VARIATIONS IN GENES CAN INFLUENCE THE RISK OF DEVELOPING AGE-RELATED MACULAR DEGENERATION AND OTHER DISEASE SUCH AS CANCER

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U.S. Department of Health and Human Services 
NATIONAL INSTITUTES OF HEALTH 
NIH News 
National Cancer Institute (NCI)
http://www.cancer.gov/
National Eye Institute (NEI)
http://www.nei.nih.gov/

EMBARGOED FOR RELEASE: Sunday, March 5, 2006, 1:00 p.m. ET

CONTACT: NCI Media Relations Branch, 301-496-6641,
ncipressofficers@xxxxxxxxxxxx; National Eye Institute, 301-496-5248,
neinews@xxxxxxxxxxx

VARIATIONS IN GENES CAN INFLUENCE THE RISK OF DEVELOPING AGE-RELATED
MACULAR DEGENERATION AND OTHER DISEASE SUCH AS CANCER

A team of researchers has determined that variations in certain genes
involved in fighting infection can successfully predict the risk of
developing age-related macular degeneration (AMD), the leading cause of
blindness in white Americans over the age of 60. The team*, led by Bert
Gold, Ph.D., and Michael Dean, Ph.D., of the National Cancer Institute
(NCI), part of the National Institutes of Health (NIH), identified a
genetic variant that is associated with an increased risk of developing
AMD. They also found two genetic variants that protect against
developing this disease. Study results appear online March 5, 2006 in
"Nature Genetics"**.

The genes analyzed in this study -- Complement Factor B (BF) and
Complement Component 2 (C2) -- contain the instructions to make proteins
that activate the body's immune defense against microbial infections.
These defense responses are part of a system called the complement
pathways. These pathways involve numerous proteins in the blood that
work in association with the body's immune cells and antibodies to
destroy bacteria, viruses or fungi invading the body. Some complement
proteins can stimulate inflammation, the redness and swelling that
result in tissues when they are infected.

Previous studies have shown that genetic variations in complement
pathway genes can cause a dysfunction in the inflammatory response that
plays a central role in the pathology of AMD***. Based on these
findings, investigators initiated this study, which screened almost 900
patients with AMD and 400 unaffected individuals for genetic variants in
the BF and C2 genes. Data analysis revealed that specific variants in
each gene were associated with AMD. One genetic variant conferred an
increased risk for AMD, while two genetic variants showed protection
against developing this disease. These results, when analyzed in
association with results linking AMD and genetic variants of Complement
Factor H -- a gene than contains the instructions to make a protein that
inhibits the complement system -- showed that 56 percent of the
unaffected individuals had a variant that conferred protection to AMD
while 74 percent of those with AMD had no protective variants.

"These studies confirm that AMD has a strong genetic component," said
Paul Sieving, M.D., Ph.D., director, National Eye Institute, at NIH.
"This may support the development of screening tests for risk of
developing AMD, which would allow us to administer treatment early in
the course of disease. Knowing the underlying genetic alterations for
risk could also aid in developing preventive therapies tailored to an
individual's genetic background."

AMD is a disease that blurs or destroys sharp, central vision.
Approximately 7.3 million Americans have intermediate stages of AMD with
a high risk of increasing vision loss, while 1.8 million are visually
impaired due to this disease. There is no known cure for AMD.

"We were studying a very common disease, but no one knew its cause. It
was unexpected to find that the immune system was involved in causing
AMD," said Gold, Laboratory of Genomic Diversity at NCI and lead author
of this study. "Understanding how genetic variations in complement
pathway genes are causing this common, complex disease could be very
helpful in understanding other complex diseases, such as cancer."

In the cancer field, there is increasing interest in how infection and
chronic inflammation could promote tumor growth. Studies have shown that
inflammatory cells can promote tumor growth by producing a favorable
growth environment. Complement proteins play an important role in
inflammation. This discovery of a link between genetic variants in
complement genes and AMD may be relevant to the role of complement in
cancer progression. 

The National Institutes of Health (NIH) -- "The Nation's Medical
Research Agency" -- includes 27 Institutes and Centers and is a
component of the U.S. Department of Health and Human Services. It is the
primary federal agency for conducting and supporting basic, clinical and
translational medical research, and it investigates the causes,
treatments, and cures for both common and rare diseases. For more
information about NIH and its programs, visit http://www.nih.gov.

------------------------------------------------
* Researchers are from the Departments of Ophthalmology and Pathology &
Cell Biology, Columbia University, New York, N.Y.; the Department of
Ophthalmology and Visual Sciences, Center for Macular Degeneration,
University of Iowa, Iowa City, Iowa; Sapio Sciences LLC, York, Pd.; F.
M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute,
University of Pennsylvania School of Medicine, Philadelphia, Pa.; and
the Laboratory of Genomic Diversity, NCI, Frederick, Md. 

** Gold B, Merriam JE, Zernant J, Hancox LS, Taiber AJ, Gehrs K, Cramer
K, Neel J, Bergeron J, Barile GR, Smith RT, Chang S, Yannuzzi LA,
Merriam JC, Barbazetto I, Lerner LE, Russell S, Hoballah J, Hageman J,
Stockman H, Hageman GS, Dean M, and Allikmets R. Variation in the Factor
B ("BF") and Complement Component 2 ("C2") genes in the MHC Class III
Locus is associated with age-related macular degeneration. "Nature
Genetics", online March 5, 2006. 

*** Hageman, GS et. al., Common haplotype in the complement regulatory
gene, Factor H (HF1/CFH), predisposes Individuals to age-related macular
degeneration. "Proc. Natl. Acad. Sci." USA, May 17, 2005; 102 (20)
7227-7232.
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This NIH News Release is available online at:
http://www.nih.gov/news/pr/mar2006/nci-05.htm.

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