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CAUSAL ASSOCIATION BETWEEN SEPSIS AND FIBROBLAST GROWTH FACTORS AS WELL AS THEIR RECEPTORS LEVELS: A TWO-SAMPLE MENDELIAN RANDOMIZATION STUDY.

Objective: The potential association between sepsis risk and circulating levels of fibroblast growth factors (FGFs) and their receptors (FGFRs) has been a focus of research; however, the causal relationship between them remains to be elucidated. We hypothesize a causal association between genetically predicted FGFs, FGFRs, and sepsis risk, and we conduct a Mendelian randomization (MR) study to validate this hypothesis. Methods: We utilized a two-sample MR design to assess the effect of genetic variants associated with various FGFs (FGF1, FGF2, FGF7, FGF16, FGF19, FGF21, FGF23, FGF5) and FGFRs (FGFR1, FGFR2, FGFR3, α-Klotho) on sepsis risk, using genome-wide association study summary statistics. Our MR analyses employed the inverse-variance weighted (IVW) method, along with weighted median, weighted mode, and MR-Egger regression, supplemented by sensitivity analyses to ensure robustness. Results: The MR analysis identified an unequal number of instrumental variables ranging from 2 to 17 for FGFs and FGFRs when sepsis was the outcome. No significant correlation was found between genetically determined FGF levels and sepsis risk by IVW analysis (all P > 0.05). Correspondingly, similar nonsignificant associations were observed for FGFRs (all P > 0.05). Other MR methods corroborated the IVW findings. Sensitivity analyses, including Cochran's Q test, MR-Egger, and MR pleiotropy residual sum and outlier, indicated no significant heterogeneity or pleiotropy in the relationships, with the exception of a nonsignificant correlation between FGFR1 and sepsis that persisted after the exclusion of an outlier (odds ratio, 0.84; P = 0.34). Conclusion: The analysis found no significant causal associations between FGFs, their receptors, and sepsis risk, indicating a need for further research on their complex interactions.

Humans↗

Biological Mechanisms Underlying the Cardiovascular Effects of Branched-Chain Amino Acids: A Proteome-Wide Mendelian Randomization Study.

BACKGROUND: Ischemic heart disease (IHD) is the leading cause of morbidity and mortality. Branched-chain amino acids (BCAAs) are associated with higher IHD risk, but the underlying biological pathways remain unclear. OBJECTIVES: This study aims to explore these pathways using 2-step proteome-wide Mendelian randomization. METHODS: We examined the associations between genetic proxies for BCAAs and 2922 proteins in the United Kingdom Biobank Pharma Proteomics Project, supplemented by a meta-analysis with data from deCODE to identify proteins associated with BCAAs. Next, we tested their effects on IHD risk using Coronary Artery Disease Genome-wide Replication and Meta-analysis plus Coronary Artery Disease Genetics Consortium (122,733 cases and 424,528 controls) and replicated in FinnGen (31,640 cases and 187,152 controls). We conducted sensitivity analyses using genetic instruments from deCODE. Proteins associated with IHD risk and, in a consistent direction, with genetically predicted BCAAs were considered potential mediators. RESULTS: Genetic proxies for BCAAs were associated with 40 proteins. Among these, 6 proteins showed consistent evidence of mediation, including complement C1s subcomponent, coagulation factor II, granulin, proprotein convertase subtilisin/kexin type 9, sex hormone-binding globulin, and V-set and transmembrane domain-containing protein 2-like. These proteins are involved in inflammation, coagulation, lipid metabolism, and cellular stress response. All associations were robust across different analytical methods and replicated in independent datasets. Mediation analysis showed that these proteins accounted for 6.5% to 32.1% of the association between BCAAs and IHD risk. CONCLUSIONS: This study identified 6 proteins that potentially link BCAAs to IHD, implicating pathways related to inflammation, coagulation, lipid metabolism, and cellular stress responses. To our knowledge, these findings provide novel mechanistic insights into the BCAA-IHD relationship and highlight potential protein targets for future prevention and intervention strategies.

Amino Acids, Branched-Chain↗

Causal effects of sedentary behaviours on the risk of migraine: A univariable and multivariable Mendelian randomization study.

BACKGROUND: Migraine is a common and burdensome neurological disorder. The causal relationship between sedentary behaviours (SBs) and migraine remains instinct. We aimed to evaluate the roles of SBs including watching TV, using computer and driving in the risk of migraine. METHODS: We conducted a univariable and multivariable Mendelian randomization (MR) study based on summary datasets of large genome-wide association studies. The inverse variance weighted method was utilized as the primary analytical tool. Cochran's Q, MR-Egger intercept test, MR pleiotropy residual sum and outlier and leave-one-out were conducted as sensitivity analysis. Additionally, we performed a meta-analysis to combine the causal estimates. RESULTS: In the discovery analysis, we identified causal associations between time spent watching TV and an increased risk of migraine (p&#x2009;=&#x2009;0.015) and migraine without aura (MO) (p&#x2009;=&#x2009;0.002). Such causalities with increasing risk of migraine (p&#x2009;=&#x2009;0.005), and MO (p&#x2009;=&#x2009;0.006) were further verified using summary datasets from another study in the replication analysis. There was no significant causal association found between time spent using computer, driving and migraine or its two subtypes. The meta-analysis and multivariable MR analysis also strongly supported the causal relationships between time spent watching TV and an increased risk of migraine (p&#x2009;=&#x2009;0.0003 and p&#x2009;=&#x2009;0.034), as well as MO (p&#x2009;<&#x2009;0.0001 and p&#x2009;=&#x2009;0.0004), respectively. These findings were robust under all sensitivity analysis. CONCLUSIONS: Our study suggested that time spent watching TV may be causally associated with an increased risk of migraine, particularly MO. Large-scale and well-designed cohort studies may be warranted for further validation. SIGNIFICANCE STATEMENT: This study represents the first attempt to investigate whether a causal relationship exists between SBs and migraine. Utilizing MR analysis helps mitigate reverse causation bias and confounding factors commonly encountered in observational cohorts, thereby enhancing the robustness of derived causal associations. Our MR analysis revealed that time spent watching TV may serve as a potential risk factor for migraine, particularly MO.

Humans↗

Mendelian randomization study on the causal effect of herpes simplex virus infection on idiopathic pulmonary fibrosis.

BACKGROUND: Previous observational studies have shown that past infection of herpes simplex virus (HSV) is associated with idiopathic pulmonary fibrosis (IPF). The present study aims to identify the causal link between HSV infection (exposure factor) and IPF (outcome factor). RESEARCH DESIGN AND METHODS: To date, the largest publicly available genome-wide association study (GWAS) for HSV infection (1,595 cases and 211,856 controls from Finnish ancestry) and for IPF (1,028 cases and 196,986 controls from Finnish ancestry) were used to perform this two-sample Mendelian randomization (MR) study. RESULTS: We found no significant pleiotropy or heterogeneity of all selected nine HSV infection-associated genetic instrumental variants (IVs) in IPF GWAS dataset. Interestingly, we found that as HSV infection genetically increased, IPF risk increased based on an inverse-variance weighted (IVW) analysis (odds ratio [OR]&#x2009;=&#x2009;1.280, 95% confidence interval [CI]: 1.048-1.563; p&#x2009;=&#x2009;0.015) and weighted median (OR&#x2009;=&#x2009;1.321, 95% CI: 1.032-1.692; p&#x2009;=&#x2009;0.027). CONCLUSIONS: Our analysis suggests a causal effect of genetically increased HSV infection on IPF risk. Thus, HSV infection may be a potential risk factor for IPF.

Humans↗

The causal relationship between multiple cardiovascular diseases and glioblastoma: A Mendelian randomization study.

Observational studies suggest an association between glioblastoma (GBM) and cardiovascular diseases (CVDs), but a causal relationship remains unestablished. This study aimed to investigate the causal link between multiple CVDs and GBM risk. The inverse variance weighted method indicated that all 18 CVDs had significant causal associations with GBM (P&#x2005;<&#x2005;.05). Genetically predicted CVDs were uniformly associated with a lower risk of GBM (odds ratio&#x2005;<&#x2005;1), identifying them as potential protective factors. Sensitivity analyses confirmed the absence of significant heterogeneity or horizontal pleiotropy, and the MR-Steiger test validated the correct causal direction. This Mendelian randomization (MR) study provides evidence that a range of CVDs are causally associated with a decreased risk of developing GBM. These findings suggest shared biological pathways and offer new insights for understanding GBM etiology. We conducted a 2-sample MR analysis using publicly available genome-wide association study data. GBM was the outcome, and 18 cardiovascular-related traits (including coronary artery disease, myocardial infarction, and venous thromboembolism) were exposures. Instrumental variables were single-nucleotide polymorphisms significantly associated with exposures (P&#x2005;<&#x2005;5&#x2005;&#xd7;&#x2005;10-8). The primary analysis used the inverse variance weighted method, supplemented with MR-Egger, weighted median, and weighted mode methods. Sensitivity analyses, including Cochran Q test, MR-Egger intercept test, leave-one-out analysis, and MR-Steiger directionality test, were performed to ensure robustness.

Causality↗

Causal association between non-steroidal anti-inflammatory drugs use and the risk of benign prostatic hyperplasia: a univariable and multivariable Mendelian randomization study.

BACKGROUND: The results of earlier observational research on the relationships between the usage of non-steroidal anti-inflammatory medicines (NSAIDs) and the risk of benign prostatic hyperplasia (BPH) have been inconsistent. METHODS: To assess these associations, we performed both univariable and multivariable Mendelian randomization (MR) studies. Instrumental variables (IVs) associated with exposures at the significance level (p&#x2009;<&#x2009;5&#x2009;&#xd7;&#x2009;10-6) were selected from a comprehensive meta-analysis conducted by the United Kingdom Biobank (UKB). Summary data for BPH were obtained from the FinnGen consortium, which comprised 30,066 cases and 119,297 controls. Sensitivity analyses were performed to evaluate heterogeneity and pleiotropy. RESULTS: We found evidence by univariable MR (UVMR) that genetically predicted NSAIDs use increased the risk of BPH (odds ratio [OR] per unit increase in log odds NSAIDs use: 1.164, 95% confidence interval [CI]: 1.041-1.302, p&#x2009;=&#x2009;0.008). After controlling for inflammation in multivariable MR (MVMR), the link persisted (OR: 1.165, 95% CI: 1.049-1.293, p&#x2009;=&#x2009;0.004). There were no indications of potential heterogeneity and pleiotropy in UVMR and MVMR analyses. CONCLUSION: The results of the MR estimates suggest that genetically predicted NSAIDs use may elevate the risk of BPH. This outcome prompts the imperative for deeper exploration into potential underlying mechanisms.

Humans↗

Association between NAFLD and liver cancer: A two-sample Mendelian randomization study.

Observational studies suggest an association between nonalcoholic fatty liver disease (NAFLD) and liver cancer, but its causal nature remains unclear. A 2-sample Mendelian randomization (MR) analysis was performed using NAFLD and liver cancer summary statistics from genome-wide association study databases. Instrumental variables satisfying the 3 core MR assumptions were selected. Causal effects were estimated using inverse-variance weighted, MR-Egger, weighted median, and other methods, followed by sensitivity and power analyses. All 4 MR analyses demonstrated a positive causal association between NAFLD and liver cancer risk [odds ratio&#x2005;>&#x2005;1, inverse-variance weighted P&#x2005;<&#x2005;.001]. Sensitivity analysis indicated no significant level of multiplicity or heterogeneity in the instrumental variables, and individual single nucleotide polymorphisms had no significant impact on the results. However, statistical power was insufficient. This study provides the first MR evidence demonstrating a genetically predicted causal relationship between NAFLD and liver cancer that is consistent across subtypes. Sensitivity analyses confirmed the absence of horizontal pleiotropy or heterogeneity, strengthening the robustness of the findings. These results offer genetic support for early NAFLD intervention to reduce the risk of liver cancer. However, the limited statistical power highlights the need for larger-scale genome-wide association study to identify more and stronger genetic instruments for a more precise quantification of the causal effect of NAFLD on liver cancer risk.

Humans↗

The causal relationship between steroid hormones and risk of stroke: evidence from a two-sample Mendelian randomization study.

It is unclear how steroid hormones contribute to stroke, and conducting randomized controlled trials to obtain related evidence is challenging. Therefore, Mendelian randomization (MR) technique was employed in this study to examine this association. Through genome-wide association meta-analysis, the genetic variants of steroid hormones, including testosterone/17&#x3b2;-estradiol (T/E2) ratio, aldosterone, androstenedione, progesterone, and hydroxyprogesterone, were acquired as instrumental variables. Analysis was done on the impact of these steroid hormones on the risk of stroke subtypes. The T/E2 ratio was associated to an elevated risk of small vessel stroke (SVS) according to the inverse variance weighted approach which was the main MR analytic technique (OR, 1.23, 95% CI: 1.05-1.44, p&#x2009;=&#x2009;0.009). These findings were solid since no heterogeneity nor horizontal pleiotropy were found. The causal association between T/E2 and SVS was also confirmed in the replication study (p&#x2009;=&#x2009;0.009). Nevertheless, there was no proof that other steroid hormones increased the risk of stroke. According to this study, T/E2 ratio and SVS are causally related. However, strong evidence for the impact of other steroid hormones on stroke subtypes is still lacking. These findings may be beneficial for developing stroke prevention strategies from steroid hormones levels.

Mendelian Randomization Analysis↗

Causal effect of the age at first birth with depression: a mendelian randomization study.

BACKGROUND: This study aimed to explore the causal relationship between age at first birth (AFB) and depression. METHODS: Using the univariable Mendelian randomization (UVMR) and multivariable Mendelian randomization (MVMR) methods to examine the potential correlation between age at first birth (AFB) and major depressive disorder and postpartum depression. A public database was used to obtain the genome-wide association studies (GWAS) summary data. We put inverse-variance-weighted (IVW) as the primary method in Mendelian randomization (MR) analysis and used sensitivity analysis to confirm the robustness of our result. RESULTS: We found a significant causal association between AFB and major depressive disorder by using the IVW algorithm (odd ratio [OR] 0.826; 95% confidence interval [CI] 0.793&#x2009;-&#x2009;0.861; P&#x2009;=&#x2009;4.51&#x2009;&#xd7;&#x2009;10-&#x2009;20). MR-Egger, weighted median, simple mode and weighted mode method concluded the same result (P&#x2009;<&#x2009;0.05). During the sensitivity analysis, the heterogeneity test (Q-value&#x2009;=&#x2009;55.061, df&#x2009;=&#x2009;48, P&#x2009;=&#x2009;2.81&#x2009;&#xd7;&#x2009;10-&#x2009;01, I2&#x2009;=&#x2009;12.82%) and the leave-one-out plot analysis confirmed the stability of the results. The outcomes of the pleiotropy test (MR-Egger intercept&#x2009;=&#x2009;8.932&#x2009;&#xd7;&#x2009;10-&#x2009;3. SE&#x2009;=&#x2009;6.909&#x2009;&#xd7;&#x2009;10-&#x2009;3. P&#x2009;=&#x2009;2.02&#x2009;&#xd7;&#x2009;10-&#x2009;01) and MR_PRESSO global test (P&#x2009;=&#x2009;2.03&#x2009;&#xd7;&#x2009;10-&#x2009;01) indicated there is no pleiotropy. CONCLUSION: There is solid evidence that a higher age at first birth is associated with a lower risk of major depressive disorder.

Humans↗

Asthma causally affects the brain cortical structure: a Mendelian randomization study.

OBJECTIVE: The potential causal relationship between asthma and brain structures remains uncertain. We performed a two-sample Mendelian randomization to investigate the causal effects of various asthma phenotypes - unspecified asthma, moderate-to-severe asthma, childhood-onset asthma, and adult-onset asthma (AOA) - on cerebral cortex structure. METHODS: We utilized phenotype data derived from genome-wide association studies (GWASs). The ENIGMA Consortium GWAS provided outcome variables for surface area (SA) and thickness across the whole brain and 34 region-specific areas of the cerebral cortex. Using the inverse variance-weighted method as our primary estimation approach, we employed several techniques, including Cochran's Q statistic, the MR-PRESSO global test, MR-Egger, and weighted median, to assess heterogeneity and pleiotropy, thereby ensuring the robustness of our findings. Additionally, we conducted enrichment analyses of gene sets with causal effects on cortical structure and applied bioinformatics techniques to construct interaction networks and identify hub nodes. RESULTS: At the global level, AOA was associated with a significant reduction in full cortical SA (&#x3b2;&#xa0;=&#xa0;-58.49 mm2, p&#xa0;=&#xa0;0.017). In regional analyses, moderate-to-severe asthma exhibited a more pronounced impact on the cerebral cortex compared to other phenotypes. Enrichment analysis revealed that pathways implicated in brain morphology among asthma patients were primarily linked to immune and inflammation-driven pathways. CONCLUSIONS: Our findings provide new evidence supporting a causal relationship between asthma and alterations in cortical structure, offering potential explanations for cognitive and psychiatric impairments observed in individual post-asthma.

Humans↗

Associations between granulysin and ovarian endometriosis: A 2-sample Mendelian randomization study.

Endometriosis (EMS) is a chronic inflammatory disease defined by the presence of endometrial-like tissue outside the uterine cavity. Ovarian EMS is considered the most prevalent disease phenotype. However, the causal relationship between granulysin and ovarian EMS remains unclear. We investigate the potential causal relationship between granulysin and ovarian EMS using a 2-sample Mendelian randomization analysis. Genome-wide association study data for granulysin and ovarian EMS were obtained from publicly available online databases. A 2-sample Mendelian randomization analysis was conducted using the inverse-variance weighted method. The causal effect was further validated through weighted median and MR-Egger regression analyses, and a leave-one-out sensitivity analysis was performed. The odds ratio and its 95% confidence interval were used to evaluate the causal relationship between granulysin and the risk of ovarian EMS. Our findings suggest a direct causal relationship between granulysin expression and ovarian EMS. The inverse-variance weighted analysis revealed that a 1-standard deviation increase in granulysin was associated with a 10.7% reduction in the risk of ovarian EMS (odd ratio&#x2005;=&#x2005;0.892, 95% confidence interval: 0.824-0.966, P&#x2005;=&#x2005;.004). There may exist a negative causal relationship between granulysin expression and ovarian EMS.

Female↗

Hidradenitis Suppurativa and Smoking, Obesity, Psoriasis, Inflammatory Bowel Disease, and Systemic Sclerosis: Results From A 2-Sample Mendelian Randomization Study.

IMPORTANCE: Smoking and obesity are associated with risk of hidradenitis suppurativa, and both are considered important environmental risk factors. However, a causal relationship remains unproven. OBJECTIVE: To primarily investigate the relationship between body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) and smoking and HS, and secondarily to investigate potential relationships between 3 inflammatory diseases (psoriasis, inflammatory bowel disease [IBD], and systemic sclerosis [SSc]) and HS. DESIGN, SETTING, AND PARTICIPANTS: A mendelian randomization (MR) study conducted in 2024 on 5 exposure phenotypes (BMI, smoking, psoriasis, IBD, and SSc) on the outcome of phenotype HS was conducted. The MR analyses used large genetic White European cohorts from genome-wide association studies (GWAS) of each of the 6 phenotypes. Initial analyses were conducted May, 2024, and were updated in May, 2025. EXPOSURE: The 5 exposure phenotypes using predetermined genome-wide significant single-nucleotide variants as proxies for each particular exposure. RESULTS: The GWAS on HS included 4814 case patients and more than 1.2 million controls from Denmark, Iceland, Finland, the UK, and the US. The BMI GWAS involved 700&#x202f;000 individuals from the UK Biobank and GIANT consortium. Smoking data were obtained from 1.23 million participants in an international consortium. The psoriasis GWAS analyzed 39&#x202f;498 case patients and 286&#x202f;769 controls from White European populations and a DNA genetic testing company. The IBD GWAS meta-analysis included 38&#x202f;155 case patients and 48&#x202f;485 controls from the International Inflammatory Bowel Disease (IBD) Genetics Consortium. The SSc GWAS included 9095 case patients and 17&#x202f;584 controls from White European populations. Genetic correlations (rg) were found between HS and all exposure phenotypes except SSc (BMI: rg&#x2009;=&#x2009;0.36, P&#x2009;<&#x2009;.001; smoking: rg&#x2009;=&#x2009;0.33, P&#x2009;<&#x2009;.001; IBD: rg&#x2009;=&#x2009;0.25, P&#x2009;<&#x2009;.001; psoriasis: rg&#x2009;=&#x2009;0.34, P&#x2009;<&#x2009;.001; SSc: rg&#x2009;=&#x2009;0.33, P&#x2009;=&#x2009;.22). MR analyses supported an effect of BMI on HS (&#x3b2;&#x2009;=&#x2009;0.87; odds ratio [OR] per BMI unit, 1.20; 95% CI, 1.17-1.23; P&#x2009;<&#x2009;.001) without signs of pleiotropy (slope: &#x3b2;&#x2009;=&#x2009;0.91, P&#x2009;<&#x2009;.001, P for intercept&#x2009;=&#x2009;.76). Smoking showed a significant causal estimate (&#x3b2;&#x2009;=&#x2009;0.59, P&#x2009;<&#x2009;.001), but results became inconclusive in subsequent sensitivity analyses. Among IBD, psoriasis, and SSc, results supported a causal effect of IBD on HS (&#x3b2;&#x2009;=&#x2009;0.18, OR&#x2009;=&#x2009;1.20; 95% CI, 1.15-1.24; P&#x2009;<&#x2009;.001), without signs of pleiotropy. CONCLUSIONS AND RELEVANCE: These findings indicate causal effects of IBD and increased BMI on the risk of HS. This information may help physicians inform patients about disease risk contributed by modifiable lifestyle behaviors, which can be beneficial for planning lifestyle interventions.

Humans↗

Exploring the Relationship Between Serological Metabolites and Oral Cancer: A Mendelian Randomization Study.

BACKGROUND: Oral cancer is a prevalent malignant tumor, comprising &#x223c;5% to 6% of all tumors. The 5-year survival rate for this condition is &#x223c;50%. However, the early symptoms of oral cancer are often inconspicuous and easily overlooked, leading to frequent misdiagnosis or missed diagnosis. Although some previous studies have investigated the correlation between oral cancer and serum metabolites, the exact relationship remains unclear. Consequently, it is of utmost importance to develop effective early diagnosis methods and explore the pathogenesis of oral cancer to enhance patients' survival rates and quality of life. METHODS: This Mendelian randomization (MR) study utilized the Genome-Wide Association Study (GWAS) catalog to obtain instrumental variables (IVs) that link 486 serum metabolites with oral cancer. The study then conducted a causal analysis, using serological metabolites as exposure factors and oral cancer as the outcome. The samples used in the study were exclusively from the European population. The main method used for the univariate MR analysis was the inverse variance weighting method. After excluding confounding factors, MR analysis was performed again. Sensitivity analyses were subsequently conducted to enhance the robustness of the MR results. Furthermore, metabolic pathway analysis was carried out on serum metabolites associated with oral cancer, aiming to identify and explore potential metabolic pathways. RESULTS: After MR analysis, 8 serum metabolites were screened out that are highly correlated with the causal relationship with oral cancer, including androsterone sulfate (OR=2.11, 95% CI: 1.37-3.27, P =0.0007), X-12100--hydroxytryptophan (OR=0.12, 95% CI: 0.02-0.73, P =0.022), gamma-glutamylphenylalanine (OR=7.57, 95% CI: 1.17-48.85, P =0.033), 7-methylxanthine (OR=0.22, 95% CI: 0.05-0.90, P =0.035), urate (OR=12.03, 95% CI: 1.16-124.32, P =0.037), palmate (16:0) (OR=11.01, 95% CI: 1.11-109.13, P =0.040), creatinine (OR=0.03, 95% CI: 0.00-0.90, P =0.047), guanosine (OR=2.66, 95% CI: 1.00-7.04, P =0.049), and the absence of heterogeneity and horizontal pleiotropy in this study indicates that the MR results obtained are quite reliable. CONCLUSION: Androsterone sulfate, gamma-glutamylphenylalanine, urate, palmitate (16:0), creatinine, and guanosine have been identified as risk factors for oral cancer. In contrast, X-12100--hydroxytryptophan and 7-methylxanthine may have a protective effect against oral cancer. The findings of this study have significant implications for early oral cancer diagnosis and offer valuable insights into the disease's pathogenesis.

Mendelian Randomization Analysis↗

Alterations of gut microbiome in chronic rhinosinusitis: insights from a mendelian randomization study.

OBJECTIVE: Gut microbiome dysbiosis is associated with various diseases. Causal association between Chronic Rhinosinusitis (CRS) and gut microbiome is yet unknown. This study aimed to investigate the potential causal relationship between CRS and gut microbiome dysbiosis. METHODS: We used Genome-Wide Association Study (GWAS) data from FinnGen database for CRS. The Dutch Microbiome Project study provided data on gut microbiota species. A total of 334,182 individuals were included. Two-sample bidirectional Mendelian Randomization (MR) analysis was used to investigate causal relationship between CRS and gut microbiome. The main methods of evaluation were Inverse Variance Weighting (IVW), weighted median, weighted mode, and MR-Egger regression. Sensitivity analyses were performed to assess heterogeneity and pleiotropy. RESULTS: Forward MR analysis indicated CRS is potentially linked to decreased risk of Haemophilus parainfluenzae (OR = 0.79, 95% CI 0.66&#x2012;0.94, p = 0.009) and increased risk of Bilophila's (OR = 1.14, 95% CI 1.02-1.27, p = 0.023) within the gut. Reduced risks in gut microbiota-related pathways like UDP-N-acetyl-d-glucosamine biosynthesis I (OR = 0.85, 95% CI 0.77&#x2012;0.94, p = 0.002) and increased risk in pathway NAD biosynthesis I from aspartate (OR = 1.14, 95% CI 1.03-1.27, p = 0.010) were also linked to CRS. Reverse MR analyses, we obtained no positive results (p > 0.05/412). CONCLUSION: This study reveals CRS exerts a causal impact on shifts within the composition of the gut microbiome and also links to the changes of gut microbiota-related metabolic pathways. The risk of changes in gut microbiota should be of greater concern in patients with CRS than in the general population. LEVEL OF EVIDENCE: Mendelian Randomized (MR) studies are second only to randomized controlled trials in terms of the level of evidence.

Humans↗

Exploring causal associations between autoimmune diseases and hearing loss: a mendelian randomization study.

OBJECTIVE: The causal relationship between Autoimmune Diseases (ADs) and Hearing Loss (HL) remains unclear. This study investigates whether genetic predispositions associated with ADs contribute to HL risk. METHODS: Mendelian Randomization (MR) analysis was conducted to explore the causal effects of ADs on HL. SNPs from Genome-Wide Association Studies (GWAS) were used as instrumental variables for ADs, including Rheumatoid Arthritis (RA), Type 1 Diabetes (T1D), Systemic Lupus Erythematosus (SLE), Sj&#xf6;gren's Syndrome (SS), Ankylosing Spondylitis (AS), Multiple Sclerosis (MS), Crohn's Disease (CD), and Ulcerative Colitis (UC). Outcome data included Sensorineural Hearing Loss (SNHL), Conductive Hearing Loss (CHL), Mixed conductive and sensorineural Hearing Loss (MHL), and Sudden Idiopathic Hearing Loss (SIHL). MR analyses employed Inverse Variance Weighted (IVW) as the primary method, supplemented with MR-Egger, weighted median, and weighted mode. Heterogeneity, pleiotropy, and sensitivity were evaluated using Cochran's Q test, MR-Egger regression, MR-PRESSO, and leave-one-out analysis. RESULTS: The IVW method identified nine significant associations: MS-SIHL (OR&#x2009;=&#x2009;1.0494, 95% CI 1.0072-1.0934), AS-CHL (OR&#x2009;=&#x2009;1.2832, 95% CI 1.0643-1.5472), AS-MHL (OR&#x2009;=&#x2009;1.5994, 95% CI 1.3696-1.8678), AS-SNHL (OR&#x2009;=&#x2009;1.1903, 95% CI 1.1104-1.276), AS-SIHL (OR&#x2009;=&#x2009;1.481, 95% CI 1.22-1.798), SLE-CHL (OR&#x2009;=&#x2009;1.0593, 95% CI 1.0116-1.1092), UC-MHL (OR&#x2009;=&#x2009;1.0907, 95% CI 1.0027-1.1865), CD-CHL (OR&#x2009;=&#x2009;1.0529, 95%CI: 1.0074-1.1005), and CD-SIHL (OR&#x2009;=&#x2009;1.0597, 95% CI 1.0177-1.1034). Among these, outliers were detected only in AS-SNHL. After outlier removal, the AS-SNHL association remained significant (OR&#x2009;=&#x2009;1.1722, p&#x2009;<&#x2009;0.00001), with resolved heterogeneity and pleiotropy. No heterogeneity and pleiotropy were found for the other associations. CONCLUSION: This study identified nine significant AD-HL associations, emphasizing the need for targeted screening and management of HL in individuals with AD. LEVEL OF EVIDENCE: Level 5.

Humans↗

Mitochondrial Function-Related Genes in Sleep Disorders: A Multi-Omics Mendelian Randomization Study.

Mitochondrial dysfunction is linked to sleep disorders in previous report, but the potential roles of specific genes remain unclear. This study aimed to dissect different subtype-specific genetic associations and their underlying mechanisms. A multi-omics Summary-data-based Mendelian Randomization (SMR) approach was performed to identify potential causal links between mitochondrial function-related genes and sleep disorders. We integrated GWAS data from FinnGen database (the discovery set), independent GWAS datasets (covering different sleep-disorder subtypes and used for validation), and cis-QTLs (including mQTLs, eQTLs, and pQTLs) to perform systematic exploration. Specially, we performed targeted validation of tissue-specific effects, leveraging gene expression data from disease-relevant brain regions within the GTEx database. Our SMR analysis identified mitochondrial function-related genes potentially modulating sleep disorders across biological layers, initially identifying 102 genes at the methylation level, 48 at the gene expression level, and 6 at the protein abundance level. Integrative analysis subsequently prioritized DCXR and ACADVL and revealed their distinct, subtype-specific associations. DCXR exhibited a protective role in sleep apnea while ACADVL showed a paradoxical risk conferring role in daytime sleepiness. In addition, the analysis identified an epigenetic regulatory mechanism for DCXR in which its expression and protein levels are modulated by DNA methylation. Finally, validation in brain-hypothalamus tissue confirmed DCXR as a significant potential protective factor (OR&#x2009;=&#x2009;0.929, 95% CI: 0.887-0.973, P_HEIDI&#x2009;=&#x2009;0.999, FDR&#x2009;=&#x2009;0.2449). Our findings implicate key mitochondrial genes, particularly DCXR and ACADVL, in the pathophysiology of specific sleep disorder subtypes, highlighting potential avenues for precision medicine. Clinical trial number: Not applicable.

Humans↗

Deciphering miRNA-mediated genetic architecture of immune cell subsets in hypertrophic scars and keloids: A 2-step Mendelian randomization study unveiling causal associations.

This study aimed to investigate the potential causal roles of specific circulating microRNAs (miRNAs) and immune cell subsets in the pathogenesis of hypertrophic scars and keloids using a 2-step Mendelian randomization framework. We employed a 2-sample Mendelian randomization approach to evaluate the causal relationships between miRNAs, immune cell genotypes, and scar phenotypes. The analysis integrated miRNA expression quantitative trait loci, immune cell genome-wide association studies, and scar datasets. A 2-step mediation analysis was conducted to assess the indirect effects of miRNAs on scars through immune cell genotypes, using inverse variance weighted methods and complementary sensitivity analyses to ensure robustness. Our analysis identified significant associations between specific miRNAs and scar phenotypes. Notably, miR-6887-5p exhibited a total effect on keloid formation risk (&#x3b2;&#x2005;=&#x2005;0.324, 95% confidence interval [CI]: 0.073-0.576) and a direct effect (&#x3b2;&#x2005;=&#x2005;0.283, 95% CI: 0.027, 0.538), with a marginally significant mediation effect through B-cell activating factor receptor on CD20- CD38- B cells (&#x3b2;&#x2005;=&#x2005;0.042, 95% CI: -0.001, 0.084, P&#x2005;=&#x2005;.047). For hypertrophic scars, miR-345-5p demonstrated a significant total effect (&#x3b2;&#x2005;=&#x2005;-0.501, 95% CI: -0.903, -0.099) and direct effect (&#x3b2;&#x2005;=&#x2005;-0.469, 95% CI: -0.872, -0.066), with a significant mediation effect through CD28+ CD45RA- CD8dim T cell percentage (&#x3b2;&#x2005;=&#x2005;-0.032, 95% CI: -0.062, -0.002, P&#x2005;=&#x2005;.034). miR-4801 showed a significant total effect (&#x3b2;&#x2005;=&#x2005;-0.246, 95% CI: -0.429, -0.064) and direct effect (&#x3b2;&#x2005;=&#x2005;-0.218, 95% CI: -0.402, -0.033), with a marginally significant mediation effect through T cell absolute count (&#x3b2;&#x2005;=&#x2005;-0.028, 95% CI: -0.057, -0.000, P&#x2005;=&#x2005;.043). These findings highlight the interplay between miRNAs and immune cell subsets in scar pathogenesis. This study provides preliminary evidence for the causal roles of specific miRNAs and immune cell subsets in scar formation, emphasizing the potential of miRNA-immune cell axes as therapeutic targets. While the identified associations offer important insights into the molecular mechanisms of scar heterogeneity, further validation through mechanistic studies and clinical trials is necessary to translate these genetic insights into clinical interventions.

Humans↗

Causal relationships between modifiable risk factors and heart failure: A comprehensive Mendelian randomization study.

Heart failure threatens human health across the globe. Comprehensively identifying its risk factors has public health importance. This work utilized the Mendelian randomization (MR) method to evaluate the effects of over 200 modifiable factors on heart failure. The data from genome-wide association studies (GWAS) was used, with the sample size ranging from 711 to 1232,091. Two distinct GWAS datasets for heart failure were employed for results validation. The inverse variance weighted (IVW) method was used and other supplementary models were employed for comparison. Sensitivity analysis was conducted to verify the results. After integrating the MR estimates derived from heart failure GWAS datasets from integrative epidemiology unit (IEU) and Finngen, we found that body measurement indices like body mass index, whole body fat mass, trunk fat mass, basal metabolic rate, body fat percentage, waist circumference, and waist-hip ratio, were associated with a higher risk of heart failure. Similarly, smoking behavior, sedentary behavior, overall health rating, and type 2 diabetes were determined to increase the risk of heart failure. In contrast, college or university degree showed a protective effect on heart failure. Among these significant findings, body mass index, whole body fat mass, trunk fat mass, basal metabolic rate, body fat percentage, overall health rating, smoking initiation, waist circumference, lifetime smoking index, college or university degree, sedentary behavior, waist-hip ratio, and type 2 diabetes were replicated validated. This MR work figured out that obesity, socioeconomic factors, lifestyle factors, and metabolic features showed broad relations with heart failure. The findings would provide evidence for future policy development for the management of heart failure.

Humans↗