[PDF][PDF] Rare and common variants in CARD14, encoding an epidermal regulator of NF-kappaB, in psoriasis

CT Jordan, L Cao, EDO Roberson, S Duan… - The American Journal of …, 2012 - cell.com
CT Jordan, L Cao, EDO Roberson, S Duan, CA Helms, RP Nair, KC Duffin, PE Stuart
The American Journal of Human Genetics, 2012cell.com
Psoriasis is a common inflammatory disorder of the skin and other organs. We have
determined that mutations in CARD14, encoding a nuclear factor of kappa light chain
enhancer in B cells (NF-kB) activator within skin epidermis, account for PSORS2. Here, we
describe fifteen additional rare missense variants in CARD14, their distribution in seven
psoriasis cohorts (> 6,000 cases and> 4,000 controls), and their effects on NF-kB activation
and the transcriptome of keratinocytes. There were more CARD14 rare variants in cases …
Psoriasis is a common inflammatory disorder of the skin and other organs. We have determined that mutations in CARD14, encoding a nuclear factor of kappa light chain enhancer in B cells (NF-kB) activator within skin epidermis, account for PSORS2. Here, we describe fifteen additional rare missense variants in CARD14, their distribution in seven psoriasis cohorts (>6,000 cases and >4,000 controls), and their effects on NF-kB activation and the transcriptome of keratinocytes. There were more CARD14 rare variants in cases than in controls (burden test p value=0.0015). Some variants were only seen in a single case, and these included putative pathogenic mutations (c.424G>A [p.Glu142Lys] and c.425A>G [p.Glu142Gly]) and the generalized-pustular-psoriasis mutation, c.413A>C (p.Glu138Ala); these three mutations lie within the coiled-coil domain of CARD14. The c.349G>A (p.Gly117Ser) familial-psoriasis mutation was present at a frequency of 0.0005 in cases of European ancestry. CARD14 variants led to a range of NF-kB activities; in particular, putative pathogenic variants led to levels >2.5× higher than did wild-type CARD14. Two variants (c.511C>A [p.His171Asn] and c.536G>A [p.Arg179His]) required stimulation with tumor necrosis factor alpha (TNF-α) to achieve significant increases in NF-kB levels. Transcriptome profiling of wild-type and variant CARD14 transfectants in keratinocytes differentiated probably pathogenic mutations from neutral variants such as polymorphisms. Over 20 CARD14 polymorphisms were also genotyped, and meta-analysis revealed an association between psoriasis and rs11652075 (c.2458C>T [p.Arg820Trp]; p value=2.1 × 10−6). In the two largest psoriasis cohorts, evidence for association increased when rs11652075 was conditioned on HLA-Cw0602 (PSORS1). These studies contribute to our understanding of the genetic basis of psoriasis and illustrate the challenges faced in identifying pathogenic variants in common disease.
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