Genetic variants in FCGR2A, PTPN2, VDR as predictive signatures of aggressive phenotypes in cerebral cavernous malformation

• Published in: Gene Vol. 933; p. 148918
• Main Authors: Galvão, Gustavo F., Trefilio, Luisa M., Salvio, Andreza L., da Silva, Elielson V., Alves-Leon, Soniza V., Fontes-Dantas, Fabrícia L., de Souza, Jorge M.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15.01.2025
• Subjects: Cerebral Cavernous Malformation; Diagnostic Biomarker; FCGR2A; Prognostic Biomarker; PTPN2; VDR; Prognostic Biomarker; Diagnostic Biomarker; SWI; Cerebral Cavernous Malformation; VDR; MRI; ROC; CNS; PSM; CCM; CASH; ICH; AUC; FCGR2A; SNP; HWE; LD; AIC; PTPN2
• ISSN: 0378-1119; 1879-0038; 1879-0038
• DOI: 10.1016/j.gene.2024.148918

•PTPN2rs72872125 CT and VDRrs7975232 CC are more common in asymptomatic patients.•PTPN2rs72872125 CC and GM-CSF levels can predict a symptomatic CCM diagnosis.•FCGR2Ars1801274 GG genotype can accurately forecasts symptoms in coming years.•Patients with VDRrs731236 AA and VDRrs11568820 CC genotypes may have earlier symptoms.•Presence of inflammatory cascade instigating an autoimmune response against CCM. The biological behavior of Cerebral Cavernous Malformation (CCM) is still controversial, lacking a clear-cut signature for a mechanistic explanation of lesion aggressiveness. In this study, we evaluated the predictive capacity of genetic variants concerning the aggressive behavior of CCM and their implications in biological processes. We genotyped the variants in VDRrs7975232, VDRrs731236, VDRrs11568820, PTPN2rs72872125 and FCGR2Ars1801274 genes using TaqMan Genotyping Assays in a cohort study with 103 patients, 42 of whom had close follow-up visits for 4 years, focusing on 2 main aspects of the disease: (1) symptomatic events, which included both intracranial bleeding or epilepsy, and (2) the onset of symptoms. The genotypes were correlated with the levels of several cytokines quantified in peripheral blood, measured using the x-MAP method. We report a novel observation that the PTPN2rs72872125 CT and the VDRrs7975232 CC genotype were independently associated with an asymptomatic phenotype. Additionally, PTPN2rs72872125 CC genotype and serum level of GM-CSF could predict a diagnostic association with symptomatic phenotype in CCM patients, while the FCGR2Ars1801274 GG genotype could predict a symptomatic event during follow-up. The study also found a correlation between VDRrs731236 AA and VDRrs11568820 CC genotype to the time to the first symptomatic event. These genetic markers could pave the way for precision medicine strategies for CCM, enhancing patient outcomes by enabling customized therapeutic approaches.