Rare SLC13A1 variants associate with intervertebral disc disorder highlighting role of sulfate in disc pathology.

Bjornsdottir, Gyda; Stefansdottir, Lilja; Thorleifsson, Gudmar; Sulem, Patrick; Norland, Kristjan; Ferkingstad, Egil; Oddsson, Asmundur; Zink, Florian et al. · Nat Commun · 2022

case_control · Level III

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Abstract

Back pain is a common and debilitating disorder with largely unknown underlying biology. Here we report a genome-wide association study of back pain using diagnoses assigned in clinical practice; dorsalgia (119,100 cases, 909,847 controls) and intervertebral disc disorder (IDD) (58,854 cases, 922,958 controls). We identify 41 variants at 33 loci. The most significant association (OR<sub>IDD</sub> = 0.92, P = 1.6 × 10<sup>-39</sup>; OR<sub>dorsalgia</sub> = 0.92, P = 7.2 × 10<sup>-15</sup>) is with a 3'UTR variant (rs1871452-T) in CHST3, encoding a sulfotransferase enzyme expressed in intervertebral discs. The largest effects on IDD are conferred by rare (MAF = 0.07 - 0.32%) loss-of-function (LoF) variants in SLC13A1, encoding a sodium-sulfate co-transporter (LoF burden OR = 1.44, P = 3.1 × 10<sup>-11</sup>); variants that also associate with reduced serum sulfate. Genes implicated by this study are involved in cartilage and bone biology, as well as neurological and inflammatory processes.

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