@article {90,
	title = {Rare protein-altering variants in ANGPTL7 lower intraocular pressure and protect against glaucoma.},
	journal = {PLoS Genet},
	volume = {16},
	year = {2020},
	month = {2020 05},
	pages = {e1008682},
	abstract = {<p>Protein-altering variants that are protective against human disease provide in vivo validation of therapeutic targets. Here we use genotyping data from UK Biobank (n = 337,151 unrelated White British individuals) and FinnGen (n = 176,899) to conduct a search for protein-altering variants conferring lower intraocular pressure (IOP) and protection against glaucoma. Through rare protein-altering variant association analysis, we find a missense variant in ANGPTL7 in UK Biobank (rs28991009, p.Gln175His, MAF = 0.8\%, genotyped in 82,253 individuals with measured IOP and an independent set of 4,238 glaucoma patients and 250,660 controls) that significantly lowers IOP (β = -0.53 and -0.67 mmHg for heterozygotes, -3.40 and -2.37 mmHg for homozygotes, P = 5.96 x 10-9 and 1.07 x 10-13 for corneal compensated and Goldman-correlated IOP, respectively) and is associated with 34\% reduced risk of glaucoma (P = 0.0062). In FinnGen, we identify an ANGPTL7 missense variant at a greater than 50-fold increased frequency in Finland compared with other populations (rs147660927, p.Arg220Cys, MAF Finland = 4.3\%), which was genotyped in 6,537 glaucoma patients and 170,362 controls and is associated with a 29\% lower glaucoma risk (P = 1.9 x 10-12 for all glaucoma types and also protection against its subtypes including exfoliation, primary open-angle, and primary angle-closure). We further find three rarer variants in UK Biobank, including a protein-truncating variant, which confer a strong composite lowering of IOP (P = 0.0012 and 0.24 for Goldman-correlated and corneal compensated IOP, respectively), suggesting the protective mechanism likely resides in the loss of interaction or function. Our results support inhibition or down-regulation of ANGPTL7 as a therapeutic strategy for glaucoma.</p>},
	keywords = {Adult, Aged, Aged, 80 and over, Angiopoietin-like Proteins, Biological Specimen Banks, Case-Control Studies, Cohort Studies, Female, Finland, Gene Frequency, Genetic Predisposition to Disease, Genetics, Population, Genome-Wide Association Study, Glaucoma, Humans, Intraocular Pressure, Loss of Function Mutation, Male, Middle Aged, Mutation, Missense, Polymorphism, Single Nucleotide, United Kingdom},
	issn = {1553-7404},
	doi = {10.1371/journal.pgen.1008682},
	author = {Tanigawa, Yosuke and Wainberg, Michael and Karjalainen, Juha and Kiiskinen, Tuomo and Venkataraman, Guhan and Lemmel{\"a}, Susanna and Turunen, Joni A and Graham, Robert R and Havulinna, Aki S and Perola, Markus and Palotie, Aarno and Daly, Mark J and Rivas, Manuel A}
}
