Linkage of Paget Disease of Bone to a Novel Region on Human Chromosome 18q23

• Published in: American journal of human genetics 2002-02, Vol.70 (2), p.517-525
• Main Authors: Good, David A., Busfield, Frances, Fletcher, Barbara H., Duffy, David L., Kesting, Janine B., Andersen, John, Shaw, Joanne T.E.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Chromosome 18; Chromosome Mapping; Chromosomes, Human, Pair 18 - genetics; Chromosomes, Human, Pair 7 - genetics; Diseases of the osteoarticular system; Female; Genetic Predisposition to Disease - genetics; Haplotypes - genetics; Humans; Lod Score; Male; Medical sciences; Middle Aged; Osteitis Deformans - genetics; Osteoporosis. Osteomalacia. Paget disease; Pedigree
• ISSN: 0002-9297; 1537-6605
• DOI: 10.1086/338658

Paget disease of bone (PDB) is characterized by increased osteoclast activity and localized abnormal bone remodeling. PDB has a significant genetic component, with evidence of linkage to chromosomes 6p21.3 ( PDB1) and 18q21-22 ( PDB2) in some pedigrees. There is evidence of genetic heterogeneity, with other pedigrees showing negative linkage to these regions. TNFRSF11A, a gene that is essential for osteoclast formation and that encodes receptor activator of nuclear factor-κ B (RANK), has been mapped to the PDB2 region. TNFRSF11A mutations that segregate in pedigrees with either familial expansile osteolysis or familial PDB have been identified; however, linkage studies and mutation screening have excluded the involvement of RANK in the majority of patients with PDB. We have excluded linkage, both to PDB1 and to PDB2, in a large multigenerational pedigree with multiple family members affected by PDB. We have conducted a genomewide scan of this pedigree, followed by fine mapping and multipoint analysis in regions of interest. The peak two-point LOD scores from the genomewide scan were 2.75, at D7S507, and 1.76, at D18S70. Multipoint and haplotype analysis of markers flanking D7S507 did not support linkage to this region. Haplotype analysis of markers flanking D18S70 demonstrated a haplotype segregating with PDB in a large subpedigree. This subpedigree had a significantly lower age at diagnosis than the rest of the pedigree (51.2±8.5 vs. 64.2±9.7 years; P=.0012). Linkage analysis of this subpedigree demonstrated a peak two-point LOD score of 4.23, at marker D18S1390 (θ=0), and a peak multipoint LOD score of 4.71, at marker D18S70. Our data are consistent with genetic heterogeneity within the pedigree and indicate that 18q23 harbors a novel susceptibility gene for PDB.