Genetic susceptibility to acute rheumatic fever: a systematic review and meta-analysis of twin studies

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dc.contributor.authorEngel, Mark Een_ZA
dc.contributor.authorStander, Raphaellaen_ZA
dc.contributor.authorVogel, Jonathanen_ZA
dc.contributor.authorAdeyemo, Adebowale Aen_ZA
dc.contributor.authorMayosi, Bongani Men_ZA
dc.date.accessioned2015-11-23T12:36:54Z
dc.date.available2015-11-23T12:36:54Z
dc.date.issued2011en_ZA
dc.description.abstractBACKGROUND: Acute rheumatic fever is considered to be a heritable condition, but the magnitude of the genetic effect is unknown. The objective of this study was to conduct a systematic review and meta-analysis of twin studies of concordance of acute rheumatic fever in order to derive quantitative estimates of the size of the genetic effect. METHODS: We searched PubMed/MEDLINE, ISI Web of Science, EMBASE, and Google Scholar from their inception to 31 January 2011, and bibliographies of retrieved articles, for twin studies of the concordance for acute rheumatic fever or rheumatic heart disease in monozygotic versus dizygotic twins that used accepted diagnostic criteria for acute rheumatic fever and zygosity without age, gender or language restrictions. Twin similarity was measured by probandwise concordance rate and odds ratio (OR), and aggregate probandwise concordance risk was calculated by combining raw data from each study. ORs from separate studies were combined by random-effects meta-analysis to evaluate association between zygosity status and concordance. Heritability was estimated by fitting a variance components model to the data. RESULTS: 435 twin pairs from six independent studies met the inclusion criteria. The pooled probandwise concordance risk for acute rheumatic fever was 44% in monozygotic twins and 12% in dizygotic twins, and the association between zygosity and concordance was strong (OR 6.39; 95% confidence interval, 3.39 to 12.06; P<0.001), with no significant study heterogeneity (P = 0.768). The estimated heritability across all the studies was 60%. CONCLUSIONS: Acute rheumatic fever is an autoimmune disorder with a high heritability. The discovery of all genetic susceptibility loci through whole genome scanning may provide a clinically useful genetic risk prediction tool for acute rheumatic fever and its sequel, rheumatic heart disease.en_ZA
dc.identifier.apacitationEngel, M. E., Stander, R., Vogel, J., Adeyemo, A. A., & Mayosi, B. M. (2011). Genetic susceptibility to acute rheumatic fever: a systematic review and meta-analysis of twin studies. <i>PLoS One</i>, http://hdl.handle.net/11427/15344en_ZA
dc.identifier.chicagocitationEngel, Mark E, Raphaella Stander, Jonathan Vogel, Adebowale A Adeyemo, and Bongani M Mayosi "Genetic susceptibility to acute rheumatic fever: a systematic review and meta-analysis of twin studies." <i>PLoS One</i> (2011) http://hdl.handle.net/11427/15344en_ZA
dc.identifier.citationEngel, M. E., Stander, R., Vogel, J., Adeyemo, A. A., & Mayosi, B. M. (2011). Genetic susceptibility to acute rheumatic fever: a systematic review and meta-analysis of twin studies. PLoS One, 6(9), e25326. doi:10.1371/journal.pone.0025326en_ZA
dc.identifier.ris TY - Journal Article AU - Engel, Mark E AU - Stander, Raphaella AU - Vogel, Jonathan AU - Adeyemo, Adebowale A AU - Mayosi, Bongani M AB - BACKGROUND: Acute rheumatic fever is considered to be a heritable condition, but the magnitude of the genetic effect is unknown. The objective of this study was to conduct a systematic review and meta-analysis of twin studies of concordance of acute rheumatic fever in order to derive quantitative estimates of the size of the genetic effect. METHODS: We searched PubMed/MEDLINE, ISI Web of Science, EMBASE, and Google Scholar from their inception to 31 January 2011, and bibliographies of retrieved articles, for twin studies of the concordance for acute rheumatic fever or rheumatic heart disease in monozygotic versus dizygotic twins that used accepted diagnostic criteria for acute rheumatic fever and zygosity without age, gender or language restrictions. Twin similarity was measured by probandwise concordance rate and odds ratio (OR), and aggregate probandwise concordance risk was calculated by combining raw data from each study. ORs from separate studies were combined by random-effects meta-analysis to evaluate association between zygosity status and concordance. Heritability was estimated by fitting a variance components model to the data. RESULTS: 435 twin pairs from six independent studies met the inclusion criteria. The pooled probandwise concordance risk for acute rheumatic fever was 44% in monozygotic twins and 12% in dizygotic twins, and the association between zygosity and concordance was strong (OR 6.39; 95% confidence interval, 3.39 to 12.06; P<0.001), with no significant study heterogeneity (P = 0.768). The estimated heritability across all the studies was 60%. CONCLUSIONS: Acute rheumatic fever is an autoimmune disorder with a high heritability. The discovery of all genetic susceptibility loci through whole genome scanning may provide a clinically useful genetic risk prediction tool for acute rheumatic fever and its sequel, rheumatic heart disease. DA - 2011 DB - OpenUCT DO - 10.1371/journal.pone.0025326 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2011 T1 - Genetic susceptibility to acute rheumatic fever: a systematic review and meta-analysis of twin studies TI - Genetic susceptibility to acute rheumatic fever: a systematic review and meta-analysis of twin studies UR - http://hdl.handle.net/11427/15344 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15344
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0025326
dc.identifier.vancouvercitationEngel ME, Stander R, Vogel J, Adeyemo AA, Mayosi BM. Genetic susceptibility to acute rheumatic fever: a systematic review and meta-analysis of twin studies. PLoS One. 2011; http://hdl.handle.net/11427/15344.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentDepartment of Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2011 Engel et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherRheumatic feveren_ZA
dc.subject.otherTwinsen_ZA
dc.subject.otherDizygotic twinsen_ZA
dc.subject.otherGenetic predispositionen_ZA
dc.subject.otherCardiovascular diseasesen_ZA
dc.subject.otherGenetics of diseaseen_ZA
dc.subject.otherMeta-analysisen_ZA
dc.subject.otherTwin studiesen_ZA
dc.titleGenetic susceptibility to acute rheumatic fever: a systematic review and meta-analysis of twin studiesen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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