Genome-wide association meta-analysis identifies five modifier loci of lung disease severity in cystic fibrosis

The identification of small molecules that target specific CFTR variants has ushered in a new era of treatment for cystic fibrosis (CF), yet optimal, individualized treatment of CF will require identification and targeting of disease modifiers. Here we use genome-wide association analysis to identify genetic modifiers of CF lung disease, the primary cause of mortality. Meta-analysis of 6,365 CF patients identifies five loci that display significant association with variation in lung disease. Regions on chr3q29 (MUC4/MUC20; P=3.3 × 10(−11)), chr5p15.3 (SLC9A3; P=6.8 × 10(−12)), chr6p21.3 (HLA Class II; P=1.2 × 10(−8)) and chrXq22-q23 (AGTR2/SLC6A14; P=1.8 × 10(−9)) contain genes of high biological relevance to CF pathophysiology. The fifth locus, on chr11p12-p13 (EHF/APIP; P=1.9 × 10(−10)), was previously shown to be associated with lung disease. These results provide new insights into potential targets for modulating lung disease severity in CF.