Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Letter
  • Published:

A genome-wide association study identifies susceptibility loci for nonsyndromic sagittal craniosynostosis near BMP2 and within BBS9

Abstract

Sagittal craniosynostosis is the most common form of craniosynostosis, affecting approximately one in 5,000 newborns. We conducted, to our knowledge, the first genome-wide association study for nonsyndromic sagittal craniosynostosis (sNSC) using 130 non-Hispanic case-parent trios of European ancestry (NHW). We found robust associations in a 120-kb region downstream of BMP2 flanked by rs1884302 (P = 1.13 × 10−14, odds ratio (OR) = 4.58) and rs6140226 (P = 3.40 × 10−11, OR = 0.24) and within a 167-kb region of BBS9 between rs10262453 (P = 1.61 × 10−10, OR = 0.19) and rs17724206 (P = 1.50 × 10−8, OR = 0.22). We replicated the associations to both loci (rs1884302, P = 4.39 × 10−31 and rs10262453, P = 3.50 × 10−14) in an independent NHW population of 172 unrelated probands with sNSC and 548 controls. Both BMP2 and BBS9 are genes with roles in skeletal development that warrant functional studies to further understand the etiology of sNSC.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Manhattan plot of the P values obtained from the genome-wide TDT of 130 trios (N = 914,402).
Figure 2: Regional association plots for associations with sNSC at genome-wide significance.

Similar content being viewed by others

Accession codes

Accessions

GenBank/EMBL/DDBJ

References

  1. Cohen, M.M. Craniosynostosis: Diagnosis, Evaluation, and Management (Oxford University Press, New York, 2000).

  2. Johnson, D. et al. A novel mutation, Ala315Ser, in FGFR2: a gene-environment interaction leading to craniosynostosis? Eur. J. Hum. Genet. 8, 571–577 (2000).

    Article  CAS  PubMed  Google Scholar 

  3. Seto, M.L. et al. Isolated sagittal and coronal craniosynostosis associated with TWIST box mutations. Am. J. Med. Genet. A 143, 678–686 (2007).

    Article  CAS  Google Scholar 

  4. Weber, I. et al. Molecular analysis of 74 patients with craniosynostosis. Eur. J. Hum. Genet. 9 (suppl. 1), P0409, 179 (2001).

    Google Scholar 

  5. Merrill, A.E. et al. Cell mixing at a neural crest-mesoderm boundary and deficient ephrin-Eph signaling in the pathogenesis of craniosynostosis. Hum. Mol. Genet. 15, 1319–1328 (2006).

    Article  CAS  PubMed  Google Scholar 

  6. Wilkie, A.O. et al. Clinical dividends from the molecular genetic diagnosis of craniosynostosis. Am. J. Med. Genet. A 143A, 1941–1949 (2007).

    Article  PubMed  Google Scholar 

  7. Mefford, H.C. et al. Copy number variation analysis in single-suture craniosynostosis: multiple rare variants including RUNX2 duplication in two cousins with metopic craniosynostosis. Am. J. Med. Genet. A 152A, 2203–2210 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  8. Vissers, L.E. et al. Heterozygous mutations of FREM1 are associated with an increased risk of isolated metopic craniosynostosis in humans and mice. PLoS Genet. 7, e1002278 (2011).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Kim, S.-D. et al. Leucine-rich repeat, immunoglobulin-like and transmembrane domain 3 (LRIT3) is a modulator of FGFR1. FEBS Lett. 586, 1516–1521 (2012).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Melville, H. et al. Genetic basis of potential therapeutic strategies for craniosynostosis. Am. J. Med. Genet. A 152A, 3007–3015 (2010).

    Article  PubMed  Google Scholar 

  11. Wilkie, A.O. et al. Prevalence and complications of single-gene and chromosomal disorders in craniosynostosis. Pediatrics 126, e391–e400 (2010).

    Article  PubMed  Google Scholar 

  12. Passos-Bueno, M.R. et al. Genetics of craniosynostosis: genes, syndromes, mutations and genotype-phenotype correlations. Front. Oral Biol. 12, 107–143 (2008).

    Article  PubMed  Google Scholar 

  13. Kimonis, V. et al. Genetics of craniosynostosis. Semin. Pediatr. Neurol. 14, 150–161 (2007).

    Article  PubMed  Google Scholar 

  14. Kolar, J.C. An epidemiological study of nonsyndromal craniosynostoses. J. Craniofac. Surg. 22, 47–49 (2011).

    Article  PubMed  Google Scholar 

  15. Lajeunie, E. et al. Genetic considerations in nonsyndromic midline craniosynostoses: a study of twins and their families. J. Neurosurg. 103 (suppl.), 353–356 (2005).

    PubMed  Google Scholar 

  16. Lajeunie, E. et al. Syndromal and nonsyndromal primary trigonocephaly: analysis of a series of 237 patients. Am. J. Med. Genet. 75, 211–215 (1998).

    Article  CAS  PubMed  Google Scholar 

  17. Lajeunie, E. et al. Genetic study of scaphocephaly. Am. J. Med. Genet. 62, 282–285 (1996).

    Article  CAS  PubMed  Google Scholar 

  18. Sanchez-Lara, P.A. et al. Fetal constraint as a potential risk factor for craniosynostosis. Am. J. Med. Genet. A 152A, 394–400 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  19. Zeiger, J.S. et al. Genetic and environmental risk factors for sagittal craniosynostosis. J. Craniofac. Surg. 13, 602–606 (2002).

    Article  PubMed  Google Scholar 

  20. Gardner, J.S. et al. Maternal exposure to prescription and non-prescription pharmaceuticals or drugs of abuse and risk of craniosynostosis. Int. J. Epidemiol. 27, 64–67 (1998).

    Article  CAS  PubMed  Google Scholar 

  21. Källén, K. Maternal smoking and craniosynostosis. Teratology 60, 146–150 (1999).

    Article  PubMed  Google Scholar 

  22. Patterson, N., Price, A.L. & Reich, D. Population structure and eigenanalysis. PLoS Genet. 2, e190 (2006).

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  23. Purcell, S. et al. PLINK: a tool set for whole-genome association and population-based linkage analyses. Am. J. Hum. Genet. 81, 559–575 (2007).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Dudbridge, F. Pedigree disequilibrium tests for multilocus haplotypes. Genet. Epidemiol. 25, 115–121 (2003).

    Article  PubMed  Google Scholar 

  25. Cordell, H.J. Epistasis: what it means, what it doesn't mean, and statistical methods to detect it in humans. Hum. Mol. Genet. 11, 2463–2468 (2002).

    Article  CAS  PubMed  Google Scholar 

  26. Browning, B.L. & Browning, S.R. A unified approach to genotype imputation and haplotype-phase inference for large data sets of trios and unrelated individuals. Am. J. Hum. Genet. 84, 210–223 (2009).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Rosen, V. BMP2 signaling in bone development and repair. Cytokine Growth Factor Rev. 20, 475–480 (2009).

    Article  CAS  PubMed  Google Scholar 

  28. Jabs, E.W. et al. A mutation in the homeodomain of the human MSX2 gene in a family affected with autosomal dominant craniosynostosis. Cell 75, 443–450 (1993).

    Article  CAS  PubMed  Google Scholar 

  29. Spruijt, L. et al. A novel mutation in the MSX2 gene in a family with foramina parietalia permagna (FPP). Am. J. Med. Genet. A 139, 45–47 (2005).

    Article  PubMed  CAS  Google Scholar 

  30. Wilkie, A.O. et al. Functional haploinsufficiency of the human homeobox gene MSX2 causes defects in skull ossification. Nat. Genet. 24, 387–390 (2000).

    Article  CAS  PubMed  Google Scholar 

  31. Howard, T.D. et al. Mutations in TWIST, a basic helix-loop-helix transcription factor, in Saethre-Chotzen syndrome. Nat. Genet. 15, 36–41 (1997).

    Article  PubMed  Google Scholar 

  32. Stankiewicz, P. et al. Phenotypic findings due to trisomy 7p15.3-pter including the TWIST locus. Am. J. Med. Genet. 103, 56–62 (2001).

    Article  CAS  PubMed  Google Scholar 

  33. Mundlos, S. et al. Mutations involving the transcription factor CBFA1 cause cleidocranial dysplasia. Cell 89, 773–779 (1997).

    Article  CAS  PubMed  Google Scholar 

  34. Desai, J. et al. Nell1-deficient mice have reduced expression of extracellular matrix proteins causing cranial and vertebral defects. Hum. Mol. Genet. 15, 1329–1341 (2006).

    Article  CAS  PubMed  Google Scholar 

  35. Zhang, X. et al. The role of NELL-1, a growth factor associated with craniosynostosis, in promoting bone regeneration. J. Dent. Res. 89, 865–878 (2010).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Yagnik, G. et al. ALX4 gain-of-function mutations in nonsyndromic craniosynostosis. Hum. Mutat. published online, doi:10.1002/humu.22166 (24 July 2012).

  37. Styrkarsdottir, U. et al. Linkage of osteoporosis to chromosome 20p12 and association to BMP2. PLoS Biol. 1, E69 (2003).

    Article  PubMed  PubMed Central  Google Scholar 

  38. Dathe, K. et al. Duplications involving a conserved regulatory element downstream of BMP2 are associated with brachydactyly type A2. Am. J. Hum. Genet. 84, 483–492 (2009).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Tobin, J.L. & Beales, P.L. Bardet-Biedl syndrome: beyond the cilium. Pediatr. Nephrol. 22, 926–936 (2007).

    Article  PubMed  PubMed Central  Google Scholar 

  40. Marshall, W.F. & Nonaka, S. Cilia: tuning in to the cell's antenna. Curr. Biol. 16, R604–R614 (2006).

    Article  CAS  PubMed  Google Scholar 

  41. Schneider, L. et al. PDGFRαα signaling is regulated through the primary cilium in fibroblasts. Curr. Biol. 15, 1861–1866 (2005).

    Article  CAS  PubMed  Google Scholar 

  42. Haycraft, C.J. et al. Gli2 and Gli3 localize to cilia and require the intraflagellar transport protein polaris for processing and function. PLoS Genet. 1, e53 (2005).

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  43. Ma, R. et al. PKD2 functions as an epidermal growth factor–activated plasma membrane channel. Mol. Cell. Biol. 25, 8285–8298 (2005).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Brailov, I. et al. Localization of 5-HT(6) receptors at the plasma membrane of neuronal cilia in the rat brain. Brain Res. 872, 271–275 (2000).

    Article  CAS  PubMed  Google Scholar 

  45. Jenkins, D. et al. RAB23 mutations in Carpenter syndrome imply an unexpected role for hedgehog signaling in cranial-suture development and obesity. Am. J. Hum. Genet. 80, 1162–1170 (2007).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Ehlen, H.W., Buelens, L.A. & Vortkamp, A. Hedgehog signaling in skeletal development. Birth Defects Res. C Embryo Today 78, 267–279 (2006).

    Article  CAS  PubMed  Google Scholar 

  47. Miettinen, P.J. et al. Epidermal growth factor receptor function is necessary for normal craniofacial development and palate closure. Nat. Genet. 22, 69–73 (1999).

    Article  CAS  PubMed  Google Scholar 

  48. Ding, H. et al. A specific requirement for PDGF-C in palate formation and PDGFR-α signaling. Nat. Genet. 36, 1111–1116 (2004).

    Article  CAS  PubMed  Google Scholar 

  49. Choi, D.S. et al. 5–HT2B receptor-mediated serotonin morphogenetic functions in mouse cranial neural crest and myocardiac cells. Development 124, 1745–1755 (1997).

    CAS  PubMed  Google Scholar 

  50. Neugebauer, J.M. et al. FGF signalling during embryo development regulates cilia length in diverse epithelia. Nature 458, 651–654 (2009).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Keen, T.J. et al. Mutations in a protein target of the Pim-1 kinase associated with the RP9 form of autosomal dominant retinitis pigmentosa. Eur. J. Hum. Genet. 10, 245–249 (2002).

    Article  CAS  PubMed  Google Scholar 

  52. Marinaki, A.M. et al. Genetic basis of hemolytic anemia caused by pyrimidine 5′ nucleotidase deficiency. Blood 97, 3327–3332 (2001).

    Article  CAS  PubMed  Google Scholar 

  53. Purcell, S. et al. PLINK: a tool set for whole-genome association and population-based linkage analyses. Am. J. Hum. Genet. 81, 559–575 (2007).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Mills, J.L. et al. Folate and vitamin B12–related genes and risk for omphalocele. Hum. Genet. 131, 739–746 (2012).

    Article  CAS  PubMed  Google Scholar 

  55. Barrett, J.C. et al. Haploview: analysis and visualization of LD and haplotype maps. Bioinformatics 21, 263–265 (2005).

    Article  CAS  PubMed  Google Scholar 

  56. Schwender, H. et al. Rapid testing of SNPs and gene-environment interactions in case-parent trio data based on exact analytic parameter estimation. Biometrics 68, 766–773 (2012).

    Article  PubMed  Google Scholar 

  57. Koeleman, B.P. et al. Adaptation of the extended transmission/disequilibrium test to distinguish disease associations of multiple loci: the conditional extended transmission/disequilibrium test. Ann. Hum. Genet. 64, 207–213 (2000).

    Article  CAS  PubMed  Google Scholar 

  58. Kazeem, G.R. & Farrall, M. Integrating case-control and TDT studies. Ann. Hum. Genet. 69, 329–335 (2005).

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank all families who contributed to this study. S.A.B. is partially funded through a Children's Miracle Network Endowed Chair and through grants K23 DE00462, R03 DE016342 and R01 DE016886 from the National Institute of Dental and Craniofacial Research (NIDCR)/NIH and M01-RR00052 from the National Center for Research Resources/NIH and was fully supported by Zlatka, Anton and Alec Boyadjiev. Partial funding was also obtained from grants to E.W.J. (US Centers for Disease Control and Prevention (CDC) 5 R01 DD000350), M.L.C. (R01 DE018227), A.O.M.W. (Wellcome Trust 093329), P.A.R. (CDC 5U01DD000492), J.K. (NIDCR/NIH R21DE022419), J.L.M. (Intramural Research Program (IRP) of the NIH, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); IRP HHSN267200703431C; NICHD N01-DK-7-3431), P.A.S.-L. (Robert Wood Johnson Foundation 3R37DE012711-13S1 and Children's Hospital Los Angeles–University of Southern California Child Health Research Career Development Program; NIH K12-HD05954), J.T.R. (NIDCR/NIH and the American Recovery and Reinvestment Act R01 DE018500 and 3R01 DE018500-02S1) and I.P. (National Center for Advancing Translational Sciences, NIH UL1TR000067). This project was also supported in part by the Division of Intramural Research Program of the National Human Genome Research Institute, NIH (C.M.J., Y.K. and A.F.W.). Genotyping services were provided by the Center for Inherited Disease Research (CIDR). CIDR is fully funded through a federal contract from the NIH to Johns Hopkins University, contract number HHSN268200782096C. We thank B. Wilson, N. Issac, C. Nauta, E. Goude, E. Cherkez, L. Peters and J. Harrison for patient recruitment, C. Boehm and A. Scott for coordination of discovery-phase genotyping, C. Stevens, A. Stoner, J.L. Liu, A. Gearhart, A. Atkins and E. McGrath for bench work, D. Mortlock for bioinformatic analysis and informative discussion and J. Graham (Cedars-Sinai Hospital, Los Angeles, California, USA), J. Bernstein (Stanford University, Palo Alto, California, USA), J. Marsh (Washington University, St. Louis, Missouri, USA), J. Panchal (University of Oklahoma Health Science Center, Oklahoma, USA), T. Tollefson (University of California Davis, Sacramento, California, USA) and M. Passos-Bueno (University of São Paolo, Brazil) for contributing clinical information and biospecimens for this project.

Author information

Authors and Affiliations

Authors

Contributions

C.M.J. and G.Y. are the first coauthors of the manuscript. C.M.J., Y.K. and I.P. performed statistical analyses. G.Y., M.E., X.Y., E.A. and L.S. performed experiments. C.M.J., G.Y., Y.K., I.P., M.L.C., V.K., T.R., A.O.M.W., J.S., J.T.R., Y.H., P.A.S.-L., M.F.B., J.K., A.F.W. and S.A.B. analyzed data. C.M.J. and G.Y. wrote the manuscript, with contributions from Y.K., I.P., J.T.R., Y.H., P.A.R., A.F.W. and S.A.B. E.W.J., M.L.C., V.K., S.A.W., J.S., P.A.S.-L., M.F.B., C.M.D., J.L.M., M.C., P.A.R., D.M.K., C.S., P.J.T., O.D.K., J.B., M.Z.-L. and C.N. contributed materials and reagents. E.W.J., A.O.M.W., M.F.B., D.M.K. and P.J.T. contributed to editing of the manuscript. E.W.J., C.M.D., J.L.M., M.C., P.A.R., D.M.K., C.S., P.J.T., O.D.K., J.B., M.Z.-L. and C.N. helped with experimental design. J.K. and A.F.W. supervised the research. S.A.B. was the principal investigator, designed and supervised research and recruited and evaluated participants.

Corresponding author

Correspondence to Simeon A Boyadjiev.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Supplementary information

Supplementary Text and Figures

Supplementary Figures 1–4 and Supplementary Tables 1–6 (PDF 2165 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Justice, C., Yagnik, G., Kim, Y. et al. A genome-wide association study identifies susceptibility loci for nonsyndromic sagittal craniosynostosis near BMP2 and within BBS9. Nat Genet 44, 1360–1364 (2012). https://doi.org/10.1038/ng.2463

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ng.2463

This article is cited by

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing