もやもや病の新たな遺伝的背景と疾患関連細胞の同定―疾患の遺伝的背景と密接に関連した細胞分画を明らかに―

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2026-03-02 東大病院

東京大学の研究グループは、日本人もやもや病患者を対象に大規模ゲノムワイド関連解析(GWAS)を実施し、既知のRNF213 p.Arg4810Lys変異に加え、HDAC9-TWIST1遺伝子間領域の多型が発症と関連することを同定した。さらに条件付き解析によりRNF213内の新たな疾患感受性領域も特定。加えて、患者浅側頭動脈の単一核RNAシークエンス解析を行い、疾患関連遺伝子群が間葉系マーカーを発現する内皮細胞(間葉系様内皮細胞)に集約することを明らかにした。遺伝的背景と病態関連細胞を結び付けた本成果は、発症機序解明や将来的なリスク予測法、診断法、治療標的開発への応用が期待される。成果はStroke誌に掲載。

もやもや病の新たな遺伝的背景と疾患関連細胞の同定―疾患の遺伝的背景と密接に関連した細胞分画を明らかに―
研究の全体像

<関連情報>

統合GWASとsnRNA-seqにより、もやもや病における間葉系血管内皮細胞のシグネチャーが明らかに Integrative GWAS and snRNA-seq Reveal a Mesenchymal-Like Endothelial Signature in Moyamoya Disease

Yudai Hirano, MD; Satoru Miyawaki, MD, PhD; Kyuto Sonehara, MD, PhD; Shinichi Namba, MD, PhD; Hirotaka Inoue, MD; Yuya Shirai, MD, PhD; Hideaki Imai, MD, PhD; …;on behalf of the BioBank Japan Project
Stroke  Published 2 March 2026

Abstract

BACKGROUND:

Moyamoya disease (MMD) has a strong genetic basis, with the rare RNF213 variant (rs112735431) representing a major risk factor, while the broader genetic architecture and disease-relevant vascular cell types remain incompletely understood.

METHODS:

We conducted a genome-wide association study in Japanese individuals (n=47 656; 401 MMD cases and 47 255 controls). Population-level features at MMD risk loci were examined by regional allele frequency and haplotype analyses. We performed single-nucleus RNA-seq of superficial temporal arteries from patients with MMD (n=3). Cell type–specific enrichment of genome-wide association study signals was assessed using the Single-Cell Disease Relevance Score. Endothelial signatures were validated by integration with publicly available single-cell data sets from controls (n=5) and immunohistochemistry for candidate markers (n=1).

RESULTS:

Beyond rs112735431, we identified a genome-wide significant signal in the HDAC9-TWIST1 region (P=3.3×10−14; odds ratio, 1.77). Conditional analysis on rs112735431 revealed a protective RNF213 missense variant, p.Asn1331Gly (rs8074015; P=3.7×109; odds ratio, 0.53), whose minor allele was mutually exclusive with rs112735431-A on haplotypes. Population analysis revealed geographic variation and extended haplotype structure of the rs112735431-A allele in Japan. Single-nucleus RNA-seq identified a mesenchymal-like endothelial cell (MEC) population with selective FN1 expression. Genome-wide association study–prioritized disease genes were strongly enriched in MECs. MECs showed mesenchymal pathway activation with a regulatory program distinct from canonical endothelial states. The proportion of MECs was markedly increased in MMD (72% versus 28% in controls), and FN1 expression in endothelial regions was confirmed by immunohistochemistry.

CONCLUSIONS:

Our findings identify a protective RNF213 variant that is mutually exclusive with the known rs112735431-A allele. Genetic risk converges on an MEC state markedly expanded in MMD.

医療・健康
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