Maximum LOD Score Research Articles

Heritability and clinical features of multigenerational families with obsessive‐compulsive disorder and hoarding

To date, only one complete genome screen for obsessive-compulsive disorder (OCD) has been published. That study identified a region of suggestive linkage (maximum lod score of 2.25) with a relatively small sample size (N = 56; 27 with OCD). Additional complete genome screens are needed to confirm this finding and identify other regions of linkage. We present the clinical characteristics and power to detect linkage of 11 multigenerational families with OCD and hoarding (N = 92; 44 with OCD), as well as heritability estimates for several quantitative traits. Families with at least two individuals with OCD were identified through probands with childhood-onset OCD. Expected lod scores were calculated for simulated genetic marker data under an additive and two dominant models assuming a dense SNP marker map. All affected individuals had an early age of onset (18 or younger). Hoarding was present in 46% of subjects. Obsessive-compulsive symptoms and hoarding were highly heritable. The maximum mean expected lod score was 3.31 for OCD and 1.39 for hoarding. We found reasonable power to detect regions of interest (lod = 2) for OCD in these families, but will need to expand our family collection to have adequate power to detect regions of interest for hoarding.

Three Families With Amyotrophic Lateral Sclerosis and Frontotemporal Dementia With Evidence of Linkage to Chromosome 9p

Amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) are neurodegenerative disorders with adult onset that generally progress rapidly after the onset of symptoms. The 2 conditions are independent, but they also overlap in a significant proportion of families, including 2 families in which the disorders are reported to be linked to chromosome 9p. A locus was established between the markers D9S2154 and D9S1791 by comparing haplotypes between these families. To determine whether additional families have ALS and FTD linked to chromosome 9p. Families were identified in Canada and France, and genotyping was performed using sequence tagged site markers around the ALS-FTD candidate interval. Three new families with mapping to the chromosome 9p ALS-FTD locus were identified. Analysis of the largest family shows a peak 2-point logarithm of odds (LOD) score of 2.81 and a multipoint LOD score of 3.01. The particular candidate interval delineated by this family spans 27.1 centimorgans (cM) between markers D9S157 and D9S1805. This reduces the centromeric boundary of the candidate interval compared with previously reported values, shortening the locus to 8.1 cM (8.0 megabase pairs). A maximum multipoint LOD score of 7.22 is obtained when the 3 families are combined. The identification of new families enables reduction of the ALS-FTD candidate region located on chromosome 9p. The clinical features observed in these families help characterize the profiles of ALS and FTD with linkage to chromosome 9p-linked families.

Genomewide Scan for Linkage Reveals Evidence of Several Susceptibility Loci for Alopecia Areata

Alopecia areata (AA) is a genetically determined, immune-mediated disorder of the hair follicle that affects 1%-2% of the U.S. population. It is defined by a spectrum of severity that ranges from patchy localized hair loss on the scalp to the complete absence of hair everywhere on the body. In an effort to define the genetic basis of AA, we performed a genomewide search for linkage in 20 families with AA consisting of 102 affected and 118 unaffected individuals from the United States and Israel. Our analysis revealed evidence of at least four susceptibility loci on chromosomes 6, 10, 16 and 18, by use of several different statistical approaches. Fine-mapping analysis with additional families yielded a maximum multipoint LOD score of 3.93 on chromosome 18, a two-point affected sib pair (ASP) LOD score of 3.11 on chromosome 16, several ASP LOD scores >2.00 on chromosome 6q, and a haplotype-based relative risk LOD of 2.00 on chromosome 6p (in the major histocompatibility complex locus). Our findings confirm previous studies of association of the human leukocyte antigen locus with human AA, as well as the C3H-HeJ mouse model for AA. Interestingly, the major loci on chromosomes 16 and 18 coincide with loci for psoriasis reported elsewhere. These results suggest that these regions may harbor gene(s) involved in a number of different skin and hair disorders.

Meta-analysis of genome-wide scans provides evidence for sex- and site-specific regulation of bone mass.

Several genome-wide scans have been performed to detect loci that regulate BMD, but these have yielded inconsistent results, with limited replication of linkage peaks in different studies. In an effort to improve statistical power for detection of these loci, we performed a meta-analysis of genome-wide scans in which spine or hip BMD were studied. Evidence was gained to suggest that several chromosomal loci regulate BMD in a site-specific and sex-specific manner. BMD is a heritable trait and an important predictor of osteoporotic fracture risk. Several genome-wide scans have been performed in an attempt to detect loci that regulate BMD, but there has been limited replication of linkage peaks between studies. In an attempt to resolve these inconsistencies, we conducted a collaborative meta-analysis of genome-wide linkage scans in which femoral neck BMD (FN-BMD) or lumbar spine BMD (LS-BMD) had been studied. Data were accumulated from nine genome-wide scans involving 11,842 subjects. Data were analyzed separately for LS-BMD and FN-BMD and by sex. For each study, genomic bins of 30 cM were defined and ranked according to the maximum LOD score they contained. While various densitometers were used in different studies, the ranking approach that we used means that the results are not confounded by the fact that different measurement devices were used. Significance for high average rank and heterogeneity was obtained through Monte Carlo testing. For LS-BMD, the quantitative trait locus (QTL) with greatest significance was on chromosome 1p13.3-q23.3 (p = 0.004), but this exhibited high heterogeneity and the effect was specific for women. Other significant LS-BMD QTLs were on chromosomes 12q24.31-qter, 3p25.3-p22.1, 11p12-q13.3, and 1q32-q42.3, including one on 18p11-q12.3 that had not been detected by individual studies. For FN-BMD, the strongest QTL was on chromosome 9q31.1-q33.3 (p = 0.002). Other significant QTLs were identified on chromosomes 17p12-q21.33, 14q13.1-q24.1, 9q21.32-q31.1, and 5q14.3-q23.2. There was no correlation in average ranks of bins between men and women and the loci that regulated BMD in men and women and at different sites were largely distinct. This large-scale meta-analysis provided evidence for replication of several QTLs identified in previous studies and also identified a QTL on chromosome 18p11-q12.3, which had not been detected by individual studies. However, despite the large sample size, none of the individual loci identified reached genome-wide significance.

Meta-Analysis of 23 Type 2 Diabetes Linkage Studies from the International Type 2 Diabetes Linkage Analysis Consortium

Background: The International Type 2 Diabetes Linkage Analysis Consortium was formed to localize type 2 diabetes predisposing variants based on 23 autosomal linkage scans. Methods: We carried out meta-analysis using the genome scan meta-analysis (GSMA) method which divides the genome into bins of ∼30 cM, ranks the best linkage results in each bin for each sample, and then sums the ranks across samples. We repeated the meta-analysis using 2 cM bins, and/or replacing bin ranks with measures of linkage evidence: bin maximum LOD score or bin minimum p value for bins with p value <0.05 (truncated p value). We also carried out computer simulations to assess the empirical type I error rates of these meta-analysis methods. Results: Our analyses provided modest evidence for type 2 diabetes-predisposing variants on chromosomes 4, 10, and 14 (using LOD scores or truncated p values), or chromosome 10 and 16 (using ranks). Our simulation results suggested that uneven marker density across studies results in substantial variation in empirical type I error rates for all meta-analysis methods, but that 2 cM bins and scores that make more explicit use of linkage evidence, especially the truncated p values, reduce this problem. Conclusion: We identified regions modestly linked with type 2 diabetes by summarizing results from 23 autosomal genome scans.

A new X-linked mental retardation (XLMR) syndrome with late-onset primary testicular failure, short stature and microcephaly maps to Xq25–q26

X-linked mental retardation (XLMR) is a heterogeneous disorder with both syndromic and non-syndromic forms. Here we describe the clinical and molecular characterisation of a family with a syndromic form of XLMR with hypogonadism and short stature. We investigated a family in which four male members in two generations presented with hypergonadotrophic hypogonadism associated with development of small and abnormal testes. In two of the males, late-onset testicular ascent was noted. In addition, all affected males had short stature (<0.4th centile) and mild learning difficulties and three out of the four had microcephaly. Karyotypes were normal and endocrine investigations confirmed primary testicular failure. The phenotype segregated as an X-linked trait. Haplotype and genetic two-point linkage analysis with 22 microsatellites excluded the whole X chromosome except for a region on Xq25–Xq27 encompassing 13.7 Mb with a maximum LOD score of 1.1 for marker DXS8038 at θ = 0.05. One family previously described as having XLMR with hypogonadism and short stature maps to the same X chromosome region implicated in our family. However, the more severe mental retardation, muscle wasting and tremor described in this other family would suggest that our family is affected by a novel XLMR syndrome.

The slick hair coat locus maps to chromosome 20 in Senepol‐derived cattle

The ability to maintain normal temperatures during heat stress is an important attribute for cattle in the subtropics and tropics. Previous studies have shown that Senepol cattle and their crosses with Holstein, Charolais and Angus animals are as heat tolerant as Brahman cattle. This has been attributed to the slick hair coat of Senepol cattle, which is thought to be controlled by a single dominant gene. In this study, a genome scan using a DNA-pooling strategy indicated that the slick locus is most likely on bovine chromosome 20 (BTA20). Interval mapping confirmed the BTA20 assignment and refined the location of the locus. In total, 14 microsatellite markers were individually genotyped in two pedigrees consisting of slick and normal-haired cattle (n = 36), representing both dairy and beef breeds. The maximum LOD score was 9.4 for a 4.4-cM support interval between markers DIK2416 and BM4107. By using additional microsatellite markers in this region, and genotyping in six more pedigrees (n = 86), the slick locus was further localized to the DIK4835 - DIK2930 interval.

A genome-wide linkage scan for 25-OH-D3 and 1,25-(OH)2-D3 serum levels in asthma families

To identify genome regions linked to serum vitamin D metabolites we analyzed 25-OH-D3 and 1,25-(OH)2-D3 levels from 947 participants of a family study recruited for asthma.From these individuals data were available from a previous genome scan that included 364 autosomal microsatellite marker. 25-OH-D3 levels showed a heritability of 80% in these families while 1,25-(OH)2-D3 reached only 30%. Genome-wide linkage using variance component analysis showed increased LOD scores for 25-OH-D3 at marker D1S2815 (unadjusted LOD 2.9), D2S2153 (LOD 3.4), D5S2017 (LOD 2.5), D6S260 (LOD 2.1) and D17S1824 (2.5). In contrast, the maximum LOD score for 1,25-(OH)2-D3 level was only 1.2 at marker D17S926.We conclude that only 25-OH-D3 serum levels are under genetic control where several genes are involved. The lead linkage region does not code for enzymes already known in the metabolic pathway of vitamin D and may therefore contain further genes relevant to the regulation of vitamin D serum levels.

Gene Conversion Mutation in Crystallin, β-B2 ( CRYBB2) in a Chilean Family with Autosomal Dominant Cataract

<h3>Purpose</h3> To map and identify the mutated gene for autosomal dominant cataract (ADC) in a large Chilean family (ADC53). <h3>Design</h3> Experimental study. <h3>Participants</h3> Large Chilean family with ADCs. <h3>Methods</h3> Linkage analyses using genome-wide polymorphic DNA markers were performed on a family with variable expression of cataracts to map the mutated gene to a chromosome; 2-point lod scores were calculated. Candidate genes in the region of the maximum lod score were sequenced. We compared haplotypes (alleles at closely linked markers) in families with previously reported mutations of the crystallin, β-B2 gene (<i>CRYBB2</i>). <h3>Main Outcome Measures</h3> Identification of the causative mutation in the ADC53 family. <h3>Results</h3> The ADC locus mapped to chromosome 22 in the region of a cluster of lens β crystallin genes (<i>CRYBB3, CRYBB2, CRYBB1</i>, and <i>CRYBA4</i> and the pseudogene <i>CRYBB2P1</i>). We sequenced <i>CRYBB1</i> and <i>CRYBB2</i> and found a previously reported mutation and a variant in exon 6 of <i>CRYBB2</i> that cosegregate with the disease; these changes in <i>CRYBB2</i> are in the reference (normal) sequence of an adjacent gene <i>CRYBB2P1</i>, a pseudogene. The haplotypes in the ADC53 Chilean family were different from the 2 previously reported families with the mutation. <h3>Conclusions</h3> The cataracts in the ADC53 Chilean family are caused by a mutation in the <i>CRYBB2</i> gene; as the 2 variations in <i>CRYBB2</i> are identical to the reference sequence of pseudogene <i>CRYBB2P1</i>, which has over 97% homology to <i>CRYBB2</i>, a gene conversion probably has occurred. Based on haplotype analyses, the mutation and variant are likely to be caused by independent gene conversions in our family and the previously reported families.

Autosomal recessive juvenile onset cataract associated with mutation in BFSP1

A genome wide scan in a consanguineous family of Indian origin with autosomal recessive developmental cataracts was performed by two-point linkage analysis with 382 microsatellite markers. It showed linkage to markers on chromosome 20q, between D20S852 and D20S912, with a maximum lod score of 5.4 obtained with D20S860. This region encompasses the beaded filament structural protein 1 (BFSP1) gene. Direct sequencing revealed a 3343 bp deletion including exon 6 (c.736-1384_c.957-66 del) predicted to result in a shift of the open reading frame. This mutation was absent in 50 control individuals from south India. This is the first report of a mutation in the BFSP1 gene associated with human inherited cataracts. This further increases the genetic heterogeneity of inherited cataracts and provides clues as to the importance of BFSP1 in the cell biology of intermediate filaments and their role in the eye lens.

Evidence for linkage of red blood cell size and count: Genome‐wide scans in the Framingham Heart Study

Red blood cell (RBC) count and size are major criteria for evaluating anemia and related hematology disease diagnoses. While environmental factors influence RBC count (RBCC) and size, mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH), studies have indicated that each of these measures has a substantial genetic component. So far, no linkage analysis or genome scan has been reported. We carried out 10 cM genome-wide scans on RBCC, MCV, and MCH in a community-based Caucasian cohort, the Framingham Heart Study, using 325 pedigrees with 1,144 individuals genotyped and phenotyped. Using variance-component linkage methods, heritabilities were estimated as 56, 52, and 52% after covariate adjusted for RBCC, MCV, and MCH, respectively. For RBCC, we found a maximum LOD score of 3.2 on chromosome 19, 24 cM (7.0 Mbp). Near this region, there lie a few important candidate genes, including erythropoietin receptor and erythroid Krüppel-like factor. For linkage analyses for MCV and MCH, there were coinciding maximized LOD scores on chromosome 11, 9 cM (5.2 Mbp) with values of 3.8 and 3.6, respectively. Under the peak resides the hemoglobin beta cluster - several beta-like genes, which are important candidates for RBC size. In subsequent analyses, we excluded individuals with low MCV to assess the possible influence of beta-thalassemia carriers, and there continued to be evidence for linkage in the same region on chromosome 11p15 (LOD scores of 2.6 and 2.7 for MCV and MCH, respectively). For MCV, we also identified a new region on chromosome 6q24 with a LOD score of 2.9. These findings suggest that further studies are warranted to identify potential causal genetic variants for RBC size and count and related erythrocyte indices.

Association and linkage studies of the 20q11.2 region (GRD-2 locus) with Graves’ disease in the Tunisian population

Objective: A genome-wide screen has shown linkage to the GRD-2 locus in Graves’ disease (GD). Furthermore, a positional candidate gene maps to this locus; the CD40 gene has been reported to be associated and may predispose to the disease. The aim of this study was to replicate/reject the GRD-2 and to determine if the single nucleotide polymorphism (SNP) of the CD40 (CD40 C/T-1) confers susceptibility to GD.Methods: The present study examined a dataset of 11 families with GD using 10 microsatellite markers and a case-control study consisting of 76 sporadic GD patients and 66 healthy subjects to determine the implication of the GRD-2. Both non-parametric linkage and association tests were performed. Genotyping of the CD40 C/T-1 was carried out using a polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP).Results: The intrafamilial association and the case-control study showed no association between CD40 C/T-1 and GD. In addition, a high percentage of the C allele (96.9%) of CD40 SNP among control data was observed. The linkage analyses showed that the highest non-parametric LOD score was 1.67 at the D20S119 marker and the maximum attainable LOD score was 1.66. This result provides interesting evidence for linkage between GRD-2 and GD.Conclusion: The CD40 gene seems to be not associated with GD in the Tunisian population, whereas the GRD-2 locus could harbour other candidate gene(s) to the genetic susceptibility of GD.

A Prospective Genetic Evaluation of Familial Dilated Cardiomyopathy in the Doberman Pinscher

The Doberman Pinscher is one of the most common breeds of dogs to develop dilated cardiomyopathy (DCM), a primary heart muscle disorder characterized by myocardial dysfunction, cardiac arrhythmias, and congestive heart failure. In the Doberman Pinscher, the disease is typically adult onset, and a familial etiology has been suggested. DCM in the Doberman Pinscher, is a familial disease linked to a specific genetic marker. The study comprised an extended family of Doberman Pinschers with a history of DCM. Participating dogs were prospectively evaluated over an 8-year period. Phenotype of participating dogs was determined by annual echocardiography and ambulatory electrocardiography, and the pedigree was evaluated to determine a specific mode of inheritance. Three hundred seventy-two microsatellite markers were selected and genotyped to cover the 38 autosomal chromosomes. Phenotyping, genotyping, and pedigree information was entered into a database, and parametric, 2-point analysis was performed. Markers were considered to be linked to the development of DCM if the logarithm of odds LOD score was >/= 3.0. An autosomal dominant mode of inheritance was defined by the appearance of the disease in multiple generations, equal gender representation (P = .973) and male-to-male transmission. A maximum LOD score of 1.31 was obtained for I marker on chromosome 20, a score not high enough to be associated with DCM. DCM in the Doberman Pinscher is a familial disease inherited as an autosomal dominant trait. The causative gene(s) responsible for this condition remain unresolved. Association studies by means of array technology may provide new insights into gene identification.

Spatacsin: a new gene for complicated hereditary spastic paraplegia

Aims: Hereditary spastic paraplegias (HSPs) comprise a clinically and genetically heterogeneous group of neurodegenerative disorders, resulting in progressive spasticity of the lower limbs. In contrast to “pure HSP“, additional clinical features are present in patients with complicated HSP. We have recently characterized in detail the phenotype of two German pedigrees with AR-HSP with thin corpus callosum (TCC; Winner et al. 2004 and 2006). For 4 large consanguineous Turkish families we could narrow down the SPG11 minimal critical region to a 2,93 cM interval with a maximum LOD score of 11,84 (Oelmez et al., 2006). Recently, KIAA1840 could be identified as the Spatacsin gene, associated with SPG11 (Stevanin et al., 2007).

THE EPIDEMIOLOGY, HERITABILITY, AND GENETIC LINKAGE OF C-REACTIVE PROTEIN IN THE JACKSON HEART STUDY.

Purpose There is limited information on CRP9s reference ranges, heritability, and relation to cardiovascular disease (CVD) risk factors and disease in African Americans. Methods The study consists of participants who underwent Exam 1 of the Jackson Heart Study (2001-2004). The distribution and correlates of CRP were analyzed for the entire study cohort. Heritability was estimated for the family cohort nested within the larger JHS (235 families, n = 1,364). The relations between CRP and traditional CVD risk factors were tested with multivariable stepwise regression analyses. Heritability was estimated using mixed-model regression analysis. QTL linkage analysis was performed using the multipoint variance components approach in SOLAR package. Results The study cohort consisted of 5,202 participants (55 ± 13 years, 64% female). The median CRP was 2.7 mg/L. In stepwise models traditional risk factors explained 23% of the variability of CRP, with BMI (partial R2 = 12.9%) explaining 57% of the variability of CRP due to traditional risk factors. The heritability for the age-, sex-, and BMI-adjusted CRP residual after winsorizing was 0.37, with a standard error (SE) of 0.06, and the heritability for the log transformed CRP residual was 0.45, with a SE of 0.06. The strongest evidence for linkage to CRP was observed on chromosome 3 (maximum LOD score of 2.92) near marker 295YC9P and chromosome 12 (maximum LOD score of 2.01) near marker D12S297. Conclusion In this large population-based cohort of African Americans, CRP concentrations were heritable and associated with several traditional cardiovascular risk factors, particularly with elevated BMI. Given the relationship between inflammation and CVD, further research into the genetic and environmental determinants of CRP is merited.

Two Pedigrees Segregating Duane’s Retraction Syndrome as a Dominant Trait Map to the DURS2 Genetic Locus

The genetic bases of Duane's retraction syndrome (DRS) were investigated to determine its molecular etiologies. In prior studies, the transcription factors SALL4 and HOXA1 were identified as the genes mutated in DRS with radial anomalies, and in DRS with deafness, vascular anomalies, and cognitive deficits, respectively. Less is known, however, about the genetic etiology of DRS when it occurs in isolation, and only one genetic locus for isolated DRS, the DURS2 locus on chromosome 2, has been mapped to date. Toward the goal of identifying the DURS2 gene, two pedigrees have been ascertained that segregate DRS as a dominant trait. Members of two large dominant DRS pedigrees were enrolled in an ongoing study of the genetic basis of the congenital cranial dysinnervation disorders, and linkage analysis was conducted to determine whether their DRS phenotype maps to the DURS2 locus. By haplotype analysis, the DRS phenotype in each family cosegregates with markers spanning the DURS2 region. Linkage analysis reveals maximum lod scores >2, establishing that the DRS phenotype in these two pedigrees maps to the DURS2 locus. These two pedigrees double the published pedigrees known to map to the DURS2 locus and can thus contribute toward the search for the DURS2 gene. The affected members represent a genetically defined population of DURS2-linked DRS individuals, and hence studies of their clinical and structural features can enhance understanding of the DURS2 phenotype, as described in the companion paper.

Dehydrated hereditary stomatocytosis mimicking familial hyperkalaemic hypertension: clinical and genetic investigation

Dehydrated hereditary stomatocytosis (DHS) is a rare dominant form of hereditary haemolytic anaemia. In some families, pseudohyperkalaemia accompanies DHS. Familial hyperkalaemic hypertension (FHHt), a rare autosomal dominant form of arterial hypertension, is associated with genuine hyperkalaemia. We present a large French family in which DHS and FHHt were diagnosed independently in two separate branches. In branch A, mild DHS accompanied by pseudohyperkalaemia was found. In branch B, the proband and her daughter were initially diagnosed with FHHt, based on the coincidence of high blood pressure and hyperkalaemia. After finding out that branches A and B were related, reinvestigation of the affected members of branch B lead to the diagnosis of DHS, yielding the largest DHS kindred known in France. This allowed extensive linkage analysis based on 19 microsatellites markers in 12 affected and 10 unaffected members at 16q24.1qter, where one known DHS locus maps to. A maximal two-point LOD score (4.71 at theta = 0) was obtained for markers D16S3074 and D16S476. Haplotype analysis led to the definition of a new 11.5 cM disease interval with an upper limit at microsatellite D16S3037.

Localization of a Novel Autosomal Recessive Non‐syndromic Hearing Impairment Locus DFNB63 to Chromosome 11q13.3‐q13.4

Hereditary hearing impairment is the most genetically heterogeneous trait known in humans. So far, 50 published autosomal recessive non-syndromic hearing impairment (ARNSHI) loci have been mapped, and 23 ARNSHI genes have been identified. Here, we report the mapping of a novel ARNSHI locus, DFNB63, to chromosome 11q13.3-q13.4 in a large consanguineous Tunisian family. A maximum LOD score of 5.33 was obtained with microsatellite markers D11S916 and D11S4207. Haplotype analysis defined a 5.55 Mb critical region between microsatellite markers D11S4136 and D11S4081. DFNB63 represents the sixth ARNSHI locus mapped to chromosome 11. We positionally excluded MYO7A from being the DFNB63-causative gene. In addition, the screening of two candidate genes, SHANK2 and KCNE3, failed to reveal any disease-causing mutations.

A genomewide linkage analysis of Kawasaki disease: evidence for linkage to chromosome 12

Kawasaki disease (KD) is an acute systemic vasculitis syndrome that primarily affects infants and young children. The cause of KD is largely unknown, but its higher incidence in the Asian population and increased risk in patients' families suggests the existence of underlying genetic factors. To determine the loci of a susceptibility gene for KD, a genomewide linkage analysis with affected sib pairs was performed on 78 family samples collected from all over Japan. Multipoint linkage analysis using MAPMAKER/SIBS 2.0 identified evidence of linkage on 12q24 [maximum lod score (MLS) = 2.69]. Possible linkage (MLS > 1.0) was also found on 4q35, 5q34, 6q27, 7p15, 8q24, 18q23, 19q13, Xp22, and Xq27. This is the first large-scale study of the genetic susceptibility to KD, and our results, combined with the accumulated knowledge of the human genome, could greatly promote research on identification of the molecular pathogenesis of KD.

Enhanced linkage of a locus on chromosome 2 to premature coronary artery disease in the absence of hypercholesterolemia

Linkage studies of complex diseases have so far had limited success in producing significant and replicable results, in part owing to genetic heterogeneity. We recently reported the results of a large genome-wide linkage scan for coronary artery disease (CAD) based on 1933 families. The greatest evidence for linkage was to a region of chromosome 2, with a logarithm of odds (LOD) score of 1.86, based on the non-parametric S(ALL) statistic, which did not reach genome-wide significance (P>0.3). Inclusion of a covariate in linkage analysis can be a powerful method of accounting for disease heterogeneity. As CAD is a heterogeneous disease, we carried out a linkage analysis of chromosome 2 incorporating covariates. Increased evidence for linkage was found when hypercholesterolemia was considered (LOD score including covariate of 4.4) reaching genome-wide significance as assessed by simulation (P=0.04). Results showed that the original evidence for linkage was largely attributable to the subset of 108 non-hypercholesterolemic affected sibling pairs. In separate linkage analyses of subsets of hypercholesterolemic and non-hypercholesterolemic sibling pairs, the maximum LOD scores were 1.09 in the former group and 3.74 in the latter. This result illustrates the potential to increase the power of linkage analysis in the presence of heterogeneity by inclusion of covariates. This linked locus on chromosome 2 should now be investigated further to identify the gene(s) influencing risk of CAD in subjects with a normal level of total cholesterol. Candidate genes include the interleukin 1 cluster and two potential regulators of high-density lipoprotein cholesterol level, PLA2R1 and OSBPL6.