A loss-of-function variant in ALOX15 protects against nasal polyps and chronic rhinosinusitis

RP Kristjansson, S Benonisdottir, OB Davidsson… - Nature …, 2019 - nature.com
Nature genetics, 2019nature.com
Nasal polyps (NP) are lesions on the nasal and paranasal sinus mucosa and are a risk
factor for chronic rhinosinusitis (CRS). We performed genome-wide association studies on
NP and CRS in Iceland and the UK (using UK Biobank data) with 4,366 NP cases, 5,608
CRS cases, and> 700,000 controls. We found 10 markers associated with NP and 2 with
CRS. We also tested 210 markers reported to associate with eosinophil count, yielding 17
additional NP associations. Of the 27 NP signals, 7 associate with CRS and 13 with asthma …
Abstract
Nasal polyps (NP) are lesions on the nasal and paranasal sinus mucosa and are a risk factor for chronic rhinosinusitis (CRS). We performed genome-wide association studies on NP and CRS in Iceland and the UK (using UK Biobank data) with 4,366 NP cases, 5,608 CRS cases, and >700,000 controls. We found 10 markers associated with NP and 2 with CRS. We also tested 210 markers reported to associate with eosinophil count, yielding 17 additional NP associations. Of the 27 NP signals, 7 associate with CRS and 13 with asthma. Most notably, a missense variant in ALOX15 that causes a p.Thr560Met alteration in arachidonate 15-lipoxygenase (15-LO) confers large genome-wide significant protection against NP (P= 8.0 × 10−27, odds ratio = 0.32; 95% confidence interval = 0.26, 0.39) and CRS (P= 1.1 × 10−8, odds ratio = 0.64; 95% confidence interval = 0.55, 0.75). p.Thr560Met, carried by around 1 in 20 Europeans, was previously shown to cause near total loss of 15-LO enzymatic activity. Our findings identify 15-LO as a potential target for therapeutic intervention in NP and CRS.
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