AUTHOR=Passarelli Chiara , Selvatici Rita , Carrieri Alberto , Di Raimo Francesca Romana , Falzarano Maria Sofia , Fortunato Fernanda , Rossi Rachele , Straub Volker , Bushby Katie , Reza Mojgan , Zharaieva Irina , D’Amico Adele , Bertini Enrico , Merlini Luciano , Sabatelli Patrizia , Borgiani Paola , Novelli Giuseppe , Messina Sonia , Pane Marika , Mercuri Eugenio , Claustres Mireille , Tuffery-Giraud Sylvie , Aartsma-Rus Annemieke , Spitali Pietro , T’Hoen Peter A. C. , Lochmüller Hanns , Strandberg Kristin , Al-Khalili Cristina , Kotelnikova Ekaterina , Lebowitz Michael , Schwartz Elena , Muntoni Francesco , Scapoli Chiara , Ferlini Alessandra TITLE=Tumor Necrosis Factor Receptor SF10A (TNFRSF10A) SNPs Correlate With Corticosteroid Response in Duchenne Muscular Dystrophy JOURNAL=Frontiers in Genetics VOLUME=11 YEAR=2020 URL=https://www.frontiersin.org/journals/genetics/articles/10.3389/fgene.2020.00605 DOI=10.3389/fgene.2020.00605 ISSN=1664-8021 ABSTRACT=Background

Duchenne muscular dystrophy (DMD) is a rare and severe X-linked muscular dystrophy in which the standard of care with variable outcome, also due to different drug response, is chronic off-label treatment with corticosteroids (CS). In order to search for SNP biomarkers for corticosteroid responsiveness, we genotyped variants across 205 DMD-related genes in patients with differential response to steroid treatment.

Methods and Findings

We enrolled a total of 228 DMD patients with identified dystrophin mutations, 78 of these patients have been under corticosteroid treatment for at least 5 years. DMD patients were defined as high responders (HR) if they had maintained the ability to walk after 15 years of age and low responders (LR) for those who had lost ambulation before the age of 10 despite corticosteroid therapy. Based on interactome mapping, we prioritized 205 genes and sequenced them in 21 DMD patients (discovery cohort or DiC = 21). We identified 43 SNPs that discriminate between HR and LR. Discriminant Analysis of Principal Components (DAPC) prioritized 2 response-associated SNPs in the TNFRSF10A gene. Validation of this genotype was done in two additional larger cohorts composed of 46 DMD patients on corticosteroid therapy (validation cohorts or VaC1), and 150 non ambulant DMD patients and never treated with corticosteroids (VaC2). SNP analysis in all validation cohorts (N = 207) showed that the CT haplotype is significantly associated with HR DMDs confirming the discovery results.

Conclusion

We have shown that TNFRSF10A CT haplotype correlates with corticosteroid response in DMD patients and propose it as an exploratory CS response biomarker.