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RYR1 and CACNA1S genetic variants identified with statin-associated muscle symptoms

    Paul J Isackson

    *Author for correspondence:

    E-mail Address: isackson@buffalo.edu

    Department of Pediatrics, State University of New York at Buffalo, NY 14203, USA

    ,
    Jianxin Wang

    Center for Computational Research, State University of New York at Buffalo, NY 14203, USA

    ,
    Mohammad Zia

    Center for Computational Research, State University of New York at Buffalo, NY 14203, USA

    ,
    Paul Spurgeon

    Center for Computational Research, State University of New York at Buffalo, NY 14203, USA

    ,
    Adrian Levesque

    Center for Computational Research, State University of New York at Buffalo, NY 14203, USA

    ,
    Jonathan Bard

    Center for Computational Research, State University of New York at Buffalo, NY 14203, USA

    ,
    Smitha James

    New York State Center of Excellence in Bioinformatics & Life Sciences, State University of New York at Buffalo, Buffalo, NY 14203, USA

    ,
    Norma Nowak

    New York State Center of Excellence in Bioinformatics & Life Sciences, State University of New York at Buffalo, Buffalo, NY 14203, USA

    Department of Biochemistry, Jacobs School of Medicine & Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14203, USA

    ,
    Tae Keun Lee

    Department of Pediatrics, State University of New York at Buffalo, NY 14203, USA

    &
    Georgirene D Vladutiu

    Department of Pediatrics, State University of New York at Buffalo, NY 14203, USA

    Departments of Neurology & Pathology & Anatomical Sciences, University at Buffalo, Buffalo, NY 14214, USA

    Published Online:https://doi.org/10.2217/pgs-2018-0106

    Aim: To examine the genetic differences between subjects with statin-associated muscle symptoms and statin-tolerant controls. Materials & methods: Next-generation sequencing was used to characterize the exomes of 76 subjects with severe statin-associated muscle symptoms and 50 statin-tolerant controls. Results: 12 probably pathogenic variants were found within the RYR1 and CACNA1S genes in 16% of cases with severe statin-induced myopathy representing a fourfold increase over variants found in statin-tolerant controls. Subjects with probably pathogenic RYR1 or CACNA1S variants had plasma CK 5X to more than 400X the upper limit of normal in addition to having muscle symptoms. Conclusions: Genetic variants within the RYR1 and CACNA1S genes are likely to be a major contributor to the susceptibility to statin-associated muscle symptoms.

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