Frontiers in Medicine (Aug 2023)

Genetic and geographic influence on phenotypic variation in European sarcoidosis patients

  • Sandra Freitag-Wolf,
  • Jonas C. Schupp,
  • Jonas C. Schupp,
  • Jonas C. Schupp,
  • Björn C. Frye,
  • Annegret Fischer,
  • Raihanatul Anwar,
  • Robert Kieszko,
  • Violeta Mihailović-Vučinić,
  • Janusz Milanowski,
  • Dragana Jovanovic,
  • Gernot Zissel,
  • Elena Bargagli,
  • Paola Rottoli,
  • Dragos Bumbacea,
  • René Jonkers,
  • Ling-Pei Ho,
  • Karoline I. Gaede,
  • Anna Dubaniewicz,
  • Ben G. Marshall,
  • Andreas Günther,
  • Martin Petrek,
  • Michael P. Keane,
  • Sigridur O. Haraldsdottir,
  • Francesco Bonella,
  • Christian Grah,
  • Tatjana Peroš-Golubičić,
  • Zamir Kadija,
  • Stefan Pabst,
  • Christian Grohé,
  • János Strausz,
  • Martina Safrankova,
  • Ann Millar,
  • Jiří Homolka,
  • Wim A. Wuyts,
  • Lisa G. Spencer,
  • Michael Pfeifer,
  • Dominique Valeyre,
  • Venerino Poletti,
  • Hubertus Wirtz,
  • Antje Prasse,
  • Antje Prasse,
  • Stefan Schreiber,
  • Stefan Schreiber,
  • Astrid Dempfle,
  • Joachim Müller-Quernheim

DOI
https://doi.org/10.3389/fmed.2023.1218106
Journal volume & issue
Vol. 10

Abstract

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IntroductionSarcoidosis is a highly variable disease in terms of organ involvement, type of onset and course. Associations of genetic polymorphisms with sarcoidosis phenotypes have been observed and suggest genetic signatures.MethodsAfter obtaining a positive vote of the competent ethics committee we genotyped 1909 patients of the deeply phenotyped Genetic-Phenotype Relationship in Sarcoidosis (GenPhenReSa) cohort of 31 European centers in 12 countries with 116 potentially disease-relevant single-nucleotide polymorphisms (SNPs). Using a meta-analysis, we investigated the association of relevant phenotypes (acute vs. sub-acute onset, phenotypes of organ involvement, specific organ involvements, and specific symptoms) with genetic markers. Subgroups were built on the basis of geographical, clinical and hospital provision considerations.ResultsIn the meta-analysis of the full cohort, there was no significant genetic association with any considered phenotype after correcting for multiple testing. In the largest sub-cohort (Serbia), we confirmed the known association of acute onset with TNF and reported a new association of acute onset an HLA polymorphism. Multi-locus models with sets of three SNPs in different genes showed strong associations with the acute onset phenotype in Serbia and Lublin (Poland) demonstrating potential region-specific genetic links with clinical features, including recently described phenotypes of organ involvement.DiscussionThe observed associations between genetic variants and sarcoidosis phenotypes in subgroups suggest that gene–environment-interactions may influence the clinical phenotype. In addition, we show that two different sets of genetic variants are permissive for the same phenotype of acute disease only in two geographic subcohorts pointing to interactions of genetic signatures with different local environmental factors. Our results represent an important step towards understanding the genetic architecture of sarcoidosis.

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