It was recently reported that rs1541160 on chromosome 1q24.2 has a marked effect on survival of amyotrophic lateral sclerosis (ALS) patients by influencing KIFAP3 expression. The cohorts used in that study were collected from ALS specialty clinics. We attempted to replicate these findings in a population-based cohort of 504 Italian ALS patients. None of 140 SNPs genotyped within the KIFAP3 locus (including rs1541160) had an effect on survival (log-rank P value for rs1541160 = 0.47) or on gene expression in that region. These data illustrate the complexities associated with analyzing ALS phenotypes for association. A myotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by rapidly progressive paralysis leading to death from respiratory failure. Population-based epidemiological studies indicate that the median survival of ALS patients is 20-36 mo (1-3). Demographic and clinical features, as well as riluzole and certain symptomatic therapies, are known to modestly modify survival, but the influence of genetics on the rate of disease progression and survival is not known (4). Landers et al. (5) recently reported that the CC genotype of SNP rs1541160 within the kinesin-associated protein 3 (KIFAP3) gene on chromosome 1q24.2 conferred a 14-mo survival advantage on ALS patients. Furthermore, expression data based on 26 occipital lobe brain samples suggested that the CC genotype of this SNP reduced KIFAP3 expression by 41% compared with the TT genotype (5). To confirm the accuracy of this report, we attempted to replicate this finding in a population-based cohort of 504 Italian ALS patients collected using the Piemonte and Valle d'Aosta Registry for ALS (PARALS). We also evaluated the effect of the identified SNP, and all SNPs within the 1-Mb surrounding region, on the expression of KIFAP3 in four brain regions obtained from 144 neurologically normal individuals.
ResultsRs1541160 had no effect on survival in our population-based cohort of 504 Italian ALS cases either under the genotypic model [median survival for CC genotype = 4.09 y; CT genotype = 3.48 y; TT genotype = 3.58 y; log-rank P = 0.48, Peto P = 0.60 (Fig. 1A)] or under the allelic model [log-rank P = 0.33, Peto P = 0.53 (Fig. 1B)]. Similarly, survival analysis limited to the 318 deceased ALS patients failed to demonstrate an effect of rs1541160 on survival either under the genotypic model [log-rank P = 0.55, Peto P = 0.92 (Fig. 1C)] or under the allelic model [log-rank P = 0.42, Peto P = 0.71 (Fig. 1D)]. Linear regression modeling of the deceasedonly cohort, incorporating age, gender, site of symptom onset, and population structure (component vectors 1 and 2 from multidimensional scaling) as covariates, was also not significant (β coefficient = 0.024, P = 0.89). Survival analysis limited to the cohort of patients attending a specialized ALS clinic was similarly negative [n = 89 patients (Fig. S1)]. None of the 139 other SNPs within the 1-Mb region surrounding KIFAP3 significantly influenced survival of the Italian ALS cohort (...