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Gurung RL, Zheng H, Koh HWL, Yiamunaa M, Liu JJ, Liu S, Chan C, Ang K, Tan CSH, Sobota RM, Subramaniam T, Sum CF, Lim SC. Plasma proteomics of diabetic kidney disease among Asians with younger-onset type 2 diabetes. J Clin Endocrinol Metab 2024:dgae266. [PMID: 38626182 DOI: 10.1210/clinem/dgae266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 02/29/2024] [Accepted: 04/15/2024] [Indexed: 04/18/2024]
Abstract
CONTEXT Patients with younger onset of type 2 diabetes (YT2D) have increased risk for kidney failure compared to those with late onset. However, the mechanism of diabetic kidney disease (DKD) progression in this high-risk group is poorly understood. OBJECTIVES To identify novel biomarkers and potential causal proteins associated with DKD progression in patients with YT2D. DESIGN AND PARTICIPANTS Among YT2D (T2D onset age ≤ 40 years), 144 DKD progressors (cases) were matched for T2D onset age, sex, and ethnicity with 292 non-progressors (controls) and divided into discovery and validation sets. DKD progression was defined as decline of estimated glomerular filtration rate (eGFR) of 3ml/min/1.73m2 or greater or 40% decline in eGFR from baseline. 1472 plasma proteins were measured through a multiplex immunoassay that uses a proximity extension assay technology. Multivariable logistic regression was used to identify proteins associated with DKD progression. Mendelian randomization (MR) was used to evaluate causal relationship between plasma proteins and DKD progression. RESULTS 42 plasma proteins were associated with DKD progression, independent of traditional cardio-renal risk factors, baseline eGFR and urine albumin-to-creatinine ratio (uACR). The proteins identified were related to inflammatory and remodelling biological processes. Our findings suggested angiogenin as one of the top signals (odds ratio =5.29, 95% CI 2.39-11.73, P = 4.03 × 10-5). Furthermore, genetically determined plasma angiogenin level was associated with increased odds of DKD progression. CONCLUSION Large-scale proteomic analysis identified novel proteomic biomarkers for DKD progression in YT2D. Genetic evidence suggest a causal role of plasma angiogenin in DKD progression.
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Affiliation(s)
- Resham Lal Gurung
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
- Cardiovascular and Metabolic Disorders Signature Research Program, Duke-NUS Medical School, Singapore
| | - Huili Zheng
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - Hiromi Wai Ling Koh
- Institute of Molecular and Cell Biology, Singapore
- Diabetes Centre, Admiralty Medical Centre, Singapore
| | - M Yiamunaa
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - Jian-Jun Liu
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - Sylvia Liu
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - Clara Chan
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - Keven Ang
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | | | - Radoslaw Mikolaj Sobota
- Institute of Molecular and Cell Biology, Singapore
- Diabetes Centre, Admiralty Medical Centre, Singapore
| | | | - Chee Fang Sum
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - Su Chi Lim
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
- Institute of Molecular and Cell Biology, Singapore
- Saw Swee Hock School of Public Heath, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Diabetes Centre, Admiralty Medical Centre, Singapore
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Qi M, Yu J, Ping F, Xu L, Li W, Zhang H, Li Y. Tumor necrosis factor-alpha mediates the negative association between telomere length and kidney dysfunction. Int J Med Sci 2023; 20:1592-1599. [PMID: 37859695 PMCID: PMC10583187 DOI: 10.7150/ijms.87254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 09/08/2023] [Indexed: 10/21/2023] Open
Abstract
Aim/hypothesis: The relationship between peripheral blood leukocyte telomere length (LTL) and kidney dysfunction, especially in people with hypertension, remains unclear. No clinical study has explored the role of inflammation and oxidative stress in the relationship between LTL and kidney dysfunction. Therefore, we examined the relationship between baseline LTL and albuminuria progression and/or rapid renal function decline in Chinese patients with or without hypertension and investigated whether inflammation and oxidative stress played a mediating role in this relationship. Methods: We conducted a prospective study including 262 patients in a 7-year follow-up period from 2014 to 2021. Data on LTL, inflammation, oxidative markers, renal function, and urine protein levels were assessed. Kidney dysfunction was defined as either albuminuria progression, rapid decline in renal function, or the composite endpoint (albuminuria progression and rapid decline in renal function). Logistic regression and simple mediation models were used for the analysis. Results: In this cohort (mean age, 54.3±9.7 years; follow-up period, 5.9±1.1 years), 42(16.0%), 21(8.0%), and 59(22.5%) patients developed albuminuria progression, rapid eGFR decline, and the composite endpoint of kidney dysfunction, respectively. Logistic regression analysis showed that each standard deviation decrease of baseline LTL and the lower quartile (Q) of baseline LTL were significantly correlated with an increased risk of rapid decline in renal function (OR=1.83 [95% CI 1.07, 3.27] per 1SD, P=0.03; OR=7.57 [95% CI 1.25, 145.88] for Q1 vs. Q4, P for trend=0.031); and the composite endpoint of kidney dysfunction (OR=1.37 [95% CI 0.97, 1.96] per 1SD, borderline positive P=0.072; OR=2.96[95% CI 1.15, 8.2] for Q1 vs. Q4, P for trend=0.036). The mediating analysis showed that tumor necrosis factor (TNF)-a partly mediated the relationship between LTL and rapid decline in renal function (direct effect: β=0.046 95%CI [0.006, 0.090],P=0.02; indirect effect: β=0.013 95%CI [0.003, 0.020]), and the mediating proportion was 22.4%.In subgroup analyses, LTL was inversely associated with rapid decline in renal function or the composite endpoint of kidney dysfunction only in patients with hypertension (OR=49.07[3.72,211.12] vs.1.32[0.69,2.58] per 1SD, P for interaction=0.045;OR=3.10 [1.48, 7.52] vs.1.08[0.92,1.63] per 1SD, P for interaction=0.036). Conclusion: Baseline LTL could independently predict kidney dysfunction at follow-up, especially in participants with hypertension. TNF-a partially mediated the negative association between LTL and kidney dysfunction.
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Affiliation(s)
| | | | | | | | | | | | - Yuxiu Li
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
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3
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Hill C, Duffy S, Kettyle LM, McGlynn L, Sandholm N, Salem RM, Thompson A, Swan EJ, Kilner J, Rossing P, Shiels PG, Lajer M, Groop PH, Maxwell AP, McKnight AJ. Differential Methylation of Telomere-Related Genes Is Associated with Kidney Disease in Individuals with Type 1 Diabetes. Genes (Basel) 2023; 14:genes14051029. [PMID: 37239390 DOI: 10.3390/genes14051029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/21/2023] [Accepted: 04/23/2023] [Indexed: 05/28/2023] Open
Abstract
Diabetic kidney disease (DKD) represents a major global health problem. Accelerated ageing is a key feature of DKD and, therefore, characteristics of accelerated ageing may provide useful biomarkers or therapeutic targets. Harnessing multi-omics, features affecting telomere biology and any associated methylome dysregulation in DKD were explored. Genotype data for nuclear genome polymorphisms in telomere-related genes were extracted from genome-wide case-control association data (n = 823 DKD/903 controls; n = 247 end-stage kidney disease (ESKD)/1479 controls). Telomere length was established using quantitative polymerase chain reaction. Quantitative methylation values for 1091 CpG sites in telomere-related genes were extracted from epigenome-wide case-control association data (n = 150 DKD/100 controls). Telomere length was significantly shorter in older age groups (p = 7.6 × 10-6). Telomere length was also significantly reduced (p = 6.6 × 10-5) in DKD versus control individuals, with significance remaining after covariate adjustment (p = 0.028). DKD and ESKD were nominally associated with telomere-related genetic variation, with Mendelian randomisation highlighting no significant association between genetically predicted telomere length and kidney disease. A total of 496 CpG sites in 212 genes reached epigenome-wide significance (p ≤ 10-8) for DKD association, and 412 CpG sites in 193 genes for ESKD. Functional prediction revealed differentially methylated genes were enriched for Wnt signalling involvement. Harnessing previously published RNA-sequencing datasets, potential targets where epigenetic dysregulation may result in altered gene expression were revealed, useful as potential diagnostic and therapeutic targets for intervention.
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Affiliation(s)
- Claire Hill
- Centre for Public Health, Queen's University of Belfast, Belfast BT12 6BA, UK
| | - Seamus Duffy
- Centre for Public Health, Queen's University of Belfast, Belfast BT12 6BA, UK
| | - Laura M Kettyle
- Centre for Cancer Research and Cell Biology, Queen's University of Belfast, Belfast BT9 7AE, UK
| | - Liane McGlynn
- College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Niina Sandholm
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, 00290 Helsinki, Finland
- Division of Nephrology, Department of Medicine, Helsinki University Central Hospital, 00290 Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, 00290 Helsinki, Finland
| | - Rany M Salem
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA 92093, USA
| | - Alex Thompson
- School of Medicine, The Biodiscovery Institute, University of Nottingham, Nottingham NG7 2RD, UK
| | - Elizabeth J Swan
- Centre for Public Health, Queen's University of Belfast, Belfast BT12 6BA, UK
| | - Jill Kilner
- Centre for Public Health, Queen's University of Belfast, Belfast BT12 6BA, UK
| | - Peter Rossing
- Nordsjaellands Hospital, Hilleroed, Denmark and Health, Aarhus University, 8000 Aarhus, Denmark
- Steno Diabetes Center, 2730 Gentofte, Denmark
- Department of Clinical Medicine, University of Copenhagen, 1165 Copenhagen, Denmark
| | - Paul G Shiels
- School of Molecular Biosciences, Davidson Building, University of Glasgow, Glasgow G12 8QQ, UK
| | - Maria Lajer
- Steno Diabetes Center, 2730 Gentofte, Denmark
| | - Per-Henrik Groop
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, 00290 Helsinki, Finland
- Division of Nephrology, Department of Medicine, Helsinki University Central Hospital, 00290 Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, 00290 Helsinki, Finland
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC 3800, Australia
| | - Alexander Peter Maxwell
- Centre for Public Health, Queen's University of Belfast, Belfast BT12 6BA, UK
- Regional Nephrology Unit, Belfast City Hospital, Belfast BT9 7AB, UK
| | - Amy Jayne McKnight
- Centre for Public Health, Queen's University of Belfast, Belfast BT12 6BA, UK
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Hill C, Duffy S, Coulter T, Maxwell AP, McKnight AJ. Harnessing Genomic Analysis to Explore the Role of Telomeres in the Pathogenesis and Progression of Diabetic Kidney Disease. Genes (Basel) 2023; 14:609. [PMID: 36980881 PMCID: PMC10048490 DOI: 10.3390/genes14030609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 03/06/2023] Open
Abstract
The prevalence of diabetes is increasing globally, and this trend is predicted to continue for future decades. Research is needed to uncover new ways to manage diabetes and its co-morbidities. A significant secondary complication of diabetes is kidney disease, which can ultimately result in the need for renal replacement therapy, via dialysis or transplantation. Diabetic kidney disease presents a substantial burden to patients, their families and global healthcare services. This review highlights studies that have harnessed genomic, epigenomic and functional prediction tools to uncover novel genes and pathways associated with DKD that are useful for the identification of therapeutic targets or novel biomarkers for risk stratification. Telomere length regulation is a specific pathway gaining attention recently because of its association with DKD. Researchers are employing both observational and genetics-based studies to identify telomere-related genes associated with kidney function decline in diabetes. Studies have also uncovered novel functions for telomere-related genes beyond the immediate regulation of telomere length, such as transcriptional regulation and inflammation. This review summarises studies that have revealed the potential to harness therapeutics that modulate telomere length, or the associated epigenetic modifications, for the treatment of DKD, to potentially slow renal function decline and reduce the global burden of this disease.
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Affiliation(s)
- Claire Hill
- Centre for Public Health, Queen’s University of Belfast, Belfast BT12 6BA, UK
| | - Seamus Duffy
- Centre for Public Health, Queen’s University of Belfast, Belfast BT12 6BA, UK
| | - Tiernan Coulter
- Centre for Public Health, Queen’s University of Belfast, Belfast BT12 6BA, UK
| | - Alexander Peter Maxwell
- Centre for Public Health, Queen’s University of Belfast, Belfast BT12 6BA, UK
- Regional Nephrology Unit, Belfast City Hospital, Belfast BT9 7AB, UK
| | - Amy Jayne McKnight
- Centre for Public Health, Queen’s University of Belfast, Belfast BT12 6BA, UK
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5
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Telomere Attrition in Chronic Kidney Diseases. Antioxidants (Basel) 2023; 12:antiox12030579. [PMID: 36978826 PMCID: PMC10045531 DOI: 10.3390/antiox12030579] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 03/02/2023] Open
Abstract
Telomeres are dynamic DNA nucleoprotein structures located at the end of chromosomes where they maintain genomic stability. Due to the end replication problem, telomeres shorten with each cell division. Critically short telomeres trigger cellular senescence, which contributes to various degenerative and age-related diseases, including chronic kidney diseases (CKDs). Additionally, other factors such as oxidative stress may also contribute to accelerated telomere shortening. Indeed, telomeres are highly susceptible to oxidative damage due to their high guanine content. Here, we provide a comprehensive review of studies examining telomere length (TL) in CKDs to highlight the association between TL and the development and progression of CKDs in humans. We then focus on studies investigating TL in patients receiving kidney replacement therapy. The mechanisms of the relationship between TL and CKD are not fully understood, but a shorter TL has been associated with decreased kidney function and the progression of nephropathy. Interestingly, telomere lengthening has been observed in some patients in longitudinal studies. Hemodialysis has been shown to accelerate telomere erosion, whereas the uremic milieu is not reversed even in kidney transplantation patients. Overall, this review aims to provide insights into the biological significance of telomere attrition in the pathophysiology of kidney disease, which may contribute to the development of new strategies for the management of patients with CKDs.
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Iio K, Kabata D, Iio R, Shibamoto S, Watanabe Y, Morita M, Imai Y, Hatanaka M, Omori H, Isaka Y. Decreased thymic output predicts progression of chronic kidney disease. Immun Ageing 2023; 20:8. [PMID: 36788556 PMCID: PMC9926722 DOI: 10.1186/s12979-023-00333-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/06/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Chronic kidney disease (CKD) is age-related disease, and decreased renal function is associated with the premature aging of T cells and increased incidence of other age-related diseases. However, the relationship between T cell senescence and CKD progression remains unclear. Here, we investigated the relationship between T cell senescence, as indicated by decreased thymic output and increased proportion of highly differentiated CD28- T cells, and CKD progression. RESULTS A total of 175 patients with non-dialysis-dependent CKD were enrolled in this study. Thymic output was assessed based on the CD45RA+CD31+CD4+ cell (recent thymic emigrant [RTE]) counts (RTEs) (/mm3) and the proportion of RTE among CD4+ T cells (RTE%). Highly differentiated T cells were assessed based on the proportion of CD28- cells among CD4+ T cells (CD28-/CD4+) and CD28- cells among CD8+ T cells (CD28-/CD8+). The primary outcome was estimated glomerular filtration rate (eGFR) decline of ≥40% or initiation of renal replacement therapy. The association between T cell senescence and renal outcomes was examined using Cox proportional hazards models and restricted cubic splines. The median age was 73 years, 33% were women, and the median eGFR was 26 mL/min/1.73 m2. The median RTEs, RTE%, CD28-/CD4+, and CD28-/CD8+ were 97.5/mm3, 16.2, 5.3, and 49.7%, respectively. After a median follow-up of 1.78 years, renal outcomes were observed in 71 patients. After adjusting for age, sex, eGFR, proteinuria, diabetes, and cytomegalovirus seropositivity, decreased RTEs, which corresponded to decreased thymic output, significantly and monotonically increased the risk of poor renal outcome (p = 0.04), and decreased RTE% and increased highly differentiated CD28-/CD4+ T cells also tended to monotonically increase the risk (p = 0.074 and p = 0.056, respectively), but not CD28-/CD8+ T cells. CONCLUSIONS Decreased thymic output in CKD patients, as well as increased highly differentiated CD4+ T cells, predicted renal outcomes. Thus, the identification of patients prone to CKD progression using T cell senescence, particularly decreased RTE as a biomarker, may help to prevent progression to end-stage kidney disease.
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Affiliation(s)
- Kenichiro Iio
- Department of Nephrology, National Hospital Organization Osaka Minami Medical Center, 2-1 Kidohigashimachi Kawachinagano, Osaka, Japan.
| | - Daijiro Kabata
- grid.258799.80000 0004 0372 2033Department of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Rei Iio
- grid.416985.70000 0004 0378 3952Department of Kidney Disease and Hypertension, Osaka General Medical Center, Osaka, Japan
| | - Shinichi Shibamoto
- grid.471868.40000 0004 0595 994XDepartment of Nephrology, National Hospital Organization Osaka Minami Medical Center, 2-1 Kidohigashimachi Kawachinagano, Osaka, Japan
| | - Yuuki Watanabe
- grid.471868.40000 0004 0595 994XDepartment of Nephrology, National Hospital Organization Osaka Minami Medical Center, 2-1 Kidohigashimachi Kawachinagano, Osaka, Japan
| | - Masashi Morita
- grid.471868.40000 0004 0595 994XDepartment of Nephrology, National Hospital Organization Osaka Minami Medical Center, 2-1 Kidohigashimachi Kawachinagano, Osaka, Japan
| | - Yosuke Imai
- grid.471868.40000 0004 0595 994XDepartment of Nephrology, National Hospital Organization Osaka Minami Medical Center, 2-1 Kidohigashimachi Kawachinagano, Osaka, Japan
| | - Masaki Hatanaka
- grid.471868.40000 0004 0595 994XDepartment of Nephrology, National Hospital Organization Osaka Minami Medical Center, 2-1 Kidohigashimachi Kawachinagano, Osaka, Japan
| | - Hiroki Omori
- grid.471868.40000 0004 0595 994XDepartment of Nephrology, National Hospital Organization Osaka Minami Medical Center, 2-1 Kidohigashimachi Kawachinagano, Osaka, Japan
| | - Yoshitaka Isaka
- grid.136593.b0000 0004 0373 3971Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Japan
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Hu J, Song J, Chen Z, Yang J, Shi Q, Jin F, Pang Q, Chang X, Tian Y, Luo Y, Chen L. Reverse causal relationship between periodontitis and shortened telomere length: Bidirectional two-sample Mendelian random analysis. Front Immunol 2022; 13:1057602. [PMID: 36601105 PMCID: PMC9806346 DOI: 10.3389/fimmu.2022.1057602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
Background Observational studies have demonstrated a link between shortened telomere lengths(TL) and chronic periodontitis. However, whether the shortened TL is the cause or the result of periodontitis is unknown.Therefore, our objective was to investigate a bidirectional causal relationship between periodontitis and TL using a two-sample Mendel randomized (MR) study. Methods A two-sample bidirectional MR analysis using publicly available genome-wide association study (GWAS) data was used. As the primary analysis, inverse variance weighting (IVW) was employed. To identify pleiotropy, we used leave-one-out analysis, MR-Egger, Weighted median, Simple mode, Weighted mode, and MR pleiotropy residual sum and outlier (MR-PRESSO). Results In reverse MR results, a genetic prediction of short TL was causally associated with a higher risk of periodontitis (IVW: odds ratio [OR]: 1.0601, 95% confidence interval [CI]: 1.0213 to 1.1002; P =0.0021) and other complementary MR methods. In the forward MR analysis, periodontitis was shown to have no significant effect on TL (IVW: p = 0.7242), with consistent results for the remaining complementary MR. No pleiotropy was detected in sensitivity analysis (all P>0.05). Conclusion Our MR studies showed a reverse causal relationship, with shorten TL being linked to a higher risk of periodontitis, rather than periodontitis shorten that TL. Future research is needed to investigate the relationship between cell senescence and the disease.
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Affiliation(s)
- Jiaxin Hu
- Guiyang Hospital of Stomatology, Stomatology Hospital of Guizhou University, Guiyang, Guizhou, China,School of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China
| | - Jukun Song
- The Affiliated Stomatological Hospital & Stomatology of Guizhou Medical University, Guizhou Medical University, Guiyang, China
| | - Zhu Chen
- Guiyang Hospital of Stomatology, Stomatology Hospital of Guizhou University, Guiyang, Guizhou, China
| | - Jing Yang
- Guiyang Hospital of Stomatology, Stomatology Hospital of Guizhou University, Guiyang, Guizhou, China
| | - Qianhui Shi
- Guiyang Hospital of Stomatology, Stomatology Hospital of Guizhou University, Guiyang, Guizhou, China
| | - Fuqian Jin
- Guiyang Hospital of Stomatology, Stomatology Hospital of Guizhou University, Guiyang, Guizhou, China,School of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China
| | - Qiyuan Pang
- Guiyang Hospital of Stomatology, Stomatology Hospital of Guizhou University, Guiyang, Guizhou, China
| | - Xingtao Chang
- School of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China
| | - Yuan Tian
- Guizhou Provincial People's Hospital, Guiyang, Guizhou, China
| | - Yi Luo
- Guiyang Hospital of Stomatology, Stomatology Hospital of Guizhou University, Guiyang, Guizhou, China,School of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China,*Correspondence: Yi Luo, ; Liming Chen,
| | - Liming Chen
- Guiyang Hospital of Stomatology, Stomatology Hospital of Guizhou University, Guiyang, Guizhou, China,School of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China,*Correspondence: Yi Luo, ; Liming Chen,
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8
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Jenkins AJ, Syreeni A, Mutter S, Januszewski AS, Groop PH. Telomeres in clinical diabetes research - Moving towards precision medicine in diabetes care? Diabetes Res Clin Pract 2022; 194:110178. [PMID: 36427630 DOI: 10.1016/j.diabres.2022.110178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 11/16/2022] [Indexed: 11/25/2022]
Abstract
The early prediction of health outcomes for people with diabetes mellitus is desirable, as are adjunct therapies to reduce the related chronic complications and risk of premature death. The length of telomeres, protective caps on chromosome ends, is influenced by genetic and acquired factors, and shorter telomeres have been associated with and predictive of adverse cardiometabolic outcomes. Many studies have shown associations between telomere length in white blood cells (WBC) and diabetes per se and its chronic complications, and some studies show that telomeres do not always progressively shorten in people with diabetes. With the pandemic of diabetes and taking into consideration the calculations of residual risk using existent risk equations, additional tests to stratify subject risk are desirable. In this evolving era of precision medicine for people with diabetes, this 'global biomarker' of WBC telomere length may be useful to help predict health outcomes, to monitor health status, and may be a therapeutic target. We comment on the field of telomere investigations in diabetes, including recommending areas for further clinical research.
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Affiliation(s)
- Alicia J Jenkins
- NHMRC Clinical Trials Centre, The University of Sydney, 92-94 Parramatta Rd, Camperdown, Sydney 2050, Australia; The University of Melbourne, The Department of Medicine, St. Vincents, 29 Princes St, Fitzroy, Melbourne 3065, Australia; Department of Endocrinology and Diabetes, St. Vincents Health, 41 Victoria Pde, Fitzroy, Melbourne 3065, Australia
| | - Anna Syreeni
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Department of Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Finland
| | - Stefan Mutter
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Department of Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Finland
| | - Andrzej S Januszewski
- NHMRC Clinical Trials Centre, The University of Sydney, 92-94 Parramatta Rd, Camperdown, Sydney 2050, Australia; The University of Melbourne, The Department of Medicine, St. Vincents, 29 Princes St, Fitzroy, Melbourne 3065, Australia; Department of Endocrinology and Diabetes, St. Vincents Health, 41 Victoria Pde, Fitzroy, Melbourne 3065, Australia
| | - Per-Henrik Groop
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Department of Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Finland; Department of Diabetes, Central Clinical School, Monash University, Melbourne, Australia.
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Kocyigit I, Taheri S, Uysal C, Memis M, Ozayturk SG, Zararsiz G, Rassoulzadegan M. Predicting Progression of Autosomal Dominant Polycystic Kidney Disease by Changes in the Telomeric Epigenome. Cells 2022; 11:cells11203300. [PMID: 36291168 PMCID: PMC9600909 DOI: 10.3390/cells11203300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/15/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022] Open
Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited cause of chronic kidney disease with Polycystin (PKD) 1 and 2 gene mutation. However, the intra-familial variability in symptoms further suggests a non-Mendelian contribution to the disease. Our goal was to find a marker to track the epigenetic changes common to rapidly progressing forms of the disease. The risk of ADPKD increases with age, and aging shortens the telomere length (TL). Telomeres are a nucleoprotein structure composed mainly of three complexes, shelterin, CST and RNA-containing telomere repeat(TERRA), which protects the ends of chromosomes from degradation and fusion, and plays a role in maintaining cellular stability and in the repair of telomeric damage. TERRAs are transcribed from telomeric regions and a part of them is engaged in a DNA/RNA hybrid (R-loop) at each chromosome end. We tracked TL and TERRA levels in blood samples of 78 patients and 20 healthy control. Our study demonstrates that TL was shortened and TERRA expression levels in the DNA-attached fraction increased in autosomal dominant polycystic kidney patients with mutations in PKD1 and PKD2 compared to the control group. Moreover, it was observed that the expression of TERRA engaged in the R-loop was higher and the length of telomeres shorter in patients with ADPKD who showed rapid disease progression. Intrafamilial variation in TL and TERRA levels with the same mutation would indicate reliable epigenetic potential biomarkers in disease monitoring.
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Affiliation(s)
- Ismail Kocyigit
- Department of Nephrology, Medical School, Erciyes University, 38280 Kayseri, Turkey
- Correspondence:
| | - Serpil Taheri
- Betul Ziya Eren Genome and Stem Cell Center, Erciyes University, 38280 Kayseri, Turkey
- Department of Medical Biology, Medical School, Erciyes University, 38280 Kayseri, Turkey
| | - Cihan Uysal
- Department of Nephrology, Medical School, Erciyes University, 38280 Kayseri, Turkey
| | - Mehmet Memis
- Betul Ziya Eren Genome and Stem Cell Center, Erciyes University, 38280 Kayseri, Turkey
| | - Salih Guntug Ozayturk
- Department of Internal Medicine, Medical School, Erciyes University, 38280 Kayseri, Turkey
| | - Gokmen Zararsiz
- Department of Biostatistics, Medical School, Erciyes University, 38280 Kayseri, Turkey
| | - Minoo Rassoulzadegan
- Betul Ziya Eren Genome and Stem Cell Center, Erciyes University, 38280 Kayseri, Turkey
- INSERM-CNRS, Université de Nice, 06107 Nice, France
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Ye M, Wang Y, Zhan Y. Genetic association of leukocyte telomere length with Graves’ disease in Biobank Japan: A two-sample Mendelian randomization study. Front Immunol 2022; 13:998102. [PMID: 36248806 PMCID: PMC9559571 DOI: 10.3389/fimmu.2022.998102] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 09/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background Telomere length (TL) has been recognized to be fundamental to the risk of autoimmune disorders. However, the role of leukocyte TL in Graves’ disease has not yet been fully elucidated. In the study, we exploited the two-sample Mendelian randomization (MR) design to evaluate the causal effect of leukocyte TL on the risk of Graves’ disease. Methods Genome-wide association study (GWAS) data of leukocyte TL from the Singapore Chinese Health Study (SCHS) cohort and Graves’ disease from Biobank Japan (BBJ, 2176 cases and 210,277 controls) were analyzed. Nine single nucleotide polymorphisms (SNPs) were selected as instrumental variables (IVs) for TL. We used the inverse variance weighted (IVW) approach as the main estimator and MR-Egger regression, weighted median, simple mode, and weighed mode methods as complementary estimators. Horizontal pleiotropy was assessed using the intercept from MR-Egger. Results The analysis demonstrated that genetically predicted longer leukocyte TL was causally associated with a lower risk of Graves’ disease using the IVW method (odds ratio [OR]: 1.64, 95% confidence interval [CI]: 1.23-2.17, P=2.27e-04, and other complementary MR approaches achieved similar results. The intercept from the MR-Egger analysis provided no noticeable evidence of horizontal pleiotropy (β=0.02, P=0.641). MR-PRESSO method reported no outliers (P=0.266). Conclusions Our results provided evidence to support a genetic predisposition to shorter leukocyte TL with an increased risk of Graves’ disease. Further studies are warranted to explore the mechanism underlying the association.
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Hill C, Avila-Palencia I, Maxwell AP, Hunter RF, McKnight AJ. Harnessing the Full Potential of Multi-Omic Analyses to Advance the Study and Treatment of Chronic Kidney Disease. FRONTIERS IN NEPHROLOGY 2022; 2:923068. [PMID: 37674991 PMCID: PMC10479694 DOI: 10.3389/fneph.2022.923068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 05/30/2022] [Indexed: 09/08/2023]
Abstract
Chronic kidney disease (CKD) was the 12th leading cause of death globally in 2017 with the prevalence of CKD estimated at ~9%. Early detection and intervention for CKD may improve patient outcomes, but standard testing approaches even in developed countries do not facilitate identification of patients at high risk of developing CKD, nor those progressing to end-stage kidney disease (ESKD). Recent advances in CKD research are moving towards a more personalised approach for CKD. Heritability for CKD ranges from 30% to 75%, yet identified genetic risk factors account for only a small proportion of the inherited contribution to CKD. More in depth analysis of genomic sequencing data in large cohorts is revealing new genetic risk factors for common diagnoses of CKD and providing novel diagnoses for rare forms of CKD. Multi-omic approaches are now being harnessed to improve our understanding of CKD and explain some of the so-called 'missing heritability'. The most common omic analyses employed for CKD are genomics, epigenomics, transcriptomics, metabolomics, proteomics and phenomics. While each of these omics have been reviewed individually, considering integrated multi-omic analysis offers considerable scope to improve our understanding and treatment of CKD. This narrative review summarises current understanding of multi-omic research alongside recent experimental and analytical approaches, discusses current challenges and future perspectives, and offers new insights for CKD.
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Affiliation(s)
| | | | | | | | - Amy Jayne McKnight
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
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Zhang W, Li Y, Li Y, Zheng K, Zou S, Jia X, Yang H. Genetically predicted higher educational attainment decreases the risk of stroke: a multivariable Mendelian randomization study. BMC Cardiovasc Disord 2022; 22:269. [PMID: 35710362 PMCID: PMC9205080 DOI: 10.1186/s12872-022-02713-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 06/06/2022] [Indexed: 11/10/2022] Open
Abstract
Background The causal association between educational attainment (EA) and stroke remains unclear. Hence, a novel multivariable Mendelian randomization (MVMR) approach was applied to solve this issue. Methods The single nucleotide polymorphisms (SNPs) from a recent genome-wide association study (GWAS) on years of schooling served as instruments. Univariable mendelian randomization (MR) and MVMR analyses were performed to detect the relationship between genetically predicted EA and the stroke risk. In the MVMR, cigarette consumption, alcohol consumption, body mass index (BMI), intelligence, and hypertension were adjusted. The summary statistics for stroke from the MEGASTROKE consortium included 446,696 participants (40,585 cases of stroke and 34,217 cases of ischemic stroke), most of whom were of European descent. Results In the univariable MR, genetically predicated EA could decrease the risks of total stroke (OR = 0.66, 95% CI 0.61–0.72, P = 2.70 × 10–23), ischemic stroke (OR = 0.67, 95% CI 0.61–0.73, P = 2.58 × 10–18), large artery atherosclerosis (OR = 0.51, 95% CI 0.40–0.64, P = 1.80 × 10–8), small vessel stroke (OR = 0.60, 95% CI 0.49–0.73, P = 5.59 × 10–7), and cardioembolic stroke (OR = 0.81, 95% CI 0.68–0.96, P = 1.46 × 10–2) using the inverse-variance weighted (IVW) estimator. Higher EA might be negatively correlated with the odds of total stroke (OR = 0.62, 95% CI 0.50–0.77, P = 1.44 × 10–5), ischemic stroke (OR = 0.63, 95% CI 0.50–0.80, P = 1.41 × 10–4), and cardioembolic stroke (OR = 0.59, 95% CI 0.39–0.90, P = 0.01), but was not significant in large artery atherosclerosis (OR = 0.65, 95% CI 0.37–1.15, P = 0.14) and small vessel stroke (OR = 0.68, 95% CI 0.41–1.13, P = 0.14) after controlling other exposures. Conclusions We found that genetically predicated higher EA decreased the risks of total stroke, ischemic stroke, and cardioembolic stroke, independent of smoking, alcohol consumption, BMI, intelligence, and hypertension.
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Affiliation(s)
- Weihao Zhang
- Department of Neurosurgery, The Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guizhou, 610041, China
| | - Yuanjin Li
- Department of Plastic Surgery, The Third People's Hospital of Guizhou Province, Guizhou, 610041, China
| | - Yuming Li
- Department of Neurosurgery, The Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guizhou, 610041, China
| | - Kai Zheng
- Department of Neurosurgery, The Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guizhou, 610041, China
| | - Shenghui Zou
- Department of Neurosurgery, The Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guizhou, 610041, China
| | - Xing Jia
- Department of Neurosurgery, People's Hospital of Jiajiang County, Leshan, 614000, Sichuan, China
| | - Hua Yang
- Department of Neurosurgery, The Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guizhou, 610041, China.
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Xiong Y, Zhong X, Zhang F, Wang W, Zhang Y, Wu C, Qin F, Yuan J. Genetic Evidence Supporting a Causal Role of Snoring in Erectile Dysfunction. Front Endocrinol (Lausanne) 2022; 13:896369. [PMID: 35692403 PMCID: PMC9174907 DOI: 10.3389/fendo.2022.896369] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/22/2022] [Indexed: 12/17/2022] Open
Abstract
Background The association between snoring and erectile dysfunction (ED) is inconsistent in multiple observational studies. To clarify the causal association of snoring on ED, we performed this two-sample Mendelian randomization study. Materials and Methods The single nucleotide polymorphisms (SNPs) associated with snoring were retrieved from the UK biobank cohort with 314,449 participants (117,812 cases and 196,637 controls). The summary statistics of ED were obtained from the European ancestry with 223,805 subjects (6,175 cases and 217,630 controls). Single-variable Mendelian randomization (MR) and multivariable MR were used to assess the causal relationship between snoring and ED. Results Snoring increases the risk of ED (Odds ratio [OR] = 3.45, 95% confidence interval [CI] = 1.68 - 7.09, P < 0.001) in the inverse variance weighting estimator. In sensitivity analyses, the ORs for the weighted median, MR robust adjusted profile score, and MR Pleiotropy Residual Sum and Outlier approach, MR-Egger, and maximum likelihood method are 5.70 (95% CI = 1.19 - 27.21, P < 0.05), 3.14 (95% CI = 1.01 - 9.72, P < 0.05), 3.11 (95% CI = 1.63 - 5.91, P < 0.01), 1.23 (95% CI = 0.01 - 679.73, P > 0.05), and 3.59 (95% CI = 1.07 - 12.00, P < 0.05), respectively. No heterogeneity and pleiotropy are observed (P for MR-Egger intercept = 0.748; P for global test = 0.997; P for Cochran's Q statistics > 0.05). After adjusting for total cholesterol, triglyceride, low-density lipoprotein, and cigarette consumption, the ORs for ED are 5.75 (95% CI = 1.80 - 18.34, P < 0.01), 4.16 (95% CI = 1.10 - 15.81, P < 0.05), 5.50 (95% CI = 1.62 - 18.69, P < 0.01), and 2.74 (95% CI = 1.06 - 7.10, P < 0.05), respectively. Conclusion This study provides genetic evidence supporting the causal role of snoring in ED.
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Affiliation(s)
- Yang Xiong
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Xin Zhong
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Fuxun Zhang
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Wang
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yangchang Zhang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Changjing Wu
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China
| | - Feng Qin
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China
| | - Jiuhong Yuan
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
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