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Chunk #30 — Discussion

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Multiomic prioritisation of risk genes for anorexia nervosa.
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Mounting evidence suggests a relationship may exist between immune function and AN (Dalton et al., 2018a; Reay et al., 2022). Starvation can lead to inflammation; however, there remains differences between the presentation of immune dysregulation during malnutrition and AN, suggesting an underlying relationship may exist beyond the pathology associated with malnutrition (Gibson & Mehler, 2019). Interestingly, four of the eight finemapped genes were members in the immune system processes gene-set, which was a statistically significant overrepresentation. This is supportive of previous observations suggesting that immune system dysregulation may contribute to AN onset and maintenance (Gibson & Mehler, 2019). Furthermore, the strongest protein PWAS signal MICB, which implicates the MHC region, and the lead mRNA isoform gene ARIH2 were also present within the immune system processes pathway. However, the overrepresentation in this instance was not significant like the finemapped genes. The identification of MICB in the PWAS necessitates further analysis of the MHC region in AN, such as the role of specific human leucocyte antigen types. Finemapped genes; MST1 (Chanda et al., 2016; Lu, Zhao, & Liu, 2020), PRKAR2A (Kong et