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Shahin MH, Rouby NE, Conrado DJ, Gonzalez D, Gong Y, Lobmeyer MT, Beitelshees AL, Boerwinkle E, Gums JG, Chapman A, Turner ST, Pepine CJ, Cooper-DeHoff RM, Johnson JA. β 2 -Adrenergic Receptor Gene Affects the Heart Rate Response of β-Blockers: Evidence From 3 Clinical Studies. J Clin Pharmacol 2019; 59:1462-1470. [PMID: 31090079 DOI: 10.1002/jcph.1443] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 04/26/2019] [Indexed: 12/25/2022]
Abstract
β-Blockers' heart rate (HR)-lowering effect is an important determinant of the effectiveness for this class of drugs, yet it is variable among β-blocker-treated patients. To date, genetic studies have revealed several genetic signals associated with HR response to β-blockers. However, these genetic signals have not been consistently replicated across multiple independent cohorts. Here we sought to use data from 3 hypertension clinical trials to validate single-nucleotide polymorphisms (SNPs) previously associated with the HR response to β-blockers. Using linear regression analysis, we investigated the effects of 6 SNPs in 3 genes, including ADRB1, ADRB2, and GNB3, relative to the HR response following β-blocker used in the PEAR (n = 757), PEAR-2 (n = 368), and INVEST (n = 1401) trials, adjusting for baseline HR, age, sex, and ancestry. Atenolol was used in PEAR and INVEST, and metoprolol was used in PEAR-2. We found that rs1042714 and rs1042713 in ADRB2 were significantly associated with HR response to both β-blockers in whites (rs1042714 C-allele carriers, meta-analysis β = -0.95 beats per minute [bpm], meta-analysis P = 3×10-4 ; rs1042713 A-allele carriers, meta-analysis β = -1.15 bpm, meta-analysis P = 2×10-3 ). In conclusion, the results of our analyses provide strong evidence to support the hypothesis that rs1042714 and rs1042713 in the ADRB2 gene are important predictors of HR response to cardioselective β-blockade in hypertensive patient cohorts.
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Affiliation(s)
- Mohamed H Shahin
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Nihal El Rouby
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Daniela J Conrado
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Daniel Gonzalez
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | - Yan Gong
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Maximilian T Lobmeyer
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | | | - Eric Boerwinkle
- Human Genetics Center and Institute of Molecular Medicine, University of Texas Health Science Center, Houston, TX, USA
| | - John G Gums
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Arlene Chapman
- Department of Medicine, The University of Chicago, Chicago, IL, USA
| | - Stephen T Turner
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Carl J Pepine
- Division of Cardiovascular Medicine, Department of Medicine, University of Florida, College of Medicine, Gainesville, FL, USA
| | - Rhonda M Cooper-DeHoff
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, College of Pharmacy, University of Florida, Gainesville, FL, USA.,Division of Cardiovascular Medicine, Department of Medicine, University of Florida, College of Medicine, Gainesville, FL, USA
| | - Julie A Johnson
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, College of Pharmacy, University of Florida, Gainesville, FL, USA.,Division of Cardiovascular Medicine, Department of Medicine, University of Florida, College of Medicine, Gainesville, FL, USA
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Ohana M, Sellers SL, Mooney J, Kueh SH, Grover R, Arepalli CD, Selvakumar K, Kim U, Blanke P, Leipsic JA. Prevalence and impact of scan-related anxiety during coronary CT angiography: A prospective cohort study of 366 patients. J Cardiovasc Comput Tomogr 2018; 12:364-371. [DOI: 10.1016/j.jcct.2018.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 03/21/2018] [Accepted: 04/30/2018] [Indexed: 10/17/2022]
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Shahin MH, Conrado DJ, Gonzalez D, Gong Y, Lobmeyer MT, Beitelshees AL, Boerwinkle E, Gums JG, Chapman A, Turner ST, Cooper-DeHoff RM, Johnson JA. Genome-Wide Association Approach Identified Novel Genetic Predictors of Heart Rate Response to β-Blockers. J Am Heart Assoc 2018; 7:JAHA.117.006463. [PMID: 29478026 PMCID: PMC5866313 DOI: 10.1161/jaha.117.006463] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background For many indications, the negative chronotropic effect of β‐blockers is important to their efficacy, yet the heart rate (HR) response to β‐blockers varies. Herein, we sought to use a genome‐wide association approach to identify novel single nucleotide polymorphisms (SNPs) associated with HR response to β‐blockers. Methods and Results We first performed 4 genome‐wide association analyses for HR response to atenolol (a β1‐adrenergic receptor blocker) as: (1) monotherapy or (2) add‐on therapy, in 426 whites and 273 blacks separately from the PEAR (Pharmacogenomic Evaluation of Antihypertensive Responses) study. A meta‐analysis was then performed between the genome‐wide association analysis performed in PEAR atenolol monotherapy and add‐on therapy, in each race separately, using the inverse variance method assuming fixed effects. From this analysis, SNPs associated with HR response to atenolol at a P<1E‐05 were tested for replication in whites (n=200) and blacks (n=168) treated with metoprolol (a β1‐adrenergic receptor blocker). From the genome‐wide association meta‐analyses, SNP rs17117817 near olfactory receptor family10 subfamily‐p‐member1 (OR10P1), and SNP rs2364349 in sorting nexin‐9 (SNX9) replicated in blacks. The combined studies meta‐analysis P values for the rs17117817 and rs2364349 reached genome‐wide significance (rs17117817G‐allele; Meta‐β=5.53 beats per minute, Meta‐P=2E‐09 and rs2364349 A‐allele; Meta‐β=3.5 beats per minute, Meta‐P=1E‐08). Additionally, SNPs in the OR10P1 and SNX9 gene regions were also associated with HR response in whites. Conclusions This study highlights OR10P1 and SNX9 as novel genes associated with changes in HR in response to β‐blockers. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00246519.
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Affiliation(s)
- Mohamed H Shahin
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, College of Pharmacy, University of Florida, Gainesville, FL
| | - Daniela J Conrado
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, FL
| | - Daniel Gonzalez
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy University of North Carolina, Chapel Hill, NC
| | - Yan Gong
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, College of Pharmacy, University of Florida, Gainesville, FL
| | - Maximilian T Lobmeyer
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, College of Pharmacy, University of Florida, Gainesville, FL
| | | | - Eric Boerwinkle
- Human Genetics Center and Institute of Molecular Medicine, University of Texas Health Science Center, Houston, TX
| | - John G Gums
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, College of Pharmacy, University of Florida, Gainesville, FL
| | | | - Stephen T Turner
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | - Rhonda M Cooper-DeHoff
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, College of Pharmacy, University of Florida, Gainesville, FL
| | - Julie A Johnson
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, College of Pharmacy, University of Florida, Gainesville, FL
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Pasternak AL, Ward KM, Luzum JA, Ellingrod VL, Hertz DL. Germline genetic variants with implications for disease risk and therapeutic outcomes. Physiol Genomics 2017; 49:567-581. [PMID: 28887371 PMCID: PMC5668651 DOI: 10.1152/physiolgenomics.00035.2017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Genetic testing has multiple clinical applications including disease risk assessment, diagnosis, and pharmacogenomics. Pharmacogenomics can be utilized to predict whether a pharmacologic therapy will be effective or to identify patients at risk for treatment-related toxicity. Although genetic tests are typically ordered for a distinct clinical purpose, the genetic variants that are found may have additional implications for either disease or pharmacology. This review will address multiple examples of germline genetic variants that are informative for both disease and pharmacogenomics. The discussed relationships are diverse. Some of the agents are targeted for the disease-causing genetic variant, while others, although not targeted therapies, have implications for the disease they are used to treat. It is also possible that the disease implications of a genetic variant are unrelated to the pharmacogenomic implications. Some of these examples are considered clinically actionable pharmacogenes, with evidence-based, pharmacologic treatment recommendations, while others are still investigative as areas for additional research. It is important that clinicians are aware of both the disease and pharmacogenomic associations of these germline genetic variants to ensure patients are receiving comprehensive personalized care.
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Affiliation(s)
- Amy L Pasternak
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan
| | - Kristen M Ward
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan
| | - Jasmine A Luzum
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan
| | - Vicki L Ellingrod
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan
| | - Daniel L Hertz
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan
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Wang DW, Liu M, Wang P, Zhan X, Liu YQ, Zhao LS. ADRB2 polymorphisms predict the risk of myocardial infarction and coronary artery disease. Genet Mol Biol 2015; 38:433-43. [PMID: 26692153 PMCID: PMC4763328 DOI: 10.1590/s1415-475738420140234] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 04/27/2015] [Indexed: 12/03/2022] Open
Abstract
Recently, the rs1042713 G > A and rs1042714 C > G polymorphisms in the beta-2
adrenergic receptor (ADRB2) gene were shown to be related to atherosclerosis
diseases. Therefore, we performed a systemic meta-analysis to determine whether the
two functional polymorphisms are related to the risk of myocardial infarction (MI)
and coronary artery disease (CAD). We identified published studies that are relevant
to our topic of interest. Seven case-control studies, with a total of 6,843 subjects,
were incorporated into the current meta-analysis. Our analysis showed a higher
frequency of rs1042713 G > A variant in patients with MI or CAD compared to
healthy controls. A similar result was also obtained with the rs1042714 C > G
variant under both the allele and dominant models. Ethnicity-stratified subgroup
analysis suggested that the rs1042714 C > G variant correlated with an increased
risk of the two diseases in both Asians and Caucasians, while rs1042713 G > A only
contributes to the risk of two diseases in Asians. In the disease type-stratified
subgroups, the frequencies of both the rs1042713 G > A and rs1042714 C > G
variants were higher in the cases than in the controls in both the MI and CAD
subgroups. Collectively, our data contribute towards understanding the correlation
between the rs1042713 G > A and rs1042714 C > G polymorphisms in
ADRB2 and the susceptibility to MI and CAD.
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Affiliation(s)
- Dong-Wei Wang
- Department of Cardiology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Min Liu
- Department of Cardiology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Ping Wang
- Department of Cardiology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Xiang Zhan
- Department of Cardiology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Yu-Qing Liu
- Department of Cardiology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Luo-Sha Zhao
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P.R. China
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Wu D, Li G, Deng M, Song W, Huang X, Guo X, Wu Z, Wu S, Xu J. Associations between ADRB1 and CYP2D6 gene polymorphisms and the response to β-blocker therapy in hypertension. J Int Med Res 2015; 43:424-34. [PMID: 25823457 DOI: 10.1177/0300060514563151] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 11/13/2014] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the associations between β1-adrenergic receptor (ADRB1) and cytochrome P450 2D6 (CYP2D6) gene polymorphisms and β-blocker treatment outcomes in patients with hypertension. METHODS Chinese patients with essential hypertension were treated with the β-blocker metoprolol and followed up for 12 weeks. xTAG® liquid-chip technology was used for CYP2D6 100 C > T and ADRB1 1165G > C genotyping. Associations between gene polymorphisms and antihypertensive therapy outcomes were assessed by generalized linear model fitting. A decrease of ≥ 10 mmHg in systolic blood pressure indicated an effective treatment outcome. RESULTS A total of 93 patients were included in the study. Mutant allele frequencies of 61.29% and 58.60% were obtained for ADRB1 and CYP2D6, respectively. There was no significant interaction between the effects of ADRB1 and CYP2D6 gene polymorphisms on treatment outcome. Patients homozygous for the mutant ADRB1 genotype (CC) had better treatment outcomes than those heterozygous for the mutation (GC). Interestingly, β-blocker treatment duration was an independent factor associated with treatment outcome. CONCLUSIONS The ADRB1 1165G > C gene polymorphism and β-blocker treatment duration are independent factors associated with β-blocker treatment outcome. These findings suggest that the selection of antihypertensive therapy should take into consideration the patient's genotype.
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Affiliation(s)
- Dingchang Wu
- Department of Laboratory Medicine, First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Ganyang Li
- Department of Cardiovascular Medicine, First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Maoqing Deng
- Department of Laboratory Medicine, First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Wei Song
- Department of Cardiovascular Medicine, First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Xiaohua Huang
- Department of Laboratory Medicine, First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Xiaoru Guo
- Department of Laboratory Medicine, First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Zhengzheng Wu
- SurExam Bio-Tech Co. Ltd, Guangzhou Technology Innovation Base, Guangzhou, China
| | - Shiyang Wu
- SurExam Bio-Tech Co. Ltd, Guangzhou Technology Innovation Base, Guangzhou, China
| | - Jiasen Xu
- SurExam Bio-Tech Co. Ltd, Guangzhou Technology Innovation Base, Guangzhou, China
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Kumar A, Tripathi M, Srivastava MVP, Vivekanandhan S, Prasad K. Relationship between polymorphisms in beta -2 adrenergic receptor gene and ischemic stroke in North Indian Population: a hospital based case control study. BMC Res Notes 2014; 7:396. [PMID: 24966013 PMCID: PMC4091742 DOI: 10.1186/1756-0500-7-396] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 06/13/2014] [Indexed: 11/24/2022] Open
Abstract
Background Stroke is a multi-factorial disease and influenced by both genetic and environmental factors. The purpose of the present case control study was to check the relationship between beta-2 adrenergic receptor (ADRB2) polymorphism and ischemic stroke in North Indian Population. Methods In a hospital based case control study, patients with ischemic stroke and control subjects from outpatient department and neurology ward of All India Institute of Medical Sciences New Delhi. Genotyping was performed by using Polymerase chain reaction–Restriction fragment length polymorphism. Frequency distributions of genotypes and alleles were compared between cases and controls using multivariate logistic regression. Results In this study, 224 patients and 224 age-and sex-matched control subjects were recruited. Mean age of cases and controls were 53.9 ± 13.4 and 53.6 ± 12.9 years respectively. Multivariate logistic regression analysis showed an independent association between Gln27Glu polymorphism and large vessel stroke (LVD) under a recessive model of inheritance (OR 3.9; 95% CI 1.3 to 11). An age-stratified analysis, suggested independent association between Gln27Glu polymorphism and ischemic stroke, large vessel disease and small vessel disease stroke who had onset of disease at an older age. Conclusions The findings of the present study suggest that Gln27Glu polymorphism of the ADRB2 gene may confer higher risk of large vessel disease stroke in a North Indian population. Prospective studies with larger sample size are required for independent validation.
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Affiliation(s)
- Amit Kumar
- Department of Neurology, Room No, 704, Neurosciences Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
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Lymperopoulos A, Negussie S, Walklett K. β1- and α2C-adrenergic receptor polymorphisms and the antiarrhythmic effect of bucindolol in heart failure with reduced ejection fraction. Pharmacogenomics 2013; 14:1545-9. [PMID: 24088125 DOI: 10.2217/pgs.13.137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Anastasios Lymperopoulos
- Laboratory for the Study of Neurohormonal Control of the Circulation, Department of Pharmaceutical Sciences, Nova Southeastern University College of Pharmacy, HPD (Terry) Building/Room 1338, Fort Lauderdale, FL 33328-2018, USA
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