Circulating Inflammatory Cytokines and Female Reproductive Diseases: A Mendelian Randomization Analysis

J Clin Endocrinol Metab. 2023 Nov 17;108(12):3154-3164. doi: 10.1210/clinem/dgad376.

Abstract

Context: Extensive studies have provided considerable evidence suggesting the role of inflammation in the development of female reproductive diseases. However, causality has not been established.

Objective: To explore whether genetically determined circulating levels of cytokines are causally associated with female reproductive diseases and discover potential novel drug targets for these diseases.

Methods: Instrumental variables (IVs) for 47 circulating cytokines were obtained from a genome-wide association study (GWAS) meta-analysis of 31 112 European individuals. Protein quantitative trait loci and expression quantitative trait loci close to genes served as our IVs. Summary data of 9 female reproductive diseases were mainly derived from GWAS meta-analysis of the UK biobank and FinnGen. We elevated the association using the Wald ratio or inverse variance-weighted Mendelian randomization (MR) with subsequent assessments for MR assumptions in several sensitivity and colocalization analyses. We consider a false discovery rate <0.05 as statistical significance in MR analyses. Replication studies were conducted for further validation, and phenome-wide association studies were designed to explore potential side effects.

Results: Our results indicated that high levels of macrophage colony-stimulating factor (MCSF), growth-regulated oncogene-alpha (GROα), and soluble intercellular adhesion molecule-1 were associated with increased risks of endometriosis, female infertility, and pre-eclampsia, respectively. High platelet-derived growth factor-BB (PDGF-BB) levels that reduced the risk of ovarian aging were also supported. Replication analysis supported the relationship between GROα and female infertility, and between MCSF and endometriosis.

Conclusion: We identified 4 correlated pairs that implied potential protein drug targets. Notably, we preferred highlighting the value of PDGF-BB as a drug target for ovarian aging, and MCSF as a drug target for endometriosis.

Keywords: cytokines; drug target; female reproductive diseases; inflammation; mendelian randomization.

Publication types

  • Meta-Analysis

MeSH terms

  • Becaplermin
  • Cytokines / genetics
  • Endometriosis* / genetics
  • Female
  • Genome-Wide Association Study
  • Humans
  • Infertility, Female* / genetics
  • Mendelian Randomization Analysis
  • Polymorphism, Single Nucleotide
  • Pregnancy

Substances

  • Cytokines
  • Becaplermin