Angiotensin-converting enzyme gene insertion/deletion polymorphism in children with Henoch-Schonlein purpua nephritis

Angiotensin-converting enzyme insertion/deletion polymorphism and susceptibility to Henoch-Schönlein purpura: a meta-analysis

Objective:

Meta-analysis was performed in the current study to evaluate the relationship of the angiotensin-converting enzyme insertion/deletion polymorphism with the risk of the incidence of Henoch–Schönlein purpura.

Methods:

The electronic databases, including Embase, PubMed and Google scholar, were systemically retrieved to search for related articles. Meanwhile, statistical analysis was performed using the odds ratio and the corresponding 95% confidence interval.

Results:

A total of six articles enrolling 504 patients and 706 healthy controls was enrolled into the current meta-analysis. Results of the meta-analysis suggested that the angiotensin-converting enzyme D allele was markedly correlated with the risk of the incidence of Henoch–Schönlein purpura among the general population (deletion (D) vs. insertion (I): odds ratio (OR) 1.42, 95% confidence interval (CI) 1.05–1.93; DD vs. II: OR 2.23, 95% CI 1.06–4.70; DI vs. II: OR 1.36, 95% CI 1.00–1.85; dominant model: OR 1.56, 95% CI 1.00–2.42; recessive model: OR 1.83, 95% CI 1.06–3.16). Moreover, such a polymorphism was found to correlate with the susceptibility to Henoch–Schönlein purpura when studies were stratified according to the sample size of over 200. In addition, such a polymorphism was recognised to be remarkably associated with the susceptibility to Henoch–Schönlein purpura in the Caucasian population, which was not found in the Asian population.

Conclusions:

The results of the current meta-analysis indicate that the angiotensin-converting enzyme D allele might be a risk factor against the risk of Henoch–Schönlein purpura, especially in Caucasians.

C1GALT1 polymorphisms are associated with Henoch-Schönlein purpura nephritis

BACKGROUND

Henoch-Schönlein purpura nephritis (HSPN) is the most serious long-term complication of Henoch-Schönlein purpura and aberrant galactosylation of IgA1 plays a role in its development. However, the precise role of genetic factors contributing to the abnormal IgA1 galactosylation remains unknown.

METHODS

In order to examine the effects of C1GALT1 gene encoding core 1 β1,3-galactosyltransferase, an important role in the β1,3 glycosylation of IgA1, on HSPN susceptibility, we conducted a case-control association genetic study in 269 HSP and 61 HSPN in China. Five tagging SNPs, SNP1(-734 C/T), SNP4(-465A/G), SNP6(-330 G/T), SNP7(-292 C/-), and SNP8(1365 G/A) in C1GALT1 were studied using single-locus and haplotype-based multilocus analysis.

RESULTS

Our results demonstrated that 1365 G allele frequency was significantly higher in HSPN patients than in HSP patients without nephritis (0.459 vs 0.331, p = 0.0008, adjusted p' = 0.004) with an odds ratio (OR) = 1.716, 95%CI 1.151-2.560). The GG genotype of 1,365 G/A was significantly different in HSP without nephritis and HSPN (p = 0.008, adjusted p'' = 0.04). We did not observe statistically significant differences in haplotype frequencies between HSPN and HSP patients.

CONCLUSIONS

In conclusion, our study suggested that the 1365 G/A polymorphism of the C1GALT1 gene may contribute to HSPN development.

The Molecular Biology and Treatment of Systemic Vasculitis in Children

Primary systemic vasculitides are rare in childhood but are associated with significant morbidity and mortality. The cause of the majority of vasculitides is unknown, although it is likely that a complex interaction between environmental factors, such as infections and inherited host responses, triggers the disease and determines the vasculitis phenotype. Several genetic polymorphisms in vasculitides have now been described, which may be relevant in terms of disease predisposition or development of disease complications. Treatment regimens continue to improve with the use of different immunosuppressive medications and newer therapeutic approaches such as biologic agents. This chapter reviews recent studies shedding light on the pathogenesis of vasculitis with emphasis on molecular biology where known, and summarizes current treatment strategies. We discuss new emerging challenges particularly with respect to the long-term cardiovascular morbidity for children with systemic vasculitis and emphasize the importance of future international multicenter collaborative studies to further increase and standardize the scientific base investigating and treating childhood vasculitis.

Associations between the angiotensin-converting enzyme insertion/deletion polymorphism and susceptibility to vasculitis: a meta-analysis

Introduction: To explore whether the insertion (I) and deletion (D) polymorphism of angiotensin-converting enzyme ( ACE) confers susceptibility to vasculitis.

Materials and methods: A meta-analysis was conducted on the associations between the ACE I/D polymorphism and vasculitis.

Results: Twelve studies, including four on Behçet’s disease (BD), four on Henoch–Schenlein purpura (HSP), three on Kawasaki disease (KD), and one on Wegener’s granulomatosis, were available for the meta-analysis. Meta-analysis showed that the DD + ID genotype was associated with susceptibility to vasculitis (odds ratio [OR] 1.468, 95% confidence interval [CI] 1.214–1.468, p = 7.4 × 10−5). The overall OR for the D allele was significantly increased in BD (OR 1.313, 95% CI 1.017–1.695). Meta-analysis of the DD+ID genotype, the DD genotype and the DD vs. II genotype showed marginal associations with BD, but meta-analysis of the D allele, and the DD+ID genotype showed significant associations with HSP (OR 1.446, 95% CI 1.021–2.049, p = 0.038; OR 1.881, 95% CI 1.385–2.595, p = 6.6 × 10−5). On the other hand, meta-analysis showed no association between KD and the ACE I/D polymorphism.

Conclusions: This meta-analysis shows that the ACE I/D polymorphism is associated with vasculitis susceptibility, especially in BD and HSP.