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Analysis of Exonic Elastin Variants in Severe, Early-Onset Chronic Obstructive Pulmonary Disease

¹ Channing Laboratory and ² Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; ³ Harvard Medical School, Boston, Massachusetts; ⁴ Veterans Affairs Boston Healthcare System, Boston, Massachusetts; and ⁵ Boston University Schools of Public Health and Medicine, Boston, Massachusetts

Correspondence and requests for reprints should be addressed to Michael H. Cho, M.D., Channing Laboratory, Brigham and Women's Hospital, Boston, MA 02115. E-mail: michael.cho{at}channing.harvard.edu.

The destruction of elastic fibers has been implicated in the pathogenesis of chronic obstructive pulmonary disease (COPD). Emphysema has been described in autosomal dominant cutis laxa, which can be caused by mutations in the elastin gene. Previously, a rare functional mutation in the terminal exon of elastin was found in a case of severe, early-onset COPD. To test the hypothesis that other similar elastin mutations may predispose to COPD, we screened 90 probands from the Boston Early-Onset COPD Study and 90 smoking control subjects from the Normative Aging Study for mutations in elastin exons using high-resolution DNA melt analysis followed by resequencing. Rare nonsynonymous single-nucleotide polymorphisms (SNPs) seen only in cases were examined for segregation with airflow obstruction within pedigrees. Common nonsynonymous SNPs were tested for association with COPD in a family-based analysis of 949 subjects from the Boston Early-Onset COPD Study, and in a case–control analysis in 389 COPD cases from the National Emphysema Treatment Trial and 472 control subjects from the Normative Aging Study. Of 28 elastin variants found, 3 were nonsynonymous SNPs found only in cases. The previously described Gly773Asp mutation was found in another proband. The other two SNPs did not clearly segregate with COPD within families. Two common nonsynonymous SNPs did not demonstrate significant associations in either a family-based or case–control analysis. Exonic SNPs in the elastin gene do not appear to be common risk factors for severe COPD.

Key Words: elastin • chronic obstructive pulmonary disease • emphysema • genetic polymorphism

CLINICAL RELEVANCE Exonic elastin variants are unlikely to be common risk factors for severe chronic obstructive pulmonary disease (COPD). Clinicians and researchers should be aware that exonic elastin mutations leading to increased severe COPD susceptibility are rare.