THBS2 Is a Candidate Modifier of Liver Disease Severity in Alagille Syndrome

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• 作者：Ellen A. Tsai¹ ; ² ; ^&lowast ; ; Melissa A. Gilbert¹ ; ^&lowast ; ; Christopher M. Grochowski¹ ; Lara A. Underkoffler¹ ; He Meng³ ; Xiaojie Zhang³ ; Michael M. Wang³ ; ⁴ ; ⁵ ; Hailu Shitaye⁶ ; Kurt D. Hankenson⁷ ; ⁸ ; David Piccoli⁹ ; Henry Lin⁹ ; Binita M. Kamath¹⁰ ; Marcella Devoto¹¹ ; ¹² ; ¹³ ; Nancy B. Spinner¹ ; Kathleen M. Loomes⁹ ; ^{loomes@email.chop.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：JAG1 ; NOTCH2 ; Gene Modifier ; Cholestasis ; Genome-Wide Association Study
• 刊名：CMGH Cellular and Molecular Gastroenterology and Hepatology
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：2
• 期：5
• 页码：663-675.e2
• 全文大小：2664 K

文摘

Alagille syndrome is an autosomal-dominant, multisystem disorder caused primarily by mutations in JAG1, resulting in bile duct paucity, cholestasis, cardiac disease, and other features. Liver disease severity in Alagille syndrome is highly variable, however, factors influencing the hepatic phenotype are unknown. We hypothesized that genetic modifiers may contribute to the variable expressivity of this disorder.

Methods

We performed a genome-wide association study in a cohort of Caucasian subjects with known pathogenic JAG1 mutations, comparing patients with mild vs severe liver disease, followed by functional characterization of a candidate locus.

Results

We identified a locus that reached suggestive genome-level significance upstream of the thrombospondin 2 (THBS2) gene. THBS2 codes for a secreted matricellular protein that regulates cell proliferation, apoptosis, and angiogenesis, and has been shown to affect Notch signaling. By using a reporter mouse line, we detected thrombospondin 2 expression in bile ducts and periportal regions of the mouse liver. Examination of Thbs2-null mouse livers showed increased microvessels in the portal regions of adult mice. We also showed that thrombospondin 2 interacts with NOTCH1 and NOTCH2 and can inhibit JAG1–NOTCH2 interactions.

Conclusions

Based on the genome-wide association study results, thrombospondin 2 localization within bile ducts, and demonstration of interactions of thrombospondin 2 with JAG1 and NOTCH2, we propose that changes in thrombospondin 2 expression may further perturb JAG1–NOTCH2 signaling in patients harboring a JAG1 mutation and lead to a more severe liver phenotype. These results implicate THBS2 as a plausible candidate genetic modifier of liver disease severity in Alagille syndrome.