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Abstract
Diabetic retinopathy (DR) is a serious complication of diabetes, which is fast reaching epidemic proportions worldwide. While tight glycemic control remains the standard of care for preventing the progression of DR, better insights into DR etiology require understanding its genetic basis, which in turn may assist in the design of novel treatments. During the last decade, genomic medicine is increasingly being applied to common multifactorial diseases such as diabetes and age-related macular degeneration. The contribution of genetics to the initiation and progression of DR has been recognized for some time, but the involvement of specific genes and genetic variants remains elusive. Several investigations are currently underway for identifying DR susceptibility loci through linkage studies, candidate gene approaches, and genome-wide association studies. Advent of next generation sequencing and high throughput genomic technologies, development of novel bioinformatics tools and collaborations among research teams should facilitate such investigations. Here, we review the current state of genetic studies in DR and discuss reported findings in the context of biochemical, cell biological and therapeutic advances. We propose the development of a consortium in India for genetic studies with large cohorts of patients and controls from limited geographical areas to stratify the impact of the environment. Uniform guidelines should be established for clinical phenotyping and data collection. These studies would permit identification of genetic loci for DR susceptibility in the Indian population and should be valuable for better diagnosis and prognosis, and for clinical management of this blinding disease.
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Affiliation(s)
| | - Anand Swaroop
- Neurobiology-Neurodegeneration and Repair Laboratory, National Eye Institute, National Institutes of Health, Bethesda, MD, USA
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Genetic Investigation of Complement Pathway Genes in Type 2 Diabetic Retinopathy: An Inflammatory Perspective. Mediators Inflamm 2016; 2016:1313027. [PMID: 26989329 PMCID: PMC4771919 DOI: 10.1155/2016/1313027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 01/10/2016] [Accepted: 01/12/2016] [Indexed: 02/06/2023] Open
Abstract
Diabetic retinopathy (DR) has complex multifactorial pathogenesis. This study aimed to investigate the association of complement pathway genes with susceptibility to DR. Eight haplotype-tagging SNPs of SERPING1 and C5 were genotyped in 570 subjects with type 2 diabetes: 295 DR patients (138 nonproliferative DR [NPDR] and 157 proliferative DR [PDR]) and 275 diabetic controls. Among the six C5 SNPs, a marginal association was first detected between rs17611 and total DR patients (P = 0.009, OR = 0.53 for recessive model). In stratification analysis, a significant decrease in the frequencies of G allele and GG homozygosity for rs17611 was observed in PDR patients compared with diabetic controls (Pcorr = 0.032, OR = 0.65 and Pcorr = 0.016, OR = 0.37, resp.); it was linked with a disease progression. A haplotype AA defined by the major alleles of rs17611 and rs1548782 was significantly predisposed to PDR with increased risk of 1.54 (Pcorr = 0.023). Regarding other variants in C5 and SERPING1, none of the tagging SNPs had a significant association with DR and its subgroups (all P > 0.05). Our study revealed an association between DR and C5 polymorphisms with clinical significance, whereas SERPING1 is not a major genetic component of DR. Our data suggest a link of complement pathway with DR pathogenesis.
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Rezaee MRS, Amiri AA, Hashemi-Soteh MB, Daneshvar F, Emady-Jamaly R, Jafari R, Soleimani B, Haghiaminjan H. Aldose reductase C-106T gene polymorphism in type 2 diabetics with microangiopathy in Iranian individuals. Indian J Endocrinol Metab 2015; 19:95-99. [PMID: 25593834 PMCID: PMC4287789 DOI: 10.4103/2230-8210.131762] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Aldose reductase (AR) is the rate-limiting enzyme in the glucose metabolism, which has been implicated in the pathogenesis of diabetic microvascular complications (MVCs). Frequent C-106T polymorphism in the promoter of the AR gene may change the expression of the gene. AIMS The aim of the following study is to study the association between AR C106T genotypes and diabetic MVCs in Iranian population. MATERIALS AND METHODS We included 206 type 2 diabetic patients categorized into two groups according to the presence or absence of diabetic microangiopathy. The cases of interest were diabetic neuropathy, retinopathy and nephropathy identified during clinical and or laboratory examination. In addition, 114 age- and sex-matched individuals were selected to serve as a control group. AR genotyping was done using an amplification gel electrophoresis. RESULTS The frequency of CC genotype was specifically higher in subjects with diabetic retinopathy as compared to those without it (53.2% vs. 38.1%, P = 0.030). Patients with diabetic microangiopathy in general; however, did not differ significantly between AR genotype groups. CONCLUSION The C-106T polymorphism in the AR gene is likely a risk factor for development of only retinal complication of diabetes microvascular in Iranian individuals.
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Affiliation(s)
- Majid Reza Sheikh Rezaee
- Bu Ali-Sina Clinical Research Development Unit, Mazandaran University of Medical Sciences, Mazandaran, Sari, Iran
| | - Ahmad Ahmadzadeh Amiri
- Bu Ali-Sina Clinical Research Development Unit, Mazandaran University of Medical Sciences, Mazandaran, Sari, Iran
| | - Mohammad Bagher Hashemi-Soteh
- Molecular and Cell Biology Research Center and Medical Faculty, Mazandaran University of Medical Sciences, Mazandaran, Sari, Iran
| | | | | | - Reza Jafari
- Bu Ali-Sina Clinical Research Development Unit, Mazandaran University of Medical Sciences, Mazandaran, Sari, Iran
| | - Behyar Soleimani
- Bu Ali-Sina Clinical Research Development Unit, Mazandaran University of Medical Sciences, Mazandaran, Sari, Iran
| | - Hamed Haghiaminjan
- Department of Toxicology and Pharmacology, Tehran University of Medical Sciences, Tehran, Iran
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Abstract
Diabetic retinopathy is the leading cause of blindness in working age individuals in developed countries. Most cases of diabetes related vision loss result from breakdown of the blood-retinal barrier with resultant diabetic macular edema (DME). For over 30 years, laser photocoagulation has been the standard therapy for DME, but most eyes do not experience significant improvements in visual acuity. Intravitreal injections of drugs that inhibit the action of vascular endothelial growth factor (VEGF) lead to gains in vision, but can be expensive and need to be repeated frequently. In addition to VEGF-mediated breakdown of the blood-retinal barrier, recent evidence suggests that inflammation plays an important role in the development of DME. Recognizing this, physicians have injected steroids into the vitreous and developers have created sustained release implants. Intravitreal injections of triamcinolone acetonide lead to rapid resolution of macular edema and significant short-term improvements in visual acuity, but unfortunately, visual acuities diminish when treatment is continued through 2 years. However, intravitreal triamcinolone remains an attractive treatment option for eyes that are pseudophakic, scheduled to undergo cataract surgery, resistant to laser photocoagulation, or require urgent panretinal photocoagulation for proliferative retinopathy. In controlled trials, intraocular implants that slowly release dexamethasone and fluocinolone show promise in reducing macular edema and improving visual acuity. The high incidences of drug related cataracts and glaucoma, however, require that corticosteroids be used cautiously and that patients be selected carefully. The increasing number of patients with DME, the burgeoning cost of medical care and the continuing development of intravitreal steroids suggest that the use of these agents will likely increase in coming years.
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Human genetics of diabetic retinopathy: current perspectives. J Ophthalmol 2010; 2010. [PMID: 20706635 PMCID: PMC2913807 DOI: 10.1155/2010/172593] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Accepted: 06/16/2010] [Indexed: 01/15/2023] Open
Abstract
Diabetic retinopathy (DR) is a most severe microvascular complication which, if left unchecked, can be sight-threatening. With the global prevalence of diabetes being relentlessly projected to rise to 438 million subjects by 2030, DR will undoubtedly pose a major public health concern. Efforts to unravel the human genetics of DR have been undertaken using the candidate gene and linkage approaches, while GWAS efforts are still lacking. Aside from evidence for a few genes including aldose reductase and vascular endothelial growth factor, the genetics of DR remain poorly elucidated. Nevertheless, the promise of impactful scientific discoveries may be realized if concerted and collaborative efforts are mounted to identify the genes for DR. Harnessing new genetic technologies and resources such as the upcoming 1000 Genomes Project will help advance this field of research, and potentially lead to a rich harvest of insights into the biological mechanisms underlying this debilitating complication.
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MOHAMED SHAKIR, SCHAA KENDRA, COOPER MARGARETE, AHRENS ELISE, ALVARADO ANA, COLAIZY TARAH, MARAZITA MARYL, MURRAY JEFFREYC, DAGLE JOHNM. Genetic contributions to the development of retinopathy of prematurity. Pediatr Res 2009; 65:193-7. [PMID: 18787502 PMCID: PMC2671288 DOI: 10.1203/pdr.0b013e31818d1dbd] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
There is growing support for the role of genetic factors in the development of retinopathy of prematurity (ROP), a serious visual morbidity resulting from preterm birth. We used both candidate gene and data-mining approaches to investigate the role of genetic polymorphisms in the development of ROP. Our study population consisted of 330 infants, less than 32 wk gestation, and their parents. We initially studied 24 single nucleotide polymorphisms (SNPs) in 11 candidate genes. Using a family-based analysis strategy, we found an association between SNPs in the EPAS1 gene and the development of ROP (p = 0.007). Logistic regression analysis showed three SNPs associated with development of ROP, two in the CFH gene (p = 0.01) and one in the EPAS1 gene (p = 0.001). Extending this analysis to include genotyping data from a larger genetic study of prematurity (455 SNPs in 153 genes), we found SNPs in five genes associated with the development of ROP: IHH (p = 0.003), AGTR1 (p = 0.005), TBX5 (p = 0.003), CETP (p = 0.004), and GP1BA (p = 0.005). Our data suggest that genetic risk factors contribute to the development of ROP.
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Affiliation(s)
- SHAKIR MOHAMED
- Department of Pediatrics [S.M., T.C., J.C.M., J.M.D.], University of Iowa Carver College of Medicine [K.S., E.A., A.A.], University of Iowa, Iowa 52242; Center for Craniofacial and Dental Genetics [M.E.C., M.L.M.], Department of Human Genetics [M.L.M.], University of Pittsburgh, Pittsburgh, Pennsylvania 15219
| | - KENDRA SCHAA
- Department of Pediatrics [S.M., T.C., J.C.M., J.M.D.], University of Iowa Carver College of Medicine [K.S., E.A., A.A.], University of Iowa, Iowa 52242; Center for Craniofacial and Dental Genetics [M.E.C., M.L.M.], Department of Human Genetics [M.L.M.], University of Pittsburgh, Pittsburgh, Pennsylvania 15219
| | - MARGARET E. COOPER
- Department of Pediatrics [S.M., T.C., J.C.M., J.M.D.], University of Iowa Carver College of Medicine [K.S., E.A., A.A.], University of Iowa, Iowa 52242; Center for Craniofacial and Dental Genetics [M.E.C., M.L.M.], Department of Human Genetics [M.L.M.], University of Pittsburgh, Pittsburgh, Pennsylvania 15219
| | - ELISE AHRENS
- Department of Pediatrics [S.M., T.C., J.C.M., J.M.D.], University of Iowa Carver College of Medicine [K.S., E.A., A.A.], University of Iowa, Iowa 52242; Center for Craniofacial and Dental Genetics [M.E.C., M.L.M.], Department of Human Genetics [M.L.M.], University of Pittsburgh, Pittsburgh, Pennsylvania 15219
| | - ANA ALVARADO
- Department of Pediatrics [S.M., T.C., J.C.M., J.M.D.], University of Iowa Carver College of Medicine [K.S., E.A., A.A.], University of Iowa, Iowa 52242; Center for Craniofacial and Dental Genetics [M.E.C., M.L.M.], Department of Human Genetics [M.L.M.], University of Pittsburgh, Pittsburgh, Pennsylvania 15219
| | - TARAH COLAIZY
- Department of Pediatrics [S.M., T.C., J.C.M., J.M.D.], University of Iowa Carver College of Medicine [K.S., E.A., A.A.], University of Iowa, Iowa 52242; Center for Craniofacial and Dental Genetics [M.E.C., M.L.M.], Department of Human Genetics [M.L.M.], University of Pittsburgh, Pittsburgh, Pennsylvania 15219
| | - MARY L. MARAZITA
- Department of Pediatrics [S.M., T.C., J.C.M., J.M.D.], University of Iowa Carver College of Medicine [K.S., E.A., A.A.], University of Iowa, Iowa 52242; Center for Craniofacial and Dental Genetics [M.E.C., M.L.M.], Department of Human Genetics [M.L.M.], University of Pittsburgh, Pittsburgh, Pennsylvania 15219
| | - JEFFREY C. MURRAY
- Department of Pediatrics [S.M., T.C., J.C.M., J.M.D.], University of Iowa Carver College of Medicine [K.S., E.A., A.A.], University of Iowa, Iowa 52242; Center for Craniofacial and Dental Genetics [M.E.C., M.L.M.], Department of Human Genetics [M.L.M.], University of Pittsburgh, Pittsburgh, Pennsylvania 15219
| | - JOHN M. DAGLE
- Department of Pediatrics [S.M., T.C., J.C.M., J.M.D.], University of Iowa Carver College of Medicine [K.S., E.A., A.A.], University of Iowa, Iowa 52242; Center for Craniofacial and Dental Genetics [M.E.C., M.L.M.], Department of Human Genetics [M.L.M.], University of Pittsburgh, Pittsburgh, Pennsylvania 15219
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Wiwanitkit V. Angiotensin-converting enzyme gene polymorphism is correlated to diabetic retinopathy: a meta-analysis. J Diabetes Complications 2008; 22:144-6. [PMID: 18280446 DOI: 10.1016/j.jdiacomp.2006.09.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2006] [Accepted: 09/22/2006] [Indexed: 10/22/2022]
Abstract
The angiotensin-converting enzyme (ACE) displays potent vasoconstrictive effects, attenuation of fibrinolysis, and platelet activation and aggregation. The ACE gene has been the main probable candidate gene predisposing the development of diabetic retinopathy (DR). However, the correlation between ACE gene polymorphism and progression of DR still requires further approval. Here, the author performs a summative analysis on recent previous reports on ACE gene polymorphism and its correlation to DR. The meta-analysis was performed in order to assess the correlation between the pattern of ACE gene polymorphism and DR. From four studies available, the author evaluated type II diabetic patients with (Group 1; n=432) and without DR (Group 2; n=329). The frequency of the DD genotype in Group 1 is not significantly different from that in Group 2 (P>.05). In addition, the author first reports a nonsignificant correlation between ethnicity and ACE gene polymorphism.
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Affiliation(s)
- Viroj Wiwanitkit
- Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
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Iizuka H, Awata T, Osaki M, Neda T, Kurihara S, Inoue K, Inukai K, Kabasawa S, Mori K, Yoneya S, Katayama S. Promoter polymorphisms of the pigment epithelium-derived factor gene are associated with diabetic retinopathy. Biochem Biophys Res Commun 2007; 361:421-6. [PMID: 17658465 DOI: 10.1016/j.bbrc.2007.07.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2007] [Accepted: 07/09/2007] [Indexed: 12/30/2022]
Abstract
Pigment epithelium-derived factor (PEDF or SERPINF1), a neuroprotective and anti-angiogenic factor, may play an important role in the pathogenesis of diabetic retinopathy (DR). In 416 patients with type 2 diabetes, four polymorphisms in the PEDF SNPs were identified, rs12150053 and rs12948385 in the promoter region, rs9913583 in the 5'-untranslated region, and rs1136287 (Met72Thr) in exon 3. Based on case-control studies, rs12150053 and rs12948385, but not rs9913583 and rs1136287, were significantly associated with DR. A logistic regression analysis revealed that the TC or CC genotype of rs12150053 was a significant risk factor for DR (odds ratio 2.40, p=0.0004). The GA or AA genotype of rs12948385 was also a significant risk factor for DR. In addition, a significant interaction between the vascular endothelial growth factor (VEGF) and PEDF SNPs in the susceptibility to DR was found. These results demonstrate that the PEDF gene, in cooperation with the VEGF gene, may contribute to the development of DR.
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Affiliation(s)
- Hiroyuki Iizuka
- Division of RI Laboratory, Biomedical Research Center, Saitama Medical University, Saitama, Japan
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