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Ferraresi P, Balestra D, Guittard C, Buthiau D, Pan-Petesh B, Maestri I, Farah R, Pinotti M, Giansily-Blaizot M. Next-generation sequencing and recombinant expression characterized aberrant splicing mechanisms and provided correction strategies in factor VII deficiency. Haematologica 2019; 105:829-837. [PMID: 31273093 PMCID: PMC7049351 DOI: 10.3324/haematol.2019.217539] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 07/02/2019] [Indexed: 01/22/2023] Open
Abstract
Despite the exhaustive screening of F7 gene exons and exon-intron boundaries and promoter region, a significant proportion of mutated alleles remains unidentified in patients with coagulation factor VII deficiency. Here, we applied next-generation sequencing to 13 FVII-deficient patients displaying genotype-phenotype discrepancies upon conventional sequencing, and identified six rare intronic variants. Computational analysis predicted splicing effects for three of them, which would strengthen (c.571+78G>A; c.806-329G>A) or create (c.572-392C>G) intronic 5′ splice sites (5′ss). In F7 minigene assays, the c.806-329G>A was ineffective while the c.571+78G>A change led to usage of the +79 cryptic 5′ss with only trace levels of correct transcripts (3% of wild-type), in accordance with factor VII activity levels in homozygotes (1-3% of normal). The c.572-392C>G change led to pseudo-exonization and frame-shift, but also substantial levels of correct transcripts (approx. 70%). However, this variant was associated with the common F7 polymorphic haplotype, predicted to further decrease factor VII levels; this provided some kind of explanation for the 10% factor VII levels in the homozygous patient. Intriguingly, the effect of the c.571+78G>A and c.572-392C>G changes, and particularly of the former (the most severe and well-represented in our cohort), was counteracted by antisense U7snRNA variants targeting the intronic 5′ss, thus demonstrating their pathogenic role. In conclusion, the combination of next-generation sequencing of the entire F7 gene with the minigene expression studies elucidated the molecular bases of factor VII deficiency in 10 of 13 patients, thus improving diagnosis and genetic counseling. It also provided a potential therapeutic approach based on antisense molecules that has been successfully exploited in other disorders.
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Affiliation(s)
- Paolo Ferraresi
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
| | - Dario Balestra
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
| | - Caroline Guittard
- Department of Biological Haematology, CHU Montpellier, Université Montpellier, Montpellier, France
| | - Delphine Buthiau
- Department of Biological Haematology, CHU Montpellier, Université Montpellier, Montpellier, France
| | | | - Iva Maestri
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Roula Farah
- Department of Pediatrics, Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Mirko Pinotti
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
| | - Muriel Giansily-Blaizot
- Department of Biological Haematology, CHU Montpellier, Université Montpellier, Montpellier, France
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2
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Olson NC, Raffield LM, Lange LA, Lange EM, Longstreth WT, Chauhan G, Debette S, Seshadri S, Reiner AP, Tracy RP. Associations of activated coagulation factor VII and factor VIIa-antithrombin levels with genome-wide polymorphisms and cardiovascular disease risk. J Thromb Haemost 2018; 16:19-30. [PMID: 29112333 PMCID: PMC5760305 DOI: 10.1111/jth.13899] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Indexed: 11/26/2022]
Abstract
ESSENTIALS Essentials A fraction of coagulation factor VII circulates in blood as an activated protease (FVIIa). We evaluated FVIIa and FVIIa-antithrombin (FVIIa-AT) levels in the Cardiovascular Health Study. Polymorphisms in the F7 and PROCR loci were associated with FVIIa and FVIIa-AT levels. FVIIa may be an ischemic stroke risk factor in older adults and FVIIa-AT may assess mortality risk. SUMMARY Background A fraction of coagulation factor (F) VII circulates as an active protease (FVIIa). FVIIa also circulates as an inactivated complex with antithrombin (FVIIa-AT). Objective Evaluate associations of FVIIa and FVIIa-AT with genome-wide single nucleotide polymorphisms (SNPs) and incident coronary heart disease, ischemic stroke and mortality. Patients/Methods We measured FVIIa and FVIIa-AT in 3486 Cardiovascular Health Study (CHS) participants. We performed a genome-wide association scan for FVIIa and FVIIa-AT in European-Americans (n = 2410) and examined associations of FVII phenotypes with incident cardiovascular disease. Results In European-Americans, the most significant SNP for FVIIa and FVIIa-AT was rs1755685 in the F7 promoter region on chromosome 13 (FVIIa, β = -25.9 mU mL-1 per minor allele; FVIIa-AT, β = -26.6 pm per minor allele). Phenotypes were also associated with rs867186 located in PROCR on chromosome 20 (FVIIa, β = 7.8 mU mL-1 per minor allele; FVIIa-AT, β = 9.9 per minor allele). Adjusted for risk factors, a one standard deviation higher FVIIa was associated with increased risk of ischemic stroke (hazard ratio [HR], 1.12; 95% confidence interval [CI], 1.01, 1.23). Higher FVIIa-AT was associated with mortality from all causes (HR, 1.08; 95% CI, 1.03, 1.12). Among European-American CHS participants the rs1755685 minor allele was associated with lower ischemic stroke (HR, 0.69; 95% CI, 0.54, 0.88), but this association was not replicated in a larger multi-cohort analysis. Conclusions The results support the importance of the F7 and PROCR loci in variation in circulating FVIIa and FVIIa-AT. The findings suggest FVIIa is a risk factor for ischemic stroke in older adults, whereas higher FVIIa-AT may reflect mortality risk.
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Affiliation(s)
- N C Olson
- Department of Pathology and Laboratory Medicine, Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, VT, USA
- Cardiovascular Research Institute of Vermont, Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, VT, USA
| | - L M Raffield
- Department of Genetics, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - L A Lange
- Division of Biomedical Informatics and Personalized Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - E M Lange
- Division of Biomedical Informatics and Personalized Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - W T Longstreth
- Department of Neurology, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - G Chauhan
- INSERM U1219 Neuroepidemiology, Bordeaux, France
- University of Bordeaux, Bordeaux, France
- Centre for Brain Research, Indian Institute of Science, Bangalore, India
| | - S Debette
- INSERM U1219 Neuroepidemiology, Bordeaux, France
- University of Bordeaux, Bordeaux, France
- Department of Neurology, Bordeaux University Hospital, Bordeaux, France
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- National Heart, Lung, and Blood Institute Framingham Heart Study, Framingham, MA, USA
| | - S Seshadri
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- National Heart, Lung, and Blood Institute Framingham Heart Study, Framingham, MA, USA
| | - A P Reiner
- Department of Neurology, Bordeaux University Hospital, Bordeaux, France
| | - R P Tracy
- Department of Pathology and Laboratory Medicine, Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, VT, USA
- Cardiovascular Research Institute of Vermont, Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, VT, USA
- Department of Biochemistry, Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, VT, USA
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3
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Marchetti G, Girelli D, Zerbinati C, Lunghi B, Friso S, Meneghetti S, Coen M, Gagliano T, Guastella G, Bochaton-Piallat ML, Pizzolo F, Mascoli F, Malerba G, Bovolenta M, Ferracin M, Olivieri O, Bernardi F, Martinelli N. An integrated genomic-transcriptomic approach supports a role for the proto-oncogene BCL3 in atherosclerosis. Thromb Haemost 2014; 113:655-63. [PMID: 25374339 DOI: 10.1160/th14-05-0466] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 10/08/2014] [Indexed: 11/05/2022]
Abstract
Data with border-line statistical significance, copiously generated in genome-wide association studies of coronary artery disease (CAD), could include functionally relevant associations. We propose an integrated genomic and transcriptomic approach for unravelling new potential genetic signatures of atherosclerosis. Fifteen among 91 single nucleotide polymorphisms (SNPs) were first selected for association in a sex- and age-adjusted model by examining 510 patients with CAD and myocardial infarction and 388 subjects with normal coronary arteries (CAD-free) in the replication stages of a genome-wide association study. We investigated the expression of 71 genes proximal to the 15 tag-SNPs by two subsequent steps of microarray-based mRNA profiling, the former in vascular smooth muscle cell populations, isolated from non-atherosclerotic and atherosclerotic human carotid portions, and the latter in whole carotid specimens. BCL3 and PVRL2, contiguously located on chromosome 19, and ABCA1, extensively investigated before, were found to be differentially expressed. BCL3 and PVRL2 SNPs were genotyped within a second population of CAD patients (n=442) and compared with CAD-free subjects (n=393). The carriership of the BCL3 rs2965169 G allele was more represented among CAD patients and remained independently associated with CAD after adjustment for all the traditional cardiovascular risk factors (odds ratio=1.70 with 95% confidence interval 1.07-2.71), while the BCL3 rs8100239 A allele correlated with metabolic abnormalities. The up-regulation of BCL3 mRNA levels in atherosclerotic tissue samples was consistent with BCL3 protein expression, which was detected by immunostaining in the intima-media of atherosclerotic specimens, but not within non-atherosclerotic ones. Our integrated approach suggests a role for BCL3 in cardiovascular diseases.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Nicola Martinelli
- Nicola Martinelli, Department of Medicine, University of Verona, 37134 Verona, Italy, E-mail:
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Sakowicz A, Fendler W, Lelonek M, Sakowicz B, Pietrucha T. Genetic polymorphisms and the risk of myocardial infarction in patients under 45 years of age. Biochem Genet 2012; 51:230-42. [PMID: 23274712 PMCID: PMC3599159 DOI: 10.1007/s10528-012-9558-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Accepted: 11/26/2012] [Indexed: 11/17/2022]
Abstract
This study investigates the potential role of 17 chosen polymorphisms in 15 candidate genes and the risk of myocardial infarction in patients under 45 years of age. The study consists of 271 patients with myocardial infarction and 141 controls. The analysis of genetic polymorphisms was performed using the PCR–RFLP method. Of the chosen polymorphisms, two (Leu125Val PECAM1 and A1/A2 FVII) are related to myocardial infarction and two (C677T MTHFR and 5A/6A MMP3) to advanced stenosis in arterial vessels (> 75%). We also found that the frequency of some combinations among the analyzed genes and environmental factors varied between the patient and control groups.
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Affiliation(s)
- Agata Sakowicz
- Department of Medical Biotechnology, Medical University of Lodz, Zeligowskiego 7/9, 90-725, Lodz, Poland.
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5
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Belozerceva LA, Voronina EN, Kokh NV, Tsvetovskay GA, Momot AP, Lifshits GI, Filipenko ML, Shevela AI, Vlasov VV. Personalized approach of medication by indirect anticoagulants tailored to the patient-Russian context: what are the prospects? EPMA J 2012; 3:10. [PMID: 23016735 PMCID: PMC3492156 DOI: 10.1186/1878-5085-3-10] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2012] [Accepted: 09/19/2012] [Indexed: 11/26/2022]
Abstract
Indirect anticoagulants such as warfarin are the ‘gold standard’ for prevention and treatment of thromboembolic complications in patients at risk (in atrial fibrillation of valvular and nonvalvular etiology, the presence of artificial heart valves, orthopedic and trauma interventions, and other pathological conditions). A wide range of doses required to achieve a therapeutic effect indicates the need for a personalized approach to the appointment of warfarin. In addition to the dependence on the patient's clinical characteristics (sex, age, smoking status, diagnosis), there is a clear association between the warfarin dose and the carriage of certain allelic variants of key genes that makes it possible to apply molecular genetic testing for individual dose adjustment. This provides a more rapid target anticoagulant effect and also reduces the risk of bleeding associated with a possible overdose of warfarin. Implementation of this approach will allow more wide and safe application of indirect anticoagulants in Russia for needy patients.
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Affiliation(s)
- Liliya Alexandrovna Belozerceva
- Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences (RAS ICBFM), Ac, Lavrentiev 8, Novosibirsk, 630090, Russia.
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6
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Ben-Hadj-Khalifa S, Lakhal B, Mahjoub T, Almawi WY. Contribution of coagulation factor VII R353Q, -323P0/10 and HVR4 polymorphisms to coronary artery disease in Tunisians. J Thromb Thrombolysis 2012; 35:243-9. [PMID: 22932775 DOI: 10.1007/s11239-012-0800-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We examined the contribution of two factor VII (FVII) bi-allelic (R353Q, -323P0/10) and one tandem repeat (HVR4) polymorphisms to the risk of coronary artery disease (CAD) in Tunisians. Study subjects comprised 308 CAD patients and 312 age-, gender- and ethnically-matched controls. Regression analysis was used in assessing the FVII association to CAD risk. While the distribution of -323P0/10 alleles and genotypes were comparable between cases and controls, marginal association of the R353Q variant was noted, with the Q allele (19.1 vs. 23.8%; P = 0.05) and Q allele-containing genotypes (R/Q + Q/Q; 33.8 vs. 48.0%) being slightly under-represented in cases than in controls. On the other hand, four alleles of FVII microsatellite HVR4 were detected at variable frequencies in Tunisians, and comprised H6 (63.2%), H7 (33.8%), and to lesser extents H5 (1.9%) and H8 (0.8%). Of these, the H7 variant was under-represented in patients [P = 0.038; OR (95%CI) = 0.75 (0.58-0.97)]. Of the major genotypes detected (H6/H6, H6/H7, H7/H7) only H6/H6 was positively associated with CAD [P = 0.047; OR (95%CI) = 1.39 (1.00-1.94)]. In conclusion, our study underscores the role of polymorphisms in the FVII gene in modulating the susceptibility to CAD in (North African) Tunisian Arabs.
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Affiliation(s)
- Sonia Ben-Hadj-Khalifa
- Faculty of Pharmacy, Research Unit of Biology and Genetics of Hematologic and Autoimmune Diseases, Monastir, Tunisia
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7
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Petrillo G, Cirillo P, D'Ascoli GL, Maresca F, Ziviello F, Chiariello M. Tissue Factor/Factor FVII Complex Inhibitors in Cardiovascular Disease. Are Things Going Well? Curr Cardiol Rev 2011; 6:325-32. [PMID: 22043208 PMCID: PMC3083813 DOI: 10.2174/157340310793566190] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2010] [Revised: 06/17/2010] [Accepted: 06/22/2010] [Indexed: 11/22/2022] Open
Abstract
Blood coagulation is a complex biological mechanism aimed to avoid bleeding in which a highly regulated and coordinated interplay of specific proteins and cellular components respond quickly to a vascular injury. However, when this mechanisms occurs in the coronary circulation, it has not a “protective” effect, but rather, it plays a pivotal role in determining acute coronary syndromes. Coagulation recognizes Tissue Factor (TF), the main physiological initiator of the extrinsic coagulation pathway, as its starter. Since TF:VIIa complex is the critical point of the blood coagulation cascade, it is a pharmacological attractive issue for the development of agents with anti thrombotic properties that can exert their activity by inhibiting complex formation and/or its catalytic activity. In fact, it is intuitive that an antithrombotic agent able to inhibit this initial step of the coagulation pathway has several theoretical, extremely important, advantages if compared with drugs active downstream the coagulation pathway, such as FXa or thrombin. The present report gives a brief overview of TF pathophysiology, highlighting the most recent advances in the field of inhibitors of the complex TF/VIIa potentially useful in cardiovascular disease.
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Affiliation(s)
- Gianluca Petrillo
- Department of Internal Medicine, Cardiovascular and Immunological Sciences (Division of Cardiology) University of Naples "Federico II", Italy
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8
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Taylor KC, Lange LA, Zabaneh D, Lange E, Keating BJ, Tang W, Smith NL, Delaney JA, Kumari M, Hingorani A, North KE, Kivimaki M, Tracy RP, O'Donnell CJ, Folsom AR, Green D, Humphries SE, Reiner AP. A gene-centric association scan for Coagulation Factor VII levels in European and African Americans: the Candidate Gene Association Resource (CARe) Consortium. Hum Mol Genet 2011; 20:3525-34. [PMID: 21676895 DOI: 10.1093/hmg/ddr264] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Polymorphisms in several distinct genomic regions, including the F7 gene, were recently associated with factor VII (FVII) levels in European Americans (EAs). The genetic determinants of FVII in African Americans (AAs) are unknown. We used a 50,000 single nucleotide polymorphism (SNP) gene-centric array having dense coverage of over 2,000 candidate genes for cardiovascular disease (CVD) pathways in a community-based sample of 16,324 EA and 3898 AA participants from the Candidate Gene Association Resource (CARe) consortium. Our aim was the discovery of new genomic loci and more detailed characterization of existing loci associated with FVII levels. In EAs, we identified three new loci associated with FVII, of which APOA5 on chromosome 11q23 and HNF4A on chromosome 20q12-13 were replicated in a sample of 4289 participants from the Whitehall II study. We confirmed four previously reported FVII-associated loci (GCKR, MS4A6A, F7 and PROCR) in CARe EA samples. In AAs, the F7 and PROCR regions were significantly associated with FVII. Several of the FVII-associated regions are known to be associated with lipids and other cardiovascular-related traits. At the F7 locus, there was evidence of at least five independently associated SNPs in EAs and three independent signals in AAs. Though the variance in FVII explained by the existing loci is substantial (20% in EA and 10% in AA), larger sample sizes and investigation of lower frequency variants may be required to identify additional FVII-associated loci in EAs and AAs and further clarify the relationship between FVII and other CVD risk factors.
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Affiliation(s)
- Kira C Taylor
- Department of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC 27514, USA.
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9
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Ken-Dror G, Drenos F, Humphries SE, Talmud PJ, Hingorani AD, Kivimäki M, Kumari M, Bauer KA, Morrissey JH, Ireland HA. Haplotype and genotype effects of the F7 gene on circulating factor VII, coagulation activation markers and incident coronary heart disease in UK men. J Thromb Haemost 2010; 8:2394-403. [PMID: 20735728 PMCID: PMC3226948 DOI: 10.1111/j.1538-7836.2010.04035.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Evidence for the associations of single nucleotide polymorphisms (SNPs) in the F7 gene and factor (F)VII levels and with risk of coronary heart disease (CHD) is inconsistent. We examined whether F7 tagging SNPs (tSNPs) and haplotypes were associated with FVII levels, coagulation activation markers (CAMs) and CHD risk in two cohorts of UK men. METHODS Genotypes for eight SNPs and baseline levels of FVIIc, FVIIag and CAMs (including FVIIa) were determined in 2773 healthy men from the Second Northwick Park Heart Study (NPHS-II). A second cohort, Whitehall II study (WH-II, n = 4055), was used for replication analysis of FVIIc levels and CHD risk. RESULTS In NPHS-II the minor alleles of three SNPs (rs555212, rs762635 and rs510317; haplotype H2) were associated with higher levels of FVIIag, FVIIc and FVIIa, whereas the minor allele for two SNPs (I/D323 and rs6046; haplotype H5) was associated with lower levels. Adjusted for classic risk factors, H2 carriers had a CHD hazard ratio of 1.34 [95% confidence interval (CI): 1.12-1.59; independent of FVIIc], whereas H5 carriers had a CHD risk of 1.29 (95% CI: 1.01-1.56; not independent of FVIIc) and significantly lower CAMs. Effects of haplotypes on FVIIc levels were replicated in WH-II, as was the association of H5 with higher CHD risk [pooled-estimate odds ratio (OR) 1.16 (1.00-1.36), P = 0.05], but surprisingly, H2 exhibited a reduced risk for CHD. CONCLUSION tSNPs in the F7 gene strongly influence FVII levels. The haplotype associated with low FVIIc level, with particularly reduced functional activity, was consistently associated with increased risk for CHD, whereas the haplotype associated with high FVIIc level was not.
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Affiliation(s)
- G Ken-Dror
- Centre for Cardiovascular Genetics, BHF Laboratories, The Rayne Building, Department of Medicine, Royal Free and University College Medical School, London, UK
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10
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Mostowska A, Hozyasz KK, Wojcicki P, Biedziak B, Paradowska P, Jagodzinski PP. Association between genetic variants of reported candidate genes or regions and risk of cleft lip with or without cleft palate in the polish population. ACTA ACUST UNITED AC 2010; 88:538-45. [DOI: 10.1002/bdra.20687] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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11
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Sakowicz A, Fendler W, Lelonek M, Gluba A, Pietrucha T. Two polymorphisms of the FVII gene and their impact on the risk of myocardial infarction in poles under 45 years of age. Mol Biol 2010. [DOI: 10.1134/s0026893310020032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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12
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Influence of clinical and genetic factors on warfarin dose requirements among Japanese patients. Eur J Clin Pharmacol 2009; 65:1097-103. [DOI: 10.1007/s00228-009-0685-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2009] [Accepted: 06/08/2009] [Indexed: 10/20/2022]
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Abstract
Inherited thrombophilia can be defined as a genetically determined predisposition to the development of thromboembolic complications. Since the discovery of activated protein C resistance in 1993, several additional disorders have been described and, at present, it is possible to identify an inherited predisposition in about 60 to 70% of patients with such complications. These inherited prothrombotic risk factors include qualitative or quantitative defects of coagulation factor inhibitors, increased levels or function of coagulation factors, defects of the fibrinolytic system, altered platelet function, and hyperhomocysteinemia. In this review, the main inherited prothrombotic risk factors are analyzed from epidemiological, laboratory, clinical, and therapeutic points of view. Finally, we discuss the synergism between genetic and acquired prothrombotic risk factors in particular conditions such as childhood and pregnancy.
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Affiliation(s)
- Massimo Franchini
- Servizio di Immunoematologia e Trasfusione, Azienda Ospedaliera di Verona, Verona, Italy.
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14
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Martinelli N, Girelli D, Malerba G, Guarini P, Illig T, Trabetti E, Sandri M, Friso S, Pizzolo F, Schaeffer L, Heinrich J, Pignatti PF, Corrocher R, Olivieri O. FADS genotypes and desaturase activity estimated by the ratio of arachidonic acid to linoleic acid are associated with inflammation and coronary artery disease. Am J Clin Nutr 2008; 88:941-9. [PMID: 18842780 DOI: 10.1093/ajcn/88.4.941] [Citation(s) in RCA: 246] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND The delta-5 and delta-6 desaturases, encoded by FADS1 and FADS2 genes, are key enzymes in polyunsaturated fatty acid (PUFA) metabolism that catalyze the conversion of linoleic acid (LA) into arachidonic acid (AA) and that of alpha-linolenic acid (ALA) into eicosapentaenoic acid (EPA). Single-nucleotide polymorphisms (SNPs) in FADS1 and FADS2 have been associated with different concentrations of AA and LA, and those associations have possible functional consequences for desaturase activity. OBJECTIVE We aimed to evaluate the possible association among FADS genotypes, desaturase activity, inflammation, and coronary artery disease (CAD). DESIGN Thirteen FADS SNPs and the ratio of AA to LA (AA/LA) on red blood cell (RBC) membranes, a marker of desaturase activity, were evaluated in 876 subjects with (n = 610) or without (n = 266) angiographically documented CAD. RESULTS Both AA/LA and the ratio of EPA to ALA (EPA/ALA) were higher in patients with CAD than in those without CAD, but, in a multiple logistic regression model, only a higher AA/LA resulted an independent risk factor for CAD (odds ratio: 2.55; 95% CI: 1.61, 4.05 for higher compared with lower ratio tertile; P for trend < 0.001). Furthermore, concentrations of high-sensitivity C-reactive protein increased progressively across tertiles of AA/LA. Graded increases in high-sensitivity C-reactive protein concentrations and CAD risk were related to the carriership of FADS haplotypes, including the alleles associated with a higher ratio. CONCLUSION In populations following a Western diet, subjects carrying FADS haplotypes that are associated with higher desaturase activity may be prone to a proinflammatory response favoring atherosclerotic vascular damage.
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Affiliation(s)
- Nicola Martinelli
- Department of Clinical and Experimental Medicine and the Section of Biology and Genetics, University of Verona, Verona, Italy
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15
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Martinelli N, Trabetti E, Pinotti M, Olivieri O, Sandri M, Friso S, Pizzolo F, Bozzini C, Caruso PP, Cavallari U, Cheng S, Pignatti PF, Bernardi F, Corrocher R, Girelli D. Combined effect of hemostatic gene polymorphisms and the risk of myocardial infarction in patients with advanced coronary atherosclerosis. PLoS One 2008; 3:e1523. [PMID: 18253477 PMCID: PMC2211406 DOI: 10.1371/journal.pone.0001523] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2007] [Accepted: 01/02/2008] [Indexed: 12/16/2022] Open
Abstract
Background Relative little attention has been devoted until now to the combined effects of gene polymorphisms of the hemostatic pathway as risk factors for Myocardial Infarction (MI), the main thrombotic complication of Coronary Artery Disease (CAD). The aim of this study was to evaluate the combined effect of ten common prothrombotic polymorphisms as a determinant of MI. Methodology/Principal Findings We studied a total of 804 subjects, 489 of whom with angiographically proven severe CAD, with or without MI (n = 307; n = 182; respectively). An additive model considering ten common polymorphisms [Prothrombin 20210G>A, PAI-1 4G/5G, Fibrinogen β -455G>A, FV Leiden and “R2”, FVII -402G>A and -323 del/ins, Platelet ADP Receptor P2Y12 -744T>C, Platelet Glycoproteins Ia (873G>A), and IIIa (1565T>C)] was tested. The prevalence of MI increased linearly with an increasing number of unfavorable alleles (χ2 for trend = 10.68; P = 0.001). In a multiple logistic regression model, the number of unfavorable alleles remained significantly associated with MI after adjustment for classical risk factors. As compared to subjects with 3-7 alleles, those with few (≤2) alleles had a decreased MI risk (OR 0.34, 95%CIs 0.13–0.93), while those with more (≥8) alleles had an increased MI risk (OR 2.49, 95%CIs 1.03–6.01). The number of procoagulant alleles correlated directly (r = 0.49, P = 0.006) with endogenous thrombin potential. Conclusions The combination of prothrombotic polymorphisms may help to predict MI in patients with advanced CAD.
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Affiliation(s)
- Nicola Martinelli
- Department of Clinical and Experimental Medicine, University of Verona, Verona, Italy
| | - Elisabetta Trabetti
- Section of Biology and Genetics, Department of Mother and Child and Biology–Genetics, University of Verona, Verona, Italy
| | - Mirko Pinotti
- Department of Biochemistry and Molecular Biology, University of Ferrara , Ferrara, Italy
| | - Oliviero Olivieri
- Department of Clinical and Experimental Medicine, University of Verona, Verona, Italy
| | - Marco Sandri
- Department of Clinical and Experimental Medicine, University of Verona, Verona, Italy
| | - Simonetta Friso
- Department of Clinical and Experimental Medicine, University of Verona, Verona, Italy
| | - Francesca Pizzolo
- Department of Clinical and Experimental Medicine, University of Verona, Verona, Italy
| | - Claudia Bozzini
- Department of Clinical and Experimental Medicine, University of Verona, Verona, Italy
| | - Pier Paolo Caruso
- Department of Biochemistry and Molecular Biology, University of Ferrara , Ferrara, Italy
| | - Ugo Cavallari
- Section of Biology and Genetics, Department of Mother and Child and Biology–Genetics, University of Verona, Verona, Italy
| | - Suzanne Cheng
- Department of Human Genetics, Roche Molecular Systems, Inc., Alameda, California, United States of America
| | - Pier Franco Pignatti
- Section of Biology and Genetics, Department of Mother and Child and Biology–Genetics, University of Verona, Verona, Italy
| | - Francesco Bernardi
- Department of Biochemistry and Molecular Biology, University of Ferrara , Ferrara, Italy
| | - Roberto Corrocher
- Department of Clinical and Experimental Medicine, University of Verona, Verona, Italy
| | - Domenico Girelli
- Department of Clinical and Experimental Medicine, University of Verona, Verona, Italy
- * To whom correspondence should be addressed. E-mail:
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16
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Smith NL, Bis JC, Biagiotti S, Rice K, Lumley T, Kooperberg C, Wiggins KL, Heckbert SR, Psaty BM. Variation in 24 hemostatic genes and associations with non-fatal myocardial infarction and ischemic stroke. J Thromb Haemost 2008; 6:45-53. [PMID: 17927806 DOI: 10.1111/j.1538-7836.2007.02795.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Arterial thrombosis involves platelet aggregation and clot formation, yet little is known about the contribution of genetic variation in fibrin-based hemostatic factors to arterial clotting risk. We hypothesized that common variation in 24 coagulation-fibrinolysis genes would contribute to risk of incident myocardial infarction (MI) or ischemic stroke (IS). METHODS We conducted a population-based, case-control study. Subjects were hypertensive adults and postmenopausal women 30-79 years of age, who sustained a first MI (n = 856) or IS (n = 368) between 1995 and 2002, and controls matched on age, hypertension status, and calendar year (n = 2,689). We investigated the risk of MI and IS associated with (i) global variation within each gene as measured by common haplotypes and (ii) individual haplotypes and single nucleotide polymorphisms (SNPs). Significance was assessed using a 0.2 threshold of the false discovery rate q-value, which accounts for multiple testing. RESULTS After accounting for multiple testing, global genetic variation in factor (F) VIII was associated with IS risk. Two haplotypes in FVIII and one in FXIIIa1 were significantly associated with increased IS risk (all q-values < 0.2). A plasminogen gene SNP was associated with MI risk. All are new discoveries not previously reported. Another 24 tests had P-values < 0.05 and q-values > 0.2 in MI and IS analyses, 23 of which are new and hypothesis generating. CONCLUSIONS Apart from the association of FVIII variation with IS, we found little evidence that common variation in the 24 candidate fibrin-based hemostasis genes strongly influences arterial thrombotic risk, but our results cannot rule out small effects.
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Affiliation(s)
- N L Smith
- Department of Epidemiology, University of Washington, Seattle, WA, USA.
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17
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Greisenegger S, Weber M, Funk M, Endler G, Lang W, Ferrari J, Lalouschek W, Mannhalter C. Polymorphisms in the coagulation factor VII gene and risk of primary intracerebral hemorrhage. Eur J Neurol 2007; 14:1098-101. [PMID: 17880564 DOI: 10.1111/j.1468-1331.2007.01906.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Data concerning genetic factors that may influence the risk of primary intracerebral hemorrhage (PICH) are scarce. One previous study, indicated that the carriers of the (-323)Ins allele of the coagulation factor VII (FVII) have an increased risk of PICH. Another recent study, tested the effect of apolipoprotein E. We analyzed, whether the (-401)G --> T polymorphism, which is in linkage disequilibrium (LD) with the 10-bp Ins/Del polymorphism at position (-323), or the (-402)G --> A polymorphisms of the FVII gene are associated with an increased risk for PICH. We performed a small case-control study in 85 patients with PICH and in 85 healthy control subjects. To each patient a control was individually matched for age, gender, and hypertension. We did not find any significant differences in allele frequencies for the A allele of the FVII (-402)G --> A polymorphism (0.25 vs. 0.25; P = 0.900, OR = 1, ns.) nor for the T Allele of the FVII (-401)G --> T polymorphism (0.09 vs. 0.12; P = 0.480, OR = 1.38, ns.). The analysis of haplotype distributions did not reveal significant differences. Our results do not support the hypothesis that the investigated polymorphisms in the FVII gene are significantly associated with the risk for PICH.
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Affiliation(s)
- S Greisenegger
- Department of Neurology, Medical University of Vienna, Vienna, Austria
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18
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Jackson AA, Cronin KR, Zachariah R, Carew JA. CCAAT/enhancer-binding protein-beta participates in insulin-responsive expression of the factor VII gene. J Biol Chem 2007; 282:31156-65. [PMID: 17675296 DOI: 10.1074/jbc.m704694200] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Expression of the human coagulation factor VII (FVII) gene by hepatoma cells was modulated in concert with levels of glucose and insulin in the culture medium. In low glucose medium without insulin, amounts of both FVII mRNA and secreted FVII protein were coordinately increased; in the presence of glucose with insulin, both were decreased. Analysis of the FVII promoter showed that these effects could be reproduced in a reporter-gene system, and a small promoter element immediately upstream of the translation start site of the gene, which mediated these effects, was identified. Mutation of this element largely abrogated the glucose/insulin-responsive change in expression of the reporter gene. Several members of the CCAAT/enhancer-binding protein family were found to be capable of binding the identified sequence element but not the mutated element. The expression of a FVII minigene directed by a segment of the native FVII promoter responded to co-expressed activating and inhibiting forms of CCAAT/enhancer-binding protein beta.
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Affiliation(s)
- Audrey A Jackson
- Veterans Affairs Boston Healthcare System, West Roxbury, Massachusetts 02132, USA
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19
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Folsom AR, Cushman M, Heckbert SR, Ohira T, Rasmussen-Torvik L, Tsai MY. Factor VII coagulant activity, factor VII -670A/C and -402G/A polymorphisms, and risk of venous thromboembolism. J Thromb Haemost 2007; 5:1674-8. [PMID: 17663738 DOI: 10.1111/j.1538-7836.2007.02620.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Most epidemiological studies have found no association between levels of factor (F) VII:C and venous thromboembolism (VTE). Our Longitudinal Investigation of Thromboembolism Etiology (LITE) had, in contrast, reported an independent, increased risk of VTE after 7.8 years of follow-up for those with high baseline levels of FVII:C. OBJECTIVE To confirm whether FVII:C is associated with VTE after 12.6 years of follow-up and to examine whether two FVII gene polymorphisms (-670A/C and -402G/A) are related to VTE occurrence. METHODS In 19 091 LITE participants with no prior history of VTE or cancer, we measured FVII:C at baseline and identified 404 new VTEs. We also performed a nested case-control study to relate the polymorphisms to VTE (n = 490 without exclusion for cancer or prior VTE). RESULTS FVII:C was not independently associated with VTE occurrence after extended follow-up. Multivariable-adjusted rate ratios for VTE were 1.00, 1.00, 0.94, 1.00, and 1.38 (P-trend = 0.48) for the <25th, 25th-49th, 50th-74th, 75th-94th, and >or=95th percentiles of FVII:C, respectively. The -670C and -402A alleles were in high linkage disequilibrium, and both were associated with greater FVII:C levels. However, neither polymorphism was associated with VTE occurrence. CONCLUSION After extended follow-up, LITE offers little evidence that a greater FVII level is a risk factor for VTE.
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Affiliation(s)
- A R Folsom
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454-1015, USA.
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20
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Reiner AP, Carlson CS, Rieder MJ, Siscovick DS, Liu K, Chandler WL, Green D, Schwartz SM, Nickerson DA. Coagulation factor VII gene haplotypes, obesity-related traits, and cardiovascular risk in young women. J Thromb Haemost 2007; 5:42-9. [PMID: 17059418 DOI: 10.1111/j.1538-7836.2006.02279.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Associations between common F7 haplotypes, plasma factor VII (FVII) levels, and cardiovascular risk have recently been reported in population studies involving predominantly European men. METHODS We assessed associations between F7 haplotypes and cardiovascular risk in two US population-based studies: a case-control study of these alleles related to a decreased risk of arterial thrombotic outcomes such as myocardial infarction (MI) in young-to-middle-aged women (n = 671), and a cohort study of cardiovascular disease risk factors in young women (n = 1040). RESULTS The high-expression F7 haplotype B (containing the promoter variant allele -402A) was associated with an increased FVII level among controls, but not with MI risk. Women carrying a> or =1 copy of the low FVII expression level haplotype C (containing the -401T/-323del/-122C and Gln353 alleles) had decreased FVII levels and decreased risk of MI (odds ratio 0.54, 95% CI 0.31-0.93) compared with women homozygous for the most common haplotype A. Haplotype C was also associated with a decreased body mass index (BMI) and an increased high-density lipoprotein (HDL) cholesterol level, but not with MI risk after adjustment for these metabolic risk factors. In a cohort study composed of young US women, individuals homozygous for haplotype C had a lower BMI and lower systolic blood pressure, but the association between the F7 haplotype and HDL cholesterol was not confirmed. CONCLUSION Common FVII haplotypes may contribute to the risk of MI in women, but the mechanisms appear complex. The association between F7 haplotypes and MI susceptibility may be mediated in part through an influence on atherogenic risk factors such as BMI.
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Affiliation(s)
- A P Reiner
- Department of Epidemiology, University of Washington, Seattle, WA, USA.
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21
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Härtel C, König I, Köster S, Kattner E, Kuhls E, Küster H, Möller J, Müller D, Kribs A, Segerer H, Wieg C, Herting E, Göpel W. Genetic polymorphisms of hemostasis genes and primary outcome of very low birth weight infants. Pediatrics 2006; 118:683-9. [PMID: 16882823 DOI: 10.1542/peds.2005-2670] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Recent investigations have reported an influence of thrombophilic mutations and antithrombotic risk factors with development of intraventricular hemorrhage. It was our objective for this study to investigate the impact of genetic polymorphisms of hemostasis genes on the primary outcome measures of sepsis, bronchopulmonary dysplasia, intraventricular hemorrhage, and periventricular leukomalacia in a large cohort of very low birth weight infants. METHODS There were 586 very low birth weight infants enrolled prospectively in a multicenter trial between September 2003 and July 2005, and an additional 595 very low birth weight infants, who had been recruited in a previous prospective trial, were studied. DNA samples were taken by buccal swab, and genotypes of factor V Leiden mutation, prothrombin G20210A mutation, the factor VII-323 del/ins polymorphism, and the factor XIII-Val34Leu polymorphisms were determined by polymerase chain reaction and restriction enzyme digestion. RESULTS In contrast to data published previously, the frequency of intraventricular hemorrhage or periventricular leukomalacia was not significantly influenced by any of the genetic variants tested. Carriers of the factor XIII-Val34Leu polymorphism, however, had a higher sepsis rate and a longer period of hospital care compared with noncarriers. The factor VII-323 del/ins polymorphism was found to be a potential protective factor against bronchopulmonary dysplasia. CONCLUSIONS We could not confirm previously reported associations of hemostasis gene variants and development of intraventricular hemorrhage in very low birth weight infants. To better understand gene-disease associations in very low birth weight infants, the prospective development of large-scale cohorts with well-defined phenotypes and corresponding DNA samples is essential.
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MESH Headings
- 3' Untranslated Regions/genetics
- Activated Protein C Resistance/complications
- Activated Protein C Resistance/epidemiology
- Activated Protein C Resistance/genetics
- Bronchopulmonary Dysplasia/epidemiology
- Bronchopulmonary Dysplasia/etiology
- Bronchopulmonary Dysplasia/prevention & control
- Catheterization/statistics & numerical data
- Cerebral Hemorrhage/epidemiology
- Cerebral Hemorrhage/etiology
- Cohort Studies
- Factor V/genetics
- Factor VII/genetics
- Factor VII Deficiency/complications
- Factor VII Deficiency/epidemiology
- Factor VII Deficiency/genetics
- Factor XIII/genetics
- Factor XIII Deficiency/complications
- Factor XIII Deficiency/epidemiology
- Factor XIII Deficiency/genetics
- Genotype
- Germany/epidemiology
- Hemorrhagic Disorders/complications
- Hemorrhagic Disorders/genetics
- Hemostasis/genetics
- Humans
- Infant, Newborn
- Infant, Premature
- Infant, Premature, Diseases/epidemiology
- Infant, Premature, Diseases/etiology
- Infant, Premature, Diseases/genetics
- Infant, Very Low Birth Weight
- Leukomalacia, Periventricular/epidemiology
- Leukomalacia, Periventricular/etiology
- Polymorphism, Single Nucleotide
- Prospective Studies
- Prothrombin/genetics
- Respiration, Artificial/statistics & numerical data
- Sepsis/epidemiology
- Sepsis/etiology
- Sequence Deletion
- Surgical Procedures, Operative/statistics & numerical data
- Thrombophilia/complications
- Thrombophilia/congenital
- Thrombophilia/genetics
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Affiliation(s)
- Christoph Härtel
- Department of Pediatrics, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
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22
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Funk M, Endler G, Lalouschek W, Hsieh K, Schillinger M, Lang W, Mannhalter C. Factor VII Gene Haplotypes and Risk of Ischemic Stroke. Clin Chem 2006; 52:1190-2. [PMID: 16556685 DOI: 10.1373/clinchem.2005.059360] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Background: Coagulation factor VII (FVII) plays an important role in the activation of blood coagulation and clot formation. Recent studies have provided evidence for an association between common polymorphic markers in the FVII gene and plasma FVII concentrations. The 353R>Q sequence variation, and 3 common sequence variations in the promoter of the FVII gene—the 10-bp insertion/deletion at position −323 and the −401G>T and −402G>A sequence variations—are well-known determinants of circulating FVII concentrations.
Methods: To clarify the role of these sequence variations in the pathogenesis of ischemic stroke, we performed a case–control study with 242 patients with ischemic stroke before the age of 60 years and 239 healthy controls.
Results: The −323 insertion/deletion and the 353R>Q and −401G>T sequence variations were in strong linkage disequilibrium, and the resulting haplotypes occurred with equal frequencies in patients and controls. The variant form of FVII (−402G>A) occurred only in combination with the common (wild-type) sequences at all other loci. This haplotype was more frequent in patients than in healthy controls (28% vs 22%). The difference in the prevalence of carriers of this haplotype among patients and controls was statistically significant (P = 0.03; odds ratio = 1.6; 95% confidence interval, 1.1–2.6).
Conclusion: According to our results, the FVII −402A allele seems to increase the risk of early ischemic cerebrovascular events, whereas the 353R>Q, G−401T, and −323ins/del sequence variations, which are in close linkage disequilibrium, apparently do not influence the risk of stroke.
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Affiliation(s)
- Marion Funk
- Institute of Medical and Chemical Laboratory Diagnostics, University Clinic of Neurology, University of Vienna, Vienna, Austria
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23
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Abstract
Atherothrombotic disease arises secondary to a complex gene-environment interaction. In the initial stages, the condition is clinically silent but with more advanced disease, an occlusive thrombus is formed resulting in the classical clinical manifestations. Both environmental factors and genetic variations in elements of the clotting cascade influence thrombosis risk by inducing quantitative and qualitative changes in the mature protein, which may affect the final structure of the clot and determine its resistance to lysis. Understanding the fine details of gene-environment interactions in relation to thrombus formation will help to shed more light on disease pathogenesis. Consequently, this will allow the development of more efficacious treatment strategies and will also help to identify subjects at risk, thereby enabling the introduction of early preventative measures.
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Affiliation(s)
- Ramzi Ajjan
- Academic Unit of Molecular Vascular Medicine, Leeds Institute of Genetics Health and Therapeutics, Faculty of Medicine and Health, The LIGHT Laboratories, Clarendon Way, University of Leeds, Leeds LS2 9JT, UK.
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24
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Dabek J, Kulach A, Gasior Z. Genetic background of acute coronary syndromes. Eur J Intern Med 2006; 17:157-62. [PMID: 16618446 DOI: 10.1016/j.ejim.2005.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2005] [Revised: 09/22/2005] [Accepted: 11/17/2005] [Indexed: 11/21/2022]
Abstract
Acute coronary syndromes (ACS) are one of the major causes of mortality nowadays. Although much is known about factors involved in atherogenesis and acute coronary events, there are still many cases in which a lack of classical risk factors, together with family history, suggests the presence of an unrevealed genetic predisposition and molecular mechanisms. This paper reviews genetic predisposition to ACS. It also indicates which genes are linked to the processes of destabilization and rupture of atherosclerotic plaque and thus may be potential targets for more effective prophylaxis and treatment.
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Affiliation(s)
- Jozefa Dabek
- Department of Cardiology, Medical University of Silesia, Ziolowa 47, PL-40-635 Katowice, Poland
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25
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Lam PPL, Leung YM, Sheu L, Ellis J, Tsushima RG, Osborne LR, Gaisano HY. Transgenic mouse overexpressing syntaxin-1A as a diabetes model. Diabetes 2005; 54:2744-54. [PMID: 16123365 DOI: 10.2337/diabetes.54.9.2744] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Soluble N-ethylmaleimide-sensitive factor (NSF) attachment protein receptor (SNARE) protein syntaxin-1A (STX-1A) plays a role not only in exocytosis, but also binds and regulates Ca(2+) and K(+) (voltage-gated K(+) and ATP-sensitive K(+) channels) to influence the sequence of events leading to secretion. Islet levels of STX-1A and cognate SNARE proteins are reduced in type 2 diabetic rodents, suggesting their role in dysregulated insulin secretion contributing to the abnormal glucose homeostasis. We investigated the specific role of STX-1A in pancreatic beta-cells by generating transgenic mice, which express a moderately increased level ( approximately 30% higher) of STX-1A in pancreatic islets (hereafter called STX-1A mice). The STX-1A mice displayed fasting hyperglycemia and a more sustained elevation of plasma glucose levels after an intraperitoneal glucose tolerance test, with correspondingly reduced plasma insulin levels. Surprisingly, beta-cells from the STX-1A male mice also exhibited abnormal insulin tolerance. To unequivocally determine the beta-cell secretory defects, we used single-cell analyses of exocytosis by patch clamp membrane capacitance measurements and ion channel recordings. Depolarization-evoked membrane capacitance increases were reduced in the STX-1A mouse islet beta-cells. The STX-1A mouse also exhibited reduced currents through the Ca(2+) channels but little change in the voltage-gated K(+) channel or ATP-sensitive K(+) channel. These results suggest that fluctuation of islet STX-1A levels in diabetes could influence the pathological and differential regulation of beta-cell ion channels and the exocytotic machinery, collectively contributing to the impaired insulin secretion.
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Affiliation(s)
- Patrick P L Lam
- University of Toronto, Room 7226, Medical Science Building, 1 King's College Circle, Toronto, Ontario, Canada
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