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Genetic variation in NFE2L2 is associated with outcome following aneurysmal subarachnoid haemorrhage

Genetic variation in NFE2L2 is associated with outcome following aneurysmal subarachnoid haemorrhage
Genetic variation in NFE2L2 is associated with outcome following aneurysmal subarachnoid haemorrhage
Background and purpose
Nuclear factor erythroid 2-related factor 2 (NRF2; encoded by the NFE2L2 gene) has been implicated in outcome following aneurysmal subarachnoid haemorrhage (aSAH) through its activity as a regulator of inflammation, oxidative injury and blood breakdown product clearance. The aim of this study was to identify whether genetic variation in NFE2L2 is associated with clinical outcome following aSAH.

Methods
Ten tagging single nucleotide polymorphisms (SNPs) in NFE2L2 were genotyped and tested for association with dichotomized clinical outcome, assessed by the modified Rankin scale, in both a discovery and a validation cohort. In silico functional analysis was performed using a range of bioinformatic tools.

Results
One SNP, rs10183914, was significantly associated with outcome following aSAH in both the discovery (n = 1007) and validation cohorts (n = 466). The risk of poor outcome was estimated to be 1.33-fold (95% confidence interval 1.12–1.58) higher in individuals with the T allele of rs10183914 (pmeta-analysis = 0.001). In silico functional analysis identified rs10183914 as a potentially regulatory variant with effects on transcription factor binding in addition to alternative splicing with the T allele, associated with a significant reduction in the NFE2L2 intron excision ratio (psQTL = 1.3 × 10−7).

Conclusions
The NFE2L2 SNP, rs10183914, is significantly associated with outcome following aSAH. This is consistent with a clinically relevant pathophysiological role for oxidative and inflammatory brain injury due to blood and its breakdown products in aSAH. Furthermore, our findings support NRF2 as a potential therapeutic target following aSAH and other forms of intracranial haemorrhage.
NF-E2-related factor 2, polymorphism, single nucleotide, subarachnoid haemorrhage
1351-5101
116-124
Gaastra, Ben
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Duncan, Poppy
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Bakker, Mark K.
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Hostettler, Isabel C.
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Alg, Varinder S.
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Houlden, Henry
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Ruigrok, Ynte M.
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Galea, Ian
66209a2f-f7e6-4d63-afe4-e9299f156f0b
Tapper, Will
456500e0-687c-45d9-9fd3-971bc4086715
Werring, David
0caabc8a-8597-4f08-9189-e8a6e6a213a6
Bulters, Diederik
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Gaastra, Ben
c7b7f371-706b-4d59-9150-94e8f254e205
Duncan, Poppy
ef7bde2a-ed01-43a1-b047-e3670ac8184e
Bakker, Mark K.
9d4329de-a731-4b13-8087-5772fc81ab36
Hostettler, Isabel C.
82239c37-f728-4295-bfe1-48b06a56fae3
Alg, Varinder S.
2e789ed1-328a-491d-bb70-8db65bb71a62
Houlden, Henry
b4cd8392-164c-4d35-8933-690a804ebb18
Ruigrok, Ynte M.
36542439-1c84-4e9a-97c3-bf9591cf8120
Galea, Ian
66209a2f-f7e6-4d63-afe4-e9299f156f0b
Tapper, Will
456500e0-687c-45d9-9fd3-971bc4086715
Werring, David
0caabc8a-8597-4f08-9189-e8a6e6a213a6
Bulters, Diederik
d6f9644a-a32f-45d8-b5ed-be54486ec21d

Gaastra, Ben, Duncan, Poppy, Bakker, Mark K., Hostettler, Isabel C., Alg, Varinder S., Houlden, Henry, Ruigrok, Ynte M., Galea, Ian, Tapper, Will, Werring, David and Bulters, Diederik (2022) Genetic variation in NFE2L2 is associated with outcome following aneurysmal subarachnoid haemorrhage. European Journal of Neurology, 30 (1), 116-124. (doi:10.1111/ene.15571).

Record type: Article

Abstract

Background and purpose
Nuclear factor erythroid 2-related factor 2 (NRF2; encoded by the NFE2L2 gene) has been implicated in outcome following aneurysmal subarachnoid haemorrhage (aSAH) through its activity as a regulator of inflammation, oxidative injury and blood breakdown product clearance. The aim of this study was to identify whether genetic variation in NFE2L2 is associated with clinical outcome following aSAH.

Methods
Ten tagging single nucleotide polymorphisms (SNPs) in NFE2L2 were genotyped and tested for association with dichotomized clinical outcome, assessed by the modified Rankin scale, in both a discovery and a validation cohort. In silico functional analysis was performed using a range of bioinformatic tools.

Results
One SNP, rs10183914, was significantly associated with outcome following aSAH in both the discovery (n = 1007) and validation cohorts (n = 466). The risk of poor outcome was estimated to be 1.33-fold (95% confidence interval 1.12–1.58) higher in individuals with the T allele of rs10183914 (pmeta-analysis = 0.001). In silico functional analysis identified rs10183914 as a potentially regulatory variant with effects on transcription factor binding in addition to alternative splicing with the T allele, associated with a significant reduction in the NFE2L2 intron excision ratio (psQTL = 1.3 × 10−7).

Conclusions
The NFE2L2 SNP, rs10183914, is significantly associated with outcome following aSAH. This is consistent with a clinically relevant pathophysiological role for oxidative and inflammatory brain injury due to blood and its breakdown products in aSAH. Furthermore, our findings support NRF2 as a potential therapeutic target following aSAH and other forms of intracranial haemorrhage.

Text
Euro J of Neurology - 2022 - Gaastra - Genetic variation in NFE2L2 is associated with outcome following aneurysmal - Version of Record
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More information

Accepted/In Press date: 6 September 2022
e-pub ahead of print date: 23 September 2022
Published date: 2 October 2022
Keywords: NF-E2-related factor 2, polymorphism, single nucleotide, subarachnoid haemorrhage

Identifiers

Local EPrints ID: 470439
URI: http://eprints.soton.ac.uk/id/eprint/470439
ISSN: 1351-5101
PURE UUID: 29d14915-9d9e-40a7-9d1b-7c65ec4d7a58
ORCID for Ben Gaastra: ORCID iD orcid.org/0000-0002-7517-6882
ORCID for Ian Galea: ORCID iD orcid.org/0000-0002-1268-5102
ORCID for Diederik Bulters: ORCID iD orcid.org/0000-0001-9884-9050

Catalogue record

Date deposited: 11 Oct 2022 16:32
Last modified: 07 Jan 2023 03:05

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Contributors

Author: Ben Gaastra ORCID iD
Author: Poppy Duncan
Author: Mark K. Bakker
Author: Isabel C. Hostettler
Author: Varinder S. Alg
Author: Henry Houlden
Author: Ynte M. Ruigrok
Author: Ian Galea ORCID iD
Author: Will Tapper
Author: David Werring
Author: Diederik Bulters ORCID iD

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