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Wu X, Li W, Huang G, Luo Z, Chen Y. Increased frequency of angiotensin converting enzyme D allele in Chinese Han patients with idiopathic pulmonary fibrosis: A systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e30942. [PMID: 36221416 PMCID: PMC9542842 DOI: 10.1097/md.0000000000030942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND To explore the association between Angiotensin Converting Enzyme (ACE) insert(I)/defect(D) gene polymorphism and the susceptibility to idiopathic pulmonary fibrosis (IPF). METHODS Searching PubMed, EMbase, CENTRAL, MEDLINE, CBM, China National Knowledge Infrastructure, WanFang Database and VIP Chinese Science database through a computer and collect the literature from China and foreign countries published before January 22, 2022. Screen the literatures and extract data such as first author, year of publication, diagnostic criteria and gene frequency, and draw a funnel chart and perform Begg's Test and Egger's test to evaluate publication bias. The influence analysis was performed for heterogeneous results and at the same time, the trial sequential analysis (TSA) was also conducted to confirm the robustness of the meta-analysis results. Registration number: CRD42021259341. RESULTS There were a total of 4 literatures (4 studies conducted in the Chinese Han population), and a total of 292 IPF patients and 351 healthy controls were included in this study. The results showed that in the Chinese Han population, the ACE I/D gene polymorphism was associated with the susceptibility of IPF (D vs I: [odds ratio, OR] = 0.53, 95% confidence interval [95%CI] [0.42, 0.67], P < .00001; DD vs II: [OR] = 0.37, 95%CI [0.24, 0.57], P < .00001; DD vs II + ID:[OR] = 0.30, 95%CI [0.21, 0.43], P < .00001), and the angiotensin II (Ang Ⅱ) level of IPF patients was higher than that of the control group (mean difference [MD] = 14.29, 95%CI [11.20,17.37], P < .00001).The TSA also confirmed that D allele was closely related to the susceptibility of IPF. CONCLUSION In the Chinese Han population, the D allele of the ACE I/D gene polymorphism is associated with the susceptibility of IPF.
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Affiliation(s)
- Xiaozheng Wu
- Department of Preclinical medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Wen Li
- Department of Preclinical medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Gao Huang
- Department of Preclinical medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Zhenliang Luo
- Department of Preclinical medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Yunzhi Chen
- Department of Preclinical medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, China
- *Correspondence: Yunzhi Chen, Department of Preclinical medicine, Guizhou University of Traditional Chinese Medicine, Guiyang 510025, China (e-mail: )
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Han T, Zhang L, Yu CY, Li YM, Wang Y, Zhang XL. Ventilatory response to exercise is preserved in patients with obesity hypoventilation syndrome. J Clin Sleep Med 2021; 16:2089-2098. [PMID: 32895118 DOI: 10.5664/jcsm.8766] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Blunted ventilatory responses to hypoxia and hypercapnia during resting conditions are common findings in patients with obesity hypoventilation syndrome (OHS). Exercise increases the work and oxygen cost of breathing and produces excessive carbon dioxide (CO₂). The aim of this investigation was to study ventilatory responses to incremental exercise in patients with OHS. METHODS Sixty-eight obese adults with OHS (n = 15), eucapnic obstructive sleep apnea (n = 26), or simple obesity (n = 27) participated in an incremental exercise test on a cycle ergometer and an in-laboratory sleep study. RESULTS The peak oxygen uptake (peak VO₂) and peak pulse oxygen was decreased in patients with OHS compared with patients with either obstructive sleep apnea or simple obesity. The ventilatory response to exertional metabolic demand (nadir VE/VCO₂, ∆VE/∆VCO₂ slope, and VE/VCO₂ at peak exercise) did not significantly differ among the 3 groups. Minute ventilation, tidal volume, respiratory frequency, tidal volume/respiratory frequency, and inspiratory time/total time ratio at a given work rate were comparable among the 3 groups. Among the whole cohort, apnea-hypopnea index was not independently associated with peak VO₂, and no association was found between the ∆VE/∆VCO₂ slope and resting arterial partial pressure of CO₂. CONCLUSIONS The ventilatory response to incremental exercise is preserved in patients with OHS compared with patients with obstructive sleep apnea and simple obesity who were matched for age and body mass index. This result highlights the complexity of the respiratory control system during exercise for patients with OHS, which may be uncoupled with the ventilatory response during sleep and resting conditions.
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Affiliation(s)
- Teng Han
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Li Zhang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China.,Peking University Health Science Center, Beijing, China
| | - Chun Yan Yu
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Yi Ming Li
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Yan Wang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Xiao Lei Zhang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China.,Peking University Health Science Center, Beijing, China.,Capital Medical University, Beijing, China.,The Graduate School of Peking Union Medical College, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
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3
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Xu G, Fan G, Sun Y, Yu L, Wu S, Niu W. Association of angiotensin-converting enzyme gene I/D polymorphism with chronic obstructive pulmonary disease: a meta-analysis. J Renin Angiotensin Aldosterone Syst 2018; 19:1470320318770546. [PMID: 29716409 PMCID: PMC5954319 DOI: 10.1177/1470320318770546] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives: We conducted a meta-analysis of published studies on the
angiotensin-converting enzyme (ACE) gene insertion/deletion
(I/D) polymorphism associated with the risk of chronic obstructive pulmonary
disease, as well as with pulmonary function and circulating
angiotensin-converting enzyme changes. Methods: A literature search, quality assessment and data extraction were completed
independently and in duplicate. Results: A total of 16 articles were meta-analysed, including 12 articles (2113
patients and 8786 controls) for chronic obstructive pulmonary disease risk
and eight articles (11,664 subjects) for pulmonary and circulating
phenotypes. In overall and subgroup analyses, no significance was noted
between the I/D polymorphism and chronic obstructive pulmonary disease risk
under all genetic models (P>0.05), without heterogeneity
or publication bias. Carriers of II, ID and II plus ID genotypes had
significantly lower levels of circulating angiotensin-converting enzyme than
those with the DD genotype (weighted mean difference −13.35, −8.13 and
−10.74 U/L, respectively, P<0.001). For forced
expiratory volume in one second (FEV1)/forced vital capacity,
carriers of the DD genotype had marginally lower levels than those with the
DD genotype (weighted mean difference –1.66, P=0.034).
Furthermore in the case of FEV1 of 50% or greater of predicted
FEV1, FEV1 was marginally lower in ID genotype
carriers than DD genotype carriers (weighted mean difference −3.50,
P=0.056). Conclusions: Our meta-analytical findings demonstrated that the ACE gene
I/D polymorphism was not associated with the risk of chronic obstructive
pulmonary disease.
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Affiliation(s)
- Guodong Xu
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, China
| | - Guohui Fan
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, China
| | - Yingtong Sun
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, China
| | - Lili Yu
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, China
| | - Sinan Wu
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, China
| | - Wenquan Niu
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, China
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4
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Ma Y, Tong X, Liu Y, Liu S, Xiong H, Fan H. ACE gene polymorphism is associated with COPD and COPD with pulmonary hypertension: a meta-analysis. Int J Chron Obstruct Pulmon Dis 2018; 13:2435-2446. [PMID: 30147309 PMCID: PMC6097829 DOI: 10.2147/copd.s168772] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Purpose Angiotensin-converting enzyme (ACE) gene I/D polymorphism has been studied in relation to the susceptibility to COPD and COPD with pulmonary hypertension (PH) with inconclusive results. We performed the first comprehensive meta-analysis to evaluate accurately the association between the ACE gene polymorphism and the risk of COPD. Methods Data were analyzed using odds ratios (ORs) and the corresponding 95% CIs to measure the strength of the models. Subgroup analyses were conducted by ethnicity and complication which referred to PH. Results In total, 15 studies (2,635 participants) were included in our study, of which four studies (288 participants) were for PH subgroup. The overall analysis results indicated that the ACE gene polymorphism was not associated with COPD susceptibility in all gene models. However, the ethnic subgroup analysis results indicated that ACE gene polymorphism was associated with Asians’ susceptibility to COPD (DD+DI vs II, OR=1.47, P=0.019, 95% CI: 1.07–2.02). Further, the overall results of the present study detected no statistical significance between ACE gene polymorphism and the risk of COPD with PH, but the homozygote variant (DD) increased the risk of PH in Asian COPD patients (DD vs ID+II, OR=2.05, P=0.05, 95% CI: 1.00–4.19). Conclusion The current study suggests that ACE polymorphism, particularly the homozygote variant (DD), might contribute to the risk of COPD and COPD with PH among Asians. Further studies with larger sample size and more ethnicities are expected to be conducted in the future to validate the results.
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Affiliation(s)
- Yao Ma
- The Center of Gerontology and Geriatrics, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China
| | - Xiang Tong
- Department of Respiratory and Critical Care Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China,
| | - Ying Liu
- The Center of Gerontology and Geriatrics, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China
| | - Sitong Liu
- Department of Respiratory and Critical Care Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China,
| | - Hai Xiong
- Department of Gerontology, No 4 West China Teaching Hospital, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China
| | - Hong Fan
- Department of Respiratory and Critical Care Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China,
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5
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The influence of angiotensin-converting enzyme gene ID polymorphism on human physical fitness performance in European and other populations. SPORT SCIENCES FOR HEALTH 2017. [DOI: 10.1007/s11332-016-0340-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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6
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Curtis KJ, Meyrick VM, Mehta B, Haji GS, Li K, Montgomery H, Man WDC, Polkey MI, Hopkinson NS. Angiotensin-Converting Enzyme Inhibition as an Adjunct to Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med 2017; 194:1349-1357. [PMID: 27248440 DOI: 10.1164/rccm.201601-0094oc] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
RATIONALE Epidemiological studies in older individuals have found an association between the use of angiotensin-converting enzyme (ACE) inhibition (ACE-I) therapy and preserved locomotor muscle mass, strength, and walking speed. ACE-I therapy might therefore have a role in the context of pulmonary rehabilitation (PR). OBJECTIVES To investigate the hypothesis that enalapril, an ACE inhibitor, would augment the improvement in exercise capacity seen during PR. METHODS We performed a double-blind, placebo-controlled, parallel-group randomized controlled trial. Patients with chronic obstructive pulmonary disease, who had at least moderate airflow obstruction and were taking part in PR, were randomized to either 10 weeks of therapy with an ACE inhibitor (10 mg enalapril) or placebo. MEASUREMENTS AND MAIN RESULTS The primary outcome measurement was the change in peak power (assessed using cycle ergometry) from baseline. Eighty patients were enrolled, 78 were randomized (age 67 ± 8 years; FEV1 48 ± 21% predicted), and 65 completed the trial (34 on placebo, 31 on the ACE inhibitor). The ACE inhibitor-treated group demonstrated a significant reduction in systolic blood pressure (Δ, -16 mm Hg; 95% confidence interval [CI], -22 to -11) and serum ACE activity (Δ, -18 IU/L; 95% CI, -23 to -12) versus placebo (between-group differences, P < 0.0001). Peak power increased significantly more in the placebo group (placebo Δ, +9 W; 95% CI, 5 to 13 vs. ACE-I Δ, +1 W; 95% CI, -2 to 4; between-group difference, 8 W; 95% CI, 3 to 13; P = 0.001). There was no significant between-group difference in quadriceps strength or health-related quality of life. CONCLUSIONS Use of the ACE inhibitor enalapril, together with a program of PR, in patients without an established indication for ACE-I, reduced the peak work rate response to exercise training in patients with chronic obstructive pulmonary disease.
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Affiliation(s)
- Katrina J Curtis
- 1 National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Trust and Imperial College, London, United Kingdom
| | - Victoria M Meyrick
- 1 National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Trust and Imperial College, London, United Kingdom.,2 Department of Respiratory Medicine, King's College London NHS Foundation Trust, London, United Kingdom
| | - Bhavin Mehta
- 1 National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Trust and Imperial College, London, United Kingdom
| | - Gulam S Haji
- 1 National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Trust and Imperial College, London, United Kingdom
| | - Kawah Li
- 3 Institute for Sport, Exercise and Health, University College London, London, United Kingdom; and
| | - Hugh Montgomery
- 3 Institute for Sport, Exercise and Health, University College London, London, United Kingdom; and
| | - William D-C Man
- 1 National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Trust and Imperial College, London, United Kingdom.,4 Harefield Pulmonary Rehabilitation Unit, Harefield Hospital, London, United Kingdom
| | - Michael I Polkey
- 1 National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Trust and Imperial College, London, United Kingdom
| | - Nicholas S Hopkinson
- 1 National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Trust and Imperial College, London, United Kingdom
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7
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Genetic Polymorphism of Angiotensin-Converting Enzyme and Chronic Obstructive Pulmonary Disease Risk: An Updated Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2016; 2016:7636123. [PMID: 27830153 PMCID: PMC5088269 DOI: 10.1155/2016/7636123] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 09/13/2016] [Accepted: 09/19/2016] [Indexed: 11/17/2022]
Abstract
The relationship between polymorphism of the angiotensin I converting enzyme (ACE) gene and chronic obstructive pulmonary disease (COPD) has been examined in many previous studies. However, their results were controversial. Therefore, we performed a meta-analysis to evaluate the relationship between the ACE gene and the risk of COPD. Fourteen case-control studies were included in this meta-analysis. The pooled p value, odds ratio (OR), and 95% confidence interval (95% CI) were used to investigate the strength of the association. The meta-analysis was performed using comprehensive meta-analysis software. Our meta-analysis results revealed that ACE polymorphisms were not related to the risk of COPD (p > 0.05 in each model). In further analyses based on ethnicity, we observed an association between insertion/deletion polymorphism of the ACE gene and risk of COPD in the Asian population (codominant 2, OR = 3.126, 95% CI = 1.919–5.093, p < 0.001; recessive, OR = 3.326, 95% CI = 2.190–5.050, p < 0.001) but not in the Caucasian population (p > 0.05 in each model). In conclusion, the present meta-analysis indicated that the insertion/deletion polymorphism of the ACE gene may be associated with susceptibility to COPD in the Asian population but not in the Caucasian population. However, the results of the present meta-analysis need to be confirmed in a larger sample.
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8
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Mlak R, Homa-Mlak I, Powrózek T, Mackiewicz B, Michnar M, Krawczyk P, Dziedzic M, Rubinsztajn R, Chazan R, Milanowski J, Małecka-Massalska T. Impact of I/D polymorphism of ACE gene on risk of development and course of chronic obstructive pulmonary disease. Arch Med Sci 2016; 12:279-87. [PMID: 27186170 PMCID: PMC4848351 DOI: 10.5114/aoms.2015.50757] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 09/10/2014] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Chronic obstructive pulmonary disease (COPD) affects more than 10% of the world's population over 40 years of age. The main exogenous risk factor is cigarette smoking; however, only 20% of smokers develop COPD, indicating that some other factors, e.g. genetic, may play an important role in the disease pathogenesis. Recent research indicates that ACE (angiotensin-converting enzyme) may be a susceptibility gene for asthma or COPD. The aim of our study was to determine the influence of I/D (insertion/deletion) polymorphism of the ACE gene (AluYa5, rs4646994) on the risk and course of COPD. MATERIAL AND METHODS We investigated ACE I/D polymorphism in 206 COPD and 165 healthy Caucasian subjects. RESULTS In the generalized linear model (GLZ) analysis of the influence of selected factors on presence of COPD we found a significant independent effect for male sex (repeatedly increases the risk of COPD, OR = 7.7, p = 0.049), as well as smoking or lower body mass index, but only in combination with older age (OR = 0.96, p = 0.003 and OR = 1.005, p = 0.04 respectively). Interestingly, analysis of factors which may influence the risk of a higher number of exacerbations demonstrated that occurrence of DD genotype, but only in men, is associated with a lower risk (OR = 0.7, p = 0.03) of this complication. CONCLUSIONS We suggest that ACE may not be a susceptibility gene for the origin of COPD but a disease-modifying gene. Since the impact of I/D polymorphism of the ACE gene on COPD risk is moderate or negligible, other molecular changes, that will help predict the development of this disease, should still be sought.
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Affiliation(s)
- Radosław Mlak
- Department of Human Physiology, Medical University of Lublin, Lublin, Poland
- Department of Oncology, Medical University of Lublin, Lublin, Poland
| | - Iwona Homa-Mlak
- Department of Human Physiology, Medical University of Lublin, Lublin, Poland
- Department of Oncology, Medical University of Lublin, Lublin, Poland
| | - Tomasz Powrózek
- Department of Oncology, Medical University of Lublin, Lublin, Poland
| | | | - Marek Michnar
- Department of Oncology, Medical University of Lublin, Lublin, Poland
| | - Paweł Krawczyk
- Department of Oncology, Medical University of Lublin, Lublin, Poland
| | - Marcin Dziedzic
- Department of Laboratory Diagnostics, Medical University of Lublin, Lublin, Poland
| | - Renata Rubinsztajn
- Department of Internal Medicine, Pulmonology and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Ryszarda Chazan
- Department of Internal Medicine, Pulmonology and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Janusz Milanowski
- Department of Oncology, Medical University of Lublin, Lublin, Poland
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Nicklas BJ. Heterogeneity of Physical Function Responses to Exercise in Older Adults: Possible Contribution of Variation in the Angiotensin-1 Converting Enzyme (ACE) Gene? PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2015; 5:575-84. [PMID: 26162198 DOI: 10.1177/1745691610383512] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Behavioral exercise interventions, aimed at improving either aerobic endurance or muscular strength, are currently the only therapy found, on average, to consistently retard loss of physical function in aging adults. However, not all individuals experience the same magnitude of benefit from a given exercise treatment, and certain persons may respond more favorably to a particular mode of exercise than another. Research now shows that genetic predisposition is one of the factors accounting for interindividual differences in responses to exercise as well as differences in the propensity to engage in exercise. This article discusses how a common variant in a single gene (the angiotensin-1 converting enzyme gene) could emerge as a prospective tool to identify older individuals more likely to benefit from and adhere to a specific type of exercise activity over another type.
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Affiliation(s)
- Barbara J Nicklas
- Department of Internal Medicine, Wake Forest University Health Sciences, Winston-Salem, NC
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10
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Steiner MC, Greening NJ. Treating the exercise problem in COPD. Chest 2014; 146:878-880. [PMID: 25287996 DOI: 10.1378/chest.14-0654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Michael C Steiner
- Leicester Respiratory Biomedical Research Unit, University Hospitals of Leicester NHS Trust, Leicester, England; School of Sport, Exercise and Health Sciences, Loughborough University, Leicester, England.
| | - Neil J Greening
- Leicester Respiratory Biomedical Research Unit, University Hospitals of Leicester NHS Trust, Leicester, England
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Laratta CR, van Eeden S. Acute exacerbation of chronic obstructive pulmonary disease: cardiovascular links. BIOMED RESEARCH INTERNATIONAL 2014; 2014:528789. [PMID: 24724085 PMCID: PMC3958649 DOI: 10.1155/2014/528789] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 12/16/2013] [Indexed: 01/03/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is a chronic, progressive lung disease resulting from exposure to cigarette smoke, noxious gases, particulate matter, and air pollutants. COPD is exacerbated by acute inflammatory insults such as lung infections (viral and bacterial) and air pollutants which further accelerate the steady decline in lung function. The chronic inflammatory process in the lung contributes to the extrapulmonary manifestations of COPD which are predominantly cardiovascular in nature. Here we review the significant burden of cardiovascular disease in COPD and discuss the clinical and pathological links between acute exacerbations of COPD and cardiovascular disease.
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Affiliation(s)
- Cheryl R Laratta
- Department of Medicine, University of Alberta, Edmonton, AB, Canada ; UBC James Hogg Research Center, Institute for Heart and Lung Health, University of British Columbia, Canada
| | - Stephan van Eeden
- UBC James Hogg Research Center, Institute for Heart and Lung Health, University of British Columbia, Canada ; Respiratory Division, Department of Medicine, St. Paul's Hospital, Vancouver, BC, Canada
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Simsek S, Tekes S, Turkyilmaz A, Tuzcu AK, Kılıc F, Culcu NN, Isık B, Akbas H. Angiotensin-converting enzyme gene insertion/deletion polymorphism with metabolic syndrome in Turkish patients. J Endocrinol Invest 2013; 36:860-3. [PMID: 23685945 DOI: 10.3275/8967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The ACE gene has received substantial attention in recent years as candidate for a variety of diseases. The most common polymorphism in ACE gene is the Insertion/Deletion (I/D, rs4646994) polymorphism located on intron 16. AIM We investigated the association between metabolic syndrome (MS) and the insertion (I) - deletion (D) polymorphisms in the angiotensin converting enzyme (ACE) gene in south-east of Turkey. SUBJECTS AND METHODS One hundred and sixty subjects, with 101 cases of MS and 59 age- and gender-matched healthy controls were included in the study. RESULTS The frequency of ACE I/D polymorphism was found to be 49.5% for DD, 36.6% for ID, and 13.9% for II in the MSstudy group and 44.1% for DD, 42.4% for ID and 13.5% for II in the control group. Allele frequencies were found to be 0.68% for D and 0.32% for I allele in the study group with MS and 0.65% for D, 0.35% for I allele in the control group. The I/D polymorphism of the ACE gene, DD, ID, and II genotypes occurred with similar frequencies in the study group with MS and the control group with no significant differences (p<0.05). On applying one-way analysis of variance to different ACE gene polymorphic groups in patients with MS were not significantly associated to ACE gene polymorphism and waist circumference, systolic blood pressure, diastolic blood pressure, fasting blood glucose, HDL, and LDL (p<0.05). CONCLUSIONS Further studies of patients in larger numbers and of different ethnic backgrounds may be necessary to elucidate the association between the ACE I/D gene polymorphism and MS.
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Affiliation(s)
- S Simsek
- Department of Medical Biology and Genetics, University of Dicle, Medical School, Diyarbakir, Turkey.
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13
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Kuzubova NA, Chukhlovin AB, Morozova EB, Totolian AA, Titova ON. Common intronic D variant of ACE gene is associated with endothelial dysfunction in COPD. Respir Med 2013; 107:1217-21. [PMID: 23702088 DOI: 10.1016/j.rmed.2012.12.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Revised: 11/01/2012] [Accepted: 12/12/2012] [Indexed: 10/26/2022]
Abstract
BACKGROUND Pathogenesis of chronic obstructive lung disease (COPD) includes primary inflammatory events, multiple vascular reactions, remodeling of bronchial and vascular walls. OBJECTIVE The aim of present single-center study was to assess relations between angiotensin-converting enzyme (ACE) gene and prevalence of clinical symptoms characteristic to COPD. METHODS The study involved sixty-three male patients with COPD (44-86 years old, a mean of 60.4 years). COPD diagnostics was performed according to common criteria, including evaluation of systolic pressure in pulmonary artery (SPPA) and endothelial disfunction (ED). Genotyping of ACE I/D was performed by means of gene-specific PCR. RESULTS 1. Allele distribution of studied gene alleles among COPD patients did not differ from control age-matched group. 2. Detectable endothelial dysfunction in COPD patients was shown to correlate with high-producer D allele of ACE gene, at an odds ratio of 6.632 (CI = 1.67-26.31; chi2 = 8.39, p = 0.004). Moreover, detectable ED correlated with numbers of COPD exacerbations per year. CONCLUSIONS These findings suggest possible association of the functional ACE D allele with altered vascular responses that may modulate development of distinct COPD symptoms. The results are obtained in a limited clinical cohort, and deserve repeated trials in other groups of COPD patients.
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Affiliation(s)
- Natalia A Kuzubova
- Research Institute of Pulmonology, St. Petersburg State I. Pavlov Medical University, 197089 St. Petersburg, Russia Federation
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14
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Li W, Lan F, Yan F, Shen H. Angiotensin-converting enzyme I/D polymorphism is associated with COPD risk in Asian population: evidence from a meta-analysis. COPD 2012; 10:35-9. [PMID: 23272666 DOI: 10.3109/15412555.2012.727047] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Several molecular epidemiological studies were conducted in recent years to evaluate the risk of chronic obstructive pulmonary disease (COPD) associated with insertion/deletion (I/D) polymorphism of angiotensin-converting enzyme (ACE). However, the results remain conflicting rather than conclusive. To derive a more precise estimation of association between ACE polymorphism and the risk of COPD, we performed a meta-analysis from all available relevant studies. We used odds ratios (ORs) with 95% confidence intervals (CIs) to assess the strength of the association. There was a markedly positive association between the D allele or DD genotype and COPD risk in Asians (D vs. I: OR = 1.55, 95% CI = 1.407-2.44; DD vs. II: OR = 2.53, 95% CI = 1.65-3.89; DD vs. DI/II: OR = 2.09, 95% CI = 1.09-4.03), but this association was not observed in Europeans (D vs. I: OR = 0.93, 95% CI = 0.75-1.15; DD vs. II: OR = 0.86, 95% CI = 0.56-1.33; DD vs. DI/II: OR = 0.88, 95% CI = 0.63-1.23). Our meta-analysis provides strong evidence that D allele and DD homozygous might be significant genetic molecular markers for COPD susceptibility in Asians, but not for Europeans. Additional well-designed large studies were required for the validation of our results.
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Affiliation(s)
- Wen Li
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Institute of Respiratory Diseases, Zhejiang University School of Medicine, Hangzhou, China
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15
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Abstract
A genetic contribution to develop chronic obstructive pulmonary disease (COPD) is well established. However, the specific genes responsible for enhanced risk or host differences in susceptibility to smoke exposure remain poorly understood. The goal of this review is to provide a comprehensive literature overview on the genetics of COPD, highlight the most promising findings during the last few years, and ultimately provide an updated COPD gene list. Candidate gene studies on COPD and related phenotypes indexed in PubMed before January 5, 2012 are tabulated. An exhaustive list of publications for any given gene was looked for. This well-documented COPD candidate-gene list is expected to serve many purposes for future replication studies and meta-analyses as well as for reanalyzing collected genomic data in the field. In addition, this review summarizes recent genetic loci identified by genome-wide association studies on COPD, lung function, and related complications. Assembling resources, integrative genomic approaches, and large sample sizes of well-phenotyped subjects is part of the path forward to elucidate the genetic basis of this debilitating disease.
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Affiliation(s)
- Yohan Bossé
- Centre de recherche Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada.
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Li X, Wei N, Wu Z, Qi Z, Zhang X, Chen Q, Xia Z, Li S. The D/I polymorphism in the angiotensin-converting enzyme gene and chronic obstructive pulmonary disease risk: a meta-analysis. COPD 2012; 9:485-91. [PMID: 22876865 DOI: 10.3109/15412555.2012.694921] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The deletion/insertion (D/I) polymorphism in the angiotensin-converting enzyme (ACE) gene has been implicated in susceptibility of chronic obstruction pulmonary disease (COPD), but a number of studies have reported inconclusive results. The aim of this study is to investigate the relationship between the D/I polymorphism in the ACE gene and COPD risk by meta-analysis. METHOD We searched Pubmed database, Embase database, CNKI database and Wanfang database, covering all studies until October 10, 2011. Statistical analysis was performed by using the software Revman4.2 and STATA 10.0. RESULTS A total of 710 COPD cases and 862 controls in 10 case-control studies were included in this study. The results suggested that the DD homozygote carriers did not have an increased or decreased risk of COPD when compared with the heterozygote DI and II homozygote carriers. However, in the subgroup analysis by race, significant increased risks were found in Asian DD homozygote carriers (OR = 2.6 and 95% CI = 1.47-4.57 for DD vs. DI+II) but not in Caucasian DD homozygote carriers (OR = 0.91, 95%CI = 0.69-1.22, P = 0.54 for DD vs. DI+II). CONCLUSIONS This meta-analysis suggested that the ACE gene is a COPD susceptible gene in Asian populations. Future studies are needed to validate our conclusions..
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Affiliation(s)
- Xiaobo Li
- Department of Respiratory Medicine , The 452 Military Hospital of China, Chengdu, Sichuan 610041, China.
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Kothari ST, Chheda P, Chatterjee L, Das BR. Molecular analysis of genetic variation in angiotensin I-converting enzyme identifies no association with sporting ability: First report from Indian population. INDIAN JOURNAL OF HUMAN GENETICS 2012; 18:62-5. [PMID: 22754223 PMCID: PMC3385181 DOI: 10.4103/0971-6866.96653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
INTRODUCTION: A polymorphism in the angiotensin-converting enzyme (ACE) gene was the first performance enhancing polymorphisms (PEPs) to be identified and correlated with athletic abilities. This polymorphism (rs. 5186) is the absence (deletion; D allele), rather than the presence (insertion, I allele) of 287bp Alu repeat element in intron 16. However, the association of ACE I/D polymorphism in sports abilities have been contradicted and debated. No study has evaluated the ACE gene polymorphism in Indian athletes so far. Hence, the genotype distribution and allelic frequency of ACE gene in selected Indian athletic and non-athletic population was studied. MATERIALS AND METHODS: A total of 147 athletes and 131 controls were genotyped for the ACE gene polymorphism using PCR. RESULTS: No significant association was observed between the allelic frequencies of ACE gene in controls and athletes on a whole, as well as after sub-categorizing the athletes based on the type of sport they played (P > 0.1). However, a higher representation of I allele was observed in the athletes. CONCLUSION: ACE genotyping studies need to focus on truly elite athletes of a single sporting discipline, to be able to find an association. The ACE I/D polymorphism may not be considered a marker for human performance, but can be further studied in combination with other potent performance enhancing polymorphisms.
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Affiliation(s)
- Sweta T Kothari
- Research and Development, Super Religare Laboratories Ltd, S. V. Road, Goregaon (W), Mumbai-62, India
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Huson HJ, Byers AM, Runstadler J, Ostrander EA. An SNP within the angiotensin-converting enzyme distinguishes between sprint and distance performing Alaskan sled dogs in a candidate gene analysis. J Hered 2011; 102 Suppl 1:S19-27. [PMID: 21846742 DOI: 10.1093/jhered/esr022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Alaskan sled dog offers a unique mechanism for studying the genetics of elite athletic performance. They are a group of mixed breed dogs, comprised of multiple common breeds, and a unique breed entity seen only as a part of the sled dog mix. Alaskan sled dogs are divided into 2 primary groups as determined by their racing skills. Distance dogs are capable of running over 1000 miles in 10 days, whereas sprint dogs run much shorter distances, approximately 30 miles, but in faster times, that is, 18-25 mph. Finding the genes that distinguish these 2 types of performers is likely to illuminate genetic contributors to human athletic performance. In this study, we tested for association between polymorphisms in 2 candidate genes; angiotensin-converting enzyme (ACE) and myostatin (MSTN) and enhanced speed and endurance performance in 174 Alaskan sled dogs. We observed 81 novel genetic variants within the ACE gene and 4 within the MSTN gene, including a polymorphism within the ACE gene that significantly (P value 2.38 × 10(-5)) distinguished the sprint versus distance populations.
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Affiliation(s)
- Heather J Huson
- Cancer Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
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Puthucheary Z, Skipworth JRA, Rawal J, Loosemore M, Van Someren K, Montgomery HE. The ACE gene and human performance: 12 years on. Sports Med 2011; 41:433-48. [PMID: 21615186 DOI: 10.2165/11588720-000000000-00000] [Citation(s) in RCA: 126] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Some 12 years ago, a polymorphism of the angiotensin I-converting enzyme (ACE) gene became the first genetic element shown to impact substantially on human physical performance. The renin-angiotensin system (RAS) exists not just as an endocrine regulator, but also within local tissue and cells, where it serves a variety of functions. Functional genetic polymorphic variants have been identified for most components of RAS, of which the best known and studied is a polymorphism of the ACE gene. The ACE insertion/deletion (I/D) polymorphism has been associated with improvements in performance and exercise duration in a variety of populations. The I allele has been consistently demonstrated to be associated with endurance-orientated events, notably, in triathlons. Meanwhile, the D allele is associated with strength- and power-orientated performance, and has been found in significant excess among elite swimmers. Exceptions to these associations do exist, and are discussed. In theory, associations with ACE genotype may be due to functional variants in nearby loci, and/or related genetic polymorphism such as the angiotensin receptor, growth hormone and bradykinin genes. Studies of growth hormone gene variants have not shown significant associations with performance in studies involving both triathletes and military recruits. The angiotensin type-1 receptor has two functional polymorphisms that have not been shown to be associated with performance, although studies of hypoxic ascent have yielded conflicting results. ACE genotype influences bradykinin levels, and a common gene variant in the bradykinin 2 receptor exists. The high kinin activity haplotye has been associated with increased endurance performance at an Olympic level, and similar results of metabolic efficiency have been demonstrated in triathletes. Whilst the ACE genotype is associated with overall performance ability, at a single organ level, the ACE genotype and related polymorphism have significant associations. In cardiac muscle, ACE genotype has associations with left ventricular mass changes in response to stimulus, in both the health and diseased states. The D allele is associated with an exaggerated response to training, and the I allele with the lowest cardiac growth response. In light of the I-allele association with endurance performance, it seems likely that other regulatory mechanisms exist. Similarly in skeletal muscle, the D allele is associated with greater strength gains in response to training, in both healthy individuals and chronic disease states. As in overall performance, those genetic polymorphisms related to the ACE genotype, such as the bradykinin 2 gene, also influence skeletal muscle strength. Finally, the ACE genotype may influence metabolic efficiency, and elite mountaineers have demonstrated an excess of I alleles and I/I genotype frequency in comparison to controls. Interestingly, this was not seen in amateur climbers. Corroboratory evidence exists among high-altitude settlements in both South America and India, where the I allele exists in greater frequency in those who migrated from the lowlands. Unfortunately, if the ACE genotype does influence metabolic efficiency, associations with peak maximal oxygen consumption have yet to be rigorously demonstrated. The ACE genotype is an important but single factor in the determinant of sporting phenotype. Much of the mechanisms underlying this remain unexplored despite 12 years of research.
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Affiliation(s)
- Zudin Puthucheary
- University College London Institute for Human Health and Performance, London, UK.
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20
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Dimitriou G, Papakonstantinou D, Stavrou EF, Tzifas S, Vervenioti A, Athanassiadou A, Mantagos S. Angiotensin-converting enzyme gene polymorphism and respiratory muscle function in infants. Pediatr Pulmonol 2010; 45:1233-9. [PMID: 20812241 DOI: 10.1002/ppul.21316] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Accepted: 06/08/2010] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Angiotensin-converting enzyme (ACE) gene contains a polymorphism consisting of either the presence (I) or absence (D) of a 287-bp fragment. Recent studies have suggested that the I-allele may be associated with superior exercise endurance; respiratory muscle function may be similarly influenced. The pressure-time index of inspiratory muscles (PTImus) is a measure of the load-capacity ratio of the inspiratory muscles. The objective of this study was to determine whether infants homozygous for the I-allele have lower PTImus compared to infants homozygous for the D-allele or heterozygous I/D. PATIENTS AND METHODS One hundred thirty-two infants were studied. ACE genotyping was performed by polymerase chain reaction amplification, using DNA from peripheral blood. PTImus was calculated as (Pi(mean)/Pi(max)) × (T(i)/T(tot)), where Pi(mean) was the mean inspiratory pressure estimated from airway pressure, generated 100 ms after an occlusion (P(0.1)), Pi(max) was the maximum inspiratory pressure and T(i)/T(tot) was the ratio of the inspiratory time to the total respiratory cycle time. Pi(max) was the largest pressure generated during brief airway occlusions performed at the end of a spontaneous crying effort. RESULTS Infants with I/I genotype had significantly lower PTImus than infants with either D/D or I/D genotypes (P = 0.000007). ACE genotype was significantly related (P = 0.005) to PTImus measurements, independent of other factors that may affect respiratory muscle function. CONCLUSION These results suggest that an association of ACE genotypes with PTImus measurements may exist in infants.
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Affiliation(s)
- Gabriel Dimitriou
- Neonatal Intensive Care Unit, Department of Pediatrics, University of Patras Medical School, Rio, Patras, Greece.
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Pabst S, Theis B, Gillissen A, Lennarz M, Tuleta I, Nickenig G, Skowasch D, Grohé C. Angiotensin-converting enzyme I/D polymorphism in chronic obstructive pulmonary disease. Eur J Med Res 2010; 14 Suppl 4:177-81. [PMID: 20156752 PMCID: PMC3521361 DOI: 10.1186/2047-783x-14-s4-177] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Study objective The etiology of chronic obstructive lung disease (COPD) is unclear. It is supposed to be the product of an exogenous antigenic stimulus, such as tobacco smoke, and an endogenous genetic susceptibility. The angiotensin-converting enzyme (ACE) gene contains a polymorphism based on the presence (insertion [I]) or absence (deletion [D]) of a 287-bp nonsense domain, resulting in three different genotypes (II, ID and DD). The aim of the study was to find out whether the ACE gene polymorphism can determine the course of COPD. Patients and design We genotyped 152 Caucasian patients with COPD and 158 healthy controls for the ACE (I/D) polymorphism. We divided the COPD group into one group of 64 patients with a stable course of disease, defined as less than three hospitalizations over the last three years due to COPD, and another group of 88 patients with an instable course with more than three hospitalizations. Results The I-allele was significantly associated with an increased risk for COPD in a dominant model (OR 1.67 (95% CI 1.00 to 2.78), p = 0.048), but not in a recessive or co-dominant model. Moreover, the I-allele of ACE (I/D) was significantly increased in patients with a stable course of COPD (p = 0.012) compared with controls. In a dominant model (II/ID v DD) we found an even stronger association between the I-allele and a stable course of COPD (OR 3.24 (95% CI 1.44 to 7.31), p = 0.003). Conclusion These data suggest that the presence of an ACE I-allele determines a stable course of COPD.
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Affiliation(s)
- S Pabst
- Medizinische Klinik und Poliklinik II, Pulmonary Division, Department of Medicine, Universitätsklinikum Bonn, Bonn, Germany.
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Schoenfelder M. Genetics-based performance talent research: polymorphisms as predictors of endurance performance. J Appl Physiol (1985) 2010; 108:1454-5. [DOI: 10.1152/japplphysiol.00331.2010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- M. Schoenfelder
- Technical University Munich, Institute of Public Health Research, Munich, Germany
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Abstract
Performance enhancing polymorphisms (PEPs) are examples of natural genetic variation that affect the outcome of athletic challenges. Elite athletes, and what separates them from the average competitor, have been the subjects of discussion and debate for decades. While training, diet, and mental fitness are all clearly important contributors to achieving athletic success, the fact that individuals reaching the pinnacle of their chosen sports often share both physical and physiological attributes suggests a role for genetics. That multiple members of a family often participate in highly competitive events, such as the Olympics, further supports this argument. In this review, we discuss what is known regarding the genes and gene families, including the mitochondrial genome, that are believed to play a role in human athletic performance. Where possible, we describe the physiological impact of the critical gene variants and consider predictions about other potentially important genes. Finally, we discuss the implications of these findings on the future for competitive athletics.
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Affiliation(s)
- Elaine A Ostrander
- Cancer Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland 20892, USA.
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Kolb MRJ, Yang I. Respirology year-in-review 2008: basic science. Respirology 2009; 14:318-26. [PMID: 19353767 DOI: 10.1111/j.1440-1843.2009.01491.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Martin R J Kolb
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
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Ruffin R, Bardin PG. Respirology year-in-review 2008: clinical science. Respirology 2009; 14:159-66. [PMID: 19192225 DOI: 10.1111/j.1440-1843.2008.01471.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Richard Ruffin
- Discipline of Medicine, University of Adelaide, Queen Elizabeth Hospital Campus, Adelaide, South Australia, Australia
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