|Publication Type||Journal Article|
|Year of Publication||2014|
|Authors||Yu, Y, Triebwasser, MP, Wong, EK, Schramm, EC, Thomas, B, Reynolds, R, Mardis, E, Atkinson, JP, Daly, M, Raychaudhuri, S, Kavanagh, D, Seddon, JM|
|Journal||Human molecular genetics|
We sequenced the whole exome of 35 cases and 7 controls from 9 age-related macular degeneration (AMD) families in whom known common genetic risk alleles could not explain their high disease burden and/or their early-onset advanced disease. Two families harbored novel rare mutations in CFH (R53C and D90G). R53C segregates perfectly with AMD in 11 cases (heterozygous) and 1 elderly control (reference allele) (LOD=5.07, P=6.7x10(-7)). In an independent cohort, 4 out of 1,676 cases but none of the 745 examined controls or the 4300 NHBLI ESP samples carried the R53C mutation (P=0.0039). In another family of 6 siblings, D90G similarly segregated with AMD in 5 cases and 1 control (LOD=1.22, P=0.009). No other sample in our large cohort or the ESP had this mutation. Functional studies demonstrated that R53C decreased the ability of FH to perform decay accelerating activity. D90G exhibited a decrease in cofactor-mediated inactivation. Both of these changes would lead to a loss of regulatory activity, resulting in excessive alternative pathway activation. This study represents an initial application of the whole-exome strategy to families with early-onset AMD. It successfully identified high impact alleles leading to clearer functional insight into AMD etiopathogenesis.