Apolipoprotein E–Promoter Single-Nucleotide Polymorphisms Affect the Phenotype of Primary Open-Angle Glaucoma and Demonstrate Interaction with the Myocilin Gene

• Published in: American journal of human genetics Vol. 70; no. 6; pp. 1575 - 1581
• Main Authors: Copin, Bruno, Brézin, Antoine P., Valtot, Françoise, Dascotte, Jean-Claude, Béchetoille, Alain, Garchon, Henri-Jean
• Format: Journal Article
• Language: English
• Published: Chicago, IL Elsevier Inc 01.06.2002; University of Chicago Press; The American Society of Human Genetics
• Subjects: Adult; Analysis of Variance; Apolipoproteins E - genetics; Biological and medical sciences; Cytoskeletal Proteins; Eye Proteins - genetics; Glaucoma and intraocular pressure; Glaucoma, Open-Angle - genetics; Glaucoma, Open-Angle - physiopathology; Glycoproteins - genetics; Humans; Intraocular Pressure - physiology; Medical sciences; Middle Aged; Ophthalmology; Phenotype; Polymorphism, Single Nucleotide - genetics; Promoter Regions, Genetic - genetics; Promoter; Eye disease; Phenotype; Myocilin; Open angle glaucoma; Gene; Apolipoprotein E; Pathogenesis; Nucleotide; Genetic determinism; Polymorphism
• ISSN: 0002-9297; 1537-6605
• DOI: 10.1086/340733

Primary open-angle glaucoma (POAG) is an optic neuropathy that has a high worldwide prevalence and that shows strong evidence of complex inheritance. The myocilin (MYOC) gene is the only one that has thus far been shown to have mutations in patients with POAG. Apolipoprotein E (APOE) plays an essential role in lipid metabolism, and the APOE gene has been involved in neuronal degeneration that occurs in Alzheimer disease (AD). Here, we report that two APOE-promoter single-nucleotide polymorphisms (SNPs) previously associated with AD also modify the POAG phenotype. APOE(−219G) is associated with increased optic nerve damage, as reflected by increased cup:disk ratio and visual field alteration. In addition, APOE(−491T), interacting at a highly significant level with an SNP in the MYOC promoter, MYOC(−1000G), is associated with increased intraocular pressure (IOP) and with limited effectiveness of IOP-lowering treatments in patients with POAG. Together, these findings establish APOE as a potent modifier for POAG, which could explain the linkage to chromosome 19q previously observed by use of a genome scan for this condition and an increased frequency of glaucoma in patients with AD. The findings also shed new light on potential mechanisms of optic nerve damage and of IOP regulation in POAG.