Open AccessCystic Fibrosis Disease Modifiers: Complex Genetics Defines the Phenotypic Diversity in a Monogenic Disease
Author(s) -
Wanda K. O’Neal,
Michael R. Knowles
Publication year - 2018
Publication title -
annual review of genomics and human genetics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.677
H-Index - 117
eISSN - 1545-293X
pISSN - 1527-8204
DOI - 10.1146/annurev-genom-083117-021329
Subject(s) - phenotype , disease , genetics , mendelian inheritance , cystic fibrosis , biology , gene , genotype phenotype distinction , genome wide association study , genetic association , human genetics , human genetic variation , genotype , genome , human genome , medicine , single nucleotide polymorphism , pathology
In many respects, genetic studies in cystic fibrosis (CF) serve as a paradigm for a human Mendelian genetic success story. From recognition of the condition as a heritable pathological entity to implementation of personalized treatments based on genetic findings, this multistep pathway of progress has focused on the genetic underpinnings of CF clinical disease. Along this path was the recognition that not all CFTR gene mutations produce the same disease and the recognition of the complex, multifactorial nature of CF genotype–phenotype relationships. The non- CFTR genetic components (gene modifiers) that contribute to variation in phenotype are the focus of this review. A multifaceted approach involving candidate gene studies, genome-wide association studies, and gene expression studies has revealed significant gene modifiers for multiple CF phenotypes. The bold challenges for the future are to integrate the findings into our understanding of CF pathogenesis and to use the knowledge to develop novel therapies.