Premium
NextGen nuclear DNA sequencing in cyclic vomiting syndrome reveals a significant association with the stress‐induced calcium channel ( RYR 2 )
Author(s) -
Lee J.,
Wong S. A.,
Li B. U. K.,
Boles R. G.
Publication year - 2015
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.12575
Subject(s) - ryanodine receptor , calcium , calcium channel , chemistry , medicine
Background Cyclic vomiting syndrome ( CVS ) is a common, frequently disabling, ‘functional’ condition characterized by recurring, stereotypical attacks of intense nausea, vomiting, and lethargy, with the essential absence of these symptoms between episodes. Although the pathogenesis of CVS is yet unexplained, evidence has accumulated which suggest pathogenic roles for stress‐related, autonomic, neuroendocrine, and mitochondrial factors. The objective of this pilot study was to elucidate mechanism(s) by identifying genes involved in the presumed multifactorial pathogenesis of CVS . Methods In this pilot study, DNA from 75 unrelated CVS cases and 60 healthy controls were assayed by Courtagen Life Science's next‐generation sequencing platform (nuc SEEK ™ ), including over 1100 nuclear‐encoded genes involved with mitochondria, metabolism, or ion channels. Significant sequence variants were defined as evolutionary conservation at least to Xenopus (frog) per the UCSC Genome Browser. Key Results The RYR 2 gene, encoding a stress‐induced calcium channel present in many neurons, was the only gene demonstrating a statistically significant difference in the proportion of conserved sequence variants among the groups (18/75 CVS , 24%, vs 3/60 controls, 5%; p = 0.0018, OR = 6.0, 95% CI = 1.7–22). Conclusions & Inferences We propose a mechanism in which RYR 2 sequence variants result in aberrant stress‐induced calcium release into the mitochondria of autonomic neurons, resulting in an increased risk to develop autonomic/functional disease such as CVS , and related conditions such as migraine and gut dysmotility. This model incorporates the existing hypotheses regarding CVS pathogenesis into a cohesive mechanism, and might have treatment implications.