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Human Molecular Genetics Advance Access originally published online on October 20, 2004
Human Molecular Genetics 2004 13(24):3203-3217; doi:10.1093/hmg/ddh332
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Human Molecular Genetics, Vol. 13, No. 24 © Oxford University Press 2004; all rights reserved

Polymorphisms in the prostaglandin E2 receptor subtype 2 gene confer susceptibility to aspirin-intolerant asthma: a candidate gene approach

Nobuyoshi Jinnai1, Takuro Sakagami1,2, Takashi Sekigawa1,2, Miho Kakihara1, Toshiaki Nakajima1, Kenichi Yoshida1, Shin Goto1, Takashi Hasegawa2, Takeshi Koshino3, Yoshinori Hasegawa4, Hiromasa Inoue5, Naohito Suzuki6, Yasuyuki Sano6 and Ituro Inoue1,*

1Division of Genetic Diagnosis, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan, 2Division of Respiratory Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan, 3Department of Respiratory Medicine, University of Tokyo, Graduate School of Medicine, Tokyo, Japan, 4Department of Internal Medicine, School of Medicine, Nagoya University, Nagoya, Japan, 5Research Institute for Diseases of the Chest, Faculty of Medicine, Kyushu University, Fukuoka, Japan and 6Department of Allergy and Respiratory Medicine, Doai Memorial Hospital, Tokyo, Japan

Received September 1, 2004; Accepted October 11, 2004

Aspirin-intolerant asthma (AIA) is a subtype of bronchial asthma characterized by development of bronchoconstriction evoked by non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs inhibit the cyclooxygenase pathway, leading to enhancement of the lipoxygenase pathway. We evaluated allelic association of 370 single nucleotide polymorphisms (SNPs) of 63 candidate genes, mostly from the arachidonic acid metabolic cascade, with AIA. After two rounds of screening with 198 AIA patients, multiple SNPs in the prostaglandin E2 receptor subtype 2 (EP2) gene were associated with AIA (P<0.05). Among the 77 SNPs identified in the EP2 gene, we selected 17 SNPs on the basis of linkage disequilibrium and allelic frequencies (minor allele frequency >0.1) for further association study. SNPs in the promoter region of the EP2 gene, uS5, uS5b, and uS7, were significantly associated with AIA (permutation P=0.039–0.001). Analysis of haplotypes constructed according to the LD pattern showed a significant association with AIA (permutation P=0.001). The most significantly associated SNP, uS5, located in the regulatory region of the EP2 gene, was in a STATs-binding consensus sequence [AIA 31.1% versus control 22.1% (permutation P=0.0016) or versus aspirin-tolerant asthma 22.2% (permutation P=0.0017)]. Although STAT1 binding was not observed in gel mobility shift assay with HeLa nuclear extract, an unidentified protein was specifically bound to the allelic sequence. In in vitro reporter assay in HCT116 cells, the site containing the uS5 allele showed reduced transcription activity. Taken together, these results suggest that uS5 allele serves as a target of a transcription repressor protein. A functional SNP of the EP2 gene associated with risk of AIA should decrease the transcription level, resulting in reduction of the PGE2 braking mechanism of inflammation and involvement in the molecular mechanism underlying AIA.

* To whom correspondence should be addressed at: Division of Genetic Diagnosis, The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan. Tel: +81 354495325; Fax: +81 354495764; Email: ituro{at}ims.u-tokyo.ac.jp


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