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Whole Genome Sequencing Study of Coagulation Factor VIII and von Willebrand Factor Reveals New Genetic Associations

P.S. de Vries, M.R. Brown, Trans-Omics for Precision Medicine (TOPMed) Hematology and Hemostasis Working Group and the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Hemostasis Working Group

The University of Texas Health Science Center at Houston, Houston, United States

Abstract Number: PB0233

Meeting: ISTH 2020 Congress

Theme: Coagulation and Natural Anticoagulants » Coagulation Factors and Inhibitors

Background: Coagulation factor VIII (FVIII) and its carrier protein von Willebrand factor (vWF) are implicated in increasing the risk of thrombotic events.

Aims: We aimed to combine whole genome sequencing data from NHLBI’s TOPMed program with TOPMed-based imputation of genotypes in the CHARGE consortium to identify genetic associations with plasma levels of FVIII and vWF.

Methods: We included 9 TOPMed studies with European, African, Asian, and Hispanic ancestry participants. Association analyses in TOPMed were conducted across all individuals adjusting for age, sex, ancestry, principal components, and a kinship matrix. Using TOPMed as a reference panel, we imputed genotypes in 12 CHARGE studies. Association analyses in CHARGE were conducted separately within each study, stratified by ancestry group. Our primary analysis consisted of a meta-analysis of TOPMed and CHARGE (N=35,006 for FVIII and N=35,362 for vWF).

Results: We identified associations (P< 5E-9) with variants at 11 known loci for FVIII and 12 for vWF, of which 10 overlapped. Additionally, 4 new loci were associated with FVIII (F12, KNG1, ASGR1, and CD36). F12 and KNG1 encode kininogen 1 and factor XII, which are both involved in the contact activation pathway that FVIII also participates in. Variants at F12 and KNG1 were not associated with vWF (P>0.05). At the ASGR1 locus, top variant rs62061426 is associated with ASGR1 expression in liver. ASGR1 encodes a protein that degrades glycoproteins like FVIII and vWF. Consistent with this, the ASGR1-decreasing allele is associated with increased levels of FVIII. The driving variant in CD36, rs3211938, is a loss-of-function variant that causes CD36 deficiency and is associated with other hematological phenotypes. The loss-of-function allele was only found among the African ancestry participants (frequency = 11.6%). Top variants at ASGR1 and CD36 were suggestively associated with vWF (P< 0.05).

Conclusions: Four new loci were identified for FVIII, including 2 loci that were independent of vWF.

To cite this abstract in AMA style:

de Vries PS, Brown MR, Trans-Omics for Precision Medicine (TOPMed) Hematology and Hemostasis Working Group and the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Hemostasis Working Group . Whole Genome Sequencing Study of Coagulation Factor VIII and von Willebrand Factor Reveals New Genetic Associations [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/whole-genome-sequencing-study-of-coagulation-factor-viii-and-von-willebrand-factor-reveals-new-genetic-associations/. Accessed September 29, 2023.

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