Background
The association between smoking induced chronic obstructive pulmonary disease (COPD) and lung cancer (LC) is well documented. Recent genome-wide association studies (GWAS) have identified 28 susceptibility loci for LC, 10 for COPD, 32 for smoking behavior (SM), and 63 for pulmonary function (PF), totaling 107 non-overlapping loci. Given that common variants have been found to be associated with LC in GWAS, exome sequencing of these high-priority regions has great potential to identify novel rare causal variants.
Patients and Methods
Using a variation of the extreme phenotype approach, we selected 48 sporadic LC patients reporting heavy smoking histories, 37 of whom also exhibited carefully documented severe COPD (in whom smoking is considered the overwhelming determinant), and 54 unique familial LC cases from families with at least three first-degree relatives with LC (who are likely enriched for genomic effects), to search for disease-causing rare germline mutations.
Results
By focusing on exome profiles of the 107 target loci, we identified two key rare mutations. A heterozygous p.Arg696Cys variant in the Coiled-Coil Domain Containing 147 (CCDC147) gene at 10q25.1 was identified in one sporadic and two familial cases. The minor allele frequency (MAF) of this variant in the 1000 Genomes (TG) database is 0.0026. The p.Val26Met variant in Dopamine Beta-Hydroxylase (DBH) gene at 9q34.2 was identified in two sporadic cases; MAF of this mutation is 0.0034 from the TG database. We also observed three suggestive rare mutations on 15q25.1 IREB2/CHRNA5/CHRNB4.
Conclusion
Our results demonstrated highly disruptive risk-conferring CCDC147 and DBH mutations.