心疾患予防に資する新しい遺伝子発見(New gene discovery aids heart disease prevention)

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2025-10-23 カロリンスカ研究所(KI)

カロリンスカ研究所の研究チームは、欧州3大コホート(SCAPIS、UK Biobank、IMPROVE)の大規模データを解析し、動脈硬化症リスクを4段階に分類できる新しい遺伝学的システムを開発した。特に、炎症制御に関与するIL6R遺伝子変異が高リスク群でのみ心筋梗塞リスクを顕著に増加させることを発見。この変異は一般集団では影響が小さいが、炎症経路が活性化している特定群では重大な役割を果たす。研究は、症状が出る前の段階でリスクを予測し、個別化された予防介入を可能にする道を開くもの。次の課題は、IL6R経路を遮断する薬剤が進行性動脈硬化を抑制できるかを検証することにある。成果は『Cardiovascular Research』誌に掲載され、心血管疾患の精密予防医療を実現する基盤として注目されている。

<関連情報>

マルチオミクスアプローチにより、IL6Rが亜臨床的頸動脈アテローム性動脈硬化症のエンドタイプに及ぼす因果関係とIL6R/OSMR経路の潜在的な役割が 明らかになった A multi-omics approach uncovers causality of IL6R on endotypes of subclinical carotid atherosclerosis and the possible role of the IL6R/OSMR pathway

Qiao Sen Chen, Hanna M Björck, Otto Bergman, Damiano Baldassarre, Gunnar Engström, Antonio Gallo, Anders Gummesson, Ulf Hedin, Sudhir Kurl, Lars Lind …
Cardiovascular Research  Published:22 October 2025
DOI:https://doi.org/10.1093/cvr/cvaf177

心疾患予防に資する新しい遺伝子発見(New gene discovery aids heart disease prevention)
Graphical Abstract

Abstract

Aims

Endotypes integrate individual clinical and molecular data and can be used to formulate molecular subclassifications of diseases. We previously derived four endotypes of subclinical carotid atherosclerosis in a large European cohort, c-IMT and c-IMT Progression as Predictors of Vascular Events in a High-Risk European Population (IMPROVE), identifying individuals with a specific cardiovascular (CV) risk, ranging from low (endotype 1) to very high (endotype 4). Here, we investigate the mechanisms underlying the differences in CV risk observed across these four endotypes.

Methods and results

We validated the four endotypes in SCAPIS (n = 5050) and UK Biobank (n = 50 396) using carotid plaque and carotid intima-media thickness (c-IMT) as subclinical atherosclerosis measures. Endotype 4 associated with a larger number of carotid plaques and increased c-IMT measures as compared to endotype 1. We performed a meta-analysis of individual genome wide association studies in IMPROVE (n = 3711), SCAPIS and UK Biobank, and identified 12 SNPs associated with endotypes. We investigated if they regulated gene expression and circulating protein levels. We found that rs2228145A/C at Interleukin-6 Receptor (IL6R), associated with endotype 4, regulated IL6R expression and circulating levels of OncoStatin M Receptor (OSMR), Complement Factor B (CFB) and Fibrinogen Chain A (FGA). We used rs2228145A/C as an instrument in two-sample Mendelian randomization analyses and showed that a decreasing IL6R expression, associated with increasing CFB, FGA, and OSMR circulating levels. Endotype 4, IL6R, CFB, FGA, and OSMR co-localized within 250 kb surrounding rs2228145A/C. However, only OSMR was up-regulated in advanced carotid atherosclerotic plaques in the presence of the A allele and in aortic region exposed to low wall shear stress. In the UK Biobank, we observed that each additional A allele at rs2228145 increased by 1.28-times the risk of myocardial infarction (MI) in endotype 4.

Conclusion

Rs2228145A/C associated with endotype 4 clinical and molecular characteristics and amplified the MI risk in individuals assigned to endotype 4. These effects appeared to be mediated by a crosstalk with OSMR.

医療・健康
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