suggestive linkage on 18q, where human AQP4 (18q11.2-12.1) is located nearby. A case-control study was performed which comprised 261 schizophrenia subjects and 278 controls from the Japanese population with four SNP markers. We found strong linkage disequilibrium (LD) and an LD block in the AQP4 gene but found no association between AQP4 and schizophrenia, both single SNP and haplotype analyses. The present study shows that AQP4 is not directly associated with schizophrenia in these Japanese patients.

Genetic factors in pemphigus

Epidemiological studies performed in different ethnic populations and family studies, notably based on a partial phenotype of the autoimmune process, indicate that genetic factors are involved in the occurrence of pemphigus. However, the precise heritability remains uncertain in the absence of twin concordance rate studies. Among the different strategies available to identify genetic factors participating in autoimmune disease susceptibility, only population studies based on case–control design have been performed in pemphigus. These studies consistently showed that MHC locus, in particular HLA class II alleles, are associated with pemphigus vulgaris and pemphigus foliaceus. Other genes of the MHC locus may also participate in disease susceptibility as shown by studies using microsatellite markers across different regions of the MHC. It is likely that other non-MHC genes are involved in the pathogenesis of pemphigus. In particular, involvement of a polymorphic variant of desmoglein 1 gene was shown to be associated with pemphigus foliaceus and to interact in an epistatic manner with MHC class II genes to contribute to the autoimmune process. Other candidate genes to which a role can be assigned in the disease pathogenesis should be considered to design case–control or family-based association studies. Genome scan studies which require a large number of multiplex families to reach statistical power, should also be considered in the endemic form of pemphigus foliaceus because of the high number of familial cases.

Molecular Genetics of Substance Abuse Vulnerability: Remarkable Recent Convergence of Genome Scan Results

Classical genetic studies document strong complex genetic contributions to abuse of multiple addictive substances. Goals of molecular genetic studies of addiction include: (1) locating chromosomal regions that contain allelic gene variants that contribute to vulnerability to drug dependence and (2) discovering which alleles of which gene markers and which genes provide these enhanced vulnerabilities. Genome scanning provides an approach to these goals. Until recently, data from genome scanning studies did not convincingly identify chromosomal positions for allelic variants predisposing to substance dependence. Nominal results of initial genome scans for alcohol and nicotine dependence failed to display much agreement; no two studies' results seemed to identify the same chromosomal regions for addiction vulnerability alleles. However, recent data from our association-based genome scans for illegal addictions, reanalyses of prior linkage-based results, and data from even newer linkage-based genome scans now provide a striking body of converging results. Sixteen chromosomal regions are identified by reproducible positive results obtained in multiple populations. These 16 regions are thus good candidates to harbor common allelic variants that confer human vulnerability to addiction to several classes of substances. Genomic markers that identify allelic variants that reproducibly alter addiction vulnerability in studies in several populations provide powerful tools for clinical research in addictions and addiction treatments.

Microsatellite marker association at chromosome region 2p13 in Finnish patients with preeclampsia and obstetric cholestasis suggests a common risk locus

The pathophysiology of preeclampsia is incompletely understood, but the familial nature of the disease has long been recognized. Recent genome-scan studies have indicated linkage at the p23 region of chromosome 2. We have previously reported microsatellite marker association at chromosome region 2p13 in patients with obstetric cholestasis. We conducted population-based association screening with microsatellite markers to find potential preeclampsia-associated loci on chromosome region 2p13-p12 and to test whether preeclampsia and obstetric cholestasis share a single risk locus. The study was carried out among 115 unrelated control women, 133 preeclamptic women and 57 cholestatic women. Screening with microsatellite markers at the 2p13-p12 region revealed that the marker D2S286 was significantly associated with obstetric cholestasis in the overall association analysis (P=0.03), while it revealed only borderline association with preeclampsia (P=0.08). However, single allele association analysis indicated that both preeclampsia and obstetric cholestasis showed a statistically significant association with a common allele (P < 0.05), which was overrepresented in both the obstetric cholestasis (0.42) and preeclamptic (0.37) groups when compared with the control group (0.28). In conclusion, These findings suggest a possible genetic link between chromosome region 2p13-p12, preeclampsia and obstetric cholestasis. More specifically, these data suggest that there may be a common risk locus associated with both obstetric complications located in the vicinity of the 2p13-p12 association region.

Gender-specific genetic determinants of blood pressure and organ weight: pharmacogenetic approach.

A total genome scan and pharmacogenetic study were designed to search for genetic determinants of blood pressure (BP) as well as heart and kidney weights. Genome scanning was carried out in 266 F2 intercrosses from Prague hypertensive hypertriglyceridemic rats for phenotypes of organ weights, baseline BP, BP after blockade of the renin-angiotensin system (RAS) by losartan, of the sympathetic nervous system (SNS) by pentolinium, and of the nitric oxide (NO) synthase by NG-nitro-L-arginine methyl ester. Pharmacogenetic analysis showed that, in males, BP was controlled by two loci on chromosomes 1 and 5 (Chr1, Chr5) through the SNS, and these loci showed a positive contribution for relative kidney weight (KW/BW). On the other hand, baseline BP in females was controlled by two loci on Chr3 and Chr7. The effect of these loci was not mediated by the RAS, SNS or NO system. These loci did not show any effect for KW/BW. Negatively-linked loci for KW/BW and relative heart weight (HW/BW) were identified on Chr2 in both genders. Another negatively-linked locus for KW/BW, located on Chr8 in males, affected BP through the SNS. This locus on Chr8 overlapped with a previously-reported modifier locus for polycystic kidney disease (PKD). In conclusion, this pharmacogenetic study determined two loci for BP and relative organ mass implicating sympathetic overactivity. Concordance of the identified locus for KW/BW and BP through the SNS on Chr8 with the PKD locus revealed the importance of this region for renal complications in various diseases.

Genome Scan for Loci Involved in Cleft Lip With or Without Cleft Palate, in Chinese Multiplex Families

Cleft lip with or without cleft palate (CL/P) is a common congenital anomaly. Birth prevalences range from 1/500 to 1/1,000 and are consistently higher in Asian populations than in populations of European descent. Therefore, it is of interest to determine whether the CL/P etiological factors in Asian populations differ from those in white populations. A sample of 36 multiplex families were ascertained through probands with CL/P who were from Shanghai. This is the first reported genome-scan study of CL/P in any Asian population. Genotyping of Weber Screening Set 9 (387 short tandem-repeat polymorphisms with average spacing approximately 9 cM [range 1-19 cM]) was performed by the Mammalian Genotyping Service of Marshfield Laboratory. Presented here are the results for the 366 autosomal markers. Linkage between each marker and CL/P was assessed by two-point and multipoint LOD scores, as well as with multipoint heterogeneity LOD scores (HLODs) plus model-free identity-by-descent statistics and the multipoint NPL statistic. In addition, association was assessed via the transmission/disequilibrium test. LOD-score and HLOD calculations were performed under a range of models of inheritance of CL/P. The following regions had positive multipoint results (HLOD > or =1.0 and/or NPL P< or =.05): chromosomes 1 (90-110 cM), 2 (220-250 cM), 3 (130-150 cM), 4 (140-170 cM), 6 (70-100 cM), 18 (110 cM), and 21 (30-50 cM). The most significant multipoint linkage results (HLOD > or =2.0; alpha=0.37) were for chromosomes 3q and 4q. Associations with P< or =.05 were found for loci on chromosomes 3, 5-7, 9, 11, 12, 16, 20, and 21. The most significant association result (P=.009) was found with D16S769 (51 cM).

A Genomewide Scan for Loci Involved in Attention-Deficit/Hyperactivity Disorder

Attention deficit/hyperactivity disorder (ADHD) is a common heritable disorder with a childhood onset. Molecular genetic studies of ADHD have previously focused on examining the roles of specific candidate genes, primarily those involved in dopaminergic pathways. We have performed the first systematic genomewide linkage scan for loci influencing ADHD in 126 affected sib pairs, using a approximately 10-cM grid of microsatellite markers. Allele-sharing linkage methods enabled us to exclude any loci with a lambda(s) of > or =3 from 96% of the genome and those with a lambda(s) of > or =2.5 from 91%, indicating that there is unlikely to be a major gene involved in ADHD susceptibility in our sample. Under a strict diagnostic scheme we could exclude all screened regions of the X chromosome for a locus-specific lambda(s) of >/=2 in brother-brother pairs, demonstrating that the excess of affected males with ADHD is probably not attributable to a major X-linked effect. Qualitative trait maximum LOD score analyses pointed to a number of chromosomal sites that may contain genetic risk factors of moderate effect. None exceeded genomewide significance thresholds, but LOD scores were >1.5 for regions on 5p12, 10q26, 12q23, and 16p13. Quantitative-trait analysis of ADHD symptom counts implicated a region on 12p13 (maximum LOD 2.6) that also yielded a LOD >1 when qualitative methods were used. A survey of regions containing 36 genes that have been proposed as candidates for ADHD indicated that 29 of these genes, including DRD4 and DAT1, could be excluded for a lambda(s) of 2. Only three of the candidates-DRD5, 5HTT, and CALCYON-coincided with sites of positive linkage identified by our screen. Two of the regions highlighted in the present study, 2q24 and 16p13, coincided with the top linkage peaks reported by a recent genome-scan study of autistic sib pairs.

The search for type 2 diabetes susceptibility genes using whole-genome scans: an epidemiologist's perspective.

Most whole-genome scan studies of type 2 diabetes have ascertained families on affected sibpairs. Although assuring enrollment of multiplex families, this strategy may lead to the enrollment of unrepresentative families, particularly in low-risk populations where relatively few diabetics have an affected sibling. In high-risk populations such as Hispanics and Native Americans, population-based ascertainment is often possible, since the high frequency of the disease favors enrollment of multiplex families even when they are not specifically sought. The results of the first generation of genome scan studies caused concern because of a perceived lack of reproducibility. More recently, however, a number of replications have emerged, specifically on chromosomes 1q, 2q, 3q, 9p, 10q, and 11q. The MODY 1 and 3 regions on chromosome 12q and 20q have also been replicated in multiple studies. The clinical features of diabetes in these latter families, however, suggest the common form of type 2 diabetes, rather than maturity-onset diabetes of the young (MODY). Also, diabetes in these families does not appear to be caused by the classical MODY mutations. Interestingly, functional variants of the MODY 4 gene (insulin promoter factor-1) have been associated with both MODY and the common form of type 2 diabetes. Currently available linkage studies implicate relatively broad chromosomal regions, and the challenge of narrowing these regions to facilitate gene discovery remains formidable. The linkages that have been replicated thus far provide good starting points to search for functional variants in type 2 diabetes susceptibility genes.

HLA and migraine genes

Human leukocyte Antigens (HLA) are encoded by genes located on chromosome 6p21. Genes important in migraine are being recognized in two basic ways: association studies and linkage analysis. One of the strongest associations is with the HLA region. Actually, genome scan studies suggest that multiple genes are involved in both migraine without aura (MWoA) and migraine with aura (MWA). However, both MWoA and MWA are disorders in which multiple factors, including environmental and genetic factors, confer disease susceptibility. Linkage analysis is identifying new candidate genes that will help to explain the etiology of migraine. In this review previous studies regarding genetic susceptibility to migraine are analyzed, particularly those related to the HLA region. I discuss evidence that HLA shared-hyplotypes in MWoA-affected pairs in different than that expected, that HLA-DR2 antigen provides additional basis for the proposed genetic heterogeneity between MWoA and MWA, and lastly that TNFB gene studies seem to play an important role in the susceptibility to MWoA. In the past years, major advances hae been made in understanding the genetic foundation of MWoA and MWA. Our reported genome-scan studies support the concept that MWoA/MWA are coinherited with a particular HLA region. However, the examination of candidate genes (Ca2+ channel, vascular, CNS, etc.) in a large migraine population seems to be the correct direction in which we have to move. More MWoA/MWa gene studies are needed to test this developing hypothesis and to further establish the complete genetic scenario of migraine.