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Ascoli Marchetti A, Belvivere L, Argirò R, Kroegler B, Oddi FM, Pennetta F, Giorgi AD, Fazzini S, Morosetti D, Triggianese P, Greco E, D'Antonio A, Coccia I, Tesauro M, Sangiuolo F, Ippoliti A. A Rare but Fatal Behçet Variant: The Hughes-Stovin Syndrome-Successful Case Report and New Evidence from Literature Review. AORTA (STAMFORD, CONN.) 2023; 11:156-161. [PMID: 38531384 PMCID: PMC11038734 DOI: 10.1055/s-0043-1777994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 11/18/2023] [Indexed: 03/28/2024]
Abstract
Hughes-Stovin syndrome (HSS) is a rare potentially fatal vasculitis supposedly belonging to the spectrum of Behçet disease without ocular involvement. HSS tends to play by a temporal pattern, starting with thrombosis and followed by formation of pulmonary aneurysms. Since its mortality can reach 25% of cases, early recognition and appropriate therapy represent the major clinical challenges. We describe a rare case of HSS successfully treated via multidisciplinary management by an endovascular approach and immunosuppressive therapy.
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Affiliation(s)
- Andrea Ascoli Marchetti
- Biomedicine and Prevention Department, Vascular Surgery Unit, University of Rome Tor Vergata, Rome, Italy
| | - Lorella Belvivere
- Cardiac Surgery, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - Renato Argirò
- Radiology Department, Interventional Radiology, University of Rome Tor Vergata, Rome, Italy
| | - Barbara Kroegler
- Department of Medicina dei Sistemi, Rheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata, Rome, Italy
| | - Fabio M. Oddi
- Biomedicine and Prevention Department, Vascular Surgery Unit, University of Rome Tor Vergata, Rome, Italy
| | - Federico Pennetta
- Biomedicine and Prevention Department, Vascular Surgery Unit, University of Rome Tor Vergata, Rome, Italy
| | - Alice de Giorgi
- Biomedicine and Prevention Department, Vascular Surgery Unit, University of Rome Tor Vergata, Rome, Italy
| | - Stefano Fazzini
- Biomedicine and Prevention Department, Vascular Surgery Unit, University of Rome Tor Vergata, Rome, Italy
| | - Daniele Morosetti
- Radiology Department, Interventional Radiology, University of Rome Tor Vergata, Rome, Italy
| | - Paola Triggianese
- Department of Medicina dei Sistemi, Rheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata, Rome, Italy
| | - Elisabetta Greco
- Department of Medicina dei Sistemi, Rheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata, Rome, Italy
| | - Arianna D'Antonio
- Department of Medicina dei Sistemi, Rheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata, Rome, Italy
| | - Ilaria Coccia
- Department of “Medicina dei Sistemi,” Internal Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Manfredi Tesauro
- Department of “Medicina dei Sistemi,” Internal Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Federica Sangiuolo
- Biomedicine and Prevention Department, Medical Genetics, University of Rome Tor Vergata, Italy
| | - Arnaldo Ippoliti
- Biomedicine and Prevention Department, Vascular Surgery Unit, University of Rome Tor Vergata, Rome, Italy
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2
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Using the optimal method-explained variance weighted genetic risk score to predict the efficacy of folic acid therapy to hyperhomocysteinemia. Eur J Clin Nutr 2022; 76:943-949. [PMID: 35001080 DOI: 10.1038/s41430-021-01055-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/22/2021] [Accepted: 11/29/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Genetic risk score (GRS) is a useful way to explore genetic architectures and the relationships of complex diseases. Several studies had revealed many single nucleotide polymorphisms (SNPs) associated with the efficacy of folic acid treatment to hyperhomocysteinemia (HHcy). METHODS We aimed to construct and screen out the optimal predictive model based on four GRSs and traditional risk factors. Four GRSs enrolled four SNPs (MTHFR rs1801131, MTHFR rs1801133, MTRR rs1801394, BHMT rs3733890) were presented as follows: (a) simple count genetic risk score (SC-GRS), (b) direct logistic regression genetic risk score (DL-GRS), (c) polygenic genetic risk score (PG-GRS), and (d) explained variance weighted genetic risk score (EV-GRS). We performed a prospective cohort study including 638 HHcy patients. Then we evaluated the associations of four GRSs with folic acid's efficacy and the performance of four GRSs. RESULTS Four GRSs were independently associated with efficacy of treatment (p < 0.05). When combining GRSs with traditional risk factors, the AUC of the four models were all above 0.900 in the training set (Tradition + SC-GRS: 0.909, Tradition + DL-GRS: 0.909, Tradition + PG-GRS: 0.904, Tradition + EV-GRS: 0.910). And EV-GRS got the highest AUC. When evaluating the models in the testing set, we got the same conclusion that EV-GRS was optimal among four GRSs with the highest AUC (0.878) and the highest increase of AUC (0.008). CONCLUSION A more precise predictive model combing the optimal GRS with traditional risk factors was constructed to predict the efficacy of folic acid therapy to HHcy.
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Merashli M, Bucci T, Pastori D, Pignatelli P, Arcaro A, Gentile F, Marottoli V, Ames PRJ. Plasma Homocysteine in Behcet's Disease: A Systematic Review and Meta-Analysis. Thromb Haemost 2022; 122:1209-1220. [PMID: 34996122 DOI: 10.1055/s-0041-1740637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIM To evaluate the relevance of plasma homocysteine (HC) in Behcet's disease (BD) and its clinical manifestations. METHODS Systematic review of EMBASE and PubMed databases according to PRISMA guidelines from inception to July 2021; random-effects meta-analyses for continuous outcomes. RESULTS The search strategy retrieved 48 case-control (2,669 BD and 2,245 control participants) and 5 cohort studies (708 BD participants). Plasma HC was higher in BD than in controls (p < 0.0001) with wide heterogeneity (I2 = 89.7%) that remained unchanged after sensitivity analysis according to year of article publication, age of BD participants, study size, study quality, method of HC determination, and male/female ratio >1.5; some pooled ethnicities explained a small part of the heterogeneity (I2 = 16.3%). Active BD participants had higher HC than inactive ones (p < 0.0001), with moderate heterogeneity (I2 = 49.2%) that disappeared after removal of an outlier study with very high disease activity. BD participants with any vascular involvement had higher HC than those without (p < 0.0001) with wide heterogeneity (I2 = 89.7%); subgroup analysis on venous thrombosis only changed neither effect size (p < 0.0001) nor heterogeneity (I2 = 72.7%). BD participants with ocular involvement had higher HC than those without (p < 0.0001) with moderate heterogeneity (I2 = 40.3%). CONCLUSION Although causality cannot be inferred, the consistency of the elevation of plasma HC in BD, particularly in patients with active disease, with vascular and ocular involvement suggests an intrinsic involvement of HC in these clinical manifestations.
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Affiliation(s)
- Mira Merashli
- Department of Rheumatology, American University of Beirut, Bliss, Beirut, Lebanon
| | - Tommaso Bucci
- Department of General Surgery, Surgical Specialties and Organ Transplantation "Paride Stefanini," Sapienza University of Rome, Rome, Italy
| | - Daniele Pastori
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Pasquale Pignatelli
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Alessia Arcaro
- Department of Medicine and Health Sciences 'V. Tiberio', Università del Molise, Campobasso, Italy
| | - Fabrizio Gentile
- Department of Medicine and Health Sciences 'V. Tiberio', Università del Molise, Campobasso, Italy
| | | | - Paul R J Ames
- Immune Response and Vascular Disease Unit, CEDOC, Nova University Lisbon, Rua Camara Pestana, Lisbon Portugal.,Department of Haematology, Dumfries Royal Infirmary, Cargenbridge, Dumfries, United Kingdom
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4
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Combining genetic risk score with artificial neural network to predict the efficacy of folic acid therapy to hyperhomocysteinemia. Sci Rep 2021; 11:21430. [PMID: 34728708 PMCID: PMC8563886 DOI: 10.1038/s41598-021-00938-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/07/2021] [Indexed: 12/30/2022] Open
Abstract
Artificial neural network (ANN) is the main tool to dig data and was inspired by the human brain and nervous system. Several studies clarified its application in medicine. However, none has applied ANN to predict the efficacy of folic acid treatment to Hyperhomocysteinemia (HHcy). The efficacy has been proved to associate with both genetic and environmental factors while previous studies just focused on the latter one. The explained variance genetic risk score (EV-GRS) had better power and could represent the effect of genetic architectures. Our aim was to add EV-GRS into environmental factors to establish ANN to predict the efficacy of folic acid therapy to HHcy. We performed the prospective cohort research enrolling 638 HHcy patients. The multilayer perception algorithm was applied to construct ANN. To evaluate the effect of ANN, we also established logistic regression (LR) model to compare with ANN. According to our results, EV-GRS was statistically associated with the efficacy no matter analyzed as a continuous variable (OR = 3.301, 95%CI 1.954-5.576, P < 0.001) or category variable (OR = 3.870, 95%CI 2.092-7.159, P < 0.001). In our ANN model, the accuracy was 84.78%, the Youden's index was 0.7073 and the AUC was 0.938. These indexes above indicated higher power. When compared with LR, the AUC, accuracy, and Youden's index of the ANN model (84.78%, 0.938, 0.7073) were all slightly higher than the LR model (83.33% 0.910, 0.6687). Therefore, clinical application of the ANN model may be able to better predict the folic acid efficacy to HHcy than the traditional LR model. When testing two models in the validation set, we got the same conclusion. This study appears to be the first one to establish the ANN model which added EV-GRS into environmental factors to predict the efficacy of folic acid to HHcy. This model would be able to offer clinicians a new method to make decisions and individual therapeutic plans.
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A Role for Folate in Microbiome-Linked Control of Autoimmunity. J Immunol Res 2021; 2021:9998200. [PMID: 34104654 PMCID: PMC8159645 DOI: 10.1155/2021/9998200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/04/2021] [Indexed: 02/03/2023] Open
Abstract
The microbiome exerts considerable control over immune homeostasis and influences susceptibility to autoimmune and autoinflammatory disease (AD/AID) such as inflammatory bowel disease (IBD), multiple sclerosis (MS), type 1 diabetes (T1D), psoriasis, and uveitis. In part, this is due to direct effects of the microbiome on gastrointestinal (GI) physiology and nutrient transport, but also to indirect effects on immunoregulatory controls, including induction and stabilization of T regulatory cells (T reg). Secreted bacterial metabolites such as short-chain fatty acids (SCFA) are under intense investigation as mediators of these effects. In contrast, folate (vitamin B9), an essential micronutrient, has attracted less attention, possibly because it exerts global physiological effects which are difficult to differentiate from specific effects on the immune system. Here, we review the role of folate in AD/AID with some emphasis on sight-threatening autoimmune uveitis. Since folate is required for the generation and maintenance of T reg , we propose that one mechanism for microbiome-based control of AD/AID is via folate-dependent induction of GI tract T reg , particularly colonic T reg, via anergic T cells (T an). Hence, folate supplementation has potential prophylactic and/or therapeutic benefit in AID/AD.
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Mölzer C, Heissigerova J, Wilson HM, Kuffova L, Forrester JV. Immune Privilege: The Microbiome and Uveitis. Front Immunol 2021; 11:608377. [PMID: 33569055 PMCID: PMC7868421 DOI: 10.3389/fimmu.2020.608377] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 12/04/2020] [Indexed: 02/03/2023] Open
Abstract
Immune privilege (IP), a term introduced to explain the unpredicted acceptance of allogeneic grafts by the eye and the brain, is considered a unique property of these tissues. However, immune responses are modified by the tissue in which they occur, most of which possess IP to some degree. The eye therefore displays a spectrum of IP because it comprises several tissues. IP as originally conceived can only apply to the retina as it contains few tissue-resident bone-marrow derived myeloid cells and is immunologically shielded by a sophisticated barrier – an inner vascular and an outer epithelial barrier at the retinal pigment epithelium. The vascular barrier comprises the vascular endothelium and the glia limitans. Immune cells do not cross the blood-retinal barrier (BRB) despite two-way transport of interstitial fluid, governed by tissue oncotic pressure. The BRB, and the blood-brain barrier (BBB) mature in the neonatal period under signals from the expanding microbiome and by 18 months are fully established. However, the adult eye is susceptible to intraocular inflammation (uveitis; frequency ~200/100,000 population). Uveitis involving the retinal parenchyma (posterior uveitis, PU) breaches IP, while IP is essentially irrelevant in inflammation involving the ocular chambers, uveal tract and ocular coats (anterior/intermediate uveitis/sclerouveitis, AU). Infections cause ~50% cases of AU and PU but infection may also underlie the pathogenesis of immune-mediated “non-infectious” uveitis. Dysbiosis accompanies the commonest form, HLA-B27–associated AU, while latent infections underlie BRB breakdown in PU. This review considers the pathogenesis of uveitis in the context of IP, infection, environment, and the microbiome.
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Affiliation(s)
- Christine Mölzer
- Institute of Medical Sciences, University of Aberdeen, Aberdeen, United Kingdom
| | - Jarmila Heissigerova
- Department of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia
| | - Heather M Wilson
- Institute of Medical Sciences, University of Aberdeen, Aberdeen, United Kingdom
| | - Lucia Kuffova
- Institute of Medical Sciences, University of Aberdeen, Aberdeen, United Kingdom.,Eye Clinic, Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| | - John V Forrester
- Institute of Medical Sciences, University of Aberdeen, Aberdeen, United Kingdom
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Huang X, Li D, Zhao Q, Zhang C, Ren B, Yue L, Du B, Godfrey O, Wang X, Zhang W. Association between BHMT and CBS gene promoter methylation with the efficacy of folic acid therapy in patients with hyperhomocysteinemia. J Hum Genet 2019; 64:1227-1235. [PMID: 31558761 DOI: 10.1038/s10038-019-0672-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 09/06/2019] [Accepted: 09/08/2019] [Indexed: 12/14/2022]
Abstract
Both betaine homocysteine methyltransferase (BHMT) and cystathionine β-synthase (CBS) are major enzymes in the metabolism of plasma homocysteine (Hcy). Abnormal methylation levels of BHMT and CBS are positively associated with Hcy levels. The present study is performed to explore the association between the methylation levels in the promoter regions of the BHMT and CBS genes and the efficacy of folic acid therapy in patient with hyperhomocysteinemia (HHcy). A prospective cohort study recruiting HHcy (Hcy ≥ 15 μmol/L) patients was performed. The subjects were treated with oral folic acid (5 mg/d) for 90 days, and the patients were divided into the success group (Hcy < 15 μmol/L) and the failure group (Hcy ≥ 15 μmol/L) according to their Hcy levels after treatment. In the logistic regression model with adjusted covariates, the patients with lower total methylation levels in the BHMT and CBS promoter regions exhibited 1.627-fold and 1.671-fold increased risk of treatment failure compared with higher methylation individuals, respectively. Similarly, subjects who had lower methylation levels (<methylation mean) in BHMT CpG1 had 1.792 times higher risks. Stratified analysis by sex found that lower CBS methylation levels were associated with a 2.128-fold increased risk for treatment failure in males with HHcy. Lower levels of BHMT or CBS promoter total methylation might be associated with increased the risk of treatment failure. These studies suggest that lower levels of BHMT and CBS methylation are all predictors of failure in folic acid therapy for HHcy. However, due to some limitations of this study, such as the small number of the loci tested, further large-scale studies are necessary to verify our observations.
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Affiliation(s)
- Xiaowen Huang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Dankang Li
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Qinglin Zhao
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Chengda Zhang
- Department of Biostatistics and Bioinformatics, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, 70112, USA
| | - Bingnan Ren
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Limin Yue
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Binghui Du
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Opolot Godfrey
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Xiliang Wang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Weidong Zhang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China.
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Liu L, Liang J, Liu Q, Luo C, Liu J, Fan R, Chen Z, Chen Y, Peng F, Jiang Y. Elevated Plasma Homocysteine Levels in Anti-N-methyl-D-aspartate Receptor Encephalitis. Front Neurol 2019; 10:464. [PMID: 31130913 PMCID: PMC6509947 DOI: 10.3389/fneur.2019.00464] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 04/16/2019] [Indexed: 01/10/2023] Open
Abstract
Objective: Homocysteine (Hcy) levels have been investigated in many diseases, such as neurodegenerative and autoimmune diseases. However, changes in Hcy levels in anti-N-Methyl-D-aspartate receptor (anti-NMDAR) encephalitis have not been investigated thus far. Methods: Case data were collected from 45 patients with anti-NMDAR encephalitis and 179 age- and sex-matched healthy controls (HCs). Clinical characteristics, Hcy levels, C reactive protein (CRP) levels, and cerebrospinal fluid (CSF) parameters were determined. Association of Hcy and clinical parameters were evaluated in these patients. Among these 45 patients, 15 had a follow-up evaluation at 3 months after treatment. Results: Hcy levels (p < 0.001) and CRP levels (p = 0.005) from the patients with anti-NMDAR encephalitis were significantly higher than those from HCs. Hcy levels from male patients were significantly lower than those from male HCs (p < 0.001). Comparing anti-NMDAR encephalitis patients after treatment with before treatment, the former has significantly higher Hcy levels (p = 0.004), CRP levels (p = 0.041) and mRS scores (p = 0.002). Furthermore, a significant negative correlation between the changes in Hcy levels and the changes in mRS scores (r = −0.534, p = 0.040) was observed. Conclusion: Elevated plasma homocysteine occurs in anti-NMDAR encephalitis, and seems associated with male sex.
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Affiliation(s)
- Lizhi Liu
- Department of Neurology and Multiple Sclerosis Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Neurology, Huizhou Hospital of Traditional Chinese Medicine, Huizhou, China
| | - Jie Liang
- Department of Neurology and Multiple Sclerosis Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qing Liu
- Department of Neurology, Huizhou Hospital of Traditional Chinese Medicine, Huizhou, China
| | - Chongliang Luo
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, United States
| | - Jia Liu
- Department of Neurology and Multiple Sclerosis Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Rong Fan
- Department of Neurology and Multiple Sclerosis Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhigang Chen
- Department of Neurology and Multiple Sclerosis Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yong Chen
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, United States
| | - Fuhua Peng
- Department of Neurology and Multiple Sclerosis Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ying Jiang
- Department of Neurology and Multiple Sclerosis Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Genetic polymorphisms of key enzymes in folate metabolism affect the efficacy of folate therapy in patients with hyperhomocysteinaemia. Br J Nutr 2019; 119:887-895. [PMID: 29644956 DOI: 10.1017/s0007114518000508] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The aim of this study is to analyse the efficacy rate of folate for the treatment of hyperhomocysteinaemia (HHcy) and to explore how folate metabolism-related gene polymorphisms change its efficacy. This study also explored the effects of gene-gene and gene-environment interactions on the efficacy of folate. A prospective cohort study enrolling HHcy patients was performed. The subjects were treated with oral folate (5 mg/d) for 90 d. We analysed the efficacy rate of folate for the treatment of HHcy by measuring homocysteine (Hcy) levels after treatment. Unconditioned logistic regression was conducted to analyse the association between SNP and the efficacy of folic acid therapy for HHcy. The efficacy rate of folate therapy for HHcy was 56·41 %. The MTHFR rs1801133 CT genotype, TT genotype and T allele; the MTHFR rs1801131 AC genotype, CC genotype and C allele; the MTRR rs1801394 GA genotype, GG genotype and G allele; and the MTRR rs162036 AG genotype and AG+GG genotypes were associated with the efficacy of folic acid therapy for HHcy (P<0·05). No association was seen between other SNP and the efficacy of folic acid. The optimal model of gene-gene interactions was a two-factor interaction model including rs1801133 and rs1801394. The optimal model of gene-environment interaction was a three-factor interaction model including history of hypertension, history of CHD and rs1801133. Folate supplementation can effectively decrease Hcy level. However, almost half of HHcy patients failed to reach the normal range. The efficacy of folate therapy may be genetically regulated.
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Chaabane S, Messedi M, Akrout R, Ben Hamad M, Turki M, Marzouk S, Keskes L, Bahloul Z, Rebai A, Ayedi F, Maalej A. Association of hyperhomocysteinemia with genetic variants in key enzymes of homocysteine metabolism and methotrexate toxicity in rheumatoid arthritis patients. Inflamm Res 2018; 67:703-710. [PMID: 29796841 DOI: 10.1007/s00011-018-1161-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 05/10/2018] [Accepted: 05/19/2018] [Indexed: 12/12/2022] Open
Affiliation(s)
- Souhir Chaabane
- Laboratory of Human Molecular Genetics, Faculty of Medicine, Avenue Majida Boulila, 3029, Sfax, Tunisia.
| | - Meriam Messedi
- UR "Molecular Bases of Human Diseases", Faculty of Medicine, Sfax, Tunisia
| | - Rim Akrout
- Department of Rheumatology, University Hospital Hedi Chaker, Sfax, Tunisia
| | - Mariem Ben Hamad
- Laboratory of Human Molecular Genetics, Faculty of Medicine, Avenue Majida Boulila, 3029, Sfax, Tunisia
| | - Mouna Turki
- UR "Molecular Bases of Human Diseases", Faculty of Medicine, Sfax, Tunisia
| | - Sameh Marzouk
- Department of Internal Medicine, University Hospital Hedi Chaker, Sfax, Tunisia
| | - Leila Keskes
- Laboratory of Human Molecular Genetics, Faculty of Medicine, Avenue Majida Boulila, 3029, Sfax, Tunisia
| | - Zouheir Bahloul
- Department of Internal Medicine, University Hospital Hedi Chaker, Sfax, Tunisia
| | - Ahmed Rebai
- Laboratory of Molecular and Cellular Screening Processes, Center of Biotechnology, Sfax, Tunisia
| | - Fatma Ayedi
- UR "Molecular Bases of Human Diseases", Faculty of Medicine, Sfax, Tunisia
| | - Abdellatif Maalej
- Laboratory of Human Molecular Genetics, Faculty of Medicine, Avenue Majida Boulila, 3029, Sfax, Tunisia
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Hekmati Azar Mehrabani Z, Ghorbanihaghjo A, Sayyah Melli M, Hamzeh-Mivehroud M, Fathi Maroufi N, Bargahi N, Bannazadeh Amirkhiz M, Rashtchizadeh N. Effects of folic acid supplementation on serum homocysteine and lipoprotein (a) levels during pregnancy. ACTA ACUST UNITED AC 2015; 5:177-82. [PMID: 26929921 PMCID: PMC4769787 DOI: 10.15171/bi.2015.26] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 12/02/2015] [Accepted: 12/26/2015] [Indexed: 11/17/2022]
Abstract
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Introduction:There are many ideas concerning the etiology and pathogenesis of preeclampsia including endothelial dysfunction, inflammation and angiogenesis. Elevated levels of total homocysteine (Hcy) and lipoprotein (a) [Lp(a)] are risk factors for endothelial dysfunction. This study aimed to evaluate the effect of high dose folic acid (FA) on serum Hcy and Lp(a) concentrations with respect to methylenetetrahydrofolate reductase (MTHFR) polymorphisms 677C→T during pregnancy.
Methods: In a prospective uncontrolled intervention, 90 pregnant women received 5 mg FA supplementation before pregnancy till 36th week of pregnancy. The MTHFR polymorphisms 677C→T, serum lactate dehydrogenase activity, urine protein and creatinine concentrations were measured before starting folic acid administration. Serum levels of Hcy and Lp(a) were determined before and after completion of folic acid supplementation period.
Results: Supplementation of the patients with FA for 36 week decreased the median (minimum– maximum) levels of serum Hcy from 11.40 μmol/L (4.40-28.70) to 9.70 (1.60-20.80) μmol/L (p=0.001). There was no significant change in serum Lp(a) after FA supplementation (p=0.17). The overall prevalence of genotypes in pregnant women that were under study for MTHFR C677T polymorphism was 53.3% CC, 26.7% CT and 20.0% TT. There was no correlation between decreasing level of serum Hcy in the patients receiving FA and MTHFR polymorphisms.
Conclusion:Although FA supplementation decreased serum levels of Hcy in different MTHFR genotypes, serum Lp(a) was not changed by FA supplements. Our data suggests that FA supplementation effects on serum Hcy is MTHFR genotype independent in pregnant women.
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Affiliation(s)
| | - Amir Ghorbanihaghjo
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Manizheh Sayyah Melli
- Department of Obstetrics and Gynecology, Alzahra Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Nazila Fathi Maroufi
- Department of clinical biochemistry and laboratory medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nasrin Bargahi
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Naouali A, Kaabachi W, Tizaoui K, Amor AB, Hamzaoui A, Hamzaoui K. Association of MMP-9 gene polymorphisms with Behçet's disease risk. Immunol Lett 2015; 164:18-24. [PMID: 25639450 DOI: 10.1016/j.imlet.2015.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 01/13/2015] [Accepted: 01/20/2015] [Indexed: 10/24/2022]
Abstract
The human matrix metalloproteinases (MMPs) are importantly involved in aneurysm formation. Since the clinical manifestations in Behçet disease (BD) include aneurysm formation among major symptoms, polymorphisms in MMP-9 might be associated with BD susceptibility. The aim of the current case-control study was to investigate the association of four single nucleotide polymorphisms (SNPs) in MMP-9 gene: -1562 C/T, 2003 G/A (R668Q), 836 A/G (Q279R) and 1721 C/G (R574P) with BD risk in the Tunisian population. The distribution of MMP-9 gene polymorphisms was analyzed by polymerase chain-reaction (PCR) and restriction fragment length polymorphism (RFLP) for 240 BD patients and 288 controls. Our study indicated that the MMP-9 -1562 C/T polymorphism (rs3918242) was not associated with BD risk. We found a significant association of the MMP-9 2003 G/A (rs17577) with an increased susceptibility to BD. However, the MMP-9 1721 C/G polymorphism (rs2250889) had a protective role against the development of BD. Subgroup analysis based on stratification by gender revealed that the MMP-9 2003 G/A polymorphism was associated with a highly significant BD risk in women's group (G vs. A: P=0.0000001). However, the MMP-9 836 A/G polymorphism had a protective role in men's group (G vs. A: P=0.00043). The MMP-9 1721 C/G polymorphism was associated with a protective effect in both men and women groups (CG+GG vs. CC: P=0.04 and P=0.0002, respectively). The haplotype analysis did not show any association with BD risk. A significant difference in the MMP-9 serum levels were observed in the patient subgroup with ocular lesions manifestations.
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Affiliation(s)
- Abir Naouali
- Department of Basic Sciences, Medicine Faculty of Tunis, University Tunis El Manar, Tunis 1007, Tunisia.
| | - Wajih Kaabachi
- Department of Basic Sciences, Medicine Faculty of Tunis, University Tunis El Manar, Tunis 1007, Tunisia.
| | - Kalthoum Tizaoui
- Department of Basic Sciences, Medicine Faculty of Tunis, University Tunis El Manar, Tunis 1007, Tunisia.
| | - Amira Ben Amor
- Department of Basic Sciences, Medicine Faculty of Tunis, University Tunis El Manar, Tunis 1007, Tunisia.
| | - Agnès Hamzaoui
- Department of Basic Sciences, Medicine Faculty of Tunis, University Tunis El Manar, Tunis 1007, Tunisia; A. Mami Hospital, Ariana Homeostasis and Cell Dysfunction, UR/12-SP-15, Tunisia.
| | - Kamel Hamzaoui
- Department of Basic Sciences, Medicine Faculty of Tunis, University Tunis El Manar, Tunis 1007, Tunisia.
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Jiang S, Pan M, Wu S, Venners SA, Zhong G, Hsu YH, Weinstock J, Wang B, Tang G, Liu D, Xu X. Elevation in Total Homocysteine Levels in Chinese Patients With Essential Hypertension Treated With Antihypertensive Benazepril. Clin Appl Thromb Hemost 2014; 22:191-8. [PMID: 25550183 DOI: 10.1177/1076029614565881] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To investigate the effect of benazepril on plasma homocysteine (Hcy) levels and to analyze the correlation between the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism and changes in Hcy levels in response to benazepril. METHODS A total of 231 patients with mild to moderate essential hypertension were enrolled, and benazepril was orally administered at a dose of 10 mg/d for 2 weeks. Plasma Hcy levels were measured by high-performance liquid chromatography at baseline and after 2 weeks of treatment. Genotyping of the MTHFR C677T polymorphism was performed by TaqMan probe technique. RESULTS There was no significant change in Hcy level after benazepril treatment for 2 weeks (P = .97). However, stratified by baseline Hcy levels, the patients with baseline Hcy <10 μmol/L had a significant increase in plasma Hcy levels (P = .003). The results from the multivariable linear regression analysis demonstrated a significant correlation between baseline Hcy levels and the changes in Hcy levels found in both the unadjusted (P = .002) and the adjusted model (P = .004). Strikingly, we found no significant effect modification by the MTHFR C677T polymorphism on the Hcy changes after benazepril treatment. There were also no statistically significant interactions of gene and environment factors (ie, gene smoking and drinking) on the changes in Hcy levels after benazepril treatment. CONCLUSION Benazepril may cause an increase in plasma Hcy levels among patients with hypertension with low baseline Hcy levels, while effect modification by MTHFR C677T genotypes on the changes in Hcy levels in response to benazepril was not significant among patients with essential hypertension.
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Affiliation(s)
- Shanqun Jiang
- School of Life Sciences, Anhui University, Hefei, China Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Mingluo Pan
- School of Life Sciences, Anhui University, Hefei, China
| | - Suwen Wu
- School of Life Sciences, Anhui University, Hefei, China
| | - Scott A Venners
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Guisheng Zhong
- Department of Chemistry and Chemical Biology, Harvard University, Cambridge, MA, USA
| | - Yi-Hsiang Hsu
- Institute for Aging Research, HSL and Harvard Medical School, Boston, MA, USA Molecular and Integrative Physiological Sciences Program, Harvard School of Public Health, Boston, MA, USA
| | - Justin Weinstock
- Department of Statistics, University of Virginia, Charlottesville, VA, USA
| | - Binyan Wang
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Genfu Tang
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Dahai Liu
- School of Life Sciences, Anhui University, Hefei, China
| | - Xiping Xu
- Institute of Biomedicine, Anhui Medical University, Hefei, China Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, IL, USA
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