1
|
Fitz FF, Bortolini MAT, Pereira GMV, Salerno GRF, Castro RA. PEOPLE: Lifestyle and comorbidities as risk factors for pelvic organ prolapse-a systematic review and meta-analysis PEOPLE: PElvic Organ Prolapse Lifestyle comorbiditiEs. Int Urogynecol J 2023; 34:2007-2032. [PMID: 37256322 DOI: 10.1007/s00192-023-05569-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/02/2023] [Indexed: 06/01/2023]
Abstract
INTRODUCTION AND HYPOTHESIS The literature is scarce regarding the effects of comorbidities, clinical parameters, and lifestyle as risk factors for pelvic organ prolapse (POP). This study was performed to systematically review the literature related to body mass index (BMI), waist circumference, diabetes mellitus (DM), hypertension (HT), dyslipidemia, chronic constipation, smoking, chronic cough, occupation, and striae and varicose veins as determinants for POP. METHODS Search terms in accordance with Medical Subject Headings were used in PubMed, Embase, LILACS, and the Cochrane Library. Clinical comparative studies between women with and without POP and containing demographic and/or clinical raw data related to lifestyle and/or comorbidities were included. The ROBINS-I (risk of bias in non-randomized studies of interventions) instrument was used. Fixed-effects and random-effects models were used for homogeneous and heterogeneous studies, respectively. RESULTS Forty-three studies were included in the meta-analysis. BMI < 25 kg/m2 was found to be a protective factor for POP [OR 0.71 (0.51, 0.99); p = 0.04], and BMI > 30 kg/m2 was a risk factor for POP [OR 1.44 (1.37, 1.52); p < 0.00001]. Waist circumference (≥ 88 cm) was reported as a risk factor for POP [OR 1.80 (1.37, 2.38); p < 0.00001], along with HT [OR 1.18 (1.09, 1.27); p = 0.04], constipation [OR 1.77 (1.23, 2.54); p < 0.00001], occupation [OR 1.86 (1.21, 2.86); p < 0.00001], persistent cough [OR 1.52 (1.18, 1.94); p < 0.0001]), and varicose veins [OR 2.01 (1.50, 2.70); p = 0.12]. CONCLUSIONS BMI < 25 kg/m2 is protective while BMI > 30 kg/m2 is a risk factor for POP. Large waist circumference, dyslipidemia, HT, constipation, occupation, persistent cough, and varicose veins are also determinants for POP.
Collapse
Affiliation(s)
- Fátima Faní Fitz
- Department of Gynecology, Universidade Federal de São Paulo, Rua Napoleão de Barros, 608 - Vila Clementino, São Paulo, SP, CEP 04024-002, Brazil.
| | - Maria Augusta Tezelli Bortolini
- Department of Gynecology, Universidade Federal de São Paulo, Rua Napoleão de Barros, 608 - Vila Clementino, São Paulo, SP, CEP 04024-002, Brazil
| | - Gláucia Miranda Varella Pereira
- Department of Obstetrics and Gynecology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Gisela Rosa Franco Salerno
- Department of Gynecology, Universidade Federal de São Paulo, Rua Napoleão de Barros, 608 - Vila Clementino, São Paulo, SP, CEP 04024-002, Brazil
| | - Rodrigo Aquino Castro
- Department of Gynecology, Universidade Federal de São Paulo, Rua Napoleão de Barros, 608 - Vila Clementino, São Paulo, SP, CEP 04024-002, Brazil
| |
Collapse
|
2
|
Kasyan G, Vishnevskiy D, Akulenko L, Grigoryan B, Pivazyan L, Pushkar D. Collagen type 3A1 and 1A1 polymorphisms in women with pelvic organ prolapse and urinary incontinence assessed with Sanger sequencing method. Cent European J Urol 2022; 74:566-570. [PMID: 35083078 PMCID: PMC8771129 DOI: 10.5173/ceju.2021.0200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/01/2021] [Accepted: 11/06/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction This case-control trial investigates the prevalence of COL3A1 and COL1A1 gene polymorphisms in female patients suffering pelvic organ prolapse (POP) and stress urinary incontinence (SUI) in comparison with controls. Material and methods Inclusion criteria were having one or more risk factors for SUI and POP. Exclusion criteria were hereditary connective tissue diseases as well as surgeries for POP/SUI for the control group. The rs1800255 polymorphism in COL3A1 gene was considered as a local substitution of guanine (G) for adenine (A). The rs1800012 polymorphism in COL1A1 gene was considered as a local substitution of guanine (G) for thymine (T). Genotyping was performed by Sanger sequencing method, followed by estimation of sensitivity and specificity for POP and SUI. Results Fifty-two patients with POP and SUI (mean age 64.4 years) and 21 women were included in the control group (mean age 63.2 years). Homozygous genotype (AA) in COL3A1 was found in 10% of patients suffering from POP or SUI. No women in the control group had this genotype. The single nucleotide polymorphism (SNP) had high specificity (1.0) for POP/SUI, but low sensitivity (0.1). Heterozygous genotype (AG) in COL3A1 had a sensitivity equal to 0.47 and specificity of 0.62. Homozygous genotype (TT) in COL1A1 was found in only 2% of patients with POP/SUI, but was not found in controls. Heterozygous genotype (TG) in COL1A1 has sensitivity equal to 0.25 and specificity of 0.74. Conclusions POP/SUI patients have specific SNPs in COL1A1 and COL3A1 sequenced by Sanger method.
Collapse
Affiliation(s)
- George Kasyan
- Urology Department of Moscow State University of Medicine and Dentistry, Moscow named after Evdokimov, Moscow, Russian Federation
| | - Dmitry Vishnevskiy
- Urology Department of Moscow State University of Medicine and Dentistry, Moscow named after Evdokimov, Moscow, Russian Federation
| | - Larisa Akulenko
- Genetics Department of Moscow State University of Medicine and Dentistry, Moscow named after Evdokimov, Moscow, Russian Federation
| | - Bagrat Grigoryan
- First Moscow State Medical University by I.M. Sechenov (Sechenov University), Moscow, Russian Federation
| | - Laura Pivazyan
- First Moscow State Medical University by I.M. Sechenov (Sechenov University), Moscow, Russian Federation
| | - Dmitry Pushkar
- Urology Department of Moscow State University of Medicine and Dentistry, Moscow named after Evdokimov, Moscow, Russian Federation
| |
Collapse
|
3
|
Deng ZM, Dai FF, Yuan MQ, Yang DY, Zheng YJ, Cheng YX. Advances in molecular mechanisms of pelvic organ prolapse (Review). Exp Ther Med 2021; 22:1009. [PMID: 34345291 PMCID: PMC8311251 DOI: 10.3892/etm.2021.10442] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/18/2021] [Indexed: 12/31/2022] Open
Abstract
Pelvic organ prolapse (POP) is a common gynecological benign disease occurring in middle-aged and elderly females. Its incidence increases every year. To date, the majority of studies investigating its etiology have not evaluated the underlying molecular mechanisms, which has caused substantial difficulties in the prevention, treatment and prognosis of POP. In the present narrative review, recent research studies concerning the molecular mechanisms of POP were systematically reviewed and the advances were summarized. The association between the incidence of POP and the reduction of the extracellular matrix, activation of oxidative stress, genetic susceptibility, denervation of the pelvic floor and reduction of estrogen infiltration were explored. POP is mainly associated with damage of pelvic floor muscles and connective tissue, which are directly caused by pregnancy and vaginal delivery. The majority of the molecular and genetic mutations associated with POP involve specific components of connective tissue synthesis and degradation. It is likely that macroscopic parameters, such as anatomy, lifestyle and reproductive factors, interact with microscopic parameters, such as physiology and genetics in the female pelvic floor, leading to POP. Additional research studies investigating the molecular mechanisms of POP should be performed, since they may aid public health strategies. In the present narrative review, a summary of these molecular mechanisms underlying the development of POP is provided. This included the relevant proteins and genes involved. On this basis, countermeasures were proposed.
Collapse
Affiliation(s)
- Zhi-Min Deng
- Department of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Fang-Fang Dai
- Department of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Meng-Qin Yuan
- Department of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Dong-Yong Yang
- Department of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Ya-Jing Zheng
- Department of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Yan-Xiang Cheng
- Department of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| |
Collapse
|
4
|
Niu K, Chen X, Lu Y. COL3A1 rs1800255 polymorphism is associated with pelvic organ prolapse susceptibility in Caucasian individuals: Evidence from a meta-analysis. PLoS One 2021; 16:e0250943. [PMID: 33930075 PMCID: PMC8087080 DOI: 10.1371/journal.pone.0250943] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 04/17/2021] [Indexed: 01/03/2023] Open
Abstract
Background The collagen 3 alpha 1 (COL3A1) rs1800255 polymorphism has been reported to be associated with women pelvic organ prolapse (POP) susceptibility, but the results of these previous studies have been contradictory. The objective of current study is to explore whether COL3A1 rs1800255 polymorphism confers risk to POP. Methods Relevant literatures were searched by searching databases including Pubmed, Embase, Google academic, the Cochrane library, China National Knowledge Infrastructure (CNKI). Search time is from database foundation to March 2021. Results A total of seven literatures were enrolled in the present meta-analysis, including 1642 participants. Overall, no significant association was found by any genetic models. In subgroup analysis based on ethnicity, significant associations were demonstrated in Caucasians by allele contrast (A vs. G: OR = 1.34, 95%CI = 1.03–1.74,), homozygote comparison (AA vs. GG: OR = 3.25, 95%CI = 1.39–7.59), and recessive genetic model (AA vs. GG/GA: OR = 3.22, 95%CI = 1.40–7.42). Conclusions The present meta-analysis suggests that the COL3A1 is a candidate gene for POP susceptibility. Caucasian individuals with A allele and AA genotype have a higher risk of POP. The COL3A1 rs1800255 polymorphism may be risk factor for POP in Caucasian population.
Collapse
Affiliation(s)
- Ke Niu
- Department of Obstetrics and Gynecology, Seventh Medical Center, Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Xu Chen
- Center of Clinical Laboratory, First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China
| | - Yongxian Lu
- Department of Obstetrics and Gynecology, Seventh Medical Center, Chinese PLA General Hospital, Beijing, People’s Republic of China
- * E-mail:
| |
Collapse
|
5
|
Allen-Brady K, Chua JWF, Cuffolo R, Koch M, Sorrentino F, Cartwright R. Systematic review and meta-analysis of genetic association studies of pelvic organ prolapse. Int Urogynecol J 2021; 33:67-82. [PMID: 33893823 PMCID: PMC8739292 DOI: 10.1007/s00192-021-04782-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/24/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Family and twin studies demonstrate that pelvic organ prolapse (POP) is heritable, but the genetic etiology is poorly understood. This review aimed to identify genetic loci and specific polymorphisms associated with POP, while assessing the strength, consistency, and risk of bias among reported associations. METHODS Updating an earlier systematic review, PubMed and HuGE Navigator as well as relevant conference abstracts were searched using genetic and phenotype keywords from 2015 to 2020. Screening and data extraction were performed in duplicate. Fixed and random effects meta-analyses were conducted using co-dominant models of inheritance. We assessed credibility of pooled associations using interim Venice criteria. RESULTS We screened 504 new abstracts and included 46 published and 7 unpublished studies. In pooled analyses we found significant associations for four polymorphisms: rs2228480 at the ESR1 gene (OR 0.67 95% CI 0.46-0.98, I2 = 0.0%, Venice rating BAB), rs12589592 at the FBLN5 gene (OR 1.46 95% CI 1.11-1.82, I2 = 36.3%, Venice rating BBB), rs484389 in the PGR gene (OR 0.61 95% CI 0.39-0.96, I2 = 32.4%, Venice rating CBB), and rs1800012 at the COL1A1 gene (OR 0.80 95% CI 0.66-0.96, I2 = 0.0%, Venice rating BAB). Further credible novel variants have also been recently identified in genome-wide association studies. CONCLUSION The genetic contributions to POP remain poorly understood. Several biologically plausible variants have been identified, but much work is required to establish the role of these genes in the pathogenesis of POP or to establish a role for genetic testing in clinical practice.
Collapse
Affiliation(s)
- Kristina Allen-Brady
- Department of Internal Medicine, Genetic Epidemiology, University of Utah, Salt Lake City, UT, USA
| | - John W F Chua
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Romana Cuffolo
- Department of Obstetrics & Gynaecology, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Marianne Koch
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Felice Sorrentino
- Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, Foggia, Italy
| | - Rufus Cartwright
- Department of Epidemiology & Biostatistics, Imperial College London, Norfolk Place, London, UK. .,Department of Urogynaecology, LNWH NHS Trust, London, UK.
| |
Collapse
|
6
|
Li L, Sun Z, Chen J, Zhang Y, Shi H, Zhu L. Genetic polymorphisms in collagen-related genes are associated with pelvic organ prolapse. Menopause 2020; 27:223-229. [PMID: 31663982 PMCID: PMC7012360 DOI: 10.1097/gme.0000000000001448] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 08/14/2019] [Accepted: 08/14/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Pelvic organ prolapse (POP) is a common health issue that has a profound negative influence on women's quality of life. Genetic susceptibility to POP has been increasingly investigated. In this study, we assessed the single-nucleotide polymorphisms (SNPs) of six collagen-related genes (COL14A1, COL5A1, COL4A2, COL3A1, COL1A1, and COL18A1) and the genetic association with POP in Chinese women. METHODS We performed a candidate gene association study of case women (n = 48) with stage III and IV prolapse and control women (n = 48) without prolapse. A target region sequencing approach was used to identify the SNPs in collagen-related genes. The association between SNPs and POP was examined by Fisher exact tests for unadjusted model and logistic regression analysis adjusted for delivery and pregnancy. RESULTS There was a significant association between COL14A1 SNPs (rs4870723, rs2305600, and rs2305598; P = 0.013, 0.019, and 0.028, respectively), a COL5A1 SNP (rs3827852; P = 0.016), and COL4A2 SNPs (rs76425569, rs388222, and rs2281968; P = 0.049 for the three, and rs445348, P = 0.040) and POP, respectively. Although there was no significant association between the COL3A1 SNP and POP, there was a trend toward significance for COL14A1 SNP (rs2305603), COL4A2 SNP (rs74941798), two COL1A1 SNPs (rs2586488 and rs2249492) and three COL18A1 SNPs (rs1050351, rs56335679, and rs55690336), and POP. CONCLUSION We are the first to evaluate the relationship between COL14A1, COL5A1, and COL4A2 polymorphisms and POP, besides COL3A1, COL1A1, and COL18A1, which have been reported previously. We found several candidate SNPs that were significantly associated with prolapse in Chinese women. Our results provide new evidence for further investigation of the involvement of these potential genes in the etiology of POP.
Collapse
Affiliation(s)
- Lei Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | | | | | | | | | | |
Collapse
|
7
|
Abulaizi A, Abula A, Ababaikeli G, Wan X, Du R, Zhakeer A. Identification of pelvic organ prolapse risk susceptibility gene SNP locus in Xinjiang women. Int Urogynecol J 2019; 31:123-130. [PMID: 31270553 DOI: 10.1007/s00192-019-04039-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 06/19/2019] [Indexed: 02/03/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Susceptibility genes play an important role and have regional specificity in the occurrence of pelvic organ prolapse (POP). This study aims to identify POP susceptibility genes and their loci in ethnic minorities with different genetic backgrounds from Xinjiang in China, providing a theoretical basis for early POP diagnosis, treatment and prevention. METHODS Genomic DNA from peripheral blood of 196 patients was prepared; there were 88 POP patients and 108 non-pelvic floor dysfunction patients. We selected 16 different susceptibility gene single-nucleotide polymorphism (SNP) loci, which had been identified as associated with POP risk by researchers in other countries, and carried out genotyping through the Snapshot reaction. The allele and genotype frequencies, odds ratio (OR) and 95% confidence interval (CI) were analyzed using SPSS 17.0 software. RESULTS The genotypic and allelic distributions demonstrated significant differences between the patients and the control subjects in the group of minority women, details are as follows: ESR1 rs17847075 AG: OR = 2.738, 95% CI = 1.067-7.025, P = 0.041; ESR1 rs2234693 TC: OR = 2.99, 95% CI = 1.163-7.684, P = 0.024; ZFAT rs1036819 CC: OR = 10.286, 95% CI = 1.158-91.386, P = 0.036; allele C: OR = 2.212, 95% CI = 1.146-4.269; P = 0.02; FBLN5 rs12589592 AA: OR = 0.111, 95% CI = 0.013-0.952, P = 0.029; allele A: OR = 0.482, 95% CI = 0.254-0.913, P = 0.028. CONCLUSIONS ESR1 rs17847075 genotype AG in the dominant model (P = 0.008) or heterozygous model (P = 0.045), ESR1 rs2234693 genotype TC in the dominant model (P = 0.008) or heterozygous model (P = 0.028), and ZFAT rs1036819 genotype CC and allele C in the recessive model (P = 0.042) were significantly associated with POP risk in Xinjiang woman.
Collapse
Affiliation(s)
- Aibibuhan Abulaizi
- Department of Gynecology and Reproductive Maternity Assistance Centre, The First Affiliated Hospital of Xinjiang Medical University, Urumchi, China
| | | | - Gulina Ababaikeli
- Department of Gynecology and Reproductive Maternity Assistance Centre, The First Affiliated Hospital of Xinjiang Medical University, Urumchi, China.
| | - Xiaohui Wan
- Department of Gynecology and Reproductive Maternity Assistance Centre, The First Affiliated Hospital of Xinjiang Medical University, Urumchi, China
| | - Rong Du
- Department of Gynecology and Reproductive Maternity Assistance Centre, The First Affiliated Hospital of Xinjiang Medical University, Urumchi, China
| | - Adilai Zhakeer
- Department of Gynecology and Reproductive Maternity Assistance Centre, The First Affiliated Hospital of Xinjiang Medical University, Urumchi, China
| |
Collapse
|
8
|
Polymorphism rs1800255 from COL3A1 gene and the risk for pelvic organ prolapse. Int Urogynecol J 2019; 31:73-78. [PMID: 31041498 DOI: 10.1007/s00192-019-03965-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 04/18/2019] [Indexed: 12/17/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Genetic variations of type III collagen may compromise the supportive structures of the female pelvic floor and consequently favor pelvic organ prolapse. The single nucleotide polymorphism G/A rs1800255 located in the coding region for type III collagen (COL3A1) was evaluated as a risk factor for pelvic organ prolapse. METHODS A single-center prospective cohort study including women with clinical diagnosis of stage III and IV prolapse (POP group) and prolapse stage 0 or I (control group). Sociodemographic, clinical data and obstetric history were retrieved by physician interview. DNA including the rs1800255 polymorphism was amplified by polymerase chain reaction from blood genomic cells and digested with AluI restriction enzyme for distinction of G and A variants. Qualitative variables were compared using the chi-square and Fisher's exact tests and unpaired t-test for quantitative variables. After stratification of the groups, risk factors for POP were estimated using odds ratios (ORs) from the binary logistic regression model. RESULTS A total of 292 women were included, 112 in the POP group and 180 in the control group. There was no significant difference between groups regarding rs1800255. Age and home birth were the only significant risk factors for pelvic organ prolapse. CONCLUSION Polymorphism rs1800255 from COL3A1 gene was not a risk factor for pelvic organ prolapse.
Collapse
|
9
|
Zhou Q, Hong L, Wang J. Identification of key genes and pathways in pelvic organ prolapse based on gene expression profiling by bioinformatics analysis. Arch Gynecol Obstet 2018; 297:1323-1332. [PMID: 29546564 DOI: 10.1007/s00404-018-4745-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 03/04/2018] [Indexed: 01/01/2023]
Abstract
PURPOSE The aim of this study was to elucidate the molecular mechanisms and to identify the key genes and pathways for pelvic organ prolapse (POP) using bioinformatics analysis. METHODS The microarray data for GSE53868 included 12 POP and 12 non-POP anterior vaginal wall samples. Differentially expressed genes (DEGs) were identified by GEO2R online tool. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed using the DAVID database, and a DEG-associated protein-protein interaction (PPI) network was constructed using STRING and visualized in Cytoscape. MCODE was used for module analysis of the PPI network. RESULTS A total of 257 upregulated and 333 downregulated genes were identified. GO and KEGG pathway enrichment analyses showed that the upregulated DEGs were strongly associated with immune response, complement activation, classical pathway, phagocytosis, and recognition; the downregulated genes were mainly associated with cellular response to zinc ion, negative regulation of growth, and apoptotic process. Based on the PPI network, IL6, MYC, CCL2, ICAM1, PTGS2, SERPINE1, ATF3, CDKN1A, and CDKN2A were screened as hub genes. The four most significant sub-modules of DEGs were extracted after network module analysis. These genes were mainly associated with the negative regulation of growth and inflammatory response. The KEGG pathway enrichment analysis revealed that these genes were associated with Mineral absorption, Jak-STAT signaling pathway, cytokine-cytokine receptor interaction, and chemokine signaling pathway. CONCLUSIONS These microarray data and bioinformatics analyses provide a useful method for the identification of key genes and pathways associated with POP. Moreover, some crucial DEGs, such as IL6, MYC, CCL2, ICAM1, PTGS2, SERPINE1, ATF3, CDKN1A, and CDKN2A, potentially play an important role in the development and progression of POP.
Collapse
Affiliation(s)
- Quan Zhou
- Department of Gynecology and Obstetrics, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuhan, 430060, Hubei, People's Republic of China
| | - Li Hong
- Department of Gynecology and Obstetrics, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuhan, 430060, Hubei, People's Republic of China.
| | - Jing Wang
- Department of Gynecology and Obstetrics, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuhan, 430060, Hubei, People's Republic of China
| |
Collapse
|
10
|
Stępień-Słodkowska M, Ficek K, Maciejewska-Karłowska A, Sawczuk M, Ziętek P, Król P, Zmijewski P, Pokrywka A, Cięszczyk P. Overrepresentation of the COL3A1 AA genotype in Polish skiers with anterior cruciate ligament injury. Biol Sport 2015; 32:143-7. [PMID: 26060338 PMCID: PMC4447760 DOI: 10.5604/20831862.1144416] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Revised: 11/15/2014] [Accepted: 11/25/2014] [Indexed: 11/13/2022] Open
Abstract
Although various intrinsic and extrinsic risk factors for anterior cruciate ligament (ACL) rupture have been identified, the exact aetiology of the injury is not yet fully understood. Type III collagen is an important factor in the repair of connective tissue, and certain gene polymorphisms may impair the tensile strength. The aim of this study was to examine the association of the COL3A1 rs1800255 polymorphism with ACL rupture in Polish male recreational skiers. A total of 321 male Polish recreational skiers were recruited for this study; 138 had surgically diagnosed primary ACL ruptures (ACL-injured group) and 183 were apparently healthy male skiers (control group – CON) who had no self-reported history of ligament or tendon injury. Both groups had a comparable level of exposure to ACL injury. Genomic DNA was extracted from the oral epithelial cells. All samples were genotyped on a real-time polymerase chain reaction instrument. The genotype distribution in the ACL-injured group was significantly different than in CON (respectively: AA=10.1 vs 2.2%, AG=22.5 vs 36.1, GG=67.4 vs 61.8%; p=0.0087). The AA vs AG+GG genotype of COL3A1 (odds ratio (OR)=5.05; 95% confidence interval (CI), 1.62-15.71, p=0.003) was significantly overrepresented in the ACL-injured group compared with CON. The frequency of the A allele was higher in the ACL-injured group (21.4%) compared with CON (20.2%), but the difference was not statistically significant (p=0.72). This study revealed an association between the COL3A1 rs1800255 polymorphism and ACL ruptures in Polish skiers.
Collapse
Affiliation(s)
- M Stępień-Słodkowska
- University of Szczecin, Faculty of Physical Education and Health Promotion, Szczecin, Poland
| | - K Ficek
- University of Szczecin, Faculty of Physical Education and Health Promotion, Szczecin, Poland
| | - A Maciejewska-Karłowska
- University of Szczecin, Faculty of Physical Education and Health Promotion, Szczecin, Poland
| | - M Sawczuk
- University of Szczecin, Faculty of Physical Education and Health Promotion, Szczecin, Poland
| | - P Ziętek
- Medical University at Szczecin, Department of Orthopaedics and Traumatology of Pomeranian Medical, Szczecin, Poland
| | - P Król
- University of Rzeszow, Department of Physical Culture, Rzeszow, Poland
| | | | - A Pokrywka
- National Medicines Institute, Warsaw, Poland
| | - P Cięszczyk
- University of Szczecin, Faculty of Physical Education and Health Promotion, Szczecin, Poland ; Academy of Physical Education and Sport, Department of Sport Education, Gdansk, Poland
| |
Collapse
|
11
|
Rao S, Lang J, Zhu L, Chen J. Exome sequencing identifies a novel gene, WNK1, for susceptibility to pelvic organ prolapse (POP). PLoS One 2015; 10:e0119482. [PMID: 25739019 PMCID: PMC4349638 DOI: 10.1371/journal.pone.0119482] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 01/16/2015] [Indexed: 12/13/2022] Open
Abstract
Pelvic organ prolapse (POP) is a common gynecological disorder; however, the genetic components remain largely unidentified. Exome sequencing has been widely used to identify pathogenic gene mutations of several diseases because of its high chromosomal coverage and accuracy. In this study, we performed whole exome sequencing (WES), for the first time, on 8 peripheral blood DNA samples from representative POP cases. After filtering the sequencing data from the dbSNP database (build 138) and the 1000 Genomes Project, 2 missense variants in WNK1, c.2668G > A (p.G890R) and c.6761C> T (p.P2254L), were identified and further validated via Sanger sequencing. In validation stage, the c.2668G > A (p.G890R) variant and 8 additional variants were detected in 11 out of 161 POP patients. All these variants were absent in 231 healthy controls. Functional experiments showed that fibroblasts from the utero-sacral ligaments of POP with WNK1 mutations exhibited loose and irregular alignment compared with fibroblasts from healthy controls. In sum, our study identified a novel gene, WNK1, for POP susceptibility, expanded the causal mutation spectrums of POP, and provided evidence for the genetic diagnosis and medical management of POP in the future.
Collapse
Affiliation(s)
- Shuquan Rao
- National Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Tsinghua University, Beijing, 100005, PR China
| | - Jinghe Lang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100005, PR China
| | - Lan Zhu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100005, PR China
| | - Juan Chen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100005, PR China
- * E-mail:
| |
Collapse
|
12
|
Cartwright R, Kirby AC, Tikkinen KAO, Mangera A, Thiagamoorthy G, Rajan P, Pesonen J, Ambrose C, Gonzalez-Maffe J, Bennett P, Palmer T, Walley A, Järvelin MR, Chapple C, Khullar V. Systematic review and metaanalysis of genetic association studies of urinary symptoms and prolapse in women. Am J Obstet Gynecol 2015; 212:199.e1-24. [PMID: 25111588 PMCID: PMC4342521 DOI: 10.1016/j.ajog.2014.08.005] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 06/01/2014] [Accepted: 08/06/2014] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Family studies and twin studies demonstrate that lower urinary tract symptoms and pelvic organ prolapse are heritable. This review aimed to identify genetic polymorphisms tested for an association with lower urinary tract symptoms or prolapse, and to assess the strength, consistency, and risk of bias among reported associations. STUDY DESIGN PubMed and HuGE Navigator were searched up to May 1, 2014, using a combination of genetic and phenotype key words, including "nocturia," "incontinence," "overactive bladder," "prolapse," and "enuresis." Major genetics, urology, and gynecology conference abstracts were searched from 2005 through 2013. We screened 889 abstracts, and retrieved 78 full texts. In all, 27 published and 7 unpublished studies provided data on polymorphisms in or near 32 different genes. Fixed and random effects metaanalyses were conducted using codominant models of inheritance. We assessed the credibility of pooled associations using the interim Venice criteria. RESULTS In pooled analysis, the rs4994 polymorphism of the ADRB3 gene was associated with overactive bladder (odds ratio [OR], 2.5; 95% confidence interval [CI], 1.7-3.6; n = 419). The rs1800012 polymorphism of the COL1A1 gene was associated with prolapse (OR, 1.3; 95% CI, 1.0-1.7; n = 838) and stress urinary incontinence (OR, 2.1; 95% CI, 1.4-3.2; n = 190). Other metaanalyses, including those for polymorphisms of COL3A1,LAMC1,MMP1,MMP3, and MMP9 did not show significant effects. Many studies were at high risk of bias from genotyping error or population stratification. CONCLUSION These metaanalyses provide moderate epidemiological credibility for associations of variation in ADRB3 with overactive bladder, and variation of COL1A1 with prolapse. Clinical testing for any of these polymorphisms cannot be recommended based on current evidence.
Collapse
Affiliation(s)
- Rufus Cartwright
- Department of Epidemiology and Biostatistics, Imperial College London, London, England, United Kingdom; Department of Urogynecology, Imperial College London, London, England, United Kingdom.
| | - Anna C Kirby
- Department of Reproductive Medicine, University of California, San Diego, School of Medicine, and Department of Obstetrics and Gynecology, Kaiser Permanente, San Diego, CA
| | - Kari A O Tikkinen
- Departments of Urology and Public Health, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Altaf Mangera
- Department of Urology Research, University of Sheffield, Sheffield, England, United Kingdom
| | - Gans Thiagamoorthy
- Department of Urogynecology, King's College London, London, England, United Kingdom
| | - Prabhakar Rajan
- Beatson Institute for Cancer Research, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Jori Pesonen
- Department of Urology, University of Tampere, Tampere, Finland
| | - Chris Ambrose
- University College London Medical School, London, England, United Kingdom
| | - Juan Gonzalez-Maffe
- Clinical Trials Unit, Imperial College London, London, England, United Kingdom
| | - Phillip Bennett
- Institute for Reproductive and Developmental Biology, Imperial College London, London, England, United Kingdom
| | - Tom Palmer
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, England, United Kingdom
| | - Andrew Walley
- Department of Genomics of Common Disease and Molecular Genetics and Genomics, Imperial College London, London, England, United Kingdom
| | - Marjo-Riitta Järvelin
- Department of Epidemiology and Biostatistics, Imperial College London, London, England, United Kingdom; Institute of Health Sciences and Biocenter Oulu, University of Oulu, Finland
| | - Chris Chapple
- Department of Urology Research, University of Sheffield, Sheffield, England, United Kingdom
| | - Vik Khullar
- Department of Urogynecology, Imperial College London, London, England, United Kingdom
| |
Collapse
|
13
|
Ward RM, Velez Edwards DR, Edwards T, Giri A, Jerome RN, Wu JM. Genetic epidemiology of pelvic organ prolapse: a systematic review. Am J Obstet Gynecol 2014; 211:326-35. [PMID: 24721264 DOI: 10.1016/j.ajog.2014.04.006] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 03/14/2014] [Accepted: 04/06/2014] [Indexed: 12/14/2022]
Abstract
Given current evidence supporting a genetic predisposition for pelvic organ prolapse, we conducted a systematic review of published literature on the genetic epidemiology of pelvic organ prolapse. Inclusion criteria were linkage studies, candidate gene association and genome-wide association studies in adult women published in English and indexed in PubMed through Dec. 2012, with no limit on date of publication. Methodology adhered to the PRISMA guidelines. Data were systematically extracted by 2 reviewers and graded by the Venice criteria for studies of genetic associations. A metaanalysis was performed on all single nucleotide polymorphisms evaluated by 2 or more studies with similar methodology. The metaanalysis suggests that collagen type 3 alpha 1 (COL3A1) rs1800255 genotype AA is associated with pelvic organ prolapse (odds ratio, 4.79; 95% confidence interval, 1.91-11.98; P = .001) compared with the reference genotype GG in populations of Asian and Dutch women. There was little evidence of heterogeneity for rs1800255 (P value for heterogeneity = .94; proportion of variance because of heterogeneity, I(2) = 0.00%). There was insufficient evidence to determine whether other single nucleotide polymorphisms evaluated by 2 or more papers were associated with pelvic organ prolapse. An association with pelvic organ prolapse was seen in individual studies for estrogen receptor alpha (ER-α) rs2228480 GA, COL3A1 exon 31, chromosome 9q21 (heterogeneity logarithm of the odds score 3.41) as well as 6 single nucleotide polymorphisms identified by a genome-wide association study. Overall, individual studies were of small sample size and often of poor quality. Future studies would benefit from more rigorous study design as outlined in the Venice recommendations.
Collapse
Affiliation(s)
- Renée M Ward
- Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Digna R Velez Edwards
- Department of Obstetrics and Gynecology, Center for Human Genetics Research, Vanderbilt University Medical Center, Nashville, TN; Institute of Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN
| | - Todd Edwards
- Department of Medicine, Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN; Institute of Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN
| | - Ayush Giri
- Institute of Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN
| | - Rebecca N Jerome
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN
| | - Jennifer M Wu
- Department of Obstetrics and Gynecology, Division of Urogynecology, University of North Carolina, Chapel Hill, NC
| |
Collapse
|
14
|
Collagen type III alpha 1 polymorphism (rs1800255, COL3A1 2209 G>A) assessed with high-resolution melting analysis is not associated with pelvic organ prolapse in the Dutch population. Int Urogynecol J 2014; 25:1237-42. [PMID: 24760181 DOI: 10.1007/s00192-014-2385-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 03/22/2014] [Indexed: 12/29/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The rs1800255, COL3A1 2209 G>A polymorphism in the alpha 1 chain of collagen type III has been associated with an increased risk of pelvic organ prolapse (POP). In one of our previous studies however, polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP) misdiagnosed rs1800255, COL3A1 2209 G>A in 6 % of cases. The high-resolution melting (HRM) analysis on the contrary obtained a 100 % accordance for this specific polymorphism and was used in the present study to validate this risk factor for POP. METHODS In this case-control study, women with and without symptoms of POP were included and compared. DNA was extracted from blood samples. HRM analysis was used to assess for the presence of the homozygous rs1800255. Groups were compared using the Pearson chi-square, Mann-Whitney, and t tests. The discrepancy between HRM and PCR-RFLP results was investigated using PCR-RFLP results available from our previous study. RESULTS The study included 354 women: 272 patients with POP and 82 controls; 18 (7 %) cases versus 3 (4 %) controls had a homozygous rs1800255, COL3A1 2209 G>A polymorphism (odds ratio 1.9, 95 % confidence interval 0.5-6.9, compared to the wild type), and thus no association between POP and the homozygous polymorphism could be demonstrated. A discrepancy between HRM and PCR-RFLP results was found in 8 % of the samples. CONCLUSIONS The previously found statistically significant association between the rs1800255, COL3A1 2209 G>A polymorphism as measured with PCR-RFLP and POP could no longer be demonstrated. This raises concerns regarding the results of other association studies using PCR-RFLP.
Collapse
|
15
|
Lim VF, Khoo JK, Wong V, Moore KH. Recent studies of genetic dysfunction in pelvic organ prolapse: the role of collagen defects. Aust N Z J Obstet Gynaecol 2014; 54:198-205. [PMID: 24575973 DOI: 10.1111/ajo.12169] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 11/16/2013] [Indexed: 12/13/2022]
Abstract
Gynaecologists are becoming increasingly aware that women with a family history of prolapse are at an increased risk of prolapse refractory to treatment. In the past five years, several genetic mutations have been shown to correlate with increased prolapse susceptibility. These mutations can result in disordered collagen metabolism, which weaken the fascial support of the pelvic organs. This review examines the contemporary evidence regarding the role of collagen in prolapse.
Collapse
Affiliation(s)
- Veronica F Lim
- Pelvic Floor Unit, St George Hospital/University of New South Wales, Sydney, NSW, Australia
| | | | | | | |
Collapse
|
16
|
Lince SL, van Kempen LC, Vierhout ME, Kluivers KB. A systematic review of clinical studies on hereditary factors in pelvic organ prolapse. Int Urogynecol J 2012; 23:1327-36. [PMID: 22422218 PMCID: PMC3448053 DOI: 10.1007/s00192-012-1704-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Accepted: 02/09/2012] [Indexed: 02/03/2023]
Abstract
INTRODUCTION AND HYPOTHESIS There is growing evidence that pelvic organ prolapse (POP) is at least partly caused by underlying hereditary risk factors. The aim of our study was to provide a systematic literature review and meta-analysis of clinical studies on family history of POP as a risk factor for POP in individual women. METHODS The databases PubMed and Embase were searched. Clinical studies reporting on family history of POP in relation to POP in individual women were included. RESULTS Sixteen studies were included, of which eight enabled us to calculate a pooled odds ratio (OR). The pooled OR of POP in case of a positive family history of POP was 2.58 (95 % confidence interval 2.12-3.15). CONCLUSIONS Women with POP are substantially more likely to have family members with the same condition compared to women without POP. This strengthens the hypothesis that genetic predisposition plays an important role in the development of POP.
Collapse
Affiliation(s)
- Sabrina L Lince
- Department of Obstetrics and Gynecology 791, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
| | | | | | | |
Collapse
|
17
|
Bortolini MAT, Rizk DEE. Genetics of pelvic organ prolapse: crossing the bridge between bench and bedside in urogynecologic research. Int Urogynecol J 2011; 22:1211-9. [PMID: 21789659 DOI: 10.1007/s00192-011-1502-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Accepted: 07/11/2011] [Indexed: 12/22/2022]
Abstract
An increasing number of scientists have studied the molecular and biochemical basis of pelvic organ prolapse (POP). The extracellular matrix content of the pelvic floor is the major focus of those investigations and pointed for potential molecular markers of the dysfunction. The identification of women predisposed to develop POP would help in the patients' management and care. This article includes a critical analysis of the literature up to now; discusses implications for future research and the role of the genetics in POP.
Collapse
Affiliation(s)
- Maria Augusta Tezelli Bortolini
- Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Gynecology, Federal University of São Paulo, Borges Lagoa, 783 Cj. 31, 04038-031, São Paulo, SP, Brazil.
| | | |
Collapse
|
18
|
Martins KDF, Bella ZIKDJD, da Fonseca AMRM, Castro RA, Guerreiro da Silva IDC, Castello Girão MJB, Ferreira Sartori MG. Evaluation of demographic, clinical characteristics, and genetic polymorphism as risk factors for pelvic organ prolapse in brazilian women. Neurourol Urodyn 2011; 30:1325-8. [DOI: 10.1002/nau.21066] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2010] [Accepted: 12/16/2010] [Indexed: 11/09/2022]
|
19
|
Abstract
PURPOSE OF REVIEW To review the available evidence regarding those risk factors potentially predicting a recurrence of pelvic organ prolapse (POP). RECENT FINDINGS POP is a very common condition in parous women, requiring very often a surgical treatment which may need to be repeated in up to 29% of cases. In the past few years, researchers have focused their attention on the evaluation of risk factors involved in either POP development or recurrence. Recent papers have reported the importance of genetic factors that could be responsible for an inherited weakness of the pelvic floor, predisposing to POP occurrence and/or recurrence. Moreover, a history of genital prolapse at the time of an elective hysterectomy, as well as an inappropriate reconstructive surgical procedure, can predict and be associated with POP development. SUMMARY POP recurrence can be associated with a combination of predisposing, inciting, and intervening factors. Based on actual knowledge, it is not possible to weight or score the importance of each single risk factor reported in literature for the development of POP recurrence. Larger series (collected with validated diagnostic and therapeutic tools) and longer follow-up are, therefore, needed to draw definitive conclusions on this issue.
Collapse
|
20
|
Lince SL, Kluivers KB, Dijkstra JR, Janssen MJ, Vierhout ME, van Kempen LC. Reliable Identification of the Type III Collagen Gene Polymorphism rs1800255 with the Use of High Resolution Melting Analysis. Lab Med 2009. [DOI: 10.1309/lmua5cs39fulvwem] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|