Identification of OCA2 as a novel locus for the co-morbidity of asthma-plus-eczema

Background Numerous genes have been associated with the three most common allergic diseases (asthma, allergic rhinitis or eczema) but these genes explain only a part of the heritability. In the vast majority of genetic studies, complex phenotypes such as co-morbidity of two of these diseases, have not been considered. This may partly explain missing heritability. Objective To identify genetic variants specifically associated with the co-morbidity of asthma-plus-eczema. Methods We first conducted a meta-analysis of four GWAS (genome-Wide Association Study) of the combined asthma-plus-eczema phenotype (total of 8,807 European-ancestry subjects of whom 1,208 subjects had both asthma and eczema). To assess whether the association with SNP(s) was specific to the co-morbidity, we also conducted a meta-analysis of homogeneity test of association according to disease status ("asthma-plus-eczema" versus the presence of only one disease "asthma only or eczema only"). We then used a joint test by combining the two test statistics from the co-morbidity-SNP association and the phenotypic heterogeneity of SNP effect meta-analyses. Results Seven SNPs were detected for specific association to the asthma-plus-eczema co-morbidity, two with significant and five with suggestive evidence using the joint test after correction for multiple testing. The two significant SNPs are located in the OCA2 gene (Oculocutaneous Albinism II), a new locus never detected for significant evidence of association with any allergic disease. This gene is a promising candidate gene, because of its link to skin and lung diseases, and to epithelial barrier and immune mechanisms. Conclusion Our study underlines the importance of studying sub-phenotypes as co-morbidities to detect new susceptibility genes.