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Pizzo H, Mirocha J, Choi J, Garrison J, Haas M, Zhang X, Kamil ES, Kim I, Jordan SC, Puliyanda DP. Pre-transplant angiotensin II receptor type I antibodies in pediatric renal transplant recipients: An observational cohort study. Pediatr Transplant 2022; 26:e14400. [PMID: 36168673 DOI: 10.1111/petr.14400] [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: 05/27/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The role of angiotensin II type 1 receptor antibodies (AT1R-Ab) in pediatric renal transplantation is unclear. Here, we evaluated pre-transplant AT1R-Ab on transplant outcomes in the first 5 years. Secondary analysis compared pre-transplant AT1R-Ab levels by age. METHODS Thirty-six patients, 2-20 years old, were divided into two groups: pre-transplant AT1R-Ab- (<17 U/ml; n = 18) and pre-transplant AT1R-Ab+ (≥17 U/ml; n = 18). eGFR was determined at 6-month, 1-, 2-, and 4-year post-transplant. Allograft biopsies were performed in the setting of strong HLA-DSA (MFI > 10 000), AT1R-Ab ≥17 U/ml, and/or elevated creatinine. RESULTS Mean age in pre-transplant AT1R-Ab- was 13.3 years vs. 11.0 in pre-transplant AT1R-Ab+ (p = 0.16). At 6 months, mean eGFR was 111.3 ml/min/1.73 m2 in pre-transplant AT1R-Ab- vs. 100.2 in pre-transplant AT1R-Ab + at 1 year, 103.6 ml/min/1.73 m2 vs. 100.5; at 2 years, 98.9 ml/min/1.73 m2 vs. and 93.7; at 4 years, 72.6 ml/min/1.73 m2 vs. 80.9. 11/36 patients had acute rejection (6 in pre-transplant AT1R-Ab-, 5 in pre-transplant AT1R-Ab + ). There was no difference in rejection rates. All 6 subjects with de novo HLA-DSA and AT1R-Ab ≥17 U/ml at the time of biopsy experienced rejection. Mean age in those with the AT1R-Ab ≥40 U/ml was 10.0 years vs. 13.2 in those <40 U/ml (p = 0.07). CONCLUSION In our small cohort, pre-transplant AT1R-Ab ≥17 U/ml was not associated with reduced graft function or rejection. The pathogenicity of pre-transplant AT1R-Ab in pediatric kidney transplantation requires further investigation.
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Affiliation(s)
- Helen Pizzo
- Pediatric Nephrology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - James Mirocha
- Biostatistics Core, Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Jua Choi
- Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Jonathan Garrison
- Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Mark Haas
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, California, Los Angeles, USA
| | - Xiaohai Zhang
- HLA and Immunogenetics Laboratory, Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Elaine S Kamil
- Pediatric Nephrology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Irene Kim
- Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Stanley C Jordan
- Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Dechu P Puliyanda
- Pediatric Nephrology, Cedars-Sinai Medical Center, Los Angeles, California, USA
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Fajar JK, Pikir BS, Sidarta EP, Saka PNB, Akbar RR, Tamara F, Mayasari ED, Gunawan A, Heriansyah T. The genes polymorphism of angiotensinogen (AGT) M235T and AGT T174M in patients with essential hypertension: A meta-analysis. GENE REPORTS 2019. [DOI: 10.1016/j.genrep.2019.100421] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lee H, Oh EJ. Angiotensin II type 1 receptor antibodies in kidney transplantation. KOREAN JOURNAL OF TRANSPLANTATION 2019. [DOI: 10.4285/jkstn.2019.33.1.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Hyeyoung Lee
- Department of Laboratory Medicine, International St. Mary’s Hospital, College of Medicine, Catholic Kwandong University, Incheon, Korea
| | - Eun-Jee Oh
- Department of Laboratory Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Genetically determined enlargement of carotid body evaluated using computed angiotomography. Respir Physiol Neurobiol 2018; 254:10-15. [PMID: 29627490 DOI: 10.1016/j.resp.2018.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 03/30/2018] [Accepted: 04/04/2018] [Indexed: 11/21/2022]
Abstract
It has recently been established that carotid bodies play a significant role in the regulation of activities of the cardiovascular system as well as in the pathogenesis of arterial hypertension, heart failure and diabetes. Aim of study was to determinate the influence of polymorphisms within genes of the renin-angiotensin-aldosterone system (RAAS) on the volume of the carotid bodies (CB) in patients with hypertension (HTA). The study group consisted of 77 patients with HTA. All patients were genotyped for single-nucleotide polymorphisms of genes coding for: angiotensinogen: rs4762, rs5049, rs5051 and rs699; angiotensin-converting enzyme: rs4343; angiotensin receptor type 1 gene (AGTR1): rs5182 and rs5186; and the aldosterone synthase: rs1799998. The estimation of volumes of CB (VrCB+lCB) was based on computed tomography angiography. Among individuals with essential hypertension certain relationships were documented between rs5182 and rs5186 polymorphisms of AGTR1 gene and rs1799998 polymorphism of CYP11B2 gene on one hand and the volume of carotid bodies on one other. Patients carrying the C alleles within the rs5182 and rs5186 of AGTR1 gene was associated with higher values of VrCB+lCB. The carriage of the T allele in the rs5182 locus of the AGTR1 gene determine lower values of VrCB+lCB. In summary, in patients with HTA a higher volume of CB may be resulted from the presence of specific genotypes in RAAS.
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Valdez-Velazquez LL, Quintero-Ramos A, Perez SA, Mendoza-Carrera F, Montoya-Fuentes H, Rivas F, Olivares N, Celis A, Vazquez OF, Rivas F. Genetic polymorphisms of the renin-angiotensin system in preterm delivery and premature rupture of membranes. J Renin Angiotensin Aldosterone Syst 2016; 8:160-8. [DOI: 10.3317/jraas.2007.026] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Introduction. Premature rupture of membranes (PRM) is a late pregnancy complication commonly associated with preterm delivery (PD).Although several markers related to the renin-angiotensin system (RAS) have been evaluated in certain pregnancy complications, only the angiotensin-converting enzyme (ACE) I/D variant has been studied in PD-PRM.The aim of this survey was to investigate the association of the polymorphisms (angiotensin II type 1 [AT1] receptor T174M and M235T, renin G2805A,ACE I/D and AT1-receptor A1166C) of the genes of RAS in women with PD-PRM. Design. Deoxyribonucleic acid samples from 89 Mexican Mestizo women with PD and PRM and 224—288 controls were studied. Polymorphisms were analysed by polymerase chain reaction-sequence specific primer assays. restricted fragment length polymorphism or sequence specific prim assays. Results. For all loci , genotype distribution was in agreement with Hardy—Weinberg expectations in the control group. Significant intergroup difference (case vs. control) was seen for angiotensinogen (AGT) M235T polymorphism, with an increased allele M235 in affected cases (50% vs. 40% in controls).Analysis of two- locus haplotype agrees with an independent segregation of physically unlinked genes. Haplotype AGT 174T-235M was also increased (50 % vs. 40% in controls). Conclusions. Physically unlinked genes involved in RAS segregate independently. The AGT 174—235 region is associated with PD-PRM in this population.
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Affiliation(s)
- Laura L Valdez-Velazquez
- Universidad de Colima, Facultad de Ciencias Químicas. Kilometro 9 carretera Colima-Coquimatlán, Colima, México. 28400, lauravaldez @ucol.mx, Universidad de Guadalajara Centro Universitario de Ciencias de la Salud Estudios de Posgrado en Genética Humana Sierra Mojada No. 950 Col. Independencia (puerta 7). Guadalajara, Jalisco, México. 44340
| | - Antonio Quintero-Ramos
- Universidad de Guadalajara Centro Universitario de Ciencias de la Salud Estudios de Posgrado en Genética Humana Sierra Mojada No. 950 Col. Independencia (puerta 7). Guadalajara, Jalisco, México. 44340
| | - Sandra A Perez
- Instituto Mexicano del Seguro Social Hospital General Regional No. 46 Lazaro Cardenas 2063 Col. Morelos Guadalajara, Jalisco, México. 44910
| | - Francisco Mendoza-Carrera
- Instituto Mexicano del Seguro Social Centro de Investigación Biomédica de Occidente Sierra Mojada 800 Col. Independencia, Guadalajara, Jalisco, México. 44340
| | - Hector Montoya-Fuentes
- Instituto Mexicano del Seguro Social Centro de Investigación Biomédica de Occidente Sierra Mojada 800 Col. Independencia, Guadalajara, Jalisco, México. 44340
| | - Fernando Rivas
- Instituto Mexicano del Seguro Social Centro de Investigación Biomédica de Occidente Sierra Mojada 800 Col. Independencia, Guadalajara, Jalisco, México. 44340
| | - Norma Olivares
- Secretaría de Salud Jalisco Hospital General de Occidente Av. Zoquipan 1050 Col. Seattle Zapopan, Jalisco, México. 45130
| | - Alfredo Celis
- Universidad de Guadalajara Departamento de Salud publica Sierra Morena No. 950 Edificio N Col. Independencia Guadalajara, Jalisco, México. 44340
| | - Oscar F Vazquez
- Universidad de Colima Facultad de Ciencias Químicas. Kilometro 9 carretera Colima-Coquimatlán, Colima, México. 28400
| | - Fernando Rivas
- Instituto Mexicano del Seguro Social Centro de Investigación Biomédica de Occidente Sierra Mojada 800 Col. Independencia, Guadalajara, Jalisco, México. 44340
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Increased negative impact of donor HLA-specific together with non-HLA-specific antibodies on graft outcome. Transplantation 2014; 97:595-601. [PMID: 24162250 DOI: 10.1097/01.tp.0000436927.08026.a8] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND De novo donor HLA-specific (dnDSA) and non-HLA antibodies including antiangiotensin type 1 receptor antibodies (AT1R-abs) have been associated with antibody-mediated rejection (AMR) and decreased graft survival as well as cellular-mediated rejection (CMR) and early onset of microvasculopathy in heart transplantation. The aim of our study was to determine the impact of anti-AT1R-ab and anti-donor HLA-specific antibody (DSA) on clinical outcomes. METHODS Pretransplant and posttransplant sera from 200 recipients transplanted between May 2007 and August 2011 were tested for DSA (Luminex-based single antigen bead assay) and AT1R-ab (enzyme-linked immunosorbent assay). Two cutoff levels (≥ 17 and ≥ 12 units) were used to define high and intermediate binding of AT1R-ab. Clinical parameters examined were 5-year AMR/CMR (≥ grade 2), coronary artery vasculopathy, and survival. RESULTS At 2 years after transplant, freedom from AMR and/or CMR was 95.4% for those with no DSA (n=175), 66.9% for those with dnDSA (n=19), and 25% for those with DSA at transplant (n=6) (P<0.0001). Neither ≥ 17 nor ≥ 12 units of pretransplant levels indicated a significant difference in freedom from AMR and/or CMR. When both dnDSA and AT1R-ab ≥ 17 or ≥ 12 units were considered, freedom from AMR and/or CMR decreased to 50% and 45% (P<0.0001), respectively. Coronary artery vasculopathy and survival were not significantly impacted. CONCLUSIONS These results show the increased negative impact of dnDSA and AT1R-ab on freedom from AMR and/or CMR and an increased hazard ratio when both parameters are considered. Both HLA- and non-HLA-specific antibodies seem to impact graft outcome in heart transplantation.
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Reinsmoen NL. Role of angiotensin II type 1 receptor-activating antibodies in solid organ transplantation. Hum Immunol 2013; 74:1474-7. [PMID: 23831255 DOI: 10.1016/j.humimm.2013.06.034] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 06/04/2013] [Accepted: 06/14/2013] [Indexed: 02/03/2023]
Abstract
Angiotensin type I receptor (AT1R) mediates physiologic and pathophysiologic actions of its ligand, angiotensin II. Overactivity of the AT1R and angiotensin II interaction results in hypertension and vascular remodeling. Antibodies to AT1R have been implicated in several vascular pathologies. In renal transplantation, elevated levels of anti-AT1R antibodies have been associated with antibody mediated rejection (AMR) in the absence of donor HLA specific antibodies. In heart transplantation, increased levels of anti-AT1R antibodies have been associated with cellular and AMR as well as an early onset of microvasculopathy. This review summarizes the current investigations regarding the impact of anti-AT1R antibodies in solid organ transplantation and provides insight into the humoral response in the presence of non-HLA and HLA specific antibodies.
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Affiliation(s)
- Nancy L Reinsmoen
- HLA Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States.
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Karakus N, Yigit S, Kalkan G, Sezer S. High association of angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism with recurrent aphthous stomatitis. Arch Dermatol Res 2013; 305:513-7. [DOI: 10.1007/s00403-013-1333-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Revised: 02/13/2013] [Accepted: 02/18/2013] [Indexed: 10/27/2022]
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Polymorphisms of angiotensin II type 1 receptor gene and those of angiotensinogen point at culprit artery in ST-segment elevation myocardial infarction. Gene X 2012; 500:148-50. [DOI: 10.1016/j.gene.2012.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Revised: 01/31/2012] [Accepted: 03/03/2012] [Indexed: 11/20/2022] Open
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Xu Y, Bao Q, He B, Pan Y, Zhang R, Mao X, Tang Z, Qu L, Zhu C, Tian F, Wang S. Association of angiotensin I converting enzyme, angiotensin II type 1 receptor and angiotensin I converting enzyme 2 gene polymorphisms with the dyslipidemia in type 2 diabetic patients of Chinese Han origin. J Endocrinol Invest 2012; 35:378-83. [PMID: 21670585 DOI: 10.3275/7797] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To investigate whether the genetic polymorphisms in the angiotensin I converting enzyme (ACE) (insertion/ deletion, or I/D), angiotensin II type 1 receptor (AT1R) (rs5186), and ACE2 (rs2285666) could be associated with dyslipidemia in Type 2 diabetic (T2D) patients of Chinese Han origin. DESIGN AND METHODS The above 3 polymorphisms were genotyped in a total of 282 patients with T2D and dyslipidemia (Group A), 182 patients with T2D but without dyslipidemia (Group B), and 324 healthy controls. The association between a certain polymorphism and each group was assessed by an odds ratio (OR). RESULTS The D allele of the ACE (I/D) was significantly associated with the risk of T2D accompanying dyslipidemia between group A and controls [OR=1.37, 95% confidence interval (CI)=1.08-1.74; p=0.010], and significant association of the D allele with dyslipidemia was also observed in diabetic patients (OR=1.88, 95% CI=1.40-2.54; p<0.001). Furthermore, the ID genotype had a decreased risk of developing T2D without dyslipidemia as compared with controls (OR=0.52, 95% CI=0.32-0.82; p=0.0060). The distributions of the AT1R (rs5186) and ACE2 (rs2285666) genotypes and alleles did not differ between T2D patients with or without dyslipidemia and the controls. CONCLUSIONS This study demonstrates that the ACE (I/D) polymorphism is associated with T2D, regardless of the absence or presence of dyslipidemia. The polymorphisms in the AT1R (rs5186) and ACE2 (rs2285666) seem to play lesser roles in the development of T2D.
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Affiliation(s)
- Y Xu
- Department of Life Sciences, Nanjing Normal University, Nanjing, Jiangsu, China
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Su SL, Lu KC, Lin YF, Hsu YJ, Lee PY, Yang HY, Kao SY. Gene polymorphisms of angiotensin-converting enzyme and angiotensin II type 1 receptor among chronic kidney disease patients in a Chinese population. J Renin Angiotensin Aldosterone Syst 2011; 13:148-54. [PMID: 22147663 DOI: 10.1177/1470320311430989] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Chronic kidney disease (CKD) is highly prevalent in Taiwan and an increasing number of patients are affected, with a high risk of progression to end-stage renal disease and huge medical expenses. It has been predicted that the presence of hypertension increases with decreasing renal function due to a decrease in sodium excretion and activation of the renin-angiotensin system (RAS). The aim of this study was to investigate the influence of genetic variants of the RAS gene on CKD. We performed a case control association study and genotyped 135 CKD patients and 270 healthy controls among Han Chinese in Taiwan. All subjects were genotyped for angiotensinogen (AGT-M235T, T174M, A-20C), angiotensin-I converting enzyme (ACE-A2350G) and angiotensin II type 1 receptor (AGTR1-A1166C, C573T, C-521T) polymorphisms of RAS genes by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. Significant associations were observed in ACE-A2350G and AGTR1-C573T polymorphism between CKD patients and controls. In regard to ACE-A2350G, compared with the AA genotype the GG genotype protected against CKD (adjusted odds ratio [OR] = 0.34; p = 0.01). In regard to AGTR1-C573T, the CT genotype was a risk for CKD compared with the CC genotype (adjusted OR = 1.82; p = 0.03). We conclude that ACE-A2350G and AGTR1-C573T polymorphisms are likely candidate determinants of CKD.
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Affiliation(s)
- Sui-Lung Su
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC.
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Elshamaa MF, Sabry SM, Bazaraa HM, Koura HM, Elghoroury EA, Kantoush NA, Thabet EH, Abd-El Haleem DA. Genetic polymorphism of ACE and the angiotensin II type1 receptor genes in children with chronic kidney disease. J Inflamm (Lond) 2011; 8:20. [PMID: 21859496 PMCID: PMC3167745 DOI: 10.1186/1476-9255-8-20] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2010] [Accepted: 08/23/2011] [Indexed: 01/20/2023] Open
Abstract
AIM AND METHODS We investigated the association between polymorphisms of the angiotensin converting enzyme-1 (ACE-1) and angiotensin II type one receptor (AT1RA1166C) genes and the causation of renal disease in 76 advanced chronic kidney disease (CKD) pediatric patients undergoing maintenance hemodialysis (MHD) or conservative treatment (CT). Serum ACE activity and creatine kinase-MB fraction (CK-MB) were measured in all groups. Left ventricular mass index (LVMI) was calculated according to echocardiographic measurements. Seventy healthy controls were also genotyped. RESULTS The differences of D allele and DI genotype of ACE were found significant between MHD group and the controls (p = 0.0001). ACE-activity and LVMI were higher in MHD, while CK-MB was higher in CT patients than in all other groups. The combined genotype DD v/s ID+II comparison validated that DD genotype was a high risk genotype for hypertension .~89% of the DD CKD patients were found hypertensive in comparison to ~ 61% of patients of non DD genotype(p = 0.02). The MHD group showed an increased frequency of the C allele and CC genotype of the AT1RA1166C polymorphism (P = 0.0001). On multiple linear regression analysis, C-allele was independently associated with hypertension (P = 0.04). CONCLUSION ACE DD and AT1R A/C genotypes implicated possible roles in the hypertensive state and in renal damage among children with ESRD. This result might be useful in planning therapeutic strategies for individual patients.
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Affiliation(s)
| | - Samar M Sabry
- Pediatric Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hafez M Bazaraa
- Pediatric Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hala M Koura
- Pediatric Department, National Research Centre, Cairo, Egypt
| | - Eman A Elghoroury
- Clinical & Chemical Pathology Department, National Research Centre, Cairo, Egypt
| | - Nagwa A Kantoush
- Clinical & Chemical Pathology Department, National Research Centre, Cairo, Egypt
| | - Eman H Thabet
- Clinical & Chemical Pathology Department, National Research Centre, Cairo, Egypt
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Abstract
Dramatic advances in molecular biology dominated twentieth century biomedical science and delineated the function of individual genes and molecules in exquisite detail. However, biological processes cannot be fully understood based on the properties of individual genes and molecules alone, since these elements act in concert to enable the specific functions that make for living cells and organisms. The discipline of systems biology provides a novel conceptual framework for understanding biological phenomenon. Systems biology synthesizes information concerning the interactions of genes and molecules and allows characterization of the supramolecular networks and functional modules that represent the most essential aspects of cell organization and physiology.
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[Individual renal hemodynamic response to chronic angiotensin II receptor blockade and the influence on the renin-angiotensin system gene polymorphisms]. ACTA ACUST UNITED AC 2011; 63:630-7. [PMID: 21446090 DOI: 10.2298/mpns1010630d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Our study was aimed at determining whether the polymorphism of genes for different components of the renin-angiotensin-aldosterone system could influence the renal hemodynamic response to losartan treatment. MATERIAL AND METHOD The study included 35 patients with type I diabetes mellitus and persistent albuminuria, genotyped for the 1166 A/C polymorphism gene for the angiotensin II type 1 receptor and I/D polymorphism of the angiotensin-converting enzyme gene. The participants were divided into groups according to the combinations of A or C allele: AA, AC, CC; and according to the combinations of I or D allele: II, ID and DD genotype. The patients received losartan therapy for 12 weeks. The renal hemodynamic measurements were determined at baseline and after the examination period. RESULTS Losartan therapy significantly reduced the filtration fraction from the baseline by 0.018 +/- 0.024 (p = 0.012) only in the AC genotype. The glomerular filtration rate remained unchanged in all genotype groups. A significant increase in the effective renal plasma flow was obtained only in AC genotype (544 +/- 88 vs 575 +/- 90 ml/min; p = 0.02), while significant reductions in the renal vascular resistance were found in AA group (115 +/- 25 vs 95 +/- 21 mmHg x l(-1) x min(-1), p = 0.001) and in AC group (118 +/- 30 vs 101 +/- 28 mmHg x l(-1) x min(-1); p = 0.001). A significant reduction of the glomerular filtration rate by 8 +/- 10 ml/min was obtained only in the DD genotype (p = 0.016), and only the DD genotype achieved a significant reduction of the filtration fraction by 0.019 +/- 0,022 (p = 0.008). The most pronounced increase of the effective renal plasma flow was found only in the ID genotype (536 +/- 75 vs 591 +/- 63 ml/min; p = 0.01). The reduction of the renal vascular resistance was independent of ACE gene polymorphism. CONCLUSION Our study shows that individual renal vascular response to losartan treatment in diabetic patients with persistent albuminuria, could be influenced by genetic polymorphisms.
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Anti-angiotensin type 1 receptor antibodies associated with antibody mediated rejection in donor HLA antibody negative patients. Transplantation 2011; 90:1473-7. [PMID: 21030904 DOI: 10.1097/tp.0b013e3181fd97f1] [Citation(s) in RCA: 165] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Angiotensin type 1 receptor (AT1R) mediates most physiologic and pathophysiologic actions of its endogenous ligand, angiotensin II, with overactivity leading to vascular remodeling and hypertension. Antibodies to AT1R are implicated in several vascular pathologies. The aim of our study was to determine the impact of antibody to AT1R on clinical outcomes including antibody mediated rejection (AMR), with or without C4d deposition, in patients whose sera contained no donor human leukocyte antigen (HLA)-specific antibody (HLA-DSA). METHODS Pretransplant sera from 97 recipients and sera obtained at the time of acute rejection (AR) were tested by Luminex-based single-antigen bead assays to determine HLA-DSA and antibodies to major histocompatibility class I chain-related gene A (MICA). The presence of antibody to AT1R was determined by a cell-based ELISA method using a cutoff of 17 units to distinguish high from low binding. RESULTS Sera from 63 recipients were determined to have no HLA-DSA and no donor-specific MICA antibodies pretransplant and at the time of AR, and 16 of these recipients were diagnosed with AR including 7 with AMR and 9 with cellular AR (cell-mediated rejection). High-binding AT1R antibodies were identified for six of seven in the AMR+ group and zero of nine in the cell-mediated rejection+ group (P=0.0009). CONCLUSIONS A strong association was observed between the presence of high binding to AT1R and AMR in recipients whose sera contained no antibody to donor HLA or MICA. Assessing the AT1R antibody status along with the HLA-DSA provides additional information to determine the immunologic risk for recipients.
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Mendizábal-Ruiz AP, Morales J, Castro Martinez X, Gutierrez Rubio SA, Valdez L, Vásquez-Camacho JG, Sanchez Corona J, Moran Moguel MC. RAS polymorphisms in cancerous and benign breast tissue. J Renin Angiotensin Aldosterone Syst 2010; 12:85-92. [PMID: 21109584 DOI: 10.1177/1470320310383735] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Recent information has revealed new roles in the angiogenic processes linked to the rennin-angiotensin system. To date few studies have been done on the association between RAS genes and cancer and the majority focus mainly on angiotensin I-converting enzyme (ACE). For breast cancer there are three reports that include the angiotensin II receptor, subtype 1 (AGTR1), only one for angiotensinogen (AGT) and none for renin gene (REN). In the present study we investigate whether REN (Bgll), AGT (M235T), ACE (A245T, Indel), and AGTR1 (A1166C) are associated with breast cancer. Polymorphisms were analysed by PCR and RFPLs or sequence specific assay in three groups: breast cancer, benign breast disease (BBD) and general population. REN polymorphism shows that homozygous for A allele have an increased risk for BBD. Differences in M235T genotype frequencies were significant with less heterozygous in breast cancer. With different risk values ACE indel was associated with BBD and breast cancer. Association of AGTR1 was observed only in the breast cancer group, where C allele carriers present a reduced risk. Results of this work supports previous observations on the possible involvement of this system in breast cancer but it also suggests a role in benign disease.
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Agrawal S, Agarwal S, Naik S. Genetic contribution and associated pathophysiology in end-stage renal disease. APPLICATION OF CLINICAL GENETICS 2010; 3:65-84. [PMID: 23776353 PMCID: PMC3681165 DOI: 10.2147/tacg.s7330] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
End-stage renal disease (ESRD) or chronic kidney disease (CKD) is the terminal state of the kidney when its function has been permanently and irreversibly damaged. A wide variety of etiologies and pathological processes culminate in ESRD, and both environmental and genetic factors contribute to its development and progression. Various reports suggest that susceptibility to develop ESRD has a significant genetic component. These studies include familial aggregation studies, comparisons of incidence rates between different racial or ethnic populations, and segregation analysis. Genetic approaches have been used to identify genes that contribute to genetic susceptibility. Many studies have now been carried out assessing the contribution of specific “candidate genes”, which correlate with different functions that are involved in the renal pathogenesis. Independent studies for specific associated genes have frequently provided contradictory results. This may be due, in part, to the modest contribution to genetic susceptibility which these genes impart. With the availability of different genomewide association studies, chromosomal regions harboring novel, previously unrecognized, genes that may contribute to renal diseases have been recently reported. We have focused on different genetic studies conducted on ESRD and have discussed the strength and weaknesses of these studies. The nonmuscle myosin heavy chain 9 gene (MYH9) and renin–angiotensin system (RAS) have been discussed in detail.
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Affiliation(s)
- Suraksha Agrawal
- Department of Medical Genetics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
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Lin E, Pei D, Huang YJ, Hsieh CH, Wu LSH. Gene-Gene Interactions Among Genetic Variants from Obesity Candidate Genes for Nonobese and Obese Populations in Type 2 Diabetes. Genet Test Mol Biomarkers 2009; 13:485-93. [DOI: 10.1089/gtmb.2008.0145] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Eugene Lin
- Bioinformatics Division, Vita Genomics, Inc., Taipei County, Taiwan
| | - Dee Pei
- Division of Endocrinology and Metabolism, Cardinal Tien Hospital, Taipei County, Taiwan
| | - Yi-Jen Huang
- Division of Endocrinology and Metabolism, Tri-Service General Hospital, Taipei, Taiwan
| | - Chang-Hsun Hsieh
- Division of Endocrinology and Metabolism, Tri-Service General Hospital, Taipei, Taiwan
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Genetic variation in angiotensin-converting enzyme-related pathways associated with sudden cardiac arrest risk. Heart Rhythm 2009; 6:1306-14. [PMID: 19716087 DOI: 10.1016/j.hrthm.2009.06.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2009] [Accepted: 06/03/2009] [Indexed: 01/13/2023]
Abstract
BACKGROUND Angiotensin-converting enzyme (ACE)-related pathways influence arrhythmias and sudden cardiac arrest (SCA) risk. OBJECTIVE The purpose of this study was to investigate whether genetic variations in ACE-related pathways are associated with SCA risk. Because these pathways are sex dependent and are influenced by estrogen, we examined these genotype-SCA associations in the full study population and tested for interaction with gender. METHODS In a population-based case-control study set in King County, Washington, 211 SCA cases (80% male; mean age 59 years,) and 730 age- and gender-matched controls of European descent were genotyped for 47 single nucleotide polymorphisms (SNPs) in eight genes (ACE, AGT, REN, AGTR1, AGTR2, ACE2, KNG1, BDKRB2). The association of SNPs and haplotypes with SCA risk was examined using logistic regression. RESULTS AGTR1 SNP rs1492099 (allele frequency 15%) was associated with decreased SCA risk (odds ratio [OR] 0.62, 95% confidence interval [CI] 0.4-0.9). Haplotype variation in AGTR2 was associated with SCA risk (global haplotype test P = .001), with haplotype 2 (allele frequency 27%) associated with increased risk (OR 1.26, 95% CI 1.1-1.5). There was interaction with gender on SCA risk for variation in KNG1 (interaction P value range 0.0004-0.017 for 6/8 SNPs). KNG1 SNP rs710448 (allele frequency 42%) was associated with decreased risk (OR 0.44, 95% CI 0.3-0.8) among women but not men. Other SNPs and haplotypes in the eight genes examined were not associated with SCA risk after multiple testing correction. CONCLUSION Variations in AGTR1 and AGTR2 are associated with SCA risk in a population-based case-control study. There was evidence of interaction with gender on SCA risk for variation in KNG1. These study findings, if replicated, suggest that variation in genes in ACE-related pathways influence SCA risk.
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Park EY, Ahn HM, Lee JA, Hong YM. Insertion/deletion polymorphism of angiotensin converting enzyme gene in Korean hypertensive adolescents. Heart Vessels 2009; 24:193-8. [PMID: 19466520 DOI: 10.1007/s00380-008-1101-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2007] [Accepted: 08/08/2008] [Indexed: 10/20/2022]
Abstract
The essential role of the renin-angiotensin system (RAS) in controlling blood pressure has been well established. Genes encoding components of the RAS have been proposed as candidate genes that determine genetic predisposition to hypertension and the risk of developing cardiovascular complications. The purpose of this study was to analyze angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphisms in Korean hypertensive adolescents, and to determine the association between ACE genotype and cardiovascular risk. Forty hypertensive adolescents (16-17 years old, systolic blood pressure (BP) > or =140 mm Hg and/or diastolic BP > or =90 mm Hg) and a control group of twenty normotensive adolescents were included in the study. Obesity index (OI) and body mass index (BMI) were calculated. Skin fold thickness and arm circumference were also measured. Fat mass and fat distribution were analyzed by bioelectrical impedance. Blood pressure was measured at resting state by oscillometric methods. Serum aldosterone, renin, insulin, ACE, homocysteine, vitamin B12, and folate levels were evaluated after a fasting period of 12 h. The carotid intima-media thickness (IMT) and carotid artery diameter were measured by carotid ultrasound. Pulse wave velocity (PWV) and ankle-brachial index (ABI) were also measured. Polymerase chain reaction (PCR) was conducted to amplify DNA from blood samples of each individuals to analyze ACE I/D polymorphism. Genotype frequencies of I/I were 37.5%, I/D 45.0% and D/D 17.5%. Serum ACE levels were 33.5 +/- 8.7 U/l in I/I genotype, 48.6 +/- 19.8 U/l in I/D genotype and 61.4 +/- 22.7 U/l in D/D genotype, which showed that ACE levels were significantly higher in those with D/D or I/D genotype than in I/I genotype. Carotid IMT was significantly greater in D/D group than in I/I group. In conclusion, the D allele is associated with the increased level of ACE in Korean hypertensive adolescents.
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Affiliation(s)
- Eun Young Park
- Department of Pediatrics, School of Medicine, Ewha Womans University, 911-1 MokDong, YangCheon-Ku, Seoul 158-710, Republic of Korea
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Cooper Worobey C, Fisher NDL, Cox D, Forman JP, Curhan GC. Genetic polymorphisms and the risk of accelerated renal function decline in women. PLoS One 2009; 4:e4787. [PMID: 19274077 PMCID: PMC2650781 DOI: 10.1371/journal.pone.0004787] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2008] [Accepted: 02/05/2009] [Indexed: 01/13/2023] Open
Abstract
Background Reduced glomerular filtration rate is an important predictor of cardiovascular disease and death. Genetic polymorphisms, particularly in genes involved in the renin-angiotensin system (RAS), may influence the rate of renal function decline. Methodology/Principal Findings We examined the relation between specific single nucleotide polymorphisms (SNPs), including those in the RAS, apolipoprotein E and alpha-adducin, and renal function decline assessed by estimated glomerular filtration rate (eGFR) over an 11-year period in 2578 Caucasian participants of the Nurses' Health Study. Logistic regression was used to examine the associations between genotype and risk of eGFR decline of ≥25%. Results After 11 years between creatinine measurements, the eGFR declined by ≥25% in 423 of 2578 (16%) women. The angiotensinogen (AGT) A-20C polymorphism was associated with a higher risk of renal function decline when two risk alleles were present than if one or no alleles were present (CC vs AA and AC) OR 1.83 (95% CI 1.02–3.26; p = 0.04). The angiotensin II type 1 receptor (AT1R) A1166C polymorphism was marginally associated with a higher risk of renal function decline when two risk alleles were present (CC vs AA, OR = 1.41; 95% CI 0.98–2.01; p = 0.06). The alpha-adducin G460W polymorphism was associated with a lower risk of renal function decline when any number of risk alleles were present (WG vs GG, OR = 0.78, 95% CI 0.61–0.99, p = 0.04; WW vs GG, OR = 0.46; 95% CI 0.20–1.07, p = 0.07). Linear regression analysis with change in eGFR as the outcome showed a larger decline of 3.5 (95% CI 0.5 to 6.4, p = 0.02) ml/min/1.73 m2 in AGT A-20C CC homozygotes. No other polymorphisms were significantly associated with renal function decline or absolute change in eGFR over the study period. Conclusions Genetic variants in the angiotensinogen, angiotensin II type 1 receptor and alpha-adducin genes may contribute to loss of renal function in the general female Caucasian population.
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Affiliation(s)
- Cynthia Cooper Worobey
- Renal Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Naomi D. L. Fisher
- Endocrine-Hypertension Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - David Cox
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - John P. Forman
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Gary C. Curhan
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
- * E-mail:
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Gil JH, Lee JA, Park EY, Hong YM. Angiotensinogen gene M235T polymorphism as a predictor of cardiovascular risk in hypertensive adolescents. KOREAN JOURNAL OF PEDIATRICS 2009. [DOI: 10.3345/kjp.2009.52.1.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Joo Hyun Gil
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Jung Ah Lee
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Eun Young Park
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Young Mi Hong
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea
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Humoral responses directed against non-human leukocyte antigens in solid-organ transplantation. Transplantation 2008; 86:1019-25. [PMID: 18946337 DOI: 10.1097/tp.0b013e3181889748] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Antibody-mediated mechanisms have a major impact on allograft function and survival. During the last decade, improved immunohistochemical and serologic diagnostic procedures have been developed to monitor antibody responses against human leukocyte antigens (HLA). Acute and chronic allograft rejection can occur in HLA-identical sibling transplants implicating the importance of immune response against non-HLA targets. Non-HLA, complement and noncomplement-fixing antibodies may be responsible for a variety of allograft injuries, reflecting the complexity of their acute and chronic actions. Non-HLA antibodies may occur as alloantibodies or autoantibodies. Their antigenic targets described, thus, far include various minor histocompatibility antigens, vascular receptors, adhesion molecules, and intermediate filaments. An analysis of the subtle mechanistic differences in the individual antibody responses directed against non-HLA may help to identify patients at particular risk for irreversible acute or chronic allograft injuries and improve overall outcomes. This review summarizes the current state of research, development in diagnostic and therapeutic strategies, discusses some emerging problems, and provides perspectives in the area of humoral response against non-HLA in solid-organ transplantation.
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Genetic variants in the renin-angiotensin system genes are associated with cardiovascular-renal-related risk factors in Mexican Americans. Hum Genet 2008; 124:557-9. [PMID: 18985387 DOI: 10.1007/s00439-008-0581-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2008] [Accepted: 10/25/2008] [Indexed: 10/21/2022]
Abstract
The aim of this study is to examine whether the ACE-I/D, AGT-M235T, and AT1R-A1166C polymorphisms of the renin-angiotensin system (RAS) genes are associated with cardiovascular and renal-related risk factors in Mexican Americans. Study participants (N = 848) were genotyped by Taqman assays. Association analyses were performed by measured genotype approach. Of the phenotypes examined, the ACE-I/D, AGT-M235T, and AT1R-A1166C polymorphisms exhibited significant association with systolic blood pressure, glomerular filtration rate and body mass index, respectively. The data suggest that the polymorphisms examined in the RAS may modulate the risk factors associated with cardiovascular-renal disease.
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Forman JP, Fisher NDL, Pollak MR, Cox DG, Tonna S, Curhan GC. Renin-angiotensin system polymorphisms and risk of hypertension: influence of environmental factors. J Clin Hypertens (Greenwich) 2008; 10:459-66. [PMID: 18550936 DOI: 10.1111/j.1751-7176.2008.08007.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Renin-angiotensin system (RAS) polymorphisms have been studied as candidate risk factors for hypertension with inconsistent results, possibly due to heterogeneity among various environmental factors. We analyzed the association between RAS candidate gene polymorphisms and risk of hypertension among 2722 women and also explored whether these associations varied according to menopausal status, body mass index, and dietary factors. In a main-effects analysis of all 2722 women adjusted for age and race, homozygosity for the AT1R A1166C polymorphism was associated with hypertension (odds ratio, 1.35; 95% confidence interval [CI], 1.03-1.78). We also found that a novel nonsense polymorphism in the aminopeptidase-A gene was associated with hypertension among postmenopausal women (hazard ratio, 1.54; 95% CI, 1.01-2.37), women with inadequate calcium intake (hazard ratio, 2.47; 95% CI, 1.29-4.72) and, marginally, women with inadequate vitamin D intake. In addition, angiotensin-converting enzyme and AT1R A1166C polymorphisms were associated or marginally associated with incident hypertension among postmenopausal women and those with inadequate calcium and vitamin D intakes. These data suggest that demographic and dietary factors may influence the associations between RAS polymorphisms and hypertension and could explain heterogeneity in prior studies.
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Affiliation(s)
- John P Forman
- Renal Division, the Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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Schürks M, Zee RYL, Buring JE, Kurth T. Polymorphisms in the renin-angiotensin system and migraine in women. Headache 2008; 49:292-9. [PMID: 19178574 DOI: 10.1111/j.1526-4610.2008.01287.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Recent findings suggest an association between the renin-angiotensin system and migraine. However, genetic studies are scarce and controversial. OBJECTIVE To investigate the association between the AGTR1 1166A > C and AGT Met235Thr polymorphisms with migraine and migraine aura status. METHODS We performed an association study among 25,000 Caucasian US women, participating in the Women's Health Study, with information on the AGTR1 1166A > C and AGT Met235Thr polymorphisms. Migraine and migraine aura status were self-reported. We distinguished between any history of migraine, active migraine with aura, active migraine without aura, and prior migraine (history of migraine, but not in the year prior to baseline). We used logistic regression to investigate the genotype-migraine association. RESULTS At baseline, 4577 (18.3%) women reported any history of migraine; 39.5% of the 3226 women with active migraine indicated aura. The polymorphisms were not associated with migraine or migraine-specific subgroups. We also did not find a significant interaction between the polymorphisms. CONCLUSIONS Data from this large cohort of Caucasian women do not suggest an association of polymorphisms in the renin-angiotensin system with migraine or aura status. Future studies should focus on haplotype analyses and additional gene-gene as well as gene-environment interactions.
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Affiliation(s)
- Markus Schürks
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215-1204, USA
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Gallego PH, Shephard N, Bulsara MK, van Bockxmeer FM, Powell BL, Beilby JP, Arscott G, Le Page M, Palmer LJ, Davis EA, Jones TW, Choong CSY. Angiotensinogen gene T235 variant: a marker for the development of persistent microalbuminuria in children and adolescents with type 1 diabetes mellitus. J Diabetes Complications 2008; 22:191-8. [PMID: 18413222 DOI: 10.1016/j.jdiacomp.2007.03.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2006] [Revised: 02/26/2007] [Accepted: 03/01/2007] [Indexed: 11/30/2022]
Abstract
AIM We examined genetic polymorphisms in the renin-angiotensin system (RAS) coding for angiotensin I-converting enzyme (ACE) insertion/deletion (I/D) for angiotensinogen (AGT) M235T and angiotensin II receptor type 1 (AGTR1) A1166C as predictors for the development of microalbuminuria (MA) in children with type 1 diabetes mellitus (T1DM). METHODS Four hundred fifty-three (215 males, 238 females) T1DM children [median (interquartile range): age, 16.7 years (13.9-18.3); diabetes duration, 6.9 years (3.3-10.8); age at diagnosis, 9.1 years (5.8-11.8)] were followed prospectively from diagnosis until the development of MA (two of three consecutive overnight urine samples with albumin excretion rates of > or =20 and <200 microg/min). Kaplan-Meier survival curves and Cox proportional multivariate model estimated the probability of developing MA and the relative risk for MA among different variables. RESULTS MA developed in 41 (9.1%) subjects. The frequencies of genotypes were as follows: ACE-II 112 (25%), ACE-ID 221 (49%), and ACE-DD 117 (26%) (n=450); AGT-MM 144 (32%), AGT-MT 231 (51%), and AGT-TT 77 (17%) (n=452); AGTR1-AA 211 (47%), AGTR1-AC 204 (45%), and AGTR1-CC 37 (8%) (n=452). The cumulative risk for the development of MA was higher in ACE-DD versus ACE-ID/II groups (log-rank test, P=.05), and a trend was noticed when AGT-TT was compared to AGT-MT/MM groups (log-rank test, P=.08). AGT-TT polymorphism conferred a fourfold increased risk for MA compared to AGT-MM/MT (hazard ratio=3.8; 95% confidence interval=1.43-10.3; P=.008). INTERPRETATION Our findings suggest that RAS gene polymorphism at AGT M235T is a strong predictor for early MA in young T1DM subjects.
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Affiliation(s)
- Patricia H Gallego
- Department of Pediatric Endocrinology and Diabetes, Princess Margaret Hospital, Perth, WA, Australia.
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Thameem F, Puppala S, Arar N, Blangero J, Stern MP, Duggirala R, Abboud HE. Genetic polymorphisms in the renin-angiotensin system (RAS) genes and their association analysis with type 2 diabetes and related traits in Mexican Americans. Diabetes Res Clin Pract 2008; 79:e14-6. [PMID: 17936396 DOI: 10.1016/j.diabres.2007.08.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2007] [Accepted: 08/30/2007] [Indexed: 11/29/2022]
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Angiotensin-converting enzyme insertion/deletion gene polymorphism in inflammatory bowel diseases. Eur J Gastroenterol Hepatol 2007; 19:976-81. [PMID: 18049167 DOI: 10.1097/meg.0b013e3282efa3fc] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
INTRODUCTION The renin-angiotensin system is strictly related to the kallikrein-kinin system and both are involved in many physiological and disease conditions and possibly in the pathogenesis of inflammatory bowel disease (IBD). Angiotensin-converting enzyme (ACE) is the pivotal enzyme of the renin-angiotensin system and the main catabolic enzyme of the kallikrein-kinin system. The ACE I/D (insertion/deletion) is a polymorphism of the gene encoding for ACE: participants who are homozygous for the D allele exhibit higher ACE levels, which in turn appear to play a deleterious role in several diseases. AIM To study the prevalence of ACE I/D polymorphism in IBD patients and its possible association with disease features. METHODS A total of 232 IBD patients, 124 with ulcerative colitis (UC) and 108 with Crohn's disease and 99 healthy controls were genotyped for the ACE I/D polymorphism. RESULTS DD, ID and II genotypes distribution did not show significant differences between IBD patients and controls: 42.2 vs. 40.4%, 42.7 vs. 47.5% and 15.1 vs. 12.1%, respectively. No significant difference was observed between Crohn's disease and UC patients. Within UC patients, the presence of DD genotype and the carriage of the D allele were significantly associated with the presence of extraintestinal manifestations: odds ratio (OR) 4.08, 95% confidence interval (CI): 1.62-10.28; P<0.003 and OR=3.07, 95% CI: 1.45-6.48; P<0.003, respectively. No significant association was found with other IBD clinical features. CONCLUSIONS The ACE I/D polymorphism is not associated with IBDs but the D allele appears to increase the risk of developing extraintestinal manifestations in UC patients.
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Thomas MC, Atkins RC. Blood pressure lowering for the prevention and treatment of diabetic kidney disease. Drugs 2007; 66:2213-34. [PMID: 17137404 DOI: 10.2165/00003495-200666170-00005] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The current pandemic of diabetes mellitus will inevitably be followed by an epidemic of chronic kidney disease. It is anticipated that 25-40% of patients with type 1 diabetes and 5-40% of patients with type 2 diabetes will ultimately develop diabetic kidney disease. The control of blood pressure represents a key component for the prevention and management of diabetic nephropathy. There is a strong epidemiological connection between hypertension in diabetes and adverse outcomes in diabetes. Hypertension is closely linked to insulin resistance as part of the 'metabolic syndrome'. Diabetic nephropathy may lead to hypertension through direct actions on renal sodium handling, vascular compliance and vasomotor function. Recent clinical trials also support the utility of blood pressure reduction in the prevention of diabetic kidney disease. In patients with normoalbuminuria, transition to microalbuminuria can be prevented by blood pressure reduction. This action appears to be significant regardless of whether patients have elevated blood pressure or not. The efficacy of ACE inhibition appears to be greater than that achieved by other agents with a similar degree of blood pressure reduction; although large observational studies suggest the risk of microalbuminuria may be reduced by blood pressure reduction, regardless of modality. In patients with established microalbuminuria, ACE inhibitors and angiotensin receptor antagonists (angiotensin receptor blockers [ARBs]) consistently reduce the risk of progression from microalbuminuria to macroalbuminuria, over and above their antihypertensive actions. The clinical utility of combining these strategies remains to be established. In patients with overt nephropathy, blood pressure reduction is associated with reduced urinary albumin excretion and, subsequently, a reduced risk of renal impairment or end stage renal disease. In addition to actions on systemic blood pressure, it is now clear that ACE inhibitors and ARBs also reduce proteinuria in patients with diabetes. This anti-proteinuric activity is distinct from other antihypertensive agents and diuretics. Although there is a clear physiological rationale for blockade of the renin angiotensin system, which is strongly supported by clinical studies, to achieve the optimal lowering of blood pressure, particularly in the setting of established diabetic renal disease, a number of different antihypertensive agents will always be needed. In the end, the choice of agents should be individualised to achieve the maximal tolerated reduction in blood pressure and albuminuria. Ultimately, no matter how it is achieved, so long as it is achieved, renal risk can be reduced by agents that lower blood pressure and albuminuria.
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Affiliation(s)
- Merlin C Thomas
- Danielle Alberti Memorial Centre for Diabetic Complications, Wynn Domain, Baker Heart Research Institute, Melbourne, Victoria, Australia.
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Darbar D, Motsinger AA, Ritchie MD, Gainer JV, Roden DM. Polymorphism modulates symptomatic response to antiarrhythmic drug therapy in patients with lone atrial fibrillation. Heart Rhythm 2007; 4:743-9. [PMID: 17556195 PMCID: PMC1948880 DOI: 10.1016/j.hrthm.2007.02.006] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2006] [Accepted: 02/05/2007] [Indexed: 01/19/2023]
Abstract
BACKGROUND The angiotensin-converting enzyme (ACE) deletion allele, ACE D, is associated with increased ACE activity and adverse outcomes in cardiovascular disease. Although activation of the renin-angiotensin-aldosterone system (RAAS) now appears to play a role in the pathophysiology of atrial fibrillation (AF), it remains to be determined if ACE genotype impacts response to conventional AAD therapy in patients with AF. OBJECTIVES The purpose of this study was to investigate whether response to antiarrhythmic drug (AAD) therapy in patients with AF is modulated by the ACE I/D polymorphism. METHODS We studied 213 patients (147 men, 66 women; ages 52 +/- 15 years) prospectively enrolled in the Vanderbilt AF Registry. AAD therapy outcome was defined prospectively as response if there was a >or=75% reduction in symptomatic AF burden or nonresponse if AF burden was unchanged, necessitating a change in drugs or therapy. RESULTS Lone AF (age <65 years, no identifiable cause) was present in 72 (34%) patients, whereas hypertension was the most common underlying disease in the remaining 141 (41%). AF was paroxysmal in 170 (80%) and persistent in 43 (20%). The frequencies of the DD, ID, and II genotypes were in Hardy-Weinberg equilibrium. Lone AF and DD/ID genotypes were highly significant predictors of failure of drug therapy (P <.005). In patients with lone AF, failure of drug response was 5%, 41%, and 47% in patients with II, ID, and DD genotypes, respectively, (P <.005, II vs. ID/DD). CONCLUSIONS These results provide further evidence for a role of RAAS activation in the pathophysiology of AF and point to a potential role for stratification of therapeutic approaches by ACE genotype.
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Affiliation(s)
- Dawood Darbar
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee 37323-6602, USA.
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Moura MSF, de Melo MB, Longui CA, Rocha MN, Monte O. [Mutation screening in Angiotensin II receptors, AGTR1 and AGTR2, and evaluation of AGTR1 polymorphisms C573T and A1166C in patients with premature adrenarche]. ARQUIVOS BRASILEIROS DE ENDOCRINOLOGIA E METABOLOGIA 2006; 50:893-900. [PMID: 17160213 DOI: 10.1590/s0004-27302006000500010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2004] [Accepted: 04/28/2006] [Indexed: 11/22/2022]
Abstract
Precocious pubarche is the appearance of pubic hair before the age of 8 years in girls and 9 years in boys. The most frequent etiology is idiopathic precocious adrenarche, suggested, after long-term follow-up, to be associated with metabolic syndrome. One of the factors involved in the genesis of precocious adrenarche is Angiotensin II (Ang II), which promotes cell proliferation and steroidogenesis through type 1 (AT1) and type 2 (AT2) receptors. In order to study Ang II receptors mutations, 50 children with idiopathic precocious adrenarche were evaluated and compared to a control group of normal individuals. Mutations were not detected in the AGTR1 and AGTR2 genes; however, two polymorphisms were identified in the AGTR1 gene: the C573T (exon 5) and the A1166C (3' untranslated region). The polymorphic allele T573 was found in 35% of the patients and 38% of controls. The polymorphic allele C1166 was present in 24% of the patients and 26% of controls. There was no statistical difference between groups. There was also no correlation between the polymorphisms and clinical and laboratory findings, as well as their family history of metabolic syndrome.
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Affiliation(s)
- Mônica S F Moura
- Unidade de Endocrinologia Pediátrica, Departamento de Pediatria e Puericultura, Santa Casa de Misericórdia de São Paulo
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Oro C, Qian H, Thomas WG. Type 1 angiotensin receptor pharmacology: signaling beyond G proteins. Pharmacol Ther 2006; 113:210-26. [PMID: 17125841 PMCID: PMC7112676 DOI: 10.1016/j.pharmthera.2006.10.001] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2005] [Accepted: 10/03/2006] [Indexed: 02/07/2023]
Abstract
Drugs that inhibit the production of angiotensin II (AngII) or its access to the type 1 angiotensin receptor (AT1R) are prescribed to alleviate high blood pressure and its cardiovascular complications. Accordingly, much research has focused on the molecular pharmacology of AT1R activation and signaling. An emerging theme is that the AT1R generates G protein dependent as well as independent signals and that these transduction systems separately contribute to AT1R biology in health and disease. Regulatory molecules termed arrestins are central to this process as is the capacity of AT1R to crosstalk with other receptor systems, such as the widely studied transactivation of growth factor receptors. AT1R function can also be modulated by polymorphisms in the AGTR gene, which may significantly alter receptor expression and function; a capacity of the receptor to dimerize/oligomerize with altered pharmacology; and by the cellular environment in which the receptor resides. Together, these aspects of the AT1R “flavour” the response to angiotensin; they may also contribute to disease, determine the efficacy of current drugs and offer a unique opportunity to develop new therapeutics that antagonize only selective facets of AT1R function.
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Affiliation(s)
- Cristina Oro
- Baker Heart Research Institute, Melbourne, Australia
- Department of Biochemistry and Molecular Biology, Monash University, Melbourne, Australia
| | - Hongwei Qian
- Baker Heart Research Institute, Melbourne, Australia
| | - Walter G. Thomas
- Baker Heart Research Institute, Melbourne, Australia
- Corresponding author. Molecular Endocrinology Laboratory, Baker Heart Research Institute, P.O. Box 6492, St. Kilda Road Central, Melbourne 8008, Australia. Tel.: +61 3 8532 1224; fax: +61 3 8532 1100.
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Joung CI, Park YW, Kim SK, Uhm WS, Kim TH, Yoo DH. Angiotensin-converting enzyme gene insertion/deletion polymorphism in Korean patients with systemic sclerosis. J Korean Med Sci 2006; 21:329-32. [PMID: 16614523 PMCID: PMC2734013 DOI: 10.3346/jkms.2006.21.2.329] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
To determine whether angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism is associated with the development and clinical features of systemic sclerosis (SSc) in Korean, we studied seventy two Korean patients with SSc fulfilling the ACR preliminary classification criteria. The controls were 114 healthy, disease free Koreans. ACE I/D genotypes were determined by PCR method using oligonucleotides. Sixty eight patients (94.4%) were women and age at diagnosis was 43.5+/-12.6 yr old (mean+/-SD). Thirty nine patients (54.2%) had a diffuse type of SSc. There were no statistical differences in the frequencies of all ACE I/D genotypes and D allele between patients and controls, and neither between diffuse and limited types of SSc. ACE I/D gene polymorphism was not associated with the development of SSc in Korea. The investigation for the pathogenesis of SSc requires more studies about the role of other candidate genes such as endothelin, TGF-beta, nitric oxide, or angiotensin II receptor in addition to the ACE genes.
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Affiliation(s)
- Chung-Il Joung
- Division of Rheumatology, Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
| | - Yong-Wook Park
- Division of Rheumatology, The Hospital for Rheumatic Diseases, Hanyang University, Seoul, Korea
| | | | - Wan-Sik Uhm
- Division of Rheumatology, The Hospital for Rheumatic Diseases, Hanyang University, Seoul, Korea
| | - Tae-Hwan Kim
- Division of Rheumatology, The Hospital for Rheumatic Diseases, Hanyang University, Seoul, Korea
| | - Dae-Hyun Yoo
- Division of Rheumatology, The Hospital for Rheumatic Diseases, Hanyang University, Seoul, Korea
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Szolnoki Z, Havasi V, Talián G, Bene J, Komlósi K, Somogyvári F, Kondacs A, Szabó M, Fodor L, Bodor A, Melegh B. Angiotensin II type-1 receptor A1166C polymorphism is associated with increased risk of ischemic stroke in hypertensive smokers. J Mol Neurosci 2006; 28:285-90. [PMID: 16691016 PMCID: PMC7090441 DOI: 10.1385/jmn:28:3:285] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2005] [Revised: 11/30/1999] [Accepted: 11/06/2005] [Indexed: 11/11/2022]
Abstract
Recent observations revealed a novel role of angiotensin-converting enzyme 2 and the angiotensin II type-1 receptor (AT1R) in lung injury, thereby extending knowledge about the functions of the angiotensin system. Angiotensin II, whose target is the AT1R, is a potent vasoconstrictor. Accordingly, an imbalance leading to enhanced activity of the angiotensin II-AT1R axis is postulated to contribute to both circulatory disturbances and lung injury. In this context, a functional single-nucleotide polymorphism, AT1R A1166C, which leads to enhanced responsiveness of the AT1R, has been postulated as a candidate susceptibility factor for ischemic stroke. The aim of our study was to investigate its occurrence in ischemic stroke and to analyze its possible synergistic associations with clinical risk factors. Genetic and clinical data on 308 consecutive patients with acutely developing ischemic stroke were analyzed. A total of 272 stroke and neuroimaging alteration-free subjects served as a control group. Univariate and logistic regression statistical approaches were used. Alone, the AT1R 1166C allele did not pose a risk of stroke. In hypertensive smokers, however, it was associated with an increased risk of ischemic stroke (OR 22.3, 95% CI 5.8-110.2, p<0.001). Further subgroup analysis revealed the same association for both small-vessel (OR 24.3, 95% CI 6.1-121.1, p<0.001) and large-vessel (OR 21.3, 95% CI 4.6-81.1, p<0.001) infarction. On a pathophysiological basis, our results suggest the possibility that the AT1R A1166C polymorphism might give rise to ischemic stroke indirectly via an unfavorable effect on the cardiorespiratory function.
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Affiliation(s)
- Zoltán Szolnoki
- Department of Neurology and Neurophysiology, Pándy Kálmán County Hospital, Gyula, and Department of Medical Genetics and Child Development, University of Pécs, Hungary.
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Szolnoki Z, Maasz A, Magyari L, Horvatovich K, Farago B, Somogyvari F, Kondacs A, Szabo M, Fodor L, Bodor A, Hadarits F, Melegh B. Coexistence of angiotensin II type-1 receptor A1166C and angiotensin-converting enzyme D/D polymorphism suggests susceptibility for small-vessel-associated ischemic stroke. Neuromolecular Med 2006; 8:353-60. [PMID: 16775386 PMCID: PMC7091324 DOI: 10.1385/nmm:8:3:353] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2005] [Revised: 01/12/2006] [Accepted: 01/13/2006] [Indexed: 11/11/2022]
Abstract
The renin-angiotensin system plays an important role in the maintenance of blood pressure homeostasis. The angiotensin-converting enzyme (ACE) converts angiotensin I into angiotensin II. Angiotensin II, which binds the angiotensin II type-1 receptor (AT1R), is a potent vasoconstrictor. On a pathophysiological basis, both ACE I/D and AT1R A1166C polymorphism lead to an enhanced activity of the angiotensin II-AT1R axis, thereby possibly contributing to circulatory disturbances. A mutually facilitatory effect may be presumed between the two polymorphisms. We examined whether this synergistic effect is involved in the evolution of different types of ischemic stroke. Genetic and clinical data on 308 consecutive patients with acutely developing ischemic stroke were analyzed. Atotal of 272 stroke and neuroimaging alteration-free subjects served as a control group. Univariate and logistic regression statistical approaches were used. The ACE D allele combined with the AT1R 1166C allele did not yield a risk of ischemic stroke. However, the co-occurrence of the homozygous ACE D/D and at least one AT1R 1166C allele was more frequent in the ischemic stroke group than in the control group (22.4 vs 11%, p < 0.005, OR, 2.33; 95% CI, 1.46-3.7). After specific subgroup analysis, this synergistic association was even stronger for small-vessel ischemic stroke (OR, 3.44; 95% CI, 1.9-6.24; p < 0.0005). Multivariate logistic regression analysis of the data confirmed this association (adjusted OR, 3.54, 95% CI, 1.88-7.16; p < 0.0005). Our results demonstrate that ACE D/D and AT1R 1166C polymorphism were associated with the development of small-vessel ischemic stroke through a mutually facilitatory interplay between them. Genetic interactions might contribute to the altered functional network in renin-angiotensin system in vascular disorders.
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Affiliation(s)
- Zoltán Szolnoki
- Department of Neurology and Neurophysiology, Pandy Kalman County Hospital, Gyula, Hungary
| | - Anita Maasz
- Department of Medical Genetics and Child Development, University of Pecs, Pecs, Hungary
| | - Lili Magyari
- Department of Medical Genetics and Child Development, University of Pecs, Pecs, Hungary
| | - Katalin Horvatovich
- Department of Medical Genetics and Child Development, University of Pecs, Pecs, Hungary
| | - Bernadett Farago
- Department of Medical Genetics and Child Development, University of Pecs, Pecs, Hungary
| | - Ferenc Somogyvari
- Central Laboratory, Pandy Kalman County Hospital, Gyula, Hungary
- Department of Clinical Microbiology, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Andras Kondacs
- Department of Neurology and Neurophysiology, Pandy Kalman County Hospital, Gyula, Hungary
| | - Mihaly Szabo
- Department of Neurology and Neurophysiology, Pandy Kalman County Hospital, Gyula, Hungary
| | - Lajos Fodor
- Central Laboratory, Pandy Kalman County Hospital, Gyula, Hungary
| | - Anita Bodor
- Department of Pathology, Rethy Pal County Hospital, Bekescsaba, Hungary
| | - Ferenc Hadarits
- Central Laboratory, Markusovszky Teaching Hospital, Szomibathely, Hungary
| | - Bela Melegh
- Department of Medical Genetics and Child Development, University of Pecs, Pecs, Hungary
- MTA-PTE Clinical Genetics Research Group of the Hungarian Academy of Sciences, University of Pecs, Pecs, Hungary
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Buraczynska M, Ksiazek P, Drop A, Zaluska W, Spasiewicz D, Ksiazek A. Genetic polymorphisms of the renin-angiotensin system in end-stage renal disease. Nephrol Dial Transplant 2005; 21:979-83. [PMID: 16384824 DOI: 10.1093/ndt/gfk012] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND End-stage renal disease (ESRD) is a complex phenotype resulting from underlying kidney diseases of different etiologies as well as from environmental and genetic factors. The responsible genes influencing the development and rate of progression to ESRD have yet to be defined. We examined an association of the three renin-angiotensin system (RAS) gene polymorphisms with renal disease and progression to ESRD in dialyzed patients. METHODS Genotyping was performed in 745 ESRD patients and 520 control subjects for the angiotensin-converting enzyme (ACE) I/D, angiotensinogen (AGT) M235T and angiotensin II type 1 receptor (AT1R) A1166C gene polymorphisms using polymerase chain reaction and gel analysis. RESULTS Allele and genotype frequencies of the ACE polymorphism did not differ significantly between ESRD patients and controls. The patient group showed an increased frequency of the T allele of the AGT polymorphism (P = 0.02) and the C allele and CC genotype of the AT1R polymorphism (P<0.01). There was an association of the AT1R gene polymorphism with the progression of renal disease to end-stage failure. The time from diagnosis to the onset of ESRD was significantly shorter in patients carrying the C allele than in subjects with the homozygous AA genotype (4.7 years vs 12.6 years, P<0.001). The observed effect was not associated with hypertension in studied subjects. CONCLUSION The results of our study demonstrate the association between the AT1R A/C polymorphism and renal disease progression. The CC/AC genotype of this polymorphism might serve as a predictor for early ESRD and might be useful in planning therapeutic strategies for individual patients.
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Affiliation(s)
- Monika Buraczynska
- Laboratory for Molecular Diagnostics of Multifactorial Diseases, Department of Nephrology, University Medical School, Dr K. Jaczewskiego 8, 20-954 Lublin, Poland.
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Lanz JR, Pereira AC, Lemos PA, Martinez E, Krieger JE. Angiotensinogen M235T polymorphism is associated with coronary artery disease severity. Clin Chim Acta 2005; 362:176-81. [PMID: 16045904 DOI: 10.1016/j.cccn.2005.06.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2005] [Revised: 06/17/2005] [Accepted: 06/18/2005] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Previous reports relating coronary artery disease and functional variants of the renin-angiotensin system have been contradictory in establishing the role of these polymorphisms in coronary artery disease (CAD) development. The aim of the present study is to determine if there is an association between the M235T variant of the angiotensinogen gene and severity of coronary artery disease in patients with clinically suspected disease undergoing cineangiogram. METHODS The angiotensinogen M235T variant was analyzed in 871 consecutive patients with clinically suspected coronary artery disease submitted to coronary angiography study. Three different angiographic scores were used to determine severity of the disease analyzing 20 coronary segments. All patients were evaluated considering classical risk factors for coronary artery disease throughout a medical oriented questionnaire, anthropometric measures, and blood glucose and lipid profile determination. RESULTS Presence of the 235T allele was associated with higher angiographic extension scores in univariate analysis (p < 0.05). The 235T allele was also associated with an increased risk of presenting 3-vessel disease (p < 0.05). In addition, the T allele was significantly associated with higher Gensini's scores both in univariate (p = 0.05) and multivariate analyses (p < 0.05). Finally, a 1.86 fold increase in the risk of multivessel disease (95% CI: 1.174-2.947) was associated with the TT genotype independently of other cardiovascular risk factors associated with disease extension. CONCLUSION The data hereby provide further support for the association between angiotensinogen M235T polymorphism and CAD severity independently of other cardiovascular risk factors.
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Affiliation(s)
- José R Lanz
- Laboratory of Genetics and Molecular Cardiology and Hemodynamics Laboratory, Heart Institute (InCor), University of São Paulo Medical School, Brazil
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Lerman LO, Chade AR, Sica V, Napoli C. Animal models of hypertension: an overview. ACTA ACUST UNITED AC 2005; 146:160-73. [PMID: 16131455 DOI: 10.1016/j.lab.2005.05.005] [Citation(s) in RCA: 108] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2005] [Revised: 05/19/2005] [Accepted: 05/20/2005] [Indexed: 10/25/2022]
Abstract
Hypertension is a multifactorial disease involving complex interactions between genetic and environmental factors. Development of experimental models of hypertension allowed dissection and isolation of various factors associated with regulation of blood pressure, inheritance of hypertensive traits, and cellular responses to injury. The phenotype-driven approach is taking advantage of selective breeding of animals (primarily rats) that exhibit a desired phenotype, like the useful SHR. Genotype-driven models include transgenic techniques, in which mice are the most successful for selective deletion or overexpression of target genes. Notably, a combination of comparative genomics strategies and phenotypic correlates enhances the utility of hypertension models and their clinical relevance. Indeed, experimental models enabled development of targeted interventions aimed at decreasing not only blood pressure but also target organ injury. Continued utilization of experimental models simulating human hypertension, particularly those that combine other clinically relevant comorbidities like obesity or hypercholesterolemia, may afford development of effective strategies to address this common disease. Nevertheless, a cautious approach is mandatory when experimental findings in these models are extrapolated to human hypertension.
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Affiliation(s)
- Lilach O Lerman
- Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA.
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Mondry A, Loh M, Liu P, Zhu AL, Nagel M. Polymorphisms of the insertion / deletion ACE and M235T AGT genes and hypertension: surprising new findings and meta-analysis of data. BMC Nephrol 2005; 6:1. [PMID: 15642127 PMCID: PMC546009 DOI: 10.1186/1471-2369-6-1] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2004] [Accepted: 01/11/2005] [Indexed: 02/02/2023] Open
Abstract
Background Essential hypertension is a common, polygenic, complex disorder resulting from interaction of several genes with each other and with environmental factors such as obesity, dietary salt intake, and alcohol consumption. Since the underlying genetic pathways remain elusive, currently most studies focus on the genes coding for proteins that regulate blood pressure as their physiological role makes them prime suspects. The present study examines how polymorphisms of the insertion/deletion (I/D) ACE and M235T AGT genes account for presence and severity of hypertension, and embeds the data in a meta-analysis of relevant studies. Methods The I/D polymorphisms of the ACE and M235T polymorphisms of the AGT genes were determined by RFLP (restriction fragment length polymorphism) and restriction analysis in 638 hypertensive patients and 720 normotensive local blood donors in Weisswasser, Germany. Severity of hypertension was estimated by the number of antihypertensive drugs used. Results No difference was observed in the allele frequencies and genotype distributions of ACE gene polymorphisms between the two groups, whereas AGT TT homozygotes were more frequent in controls (4.6% vs. 2.7%, P = .08). This became significant (p = 0.035) in women only. AGT TT genotype was associated with a 48% decrease in the risk of having hypertension (odds ratio: 0.52; 95% CI, 0.28 to 0.96), and this risk decreased more significantly in women (odds ratio: 0.28; 95% CI, 0.1 to 0.78). The meta-analysis showed a pooled odds ratio for hypertension of 1.21 (TT vs. MM, 95% CI: 1.11 to 1.32) in Caucasians. No correlation was found between severity of hypertension and a specific genotype. Conclusion The ACE I/D polymorphism does not contribute to the presence and severity of essential hypertension, while the AGT M235T TT genotype confers a significantly decreased risk for the development of hypertension in the population studied here. This contrasts to the findings of meta-analyses, whereby the T allele is associated with increased risk for hypertension.
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Affiliation(s)
- Adrian Mondry
- Bioinformatics Institute, 30 Biopolis Street, #07-01 Matrix Building, 138671 Singapore
| | - Marie Loh
- Bioinformatics Institute, 30 Biopolis Street, #07-01 Matrix Building, 138671 Singapore
| | - Pengbo Liu
- Bioinformatics Institute, 30 Biopolis Street, #07-01 Matrix Building, 138671 Singapore
| | - Ai- Ling Zhu
- Bioinformatics Institute, 30 Biopolis Street, #07-01 Matrix Building, 138671 Singapore
| | - Mato Nagel
- MolDiag Ag, Albert- Schweitzer- Ring 32, 02943 Weisswasser, Germany
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Saeed M, Saleheen D, Siddiqui S, Khan A, Butt ZA, Frossard PM. Association of Angiotensin Converting Enzyme Gene Polymorphisms with Left Ventricular Hypertrophy. Hypertens Res 2005; 28:345-9. [PMID: 16138565 DOI: 10.1291/hypres.28.345] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The angiotensin converting enzyme gene (ACE) is of much interest as a candidate gene conferring an individual's genetic susceptibility to left ventricular hypertrophy (LVH). LVH has long been thought to be an end point of essential hypertension (EH), rather than a separate entity, though it is influenced by a unique set of hormonal, vascular and genetic factors. In this study, we attempted to determine whether two representative polymorphisms of the ACE gene, ACE I/D and 2350 G>A, known to be associated with EH and to have a highly significant influence on plasma ACE levels, could implicate ACE as a quantitative trait locus (QTL) for LVH. We carried out a retrospective, case-control study of the two ACE polymorphisms amongst 180 nationals (50 LVH patients and 130 controls) from the United Arab Emirates (Emirati)--an ethnic group characterized by an absence of alcohol intake and cigarette smoking--for putative correlations with LVH. Clinical diagnoses of LVH were based on echocardiographic and ECG criteria. ACE I/D and 2350 G>A genotypes were determined by polymerase chain reaction (PCR) and restriction digestion. Univariate and multivariate logistic regression analyses revealed an association between ACE polymorphisms and LVH. Haplotype analysis further supported this finding. The ACE I/D and ACE 2350 G>A polymorphisms were in strong linkage disequilibrium and were independently associated with LVH, suggesting that ACE is likely to be a QTL for LVH. In conclusion, This is the first association study of the ACE 2350 G>A polymorphism with LVH; the results showed that this polymorphism, along with ACE I/D, is associated with LVH.
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Affiliation(s)
- Mohammad Saeed
- From the Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
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Renner W, Nauck M, Winkelmann BR, Hoffmann MM, Scharnagl H, Mayer V, Boehm BO, März W. Association of angiotensinogen haplotypes with angiotensinogen levels but not with blood pressure or coronary artery disease: the Ludwigshafen Risk and Cardiovascular Health Study. J Mol Med (Berl) 2004; 83:235-9. [PMID: 15599691 DOI: 10.1007/s00109-004-0618-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2004] [Accepted: 09/28/2004] [Indexed: 10/26/2022]
Abstract
Angiotensinogen and its cleaved forms angiotensin I and angiotensin II are important regulators of blood pressure. The gene for angiotensinogen (AGT) carries two common polymorphisms, T207M and M268T (previously described as T174M and M235T). To investigate the role of haplotypes formed by these polymorphisms for angiotensinogen levels we examined blood pressure, coronary artery disease (CAD), myocardial infarction (MI), and AGT genotypes and haplotypes in 2,575 patients with angiographically documented CAD and 731 individuals in whom CAD had been ruled out by angiography. Three haplotypes, designated as Hap1 (T207, M268), Hap2 (T207, T268) and Hap3 (M207, T268), accounted for more than 99% of alleles. The AGT Hap2 haplotype was significantly associated with angiotensinogen levels; one additional Hap2 allele accounted for an approx. 8% increase in angiotensinogen. This association was stronger than that of either single polymorphism. AGT genotypes or haplotypes were not related to hypertension, CAD or MI. We conclude that a common haplotype of the angiotensinogen gene is linked to angiotensinogen levels but has no major impact on blood pressure, hypertension, or cardiovascular risk.
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Affiliation(s)
- Wilfried Renner
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, University and General Hospital, Medical University, Auenbruggerplatz 30, 8036, Graz, Austria.
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