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Negm HMH, Farag AF, Taha RROO. Polymorphisms in ENAM, AMBN, and KLK4 predispose Egyptian adults to dental caries: A cross-sectional study. Saudi Dent J 2024; 36:915-919. [PMID: 38883909 PMCID: PMC11178948 DOI: 10.1016/j.sdentj.2024.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 03/14/2024] [Accepted: 03/18/2024] [Indexed: 06/18/2024] Open
Abstract
Objective This study investigates the distributional discrepancies of four single-nucleotide polymorphic loci as correlatives and causatives of dental caries susceptibility among Egyptians. Method We conducted a cross-sectional study through the genotyping of enamelin (ENAM rs3796703), ameloblastin (AMBN rs4694075), tuftelin 1 (TUFT1 rs78802584), and kallikrein 4 (KLK4 rs2242670) in 132 adults (males = 74, females = 58) and 72 controls (males = 40, females = 32) referred from various Egyptian hospitals. For each participant, the number of decayed, missing, and filled teeth was charted, and the presence of biofilm/gingivitis/fluorosis was assessed. Bitewing radiographs were taken to detect interproximal caries. In addition, statistical analysis was conducted using Chi-square test, odds ratios, and corresponding P-values. Results The alleles and genotypes of ENAM rs3796703, AMBN rs4694075, and KLK4 rs2242670 correlated strongly with dental caries susceptibility. However, TUFT1 rs78802584 did not exhibit such associations. Conclusion These findings suggest the potential role of ENAM, AMBN, and KLK4 as determinants of dental caries susceptibility among Egyptian adults. The role of ENAM, AMBN, and KLK4 genetic variants is determinant in influencing susceptibility to dental caries in the Egyptian population, providing valuable insights into the genetic aspects of oral health. However, the lack of associations of caries susceptibility with TUFT1 rs78802584 contradicts its cariogenic role in many ethnicities.
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Affiliation(s)
| | - Amina Fouad Farag
- Department of Oral Pathology, Faculty of Dentistry, October 6 University, Giza, Egypt
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Khami MR, Asgari S, Valizadeh S, Karami J, Rezaei A, Rezaei N. AMELX and ENAM Polymorphisms and Dental Caries. Int J Dent 2022; 2022:8501179. [PMID: 36624859 PMCID: PMC9825226 DOI: 10.1155/2022/8501179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 12/01/2022] [Accepted: 12/19/2022] [Indexed: 01/02/2023] Open
Abstract
Introduction The variety of the genetic factors playing role in development of dental caries calls for further research in this regard. The aim of the present study was to investigate the differences between caries-free adults and adults with dental caries in terms of polymorphism of caries-related genes (AMELX and ENAM). Methods The present case-control study was performed on 81 adults aged 18-24 years, 41 caries free, and 40 with a DMFT ≥ 4. A questionnaire containing background and demographic information (such as age, gender, time and type of latest dental check-ups, parent's education, oral self-care, and the place of residence in the first 12 years of life) was completed by participants at the time of examination. The blood sample was taken from each participant in the EDTA tube, and PCR was performed. Gene diversity of AMELX and ENAM genes was compared between the two groups. Results Regarding AMELX gene, in the caries-free group 33 (80.5%) and in the group with DMFT ≥ 4, 33 (82.5%) students had TT genotype, but this difference was insignificant. For ENAM gene, in the caries-free group 34 (82.9%) and in the group with DMFT ≥ 4, 39 (97.5%) students had TT genotype, but this difference was insignificant (P value = 0.048, CI 95%:0.02-1.27, and OR = 0.145). Conclusion There was no relationship between TT and TC genotypes of single nucleotide polymorphism of AMELX and ENAM gene and susceptibility to dental caries, but with increasing sample size, there may be a relationship between SNP of ENAM gene and being caries free.
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Affiliation(s)
- Mohammad Reza Khami
- Research Center for Caries Prevention Dentistry Research, Institute Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Asgari
- Department of Periodontology, School of Dentistry, Babol University of Medical Sciences, Babol, Iran
| | - Sara Valizadeh
- Department of Operative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Jafar Karami
- Molecular and Medicine Research Center, Khomein University of Medical Sciences, Khomein, Iran
| | - Arezou Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA) Universal Scientific Education and Research Network (USERN), Tehran, Iran
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Lei W, Tian H, Xia Y. Association Between the TaqI (rs731236 T>C) Gene Polymorphism and Dental Caries Risk: A Meta-analysis. Genet Test Mol Biomarkers 2021; 25:368-375. [PMID: 33960841 PMCID: PMC8140352 DOI: 10.1089/gtmb.2020.0263] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective: This study investigated the association of the TaqI (rs731236 T>C) polymorphism in the VDR gene with dental caries. Methods: A comprehensive literature search was performed in PubMed, Web of Science, Embase, SinoMed (the Chinese biomedical literature service system), and the Wiley Online Library. Overall comparisons and subgroup analyses based on ethnicity and the presence of dental caries in dentition were performed. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess associations between gene polymorphisms and the risk of dental caries. Results: Seven articles were included in this meta-analysis. The pooled results revealed a significant association of the TaqI (rs731236 T>C) polymorphism with dental caries in the allele contrast model (C vs. T: OR = 1.24, 95% CI = 1.07–1.44, I2 = 42%, p = 0.005) and in the recessive genetic model (CC vs. TT/CT: OR = 1.38, 95% CI = 1.03–1.84, I2 = 0%, p = 0.03). A stratified analysis based on ethnicity revealed a significant association between the TaqI (rs731236 T>C) polymorphism and the risk of dental caries in Asians (C vs. T: OR = 1.28, 95% CI = 1.06–1.54, I2 = 60%, p = 0.009). Subgroup analysis based on the presence of dental caries in dentition found a significant association of the TaqI (rs731236 T>C) polymorphism with permanent tooth caries in the allele contrast model (C vs. T: OR = 1.40, 95% CI = 1.11–1.77, I2 = 76%, p = 0.005) and the recessive genetic model (CC vs. TT/CT: OR = 1.44, 95% CI = 1.03–2.00, I2 = 0%, p = 0.03). Conclusion: The results of this meta-analysis suggest that the C allele and CC genotype of the TaqI (rs731236 T>C) polymorphism in the VDR gene are associated with an increased risk of dental caries.
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Affiliation(s)
- Wei Lei
- College of Stomatology, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Haonan Tian
- College of Stomatology, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yinlan Xia
- College of Stomatology, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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Kelly AM, Bezamat M, Modesto A, Vieira AR. Biomarkers for Lifetime Caries-Free Status. J Pers Med 2020; 11:jpm11010023. [PMID: 33396693 PMCID: PMC7824168 DOI: 10.3390/jpm11010023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/21/2020] [Accepted: 12/28/2020] [Indexed: 01/08/2023] Open
Abstract
The purpose of this study was to address the hypothesis that extreme outcomes of dental caries, such as edentulism
or prematurely losing permanent teeth are associated with genetic variation in enamel-formation genes. After scanning 6206 individuals, samples of 330 were selected for this study. Tested phenotypes included patients who were edentulous by age 30, patients with missing first molars by age 30, patients with missing second molars by age 30, and caries-free patients. Fourteen single nucleotide polymorphisms were genotyped by TaqMan chemistry. The analyses of each phenotype were performed using the software PLINK with an alpha of 0.05. Nominal associations were found between rs12640848 in enamelin (p = 0.05), rs1784418 in matrix metallopeptidase 20 (p = 0.02), and rs5997096 in the tuftelin interacting protein 11 and being caries-free at the age of 60. When combining patients that were missing both first mandibular molars and missing both second mandibular molars, no associations were found. Matrix metallopeptidase 20, and tuftelin interacting protein 11 also showed trends for association with being caries-free. Genetic variation in TFIP11, MMP20, and ENAM may have a protective effect increasing the chances of individuals preserving their teeth caries-free over a lifetime.
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Vieira AR, Modesto A. Amelogenesis Imperfecta Enamel Changes, Amelogenin, and Dental Caries Susceptibility. FRONTIERS IN DENTAL MEDICINE 2020. [DOI: 10.3389/fdmed.2020.613851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
There is great interest in identifying the subset of individuals in the population that are more susceptible to dental caries. We proposed that a portion of these particular individuals are more susceptible to dental caries due to changes in dental enamel that are related to amelogenin genomic variation. However, apparently amelogenin function can be impacted by inflammation, and this can lead to small changes in the structure of the dental enamel that later in life increases the risk of dental caries.
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Randazzo AC, Burnheimer JM, Bayram M, Seymen F, Vieira AR. Genetic polymorphisms influence shear bond resistance of orthodontic brackets. J World Fed Orthod 2020; 9:101-105. [PMID: 32943154 DOI: 10.1016/j.ejwf.2020.06.001] [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: 04/02/2020] [Revised: 05/29/2020] [Accepted: 06/02/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The purpose of this study was to determine if shear bond resistance of orthodontic brackets bonded to enamel is associated with genes implicated in the enamel mineralization process. METHODS Ninety-two permanent, caries-free premolars extracted for orthodontic purposes and their associated saliva samples were obtained. Eighteen single nucleotide polymorphisms (SNPs) were studied for association with shear bond resistance. The genes of interest in this study were those previously associated with dental caries by our group. All tooth samples were bonded on the buccal surface with metallic lower lateral brackets, and then subjected to physical debonding. The force required to debond the bracket was recorded in Newtons (N) and converted to a shear bond resistance value in Megapascals (N/mm2). The data were analyzed for statistical significance as compared with the mean shear bond resistance value via PLINK whole genome analysis software. RESULTS Associations were found between the SNPs for tuftelin (rs7526319, P = 0.004) and amelogenin (rs17878486, P = 0.04) and a higher shear bond resistance. CONCLUSION The collected data support the proposed hypothesis that genes involved in the mineralization process affect the bonding of orthodontic brackets, and such an association is of value for the field of orthodontics, particularly in evaluating the efficacy of enamel-resin bond strength for patients receiving treatment.
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Affiliation(s)
- Adam C Randazzo
- Student, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - John M Burnheimer
- Assistant Professor, Department of Orthodontics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Merve Bayram
- Assistant Professor, Department of Pedodontics, School of Dentistry, Istanbul Medipol University, Istanbul, Turkey
| | - Figen Seymen
- Professor, Department of Pedodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Alexandre R Vieira
- Professor, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
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Sharifi R, Jahedi S, Mozaffari HR, Imani MM, Sadeghi M, Golshah A, Moradpoor H, Safaei M. Association of LTF, ENAM, and AMELX polymorphisms with dental caries susceptibility: a meta-analysis. BMC Oral Health 2020; 20:132. [PMID: 32375748 PMCID: PMC7204276 DOI: 10.1186/s12903-020-01121-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 04/27/2020] [Indexed: 12/22/2022] Open
Abstract
Background This meta-analysis evaluated the association of LTF, ENAM, and AMELX polymorphisms with dental caries susceptibility. Methods We searched the Scopus, PubMed/Medline, Web of Science, and Cochrane Library databases to retrieve articles published by October 2019. Review Manager 5.3 software was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). The results of publication bias tests were retrieved by Comprehensive Meta-Analysis 2.0 software. Results A total of 150 relevant records were identified; out of which, 16 were entered into the analysis (4 studies assessed LTF, 11 ENAM, and 11 AMELX polymorphisms). Of all polymorphisms, there was a significant association only between ENAM rs3796704 polymorphism and dental caries susceptibility. Both ENAM rs3796704 and AMELX rs17878486 polymorphisms had a significant association with dental caries risk in the Caucasian ethnicity and the studies including caries-free control group. Conclusions The results of this meta-analysis showed that the G allele and the GG genotype of ENAM rs3796704 were associated with an increased risk of caries in the case group compared with the control group. But there was no association between LTF rs1126478, ENAM (rs1264848 and rs3796703), and AMELX (rs946252, rs17878486, and rs2106416) polymorphisms and dental caries susceptibility.
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Affiliation(s)
- Roohollah Sharifi
- Department of Endodontics, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, 6713954658, Iran
| | - Sajjad Jahedi
- Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, 6715847141, Iran
| | - Hamid Reza Mozaffari
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, 6713954658, Iran
| | - Mohammad Moslem Imani
- Department of Orthodontics, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, 6713954658, Iran
| | - Masoud Sadeghi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, 6714415185, Iran.
| | - Amin Golshah
- Department of Orthodontics, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, 6713954658, Iran
| | - Hedaiat Moradpoor
- Department of Prosthodontics, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, 6713954658, Iran
| | - Mohsen Safaei
- Advanced Dental Sciences Research Laboratory, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, 6713954658, Iran
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Duran-Merino D, Molina-Frechero N, Sánchez-Pérez L, Nevárez-Rascón M, González-González R, Tremillo-Maldonado O, Cassi D, Bologna-Molina R. ENAM Gene Variation in Students Exposed to Different Fluoride Concentrations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061832. [PMID: 32178265 PMCID: PMC7143052 DOI: 10.3390/ijerph17061832] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/06/2020] [Accepted: 03/08/2020] [Indexed: 02/07/2023]
Abstract
UNLABELLED The ENAM gene is important in the formation of tooth enamel; an alteration can affect the lengthening of the crystals, and the thickness in enamel. The objective was to determine the presence of the single nucleotide variant (SNV) rs12640848 of the ENAM gene in students exposed to different concentrations of fluoride. METHODS A cross-sectional study was conducted on students exposed to high concentrations of fluoride in the city of Durango which were divided according to the severity of fluorosis and dental caries. Genotype determination was performed by DNA sequencing. The relationship between the severity of dental fluorosis and the allele distribution was determined by the Fisher's exact and Kruskal-Wallis tests. RESULTS Seventy-one students were included for the sequencing. In the different allelic variations, for the normal genotype AA/TT, the control group presented 75%, for the AG/TC variation, 70.8% in the TF ≤ 4 group, 65% in TF ≥ 5, and 16.7% in TF = 0; with respect to GG/CC variation, 12.5% in TF ≤ 4, 22% in TF ≥ 5, and 8.3% in TF = 0 group (p = 0.000). CONCLUSION The ENAM gene showed an association in the population exposed to different concentrations of fluoride.
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Affiliation(s)
- Denisse Duran-Merino
- Dental Sciences, Autonomous Metropolitan University Xochimilco (UAM), Calzada del Hueso 1100, Mexico City 04900, Mexico;
| | - Nelly Molina-Frechero
- Department of Health Care, Autonomous Metropolitan University Xochimilco (UAM), Calzada del Hueso 1100, Mexico City 04900, Mexico;
- Correspondence: ; Tel.: +52-55-5483-7182
| | - Leonor Sánchez-Pérez
- Department of Health Care, Autonomous Metropolitan University Xochimilco (UAM), Calzada del Hueso 1100, Mexico City 04900, Mexico;
| | - Martina Nevárez-Rascón
- School of Dentistry, Autonomous University of Chihuahua (UACH), Chihuahua, Campus I Av. Universidad s/n, Chihuahua 31000, Mexico;
| | - Rogelio González-González
- Department of Research, School of Dentistry, Juarez University of the State of Durango, Durango (UJED) Predio Canoas s/n, Durango 34000, Mexico; (R.G.-G.); (O.T.-M.)
| | - Omar Tremillo-Maldonado
- Department of Research, School of Dentistry, Juarez University of the State of Durango, Durango (UJED) Predio Canoas s/n, Durango 34000, Mexico; (R.G.-G.); (O.T.-M.)
| | - Diana Cassi
- Department of Surgical, Medical, Dental and Morphological Science–University of Modena, 41121 Modena, Italy;
| | - Ronell Bologna-Molina
- Molecular Pathology Area, School of Dentistry, University of the Republic, Uruguay (UDELAR) Montevideo 11600, Montevideo 11200, Uruguay;
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Kelly AM, Kallistova A, Küchler EC, Romanos HF, Lips A, Costa MC, Modesto A, Vieira AR. Measuring the Microscopic Structures of Human Dental Enamel Can Predict Caries Experience. J Pers Med 2020; 10:jpm10010005. [PMID: 32024259 PMCID: PMC7151622 DOI: 10.3390/jpm10010005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 01/28/2020] [Accepted: 01/28/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The hierarchical structure of enamel gives insight on the properties of enamel and can influence its strength and ultimately caries experience. Currently, past caries experience is quantified using the decayed, missing, filled teeth/decayed, missing, filled surface (DMFT/DMFS for permanent teeth; dmft/dmfs for primary teeth), or international caries detection and assessment system (ICDAS) scores. By analyzing the structure of enamel, a new measurement can be utilized clinically to predict susceptibility to future caries experience based on a patient's individual's biomarkers. The purpose of this study was to test the hypothesis that number of prisms by square millimeter in enamel and average gap distance between prisms and interprismatic areas, influence caries experience through genetic variation of the genes involved in enamel formation. MATERIALS AND METHODS Scanning electron microscopy (SEM) images of enamel from primary teeth were used to measure (i) number of prisms by square millimeter and interprismatic spaces, (ii) prism density, and (iii) gap distances between prisms in the enamel samples. The measurements were tested to explore a genetic association with variants of selected genes and correlations with caries experience based on the individual's DMFT+ dmft score and enamel microhardness at baseline, after an artificial lesion was created and after the artificial lesion was treated with fluoride. RESULTS Associations were found between variants of genes including ameloblastin, amelogenin, enamelin, tuftelin, tuftelin interactive protein 11, beta defensin 1, matrix metallopeptidase 20 and enamel structure variables measured (number of prisms by square millimeter in enamel and average gap distance between prisms and interprismatic areas). Significant correlations were found between caries experience and microhardness and enamel structure. Negative correlations were found between number of prisms by square millimeter and high caries experience (r value= -0.71), gap distance between prisms and the enamel microhardness after an artificial lesion was created (r value= -0.70), and gap distance between prisms and the enamel microhardness after an artificial lesion was created and then treated with fluoride (r value= -0.81). There was a positive correlation between number of prisms by square millimeter and prism density of the enamel (r value = 0.82). CONCLUSIONS Our data support that genetic variation may impact enamel formation, and therefore influence susceptibility to dental caries and future caries experience. CLINICAL RELEVANCE The evaluation of enamel structure that may impact caries experience allows for hypothesizing that the identification of individuals at higher risk for dental caries and implementation of personalized preventative treatments may one day become a reality.
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Affiliation(s)
- Ariana M. Kelly
- Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA; (A.M.K.); (E.C.K.)
| | - Anna Kallistova
- Institute of Geochemistry, Mineralogy and Mineral Resources, Faculty of Science, Charles University, Albertov 6, Prague 2, Czech;
- Institute of Geology of the CAS, v.v.i., Rozvojová 269, Prague 6, Czech
| | - Erika C. Küchler
- Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA; (A.M.K.); (E.C.K.)
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ 21941-901, Brazil; (H.F.R.); (M.C.C.)
| | - Helena F. Romanos
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ 21941-901, Brazil; (H.F.R.); (M.C.C.)
| | - Andrea Lips
- Clinical Research Unit, Fluminense Federal University, Niteról 24020, Brazil;
| | - Marcelo C. Costa
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ 21941-901, Brazil; (H.F.R.); (M.C.C.)
| | - Adriana Modesto
- Department of Pediatric Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA;
| | - Alexandre R. Vieira
- Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA; (A.M.K.); (E.C.K.)
- Correspondence:
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Cavallari T, Arima LY, Ferrasa A, Moysés SJ, Tetu Moysés S, Hirochi Herai R, Iani Werneck R. Dental caries: Genetic and protein interactions. Arch Oral Biol 2019; 108:104522. [PMID: 31476523 DOI: 10.1016/j.archoralbio.2019.104522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 07/09/2019] [Accepted: 08/11/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To present a genetic and protein interaction analysis associated with dental caries. MATERIAL AND METHODS The first step was to conduct a systematic literature review (SLR) through an electronic database search. Case-controls that reported associations between genes and dental caries were the main type of study design used as inclusion criteria, retrieved from the PubMed and the Virtual Health Library databases, comprising the chronological range from 1982 to 2017. The SLR was guided by PRISMA protocol and the methodological quality of the studies was established through Newcastle-Ottawa Scale (NOS). In the second step, the String Protein Interaction (SPI) approach was used to analyze protein interaction (by esyN software) and also the Ingenuity Pathway Analysis (IPA) to check biological pathways associated with dental caries genes. RESULTS A total of 51 articles were included to perform this SLR, describing a number of 27 genes associated with dental caries development. At the genetic level, 23 genes have at least one other gene with which they interact. The genes TUFT1, VDR, TFIP11, LTF, HLA-DRB1, MMP2, MMP3 and MUC5B were shown to be connected in interactive networks by at least 10 other genes. CONCLUSION It is essential to apprehend the multifactorial pattern of inheritance in human disease. This study presents pathways which may be directly correlated with several dental caries phenotype and this contributes to a better understanding of this disease, opening up a wider range of biotechnology options for its effective control in the future.
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Affiliation(s)
- Tayla Cavallari
- Graduate Program in Dentistry, Dentistry Department, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição 1155, Curitiba, Paraná, Brazil, 80215-901.
| | - Letícia Yumi Arima
- Graduate Program in Dentistry, Dentistry Department, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição 1155, Curitiba, Paraná, Brazil, 80215-901.
| | - Adriano Ferrasa
- Graduate Program in Health Sciences (PPGCS), School of Medicine, Pontifícia Universidade Católica do Paraná (PUCPR), Rua Imaculada Conceição 1155, Curitiba, Paraná, Brazil, 80215-901; Informatics Department, Universidade Estadual de Ponta Grossa (UEPG), Paraná, Brazil, 84030-900.
| | - Samuel Jorge Moysés
- Graduate Program in Dentistry, Dentistry Department, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição 1155, Curitiba, Paraná, Brazil, 80215-901.
| | - Simone Tetu Moysés
- Graduate Program in Dentistry, Dentistry Department, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição 1155, Curitiba, Paraná, Brazil, 80215-901.
| | - Roberto Hirochi Herai
- Graduate Program in Health Sciences (PPGCS), School of Medicine, Pontifícia Universidade Católica do Paraná (PUCPR), Rua Imaculada Conceição 1155, Curitiba, Paraná, Brazil, 80215-901; Research Division, Lico Kaesemodel Institute, Paraná, Brazil, 80240-000.
| | - Renata Iani Werneck
- Graduate Program in Dentistry, Dentistry Department, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição 1155, Curitiba, Paraná, Brazil, 80215-901.
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11
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Nibali L, Di Iorio A, Tu YK, Vieira AR. Host genetics role in the pathogenesis of periodontal disease and caries. J Clin Periodontol 2018; 44 Suppl 18:S52-S78. [PMID: 27754553 DOI: 10.1111/jcpe.12639] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND This study aimed to produce the latest summary of the evidence for association of host genetic variants contributing to both periodontal diseases and caries. MATERIALS AND METHODS Two systematic searches of the literature were conducted in Ovid Medline, Embase, LILACS and Cochrane Library for large candidate gene studies (CGS), systematic reviews and genome-wide association studies reporting data on host genetic variants and presence of periodontal disease and caries. RESULTS A total of 124 studies were included in the review (59 for the periodontitis outcome and 65 for the caries outcome), from an initial search of 15,487 titles. Gene variants associated with periodontitis were categorized based on strength of evidence and then compared with gene variants associated with caries. Several gene variants showed moderate to strong evidence of association with periodontitis, although none of them had also been associated with the caries trait. CONCLUSIONS Despite some potential aetiopathogenic similarities between periodontitis and caries, no genetic variants to date have clearly been associated with both diseases. Further studies or comparisons across studies with large sample size and clear phenotype definition could shed light into possible shared genetic risk factors for caries and periodontitis.
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Affiliation(s)
- Luigi Nibali
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London (QMUL), London, UK
| | - Anna Di Iorio
- Library Services, UCL Eastman Dental Institute, London, UK
| | - Yu-Kang Tu
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Alexandre R Vieira
- Department of Oral Biology, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA
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12
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Haworth S, Shungin D, van der Tas JT, Vucic S, Medina-Gomez C, Yakimov V, Feenstra B, Shaffer JR, Lee MK, Standl M, Thiering E, Wang C, Bønnelykke K, Waage J, Jessen LE, Nørrisgaard PE, Joro R, Seppälä I, Raitakari O, Dudding T, Grgic O, Ongkosuwito E, Vierola A, Eloranta AM, West NX, Thomas SJ, McNeil DW, Levy SM, Slayton R, Nohr EA, Lehtimäki T, Lakka T, Bisgaard H, Pennell C, Kühnisch J, Marazita ML, Melbye M, Geller F, Rivadeneira F, Wolvius EB, Franks PW, Johansson I, Timpson NJ. Consortium-based genome-wide meta-analysis for childhood dental caries traits. Hum Mol Genet 2018; 27:3113-3127. [PMID: 29931343 PMCID: PMC6097157 DOI: 10.1093/hmg/ddy237] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 05/29/2018] [Accepted: 06/14/2018] [Indexed: 12/26/2022] Open
Abstract
Prior studies suggest dental caries traits in children and adolescents are partially heritable, but there has been no large-scale consortium genome-wide association study (GWAS) to date. We therefore performed GWAS for caries in participants aged 2.5-18.0 years from nine contributing centres. Phenotype definitions were created for the presence or absence of treated or untreated caries, stratified by primary and permanent dentition. All studies tested for association between caries and genotype dosage and the results were combined using fixed-effects meta-analysis. Analysis included up to 19 003 individuals (7530 affected) for primary teeth and 13 353 individuals (5875 affected) for permanent teeth. Evidence for association with caries status was observed at rs1594318-C for primary teeth [intronic within ALLC, odds ratio (OR) 0.85, effect allele frequency (EAF) 0.60, P 4.13e-8] and rs7738851-A (intronic within NEDD9, OR 1.28, EAF 0.85, P 1.63e-8) for permanent teeth. Consortium-wide estimated heritability of caries was low [h2 of 1% (95% CI: 0%: 7%) and 6% (95% CI 0%: 13%) for primary and permanent dentitions, respectively] compared with corresponding within-study estimates [h2 of 28% (95% CI: 9%: 48%) and 17% (95% CI: 2%: 31%)] or previously published estimates. This study was designed to identify common genetic variants with modest effects which are consistent across different populations. We found few single variants associated with caries status under these assumptions. Phenotypic heterogeneity between cohorts and limited statistical power will have contributed; these findings could also reflect complexity not captured by our study design, such as genetic effects which are conditional on environmental exposure.
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Affiliation(s)
- Simon Haworth
- Medical Research Council Integrative Epidemiology Unit at Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
| | - Dmitry Shungin
- Department of Odontology, Umeå University, Umeå 901 87, Sweden
- Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, MA 02142, USA
| | - Justin T van der Tas
- Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics
| | - Strahinja Vucic
- Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics
| | - Carolina Medina-Gomez
- The Generation R Study Group
- Department of Internal Medicine
- Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam 3015 CN, The Netherlands
| | - Victor Yakimov
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen DK-2300, Denmark
| | - Bjarke Feenstra
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen DK-2300, Denmark
| | - John R Shaffer
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Myoung Keun Lee
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Marie Standl
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg D-85764, Germany
| | - Elisabeth Thiering
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg D-85764, Germany
- Division of Metabolic and Nutritional Medicine, Dr von Hauner Children's Hospital, University of Munich Medical Center, Munich 80337, Germany
| | - Carol Wang
- Division of Obstetrics and Gynaecology, The University of Western Australia, Perth WA 6009, Australia
| | - Klaus Bønnelykke
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofe Hospital, University of Copenhagen, Copenhagen 2730, Denmark
| | - Johannes Waage
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofe Hospital, University of Copenhagen, Copenhagen 2730, Denmark
| | - Leon Eyrich Jessen
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofe Hospital, University of Copenhagen, Copenhagen 2730, Denmark
| | - Pia Elisabeth Nørrisgaard
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofe Hospital, University of Copenhagen, Copenhagen 2730, Denmark
| | - Raimo Joro
- Institute of Biomedicine, School of Medicine, University of Eastern Finland Kuopio Campus, 70211 Kuopio, Finland
| | - Ilkka Seppälä
- Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center Tampere - Faculty of Medicine and Life Sciences, University of Tampere, Tampere 33520, Finland
| | - Olli Raitakari
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku 20520, Finland
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku 20520, Finland
| | - Tom Dudding
- Medical Research Council Integrative Epidemiology Unit at Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
| | - Olja Grgic
- Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics
- The Generation R Study Group
| | | | - Anu Vierola
- Institute of Biomedicine, School of Medicine, University of Eastern Finland Kuopio Campus, 70211 Kuopio, Finland
| | - Aino-Maija Eloranta
- Institute of Biomedicine, School of Medicine, University of Eastern Finland Kuopio Campus, 70211 Kuopio, Finland
| | - Nicola X West
- Bristol Dental School, University of Bristol, Bristol BS1 2LY, UK
| | - Steven J Thomas
- Bristol Dental School, University of Bristol, Bristol BS1 2LY, UK
| | - Daniel W McNeil
- Department of Psychology, Eberly College of Arts and Sciences, West Virginia University, Morgantown, WA 26506-6286, USA
| | - Steven M Levy
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Cedar Rapids, IA 52242-1010, USA
| | - Rebecca Slayton
- Department of Pediatric Dentistry (Retired), School of Dentistry, University of Washington, Seattle, WA 98195, USA
| | - Ellen A Nohr
- Research Unit for Gynaecology and Obstetrics, Department of Clinical Research, University of Southern Denmark, Odense 5000, Denmark
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center Tampere - Faculty of Medicine and Life Sciences, University of Tampere, Tampere 33520, Finland
| | - Timo Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland Kuopio Campus, 70211 Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio 70210, Finland
- Kuopio Research Institute of Exercise Medicine, Kuopio 70100, Finland
| | - Hans Bisgaard
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofe Hospital, University of Copenhagen, Copenhagen 2730, Denmark
| | - Craig Pennell
- Division of Obstetrics and Gynaecology, The University of Western Australia, Perth WA 6009, Australia
| | - Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-Universität München, Munich 80336, Germany
| | - Mary L Marazita
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Mads Melbye
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen DK-2300, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen 2200, Denmark
- Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Frank Geller
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen DK-2300, Denmark
| | - Fernando Rivadeneira
- The Generation R Study Group
- Department of Internal Medicine
- Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam 3015 CN, The Netherlands
| | - Eppo B Wolvius
- Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics
| | - Paul W Franks
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Malmö 202 13, Sweden
- Department of Public Health and Clinical Medicine, Umeå University, Umeå 901 85, Sweden
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
| | | | - Nicholas J Timpson
- Medical Research Council Integrative Epidemiology Unit at Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
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13
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Casado PL, Quinelato V, Cataldo P, Prazeres J, Campello M, Bonato LL, Aguiar T. Dental genetics in Brazil: Where we are. Mol Genet Genomic Med 2018; 6:689-701. [PMID: 30078197 PMCID: PMC6160708 DOI: 10.1002/mgg3.457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 07/12/2018] [Indexed: 12/11/2022] Open
Abstract
Dentistry constitutes the basic nucleus of professionals of higher level of health in Brazil with one of the largest concentrations of dentists per capita in the world. However, the genetic in dentistry in Brazil is explored, basically, in research field. Future actions need to be performed in order to deep the whole knowledge about diagnosis and treatment of diseases with genetic basis in dentistry, in Brazil.
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Affiliation(s)
| | | | | | | | | | | | - Telma Aguiar
- Universidade Federal Fluminense, Niterói, Brazil
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14
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Koruyucu M, Kasimoğlu Y, Seymen F, Bayram M, Patir A, Ergöz N, Tuna EB, Gencay K, Deeley K, Bussaneli D, Modesto A, Vieira AR. Rethinking isolated cleft lip and palate as a syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125:307-312. [PMID: 29500156 DOI: 10.1016/j.oooo.2018.01.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 01/02/2018] [Accepted: 01/08/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The goal of the present work was to use dental conditions that have been independently associated with cleft lip and palate (CL/P) as a tool to identify a broader collection of individuals to be used for gene identification that lead to clefts. STUDY DESIGN We studied 1573 DNA samples combining individuals that were born with CL/P or had tooth agenesis, supernumerary teeth, molar incisor hypomineralization, or dental caries with the goal to identify genetic associations. We tested 2 single-nucleotide polymorphisms that were located in the vicinity of regions suggested to contribute to supernumerary teeth. Overrepresentation of alleles were determined for combinations of individuals as well as for each individual phenotypic group with an α of .05. RESULTS We determined that the allele C of rs622260 was overrepresented in all individuals studied compared with a group of unrelated individuals who did not present any of the conditions described earlier. When subgroups were tested, associations were found for individuals with hypomineralization. CONCLUSIONS Although we did not test this hypothesis directly in the present study, based on associations reported previously, we believe that CL/P is actually a syndrome of alterations of the dentition, and considering it that way may allow for the identification of genotype-phenotype correlations that may be useful for clinical care.
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Affiliation(s)
- Mine Koruyucu
- Department of Pedodontics, School of Dentistry, Istanbul University, Istanbul, Turkey
| | - Yelda Kasimoğlu
- Department of Pedodontics, School of Dentistry, Istanbul University, Istanbul, Turkey
| | - Figen Seymen
- Department of Pedodontics, School of Dentistry, Istanbul University, Istanbul, Turkey
| | - Merve Bayram
- Department of Pedodontics, School of Dentistry, Istanbul Medipol University, Istanbul, Turkey
| | - Asli Patir
- Department of Pedodontics, School of Dentistry, Istanbul Medipol University, Istanbul, Turkey
| | - Nihan Ergöz
- Department of Pedodontics, School of Dentistry, Istanbul University, Istanbul, Turkey
| | - Elif B Tuna
- Department of Pedodontics, School of Dentistry, Istanbul University, Istanbul, Turkey
| | - Koray Gencay
- Department of Pedodontics, School of Dentistry, Istanbul University, Istanbul, Turkey
| | - Kathleen Deeley
- Department of Oral Biology, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA
| | - Diego Bussaneli
- Department of Oral Biology, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA; Department of Pediatric Dentistry, UNESP, Araraquara, Brazil
| | - Adriana Modesto
- Department of Oral Biology, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA; Department of Pediatric Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA
| | - Alexandre R Vieira
- Department of Oral Biology, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA; Department of Pediatric Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA.
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15
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Lack of association between ENAM gene polymorphism and dental caries in primary and permanent teeth in Czech children. Clin Oral Investig 2017; 22:1873-1877. [PMID: 29185146 DOI: 10.1007/s00784-017-2280-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 11/20/2017] [Indexed: 01/22/2023]
Abstract
OBJECTIVES The enamelin gene (ENAM) polymorphism (rs12640848) was recently associated with dental caries in primary teeth in Polish children. The aims of the present study were to prove this association in primary dentition and to find a possible effect of this variant on caries development in permanent dentition in Czech children. MATERIALS AND METHODS This study comprised 905 Czech children. Totally, 187 children aged 2-6 years with primary dentition [78 healthy subjects (with decayed/missing/filled teeth, dmft = 0) and 109 patients with early childhood caries (ECC; dmft ≥ 1)] were included in this case-control study. In addition, 177 subjects aged 13-15 years without caries (DMFT = 0) and 541 children with dental caries (DMFT ≥ 1) in permanent dentition were selected from the ELSPAC study. Genotype determination of the ENAM polymorphism (rs12640848) was based on the TaqMan method. RESULTS No significant differences in the allele or genotype frequencies between the caries-free children and those affected by dental caries were observed in both primary and permanent dentitions. CONCLUSIONS Lack of association between the ENAM polymorphism (rs12640848) and dental caries in Czech children was detected. CLINICAL RELEVANCE Although ENAM is considered as a candidate gene for dental caries, the presence of the ENAM variant (rs12640848) cannot be used as a risk factor of this multifactorial disease in the Czech population.
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16
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Pang L, Zhi Q, Zhuang P, Yu L, Tao Y, Lin H. Variation in Enamel Formation Genes Influences Enamel Demineralization In Vitro in a Streptococcus mutans Biofilm Model. Front Physiol 2017; 8:851. [PMID: 29163197 PMCID: PMC5670349 DOI: 10.3389/fphys.2017.00851] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 10/12/2017] [Indexed: 01/25/2023] Open
Abstract
Genetic studies have shown that variations in enamel formation genes are associated with caries susceptibility. The aim of this study was to test in vitro whether variants in these genes are associated with dental enamel demineralization in a Streptococcus mutans biofilm model. DNA and enamel samples were obtained from 213 individuals. DNA was extracted from saliva, and 16 single nucleotide polymorphisms were analyzed. The physical and chemical properties of sound enamel samples and the mineral loss and the lesion depth of the demineralized enamel samples under cariogenic challenge were analyzed. Microhardness, enamel chemicals, mineral loss and demineralization depth were compared between different genotypes at each single nucleotide polymorphism. The GG genotype of TUFT1 (rs17640579) and the GT genotype of MMP20 (rs1612069) exhibited increased microhardness (p = 0.044 and 0.016, respectively). The GG genotype of AMBN (rs7694409) had a higher magnesium level, while the CT genotype of TFIP11 (rs2097470) had a lower magnesium level (p = 0.044 and 0.046, respectively). The GT genotype of MMP20 (rs1612069) had a higher calcium level (p = 0.034). The GG genotype of AMBN (rs13115627), the AG genotype of ENAM (rs12640848) and the AA genotype of MMP20 (rs2292730) had a lower phosphorus level (p = 0.012, 0.006, and 0.023, respectively). The GG genotype of AMBN (rs13115627) was also associated with a higher calcium-phosphorus ratio (p = 0.034). Individuals with the CC genotype of TFIP11 (rs134143) exhibited significantly more mineral loss (p = 0.011) and a deeper lesions (p = 0.042). Individuals with the TT genotype of TFIP11 (rs2097470) had more mineral loss (p = 0.018). Individuals with the GG genotype of TUFT1 (rs17640579) exhibited a shallower demineralization depth (p = 0.047). Individuals with the GT genotype of MMP20 (rs1612069) exhibited a shallower demineralization depth (p = 0.042). Individuals with the GG genotype of ENAM (rs12640848) exhibited less mineral loss (p = 0.01) and a shallower demineralization depth (p = 0.03). Genetic variations in TFIP11, TUFT1, MMP20, and ENAM influenced enamel demineralization in a Streptococcus mutans biofilm model.
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Affiliation(s)
- Liangyue Pang
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Department of Preventive Dentistry, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Qinghui Zhi
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Department of Preventive Dentistry, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Peilin Zhuang
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Department of Stomatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Lixia Yu
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Department of Preventive Dentistry, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Ye Tao
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Department of Preventive Dentistry, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Huancai Lin
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Department of Preventive Dentistry, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
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17
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Kastovsky J, Borilova Linhartova P, Musilova K, Zackova L, Kukletova M, Kukla L, Izakovicova Holla L. Lack of Association between BMP2/DLX3 Gene Polymorphisms and Dental Caries in Primary and Permanent Dentitions. Caries Res 2017; 51:590-595. [PMID: 29059672 DOI: 10.1159/000479828] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 07/26/2017] [Indexed: 01/24/2023] Open
Abstract
The aim of this study was to analyze the association between BMP2 (rs1884302) and DLX3 (rs2278163) gene polymorphisms and dental caries in primary and permanent dentitions. A total of 914 subjects were genotyped by the TaqMan methods: 176 caries-free children (with Decayed/Missing/Filled Teeth, DMFT = 0), 542 patients with dental caries in permanent dentition (DMFT ≥1), 83 caries-free children with primary teeth (with decayed/missing/filled teeth, dmft = 0), and 113 children with early childhood caries (ECC, dmft ≥1). There were no significant differences in allele/genotype frequencies between patients with caries in permanent dentition/ECC and caries-free children or between patients with very low (DMFT = 0-2), low (DMFT = 3-5), moderate (DMFT = 6-8), or high (DMFT ≥9) caries experience. Variability in BMP2 and DLX3 was not associated with caries in the Czech population.
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18
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Varga G, DenBesten P, Rácz R, Zsembery Á. Importance of bicarbonate transport in pH control during amelogenesis - need for functional studies. Oral Dis 2017; 24:879-890. [PMID: 28834043 DOI: 10.1111/odi.12738] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 08/13/2017] [Indexed: 12/27/2022]
Abstract
Dental enamel, the hardest mammalian tissue, is produced by ameloblasts. Ameloblasts show many similarities to other transporting epithelia although their secretory product, the enamel matrix, is quite different. Ameloblasts direct the formation of hydroxyapatite crystals, which liberate large quantities of protons that then need to be buffered to allow mineralization to proceed. Buffering requires a tight pH regulation and secretion of bicarbonate by ameloblasts. Many investigations have used immunohistochemical and knockout studies to determine the effects of these genes on enamel formation, but up till recently very little functional data were available for mineral ion transport. To address this, we developed a novel 2D in vitro model using HAT-7 ameloblast cells. HAT-7 cells can be polarized and develop functional tight junctions. Furthermore, they are able to accumulate bicarbonate ions from the basolateral to the apical fluid spaces. We propose that in the future, the HAT-7 2D system along with similar cellular models will be useful to functionally model ion transport processes during amelogenesis. Additionally, we also suggest that similar approaches will allow a better understanding of the regulation of the cycling process in maturation-stage ameloblasts, and the pH sensory mechanisms, which are required to develop sound, healthy enamel.
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Affiliation(s)
- G Varga
- Department of Oral Biology, Semmelweis University, Budapest, Hungary
| | - P DenBesten
- Department of Orofacial Sciences, University of California, San Francisco, CA, USA
| | - R Rácz
- Department of Oral Biology, Semmelweis University, Budapest, Hungary
| | - Á Zsembery
- Department of Oral Biology, Semmelweis University, Budapest, Hungary
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19
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Kirkham J, Brookes SJ, Diekwisch TGH, Margolis HC, Berdal A, Hubbard MJ. Enamel Research: Priorities and Future Directions. Front Physiol 2017; 8:513. [PMID: 28775693 PMCID: PMC5517532 DOI: 10.3389/fphys.2017.00513] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 07/05/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jennifer Kirkham
- Division of Oral Biology, School of Dentistry, St James's University Hospital, University of LeedsLeeds, United Kingdom
| | - Steven J Brookes
- Division of Oral Biology, School of Dentistry, St James's University Hospital, University of LeedsLeeds, United Kingdom
| | | | - Henry C Margolis
- Center for Biomineralization, The Forsyth InstituteCambridge, MA, United States
| | - Ariane Berdal
- Centre de Recherche des Cordeliers, INSERM UMRS 1138, University Paris-DiderotParis, France
| | - Michael J Hubbard
- Department of Paediatrics, University of MelbourneMelbourne, VIC, Australia
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20
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Kong YY, Zheng JM, Zhang WJ, Jiang QZ, Yang XC, Yu M, Zeng SJ. The relationship between vitamin D receptor gene polymorphism and deciduous tooth decay in Chinese children. BMC Oral Health 2017; 17:111. [PMID: 28697775 PMCID: PMC5505030 DOI: 10.1186/s12903-017-0398-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 06/30/2017] [Indexed: 12/19/2022] Open
Abstract
Background In the present study, we explored the link between vitamin D receptor (VDR) BsmI, TaqI, ApaI and FokI gene polymorphisms with deciduous tooth decay in Chinese children. Methods Our study included 380 Chinese children aged 4–7 years, whose DNA sample was collected from the buccal mucosa. VDR gene polymorphisms was determined by PCR-RFLP. Results The adjusted logistic regression analysis demonstrated that BsmI containing the Bb genotype was linked with the increased risk of deciduous tooth decay (OR = 1.856, 95% CI = [1.184, 2.908], p = 0.007). However, VDR polymorphisms ApaI, TaqI and FokI were not associated with deciduous tooth decay (ApaI: OR = 0.839, 95% CI = [0.614, 1.145], p = 0.268; TaqI: OR = 1.150, 95% CI = [0.495, 2.672], p = 0.744; FokI: OR = 0.856, 95% CI = [0.616, 1.191], p = 0.356). Conclusions Our results showed that VDR BsmI polymorphism was associated with the risk of deciduous tooth decay in Chinese children aged 4–7 years. However, the specific mechanism remains to further verify through experiment.
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Affiliation(s)
- Yuan-Yuan Kong
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, 39# Huangsha Road, Guangzhou, 510140, China.,Department of Endodontics, Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510140, China
| | - Jian-Mao Zheng
- Guangdong Provincial Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Affiliated Stomatological Hospital, Sun Yat-sen University, Guangzhou, 510140, China
| | - Wen-Juan Zhang
- Department of Endodontics, Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510140, China
| | - Qian-Zhou Jiang
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, 39# Huangsha Road, Guangzhou, 510140, China. .,Department of Endodontics, Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510140, China.
| | - Xue-Chao Yang
- Department of Oral Digital Center, Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510140, China
| | - Miao Yu
- Department of Dongfengxi Clinic, Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510140, China
| | - Su-Juan Zeng
- Department of Pediatric Dentistry, Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510140, China
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21
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Küchler EC, Pecharki GD, Castro ML, Ramos J, Barbosa F, Brancher JA, Vieira AR, Gerlach RF, Trevilatto PC. Genes Involved in the Enamel Development Are Associated with Calcium and Phosphorus Level in Saliva. Caries Res 2017; 51:225-230. [PMID: 28395292 DOI: 10.1159/000450764] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Accepted: 09/09/2016] [Indexed: 01/24/2023] Open
Abstract
Saliva components play a crucial role in the integrity of the dental enamel and in caries susceptibility. The saliva characteristics are controlled by many factors, including genetic factors. Therefore, this study aimed to evaluate the association between the genetic variations in genes expressed in enamel development with calcium and phosphorus levels in saliva. We collected 276 unrelated 12-year-old children from private and public schools. Saliva was collected for DNA extraction from oral cells and for measurement of calcium and phosphorus. Inductively coupled plasma-mass spectrometry determined calcium and phosphorus levels in whole saliva. Fifteen genetic variations in 9 genes were analyzed. The genotype was determined by real-time polymerase chain reactions. Data were analyzed using Plink with an alpha of 5%. Genetic variations in AMELX, AMNB and ESRRB were associated with the calcium level in saliva (p < 0.05). A borderline association was observed in ENAM allele distribution shown with phosphate level in saliva (p = 0.049). In conclusion, our results are the first to report that genetic variations contribute to calcium and phosphorus levels in saliva.
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Affiliation(s)
- Erika Calvano Küchler
- Department of Pediatric Dentistry, Ribeirao Preto Dental School, Faculty of Pharmacy of Ribeirao Preto, USP - University of Sao Paulo, Ribeirao Preto, Brazil
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22
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Chapple IL, Bouchard P, Cagetti MG, Campus G, Carra MC, Cocco F, Nibali L, Hujoel P, Laine ML, Lingström P, Manton DJ, Montero E, Pitts N, Rangé H, Schlueter N, Teughels W, Twetman S, Van Loveren C, Van der Weijden F, Vieira AR, Schulte AG. Interaction of lifestyle, behaviour or systemic diseases with dental caries and periodontal diseases: consensus report of group 2 of the joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases. J Clin Periodontol 2017; 44 Suppl 18:S39-S51. [DOI: 10.1111/jcpe.12685] [Citation(s) in RCA: 223] [Impact Index Per Article: 31.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2016] [Indexed: 12/19/2022]
Affiliation(s)
- Iain L.C. Chapple
- Periodontal Research Group; The University of Birmingham; Birmingham UK
| | - Philippe Bouchard
- Department of Periodontology; Service of Odontology; Rothschild Hospital; AP-HP, Paris 7-Denis Diderot University; U.F.R. of Odontology; Paris France
- EA 2496; Paris 5-Descartes University; U.F.R. of Odontology; Paris France
| | | | - Guglielmo Campus
- WHO Collaboration Centre for Epidemiology and Community Dentistry; Milan Italy
- Department of Surgery, Microsurgery and Medicine Sciences; School of Dentistry; Universita degli Studi di Sassari; Sassari Italy
| | - Maria-Clotilde Carra
- Department of Periodontology; Service of Odontology; Rothschild Hospital; AP-HP, Paris 7-Denis Diderot University; U.F.R. of Odontology; Paris France
- INSERM; U1018; Villejuif; France
| | - Fabio Cocco
- Department of Surgery, Microsurgery and Medicine Sciences; School of Dentistry; Universita degli Studi di Sassari; Sassari Italy
| | - Luigi Nibali
- Centre for Oral Clinical Research; Institute of Dentistry; Barts and The London School of Medicine and Dentistry; Queen Mary University London (QMUL); London UK
| | - Philippe Hujoel
- Public Health Sciences; University of Washington; Seattle WA USA
| | - Marja L. Laine
- Department of Periodontology; Academic Centre for Dentistry in Amsterdam; Amsterdam the Netherlands
| | - Peter Lingström
- Department of Cariology; Institute of Odontology; Gothenburg Sweden
| | - David J. Manton
- Melbourne Dental School; University of Melbourne; Parkville Vic. Australia
| | - Eduardo Montero
- Faculty of Dentistry; Universidad Complutense de Madrid; Madrid Spain
| | - Nigel Pitts
- Dental Innovation and Translation Centre; Dental Institute; Kings College London; London UK
| | - Hélène Rangé
- Department of Periodontology; Service of Odontology; Rothschild Hospital; AP-HP, Paris 7-Denis Diderot University; U.F.R. of Odontology; Paris France
- EA 2496; Paris 5-Descartes University; U.F.R. of Odontology; Paris France
| | - Nadine Schlueter
- Division for Cariology; Department of Operative Dentistry and Periodontology; Center for Dental Medicine; University Medical Center; Albert-Ludwig-University; Freiburg Germany
| | | | - Svante Twetman
- Faculty of Health and Medical Sciences; School of Dentistry; Section of Cariology and Endodontics; University of Copenhagen; Copenhagen Denmark
| | - Cor Van Loveren
- Department of Cariology; Academic Centre for Dentistry Amsterdam; Amsterdam the Netherlands
| | - Fridus Van der Weijden
- Department of Periodontology; Academic Centre for Dentistry in Amsterdam; Amsterdam the Netherlands
| | | | - Andreas G. Schulte
- Department of Special Care Dentistry; Dental School; Witten/Herdecke University; Witten Germany
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23
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Vieira AR, Bayram M, Seymen F, Sencak RC, Lippert F, Modesto A. In Vitro Acid-Mediated Initial Dental Enamel Loss Is Associated with Genetic Variants Previously Linked to Caries Experience. Front Physiol 2017; 8:104. [PMID: 28275354 PMCID: PMC5319969 DOI: 10.3389/fphys.2017.00104] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 02/08/2017] [Indexed: 12/15/2022] Open
Abstract
We have previously shown that AQP5 and BTF3 genetic variation and expression in whole saliva are associated with caries experience suggesting that these genes may have a functional role in protecting against caries. To further explore these results, we tested ex vivo if variants in these genes are associated with subclinical dental enamel mineral loss. DNA and enamel samples were obtained from 53 individuals. Enamel samples were analyzed for Knoop hardness of sound enamel, integrated mineral loss after subclinical carious lesion creation, and change in integrated mineral loss after remineralization. DNA samples were genotyped for single nucleotide polymorphisms using TaqMan chemistry. Chi-square and Fisher's exact tests were used to compare individuals above and below the mean sound enamel microhardness of the cohort with alpha of 0.05. The A allele of BTF3 rs6862039 appears to be associated with harder enamel at baseline (p = 0.09), enamel more resistant to demineralization (p = 0.01), and enamel that more efficiently regain mineral and remineralize (p = 0.04). Similarly, the G allele of AQP5 marker rs3759129 and A allele of AQP5 marker rs296763 are associated with enamel more resistant to demineralization (p = 0.03 and 0.05, respectively). AQP5 and BTF3 genetic variations influence the initial subclinical stages of caries lesion formation in the subsurface of enamel.
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Affiliation(s)
- Alexandre R Vieira
- Department of Oral Biology, School of Dental Medicine, University of PittsburghPittsburgh, PA, USA; Department of Pediatric Dentistry, School of Dental Medicine, University of PittsburghPittsburgh, PA, USA
| | - Merve Bayram
- Department of Pedodontics, School of Dentistry, Medipol Istanbul University Istanbul, Turkey
| | - Figen Seymen
- Department of Pedodontics, School of Dentistry, Istanbul University Istanbul, Turkey
| | - Regina C Sencak
- Department of Oral Biology, School of Dental Medicine, University of Pittsburgh Pittsburgh, PA, USA
| | - Frank Lippert
- Department of Cariology, Operative Dentistry and Dental Public Health, School of Dentistry, Indiana University Indianapolis, IN, USA
| | - Adriana Modesto
- Department of Oral Biology, School of Dental Medicine, University of PittsburghPittsburgh, PA, USA; Department of Pediatric Dentistry, School of Dental Medicine, University of PittsburghPittsburgh, PA, USA
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24
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Eckert S, Feingold E, Cooper M, Vanyukov MM, Maher BS, Slayton RL, Willing MC, Reis SE, McNeil DW, Crout RJ, Weyant RJ, Levy SM, Vieira AR, Marazita ML, Shaffer JR. Variants on chromosome 4q21 near PKD2 and SIBLINGs are associated with dental caries. J Hum Genet 2017; 62:491-496. [PMID: 28100911 PMCID: PMC5367940 DOI: 10.1038/jhg.2016.161] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 11/17/2016] [Accepted: 12/07/2016] [Indexed: 11/15/2022]
Abstract
A recent genome-wide association study for dental caries nominated the chromosomal region 4q21 near ABCG2, PKD2 and the SIBLING gene family. In this investigation we followed-up and fine-mapped this region using a tag-SNP (single nucleotide polymorphism) approach in 13 age- and race-stratified samples from 6 independent studies (N=4,089). Participants were assessed for dental caries via intra-oral examination and 49 tag-SNPs were genotyped capturing much of the variation in the 4q21 locus. Linear models were used to test for genetic association, while adjusting for sex, age, and components of ancestry. SNPs in and near PKD2 showed significant evidence of association in individual samples of black adults (rs17013735, p-value=0.0009) and white adults (rs11938025; p-value=0.0005; rs2725270, p-value=0.003). Meta-analyses across black adult samples recapitulated the association with rs17013735 (p-value=0.003), which occurs at low frequency in non-African populations, possibly explaining the race-specificity of the effect. In addition to race-specific associations, we also observed evidence of gene-by-fluoride exposure interaction effects in white adults for SNP rs2725233 upstream of PKD2 (p=0.002). Our results show evidence of regional replication, though no single variant clearly accounted for the original GWAS signal. Therefore, while we interpret our results as strengthening the hypothesis that chromosome 4q21 may impact dental caries, additional work is needed.
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Affiliation(s)
- Scott Eckert
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Eleanor Feingold
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Margaret Cooper
- Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michael M Vanyukov
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brion S Maher
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Rebecca L Slayton
- Department of Pediatric Dentistry, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Marcia C Willing
- Division of Genetics and Genomics, Department of Pediatrics, School of Medicine, Washington University at St Louis, St Louis, MO, USA
| | - Steven E Reis
- Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,Clinical and Translational Science Institute, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Daniel W McNeil
- Department of Dental Practice and Rural Health, West Virginia University, Morgantown, WV, USA.,Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - Richard J Crout
- Department of Periodontics, School of Dentistry, West Virginia University, Morgantown, WV, USA
| | - Robert J Weyant
- Department of Dental Public Health and Information Management, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Steven M Levy
- Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, Iowa City, IA, USA.,Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Alexandre R Vieira
- Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Mary L Marazita
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.,Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,Clinical and Translational Science Institute, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - John R Shaffer
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
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