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      Effects of circulating inflammatory proteins on spinal degenerative diseases: Evidence from genetic correlations and Mendelian randomization study

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          Abstract

          Background

          Numerous investigations have suggested links between circulating inflammatory proteins (CIPs) and spinal degenerative diseases (SDDs), but causality has not been proven. This study used Mendelian randomization (MR) to investigate the causal associations between 91 CIPs and cervical spondylosis (CS), prolapsed disc/slipped disc (PD/SD), spinal canal stenosis (SCS), and spondylolisthesis/spondylolysis.

          Methods

          Genetic variants data for CIPs and SDDs were obtained from the genome‐wide association studies (GWAS) database. We used inverse variance weighted (IVW) as the primary method, analyzing the validity and robustness of the results through pleiotropy and heterogeneity tests and performing reverse MR analysis to test for reverse causality.

          Results

          The IVW results with Bonferroni correction indicated that beta‐nerve growth factor (β‐NGF), C‐X‐C motif chemokine 6 (CXCL6), and interleukin‐6 (IL‐6) can increase the risk of CS. Fibroblast growth factor 19 (FGF19), sulfotransferase 1A1 (SULT1A1), and tumor necrosis factor‐beta (TNF‐β) can increase PD/SD risk, whereas urokinase‐type plasminogen activator (u‐PA) can decrease the risk of PD/SD. FGF19 and TNF can increase SCS risk. STAM binding protein (STAMBP) and T‐cell surface glycoprotein CD6 isoform (CD6 isoform) can increase the risk of spondylolisthesis/spondylolysis, whereas monocyte chemoattractant protein 2 (MCP2) and latency‐associated peptide transforming growth factor beta 1 (LAP‐TGF‐β1) can decrease spondylolisthesis/spondylolysis risk.

          Conclusions

          MR analysis indicated the causal associations between multiple genetically predicted CIPs and the risk of four SDDs (CS, PD/SD, SCS, and spondylolisthesis/spondylolysis). This study provides reliable genetic evidence for in‐depth exploration of the involvement of CIPs in the pathogenic mechanism of SDDs and provides novel potential targets for SDDs.

          Abstract

          MR analyses indicated the causal associations between multiple genetically predicted CIPs and the risk of four SDDs (CS, PD/SD, SCS, and spondylolisthesis/spondylolysis). This study provides reliable genetic evidence for in‐depth exploration of the involvement of CIPs in the pathogenic mechanism of SDDs and provides novel potential targets for SDDs.

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          Most cited references69

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          Detection of widespread horizontal pleiotropy in causal relationships inferred from Mendelian randomization between complex traits and diseases

          Horizontal pleiotropy occurs when the variant has an effect on disease outside of its effect on the exposure in Mendelian randomization (MR). Violation of the ‘no horizontal pleiotropy’ assumption can cause severe bias in MR. We developed the Mendelian Randomization Pleiotropy RESidual Sum and Outlier (MR-PRESSO) test to identify horizontal pleiotropic outliers in multi-instrument summary-level MR testing. We showed using simulations that MR-PRESSO is best suited when horizontal pleiotropy occurs in <50% of instruments. Next, we applied MR-PRESSO, along with several other MR tests to complex traits and diseases, and found that horizontal pleiotropy: (i) was detectable in over 48% of significant causal relationships in MR; (ii) introduced distortions in the causal estimates in MR that ranged on average from −131% to 201%; (iii) induced false positive causal relationships in up to 10% of relationships; and (iv) can be corrected in some but not all instances.
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            Interpreting findings from Mendelian randomization using the MR-Egger method

            Mendelian randomization-Egger (MR-Egger) is an analysis method for Mendelian randomization using summarized genetic data. MR-Egger consists of three parts: (1) a test for directional pleiotropy, (2) a test for a causal effect, and (3) an estimate of the causal effect. While conventional analysis methods for Mendelian randomization assume that all genetic variants satisfy the instrumental variable assumptions, the MR-Egger method is able to assess whether genetic variants have pleiotropic effects on the outcome that differ on average from zero (directional pleiotropy), as well as to provide a consistent estimate of the causal effect, under a weaker assumption—the InSIDE (INstrument Strength Independent of Direct Effect) assumption. In this paper, we provide a critical assessment of the MR-Egger method with regard to its implementation and interpretation. While the MR-Egger method is a worthwhile sensitivity analysis for detecting violations of the instrumental variable assumptions, there are several reasons why causal estimates from the MR-Egger method may be biased and have inflated Type 1 error rates in practice, including violations of the InSIDE assumption and the influence of outlying variants. The issues raised in this paper have potentially serious consequences for causal inferences from the MR-Egger approach. We give examples of scenarios in which the estimates from conventional Mendelian randomization methods and MR-Egger differ, and discuss how to interpret findings in such cases. Electronic supplementary material The online version of this article (doi:10.1007/s10654-017-0255-x) contains supplementary material, which is available to authorized users.
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              Reading Mendelian randomisation studies: a guide, glossary, and checklist for clinicians

              Mendelian randomisation uses genetic variation as a natural experiment to investigate the causal relations between potentially modifiable risk factors and health outcomes in observational data. As with all epidemiological approaches, findings from Mendelian randomisation studies depend on specific assumptions. We provide explanations of the information typically reported in Mendelian randomisation studies that can be used to assess the plausibility of these assumptions and guidance on how to interpret findings from Mendelian randomisation studies in the context of other sources of evidence
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                Author and article information

                Contributors
                zheng.alan@hotmail.com
                xuweihong815@126.com
                Journal
                JOR Spine
                JOR Spine
                10.1002/(ISSN)2572-1143
                JSP2
                JOR Spine
                John Wiley & Sons, Inc. (Hoboken, USA )
                2572-1143
                17 June 2024
                June 2024
                : 7
                : 2 ( doiID: 10.1002/jsp2.v7.2 )
                : e1346
                Affiliations
                [ 1 ] Department of Spinal Surgery The First Affiliated Hospital of Fujian Medical University Fuzhou China
                [ 2 ] Department of Orthopedic Surgery Fujian Medical University Union Hospital Fuzhou China
                [ 3 ] Arthritis Clinical and Research Center, Peking University People's Hospital Beijing China
                [ 4 ] Department of Microbiology, Immunology and Infectious Diseases University of Calgary Calgary Alberta Canada
                Author notes
                [*] [* ] Correspondence

                Chunfu Zheng, Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, AB, Canada.

                Email: zheng.alan@ 123456hotmail.com

                Weihong Xu, Fujian Medical University, Fuzhou 350004, China.

                Email: xuweihong815@ 123456126.com

                Author information
                https://orcid.org/0009-0009-3978-7852
                Article
                JSP21346
                10.1002/jsp2.1346
                11183170
                38895179
                978b3f04-33fd-4b05-97cf-707cc053c331
                © 2024 The Authors. JOR Spine published by Wiley Periodicals LLC on behalf of Orthopaedic Research Society.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 22 May 2024
                : 15 April 2024
                : 28 May 2024
                Page count
                Figures: 2, Tables: 0, Pages: 9, Words: 6600
                Funding
                Funded by: Natural Science Foundation of Fujian Province , doi 10.13039/501100003392;
                Award ID: 2021J02035
                Funded by: Fujian Provincial Health Technology Project , doi 10.13039/501100017686;
                Award ID: 2020CXA039
                Funded by: National Natural Science Foundation of China , doi 10.13039/501100001809;
                Award ID: 82072263
                Categories
                Research Article
                Research Articles
                Custom metadata
                2.0
                June 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.4.4 mode:remove_FC converted:18.06.2024

                cervical spondylosis,circulating inflammatory proteins,mendelian randomization,prolapsed disc/slipped disc,spinal canal stenosis,spinal degenerative diseases,spondylolisthesis/spondylolysis

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