The genetics of POAG are complex, with links to at least 20 genetic loci.
11 Among them, 11 genetic loci designated
GLC1A to
GLC1K have been defined for POAG in family-based linkage studies of several pedigrees.
12 13 14 15 16 17 18 19 20 21 22 Mutations in genes located in
GLC1A,
GLC1E, and
GLC1G have been identified in some POAG families. Myocilin (
MYOC) at
GLC1A is primarily mutated in patients with JOAG, whereas optineurin (
OPTN) at
GLC1E is mainly mutated in patients with NTG.
23 24 25 26 27 28 29 30 31 32 WD repeat-domain 36 (
WDR36) at
GLC1G, the recently identified causative gene for POAG, was found in approximately 5% familial and sporadic cases of POAG.
18 For the three known POAG genes,
MYOC is established as directly glaucoma causative, whereas the role of
OPTN is still unclear due to conflicting evidence and the impact of
WDR36 on the wider POAG population is yet to be determined.
33 34 35 However, mutations in these three genes account for only a small fraction of POAG cases, indicating additional loci or genes involved in the development of POAG. Recently, several genome-wide scans have suggested that several chromosomal loci may be linked to POAG. Genome-wide linkage analysis has become a mainstream in search for POAG susceptibility genes. A genome-wide scan of an initial pedigree set of 113 affected sib pairs and a second pedigree set of 69 affected sib pairs has reported putative POAG loci on 2p14, 14q11, 14q21-q22, 17p13, 17q25, and 19q12-q14.
36 Another genome-wide scan on 146 POAG families of African descent showed possible linkage to 2q33-q34 and 10p12-p13.
37 Recently, in a genome-wide scan of a large Tasmanian POAG family, a new POAG locus was identified on 3p21-p22 by using a Markov Chain Monte Carlo method.
38 In addition, a genome-wide scan of 218 affected sibling pairs by using IOP as a continuous trait in linkage analysis identified two putative loci for IOP. The strongest linkage peaks were observed at markers
D6S1027 and
D13S317.
39 A genome-wide scan in an extended POAG pedigree revealed positive linkage to 10q22 for IOP and 1p32 for cup-to-disc ratio.
40 However, no linkage was found with POAG at 14 chromosomal loci, including
GLC1A to
GLC1F, 2p14, 2q33-q34, 10p12-p13, 14q11, 14q21-q22, 17p13, 17q25, and 19q12-q14 in a study that involved eight Finnish POAG families, indicating that additional loci are involved in the etiology of POAG.
41 Four genes (
PIX2,
FOXC1,
PAX6, and
CYP1B1) have been reported to cause JOAG as well as Axenfeld-Rieger syndrome, aniridia, or congenital glaucoma.
42 43 44 In the present study, we performed a genome-wide scan and identified a novel locus to 15q22-q24 in one JOAG family, supported by clinical, linkage, and haplotype transmission data.