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Aung M, Konoshita T, Moodley J, Naicker T, Connolly C, Khaliq OP, Gathiram P. Aminopeptidase A (ENPEP) gene polymorphisms and preeclampsia: Descriptive analysis. Eur J Obstet Gynecol Reprod Biol 2020; 258:70-74. [PMID: 33421813 DOI: 10.1016/j.ejogrb.2020.12.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 12/28/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The etiology of preeclampsia (PE) remains elusive. Recent genome-wide association studies have identified a number of genetic variants associated with blood pressure variations in east Asians. One of the genetic variants is the aminopeptidase A (ENPEP) gene, which converts angiotensin II to angiotensin III. The C allele of rs6825911 is a risk for hypertension. The current study investigated whether genetic variants of ENPEP play a role in the pathogenesis of preeclampsia. STUDY DESIGN The study was a descriptive analysis of gene polymorphisms of ENPEP; 602 pregnant women of African ancestry [normotensive (n = 245) and PE (n = 357)] were recruited. The two groups were divided according to their HIV status. The PE group consisted of early- and late-onset sub-categories. A single nucleotide polymorphism of rs6825911 was analyzed using the TaqMan® Probe mix and by means of real time polymerase chain reaction. RESULTS The risk of C allele for PE was 1.07 (95 % CI 0.83-1.38, P = 0.589) for allele comparison and the risk for preeclampsia CC to CT/TT was 1.33 (95 % CI 0.96-1.85, P = 0.086). The sub analysis for the PE group without HIV infection the risk of C allele was 1.25 (95 % CI 0.838-1.78, P = 0.199) and the risk of PE of CC to CT/TT was 1.51 (95 %CI: 0.96-2.35, P = 0.071). CONCLUSION This is the first study in a homogenous South African population of African ancestry to show that the variant of ENPEP gene does not play a role in pathogenesis of preeclampsia.
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Affiliation(s)
- M Aung
- Department of Family Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - T Konoshita
- The Third Department of Internal Medicine, University of Fukui Faculty of Medicine Sciences, Fukui, Japan
| | - J Moodley
- Department of Women's Health and HIV Research Group, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - T Naicker
- Department of Optics & Imaging, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - C Connolly
- Department of Public Health Medicine & Biostatistics, College of Health Science, University of KwaZulu-Natal, Durban. South Africa
| | - O P Khaliq
- Department of Women's Health and HIV Research Group, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
| | - P Gathiram
- Department of Family Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Mlambo ZP, Varaden D, Moodley J, Naicker T. Are concentrations of clusterin and beta-2-glycoprotein I dysregulated in HIV associated preeclampsia? Eur J Obstet Gynecol Reprod Biol 2020; 251:1-7. [PMID: 32454375 DOI: 10.1016/j.ejogrb.2020.03.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 03/13/2020] [Accepted: 03/16/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the levels of serum beta-2-glycoprotein I (β2GP1) and clusterin in the duality of Pre-eclampsia and HIV. METHOD Stored serum samples collected from 72 pregnant women were stratified according to the pregnancy type (pre-eclamptic and healthy normotensive groups) and HIV status (positive or negative). A Bio-Plex multiplex immunoassay was used to determine the concentrations of clusterin and β2GP1. RESULTS Clusterin concentrations differed significantly (p = 0.01) between the HIV positive (+) (mean = 123 800 ng/ml; 95 % CI: 105 400-142 200) vs. HIV negative (-) (mean = 92 190 ng /ml; 95 %CI: 75 840-108 500) groups and across all groups (p = 0.0006). Beta-2-glycoprotein I concentration differed significantly based on HIV status (p < 0.0001); HIV+ (mean = 393 649 ng/ml; 95 %CI: 30 300-467 000) vs HIV- (mean = 224 309 ng/ml; 95 %CI: 154 000-294 700) and across all groups (p < 0.0001). No significant difference was observed between normotensive and Pre-eclamptic groups for both clusterin and β2GPI. CONCLUSION Serum concentrations of clusterin and β2GPI were significantly increased in HIV positive pregnancies. It is postulated that both clusterin and β2GPI may have a role in HIV disease progression. These findings need to be confirmed in studies having larger sample sizes and detailed information on anti-retroviral therapy.
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Affiliation(s)
- Zinhle P Mlambo
- Optics and Imaging Centre, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa.
| | - Deneshree Varaden
- Optics and Imaging Centre, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa
| | - Jagidesa Moodley
- Womens' Health and HIV Research Group, University of KwaZulu-Natal, Durban, South Africa
| | - Thajasvarie Naicker
- Optics and Imaging Centre, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa
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Okello S, Amir A, Bloomfield GS, Kentoffio K, Lugobe HM, Reynolds Z, Magodoro IM, North CM, Okello E, Peck R, Siedner MJ. Prevention of cardiovascular disease among people living with HIV in sub-Saharan Africa. Prog Cardiovasc Dis 2020; 63:149-159. [PMID: 32035126 PMCID: PMC7237320 DOI: 10.1016/j.pcad.2020.02.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 02/03/2020] [Indexed: 02/07/2023]
Abstract
As longevity has increased for people living with HIV (PLWH) in the United States and Europe, there has been a concomitant increase in the prevalence of cardiovascular disease (CVD) risk factors and morbidity in this population. Whereas the availability of HIV antiretroviral therapy has resulted in dramatic increases in life expectancy in sub-Saharan Africa (SSA), where over two thirds of PLWH reside, if and how these trends impact the epidemiology of CVD is less clear. In this review, we describe the current state of the science on how both HIV and its treatment impact CVD risk factors and outcomes among PLWH in sub-Saharan Africa, including regional factors (unique to SSA) likely to differentiate these relationships from the global North. We then outline how current regional guidelines address CVD prevention among PLWH and which clinical and structural interventions are best poised to confront the co-epidemics of HIV and CVD in the region. We conclude with a discussion of key research gaps that need to be addressed to optimally develop an actionable public health response.
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Affiliation(s)
- Samson Okello
- Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; Lown Scholars Program, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Medicine, University of Virginia Health Systems, Charlottesville, VA, USA.
| | - Abdallah Amir
- Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; Department of Neurology, Mayo Clinic, Phoenix/Scottsdale, AZ, USA
| | - Gerald S Bloomfield
- Duke Clinical Research Institute, Durham, NC, USA; Duke Global Health Institute, Durham, NC, USA; Duke University Medical Center, Durham, NC, USA
| | - Katie Kentoffio
- Department of Cardiology, University of California San Francisco, San Francisco, CA, USA
| | - Henry M Lugobe
- Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Zahra Reynolds
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Itai M Magodoro
- Departments of Medicine & Diagnostic Radiology, McGill University Health Center, Montreal, QC, Canada; Division of Cardiology, University of Cape Town, Cape Town, South Africa
| | - Crystal M North
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | | | - Robert Peck
- The Center for Global Health, Weill Cornell Medical Center for Global Health, New York, USA; Department of Internal Medicine, Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Mark J Siedner
- Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
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Premkumar A, Dude AM, Haddad LB, Yee LM. Combined antiretroviral therapy for HIV and the risk of hypertensive disorders of pregnancy: A systematic review. Pregnancy Hypertens 2019; 17:178-190. [PMID: 31487638 PMCID: PMC6733581 DOI: 10.1016/j.preghy.2019.05.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 04/18/2019] [Accepted: 05/17/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess if there is a relationship between use of combined antiretroviral therapy among pregnant women living with HIV and hypertensive disorders of pregnancy (HDP). DESIGN Due to the heterogeneity of study designs in the literature and the utilization of different outcome measures in regards to assessing the presence of HDP, a systematic review was performed. METHODS ClinicalTrials.gov and MEDLINE, via PubMed, EMBASE, Scopus, CINAHL, ProQuest Dissertations & Theses Global, EBSCOHost, DARE, and the Cochrane Library, were queried from January 1997 to October 2017. Studies were included if they reported HDP and focused on pregnant women living with HIV who used combined antiretroviral therapy. The Cochrane Collaboration's tool for assessment of risk of bias and the U.S. Preventive Services Task Force grading scale were used to assess the studies. RESULTS Of 1055 abstracts, 28 articles met inclusion criteria. The data are marked by multiple biases and poor study design. All studies demonstrate an increased risk of HDP among pregnant women living with HIV who used combined antiretroviral therapy when compared to seropositive pregnant women not using antiretroviral therapy. Three studies suggest protease inhibitors may be associated with a higher risk of HDP. CONCLUSION Despite all studies indicating a higher frequency of HDP among pregnant women living with HIV using combined antiretroviral therapy when compared with seropositive pregnant women not using antiretroviral therapy, the quality of the studies is mixed, necessitating further research.
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Affiliation(s)
- Ashish Premkumar
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, 250 E. Superior Street, Chicago, IL 60611, USA.
| | - Annie M Dude
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, 250 E. Superior Street, Chicago, IL 60611, USA
| | - Lisa B Haddad
- Department of Gynecology and Obstetrics, Emory University School of Medicine, 49 Jesse Hill Jr Dr SE, Atlanta, GA 30303, USA
| | - Lynn M Yee
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, 250 E. Superior Street, Chicago, IL 60611, USA
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Odun-Ayo F, Moodley J, Naicker T. Urinary clusterin and glutathione-s-transferase levels in HIV positive normotensive and preeclamptic pregnancies. Hypertens Pregnancy 2018; 37:160-167. [PMID: 30024772 DOI: 10.1080/10641955.2018.1498881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To determine the level and effect of urinary clusterin (CLU) and glutathione-s-transferase (GST) proteins in normotensive and preeclamptic pregnant women with HIV infection. METHODS The urine concentration of CLU and GST in normotensive (n = 38) and preeclamptic pregnant (n = 38) women stratified by HIV status were estimated using the Bio-Plex® ProTM immunoassay. RESULTS Across the group, a significant down-regulation of CLU (p = 0.039) with a reduced trend in GST was shown in HIV positive preeclampsia. CONCLUSION HIV infection affects the activity of urinary CLU protein in HIV positive preeclampsia. However, the cytoprotective role of these proteins neutralizes the oxidative radicals associated with preeclampsia development through complement response in HIV infection.
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Affiliation(s)
- Frederick Odun-Ayo
- a Optics and Imaging Centre, Doris Duke Medical Research Institute, College of Health Sciences , University of KwaZulu-Natal , Durban , South Africa
| | - Jagidesa Moodley
- b Women's Health and HIV Research Unit, Nelson R Mandela School of Medicine , University of KwaZulu-Natal , Durban , South Africa
| | - Thajasvarie Naicker
- a Optics and Imaging Centre, Doris Duke Medical Research Institute, College of Health Sciences , University of KwaZulu-Natal , Durban , South Africa
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Association of gene polymorphisms of aldosterone synthase and angiotensin converting enzyme in pre-eclamptic South African Black women. Pregnancy Hypertens 2017. [PMID: 29523271 DOI: 10.1016/j.preghy.2017.12.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The exact cause of preeclampsia (PE) remains elusive. Recently, many researchers have focused on the role of genetic variations in pathogenesis of PE. The renin-angiotensin-aldosterone system is affected in the pathogenesis of PE. OBJECTIVES To determine association of gene polymorphisms of aldosterone synthase (CYP11B2) and angiotensin converting enzyme (ACE) in PE and normotensive South African Black women. METHODS A group of 603 South African Black pregnant women, 246 normotensive and 357 with PE, was recruited. Purified DNA was extracted from venous blood. The distribution and frequencies of gene polymorphisms of CYP11B2 (C-344T) and ACE deletion/insertion (D/I) were determined by real time polymerase chain reaction. RESULTS As the main outcome measure, the risk of C allele for PE was 1.28 (95%CI: 0.94-1.74; p = .1) for all allele comparisons. Thus no significant association with development of PE was observed for the CYP11B2 variants. However, post analysis of the distribution of TT genotypes of CYP11B2 were higher in the HIV uninfected normotensive than in the HIV uninfected PE group (OR: 0.47, 95%CI: 0.27-0.79, p = .0027). The C alleles of late-onset PE and HIV uninfected PE were higher than all normotensive and HIV uninfected normotensive (OR: 1.47, 95%CI: 1.02-2.10, p = .03 and OR: 1.77, 95%CI: 1.13-2.81, p = .0094 respectively). The CT genotype of CYP11B2 was statistically significant between normotensive and PE in HIV uninfected groups (OR: 2.24, 95%CI: 1.28-3.98, p = .0026). There was no significant difference in frequencies of D/I for ACE gene in PE.
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Aung M, Konoshita T, Moodley J, Gathiram P. Association of gene polymorphisms of four components of renin-angiotensin-aldosterone system and preeclampsia in South African black women. Eur J Obstet Gynecol Reprod Biol 2017. [DOI: 10.1016/j.ejogrb.2017.05.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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