Alpha-1 Antitrypsin PiMZ Genotype Is Associated with Chronic Obstructive Pulmonary Disease in Two Racial Groups

被引：56

作者：

Foreman, Marilyn G. ^{[1
]}

Wilson, Carla ^{[2
]}

Demeo, Dawn L. ^{[3
,4
]}

Hersh, Craig P. ^{[3
,4
]}

Beaty, Terri H. ^{[5
]}

Cho, Michael H. ^{[3
,4
]}

Ziniti, John ^{[3
,4
]}

Curran-Everett, Douglas ^{[2
,6
]}

Criner, Gerard ^{[7
]}

Hokanson, John E. ^{[6
]}

Brantly, Mark ^{[8
]}

Rouhani, Farshid N. ^{[8
]}

Sandhaus, Robert A. ^{[2
]}

Crapo, James D. ^{[2
]}

Silverman, Edwin K. ^{[3
,4
]}

机构：

[1] Morehouse Sch Med, Atlanta, GA 30310 USA

[2] Natl Jewish Hlth, Denver, CO USA

[3] Brigham & Womens Hosp, Channing Div Network Med, 75 Francis St, Boston, MA 02115 USA

[4] Harvard Med Sch, Boston, MA USA

[5] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Baltimore, MD USA

[6] Univ Colorado, Sch Publ Hlth, Denver, CO 80202 USA

[7] Temple Univ, Sch Med, Philadelphia, PA 19122 USA

[8] Univ Florida, Coll Med, Gainesville, FL USA

来源：

ANNALS OF THE AMERICAN THORACIC SOCIETY | 2017年 / 14卷 / 08期

基金：

美国国家卫生研究院;

关键词：

alpha-1 antitrypsin deficiency; chronic obstructive pulmonary disease; emphysema; African Americans; genetics; GENOME-WIDE ASSOCIATION; AIR-FLOW OBSTRUCTION; MZ HETEROZYGOTES; LUNG-FUNCTION; ALPHA(1)-ANTITRYPSIN DEFICIENCY; RISK; EMPHYSEMA; SMOKING; DECLINE; COPD;

D O I：

10.1513/AnnalsATS.201611-838OC

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Rationale: Alpha-1 antitrypsin deficiency, caused primarily by homozygosity for the Z allele of the SERPINA1 gene, is a well-established genetic cause of chronic obstructive pulmonary disease (COPD). Whether the heterozygous PiMZ genotype for alpha-1 antitrypsin confers increased risk for COPD has been debated. Objectives: Weanalyzed 8,271 subjects in the Genetic Epidemiology of COPD (COPDGene) Study, hypothesizing that PiMZ would independently associate with COPD and COPD-related phenotypes. Methods: The COPDGene Study comprises a multiethnic, cross-sectional, observational cohort of non-Hispanic white and African American current and former smokers with at least 10 pack-years of smoking who were enrolled for detailed clinical and genetic studies of COPD and COPD-related traits. We performed multivariate logistic regression analysis for moderate to severe COPD and assessed Pi genotype with other relevant covariates in models stratified by race. We analyzed quantitative characteristics on the basis of volumetric computed tomography with generalized linear models controlling for genotype, scanner type, and similar covariates. Results: White PiMZ COPDGene subjects had significantly lower lung function, FEV1 percent predicted (68 +/- 28 vs. 75 +/- 27; P = 0.0005), and FEV1/FVC ratio (0.59 60.18 vs. 0.63 +/- 0.17; P = 0.0008), as well as more radiographic emphysema (P = 0.001), than subjects without alpha-1 antitrypsin Z risk alleles. Similarly, African American PiMZ subjects had lower lung function, FEV1 percent predicted (65 +/- 33 vs. 84 +/- 25; P = 0.009) and FEV1/FVC (0.61 +/- 0.21 vs. 0.71 +/- 0.15; P = 0.03). Conclusions: In the COPDGene Study, we demonstrate that PiMZ heterozygous individuals who smoke are at increased risk for COPD and obstructive lung function impairment compared with Z-allele noncarriers, regardless of race. Although severe alpha-1 antitrypsin deficiency is uncommon in African Americans, our study adds further support for initial targeted detection of all subjects with COPD for alpha-1 antitrypsin deficiency, including African Americans.

引用

页码：1280 / 1287

页数：8

共 39 条

[11] α1-Antitrypsin deficiency•2:: Genetic aspects of α1-antitrypsin deficiency:: phenotypes and genetic modifiers of emphysema risk [J].