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Ghosh S. Angiotensin-Converting Enzyme (ACE) gene polymorphism and arterial blood pressure among the Tawang Monpa of Eastern Himalayan Mountains: Is there a signature of natural selection? PLoS One 2023; 18:e0291810. [PMID: 37733712 PMCID: PMC10513219 DOI: 10.1371/journal.pone.0291810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/05/2023] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVES The present paper aims to characterize the Angiotensin-converting enzyme (ACE) genotype, with particular emphasis on its association with arterial oxygen saturation, arterial blood pressure, hemoglobin [Hb] concentration, and ventilatory measures among the Tawang Monpa, a high-altitude native population of the Eastern Himalaya, India. METHODS A cross-sectional sample of 168Monpa participants from Tawang town, Arunachal Pradesh, India, was selected who live at an altitude of ∼3,200 meters (m) above sea level. For each participant, height, weight, and skinfold thickness were measured, based on which body mass index (BMI, kg/m2) and percentage of body fat (%BF) were calculated. Physiological measures, such as the transcutaneous arterial oxygen saturation (SaO2), hemoglobin [Hb] concentration, forced vital capacity (FVC), forced expiratory volume in 1-second (FEV1), and systemic arterial blood pressure were measured. First, the peripheral venous blood samples (four ml) were drawn, and then white blood cells were separated for the ACE genotyping of each participant. RESULTS Unlike high-altitude natives from Peru and Ladakh, who exhibit high frequencies of II homozygotes, the Tawang Monpa shows a significantly high frequency of ID heterozygotes (p<0.0001). In addition, no significant association was identified between ACE gene polymorphism and arterial blood pressure, oxygen saturation at rest, vital capacity, or [Hb] concentration. DISCUSSION The results suggest that the association of the ACE gene with resting SaO2 is inconsistent across native populations living under hypobaric hypoxia. Further, ACE I/D gene polymorphism may not be under natural selection in specific native populations, including Tawang Monpa, for their adaptation to high-altitude hypoxia.
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Affiliation(s)
- Sudipta Ghosh
- Department of Anthropology, North-Eastern Hill University, Shillong, Meghalaya, India
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Castagna O, Druelle A, Michoud G, Prevautel T, Lacour JR. Individual Changes in Respiratory Compliance Upon Immersion May Predict Susceptibility to Immersion Pulmonary Edema. SPORTS MEDICINE - OPEN 2023; 9:39. [PMID: 37261587 DOI: 10.1186/s40798-023-00590-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 05/25/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Immersion pulmonary edema (IPE) is a frequent diving accident, and it is the primary cause of hospitalization for young military divers during training. The objective of this study was to identify immersion-induced parameters predicting individual susceptibility to IPE. METHODS Eighteen experienced male divers having completed at least 100 dives were recruited. Eight divers had previously been hospitalized for IPE (IPE), and the other ten had never developed IPE (non-IPE). The two groups were matched for age, BMI, and number of dives performed. Ventilatory function and overall compliance of the respiratory system (Crs) were measured on land and during head-out-of-water immersion. Subjects also performed 30 min of fin swimming in a channel at 33 m min-1. Following this exercise, the presence of extravascular lung water, revealed by ultrasound lung comets (ULC), was assessed. RESULTS In the whole group, the decrease in Crs upon immersion correlated with the immersion-induced alterations to expiratory reserve volume, ERV (r2 = 0.91; p < 0.001), inspiratory reserve volume, IRV (r2 = 0.94; p < 0.001), and tidal volume, Vt, changes (r2 = 0.43; p < 0.003). The number of ULC correlated strongly with immersion-induced changes in ventilatory function (r2 = 0.818; p < 0.001 for ERV, r2 = 0.849; p < 0.001 for IRV, r2 = 0.304; p = 0.0164 for Vt) and reduced Crs (r2 = 0.19; p < 0.001). The variations of ERV, IRV, and Crs at rest induced by head-out-of-water immersion and the number of ULC measured after swimming for 30 min were significantly greater in IPE subjects. CONCLUSION In the face of similar immersion stresses, the extent of alterations to ventilatory function and the number of ULCs were very different between individuals but remained statistically correlated. These parameters were significantly greater in divers with a history of IPE. Alterations to pulmonary function and, in particular, to pulmonary compliance induced by head-out-of-water immersion, through their effects on work of breathing appear to allow the identification of divers with a greater susceptibility to developing IPE. Measurement of these parameters could therefore be proposed as a predictive test for the risk of developing IPE.
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Affiliation(s)
- Olivier Castagna
- Underwater Research Team - ERRSO, Military Biomedical Research Institute-IRBA, Toulon, France.
- LAMHESS (UPR 6312), Université de Nice, Nice, France.
| | | | | | - Thibaut Prevautel
- Department of Cardiology, Laveran Military Hospital (HIA Laveran), Marseille, France
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Genetics of High-Altitude Pulmonary Edema. Heart Fail Clin 2023; 19:89-96. [DOI: 10.1016/j.hfc.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Eichstaedt CA, Benjamin N, Grünig E. Genetics of pulmonary hypertension and high-altitude pulmonary edema. J Appl Physiol (1985) 2020; 128:1432-1438. [PMID: 32324476 DOI: 10.1152/japplphysiol.00113.2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Heritable pulmonary arterial hypertension (PAH) is an autosomal dominantly inherited disease caused by mutations in the bone morphogenetic protein receptor 2 (BMPR2) gene and/or genes of its signaling pathway in ~85% of patients. A genetic predisposition to high-altitude pulmonary edema (HAPE) has long been suspected because of familial HAPE cases, but very few possibly disease-causing mutations have been identified to date. This minireview provides an overview of genetic analyses investigating common polymorphisms in HAPE-susceptible patients and the directed identification of disease-causing mutations in PAH patients. Increased pulmonary artery pressure is highlighted as an overlapping clinical feature of the two diseases. Moreover, studies showing increased pulmonary artery pressures in HAPE-susceptible patients during exercise or hypoxia as well as in healthy BMPR2 mutation carriers are illustrated. Finally, high-altitude pulmonary hypertension is introduced and future research perspectives outlined.
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Affiliation(s)
- Christina A Eichstaedt
- Centre for Pulmonary Hypertension, Thoraxklinik Heidelberg gGmbH at Heidelberg University Hospital, Heidelberg Germany.,Laboratory for Molecular Genetic Diagnostics, Institute of Human Genetics, Heidelberg University, Heidelberg, Germany.,Translational Lung Research Center Heidelberg (TLRC), Member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - Nicola Benjamin
- Centre for Pulmonary Hypertension, Thoraxklinik Heidelberg gGmbH at Heidelberg University Hospital, Heidelberg Germany.,Translational Lung Research Center Heidelberg (TLRC), Member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - Ekkehard Grünig
- Centre for Pulmonary Hypertension, Thoraxklinik Heidelberg gGmbH at Heidelberg University Hospital, Heidelberg Germany.,Translational Lung Research Center Heidelberg (TLRC), Member of the German Center for Lung Research (DZL), Heidelberg, Germany
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Zheng Y, Huang J. Angiotensin-converting enzyme gene insertion/deletion polymorphism and high-altitude pulmonary edema: An updated meta-analysis. J Renin Angiotensin Aldosterone Syst 2020; 21:1470320319900039. [PMID: 32106754 PMCID: PMC7052470 DOI: 10.1177/1470320319900039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: The purpose of the study was to investigate the association between
angiotensin-converting enzyme gene insertion/deletion polymorphism and
high-altitude pulmonary edema. Methods: A systematic search for relevant literature was performed in MEDLINE, CNKI,
and EMBASE. The pooled odds ratios and their corresponding 95% confidence
intervals were calculated in STATA 12.0 software. Results: Seven studies, with a total of 304 patients and 564 controls, qualified for
the inclusion in the analysis. There was no significant association between
angiotensin-converting enzyme insertion/deletion polymorphism and
high-altitude pulmonary edema risk in the total population (DD vs II: odds
ratio=1.07, 95% confidence interval 0.52–2.24; DI vs II: odds ratio=1.12,
0.85–1.49; dominant model: odds ratio=1.07, 0.83–1.40; recessive model: odds
ratio=0.96, 0.53–1.77). Subgroup analysis according to race also revealed no
significant correlation between angiotensin-converting enzyme gene
insertion/deletion polymorphism and high-altitude pulmonary edema. Conclusions: Our findings suggest that angiotensin-converting enzyme insertion/deletion
polymorphism does not contribute to the risk of high-altitude pulmonary
edema. Larger, well-designed studies are required to further validate these
results.
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Affiliation(s)
- Yan Zheng
- Department of Respiratory Medicine, The
Third People’s Hospital of Anji, China
| | - Jin Huang
- Emergency Department, The People’s
Hospital of Anji, China
- Jin Huang, Emergency Department, The
People’s Hospital of Anji, Anji, Zhejiang 313301, China.
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Sikri G, Bhattachar S. Risk of high altitude pulmonary edema and telomere length. J Gene Med 2017; 19. [PMID: 28544179 DOI: 10.1002/jgm.2953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 12/14/2016] [Accepted: 03/26/2017] [Indexed: 11/09/2022] Open
Affiliation(s)
- Gaurav Sikri
- Department of Physiology, Armed Forces Medical College, Wanowarie, Pune, Maharashtra, India
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Zhu L, Liu L, He X, Yan M, Du J, Yang H, Zhang Y, Yuan D, Jin T. Association between genetic polymorphism of telomere-associated gene ACYP2 and the risk of HAPE among the Chinese Han population: A Case-control study. Medicine (Baltimore) 2017; 96:e6504. [PMID: 28353602 PMCID: PMC5380286 DOI: 10.1097/md.0000000000006504] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
High-altitude pulmonary edema (HAPE) is a hypoxia-induced, life-threatening, pulmonary edema, which is characterized by exaggerated pulmonary hypertension caused by stress failure. ACYP2 was found to associated with telomere length, the aim of this study was to identify whether ACYP2 polymorphisms increase or decrease HAPE risk in the Chinese Han individuals.In present study, we have genotyped 7 single-nucleotide polymorphisms (SNPs) in ACYP2 to determine the haplotypes in a case-control study with 265 HAPE patients and 303 healthy individuals. Genotypes were determined using the Sequenom MassARRAY method. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by unconditional logistic regression with adjustment for gender and age. We found 3 SNPs yielded significant evidence for association with HAPE risk which had not been investigated before. Rs6713088 was found to have a 1.85- and 1.30-fold increased risk of HAPE in the recessive and additive model. The GT of rs843752 also conferred an increased risk of HAPE (GT/TT: OR = 1.51, 95% CI: 1.05-2.16, P = 0.026) and the genotype frequency distributions of rs843752 had significant difference between cases and controls. The CC genotype of rs17045754 had a protect effect on HAPE patients, and it was found to have a 0.29-fold reduced risk of HAPE in the recessive model.Although additional, larger population-based studies are needed to confirm these findings, our study shed light on the association between ACYP2 variant and HAPE risk in Han Chinese population for the first time.
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Affiliation(s)
- Linhao Zhu
- Key Laboratory of Molecular Mechanism and Intervention Research for Plateau Diseases of Tibet Autonomous Region
- Key Laboratory of High Altitude Environment and Genes Related to Diseases of Tibet Autonomous Region
- Key Laboratory for Basic Life Science Research of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang, Shaanxi
| | - Lijun Liu
- Key Laboratory of Molecular Mechanism and Intervention Research for Plateau Diseases of Tibet Autonomous Region
- Key Laboratory of High Altitude Environment and Genes Related to Diseases of Tibet Autonomous Region
- Key Laboratory for Basic Life Science Research of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang, Shaanxi
| | - Xue He
- Key Laboratory of Molecular Mechanism and Intervention Research for Plateau Diseases of Tibet Autonomous Region
- Key Laboratory of High Altitude Environment and Genes Related to Diseases of Tibet Autonomous Region
- Key Laboratory for Basic Life Science Research of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang, Shaanxi
| | - Mengdan Yan
- School of Life Sciences, Northwest University, Xi’an
| | - Jieli Du
- Inner Mongolia Medical University, Hohhot, Inner Mongolia, China
| | - Hua Yang
- School of Life Sciences, Northwest University, Xi’an
| | - Yuan Zhang
- Key Laboratory of Molecular Mechanism and Intervention Research for Plateau Diseases of Tibet Autonomous Region
- Key Laboratory of High Altitude Environment and Genes Related to Diseases of Tibet Autonomous Region
- Key Laboratory for Basic Life Science Research of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang, Shaanxi
| | - Dongya Yuan
- Key Laboratory of Molecular Mechanism and Intervention Research for Plateau Diseases of Tibet Autonomous Region
- Key Laboratory of High Altitude Environment and Genes Related to Diseases of Tibet Autonomous Region
- Key Laboratory for Basic Life Science Research of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang, Shaanxi
| | - Tianbo Jin
- Key Laboratory of Molecular Mechanism and Intervention Research for Plateau Diseases of Tibet Autonomous Region
- Key Laboratory of High Altitude Environment and Genes Related to Diseases of Tibet Autonomous Region
- Key Laboratory for Basic Life Science Research of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang, Shaanxi
- School of Life Sciences, Northwest University, Xi’an
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Li XF, Huang QY, Yang WZ, Wang HJ, Li CW. Alterations in ACE and ABCG2 expression levels in the testes of rats subjected to atropine-induced toxicity. Mol Med Rep 2016; 14:5211-5216. [PMID: 27779686 DOI: 10.3892/mmr.2016.5857] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 07/20/2016] [Indexed: 11/06/2022] Open
Abstract
Atropine-induced damage is associated with enzyme and protein alterations. The aim of the present study was to investigate atropine‑induced alterations in testicular expression levels of angiotensin‑converting enzyme (ACE) and adenosine 5'-triphosphate binding cassette sub‑family G member 2 (ABCG2) following atropine treatment. Male Wistar rats received 15 mg/kg/day atropine for 7 days; control rats received an identical volume of saline, Following treatment, the testes were harvested for immunohistochemistry and in situ hybridization to examine the protein and gene expression levels of ACE and ABCG2 by digital image analysis. ACE gene and protein expression levels were significantly reduced in the testes of atropine‑treated rats, compared with control rats (P=0.0001 and P<0.001, respectively). In addition, ABCG2 gene and protein expression levels were significantly increased in the testes of atropine‑treated rats, compared with control rats (P=0.0017 and P<0.001, respectively). Thus, the results of the present study demonstrate that testicular protein and gene expression levels of ACE and ABCG2 were altered as a result of atropine‑induced toxicity in the rats. These alterations may result in abnormal testicular function, and the proteins and genes identified in the present study may be useful to elucidate the mechanisms underlying atropine‑induced toxicity and provide a direction for further studies.
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Affiliation(s)
- Xue-Fang Li
- Library of Dali University, Dali, Yunnan 671003, P.R. China
| | - Quan-Yong Huang
- Department of Pathology, School of Basic Medical Sciences, Dali University, Dali, Yunnan 671000, P.R. China
| | - Wen-Zhong Yang
- Department of Pathology, School of Basic Medical Sciences, Dali University, Dali, Yunnan 671000, P.R. China
| | - Hui-Jie Wang
- Department of Histology and Embryology, School of Basic Medical Sciences, Dali University, Dali, Yunnan 671000, P.R. China
| | - Can-Wei Li
- Department of Epidemiology and Health Statistics, School of Public Health, Dali University, Dali, Yunnan 671000, P.R. China
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MacInnis MJ, Koehle MS. Evidence for and Against Genetic Predispositions to Acute and Chronic Altitude Illnesses. High Alt Med Biol 2016; 17:281-293. [PMID: 27500591 DOI: 10.1089/ham.2016.0024] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
MacInnis, Martin J., and Michael S. Koehle. Evidence for and against genetic predispositions to acute and chronic altitude illnesses. High Alt Med Biol. 17:281-293, 2016.-Humans exhibit marked variation in their responses to hypoxia, with susceptibility to acute and chronic altitude illnesses being a prominent and medically important example. Many have hypothesized that genetic differences are the cause of these variable responses to hypoxia; however, until recently, these hypotheses were based primarily on small (and sometimes anecdotal) reports pertaining to apparent differences in altitude illness susceptibility between populations, the notion that a history of altitude illness is indicative of subsequent risk, the heritability of hypoxia-related traits, and candidate gene association studies. In the past 5 years, the use of genomic techniques has helped bolster the claim that susceptibility to some altitude illnesses is likely the result of genetic variation. For each of the major altitude illnesses, we summarize and evaluate the evidence stemming from three important characteristics of a genetic trait: (1) individual susceptibility and repeatability across assessments, (2) biogeographical differences and familial aggregation, and (3) association(s) with genetic variants. Evidence to support a genetic basis for susceptibilities to acute mountain sickness (AMS) and high-altitude cerebral edema (HACE) is limited, owing partially to the subjective and unclear phenotype of AMS and the rarity and severity of HACE. In contrast, recent genomic studies have identified genes that influence susceptibility to high-altitude pulmonary edema, chronic mountain sickness, and high-altitude pulmonary hypertension. The collection of more individual, familial, and biogeographical susceptibility data should improve our understanding of the extent to which genetic variation contributes to altitude illness susceptibility, and genomic and molecular investigations have the potential to elucidate the mechanisms that underpin altitude illness susceptibility.
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Affiliation(s)
| | - Michael S Koehle
- 2 School of Kinesiology, University of British Columbia , Vancouver, Canada .,3 Allan McGavin Sport Medicine Clinic, Department of Family Practice, University of British Columbia , Vancouver, Canada
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Srivastava S. In Reply to Dr Sikri et al. Wilderness Environ Med 2016; 27:341. [DOI: 10.1016/j.wem.2016.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 04/04/2016] [Indexed: 10/21/2022]
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Sikri G, A B S, Thapa B. In Response to ACE I/D Polymorphism and HAPE by Bhagi et al. Wilderness Environ Med 2016; 27:340-1. [PMID: 27132026 DOI: 10.1016/j.wem.2016.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 01/07/2016] [Indexed: 11/17/2022]
Affiliation(s)
- Gaurav Sikri
- Armed Forces Medical College Pune, Maharashtra, India
| | - Srinivasa A B
- Armed Forces Medical College Pune, Maharashtra, India
| | - Bikalp Thapa
- Nepal Army Institute of Health Sciences, Kathmandu, Nepal
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Tomar A, Malhotra S, Sarkar S. Polymorphism profiling of nine high altitude relevant candidate gene loci in acclimatized sojourners and adapted natives. BMC Genet 2015; 16:112. [PMID: 26373931 PMCID: PMC4572652 DOI: 10.1186/s12863-015-0268-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 08/28/2015] [Indexed: 01/31/2023] Open
Abstract
Background Sea level sojourners, on ascent to high altitude, undergo acclimatization through integrated physiological processes for defending the body against oxygen deprivation while the high altitude natives (resident population) are adapted to the prevailing hypobaric hypoxic condition through natural selection. Separating the acclimatization processes from adaptive changes and identifying genetic markers in lowlanders that may be beneficial for offsetting the high altitude hypoxic stress, although challenging, is worth investigating. We genotyped nine candidate gene polymorphisms, suggested to be relevant in high altitude environment, in sea level acclimatized sojourners and adapted natives for understanding differences/commonality between the acclimatized and the adapted cohorts at the genetic level. Results Statistically similar genotypic and allelic frequencies were observed between the sea level sojourners (acclimatized) and the high altitude natives (adapted) in six loci viz., EDN1 (endothelin 1) -3A/-4A VNTR, ADRB2 (beta-2 adrenergic receptor, surface) Arg16Gly (rs1042713:A > G), ADRB3 (beta-3 adrenergic receptor) Trp64Arg (rs4994:T > C), eNOS (nitric oxide synthase, endothelial) Glu298Asp (rs1799983:T > G), TH (tyrosine hydroxylase) Val81Met (rs6356:G > A) and VEGF (vascular endothelial growth factor) 963C > T (rs3025039:C > T) while SCNN1B (amiloride-sensitive sodium channel, subunit beta) Thr594Met (rs1799979:C > T) was monomorphic. Genotypic and allelic frequencies in EDN1 9465G > A (rs2071942:G > A) and ADRB2 Gln27Glu (rs1042714:G > C) were significantly different between the acclimatized sojourners and the high altitude natives with higher frequency of GG and GA genotypes of EDN1 rs2071942 and CC genotype of ADRB2 rs1042714 being observed in Ladakh natives. Mutated A allele (AA genotype) of rs2071942 and carriers of G allele (GG + GC genotypes) of rs1042714 were less favorable during acclimatization under recessive and dominant genetic models of inheritance respectively indicating thereby that GG genotype and G allele of EDN1 rs2071942 and CC genotype of ADRB2 rs1042714 conferred acclimatization benefit. Conclusion Sea level acclimatized individuals shared similarity with the adapted natives in certain high altitude relevant genetically based trait variation suggesting advantageous consequence as well as commonality in gene regulatory pathways in which these gene products function both during process of acclimatization and adaptation in high altitude environment. Electronic supplementary material The online version of this article (doi:10.1186/s12863-015-0268-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Arvind Tomar
- Defence Research and Development Establishment, Ministry of Defence R&D Organization, Jhansi Road, Gwalior, 474002, India.
| | - Seema Malhotra
- Defence Institute of Physiology and Allied Sciences, Ministry of Defence R&D Organization, Lucknow Road, Delhi, 110054, India.
| | - Soma Sarkar
- Defence Institute of Physiology and Allied Sciences, Ministry of Defence R&D Organization, Lucknow Road, Delhi, 110054, India.
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