Pulmonary vascular disease & thromboembolism

Novel Mutations and Decreased Expression of the Epigenetic Regulator TET2 in Pulmonary Arterial Hypertension

CirculationPublished Genetic association and mechanistic study

Main finding · Rare, predicted deleterious germline TET2 variantsResult — go to the resultRelative risk 6

Authors' conclusion

PAH is the first human disease related to potential TET2 germline mutations. Inherited and acquired abnormalities of TET2 occur in 0.39% of PAH cases. Decreased TET2 expression is ubiquitous and has potential as a PAH biomarker.

Study context

Population
Patients with pulmonary arterial hypertension (PAH) from the PAH Biobank2,572 PAH Biobank cases
Participants
1,832 vs 7,509
Comparison
PAH patients vs Genome Aggregation Database (gnomAD) control subjects
  • PAHn = 1,832
  • gnomAD controlsn = 7,509reference
Outcome
Rare, predicted deleterious germline TET2 variants
Methodological detailsrare variant association tests, independent expression cohort, hematopoietic Tet2-knockout mice
  • Rare variant association tests
  • Independent expression cohort
  • Hematopoietic Tet2-knockout mice

Main finding

As reported in the abstract

Relative risk

6

P = 0.00067

Events by group

PAH

9

events

gnomAD controls

6

events

Patients with TET2 mutations in whole cohort
0.39% (10/2572)

Further findings

Clinical features, TET2 mutation vs no mutation

Age, years
71±7 versus 48±19; P<0.0001
Vasodilator responders
0/7 versus 140/1055 [13.2%]
Pulmonary vascular resistance, Wood units
5.2±3.1 versus 10.5±7.0; P=0.02

Circulating TET2 expression (independent cohort, n = 140)

Decreased in PAH patients
>86%

Hematopoietic Tet2-knockout mice

Spontaneous PAH, adverse pulmonary vascular remodeling and inflammation; anti-interleukin-1β therapy led to regression of PAH

Original publication

Novel Mutations and Decreased Expression of the Epigenetic Regulator TET2 in Pulmonary Arterial Hypertension. Circulation. Published 20 March 2020. doi:10.1161/circulationaha.119.044320

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