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Identification and Characterization of Genetic Risk Variants for Chronic Kidney Disease and Related Traits

Fachliche Zuordnung Nephrologie
Förderung Förderung von 2010 bis 2017
Projektkennung Deutsche Forschungsgemeinschaft (DFG) - Projektnummer 159166183
 
Erstellungsjahr 2016

Zusammenfassung der Projektergebnisse

Chronic kidney disease (CKD) affects ~10% of the adult population in many countries. It can not only progress to kidney failure but also increases the risk for cardiovascular morbidity and mortality. The processes causing CKD and contributing to its progression are incompletely understood. The aim of the Emmy Noether Group "Identification and Characterization of Genetic Risk Variants for Chronic Kidney Disease and Related Traits" was to generate insights into the mechanisms underlying kidney function in health and disease through a combination of unbiased forward genetic screens in human populations identification of biomarkers of renal function and the functional and epidemiological characterization of identified genetic risk variants. Improved insights into the underlying genetic architecture of CKD can provide a starting point for improved detection, treatment and prevention of renal dysfunction. From 2010-2015, the Emmy Noether group has worked on three specific aims. In Aim 1, we used unbiased genome-wide association studies (GWAS) in population-based studies and patients with CKD to identify and characterize genetic variants associated with kidney function and damage, serum urate and gout as well as with the concentrations of additional metabolites. Our work on kidney function markers highlights a central role for the contribution of common variants that map into regulatory regions of DNA in or near genes that are preferentially expressed in the kidney. Our work on kidney damage highlights an important role of the tubular reabsorption of filtered albumin especially in individuals with diabetes. Through GWAS of serum urate, we identified a surprising new role for multiple players in the inhibins/activins pathway as potential new targets to lower serum urate concentrations. The examination of CKD from specific etiologies generated the insight that specific risk variants in the HLA region are shared across several kidney diseases. In Aim 2, targeted re-sequencing of the UMOD gene led to the insights that the association signal detected by GWAS could not be explained by rare protein-altering variants either alone or in combination consistent with a proposed causal role of common regulatory variants that influence the risk of CKD in adult life. We expanded the scope of our studies to patients with rare kidney diseases and to the whole exome and identified the first instance of a family in which the co-occurrence of three independent autosomal-recessive diseases gives rise to a complex clinical presentation. In Aim 3, we identified and replicated serum metabolites that can serve as novel kidney function markers. By examining hundreds of known and unknown metabolites in several thousands of study participants we identified metabolites that showed an equal or better correlation with kidney function than serum creatinine while showing additional advantages such as independence from muscle mass. These metabolites represent attractive novel markers to improve the estimation of kidney function in research and clinical practice. Our results have been published in high-impact peer-reviewed international journals such as Nature Genetics. The identification of novel gout genes has received substantial coverage in the media (e.g. http://www.spiegel.de/wissenschaft/medizin/gicht-forscher-entdecken-gene-der-stoffwechselkrankheit-a-874636.html). Our findings open up new research areas in both basic and population sciences which we hope will ultimately lead to the development of novel ways to diagnose treat and prevent CKD.

Projektbezogene Publikationen (Auswahl)

 
 

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