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The TNFα receptor TNFRSF1A and genes encoding the amiloride-sensitive sodium channel ENaC as modulators in cystic fibrosis

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Abstract

The CFTR mutations in cystic fibrosis (CF) lead to ion transport anomalities which predispose to chronic infection and inflammation of CF airways as the major determinants for morbidity and mortality in CF. Discordant clinical phenotypes of siblings with identical CFTR mutations and the large variability of clinical manifestations of patients who are homozygous for the most common mutation F508del suggest that both environment and genes other than CFTR contribute substantially to CF disease. The prime candidates for genetic modifiers in CF are elements of host defence such as the TNFα receptor and of ion transport such as the amiloride-sensitive epithelial sodium channel ENaC, both of which are encoded side by side on 12p13 (TNFRSF1A, SCNN1A) and 16p12 (SCNN1B, SCNN1G). Thirty-seven families with F508del-CFTR homozygous siblings exhibiting extreme clinical phenotypes that had been selected from the 467 pairs of the European CF Twin and Sibling Study were genotyped at 12p13 and 16p12 markers. The ENaC was identified as a modulator of CF by transmission disequilibrium at SCNN1G and association with CF phenotype intrapair discordance at SCNN1B. Family-based and case-control analyses and sequencing of SCNN1A and TNFRSF1A uncovered an association of the TNFRSF1A intron 1 haplotype with disease severity. Carriers of risk haplotypes were underrepresented suggesting a strong impact of both loci on survival. The finding that TNFRSF1A, SCNN1B and SCNN1G are clinically relevant modulators of CF disease supports current concepts that the depletion of airway surface liquid and inadequate host inflammatory responses trigger pulmonary disease in CF.

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Acknowledgements

This work was executed as part of the European Cystic Fibrosis Twin and Sibling Study and financially supported by the BIOMED programme of the European Union (QL G1-CF-2001-01005), the Deutsche Forschungsgemeinschaft (SFB621-C7), the Deutsche Fördergesellschaft für die Mukoviszidoseforschung eV and the Mukoviszidose eV. TB was supported by grant KN 378/1-1 (Project D1 of FOR 423) from the Deutsche Forschungsgemeinschaft. The authors are indebted to the patients and families for their participation in the study and gratefully acknowledge the co-operation and assistance by the physicians, CF centers and their staff without which this study would not have been possible.

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  1. Department of Pediatrics, OE6711, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Frauke Stanke, Vinod Kumar, Silke Jansen, Benny Siebert & Burkhard Tümmler

  2. Institute for Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany

    Tim Becker & Thomas F. Wienker

  3. Department of Human Genetics, KU Leuven, Leuven, Belgium

    Harry Cuppens, Jean-Jacques Cassiman, Dragica Radojkovic & Jennifer Yarden

  4. Institute of Molecular Genetics and Genetic Engineering, Belgrade, Serbia and Montenegro

    Dragica Radojkovic

  5. Center for Biological Sequence Analysis, The Technical University of Denmark, Lyngby, Denmark

    David W. Ussery

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  1. Frauke Stanke
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  2. Tim Becker
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  3. Harry Cuppens
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Correspondence to Frauke Stanke.

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Stanke, F., Becker, T., Cuppens, H. et al. The TNFα receptor TNFRSF1A and genes encoding the amiloride-sensitive sodium channel ENaC as modulators in cystic fibrosis. Hum Genet 119, 331–343 (2006). https://doi.org/10.1007/s00439-006-0140-2

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