The genetic architecture of membranous nephropathy and its potential to improve non-invasive diagnosis
Jingyuan Xie, Lili Liu, Nikol Mladkova, Yifu Li, Hong Ren, Weiming Wang, Zhao Cui, Li Lin, Xiaofan Hu, Xialian Yu, Jing Xu, Gang Liu, Yaşar Çalışkan, Carlo Sidore, Olivia Balderes, Raphael J. Rosen, Monica Bodria, Francesca Zanoni, Jun Y. Zhang, Priya Krithivasan, Karla Mehl, Maddalena Marasà, Atlas Khan, Fatih Ozay, Pietro A. Canetta, Andrew S. Bomback, Gerald B. Appel, Simone Sanna‐Cherchi, Matthew G. Sampson, Laura Mariani, Agnieszka Perkowska‐Ptasińska, Magdalena Durlik, Krzysztof Mucha, Barbara Moszczuk, Bartosz Foroncewicz, Leszek Pączek, Ireneusz Habura, Elisabet Ars, José Ballarín, Laila-Yasmin Mani, Bruno Vogt, Savaş Öztürk, Abdülmecit Yıldız, Nurhan Seyahi, Hakkı Arikan, Mehmet Koç, Taner Baştürk, Gonca E. Karahan, Sebahat Usta Akgül, Mehmet Şükrü Sever, Dan Zhang, Domenico Santoro, Mario Bonomini, Francesco Londrino, Loreto Gesualdo, Jana Reiterová, Vladimı́r Tesař, Claudia Izzi, Silvana Savoldi, Donatella Spotti, Carmelita Marcantoni, Piergiorgio Messa, Marco Galliani, Dario Roccatello, Simona Granata, Gianluigi Zaza, Francesca Lugani, Gian Marco Ghiggeri, Isabella Pisani, Landino Allegri, Ben Sprangers, Jin‐Ho Park, Belong Cho, Yon Su Kim, Dong Ki Kim, Hitoshi Suzuki, Antonio Amoroso, Daniel Cattran, Fernando C. Fervenza, Antonello Pani, Patrick Hamilton, Shelly Harris, Sanjana Gupta, Chris Cheshire, Stephanie Dufek, Naomi Issler, Ruth J. Pepper, John Connolly, Stephen H. Powis, Detlef Böckenhauer, Horia Stanescu, Neil Ashman, Ruth J. F. Loos, Eimear E. Kenny, Matthias Wuttke, Kai‐Uwe Eckardt, Anna Köttgen, Julia M. Hofstra, Marieke J. H. Coenen, Lambertus A. Kiemeney
IF 15.7
Nature Communications
Membranous Nephropathy (MN) is a rare autoimmune cause of kidney failure. Here we report a genome-wide association study (GWAS) for primary MN in 3,782 cases and 9,038 controls of East Asian and European ancestries. We discover two previously unreported loci, NFKB1 (rs230540, OR = 1.25, P = 3.4 × 10<sup>-12</sup>) and IRF4 (rs9405192, OR = 1.29, P = 1.4 × 10<sup>-14</sup>), fine-map the PLA2R1 locus (rs17831251, OR = 2.25, P = 4.7 × 10<sup>-103</sup>) and report ancestry-specific effects of three classical HLA alleles: DRB1*1501 in East Asians (OR = 3.81, P = 2.0 × 10<sup>-49</sup>), DQA1*0501 in Europeans (OR = 2.88, P = 5.7 × 10<sup>-93</sup>), and DRB1*0301 in both ethnicities (OR = 3.50, P = 9.2 × 10<sup>-23</sup> and OR = 3.39, P = 5.2 × 10<sup>-82</sup>, respectively). GWAS loci explain 32% of disease risk in East Asians and 25% in Europeans, and correctly re-classify 20-37% of the cases in validation cohorts that are antibody-negative by the serum anti-PLA2R ELISA diagnostic test. Our findings highlight an unusual genetic architecture of MN, with four loci and their interactions accounting for nearly one-third of the disease risk.