: Revised Abstract Our primary objective is to identify specific gene variants that are related to the formation and rupture of intracranial aneurysms (IA). Our experienced collaborative and highly productive team of Familial Intracranial Aneurysm (FIA) Investigators at 27 original sites in North America, Australia and New Zealand accomplished and surpassed our original goals during FIA I. We completely characterized 441 families (2800 subjects) with multiple members with an IA including collection of genetic material, extensive interviews, and magnetic resonance angiography to detect unruptured aneurysms in 20% of eligible subjects. Genotyping using the Illumina 6K SNP linkage set in the majority of the FIA I family sample was used to perform a linkage analysis which did not identify statistically significant evidence of linkage by traditional criteria. Subsequently, we performed a genome-wide case-control association study (GWAS) using the Affymetrix 6.0 array with one affected case from each white FIA family and age,gender and race matched population controls. In a final GWAS dataset of 407 FIA cases and 396 controls, we identified COL9A1 (collagen 9A1 gene) and PDE1A (phosphodiesterase 1A gene) as high priority candidate genes based not only the strength of the association with FIA but also on their biological function. Using a larger GWAS dataset of IA cases and controls, we have replicated the recent findings for SNPs in the regions of chromosome 9 (CDKN2A and CDKN2B closest genes) and 8 (SOX17 closest gene) but not chromosome 2. We are currently completing genotyping for a replication set consisting of additional IA cases and controls. Our collaborator, Dr. Ituro Inoue, will genotype out most significant 50 SNPs from our GWAS in his sample of1000 IA Japanese cases and 950 controls. In FIA II, we will enroll an additional 1800 sporadic and 200 familial IA patients (as well as other affected and genetically informative members from these 200 families). The 1675 white IA cases will be used for a case-control GWAS (Affymetrix 6.0 platform) that will be a critical replication data set for FIA I and just completed GWAS studies. We have already enrolled >205 (167 white) IA cases thus far. 3000+ white controls from the publicly available national databases (ongoing collaborations with Framingham and ARIC investigators), with available information regarding smoking and hypertension and who are genotyped with the same platform, will be matched for gender and age to the FIA II IA cases. Second, we propose to take the highest priority SNPs from our replicated case-control analyses for a family-based test of association using the 600+ multiplex IA families collected as part of FIA I and FIA II. We will enroll and genotype 500+ minority IA cases (Blacks and Hispanics) in whom SNPs of interest from the FIA I and II GWAS will be compared with minority controls from ARIC and other national databases (such as REGARDS). Finally, we will use bioinformatics, statistical methods, and gene sequencing, to identify specific disease producing mutations and/or high risk haplotypes whose functional relevance will be subsequently explored.

Public Health Relevance

: The long-term goal of the Familial Intracranial Aneurysm (FIA) study is to identify individuals who are genetically at high-risk for developing intracranial aneurysms. Rupture of intracranial aneurysms is associated with a very high immediate mortality of 30-40% with substantial morbidity among many of the survivors and high economic and societal cost. The knowledge gained from this study will provide better insights into the biology of aneurysm formation and rupture which can allow for more targeted and effective prevention and treatment of intracranial aneurysms. Specific paragraph from Public Health Section of 25 words or less: Knowledge gained from the FIA II study will allow for more effective prevention and treatment of the formation and rupture of intracranial aneurysms. References 1. Bilguvar K, Yasuno K, Niemela M, Ruigrok YM, von Und Zu Fraunberg M, van Duijn CM, van den Berg LH, Mane S, Mason CE, Choi M, Gaal E, Bayri Y, Kolb L, Arlier Z, Ravuri S, Ronkainen A, Tajima A, Laakso A, Hata A, Kasuya H, Koivisto T, Rinne J, Ohman J, Breteler MM, Wijmenga C, State MW, Rinkel GJ, Hernesniemi J, Jaaskelainen JE, Palotie A, Inoue I, Lifton RP, Gunel M. Susceptibility loci for intracranial aneurysm in European and Japanese populations. Nat Genet. 2008;40: 1472-1477. 2. Helgadottir A, Thorleifsson G, Magnusson KP, Gretarsdottir S, Steinthorsdottir V, Manolescu A, Jones GT, Rinkel GJ, Blankensteijn JD, Ronkainen A, Jaaskelainen JE, Kyo Y, Lenk GM, Sakalihasan N, Kostulas K, Gottsater A, Flex A, Stefansson H, Hansen T, Andersen G, Weinsheimer S, Borch-Johnsen K, Jorgensen T, Shah SH, Quyyumi AA, Granger CB, Reilly MP, Austin H, Levey AI, Vaccarino V, Palsdottir E, Walters GB, Jonsdottir T, Snorradottir S, Magnusdottir D, Gudmundsson G, Ferrell RE, Sveinbjornsdottir S, Hernesniemi J, Niemela M, Limet R, Andersen K, Sigurdsson G, Benediktsson R, Verhoeven EL, Teijink JA, Grobbee DE, Rader DJ, Collier DA, Pedersen O, Pola R, Hillert J, Lindblad B, Valdimarsson EM, Magnadottir HB, Wijmenga C, Tromp G, Baas AF, Ruigrok YM, van Rij AM, Kuivaniemi H, Powell JT, Matthiasson SE, Gulcher JR, Thorgeirsson G, Kong A, Thorsteinsdottir U, Stefansson K. The same sequence variant on 9p21 associates with myocardial infarction, abdominal aortic aneurysm and intracranial aneurysm. Nat Genet. 2008;40: 217- 224. 3. International Consortium for Systemic Lupus Erythematosus Genetics (SLEGEN), Harley JB, Alarcon- Riquelme ME, Criswell LA, Jacob CO, Kimberly RP, Moser KL, Tsao BP, Vyse TJ, Langefeld CD, Nath SK, Guthridge JM, Cobb BL, Mirel DB, Marion MC, Williams AH, Divers J, Wang W, Frank SG, Namjou B, Gabriel SB, Lee AT, Gregersen PK, Behrens TW, Taylor KE, Fernando M, Zidovetzki R, Gaffney PM, Edberg JC, Rioux JD, Ojwang JO, James JA, Merrill JT, Gilkeson GS, Seldin MF, Yin H, Baechler EC, Li QZ, Wakeland EK, Bruner GR, Kaufman KM, Kelly JA. Genome-wide association scan in women with systemic lupus erythematosus identifies susceptibility variants in ITGAM, PXK, KIAA1542 and other loci. Nat Genet. 2008;40: 204-210. PHS 398/2590 (Rev. 11/07) Page 5 Continuation Format Page

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Research Project (R01)
Project #
2R01NS039512-06A1
Application #
7528586
Study Section
Special Emphasis Panel (ZNS1-SRB-G (27))
Program Officer
Gwinn, Katrina
Project Start
1999-12-01
Project End
2011-08-31
Budget Start
2009-09-15
Budget End
2010-08-31
Support Year
6
Fiscal Year
2009
Total Cost
$3,270,460
Indirect Cost
Name
University of Cincinnati
Department
Neurology
Type
Schools of Medicine
DUNS #
041064767
City
Cincinnati
State
OH
Country
United States
Zip Code
45221
Mackey, Jason; Brown, Robert D; Sauerbeck, Laura et al. (2015) Affected twins in the familial intracranial aneurysm study. Cerebrovasc Dis 39:82-6
Farlow, Janice L; Lin, Hai; Sauerbeck, Laura et al. (2015) Lessons learned from whole exome sequencing in multiplex families affected by a complex genetic disorder, intracranial aneurysm. PLoS One 10:e0121104
Foroud, Tatiana; Lai, Dongbing; Koller, Daniel et al. (2014) Genome-wide association study of intracranial aneurysm identifies a new association on chromosome 7. Stroke 45:3194-9
Foroud, Tatiana; FIA Study Investigators (2013) Whole exome sequencing of intracranial aneurysm. Stroke 44:S26-8
Southerland, Andrew M; Meschia, James F; Worrall, Bradford B (2013) Shared associations of nonatherosclerotic, large-vessel, cerebrovascular arteriopathies: considering intracranial aneurysms, cervical artery dissection, moyamoya disease and fibromuscular dysplasia. Curr Opin Neurol 26:13-28
Flaherty, Matthew L; Kissela, Brett; Khoury, Jane C et al. (2013) Carotid artery stenosis as a cause of stroke. Neuroepidemiology 40:36-41
Sauerbeck, Laura; Hornung, Richard; Woo, Daniel et al. (2013) Mortality and causes of death in the Familial Intracranial Aneurysm study. Int J Stroke 8:696-700
Woo, Daniel (2013) Location, interaction, and anticipation of aneurysm formation. Acta Neurochir Suppl 115:279-80
Foroud, Tatiana; Koller, Daniel L; Lai, Dongbing et al. (2012) Genome-wide association study of intracranial aneurysms confirms role of Anril and SOX17 in disease risk. Stroke 43:2846-52
Mackey, Jason; Brown Jr, Robert D; Moomaw, Charles J et al. (2012) Unruptured intracranial aneurysms in the Familial Intracranial Aneurysm and International Study of Unruptured Intracranial Aneurysms cohorts: differences in multiplicity and location. J Neurosurg 117:60-4

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