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Kontovazainitis CG, Gialamprinou D, Theodoridis T, Mitsiakos G. Hemostasis in Pre-Eclamptic Women and Their Offspring: Current Knowledge and Hemostasis Assessment with Viscoelastic Tests. Diagnostics (Basel) 2024; 14:347. [PMID: 38337863 PMCID: PMC10855316 DOI: 10.3390/diagnostics14030347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/22/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
Pre-eclampsia (PE) is a placenta-mediated disease and remains a major cause of maternal and neonatal mortality and morbidity. As PE develops, normal pregnancy's hypercoagulable balance is disrupted, leading to platelet hyperactivation, excessive pathological hypercoagulability, and perturbed fibrinolysis. This narrative review aims to summarize the current knowledge regarding hemostasis in PE compared with healthy gestation and the potential effects of maternal PE on neonatal hemostasis. Finally, it aims to discuss hemostasis assessments for normal pregnancies and PE, emphasizing the role of viscoelastic tests, namely, thromboelastography (TEG) and thromboelastometry (ROTEM), for monitoring PE-associated hemostatic alterations. The use of TEG/ROTEM for assessing the hemostatic profile of PE women has been little considered, even though conventional coagulation tests (CCTs) have not helped to monitor hemostasis in this population. Compared with normal pregnancy, TEG/ROTEM in PE reveals an excessive hypercoagulability analogous with the severity of the disease, characterized by higher-stability fibrin clots. The TEG/ROTEM parameters can reflect PE severity and may be used for monitoring and as predictive markers for the disease.
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Affiliation(s)
- Christos-Georgios Kontovazainitis
- 2nd Neonatal Department and Neonatal Intensive Care Unit (NICU), “Papageorgiou” University Hospital, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece; (C.-G.K.); (D.G.)
| | - Dimitra Gialamprinou
- 2nd Neonatal Department and Neonatal Intensive Care Unit (NICU), “Papageorgiou” University Hospital, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece; (C.-G.K.); (D.G.)
| | - Theodoros Theodoridis
- 1st Department of Obstetrics and Gynecology, “Papageorgiou” University Hospital, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece;
| | - Georgios Mitsiakos
- 2nd Neonatal Department and Neonatal Intensive Care Unit (NICU), “Papageorgiou” University Hospital, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece; (C.-G.K.); (D.G.)
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Svyatova G, Mirzakhmetova D, Berezina G, Murtazaliyeva A. Candidate genes related to acute cerebral circulatory disorders in Preeclampsia in the Kazakh Population. J Stroke Cerebrovasc Dis 2023; 32:107392. [PMID: 37776726 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/02/2023] Open
Abstract
BACKGROUND The purpose of this study is to conduct a comparative analysis of the population frequencies of alleles and genotypes of polymorphic variants of coagulation and fibrinolysis genes SERPINE1 rs1799889, ITGA2 rs1126643, THBD rs1042580, FII rs1799963, FV rs6025, FVII rs6046, angiogenesis and endothelial dysfunction PGF rs12411, FLT1 rs4769612, KDR rs2071559, ACE rs4340, GWAS associated with the development of acute cerebral circulatory disorders in preeclampsia, in an ethnically homogeneous population of Kazakhs with previously studied populations of the world. METHODS The genomic database was analysed based on the results of genotyping of 1800 conditionally healthy individuals of Kazakh nationality ∼2.5 million SNPs using OmniChip 2.5 M Illumina chips at the DECODE Iceland Genomic Center as part of the joint implementation of the project "Genetic Studies of Preeclampsia in Populations of Central Asia and Europe" (InterPregGen) within the 7th Framework Programme of the European Commission under Grant Agreement No. 282540. RESULT The study discovered a significantly higher population frequency of carrying the unfavorable rs1126643 allele of the ITGA2 gene polymorphism when compared with European populations. The population frequencies of carrying minor alleles of the SERPINE1 (rs179988) and KDR (rs2071559) genes in the Kazakh population were significantly lower when compared with the previously studied populations of Europe and Asia. An intermediate frequency of unfavorable minor alleles between European and Asian populations was found in Kazakhs for gene polymorphisms: FV rs6025, PGF rs12411, and ACE rs4340. The genomic analysis determined the choice of polymorphisms for their further replicative genotyping in patients with ACCD in PE in the Kazakh population. CONCLUSION The obtained results will serve as a basis for the development of effective methods of early diagnosis and treatment of PE in pregnant women, carriers of unfavorable genotypes.
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Affiliation(s)
- Gulnara Svyatova
- Republican Medical Genetic Consultation, Scientific Center of Obstetrics, Gynecology and Perinatology, 050020, 125 Dostyk Ave., Almaty, Kazakhstan
| | - Dinara Mirzakhmetova
- Scientific Center of Obstetrics, Gynecology and Perinatology, 050020, 125 Dostyk Ave., Almaty, Kazakhstan.
| | - Galina Berezina
- Republican Medical Genetic Consultation, Scientific Center of Obstetrics, Gynecology and Perinatology, 050020, 125 Dostyk Ave., Almaty, Kazakhstan
| | - Alexandra Murtazaliyeva
- Republican Medical Genetic Consultation, Scientific Center of Obstetrics, Gynecology and Perinatology, 050020, 125 Dostyk Ave., Almaty, Kazakhstan
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Figueroa MAC, Lujambio IM, Gutiérrez TA, Hernández MFP, Ramírez EYE, Guzmán DJ, Sánchez MFL, Morales HFG, Samudio HJG, Sánchez FS, Flores MD, Zamarripa CAJ, Mendoza CCC, Hernández MEO, Velázquez CMO, Flores MS, Orozco DVH, Moreno GYC, Cruz M, de Jesús Peralta Romero J. Association of the rs5186 polymorphism of the AGTR1 gene with decreased eGFR in patients with type 2 diabetes from Mexico City. Nefrologia 2023; 43:546-561. [PMID: 37996337 DOI: 10.1016/j.nefroe.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 06/10/2022] [Accepted: 06/29/2022] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Early biomarkers search for Diabetic Kidney Disease (DKD) in patients with Type 2 Diabetes Mellitus (T2DM), as genetic markers to identify vulnerable carriers of the disease even before Glomerular Filtration Rate (GFR) decline or microalbuminuria development, has been relevant during the last few years. The rs5186 (A116C) polymorphism of the Angiotensin II Receptor Type I gene (AGTR1), has been associated to multiple effects of renal injury risk, commonly detected in patients with Diabetes Mellitus (DM). It has been described that rs5186 could have an effect in stability proteins that assemble Angiotensin II Receptor Type I (AT1), modifying its action, which is why it should be considered as a risk factor for Chronic Kidney Disease (CKD), characterized by a GFR progressive reduction. Even though, the association between rs5186 AGTR1 gene polymorphism and DKD in patients with T2DM has been controversial, inconclusive, and even absent. This disputable issue might be as a result of association studies in which many and varied clinical phenotypes included are contemplated as CKD inductors and enhancers. Although, the sample sizes studied in patients with T2DM are undersized and did not have a strict inclusion criteria, lacking of biochemical markers or KDOQI classification, which have hindered its examination. OBJECTIVE The aim of our study was to establish an association between rs5186 AGTR1 gene polymorphism and GFR depletion, assessed as a risk factor to DKD development in patients with T2DM. METHODS We analyzed 297 not related patients with T2DM, divided into 221 controls (KDOQI 1) and 76 cases (KDOQI 2). Arterial pressure, anthropometric and biochemical parameters were measured. rs5186 of AGTR1 genotyping was performed by TaqMan assay real-time PCR method. Allele and genotype frequencies, and Hardy-Weinberg equilibrium were measured. Normality test for data distribution was analyzed by Shapiro-Wilk test, variable comparison by Student's t-test for continuous variables, and Chi-squared test for categorical variables; ANOVA test was used for mean comparison of more than two groups. Effect of rs5186 to DKD was estimated by multiple heritability adjustment models for risk variables of DKD. Statistical significance was indicated by p<0.05. Data was analyzed using Statistical Package STATA v11 software. RESULTS Dominant and Over-dominant models showed a likelihood ratio to GFR depletion of 1.89 (1.05-3.39, p=0.031) and 2.01 (1.08-3.73, p=0.023) in patients with T2DM. Risk factor increased to 2.54 (1.10-5.89) in women in Over-dominant model. CONCLUSION In clinical practice, most of nephropathies progress at a slow pace into a total breakdown of renal function, even asymptomatic. This is the first study, reporting that rs5186 polymorphism of AGTR1 gene contribution to GFR depletion, and this could be evaluated as a predisposing factor for DKD in patients with T2DM.
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Affiliation(s)
- Manuel Alejandro Contreras Figueroa
- Unidad de Investigación Médica en Bioquímica, Unidad Médica de Alta Especialidad "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, México; Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina del Instituto Politécnico Nacional, Ciudad de México, México
| | - Irene Mendoza Lujambio
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina del Instituto Politécnico Nacional, Ciudad de México, México
| | - Teresa Alvarado Gutiérrez
- Coordinación Clínica de Educación e Investigación en Salud de la Unidad de Medicina Familiar 31, Instituto Mexicano del Seguro Social, Delegación sur, Ciudad de México, México
| | - María Fernanda Pérez Hernández
- Unidad de Investigación Médica en Bioquímica, Unidad Médica de Alta Especialidad "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, México; Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina del Instituto Politécnico Nacional, Ciudad de México, México; Red de Medicina Para la Educación, el Desarrollo y la Investigación Científica de Iztacala. MEDICI, Facultad de Estudios Superiores Iztacala, UNAM, Estado de México, México
| | - Evelyn Yazmín Estrada Ramírez
- Unidad de Investigación Médica en Bioquímica, Unidad Médica de Alta Especialidad "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, México; Departamento de Nefrología del Hospital de Especialidades "Dr. Antonio Fraga Mouret", CMN La Raza, IMSS, Ciudad de México, México
| | - Dominga Jiménez Guzmán
- Departamento de Nefrología del Hospital de Especialidades "Dr. Bernardo Sepúlveda" CMN Siglo XXI, IMSS, Ciudad de México, México; Jefatura de la Unidad de Consulta Externa de la UMAE, Hospital de Alta Especialidad Médica "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, México
| | - María Fernanda Lucas Sánchez
- Secretaría de Enseñanza Clínica, Internado y Servicio Social. Facultad de Medicina UNAM, Ciudad de México, México; Becaria de la Dirección General de Calidad y Educación en Salud, Secretaría de Salud, México
| | - Hannia Fernanda González Morales
- Unidad de Investigación Médica en Bioquímica, Unidad Médica de Alta Especialidad "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, México; Red de Medicina Para la Educación, el Desarrollo y la Investigación Científica de Iztacala. MEDICI, Facultad de Estudios Superiores Iztacala, UNAM, Estado de México, México
| | - Héctor Jaime Gómez Samudio
- Unidad de Investigación Médica en Bioquímica, Unidad Médica de Alta Especialidad "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, México
| | - Fernando Suarez Sánchez
- Unidad de Investigación Médica en Bioquímica, Unidad Médica de Alta Especialidad "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, México
| | - Margarita Díaz Flores
- Unidad de Investigación Médica en Bioquímica, Unidad Médica de Alta Especialidad "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, México
| | - Carlos Alberto Jiménez Zamarripa
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina del Instituto Politécnico Nacional, Ciudad de México, México
| | - Claudia Camelia Calzada Mendoza
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina del Instituto Politécnico Nacional, Ciudad de México, México
| | - María Esther Ocharán Hernández
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina del Instituto Politécnico Nacional, Ciudad de México, México
| | - Cora Mariana Orozco Velázquez
- Unidad de Investigación Médica en Bioquímica, Unidad Médica de Alta Especialidad "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, México; Secretaría de Enseñanza Clínica, Internado y Servicio Social. Facultad de Medicina UNAM, Ciudad de México, México
| | - Mariana Soto Flores
- Unidad de Investigación Médica en Bioquímica, Unidad Médica de Alta Especialidad "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, México; Departamento de Formación Integral e Institucional, Escuela Nacional de Medicina y Homeopatía, Instituto Politécnico Nacional, Ciudad de México, México
| | - Daniela Vicenta Hernández Orozco
- Unidad de Investigación Médica en Bioquímica, Unidad Médica de Alta Especialidad "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, México; Departamento de Formación Integral e Institucional, Escuela Nacional de Medicina y Homeopatía, Instituto Politécnico Nacional, Ciudad de México, México
| | - Gabriela Yanet Cortés Moreno
- Coordinación Nacional de Investigación, Subdirección de Servicios de salud de Petróleos Mexicanos, PEMEX, Ciudad de México, México
| | - Miguel Cruz
- Unidad de Investigación Médica en Bioquímica, Unidad Médica de Alta Especialidad "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, México
| | - José de Jesús Peralta Romero
- Unidad de Investigación Médica en Bioquímica, Unidad Médica de Alta Especialidad "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, México.
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Macías-Salas A, Sosa-Macías M, Barragán-Zúñiga LJ, Blanco-Castañeda R, Damiano A, Garcia-Robles R, Ayala-Ramírez P, Bueno-Sánchez J, Giachini FR, Escudero C, Galaviz-Hernández C. Preeclampsia association of placental nucleotide variations in eNOS, VEGFA, and FLT-1 genes in Latin American pregnant women. Placenta 2023; 135:1-6. [PMID: 36878143 DOI: 10.1016/j.placenta.2023.02.010] [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: 09/12/2022] [Revised: 02/06/2023] [Accepted: 02/24/2023] [Indexed: 03/05/2023]
Abstract
INTRODUCTION Preeclampsia is a leading cause of maternal and fetal morbidity in low- and middle-income countries, including those in Latin America. Placental vascular alterations are crucial in the pathophysiology of preeclampsia and few studies have evaluated nucleotide variations on genes associated with vascular regulation in the human placenta. This study aimed to evaluate whether placental nucleotide variations on eNOS, VEGFA, and FLT-1 genes are more frequently associated with preeclampsia in the Latin American population. METHODS This case-control study included placental tissue from 88 controls and 82 cases that were genotyped through Taqman probes for eNOS, VEGFA, and FLT-1 genes. The intergroup comparisons were analyzed with the Mann-Whitney U test. Genotype and allele frequencies were compared by the X2 test. The association between the nucleotide variants with preeclampsia was evaluated through logistic regression analysis. RESULTS A significant association was observed for VEGFA SNV rs2010963 (OR 1.95; CI 95% 1.13-3.37), after adjusting for population substructure. The allele combination T, G, G, C, C, C (rs2070744, rs1799983, rs2010963, rs3025039, rs699947 and rs4769613 respectively), showed a negative association with preeclampsia (OR 0.08; CI 95% 0.01-0.93). RESULTS DISCUSSION Placental SNV rs2010963 in the VEGFA gene was a risk factor for preeclampsia, while the allele combination T, G, G, C, C, C may represent potential protective factors for preeclampsia within Latin American women.
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Affiliation(s)
- Alejo Macías-Salas
- Pharmacogenomics Academia, Instituto Politécnico Nacional-CIIDIR Durango, Mexico
| | - Martha Sosa-Macías
- Pharmacogenomics Academia, Instituto Politécnico Nacional-CIIDIR Durango, Mexico; Red Iberoamericana de Alteraciones Vasculares en Transtornos del Embarazo (RIVATREM), Chillan, Chile
| | | | | | - Alicia Damiano
- Red Iberoamericana de Alteraciones Vasculares en Transtornos del Embarazo (RIVATREM), Chillan, Chile; Laboratorio de Biología de la Reproducción, IFIBIO Houssay-UBA- CONICET, Buenos Aires, Argentina; Cátedra de Biología Celular y Molecular, Departamento de Ciencias Biológicas, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Reggie Garcia-Robles
- Red Iberoamericana de Alteraciones Vasculares en Transtornos del Embarazo (RIVATREM), Chillan, Chile; Department of Physiological Sciences, School of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Paola Ayala-Ramírez
- Red Iberoamericana de Alteraciones Vasculares en Transtornos del Embarazo (RIVATREM), Chillan, Chile; Human Genetics Institute, School of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Julio Bueno-Sánchez
- Red Iberoamericana de Alteraciones Vasculares en Transtornos del Embarazo (RIVATREM), Chillan, Chile; Grupo Reproducción, Department of Obstetrics and Gynecology, Department of Physiology and biochemisty, Universidad de Antioquia, Medellín, Colombia
| | - Fernanda Regina Giachini
- Red Iberoamericana de Alteraciones Vasculares en Transtornos del Embarazo (RIVATREM), Chillan, Chile; Institute of Biological Sciences and Health, Federal University of Mato Grosso, Barra do Garças, Brazil
| | - Carlos Escudero
- Red Iberoamericana de Alteraciones Vasculares en Transtornos del Embarazo (RIVATREM), Chillan, Chile; Vascular Physiology Laboratory, Department of Basic Sciences, Universidad del Bío-Bío, Chillán, Chile; Group of Research and Innovation in Vascular Health (GRIVAS Health), Chillan, Chile.
| | - Carlos Galaviz-Hernández
- Pharmacogenomics Academia, Instituto Politécnico Nacional-CIIDIR Durango, Mexico; Red Iberoamericana de Alteraciones Vasculares en Transtornos del Embarazo (RIVATREM), Chillan, Chile.
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Asociación del polimorfismo rs5186 del gen AGTR1 con disminución de la TFGe en pacientes con diabetes tipo 2 de la Ciudad de México. Nefrologia 2022. [DOI: 10.1016/j.nefro.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Preeclampsia, Natural History, Genes, and miRNAs Associated with the Syndrome. J Pregnancy 2022; 2022:3851225. [PMID: 35198246 PMCID: PMC8860533 DOI: 10.1155/2022/3851225] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 01/19/2022] [Indexed: 12/13/2022] Open
Abstract
Preeclampsia (PE) is a hypertensive disease that affects pregnant women after 20 weeks of gestation. This disease is associated with an important risk of maternal and fetal mortality. PE is described as a placental pathology because, after delivery, most women recover normal arterial pressure. Poor invasion of the spiral arteries is a phenomenon well described in PE; this leads to a hypoxic uterine bed and imbalance of antiangiogenic and proangiogenic factors in the uteroplacental region, which in turn triggers the disease phenotype. The causes of the pathology are unclear; nevertheless, numerous approaches, including next-generation sequencing, association, and case control and miRNA studies, have shed light on the genetic/molecular basis of PE. These studies help us better understand the disease to advance new treatment strategies.
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Er ZC, Muderrisoglu A, Ekim M, Ekim H. MTHFR C677T (rs1801133) genetic polymorphism is associated with development risk of essential hypertension in the Turkish population. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2022. [DOI: 10.1186/s43042-022-00221-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Hypertension is a serious condition that is spread worldwide and may lead to severe complications such as heart attack, stroke, hypertensive retinopathy, and renal failure. Although some genetic and environmental risk factors are known to play a role in the etiology of hypertension, like most of the other multi-factorial diseases, its etiology is yet to be fully elucidated. Our study aimed to investigate the effects of methylenetetrahydrofolate reductase (MTHFR) C677T (rs1801133) and A1298C (rs1801131), factor V Leiden (FVL) G1691A (rs6025), and prothrombin (PT) G20210A (rs1799963) genetic polymorphisms on the development risk of essential hypertension and level of blood pressure in hypertensive patients.
Results
The frequency of the homozygous polymorphic TT genotype for the MTHFR C677T polymorphism was significantly higher in male hypertensive patients than in the male control group (27% vs 6.3%, p = 0.028). The rate of the variant T allele for the MTHFR C677T polymorphism was also significantly higher in male hypertensive patients compared to male healthy controls (51.4% vs 21.9%, p = 0.0004). There was no difference among hypertensive patients and healthy controls regarding the frequencies of MTHFR A1298C, FVL G1691A and PT G20210A polymorphisms. In addition, we found no difference between genotype groups regarding systolic and diastolic blood pressure levels in hypertensive patients.
Conclusions
Homozygous polymorphic TT genotype and variant T allele for the MTHFR C677T polymorphism may be considered as a risk factor for the development of essential hypertension in the Turkish male population.
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Associations between AGT, MTHFR, and VEGF gene polymorphisms and preeclampsia in the Chinese population. Placenta 2022; 118:38-45. [PMID: 35030476 DOI: 10.1016/j.placenta.2022.01.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 12/29/2021] [Accepted: 01/05/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Preeclampsia (PE) is a pregnancy-specific multisystemic syndrome. This study aimed to investigate the associations between angiotensinogen (AGT), methylenetetrahydrofolate reductase (MTHFR), vascular endothelial growth factor (VEGF) polymorphisms, and PE in the Han Chinese population. METHODS We genotyped 26 single-nucleotide polymorphisms (SNP) in three genes by using QuantStudio™ 12 K Flex Real-Time PCR technology in 168 patients with PE and 204 healthy pregnant control subjects. The associations of tested polymorphisms with PE were analyzed at allele, genotype, and haplotype levels. RESULTS A common coding variant in MTHFR, rs2274976, was significantly associated with increased risk of PE in both allelic and genotype models (P < 0.05). The heterozygous genotypes of rs699 (G/A vs G/G) in AGT gene and rs3025035 (C/T vs C/C) in VEGF gene showed weak associations with increased PE risk, whereas the mutant homozygous genotype of rs3024987 (TT vs C/C) and the heterozygous genotype of rs3025039 (C/T vs C/C) in VEGF gene displayed weak associations with decreased PE risk (P < 0.05). DISCUSSION However, these weak associations lost significance after multiple testing correction. The results indicated that rs2274976 in MTHFR gene may contribute to the increased risk of PE in pregnant women. AGT and VEGF gene polymorphisms may not play a significant role in PE development.
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Nasri F, Zare M, Hesampour F, Ahmadi M, Ali-Hassanzadeh M, Mostafaei S, Gharesi-Fard B. Are genetic variations in IL-1β and IL-6 cytokines associated with the risk of pre-eclampsia? Evidence from a systematic review and meta-analysis. J Matern Fetal Neonatal Med 2021; 35:6600-6609. [PMID: 34275427 DOI: 10.1080/14767058.2021.1918092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE This systematic review and meta-analysis study was performed to assess the potential association between interleukin-1 beta (IL-1β) single nucleotide polymorphisms (SNPs) (rs1143634 and rs16944) and interleukin-6 (IL-6) SNP (rs1800795) and pre-eclampsia (PE). METHODS A comprehensive literature search was conducted in the international search engines and databases, including MEDLINE (via PubMed), Scopus, and Web of Science (ISI) up to 9 March 2021. After retrieving relevant articles, data extraction was performed by four authors independently. Pooled ORs and corresponding 95% CIs were used to evaluate the association between IL-1β and IL-6 polymorphisms and PE risk. Cochran's Q test was used to check heterogeneity, and the I2 index was calculated for measuring the heterogeneity between the estimations of included studies. RESULTS After reviewing fully published studies, 21 studies were included in this study based on the eligibility criteria. Our results showed that rs16944 and rs1143634 of IL-1β were significantly associated with the risk of PE. Regarding rs16944, the minor C allele significantly decreased the risk of PE (C vs. T: OR = 0.79, 95% CI = 0.69-0.90). In contrast, the minor T allele of rs1143634 significantly increased the risk of PE (T vs. C: OR = 1. 28, 95% CI = 1.04-1.58). There was no significant association between IL-6 rs1800795 (C vs. G: OR = 1.04, 95% CI = 0.93-1.16) polymorphism and PE risk. CONCLUSIONS In conclusion, this meta-analysis suggests rs1143634 and rs16944 polymorphisms of IL-1β are related to the risk of PE.
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Affiliation(s)
- Fatemeh Nasri
- Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Laboratory Sciences, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.,Diagnostic Laboratory Sciences and Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Zare
- Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Hesampour
- Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Moslem Ahmadi
- Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Ali-Hassanzadeh
- Department of Immunology, School of Medicine, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Shayan Mostafaei
- Department of Biostatistics, Faculty of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Epidemiology and Biostatistics Unit, Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Behrouz Gharesi-Fard
- Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Genetic association of ERAP1 and ERAP2 with eclampsia and preeclampsia in northeastern Brazilian women. Sci Rep 2021; 11:6764. [PMID: 33762660 PMCID: PMC7990956 DOI: 10.1038/s41598-021-86240-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 03/09/2021] [Indexed: 01/28/2023] Open
Abstract
The clinical spectrum of hypertensive disorders of pregnancy (HDP) is determined by the interplay between environmental and genetic factors, most of which remains unknown. ERAP1, ERAP2 and LNPEP genes code for multifunctional aminopeptidases involved with antigen processing and degradation of small peptides such as angiotensin II (Ang II), vasopressin and oxytocin. We aimed to test for associations between genetic variants in aminopeptidases and HDP. A total of 1282 pregnant women (normotensive controls, n = 693; preeclampsia, n = 342; chronic hypertension with superimposed preeclampsia, n = 61; eclampsia, n = 74; and HELLP syndrome, n = 112) were genotyped for variants in LNPEP (rs27300, rs38034, rs2303138), ERAP1 (rs27044, rs30187) and ERAP2 (rs2549796 rs2927609 rs11135484). We also evaluated the effect of ERAP1 rs30187 on plasma Ang II levels in an additional cohort of 65 pregnant women. The genotype C/C, in ERAP1 rs30187 variant (c.1583 T > C, p.Lys528Arg), was associated with increased risk of eclampsia (OR = 1.85, p = 0.019) whereas ERAP2 haplotype rs2549796(C)–rs2927609(C)–rs11135484(G) was associated with preeclampsia (OR = 1.96, corrected p-value = 0.01). Ang II plasma levels did not differ across rs30187 genotypic groups (p = 0.895). In conclusion, ERAP1 gene is associated with eclampsia whereas ERAP2 is associated with preeclampsia, although the mechanism by which genetic variants in ERAPs influence the risk of preeclampsia and eclampsia remain to be elucidated.
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11
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Zhao G, Liu J, Meng T. Oxidative stress-related genes ( EPHX1 and MnSOD) polymorphism and risk of pre-eclampsia: a meta-analysis. J Matern Fetal Neonatal Med 2021; 35:5526-5538. [PMID: 33586574 DOI: 10.1080/14767058.2021.1887123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Previous studies have detected the association of polymorphisms in oxidative stress-related genes EPHX1 and MnSOD with pre-eclampsia (PE) risk, but the results are inconsistent among studies. Thus, a meta-analysis was performed to obtain more conclusive results. METHODS Eligible studies were retrieved in PubMed, Web of Science, EMBASE, Scopus, and CNKI. Odds ratios (ORs) with 95% confidence intervals (CIs) were utilized to evaluate the relationship between EPHX1 rs1051740, EPHX1 rs2234922, MnSOD rs4880 polymorphisms, and PE susceptibility in the genetic models. The subgroup analysis was also performed. RESULTS Fourteen studies with a total of 4250 participants were included, including 1784 PE patients and 2466 healthy women. There was a statistically significant association between EPHX1 rs1051740 polymorphism and PE in Caucasians within the allele, dominant, heterozygous, and homozygous models (OR = 0.79, 95% CI = 0.64-0.98; OR = 0.64, 95% CI = 0.47-0.87; OR = 0.61, 95% CI = 0.44-0.85; OR = 0.63, 95% CI = 0.42-0.97, respectively). There was a statistically significant association between EPHX1 rs2234922 polymorphism and PE in Middle Easterners within the recessive and homozygous models (OR = 3.59, 95% CI = 1.25-10.32; OR = 3.99, 95% CI = 1.38-11.49, respectively). There was no statistically significant association between MnSOD rs4880 polymorphism and PE within five genetic models. Subgroup analysis didn't reveal any association between MnSOD rs4880 polymorphism and PE in Asians, Caucasians, or Middle Easterners. CONCLUSIONS This meta-analysis shows a significant association between the EPHX1 rs1051740 and PE risk in Caucasians. Meantime, there was a statistically significant association between EPHX1 rs2234922 polymorphism and PE in Middle Easterners.
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Affiliation(s)
- Ge Zhao
- Department of Obstetrics, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jing Liu
- Department of Obstetrics, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Tao Meng
- Department of Obstetrics, The First Affiliated Hospital of China Medical University, Shenyang, China
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Serebrova VN, Trifonova EA, Stepanov VA. Pregnancy as a Factor of Adaptive Human Evolution. The Role of Natural Selection in the Origin of Preeclampsia. RUSS J GENET+ 2021. [DOI: 10.1134/s1022795421010142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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13
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Aljuaid NM, Muharram EI, Loqtum NN, Al-Amoudi RM, AlMahdi HB, Salama MA, Banaganapalli B, Shaik NA, Elango R, Bondagji NS. Association of Four Missense SNPs with Preeclampsia in Saudi Women. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2020; 8:174-180. [PMID: 32952508 PMCID: PMC7485656 DOI: 10.4103/sjmms.sjmms_280_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 10/06/2019] [Accepted: 03/12/2020] [Indexed: 02/06/2023]
Abstract
Objective: The objective of this study was to investigate the association of rs1051740, rs2234922 (in microsomal epoxide hydrolase 1; EPHX1), rs268 (in lipoprotein lipase; LPL) and rs6025 (in Factor V Leiden; F5) genetic variants with the risk of preeclampsia development in Saudi women. Materials and Methods: This case–control study recruited 233 Saudi women (94 preeclampsia cases and 139 healthy controls) who visited the Gynecology and Obstetrics Departments of two hospitals in Jeddah, Saudi Arabia, for routine postpregnancy clinical follow-ups. All the women underwent thorough clinical and biochemical investigations conducted according to the standard clinical guidelines. Genotyping of the study participants was done using real-time polymerase chain reaction-based TaqMan allelic discrimination assay. The strength of the association between genetic variants and disease development was assessed using chi-square, odds ratio, 95% confidence interval and multifactor dimensionality reduction tests. Result: The minor alleles “G” in rs268 (LPL) and “A” in rs6025 (F5) were absent in Saudi women. The frequencies of rs1051740 and rs2234922 of EPHX1, both in the homozygous and allelic forms, were not significantly different between preeclampsia patients and healthy controls (for all tests, P > 0.05). The multifactor dimensionality reduction analysis also indicated that the interaction between the four studied single-nucleotide polymorphisms (SNPs) had no significant association with preeclampsia risk. Conclusion: This study found that none of the studied genetic variants (neither the single SNP nor the SNP–SNP interactions) explain the development of preeclampsia in the Saudi population. These findings not only underscore the disease heterogeneity but also highlight the need to develop population-specific diagnostic genetic biomarkers for preeclampsia.
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Affiliation(s)
- Nada Mohammed Aljuaid
- Department of Biological Sciences, Faculty of Science, University of Jeddah, Jeddah, Saudi Arabia.,Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Nouf Nasser Loqtum
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Reem Mohammed Al-Amoudi
- Department of Obstetrics and Gynecology, Maternity and Children's Hospital, Jeddah, Saudi Arabia
| | - Hadiah Bassam AlMahdi
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia.,Princess Al-Jawhara Al-Brahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed Assem Salama
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia.,Princess Al-Jawhara Al-Brahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Babajan Banaganapalli
- Princess Al-Jawhara Al-Brahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Genetic Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Noor Ahmad Shaik
- Princess Al-Jawhara Al-Brahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Genetic Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ramu Elango
- Princess Al-Jawhara Al-Brahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Genetic Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nabeel Salem Bondagji
- Princess Al-Jawhara Al-Brahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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14
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Liu Y, Li P. Meta-analysis of angiotensin-converting enzyme insersion/delection polymorphism and pre-eclampsia susceptibility. J Obstet Gynaecol Res 2020; 46:1744-1757. [PMID: 32643244 DOI: 10.1111/jog.14369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 05/13/2020] [Accepted: 06/10/2020] [Indexed: 01/11/2023]
Abstract
AIM In recent years, there were many studies on angiotensin-converting enzyme insersion/delection (ACE I/D) polymorphism and pre-eclampsia susceptibility, but the conclusion was still inconclusive. Our study is to explore the relationship between the ACE I/D polymorphism and the risk of pre-eclampsia. METHODS The literature on the relationship between ACE I/D gene polymorphism and Pre-eclampsia susceptibility was obtained by searching the databases of Wanfang, VIP, Medline, CNKI, Embase, Pubmed and Springerlink, which was published from the establishment of the databases to October 2019. Taking the odds ratio (OR) value and its 95% confidence interval (CI) as the effect size, the Meta-analysis was carried out by using stata 15.0 software. RESULTS Thirty articles, consisting of 3184 patients and 3912 controls, were included. The results showed that allele D was compared with allele I, with the OR value of 1.29 (95% CI: 1.12 ~ 1.50, P < 0.05). Subgroup analysis showed that in Caucasians, allele D was associated with OR of 1.28 (95% CI: 1.08 ~ 1.53, P < 0.05). There was no significant difference in Asians. There was statistical significance in recessive gene model and homozygous gene model, as well as in that of Asian and Caucasian. In homozygous model, there was statistical significance, but subgroup analysis showed there was no statistical significance in Asian and Caucasian. There was no statistical significance in dominant model and heterozygous model. CONCLUSION The polymorphism of ACE I/D gene was associated with the risk of pre-eclampsia. Allele D and genotype DD may increase the risk of Pre-eclampsia in pregnant women.
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Affiliation(s)
- Yun Liu
- Department of obstetrics, Tianjin Nankai Hospital, Tianjin, China
| | - Ping Li
- Department of obstetrics, Tianjin Nankai Hospital, Tianjin, China
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15
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Huang T, Yan Y, Li J, Chen H, Chen Z. An insertion-deletion polymorphism in angiotensin-converting enzyme is associated with a reduced risk of preeclampsia: an evidence-based meta-analysis from 44 studies. Hypertens Pregnancy 2020; 39:336-347. [PMID: 32484368 DOI: 10.1080/10641955.2020.1769644] [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] [Indexed: 10/24/2022]
Abstract
Objective An updated meta-analysis was performed to evaluate the relationship between an insertion/deletion (I/D) polymorphism in angiotensin-converting enzyme (ACE) and preeclampsia (PE) risk. Methods Pubmed, OVID and China National Knowledge Infrastructure databases were searched. Pooled odds ratios with 95% confidence intervals were calculated using fixed-effects or random-effects model. Results ACE I/D polymorphism decreased the risk of PE in overall analysis. Subgroup analysis revealed a significantly lower risk of PE with ACE I/D polymorphism in Asians, Caucasians. The decreased risk was also found in severe PE and early-onset PE. Conclusion ACE I/D polymorphism may protect against the development of PE.
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Affiliation(s)
- Ting Huang
- Department of Obstetrics, Chongqing Health Center for Women and Children , Chongqing, P.R. China
| | - Yu Yan
- Department of Obstetrics, Chongqing Health Center for Women and Children , Chongqing, P.R. China
| | - Jianxin Li
- Department of Obstetrics, Chongqing Health Center for Women and Children , Chongqing, P.R. China
| | - Hong Chen
- Department of Obstetrics, Chongqing Health Center for Women and Children , Chongqing, P.R. China
| | - Zhen Chen
- Department of Obstetrics, Chongqing Health Center for Women and Children , Chongqing, P.R. China
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16
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Novel association of SNP rs479200 in EGLN1 gene with predisposition to preeclampsia. Gene 2019; 705:1-4. [PMID: 31009679 DOI: 10.1016/j.gene.2019.04.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 04/16/2019] [Accepted: 04/18/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Placental hypoxia is a hallmark of preeclampsia. SNP rs479200 in the EGLN1 gene is associated with reduced responsiveness to hypoxia. Whether this translates into an association between SNP rs479200 and preeclampsia is not known. We evaluated the association of SNP rs479200 (T>C) with the risk of preeclampsia. METHODS This case-control study involved 600 pregnant women of whom 300 were preeclamptic and 300 were normotensive. SNP rs479200 was genotyped by PCR-RFLP method. RESULT Minor allele frequency was 44% in preeclamptic women and 53% in normotensive pregnant women (P = 1.8 × 10-3; odds ratio = 1.43). The odds ratio was heterogeneous when compared after categorization of the preeclamptic group into clinical sub-groups. The association was significant with both mild (P = 6.2 × 10-5) and severe (3.8 × 10-3) preeclampsia. However, the odds ratio was 0.52 for mild preeclampsia and 1.43 for severe preeclampsia. CONCLUSION The minor allele of SNP rs479200 is associated with the predisposition to preeclampsia. This association underlines the importance of oxygen sensing in the pathogenesis of preeclampsia.
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17
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Townsend R, Khalil A, Premakumar Y, Allotey J, Snell KIE, Chan C, Chappell LC, Hooper R, Green M, Mol BW, Thilaganathan B, Thangaratinam S. Prediction of pre-eclampsia: review of reviews. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2019; 54:16-27. [PMID: 30267475 DOI: 10.1002/uog.20117] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 08/23/2018] [Accepted: 08/26/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Primary studies and systematic reviews provide estimates of varying accuracy for different factors in the prediction of pre-eclampsia. The aim of this study was to review published systematic reviews to collate evidence on the ability of available tests to predict pre-eclampsia, to identify high-value avenues for future research and to minimize future research waste in this field. METHODS MEDLINE, EMBASE and The Cochrane Library including DARE (Database of Abstracts of Reviews of Effects) databases, from database inception to March 2017, and bibliographies of relevant articles were searched, without language restrictions, for systematic reviews and meta-analyses on the prediction of pre-eclampsia. The quality of the included reviews was assessed using the AMSTAR tool and a modified version of the QUIPS tool. We evaluated the comprehensiveness of search, sample size, tests and outcomes evaluated, data synthesis methods, predictive ability estimates, risk of bias related to the population studied, measurement of predictors and outcomes, study attrition and adjustment for confounding. RESULTS From 2444 citations identified, 126 reviews were included, reporting on over 90 predictors and 52 prediction models for pre-eclampsia. Around a third (n = 37 (29.4%)) of all reviews investigated solely biochemical markers for predicting pre-eclampsia, 31 (24.6%) investigated genetic associations with pre-eclampsia, 46 (36.5%) reported on clinical characteristics, four (3.2%) evaluated only ultrasound markers and six (4.8%) studied a combination of tests; two (1.6%) additional reviews evaluated primary studies investigating any screening test for pre-eclampsia. Reviews included between two and 265 primary studies, including up to 25 356 688 women in the largest review. Only approximately half (n = 67 (53.2%)) of the reviews assessed the quality of the included studies. There was a high risk of bias in many of the included reviews, particularly in relation to population representativeness and study attrition. Over 80% (n = 106 (84.1%)) summarized the findings using meta-analysis. Thirty-two (25.4%) studies lacked a formal statement on funding. The predictors with the best test performance were body mass index (BMI) > 35 kg/m2 , with a specificity of 92% (95% CI, 89-95%) and a sensitivity of 21% (95% CI, 12-31%); BMI > 25 kg/m2 , with a specificity of 73% (95% CI, 64-83%) and a sensitivity of 47% (95% CI, 33-61%); first-trimester uterine artery pulsatility index or resistance index > 90th centile (specificity 93% (95% CI, 90-96%) and sensitivity 26% (95% CI, 23-31%)); placental growth factor (specificity 89% (95% CI, 89-89%) and sensitivity 65% (95% CI, 63-67%)); and placental protein 13 (specificity 88% (95% CI, 87-89%) and sensitivity 37% (95% CI, 33-41%)). No single marker had a test performance suitable for routine clinical use. Models combining markers showed promise, but none had undergone external validation. CONCLUSIONS This review of reviews calls into question the need for further aggregate meta-analysis in this area given the large number of published reviews subject to the common limitations of primary predictive studies. Prospective, well-designed studies of predictive markers, preferably randomized intervention studies, and combined through individual-patient data meta-analysis are needed to develop and validate new prediction models to facilitate the prediction of pre-eclampsia and minimize further research waste in this field. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- R Townsend
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
| | - A Khalil
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
| | - Y Premakumar
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
| | - J Allotey
- Women's Health Research Unit, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - K I E Snell
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK
| | - C Chan
- Pragmatic Clinical Trials Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - L C Chappell
- Department of Women and Children's Health, King's College London, London, UK
| | - R Hooper
- Pragmatic Clinical Trials Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - M Green
- Action on Pre-eclampsia (APEC) Charity, Worcestershire, UK
| | - B W Mol
- Department of Obstetrics and Gynaecology, School of Medicine, Monash University, Melbourne, Australia
| | - B Thilaganathan
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
| | - S Thangaratinam
- Women's Health Research Unit, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Sun X, Huang Y, Si D, Gao S, Wang P. Questionnaire survey on association between preeclampsia and incontinentia pigmenti. J Obstet Gynaecol Res 2019; 45:1363-1370. [PMID: 31106959 DOI: 10.1111/jog.13983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 04/10/2019] [Indexed: 11/30/2022]
Abstract
AIM In this study, a questionnaire survey was conducted to find the relationship between preeclampsia (PE) and incontinentia pigmenti (IP). METHODS Using a questionnaire survey of 147 women whose children were diagnosed with IP, this study first investigated their clinical manifestations and complications during pregnancy. The manifestations included high blood pressure, proteinuria and edema after 20 weeks of gestation. Women with and without IP were separated into two groups, then analyzed accordingly. RESULTS There were 45 mothers with IP in the case group and 102 mothers without IP in the control group. IP mothers who were pregnant with an IP fetus were at higher risk for hypertension, proteinuria, and edema during pregnancy as compared with non-IP mothers that carried an IP fetus. Out of these 147 mothers, 8 mothers with IP and 6 mothers without IP presented with new-onset hypertension during pregnancy (P = 0.024),7 mothers with IP and 4 mothers without IP presented with new-onset proteinuria during pregnancy (P = 0.013),and 21 IP mothers and 27 non-IP mothers presented with edema during pregnancy (P = 0.016). Although no statistical difference was observed, mothers in the case group were more likely to develop the above three symptoms concurrently (6.7% vs 2.0%; P = 0.168), and were more likely to be diagnosed with PE (8.9% vs 3.9%; P = 0.249). CONCLUSION Our study revealed that the simultaneous occurrence of IP in the mother and fetus increased the likelihood of clinical manifestations associated with PE during pregnancy.
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Affiliation(s)
- Xiaoyan Sun
- Clinical Laboratory Department, Xuanwu Hospital, Capital Medical University, Beijing, China.,Obstetrics and Gynecology Department, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yu Huang
- Department of Medical Genetics, School of Basic Medical Science, Peking University Health Science Center, Beijing, China
| | - Dayong Si
- School of Life Science, Jilin University, Changchun, China
| | - Shichao Gao
- Clinical Laboratory Department, Xuanwu Hospital, Capital Medical University, Beijing, China.,Obstetrics and Gynecology Department, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Peichang Wang
- Clinical Laboratory Department, Xuanwu Hospital, Capital Medical University, Beijing, China.,Obstetrics and Gynecology Department, Xuanwu Hospital, Capital Medical University, Beijing, China
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Amosco MD, Tavera GR, Villar VAM, Naniong JMA, David-Bustamante LMG, Williams SM, Jose PA, Palmes-Saloma CP. Non-additive effects of ACVR2A in preeclampsia in a Philippine population. BMC Pregnancy Childbirth 2019; 19:11. [PMID: 30621627 PMCID: PMC6323705 DOI: 10.1186/s12884-018-2152-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 12/17/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Multiple interrelated pathways contribute to the pathogenesis of preeclampsia, and variants in susceptibility genes may play a role among Filipinos, an ethnically distinct group with high prevalence of the disease. The objective of this study was to examine the association between variants in maternal candidate genes and the development of preeclampsia in a Philippine population. METHODS A case-control study involving 29 single nucleotide polymorphisms (SNPs) in 21 candidate genes was conducted in 150 patients with preeclampsia (cases) and 175 women with uncomplicated normal pregnancies (controls). Genotyping for the GRK4 and DRD1 gene variants was carried out using the TaqMan Assay, and all other variants were assayed using the Sequenom MassARRAY Iplex Platform. PLINK was used for SNP association testing. Multilocus association analysis was performed using multifactor dimensionality reduction (MDR) analysis. RESULTS Among the clinical factors, older age (P < 1 × 10-4), higher BMI (P < 1 × 10-4), having a new partner (P = 0.006), and increased time interval from previous pregnancy (P = 0.018) associated with preeclampsia. The MDR algorithm identified the genetic variant ACVR2A rs1014064 as interacting with age and BMI in association with preeclampsia among Filipino women. CONCLUSIONS The MDR algorithm identified an interaction between age, BMI and ACVR2A rs1014064, indicating that context among genetic variants and demographic/clinical factors may be crucial to understanding the pathogenesis of preeclampsia among Filipino women.
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Affiliation(s)
- Melissa D. Amosco
- National Institute of Molecular Biology and Biotechnology, National Science Complex, University of the Philippines, Diliman, 1101 Quezon City, Philippines
- Department of Obstetrics and Gynecology, Philippine General Hospital - University of the Philippines, Taft Avenue, 1000 Manila, Philippines
| | - Gloria R. Tavera
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, School of Medicine, Cleveland, OH 44106 USA
| | - Van Anthony M. Villar
- Division of Renal Diseases & Hypertension, Department of Medicine, The George Washington University of School of Medicine & Health Sciences, Washington, DC, 20037 USA
| | - Justin Michael A. Naniong
- National Institute of Molecular Biology and Biotechnology, National Science Complex, University of the Philippines, Diliman, 1101 Quezon City, Philippines
| | - Lara Marie G. David-Bustamante
- Department of Obstetrics and Gynecology, Philippine General Hospital - University of the Philippines, Taft Avenue, 1000 Manila, Philippines
| | - Scott M. Williams
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, School of Medicine, Cleveland, OH 44106 USA
| | - Pedro A. Jose
- Division of Renal Diseases & Hypertension, Department of Medicine, The George Washington University of School of Medicine & Health Sciences, Washington, DC, 20037 USA
- Department of Pharmacology and Physiology, The George Washington University of School of Medicine & Health Sciences, Washington, DC, 20037 USA
| | - Cynthia P. Palmes-Saloma
- National Institute of Molecular Biology and Biotechnology, National Science Complex, University of the Philippines, Diliman, 1101 Quezon City, Philippines
- Philippine Genome Center, National Science Complex, University of the Philippines, Diliman, 1101 Quezon City, Philippines
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Michita RT, Kaminski VDL, Chies JAB. Genetic Variants in Preeclampsia: Lessons From Studies in Latin-American Populations. Front Physiol 2018; 9:1771. [PMID: 30618791 PMCID: PMC6302048 DOI: 10.3389/fphys.2018.01771] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 11/23/2018] [Indexed: 12/13/2022] Open
Abstract
Placental vascularization is a tightly regulated physiological process in which the maternal immune system plays a fundamental role. Vascularization of the maternal-placental interface involves a wide range of mechanisms primarily orchestrated by the fetal extravillous trophoblast and maternal immune cells. In a healthy pregnancy, an immune cross-talk between the mother and fetal cells results in the secretion of immunomodulatory mediators, apoptosis of specific cells, cellular differentiation/proliferation, angiogenesis, and vasculogenesis, altogether favoring a suitable microenvironment for the developing embryo. In the context of vasculopathy underlying common pregnancy disorders, it is believed that inefficient invasion of extravillous trophoblast cells in the endometrium leads to a poor placental blood supply, which, in turn, leads to decreased secretion of angiogenic factors, hypoxia, and inflammation commonly associated with preterm delivery, intrauterine growth restriction, and preeclampsia. In this review, we will focus on studies published by Latin American research groups, providing an extensive review of the role of genetic variants from candidate genes involved in a broad spectrum of biological processes underlying the pathophysiology of preeclampsia. In addition, we will discuss how these studies contribute to fill gaps in the current understanding of preeclampsia. Finally, we discuss some trending topics from important fields associated with pregnancy vascular disorders (e.g., epigenetics, transplantation biology, and non-coding RNAs) and underscore their possible implications in the pathophysiology of preeclampsia. As a result, these efforts are expected to give an overview of the extent of scientific research produced in Latin America and encourage multicentric collaborations by highlighted regional research groups involved in preeclampsia investigation.
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Affiliation(s)
- Rafael Tomoya Michita
- Immunogenetics Laboratory, Department of Genetics, Biosciences Institute, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Valéria de Lima Kaminski
- Immunogenetics Laboratory, Department of Genetics, Biosciences Institute, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - José Artur Bogo Chies
- Immunogenetics Laboratory, Department of Genetics, Biosciences Institute, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Gray KJ, Kovacheva VP, Mirzakhani H, Bjonnes AC, Almoguera B, DeWan AT, Triche EW, Saftlas AF, Hoh J, Bodian DL, Klein E, Huddleston KC, Ingles SA, Lockwood CJ, Hakonarson H, McElrath TF, Murray JC, Wilson ML, Norwitz ER, Karumanchi SA, Bateman BT, Keating BJ, Saxena R. Gene-Centric Analysis of Preeclampsia Identifies Maternal Association at PLEKHG1. Hypertension 2018; 72:408-416. [PMID: 29967039 PMCID: PMC6043396 DOI: 10.1161/hypertensionaha.117.10688] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 12/30/2017] [Accepted: 04/14/2018] [Indexed: 12/13/2022]
Abstract
The genetic susceptibility to preeclampsia, a pregnancy-specific complication with significant maternal and fetal morbidity, has been poorly characterized. To identify maternal genes associated with preeclampsia risk, we assembled 498 cases and 1864 controls of European ancestry from preeclampsia case-control collections in 5 different US sites (with additional matched population controls), genotyped samples on a cardiovascular gene-centric array composed of variants from ≈2000 genes selected based on prior genetic studies of cardiovascular and metabolic diseases and performed case-control genetic association analysis on 27 429 variants passing quality control. In silico replication testing of 9 lead signals with P<10-4 was performed in independent European samples from the SOPHIA (Study of Pregnancy Hypertension in Iowa) and Inova cohorts (212 cases, 456 controls). Multiethnic assessment of lead signals was then performed in samples of black (26 cases, 136 controls), Hispanic (132 cases, 468 controls), and East Asian (9 cases, 80 controls) ancestry. Multiethnic meta-analysis (877 cases, 3004 controls) revealed a study-wide statistically significant association of the rs9478812 variant in the pleiotropic PLEKHG1 gene (odds ratio, 1.40 [1.23-1.60]; Pmeta=5.90×10-7). The rs9478812 effect was even stronger in the subset of European cases with known early-onset preeclampsia (236 cases diagnosed <37 weeks, 1864 controls; odds ratio, 1.59 [1.27-1.98]; P=4.01×10-5). PLEKHG1 variants have previously been implicated in genome-wide association studies of blood pressure, body weight, and neurological disorders. Although larger studies are required to further define maternal preeclampsia heritability, this study identifies a novel maternal risk locus for further investigation.
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Affiliation(s)
- Kathryn J Gray
- From the Division of Maternal-Fetal Medicine (K.J.G., T.F.M.)
- Center for Genomic Medicine (K.J.G., A.C.B., R.S.)
- Massachusetts General Hospital, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA (K.J.G., A.C.B., R.S.)
| | | | - Hooman Mirzakhani
- Brigham and Women's Hospital, Boston, MA; Department of Anesthesia, Critical Care and Pain Medicine (H.M., B.T.B., R.S.)
| | - Andrew C Bjonnes
- Center for Genomic Medicine (K.J.G., A.C.B., R.S.)
- Massachusetts General Hospital, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA (K.J.G., A.C.B., R.S.)
| | - Berta Almoguera
- Center for Applied Genomics, Children's Hospital of Philadelphia, PA (B.A., H.H.)
| | | | - Elizabeth W Triche
- Yale School of Public Health, New Haven, CT; Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, CT (E.W.T.)
| | - Audrey F Saftlas
- Department of Epidemiology, College of Public Health, University of Iowa (A.F.S.)
| | | | - Dale L Bodian
- Inova Translational Medicine Institute, Inova Health System, Falls Church, VA (D.L.B., E.K., K.C.H.)
| | - Elisabeth Klein
- Inova Translational Medicine Institute, Inova Health System, Falls Church, VA (D.L.B., E.K., K.C.H.)
| | - Kathi C Huddleston
- Inova Translational Medicine Institute, Inova Health System, Falls Church, VA (D.L.B., E.K., K.C.H.)
| | - Sue Ann Ingles
- Department of Preventative Medicine, University of Southern California, Keck School of Medicine, Los Angeles (S.A.I., M.L.W.)
| | - Charles J Lockwood
- University of South Florida, Morsani College of Medicine, Tampa (C.J.L.)
| | - Hakon Hakonarson
- Divisions of Human Genetics and Pulmonary Medicine, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (H.H.)
| | | | - Jeffrey C Murray
- Department of Pediatrics, Carver College of Medicine, University of Iowa (J.C.M.)
| | - Melissa L Wilson
- Department of Preventative Medicine, University of Southern California, Keck School of Medicine, Los Angeles (S.A.I., M.L.W.)
| | - Errol R Norwitz
- Department of Obstetrics and Gynecology, Tufts Medical Center, Boston, MA (E.R.N.)
| | - S Ananth Karumanchi
- Center for Vascular Biology Research, Beth Israel Deaconess Medical Center, Boston, MA (S.A.K.)
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA (S.A.K.)
| | - Brian T Bateman
- Brigham and Women's Hospital, Boston, MA; Department of Anesthesia, Critical Care and Pain Medicine (H.M., B.T.B., R.S.)
| | - Brendan J Keating
- Department of Surgery and Pediatrics, University of Pennsylvania, Philadelphia (B.J.K.)
| | - Richa Saxena
- Brigham and Women's Hospital, Boston, MA; Department of Anesthesia, Critical Care and Pain Medicine (H.M., B.T.B., R.S.)
- Center for Genomic Medicine (K.J.G., A.C.B., R.S.)
- Massachusetts General Hospital, Boston; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA (K.J.G., A.C.B., R.S.)
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22
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Giannakou K, Evangelou E, Papatheodorou SI. Genetic and non-genetic risk factors for pre-eclampsia: umbrella review of systematic reviews and meta-analyses of observational studies. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2018; 51:720-730. [PMID: 29143991 DOI: 10.1002/uog.18959] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/09/2017] [Accepted: 10/30/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To summarize evidence from the literature on genetic and non-genetic risk factors associated with pre-eclampsia (PE), assess the presence of statistical bias in the studies and identify risk factors for which there is robust evidence supporting their association with PE. METHODS PubMed and ISI Web of Science were searched from inception to October 2016, to identify systematic reviews and meta-analyses of observational studies examining associations between genetic or non-genetic risk factors and PE. For each meta-analysis, the summary-effect size was estimated using random-effects and fixed-effects models, along with 95% CIs and the 95% prediction interval. Between-study heterogeneity was expressed using the I2 statistic, and evidence of small-study effects (large studies had significantly more conservative results than smaller studies) and evidence of excess significance bias (too many studies with statistically significant results) were estimated. RESULTS Fifty-eight eligible meta-analyses were identified, which included 1466 primary studies and provided data on 130 comparisons of risk factors associated with PE, covering a wide range of comorbid diseases, genetic factors, exposure to environmental agents and biomarkers. Sixty-five (50%) associations had nominally statistically significant findings at P < 0.05, while 16 (12%) were significant at P < 10-6 . Sixty-five (50%) associations had large or very large heterogeneity. Evidence for small-study effects and excess significance bias was found in 10 (8%) and 26 (20%) associations, respectively. The only non-genetic risk factor with convincing evidence for an association with PE was oocyte donation vs spontaneous conception, which had a summary odds ratio of 4.33 (95% CI, 3.11-6.03), was supported by 2712 cases with small heterogeneity (I2 = 26%) and 95% prediction intervals excluding the null value, and without hints of small-study effects (P for Egger's test > 0.10) or excess of significance (P > 0.05). Of the statistically significant (P < 0.05) genetic risk factors for PE, only PAI-1 4G/5G (recessive model) polymorphism was supported by strong evidence for a contribution to the pathogenesis of PE. Eleven factors (serum iron level, pregnancy-associated plasma protein-A, chronic kidney disease, polycystic ovary syndrome, mental stress, bacterial and viral infections, cigarette smoking, oocyte donation vs assisted reproductive technology, obesity vs normal weight, severe obesity vs normal weight and primiparity) presented highly suggestive evidence for an association with PE. CONCLUSIONS A large proportion of meta-analyses of genetic and non-genetic risk factors for PE have caveats that threaten their validity. Oocyte donation vs spontaneous conception and PAI-1 4G/5G polymorphism (recessive model) showed the strongest consistent evidence for an association with risk for PE. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- K Giannakou
- Cyprus International Institute for Environmental & Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - E Evangelou
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - S I Papatheodorou
- Cyprus International Institute for Environmental & Public Health, Cyprus University of Technology, Limassol, Cyprus
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Gray KJ, Saxena R, Karumanchi SA. Genetic predisposition to preeclampsia is conferred by fetal DNA variants near FLT1, a gene involved in the regulation of angiogenesis. Am J Obstet Gynecol 2018; 218:211-218. [PMID: 29138037 DOI: 10.1016/j.ajog.2017.11.562] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 11/06/2017] [Accepted: 11/07/2017] [Indexed: 10/18/2022]
Abstract
Preeclampsia risk is influenced by both the mother's genetic background and the genetics of her fetus; however, the specific genes responsible for conferring preeclampsia risk have largely remained elusive. Evidence that preeclampsia has a genetic predisposition was first detailed in the early 1960s, and overall preeclampsia heritability is estimated at ∼55%. Many traditional gene discovery approaches have been used to investigate the specific genes that contribute to preeclampsia risk, but these have largely not been successful or reproducible. Over the past decade, genome-wide association studies have allowed for significant advances in the understanding of the genetic basis of many common diseases. Genome-wide association studies are predicated on the idea that the genetic basis of many common diseases are complex and polygenic with many variants, each with modest effects that contribute to disease risk. Using this approach in preeclampsia, a large genome-wide association study recently identified and replicated the first robust fetal genomic region associated with excess risk. A screen of >7 million genetic variants in 2658 offspring from preeclamptic women and 308,292 population controls identified a single association signal close to the Fms-like tyrosine kinase 1 gene, on chromosome 13. Fms-like tyrosine kinase 1 encodes soluble Fms-like tyrosine kinase 1, a splice variant of the vascular endothelial growth factor receptor that exerts antiangiogenic activity by inhibiting signaling of proangiogenic factors. The Fms-like tyrosine kinase 1 pathway is central in preeclampsia pathogenesis because excess circulating soluble Fms-like tyrosine kinase 1 in the maternal plasma leads to the hallmark clinical features of preeclampsia, including hypertension and proteinuria. The success of this landmark fetal preeclampsia genome-wide association study suggests that well-powered, larger maternal and fetal genome-wide association study will be fruitful in identifying additional common variants that implicate causal preeclampsia genes and pathways. Such efforts will rely on the continued development of large preeclampsia consortia focused on preeclampsia genetics to obtain adequate sample sizes, detailed clinical phenotyping, and matched maternal-fetal samples. In summary, the fetal preeclampsia genome-wide association study represents an exciting advance in preeclampsia biology, suggesting that dysregulation at the Fms-like tyrosine kinase 1 locus in the fetal genome (likely in the placenta) is a fundamental molecular defect in preeclampsia.
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Abstract
Preeclampsia (PE) is a serious hypertensive disorder that affects up to 8% of all pregnancies annually. An established risk factor for PE is family history, clearly demonstrating an underlying genetic component to the disorder. To date, numerous genetic studies, using both the candidate gene and genome-wide approach, have been undertaken to tease out the genetic basis of PE and understand its origins. Such studies have identified some promising candidate genes such as STOX1 and ACVR2A. Nevertheless, researchers face ongoing challenges of replicating these genetic associations in different populations and performing the functional validation of identified genetic variants to determine their causality in the disorder. This chapter will review the genetic approaches used in the study of PE, discuss their limitations and possible confounders, and describe current strategies.
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Affiliation(s)
- Hannah E J Yong
- Department of Maternal-Fetal Medicine Pregnancy Research Centre, The Royal Women's Hospital, Melbourne, VIC, Australia.
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, Australia.
- Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, The University of Cambridge, Cambridge, UK.
| | - Padma Murthi
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
- Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia
| | - Shaun P Brennecke
- Department of Maternal-Fetal Medicine Pregnancy Research Centre, The Royal Women's Hospital, Melbourne, VIC, Australia
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, Australia
| | - Eric K Moses
- Centre for Genetic Origins of Health and Disease, The University of Western Australia, Perth, Australia
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25
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Affiliation(s)
- Claire Infante-Rivard
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montréal, QC, Canada
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26
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Abstract
Preeclampsia is a major, frequent and potentially severe condition of pregnancy, characterized by severe hypertension and proteinuria. In this review, we describe recent advances in understanding the pathology, and discuss the long-term impacts on maternal vascular health. Next, we describe the genetic, epigenetic and immunological basis of preeclampsia. We describe the links between preeclampsia and oxidative stress in placental (trophoblast) and endothelial cells. We mention cellular and animal models commonly used to decipher modified pathophysiological pathways in a preeclamptic pregnancy compared to a normal pregnancy. Finally, we discuss the therapeutic options, readily available or in development, to improve the monitoring of pregnancies, the health of patients and that of children born from preeclamptic pregnancies.
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Affiliation(s)
- Céline Méhats
- Inserm U1016, CNRS UMR8104, Institut Cochin, équipe FGTB, 24, rue du faubourg Saint-Jacques, 75014 Paris, France
| | - Francisco Miralles
- Inserm U1016, CNRS UMR8104, Institut Cochin, équipe FGTB, 24, rue du faubourg Saint-Jacques, 75014 Paris, France
| | - Daniel Vaiman
- Inserm U1016, CNRS UMR8104, Institut Cochin, équipe FGTB, 24, rue du faubourg Saint-Jacques, 75014 Paris, France
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27
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Tejera E, Cruz-Monteagudo M, Burgos G, Sánchez ME, Sánchez-Rodríguez A, Pérez-Castillo Y, Borges F, Cordeiro MNDS, Paz-Y-Miño C, Rebelo I. Consensus strategy in genes prioritization and combined bioinformatics analysis for preeclampsia pathogenesis. BMC Med Genomics 2017; 10:50. [PMID: 28789679 PMCID: PMC5549357 DOI: 10.1186/s12920-017-0286-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 07/28/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Preeclampsia is a multifactorial disease with unknown pathogenesis. Even when recent studies explored this disease using several bioinformatics tools, the main objective was not directed to pathogenesis. Additionally, consensus prioritization was proved to be highly efficient in the recognition of genes-disease association. However, not information is available about the consensus ability to early recognize genes directly involved in pathogenesis. Therefore our aim in this study is to apply several theoretical approaches to explore preeclampsia; specifically those genes directly involved in the pathogenesis. METHODS We firstly evaluated the consensus between 12 prioritization strategies to early recognize pathogenic genes related to preeclampsia. A communality analysis in the protein-protein interaction network of previously selected genes was done including further enrichment analysis. The enrichment analysis includes metabolic pathways as well as gene ontology. Microarray data was also collected and used in order to confirm our results or as a strategy to weight the previously enriched pathways. RESULTS The consensus prioritized gene list was rationally filtered to 476 genes using several criteria. The communality analysis showed an enrichment of communities connected with VEGF-signaling pathway. This pathway is also enriched considering the microarray data. Our result point to VEGF, FLT1 and KDR as relevant pathogenic genes, as well as those connected with NO metabolism. CONCLUSION Our results revealed that consensus strategy improve the detection and initial enrichment of pathogenic genes, at least in preeclampsia condition. Moreover the combination of the first percent of the prioritized genes with protein-protein interaction network followed by communality analysis reduces the gene space. This approach actually identifies well known genes related with pathogenesis. However, genes like HSP90, PAK2, CD247 and others included in the first 1% of the prioritized list need to be further explored in preeclampsia pathogenesis through experimental approaches.
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Affiliation(s)
- Eduardo Tejera
- Facultad de Medicina, Universidad de Las Américas, Av. de los Granados E12-41y Colimes esq, EC170125, Quito, Ecuador.
| | - Maykel Cruz-Monteagudo
- Department of Molecular and Cellular Pharmacology, Miller School of Medicine and Center for Computational Science, University of Miami, FL 33136, Miami, USA.,Department of General Education, West Coast University-Miami Campus, Doral, FL 33178, USA.,CIQUP/Departamento de Quimica e Bioquimica, Faculdade de Ciências, Universidade do Porto, 4169-007, Porto, Portugal.,REQUIMTE, Department of Chemistry and Biochemistry, Faculty of Sciences, University of Porto, 4169-007, Porto, Portugal
| | - Germán Burgos
- Facultad de Medicina, Universidad de Las Américas, Av. de los Granados E12-41y Colimes esq, EC170125, Quito, Ecuador
| | - María-Eugenia Sánchez
- Facultad de Medicina, Universidad de Las Américas, Av. de los Granados E12-41y Colimes esq, EC170125, Quito, Ecuador
| | - Aminael Sánchez-Rodríguez
- Departamento de Ciencias Naturales, Universidad Técnica Particular de Loja, Calle París S/N, EC1101608, Loja, Ecuador
| | | | - Fernanda Borges
- CIQUP/Departamento de Quimica e Bioquimica, Faculdade de Ciências, Universidade do Porto, 4169-007, Porto, Portugal
| | | | - César Paz-Y-Miño
- Centro de Investigaciones genética y genómica, Facultad de Ciencias de la Salud, Universidad Tecnológica Equinoccial, Quito, Ecuador
| | - Irene Rebelo
- Faculty of Pharmacy, University of Porto, Porto, Portugal.,UCIBIO@REQUIMTE, Caparica, Portugal
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28
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Sakowicz A, Pietrucha T, Rybak-Krzyszkowska M, Huras H, Gach A, Sakowicz B, Banaszczyk M, Grzesiak M, Biesiada L. Double hit of NEMO gene in preeclampsia. PLoS One 2017; 12:e0180065. [PMID: 28654673 PMCID: PMC5487068 DOI: 10.1371/journal.pone.0180065] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 06/08/2017] [Indexed: 12/19/2022] Open
Abstract
The precise etiology of preeclampsia is unknown. Family studies indicate that both genetic and environmental factors influence its development. One of these factors is NFkB, whose activation depends on NEMO (NFkB essential modulator. This is the first study to investigate the association between the existence of single nucleotide variant of the NEMO gene and the appearance of preeclampsia. A total of 151 women (72 preeclamptic women and 79 controls) and their children were examined. Sanger sequencing was performed to identify variants in the NEMO gene in the preeclamptic mothers. The maternal identified variants were then sought in the studied groups of children, and in the maternal and child controls, using RFLP-PCR. Real-time RT-PCR was performed to assess NEMO gene expression in maternal blood, umbilical cord blood and placentas. The sequencing process indicated the existence of two different variants in the 3'UTR region of the NEMO gene of preeclamptic women (IKBKG:c.*368C>A and IKBKG:c.*402C>T). The simultaneous occurrence of the TT genotype in the mother and the TT genotype in the daughter or a T allele in the son increased the risk of preeclampsia development 2.59 fold. Additionally, we found that the configuration of maternal/fetal genotypes (maternal TT/ daughter TT or maternal TT/son T) of IKBKG:c.*402C/T variant is associated with the level of NEMO gene expression. Our results showed that, the simultaneous occurrence of the maternal TT genotype (IKBKG:c.*402C>T variants) and TT genotype in the daughter or T allele in the son correlates with the level of NEMO gene expression and increases the risk of preeclampsia development. Our observations may offer a new insight into the genetic etiology and pathogenesis of preeclampsia.
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Affiliation(s)
- Agata Sakowicz
- Department of Medical Biotechnology, Medical University of Lodz, Lodz, Poland
- * E-mail:
| | - Tadeusz Pietrucha
- Department of Medical Biotechnology, Medical University of Lodz, Lodz, Poland
| | | | - Hubert Huras
- Department of Obstetrics and Perinatology, University Hospital in Krakow, Krakow, Poland
| | - Agnieszka Gach
- Departments of Genetic, Polish Mother's Memorial Hospital-Research Institute in Lodz, Lodz, Poland
| | - Bartosz Sakowicz
- Department of Microelectronics and Computer Science, Lodz University of Technology, Lodz, Poland
| | | | - Mariusz Grzesiak
- Department of Obstetrics and Gynecology, Polish Mother's Memorial Hospital-Research Institute in Lodz, Lodz, Poland
| | - Lidia Biesiada
- Department of Obstetrics and Gynecology, Polish Mother's Memorial Hospital-Research Institute in Lodz, Lodz, Poland
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29
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Inherited predisposition to preeclampsia: Analysis of the Aberdeen intergenerational cohort. Pregnancy Hypertens 2017; 8:37-41. [DOI: 10.1016/j.preghy.2017.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 02/02/2017] [Accepted: 03/04/2017] [Indexed: 12/20/2022]
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30
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Luizon MR, Palei ACT, Cavalli RC, Sandrim VC. Pharmacogenetics in the treatment of pre-eclampsia: current findings, challenges and perspectives. Pharmacogenomics 2017; 18:571-583. [DOI: 10.2217/pgs-2016-0198] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Pre-eclampsia (PE) is defined as pregnancy-induced hypertension and proteinuria, and is a major cause of maternal and perinatal morbidity and mortality. A large subgroup of pregnant women with PE is nonresponsive to antihypertensive drugs, including methyldopa, nifedipine and hydralazine. Pharmacogenomics may help to guide the individualized therapy for this nonresponsive subgroup. However, just a few pharmacogenetic studies examined the effects of genetic polymorphisms on response to antihypertensive drugs in PE, and the criteria of responsiveness used to define responsive or nonresponsive subgroups to antihypertensive therapy should be replicated by others. We review these gene–drugs interactions, novel approaches to pharmacogenomics research and potential novel drugs for PE therapy. Finally, we discuss the challenges and perspectives of pharmacogenetics in the treatment of PE.
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Affiliation(s)
- Marcelo R Luizon
- Department of Pharmacology, Institute of Biosciences of Botucatu, Universidade Estadual Paulista (UNESP), Botucatu, Sao Paulo 18680-000, Brazil
- Department of General Biology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais 31270-901, Brazil
| | - Ana CT Palei
- Department of Surgery, Division of Pediatric & Congenital Heart Surgery, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Cardiovascular-Renal Research Center, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Ricardo C Cavalli
- Department of Gynecology & Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo 14049-900, Brazil
| | - Valeria C Sandrim
- Department of Pharmacology, Institute of Biosciences of Botucatu, Universidade Estadual Paulista (UNESP), Botucatu, Sao Paulo 18680-000, Brazil
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31
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Li X, Tan H, Zhou S, Hu S, Zhang T, Li Y, Dou Q, Lai Z, Chen F. Renin-angiotensin-aldosterone system gene polymorphisms in gestational hypertension and preeclampsia: A case-control gene-association study. Sci Rep 2016; 6:38030. [PMID: 27910864 PMCID: PMC5133626 DOI: 10.1038/srep38030] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 11/03/2016] [Indexed: 12/12/2022] Open
Abstract
Pregnancy-induced hypertension (PIH, including preeclampsia [PE] and gestational hypertension [GH]) and cardiovascular diseases (CVDs) have some metabolic changes and risk factors in common. Many studies have reported associations between single nucleotide polymorphisms (SNPs) of renin-angiotensin-aldosterone system (RAAS) genes and CVDs (particularly hypertension), and their findings have provided candidate SNPs for research on genetic correlates of PIH. We explored the association between hypertension-related RAAS SNPs and PIH in a Chinese population. A total of 130 cases with PE, 67 cases with GH, and 316 controls were recruited. Six candidate SNPs of the RAAS system were selected. Multiple logistic regression analysis adjusting for maternal age, fetal sex, and gestational diabetes mellitus showed significant associations between angiotensinogen (AGT) rs3789678 T/C and GH (p = 0.0088) and between angiotensin II receptor type 1 (AGTR1) rs275645 G/A and PE (p = 0.0082). The study population was further stratified by maternal age (<30 and ≥30 years), and stratified and crossover analyses were conducted to determine genetic associations in different age groups. Our findings suggest that the impacts of different SNPs might be affected by maternal age; however, the effect of this potential gene-age interaction on PIH needs further exploration.
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Affiliation(s)
- Xun Li
- Xiangya School of Public Health, Central South University, 90 Xiangya Road, Changsha, Hunan, China
| | - Hongzhuan Tan
- Xiangya School of Public Health, Central South University, 90 Xiangya Road, Changsha, Hunan, China
| | - Shujin Zhou
- Liuyang Municipal Hospital of Maternal and Child Health, 53 Beizheng North Road, Liuyang, Hunan, China
| | - Shimin Hu
- Xiangya School of Public Health, Central South University, 90 Xiangya Road, Changsha, Hunan, China
| | - Tianyi Zhang
- Xiangya School of Public Health, Central South University, 90 Xiangya Road, Changsha, Hunan, China
| | - Yangfen Li
- Xiangya School of Public Health, Central South University, 90 Xiangya Road, Changsha, Hunan, China
| | - Qianru Dou
- Xiangya School of Public Health, Central South University, 90 Xiangya Road, Changsha, Hunan, China
| | - Zhiwei Lai
- Xiangya School of Public Health, Central South University, 90 Xiangya Road, Changsha, Hunan, China
| | - Fenglei Chen
- Xiangya School of Public Health, Central South University, 90 Xiangya Road, Changsha, Hunan, China
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32
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Systematic review and meta-analysis of genetic association studies in idiopathic recurrent spontaneous abortion. Fertil Steril 2016; 107:150-159.e2. [PMID: 27842992 DOI: 10.1016/j.fertnstert.2016.10.007] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 10/03/2016] [Accepted: 10/04/2016] [Indexed: 01/12/2023]
Abstract
OBJECTIVES 1) To perform the first comprehensive systematic review of genetic association studies (GASs) in idiopathic recurrent spontaneous abortion (IRSA); 2) to analyze studies according to recurrent spontaneous abortion (RSA) definition and selection criteria for patients and control subjects; and 3) to perform meta-analyses for the association of candidate genes with IRSA. DESIGN Systematic review and meta-analysis. SETTING Not applicable. PATIENT(S) Couples with IRSA and their spontaneously aborted embryos. INTERVENTION(S) Summary odds ratios (ORs) were calculated by means of fixed- or random-effects models. MAIN OUTCOME MEASURE(S) Association of genetic variants with IRSA. RESULT(S) The systematic review included 428 case-control studies (1990-2015), which differed substantially regarding RSA definition, clinical evaluation of patients, and selection of control subjects. In women, 472 variants in 187 genes were investigated. Meta-analyses were performed for 36 variants in 16 genes. Association with IRSA defined as three or more spontaneous abortions (SAs) was detected for 21 variants in genes involved in immune response (IFNG, IL10, KIR2DS2, KIR2DS3, KIR2DS4, MBL, TNF), coagulation (F2, F5, PAI-1, PROZ), metabolism (GSTT1, MTHFR), and angiogenesis (NOS3, VEGFA). However, ORs were modest (0.51-2.37), with moderate or weak epidemiologic credibility. Minor differences in summary ORs were detected between IRSA defined as two or more and as three or more SAs. Male partners were included in 12.1% of studies, and one study included spontaneously aborted embryos. CONCLUSION(S) Candidate gene studies show moderate associations with IRSA. Owing to large differences in RSA definition and selection criteria for participants, consensus is needed. Future GASs should include both partners and spontaneously aborted embryos. Genome-wide association studies and large-scale replications of identified associations are recommended.
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Karppanen T, Kaartokallio T, Klemetti MM, Heinonen S, Kajantie E, Kere J, Kivinen K, Pouta A, Staff AC, Laivuori H. An RGS2 3'UTR polymorphism is associated with preeclampsia in overweight women. BMC Genet 2016; 17:121. [PMID: 27558088 PMCID: PMC4997762 DOI: 10.1186/s12863-016-0428-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 08/18/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Preeclampsia is a common and heterogeneous vascular syndrome of pregnancy. Its genetic risk profile is yet unknown and may vary between individuals and populations. The rs4606 3' UTR polymorphism of the Regulator of G-protein signaling 2 gene (RGS2) in the mother has been implicated in preeclampsia as well as in the development of chronic hypertension after preeclampsia. The RGS2 protein acts as an inhibitor of physiological vasoconstrictive pathways, and a low RGS2 level is associated with hypertension and obesity, two conditions that predispose to preeclampsia. We genotyped the rs4606 polymorphism in 1339 preeclamptic patients and in 697 controls from the Finnish Genetics of Preeclampsia Consortium (FINNPEC) cohort to study the association of the variant with preeclampsia. RESULTS No association between rs4606 and preeclampsia was detected in the analysis including all women. However, the polymorphism was associated with preeclampsia in a subgroup of overweight women (body mass index ≥ 25 kg/m(2), and < 30 kg/m(2)) (dominant model; odds ratio, 1.64; 95 % confidence interval, 1.10-2.42). CONCLUSIONS Our results suggest that RGS2 might be involved in the pathogenesis of preeclampsia particularly in overweight women and contribute to their increased risk for hypertension and other types of cardiovascular disease later in life.
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Affiliation(s)
- Tiina Karppanen
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Tea Kaartokallio
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Miira M Klemetti
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Obstetrics and Gynecology, South-Karelia Central Hospital, Lappeenranta, Finland
| | - Seppo Heinonen
- Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Eero Kajantie
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland.,Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.,PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Juha Kere
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Biosciences and Nutrition, and Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden.,Folkhälsan Institute of Genetics, Helsinki, Finland
| | - Katja Kivinen
- Division of Cardiovascular Medicine, University of Cambridge, Cambridge, UK
| | - Anneli Pouta
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Government services, National Institute for Health and Welfare, Helsinki, Finland
| | - Anne Cathrine Staff
- Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
| | - Hannele Laivuori
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
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Exome sequencing in pooled DNA samples to identify maternal pre-eclampsia risk variants. Sci Rep 2016; 6:29085. [PMID: 27384325 PMCID: PMC4935848 DOI: 10.1038/srep29085] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 06/14/2016] [Indexed: 02/04/2023] Open
Abstract
Pre-eclampsia is a common pregnancy disorder that is a major cause for maternal and perinatal mortality and morbidity. Variants predisposing to pre-eclampsia might be under negative evolutionary selection that is likely to keep their population frequencies low. We exome sequenced samples from a hundred Finnish pre-eclamptic women in pools of ten to screen for low-frequency, large-effect risk variants for pre-eclampsia. After filtering and additional genotyping steps, we selected 28 low-frequency missense, nonsense and splice site variants that were enriched in the pre-eclampsia pools compared to reference data, and genotyped the variants in 1353 pre-eclamptic and 699 non-pre-eclamptic women to test the association of them with pre-eclampsia and quantitative traits relevant for the disease. Genotypes from the SISu project (n = 6118 exome sequenced Finnish samples) were included in the binary trait association analysis as a population reference to increase statistical power. In these analyses, none of the variants tested reached genome-wide significance. In conclusion, the genetic risk for pre-eclampsia is likely complex even in a population isolate like Finland, and larger sample sizes will be necessary to detect risk variants.
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Zhang G, Zhao J, Yi J, Luan Y, Wang Q. Association Between Gene Polymorphisms on Chromosome 1 and Susceptibility to Pre-Eclampsia: An Updated Meta-Analysis. Med Sci Monit 2016; 22:2202-14. [PMID: 27348238 PMCID: PMC4927145 DOI: 10.12659/msm.896552] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background This meta-analysis enabled us to obtain a precise estimation of the association between gene polymorphisms on chromosome 1 (MTHFR, AGT, F5, IL-10, LEPR) and the susceptibility to pre-eclampsia (PE) in order to reach a uniform conclusion. Material/Methods Web of Science, PubMed, EMBASE, Cochran Library (CENTRAL), and Chinese databases (Chinese National Knowledge Infrastructure-CNKI and Wan Fang) were electronically searched to select relevant studies for this meta-analysis. We selected 95 case-control studies investigating 5 genes (MTHFR, AGT, F5, IL-10, and LEPR) with 8 SNPs. Odds ratios (OR) with their 95% confidence intervals (CI) were used for estimating the association. Results A total of 16 646 PE patients and 28 901 normal-pregnancy patients were included in this meta-analysis. The overall results suggested that rs1801133 of MTHFR (OR=1.17, 95% CI: 1.05–1.13) and rs6025 of F5 (OR=1.53, 95%CI: 1.07–2.20) are significantly associated with PE, whereas rs1801131 of MTHFR, rs699 and rs4762 of AGT, rs1800896 and rs1800871 of IL-10, and rs1137101 of LEPR have no significant association with PE. Subgroup analysis by ethnicity revealed that, except for MTHFR rs1801133 and F5 rs6025 in Caucasians, which were significantly associated with an increased risk of PE, none of these SNPs were significantly associated with PE. As suggested by a symmetric funnel plot in conjunction with the Egger’s test, there was no significant publication bias in MTHFR rs1801133 (P=0.318) and rs1801131 (P=0.204), F5 rs6025 (P=0.511), LEPR rs1137101 (P=0.511), AGT rs4762 (P=0.215) and rs699 (P=0.482), IL-10 rs1800871 (P=0.955), and rs1800896 (P=0.144). Conclusions This meta-analysis provides evidence that MTHFR rs1801133 and F5 rs6025 are associated with an increased risk of PE, especially in Caucasians. However, we do not have sufficient evidence to conclude there is a significant association between other gene polymorphisms and PE.
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Affiliation(s)
- Guixin Zhang
- , The Hospital of Maternal and Child Health of Tangshan, Tangshan, Hebei, China (mainland)
| | - Jinheng Zhao
- , The Hospital of Maternal and Child Health of Tangshan, Tangshan, Hebei, China (mainland)
| | - Jianping Yi
- , The Hospital of Maternal and Child Health of Tangshan, Tangshan, Hebei, China (mainland)
| | - Yuanyuan Luan
- , The Hospital of Maternal and Child Health of Tangshan, Tangshan, Hebei, China (mainland)
| | - Qian Wang
- , The Hospital of Maternal and Child Health of Tangshan, Tangshan, Hebei, China (mainland)
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Silva Carmona A, Mendieta Zerón H. NF-κΒ and SOD expression in preeclamptic placentas. Turk J Med Sci 2016; 46:783-8. [PMID: 27513256 DOI: 10.3906/sag-1503-75] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 08/09/2015] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND/AIM Preeclampsia is a leading cause of maternal death in the developing world. Our aim was to quantify and compare messenger (mRNA) expression of nuclear factor-kappa beta (NF-κΒ) and superoxide dismutase (SOD) in control patients with preeclampsia and without preeclampsia with or without familial hereditary background. MATERIALS AND METHODS Four groups of patients were formed depending on the presence or absence of preeclampsia and presence or absence of familial history for preeclampsia. NF-κΒ and SOD were measured in human placentas by real-time quantitative polymerase chain reaction. The 2-ΔΔct analysis method was used to measure the difference in the relative expression of the target genes in each group of patients. RESULTS In NF-κΒ expression, there was an increase of 23.35% in the group of women with preeclampsia versus women with preeclampsia without familial history. Regarding SOD, there was a reduction of about 33.33% in the expression in women with preeclampsia with familial history versus women with preeclampsia without familial history. CONCLUSION Familial presence of preeclampsia could predispose to altered expression in SOD and NF-κΒ.
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Affiliation(s)
| | - Hugo Mendieta Zerón
- Maternal-Perinatal Hospital "Mónica Pretelini Sáenz" (HMPMPS), Health Institute of the State of Mexico (ISEM), Toluca, Mexico
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Abstract
Pre-eclampsia affects 3-5% of pregnancies and is traditionally diagnosed by the combined presentation of high blood pressure and proteinuria. New definitions also include maternal organ dysfunction, such as renal insufficiency, liver involvement, neurological or haematological complications, uteroplacental dysfunction, or fetal growth restriction. When left untreated, pre-eclampsia can be lethal, and in low-resource settings, this disorder is one of the main causes of maternal and child mortality. In the absence of curative treatment, the management of pre-eclampsia involves stabilisation of the mother and fetus, followed by delivery at an optimal time. Although algorithms to predict pre-eclampsia are promising, they have yet to become validated. Simple preventive measures, such as low-dose aspirin, calcium, and diet and lifestyle interventions, show potential but small benefit. Because pre-eclampsia predisposes mothers to cardiovascular disease later in life, pregnancy is also a window for future health. A collaborative approach to discovery and assessment of the available treatments will hasten our understanding of pre-eclampsia and is an effort much needed by the women and babies affected by its complications.
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Affiliation(s)
- Ben W J Mol
- The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, SA, Australia.
| | - Claire T Roberts
- The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, SA, Australia
| | - Shakila Thangaratinam
- Women's Health Research Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Laura A Magee
- BC Women's Hospital and Health Centre, Vancouver, BC, Canada
| | | | - G Justus Hofmeyr
- Effective Care Research Unit, University of the Witwatersrand, University of Fort Hare, and Eastern Cape Department of Health, East London, South Africa
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Malik R, Kumar V. Hypertension in Pregnancy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 956:375-393. [DOI: 10.1007/5584_2016_150] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Pereza N, Ostojić S, Zdravčević M, Volk M, Kapović M, Peterlin B. Insertion/deletion polymorphism in intron 16 of ACE gene in idiopathic recurrent spontaneous abortion: case-control study, systematic review and meta-analysis. Reprod Biomed Online 2015; 32:237-46. [PMID: 26673102 DOI: 10.1016/j.rbmo.2015.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 11/03/2015] [Accepted: 11/04/2015] [Indexed: 11/19/2022]
Abstract
The insertion/deletion (I/D) polymorphism in intron 16 of the angiotensin I-converting enzyme gene (ACE) has been extensively studied as a predisposing factor for idiopathic recurrent spontaneous abortion (IRSA). A case-control study including 149 women with ≥3 spontaneous abortions and 149 controls was performed to test the association of ACE I/D polymorphism with IRSA. A systematic review was conducted of previous case-control studies, with strict selection criteria for meta-analyses. We also aimed to evaluate the potential differences in summary estimates between studies defining IRSA as ≥2 and ≥3 spontaneous abortions. Genotyping was performed by PCR, and systematic review conducted using PubMed and Scopus. There was no association of the polymorphism with IRSA in Slovenian women. Sixteen case-control studies, showing substantial differences regarding IRSA definition and selection criteria for women were identified. Meta-analysis was performed and included four studies defining IRSA as ≥2 spontaneous abortions and the current study, which defined IRSA as ≥3 spontaneous abortions. Based on random effects model, meta-analysis conducted on 1192 patients and 736 controls showed no association with IRSA under dominant(DD+IDvsII) and recessive(DDvsID+II) genetic models. Well-designed studies are needed to evaluate the role of ACE I/D polymorphism in IRSA defined as ≥3 spontaneous abortions.
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Affiliation(s)
- Nina Pereza
- Department of biology and medical genetics, Faculty of medicine, University of Rijeka, B. Branchetta 20, 51000 Rijeka, Croatia.
| | - Saša Ostojić
- Department of biology and medical genetics, Faculty of medicine, University of Rijeka, B. Branchetta 20, 51000 Rijeka, Croatia
| | - Matea Zdravčević
- Department of biology and medical genetics, Faculty of medicine, University of Rijeka, B. Branchetta 20, 51000 Rijeka, Croatia
| | - Marija Volk
- Clinical Institute of Medical Genetics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | - Miljenko Kapović
- Department of biology and medical genetics, Faculty of medicine, University of Rijeka, B. Branchetta 20, 51000 Rijeka, Croatia
| | - Borut Peterlin
- Clinical Institute of Medical Genetics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
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Belbasis L, Panagiotou OA, Dosis V, Evangelou E. A systematic appraisal of field synopses in genetic epidemiology: a HuGE review. Am J Epidemiol 2015; 181:1-16. [PMID: 25504025 DOI: 10.1093/aje/kwu249] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Evidence from genetic association studies is accumulating rapidly. Field synopses have recently arisen as an unbiased way of systematically synthesizing this evidence. We performed a systematic review and appraisal of published field synopses in genetic epidemiology and assessed their main findings and methodological characteristics. We identified 61 eligible field synopses, published between January 1, 2007, and October 31, 2013, on 52 outcomes reporting 734 significant associations at the P < 0.05 level. The median odds ratio for these associations was 1.25 (interquartile range, 1.15-1.43). Egger's test was the most common method (n = 30 synopses) of assessing publication bias. Only 12 synopses (20%) used the Venice criteria to evaluate the epidemiologic credibility of their findings (n = 449 variants). Eleven synopses (18%) were accompanied by an online database that has been regularly updated. These synopses received more citations (P = 0.01) and needed a larger research team (P = 0.02) than synopses without an online database. Overall, field synopses are becoming a valuable tool for the identification of common genetic variants, especially when researchers follow relevant methodological guidelines. Our work provides a summary of the current status of the field synopses published to date and may help interested readers efficiently identify the online resources containing the relevant genetic evidence.
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Morgan L, McGinnis R, Steinthorsdottir V, Svyatova G, Zakhidova N, Lee WK, Iversen AC, Magnus P, Walker J, Casas JP, Sultanov S, Laivuori H. InterPregGen: genetic studies of pre-eclampsia in three continents. NORSK EPIDEMIOLOGI 2014; 24:141-146. [PMID: 26568652 PMCID: PMC4641320 DOI: 10.5324/nje.v24i1-2.1815] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Pre-eclampsia is a major cause of maternal and fetal mortality in pregnancy. The identification of genetic variants which predispose to pre-eclampsia demands large DNA collections from affected mothers and babies and controls, with reliable supporting phenotypic data. The InterPregGen study has assembled a consortium of researchers from Europe, Central Asia and South America with the aim of elucidating the genetic architecture of pre-eclampsia. The MoBa collection is playing a vital role in this collaborative venture, which has the potential to provide new insights into the causes of pre-eclampsia, and provide a rational basis for novel approaches to prevention and treatment.
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Affiliation(s)
- Linda Morgan
- School of Life Sciences, University of Nottingham, UK
| | | | | | - Gulnara Svyatova
- Scientific Centre of Obstetrics, Gynaecology and Perinatology of Ministry of Health, Kazakhstan
| | | | - Wai Kwong Lee
- BHF Glasgow Cardiovascular Research Centre, University of Glasgow, UK
| | - Ann-Charlotte Iversen
- Department of Cancer Research and Molecular Medicine and Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Norway
| | - Per Magnus
- Norwegian Institute of Public Health, Norway
| | - James Walker
- Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, UK
| | - Juan Pablo Casas
- London School of Hygiene and Tropical Medicine and University College London, UK
| | - Saidazim Sultanov
- Republic Specialized Scientific-Practical Medical Centre of Obstetrics and Gynaecology, Uzbekistan
| | - Hannele Laivuori
- Haartman Institute, Medical Genetics, University of Helsinki, Finland
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Stepanian A, Alcaïs A, de Prost D, Tsatsaris V, Dreyfus M, Treluyer JM, Mandelbrot L. Highly significant association between two common single nucleotide polymorphisms in CORIN gene and preeclampsia in Caucasian women. PLoS One 2014; 9:e113176. [PMID: 25474356 PMCID: PMC4256174 DOI: 10.1371/journal.pone.0113176] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 09/24/2014] [Indexed: 11/19/2022] Open
Abstract
Preeclampsia is a frequent medical complication during pregnancy. Corin, a serine protease which activates pro-atrial natriuretic peptide, has recently been shown to be involved in the pathophysiology of preeclampsia. The aim of this study was to search for CORIN gene variations and their association to preeclampsia in Caucasian and African women. Our study population was composed of 571 pregnant women (295 with preeclampsia and 276 normotensive controls) matched for maternal and gestational age, and ethnic origin. The 22 exons of the CORIN gene were sequenced in a discovery sample (n = 260), where 31 single nucleotide polymorphisms were identified. In a replication sample (n = 311), 4 single nucleotide polymorphisms were tested. Two minor alleles (C for rs2271036 and G for rs2271037) were significantly associated to preeclampsia. Adjusted odds ratios [95% confidence interval] were 2.5 [1.2-3.8] (p = 0.007) and 2.3 [1.5-3.5] (p = 1.3 × 10(-4)), respectively. These associations were ethnic-specific, as only found in the Caucasian of subjects (odds ratio = 3.5 [1.8-6.6], p = 1.1 × 10(-4); odds ratio = 3.1 [1.7-5.8], p = 2.1 × 10(-4), for each single nucleotide polymorphism, respectively). The two single nucleotide polymorphisms are in almost perfect linkage disequilibrium (r(2) = 0.93). No specific association was found with severe preeclampsia, early-onset preeclampsia nor fetal growth retardation. In conclusion, this is the first report of a highly significant association between these two single nucleotide polymorphisms in CORIN gene and preeclampsia. Our findings further support the probability of a critical role of corin in preeclamspia pathophysiology at the uteroplacental interface.
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Affiliation(s)
- Alain Stepanian
- Service d’Hématologie Biologique, Hôpital Lariboisière, Paris, France
| | - Alexandre Alcaïs
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale, U1163, Imagine Institute, Paris, France
- University Paris Descartes, Sorbonne Paris Cité, Paris, France
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, New York, United States of America
- INSERM CIC P0901, Paris, France
| | - Dominique de Prost
- Service d’Hématologie biologique et Transfusion, Hôpital Louis Mourier (AP-HP), Colombes, France
- Unité 770, INSERM, Le Kremlin-Bicêtre, France
- Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Vassilis Tsatsaris
- Service de Gynécologie-Obstétrique, Hôpital Port-Royal (AP-HP), Paris, France
- Unité 767, INSERM, Université Paris Descartes, Paris, France
- Département Hospitalo-Universitaire Risque et Grossesse, Paris, France
- Fondation PremUP, Paris, France
| | - Michel Dreyfus
- CHU Clémenceau, Unité de Gynécologie-Obstétrique et Médecine de la Reproduction, Caen, France
| | - Jean-Marc Treluyer
- University Paris Descartes, Sorbonne Paris Cité, Paris, France
- Département Hospitalo-Universitaire Risque et Grossesse, Paris, France
- INSERM CIC P0901, Paris, France
| | - Laurent Mandelbrot
- Département Hospitalo-Universitaire Risque et Grossesse, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, Paris, France
- AP-HP, Hôpital Louis Mourier, service de Gynécologie-Obstétrique, Colombes, France
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Investigation of polymorphisms in pre-eclampsia related genes VEGF and IL1A. Arch Gynecol Obstet 2014; 291:1029-35. [DOI: 10.1007/s00404-014-3503-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 09/29/2014] [Indexed: 01/25/2023]
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Yang W, Zhu Z, Wang J, Ye W, Ding Y. Evaluation of association of maternal IL-10 polymorphisms with risk of preeclampsia by A meta-analysis. J Cell Mol Med 2014; 18:2466-77. [PMID: 25257050 PMCID: PMC4302652 DOI: 10.1111/jcmm.12434] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 08/19/2014] [Indexed: 11/26/2022] Open
Abstract
Emerging evidence shows that interleukin (IL)-10 gene polymorphisms can regulate its expression level and thus influence person's susceptibility to preeclampsia. However, various published results were inconsistent. To explore the association between maternal IL-10 gene polymorphisms and preeclampsia, we performed a meta-analysis based upon 11 individual studies here. Our meta-analysis results indicated that IL-10 -819C/T (C versus T, OR = 1.28, 95% CI = 1.08–1.50, P = 0.003) and -592C/A (C versus A, OR = 1.28, 95% CI = 1.03–1.59, P = 0.03) polymorphisms were associated with preeclampsia. Although there was no overall association between -1082A/G polymorphism and preeclampsia (G versus A, OR = 0.93, 95% CI = 0.77–1.13, P = 0.49), such association existed among Asian (G versus A, OR = 1.29, 95% CI = 1.04–1.60, P = 0.02) and South American (G versus A, OR = 0.72, 95% CI = 0.54–0.94, P = 0.02) populations in the subgroup analysis stratified by continents.
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Affiliation(s)
- Wenchao Yang
- Management Department, Shanghai Medical Instrumentation College, Shanghai, China
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Zawiejska A, Wender-Ozegowska E, Iciek R, Brazert J. Concentrations of endothelial nitric oxide synthase, angiotensin-converting enzyme, vascular endothelial growth factor and placental growth factor in maternal blood and maternal metabolic status in pregnancy complicated by hypertensive disorders. J Hum Hypertens 2014; 28:670-6. [PMID: 25186136 DOI: 10.1038/jhh.2014.42] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2013] [Revised: 03/20/2014] [Accepted: 04/29/2014] [Indexed: 01/21/2023]
Abstract
Hypertensive disorders of pregnancy (HDPs) are associated with altered maternal metabolism, impaired perinatal outcome and increased risk for remote maternal complications. The aim of our study was to analyse associations between circulating levels of angiogenic factors and markers of oxidative stress and metabolic status in women with HDP. Forty-six women in singleton pregnancies complicated by HDP and 30 healthy controls were enrolled in a prospective observational study. Serum concentrations of endothelial nitric oxide synthase (eNOS), angiotensin-converting enzyme, vascular endothelial growth factor (VEGF) and placental growth factor (PlGF) were measured in the third trimester and correlated with maternal anthropometrics and metabolic status. We found significantly lower eNOS levels in patients with severe hypertension vs controls, a strong association between eNOS and PlGF in the study group, a significant association between maternal prepregnancy body mass index (BMI) and VEGF levels and an inverse correlation between VEGF and PlGF. Maternal prepregnancy BMI was the only independent predictor for VEGF concentrations. We noted reduced levels of PlGF and eNOS and increased VEGF levels in women with severe hypertension/preeclampsia. First, different forms of HDP are associated with different alteration patterns in concentrations of angiogenic factors and markers of oxidative stress. Second, maternal prepregnancy BMI, but not body weight, is a significant predictor for VEGF levels in late pregnancy.
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Affiliation(s)
- A Zawiejska
- Department of Obstetrics and Women's Diseases, University of Medical Sciences, Poznan, Poland
| | - E Wender-Ozegowska
- Department of Obstetrics and Women's Diseases, University of Medical Sciences, Poznan, Poland
| | - R Iciek
- Department of Obstetrics and Women's Diseases, University of Medical Sciences, Poznan, Poland
| | - J Brazert
- Department of Obstetrics and Women's Diseases, University of Medical Sciences, Poznan, Poland
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Fong FM, Sahemey MK, Hamedi G, Eyitayo R, Yates D, Kuan V, Thangaratinam S, Walton RT. Maternal genotype and severe preeclampsia: a HuGE review. Am J Epidemiol 2014; 180:335-45. [PMID: 25028703 DOI: 10.1093/aje/kwu151] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Severe preeclampsia is a common cause of maternal and perinatal morbidity worldwide. The disease clusters in families; however, individual genetic studies have produced inconsistent results. We conducted a review to examine relationships between maternal genotype and severe preeclampsia. We searched the MEDLINE and Embase databases for prospective and retrospective cohort and case-control studies reporting associations between genes and severe preeclampsia. Four reviewers independently undertook study selection, quality assessment, and data extraction. We performed random-effects meta-analyses by genotype and predefined functional gene group (thrombophilic, vasoactive, metabolic, immune, and cell signalling). Fifty-seven studies evaluated 50 genotypes in 5,049 cases and 16,989 controls. Meta-analysis showed a higher risk of severe preeclampsia with coagulation factor V gene (proaccelerin, labile factor) (F5) polymorphism rs6025 (odds ratio = 1.90, 95% confidence interval: 1.42, 2.54; 23 studies, I(2) = 29%), coagulation factor II (thrombin) gene (F2) mutation G20210A (rs1799963) (odds ratio = 2.01, 95% confidence interval: 1.14, 3.55, 9 studies, I(2) = 0%), leptin receptor gene (LEPR) polymorphism rs1137100 (odds ratio = 1.75, 95% confidence interval: 1.15, 2.65; 2 studies, I(2) = 0%), and the thrombophilic gene group (odds ratio = 1.87, 95% confidence interval: 1.43, 2.45, I(2) = 27%). There were no associations with other gene groups. There was moderate heterogeneity between studies and potential for bias from poor-quality genotyping and inconsistent definition of phenotype. Further studies with robust methods should investigate genetic factors that might potentially be used to stratify pregnancies according to risk of complications.
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Barrett HL, Dekker Nitert M, McIntyre HD, Callaway LK. Maternal lipids in pre-eclampsia: innocent bystander or culprit? Hypertens Pregnancy 2014; 33:508-23. [PMID: 25121342 DOI: 10.3109/10641955.2014.946614] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Pre-eclampsia continues to be a challenge--to understand the underlying pathogenesis and to prevent or treat in the clinical setting. One area of potential therapies opening up is treatment of maternal lipids and clinical trials are underway using statins in early pre-eclampsia. At present, most potential therapies to treat lipids cannot be recommended for general use in pregnancy and if we were to target maternal lipids to reduce rates of pre-eclampsia, very large numbers of women may need to be treated. Prior to reaching that point, we first need to understand whether maternal lipids are pathogenic in the processes underlying pre-eclampsia. The aim of this review is to examine the role of lipids in the pathogenesis and outcomes of pre-eclampsia, how abnormal lipid genes may be implicated and consider whether treatment of hyperlipidemia has a more general place in the prevention or treatment of pre-eclampsia.
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Affiliation(s)
- Helen L Barrett
- School of Medicine, The University of Queensland, St Lucia , Queensland , Australia
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Methylenetetrahydrofolate reductase gene C677T, A1298C polymorphisms and pre-eclampsia risk: a meta-analysis. Mol Biol Rep 2014; 41:5435-48. [DOI: 10.1007/s11033-014-3415-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 05/15/2014] [Indexed: 01/09/2023]
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Nakimuli A, Chazara O, Byamugisha J, Elliott AM, Kaleebu P, Mirembe F, Moffett A. Pregnancy, parturition and preeclampsia in women of African ancestry. Am J Obstet Gynecol 2014; 210:510-520.e1. [PMID: 24184340 PMCID: PMC4046649 DOI: 10.1016/j.ajog.2013.10.879] [Citation(s) in RCA: 66] [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: 09/11/2013] [Revised: 10/22/2013] [Accepted: 10/28/2013] [Indexed: 12/16/2022]
Abstract
Maternal and associated neonatal mortality rates in sub-Saharan Africa remain unacceptably high. In Mulago Hospital (Kampala, Uganda), 2 major causes of maternal death are preeclampsia and obstructed labor and their complications, conditions occurring at the extremes of the birthweight spectrum, a situation encapsulated as the obstetric dilemma. We have questioned whether the prevalence of these disorders occurs more frequently in indigenous African women and those with African ancestry elsewhere in the world by reviewing available literature. We conclude that these women are at greater risk of preeclampsia than other racial groups. At least part of this susceptibility seems independent of socioeconomic status and likely is due to biological or genetic factors. Evidence for a genetic contribution to preeclampsia is discussed. We go on to propose that the obstetric dilemma in humans is responsible for this situation and discuss how parturition and birthweight are subject to stabilizing selection. Other data we present also suggest that there are particularly strong evolutionary selective pressures operating during pregnancy and delivery in Africans. There is much greater genetic diversity and less linkage disequilibrium in Africa, and the genes responsible for regulating birthweight and placentation may therefore be easier to define than in non-African cohorts. Inclusion of African women into research on preeclampsia is an essential component in tackling this major disparity of maternal health.
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Affiliation(s)
- Annettee Nakimuli
- Department of Obstetrics and Gynaecology, Makerere University and Mulago Hospital, Kampala, Uganda
| | - Olympe Chazara
- Department of Pathology and Centre for Trophoblast Research, University of Cambridge, Cambridge, United Kingdom
| | - Josaphat Byamugisha
- Department of Obstetrics and Gynaecology, Makerere University and Mulago Hospital, Kampala, Uganda
| | - Alison M Elliott
- Medical Research Council/Uganda Virus Research Institute Uganda Research Unit on AIDS, Entebbe, Uganda; London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Pontiano Kaleebu
- Medical Research Council/Uganda Virus Research Institute Uganda Research Unit on AIDS, Entebbe, Uganda
| | - Florence Mirembe
- Department of Obstetrics and Gynaecology, Makerere University and Mulago Hospital, Kampala, Uganda
| | - Ashley Moffett
- Department of Pathology and Centre for Trophoblast Research, University of Cambridge, Cambridge, United Kingdom.
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Li X, Shen L, Tan H. Polymorphisms and plasma level of transforming growth factor-Beta 1 and risk for preeclampsia: a systematic review. PLoS One 2014; 9:e97230. [PMID: 24823830 PMCID: PMC4019528 DOI: 10.1371/journal.pone.0097230] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 04/16/2014] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Transforming growth factor-beta 1 (TGF-β1) is thought to be involved in the pathogenesis of preeclampsia (PE), but the results are inconsistent among studies. This article aims to compile an overview of the studies about the associations of TGF-β 1 polymorphism and plasma level with PE risk and to provide recommendations for future research. METHODS AND RESULTS The databases PubMed, Embase and Web of Science were searched up to December 2013. Five studies investigating the associations of four polymorphisms with the risks of PE were involved. A meta-analysis was conducted for the 869T>C polymorphism and PE risk. The results show that genotype TT of 869T>C polymorphism is a protective factor of PE (pooled odds ratio=0.73, 95% CI: 0.56, 0.95). Eight case-control studies reported the plasma level of TGF-β 1. The substantial heterogeneity among studies may be attributed to the differences in the blood sample processing and the TGF-β 1 analysis kits. The results suggest that plasma TGF-β 1 level in the second trimester was significantly lower in the PE group than in the normal pregnancy group, but was significantly higher in the PE group during the third trimester. CONCLUSIONS The current results support that the TGF-β 1 869 T>C polymorphism was associated with the risk of PE. However, the number of eligible studies is small and more studies are needed to clarify whether this association can be detected on larger sample sizes and different populations. Owing to the heterogeneity between studies, no conclusion on the association between plasma TGF-β 1 level and PE risk can be drawn from this review. Further studies about the TGF-β 1 levels at different stages of pregnancy and the development of TGF-β 1 assay methodology are required to reveal the role of TGF-β 1 in the pathological development of PE.
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Affiliation(s)
- Xun Li
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan, China
| | - Lin Shen
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan, China
| | - Hongzhuan Tan
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan, China
- * E-mail:
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