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Drug targets for haemorrhoidal disease: proteome-wide Mendelian randomisation and colocalisation analyses
  1. Shifang Li,
  2. Meijiao Gong
  1. University of Liege, Liege, Belgium
  1. Correspondence to Dr Shifang Li, University of Liege, Liege B-4000, Belgium; fruceslee{at}

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We read with interest the recent report by Zheng et al which reported the first and largest genome-wide association study (GWAS) with haemorrhoidal disease (HEM), and these data offered us a resource for understanding the genetic risk factors for HEM.1 However, the aetiology of HEM, as well as its molecular mechanism, remains primarily unclear.2 In addition, the identification of proteins with therapeutic effects needs to be conducted. In recent years, by incorporating protein quantitative trait loci (pQTLs) into Mendelian randomisation (MR) analysis, such an approach has been successfully used to prioritise drug targets.3 4 Here, using a two-sample bidirectional MR analysis, we estimated the causal effects of 4907 plasma proteins on HEM outcomes, and investigated the effects of plasma proteins that may mediate the impact of risk factors on HEM.

As stated in the online supplemental methods, 4907 proteins (cis-pQTLs) were used as instrumental variables for exposure and HEM as the outcome to estimate the causal effect of plasma protein levels on HEM in a proteome-wide context using MR analysis.5–8 Our study revealed five potential causative proteins at the Bonferroni-corrected threshold of p<1.01e-05, including three negative and two positive associations (figure 1A,B). MR analysis, for example, revealed that genetically predicted ERLEC1 levels were linked to an increased risk of HEM (p=5.18e-07). To determine whether the identified relationships of the …

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  • SL and MG contributed equally.

  • Contributors SL was involved in the conceptualisation. SL and MG were involved in the formal analysis. SL and MG were involved in writing, reviewing and editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.