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Original Investigation
September 2017

Association of C-Reactive Protein Genetic Polymorphisms With Late Age-Related Macular Degeneration

Author Affiliations
  • 1Department of Ocular Biology and Therapeutics, UCL Institute of Ophthalmology, University College London, London, England
  • 2Moorfields Eye Hospital, London, England
  • 3University College London Genetics Institute, London, England
  • 4Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland
  • 5Centre for Clinical Pharmacology, Division of Medicine, University College London, London, England
  • 6Ophthalmology Department, School of Medicine, University of California, San Francisco
  • 7Department of Medical Genetics, University of Cambridge, Cambridge, England
  • 8Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, England
JAMA Ophthalmol. 2017;135(9):909-916. doi:10.1001/jamaophthalmol.2017.2191
Key Points

Question  Are variants in the C-reactive protein (CRP) gene that are known to influence circulating C-reactive protein concentrations associated with late age-related macular degeneration?

Findings  This pooled analysis examined 4 CRP variants among 1727 patients with late age-related macular degeneration and 1153 controls from 2 hospital-based case-control studies and 1 cross-sectional population-based study. No statistical association was found between these CRP variants and any type of late age-related macular degeneration.

Meaning  Circulating C-reactive protein concentrations are unlikely to be causally associated with age-related macular degeneration.

Abstract

Importance  C-reactive protein (CRP) is a circulating inflammatory marker associated with late age-related macular degeneration (AMD). It remains uncertain whether the association between CRP concentrations and AMD is causal.

Objective  To assess whether CRP (OMIM 123260) single-nucleotide polymorphisms that influence circulating CRP concentrations are associated with late AMD.

Design, Setting, and Participants  Participants in 2 UK, hospital-based, case-control studies (Cambridge AMD study and Moorfields Eye Hospital AMD study) and 1 pan-European, cross-sectional, population-based study (the European Eye [EUREYE] Study) were recruited between November 6, 2000, and April 30, 2007. Participants underwent dilated stereo-digital fundus photography graded according to the International Classification of Age-related Maculopathy and Macular Degeneration. There were 1727 cases of late AMD (1151 neovascular, 384 geographic atrophy, and 192 mixed [neovascular AMD and geographic atrophy]) and 1153 controls. Early AMD cases (n = 574) were included only from the EUREYE Study. Data analysis was performed from August 1 to November 30, 2016. Four common single-nucleotide polymorphisms (rs1205, rs1130864, rs1800947, and rs3093077) were selected based on demonstrated influence on circulating CRP concentrations in the literature. In one study, genotyping of rs3093077 failed, and rs1800947 was typed in only 1 study.

Main Outcomes and Measures  A genetic multiplicative model was used for the association of single-nucleotide polymorphisms with late AMD adjusted for age and sex.

Results  Among the 1727 patients with late AMD, the mean (SD) age was 78.7 (7.4) years, and 668 (38.7%) were men. The mean (SD) age of the controls was 74.9 (7.0) years, and 510 (44.2%) were men. In the pooled results of all 3 studies, neither rs1205 (odds ratio [OR], 0.99; 95% CI, 0.86-1.14) nor rs1130864 (OR, 0.96; 95% CI, 0.83-1.11) was associated with late AMD. For geographic atrophy, rs1205 had an OR of 0.91 (95% CI, 0.74-1.13) and rs1130864 had an OR of 0.94 (95% CI, 0.76-1.16). For neovascular AMD, rs1205 had an OR of 1.01 (95% CI, 0.87-1.19) and rs1130864 had an OR of 0.99 (95% CI, 0.84-1.16). There was no association of rs3093077 and rs1800947 with late AMD or any late AMD phenotype. There were no significant findings for early AMD.

Conclusions and Relevance  Our results do not support a causal association between CRP concentrations and AMD.

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