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Ajoolabady A, Shademan B, Avci CB, Nikanfar M, Nourazarian A, Laghousi D. Diagnostic Potential of Autophagy-5 Protein, Apolipoprotein B-48, and Oxidative Stress Markers in Serum of Patients with Early-Stage Ischemic Stroke. World Neurosurg 2022; 167:e656-e663. [PMID: 36030010 DOI: 10.1016/j.wneu.2022.08.063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 08/13/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Strokes are among the leading causes of death worldwide and have different characteristics. Different physiopathological mechanisms characterize the numerous subtypes of ischemic stroke (IS). In this study, we investigated the relationship between serum levels of autophagy-5 protein, apolipoprotein B-48, and oxidative stress markers in patients with ischemic stroke. METHODS For this study, 100 participants were recruited, of which 50 were patients with IS and 50 were healthy individuals. We conducted a case-control study at Imam Reza Hospital from March 2019 to April 2020. Serum levels of ATG5, apo B-48, and oxidative stress markers were determined in both groups. Our Receiver Operating Characteristic Analysis evaluated the additional diagnostic value of these factors in both groups. RESULTS Diabetes, smoking, age, sex, alcohol consumption, weight, and height did not differ significantly between the 2 groups (P > 0.05). However, the 2 groups had significant differences in hypertension and body mass index (P < 0.05). Fifty-four percent (27 patients) of patients with IS had an ischemic stroke in large vessels, while 46% (23 patients) had an ischemic stroke in small vessels. Serum levels of ATG5, apo B-48, and oxidative stress markers were higher in the case group than in the control group (P < 0.0001). CONCLUSIONS In patients with IS, serum levels of ATG5, apoB-48, malonaldehyde, total oxidative stress, and total antioxidant capacity can be used as novel biomarkers to predict or treat the disease.
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Affiliation(s)
- Amir Ajoolabady
- Neurosciences Research Center (NSRC), Tabriz University of Medical Sciences, Tabriz, Iran; Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Behrouz Shademan
- Department of Medical Biology, Faculty of Medicine, EGE University, Izmir, Turkey
| | - Cigir Biray Avci
- Department of Medical Biology, Faculty of Medicine, EGE University, Izmir, Turkey
| | - Masoud Nikanfar
- Department of Neurology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Nourazarian
- Neurosciences Research Center (NSRC), Tabriz University of Medical Sciences, Tabriz, Iran; Department of Basic Medical Sciences, Khoy University of Medical Sciences, Khoy, Iran.
| | - Delara Laghousi
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Apolipoprotein E ε4 Polymorphism as a Risk Factor for Ischemic Stroke: A Systematic Review and Meta-Analysis. DISEASE MARKERS 2022; 2022:1407183. [PMID: 35154509 PMCID: PMC8831053 DOI: 10.1155/2022/1407183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/21/2021] [Accepted: 01/05/2022] [Indexed: 11/18/2022]
Abstract
Introduction Rising studies indicate that the apolipoprotein E (APOE) gene is related to the susceptibility of ischemic stroke (IS). However, certain consensus is limited by the lack of a large sample size of researches. This meta-analysis was performed to explore the potential association between the APOE gene and IS. Methods To identify relevant case control studies in English publications by October 2020, we searched PubMed, Embase, Web of Science, and the Cochrane Library. Pooled odds ratios (ORs) with fixed- or random-effect models and corresponding 95% confidence intervals (CIs) were calculated to analyze potential associations. Results A total of 55 researches from 32 countries containing 12207 IS cases and 27742 controls were included. The association between APOE gene ε4 mutation and IS was confirmed (ε4 vs. ε3 allele: pooled OR = 1.374, 95% CI, 1.214-1.556; ε2/ε4 vs. ε3/ε3: pooled OR = 1.233, 95% CI, 1.056-1.440; ε3/ε4 vs. ε3/ε3: pooled OR = 1.340, 95% CI, 1.165-1.542; ε4/ε4 vs. ε3/ε3: pooled OR = 1.833, 95% CI, 1.542-2.179; and APOE ε4 carriers vs. non-ε4 carriers: pooled OR = 1.377; 95% CI, 1.203-1.576). Interestingly, APOE ε4 mutation showed a dose-response correlation with IS risk (ε4/ε4 vs. ε2/ε4: pooled OR = 1.625; 95% CI, 1.281-2.060; ε4/ε4 vs. ε3/ε4: pooled OR = 1.301; 95% CI, 1.077-1.571). Similar conclusions were drawn in the small artery disease (SAD) subtype, but not in large artery atherosclerosis (LAA) or in cardioaortic embolism (CE), by subgroup analysis. Conclusions These observations reveal that specific APOE ε4 mutation was significantly associated with the risk of IS in a dose-dependent manner, while APOE ε4 mutation was related to SAD subtype onset without a cumulative effect.
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Javadifar A, Ghezeldasht SA, Rahimi H, Valizadeh N, Borojerdi ZR, Vahidi Z, Rezaee SR. Possible deterioration of Apolipoproteins expression by HTLV-1 infection in favor of infected leukemic cells in adult T-cell leukemia/lymphoma (ATLL). GENE REPORTS 2022. [DOI: 10.1016/j.genrep.2022.101531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kumar P, Swarnkar P, Misra S, Nath M. Lipoprotein (a) level as a risk factor for stroke and its subtype: A systematic review and meta-analysis. Sci Rep 2021; 11:15660. [PMID: 34341405 PMCID: PMC8329213 DOI: 10.1038/s41598-021-95141-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 07/13/2021] [Indexed: 01/11/2023] Open
Abstract
The role of lipoprotein-A [Lp (a)] as a risk factor for stroke is less well documented than for coronary heart disease. Hence, we conducted a systematic review and meta-analysis for the published observational studies in order to investigate the association of Lp (a) levels with the risk of stroke and its subtypes. In our meta-analysis, 41 studies involving 7874 ischemic stroke (IS) patients and 32,138 controls; 13 studies for the IS subtypes based on TOAST classification and 7 studies with 871 Intracerebral hemorrhage (ICH) cases and 2865 control subjects were included. A significant association between increased levels of Lp (a) and risk of IS as compared to control subjects was observed (standardized mean difference (SMD) 0.76; 95% confidence interval (CIs) 0.53-0.99). Lp (a) levels were also found to be significantly associated with the risk of large artery atherosclerosis (LAA) subtype of IS (SMD 0.68; 95% CI 0.01-1.34) as well as significantly associated with the risk of ICH (SMD 0.65; 95% CI 0.13-1.17) as compared to controls. Increased Lp (a) levels could be considered as a predictive marker for identifying individuals who are at risk of developing IS, LAA and ICH.
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Affiliation(s)
- Pradeep Kumar
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Priyanka Swarnkar
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Shubham Misra
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Manabesh Nath
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, 110029, India
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Ganaie HA, Biswas A, Bhattacharya AP, Pal S, Ray J, Das SK. Association of APOE Gene Polymorphism with Stroke Patients from Rural Eastern India. Ann Indian Acad Neurol 2020; 23:504-509. [PMID: 33223668 PMCID: PMC7657292 DOI: 10.4103/aian.aian_45_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 02/03/2019] [Accepted: 02/16/2019] [Indexed: 11/25/2022] Open
Abstract
CONTEXT Studies from the different ethnic regions of the world have reported variable results on association of APOE gene polymorphism in stroke. AIM The aim of this study is to find out the possible association of APOE polymorphism in stroke patients in ethnic Bengali population. SETTINGS AND DESIGN A prospective case-control study was undertaken in the Department of Neurology, Burdwan Medical College, Burdwan, West Bengal, India, over a period of 3 years. METHODS We collected 10 ml venous blood samples from 148 clinically and radiologically diagnosed acute stroke patients (80 of ischemic stroke and 68 of intracerebral hemorrhage) and consecutive 108 ethnic age- and sex-matched controls, in ethylenediaminetetraacetic acid vials after informed written consent. Genomic DNA was prepared at S.N. Pradhan Centre of Neurosciences, University of Calcutta, Kolkata, India. Exotic single-nucleotide polymorphisms (rs429358, rs 7412) were analyzed by polymerase chain reaction-restriction fragment length polymorphism for genotype of APOE. RESULTS The frequencies of different APOE allele among 80 ischemic stroke patients were 5.6% (n = 9) for E2, 75.68% (n = 121) for E3, and 18.7% (n = 30) for E4. The E3 allele is significantly over-represented (P = 0.004) in controls compared to the patients (88% in controls vs 75.6% ischemic stroke patients and 80% hemorrhagic patients). A significantly high frequency of APOE4 allele was observed in ischemic (18.7%) and hemorrhagic patients (11%) compared to controls (8%). The E4 allele plays a major risk for developing ischemic stroke [odds ratio (OR) = 2.744; 95% confidence interval (CI): 1.43-5.10] and E3 plays a protective role for hemorrhagic stroke (OR = 0.53; 95% CI: 0.29-0.96), while E4 allele plays a nonsignificant (P = 0.31) increase in trend in hemorrhage stroke (OR = 1.4). CONCLUSIONS There is significant association of APOE gene polymorphism in stroke patients of ethnic Bengali population. The E4 allele increases significant risk for development of ischemic strokes, and it also plays nonsignificant increase in trend in hemorrhagic strokes.
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Affiliation(s)
- Hilal Ahmad Ganaie
- Department of Neurology, Burdwan Medical College, Burdwan, West Bengal, India
| | - Arindam Biswas
- S.N. Pradhan Centre for Neurosciences, University of Calcutta, Kolkata, West Bengal, India
| | | | - Sandip Pal
- Department of Neurology, Calcutta Medical College, Kolkata, West Bengal, India
| | - Jharna Ray
- S.N. Pradhan Centre for Neurosciences, University of Calcutta, Kolkata, West Bengal, India
| | - Shymal Kumar Das
- Department of Neurology, Burdwan Medical College, Burdwan, West Bengal, India
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Bukar A, Tosan E, Obi O, Akinola A, Waziri G, Thomas M, Kevin A, Fredrick C, Osakue O, Erifeta G, Osadolor H, Olaniyan M. The inconspicuous health benefit of blood donation. GLOBAL JOURNAL OF TRANSFUSION MEDICINE 2020. [DOI: 10.4103/gjtm.gjtm_14_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Raz L, Bhaskar K, Weaver J, Marini S, Zhang Q, Thompson JF, Espinoza C, Iqbal S, Maphis NM, Weston L, Sillerud LO, Caprihan A, Pesko JC, Erhardt EB, Rosenberg GA. Hypoxia promotes tau hyperphosphorylation with associated neuropathology in vascular dysfunction. Neurobiol Dis 2018; 126:124-136. [PMID: 30010004 DOI: 10.1016/j.nbd.2018.07.009] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 06/11/2018] [Accepted: 07/10/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Hypertension-induced microvascular brain injury is a major vascular contributor to cognitive impairment and dementia. We hypothesized that chronic hypoxia promotes the hyperphosphorylation of tau and cell death in an accelerated spontaneously hypertensive stroke prone rat model of vascular cognitive impairment. METHODS Hypertensive male rats (n = 13) were fed a high salt, low protein Japanese permissive diet and were compared to Wistar Kyoto control rats (n = 5). RESULTS Using electron paramagnetic resonance oximetry to measure in vivo tissue oxygen levels and magnetic resonance imaging to assess structural brain damage, we found compromised gray (dorsolateral cortex: p = .018) and white matter (corpus callosum: p = .016; external capsule: p = .049) structural integrity, reduced cerebral blood flow (dorsolateral cortex: p = .005; hippocampus: p < .001; corpus callosum: p = .001; external capsule: p < .001) and a significant drop in cortical oxygen levels (p < .05). Consistently, we found reduced oxygen carrying neuronal neuroglobin (p = .008), suggestive of chronic cerebral hypoperfusion in high salt-fed rats. We also observed a corresponding increase in free radicals (NADPH oxidase: p = .013), p-Tau (pThr231) in dorsolateral cortex (p = .011) and hippocampus (p = .003), active interleukin-1β (p < .001) and neurodegeneration (dorsolateral cortex: p = .043, hippocampus: p = .044). Human patients with subcortical ischemic vascular disease, a type of vascular dementia (n = 38; mean age = 68; male/female ratio = 23/15) showed reduced hippocampal volumes and cortical shrinking (p < .05) consistent with the neuronal cell death observed in our hypertensive rat model as compared to healthy controls (n = 47; mean age = 63; male/female ratio = 18/29). CONCLUSIONS Our data support an association between hypertension-induced vascular dysfunction and the sporadic occurrence of phosphorylated tau and cell death in the rat model, correlating with patient brain atrophy, which is relevant to vascular disease.
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Affiliation(s)
- Limor Raz
- Department of Neurology, 1 University of New Mexico Health Sciences Center, Albuquerque, NM 87131, United States.
| | - Kiran Bhaskar
- Department of Neurology, 1 University of New Mexico Health Sciences Center, Albuquerque, NM 87131, United States; Department of Molecular Genetics and Microbiology, 1 University of New Mexico Health Sciences Center, Albuquerque, NM 87131, United States.
| | - John Weaver
- BRaIN Imaging Center, 1 University of New Mexico Health Sciences Center, Albuquerque, NM 87131, United States.
| | - Sandro Marini
- Center for Genomic Medicine, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA 02114, United States.
| | - Quanguang Zhang
- Department of Neuroscience and Regenerative Medicine, Department of Neurology, Augusta University, 1120 15th Street, Augusta, GA 30912, United States.
| | - Jeffery F Thompson
- Department of Neurology, 1 University of New Mexico Health Sciences Center, Albuquerque, NM 87131, United States.
| | - Candice Espinoza
- Department of Neurology, 1 University of New Mexico Health Sciences Center, Albuquerque, NM 87131, United States.
| | - Sulaiman Iqbal
- Department of Neurology, 1 University of New Mexico Health Sciences Center, Albuquerque, NM 87131, United States.
| | - Nicole M Maphis
- Department of Molecular Genetics and Microbiology, 1 University of New Mexico Health Sciences Center, Albuquerque, NM 87131, United States.
| | - Lea Weston
- Department of Molecular Genetics and Microbiology, 1 University of New Mexico Health Sciences Center, Albuquerque, NM 87131, United States.
| | - Laurel O Sillerud
- Department of Neurology, 1 University of New Mexico Health Sciences Center, Albuquerque, NM 87131, United States; MIND Research Network, 1 University of New Mexico Health Sciences Center, Albuquerque, NM 87131, United States.
| | - Arvind Caprihan
- MIND Research Network, 1 University of New Mexico Health Sciences Center, Albuquerque, NM 87131, United States.
| | - John C Pesko
- Department of Mathematics and Statistics, 1 University of New Mexico Health Sciences Center, Albuquerque, NM 87131, United States
| | - Erik B Erhardt
- Department of Mathematics and Statistics, 1 University of New Mexico Health Sciences Center, Albuquerque, NM 87131, United States.
| | - Gary A Rosenberg
- Department of Neurology, 1 University of New Mexico Health Sciences Center, Albuquerque, NM 87131, United States.
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Teijido Ó, Carril JC, Cacabelos R. Population-based Study of Risk Polymorphisms Associated with Vascular Disorders and Dementia. Curr Genomics 2017; 18:430-441. [PMID: 29081698 PMCID: PMC5635648 DOI: 10.2174/1389202918666170608093833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 04/12/2016] [Accepted: 04/29/2016] [Indexed: 12/27/2022] Open
Abstract
Introduction: Cardiovascular and neurodegenerative disorders are among the major causes of mortality in the developed countries. Population studies evaluate the genetic risk, i.e. the probability of an individual carrying a specific disease-associated polymorphism. Identification of risk polymorphisms is essential for an accurate diagnosis or prognosis of a number of pathologies. Aims: The aim of this study was to characterize the influence of risk polymorphisms associated with lipid metabolism, hypertension, thrombosis, and dementia, in a large population of Spanish individuals affected by a variety of brain and vascular disorders as well as metabolic syndrome. Material & Method: We performed a cross-sectional study on 4415 individuals from a widespread regional distribution in Spain (48.15% males and 51.85% females), with mental, neurodegenerative, cerebrovascular, and metabolic disorders. We evaluated polymorphisms in 20 genes involved in obesity, vascular and cardiovascular risk, and dementia in our population and compared it with representative Spanish and European populations. Risk polymorphisms in ACE, AGT(235), IL6(573), PSEN1, and APOE (specially the APOE-ε4 allele) are representative of our population as compared to the reference data of Spanish and European individuals. Conclusion: The significantly higher distribution of risk polymorphisms in PSEN1 and APOE-ε4 is characteristic of a representative number of patients with Alzheimer’s disease; whereas polymorphisms in ACE, AGT(235), and IL6(573), are most probably related with the high number of patients with metabolic syndrome or cerebrovascular damage.
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Affiliation(s)
- Óscar Teijido
- EuroEspes Biomedical Research Center, Institute of Medical Science and Genomic Medicine, 15165-Bergondo, Corunna, Spain.,Genomic Medicine, Camilo José Cela University, 28692-Madrid, Spain
| | - Juan Carlos Carril
- EuroEspes Biomedical Research Center, Institute of Medical Science and Genomic Medicine, 15165-Bergondo, Corunna, Spain.,Genomic Medicine, Camilo José Cela University, 28692-Madrid, Spain
| | - Ramón Cacabelos
- EuroEspes Biomedical Research Center, Institute of Medical Science and Genomic Medicine, 15165-Bergondo, Corunna, Spain.,Genomic Medicine, Camilo José Cela University, 28692-Madrid, Spain
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Carril JC, Cacabelos R. Genetic Risk Factors in Cerebrovascular Disorders and Cognitive Deterioration. Curr Genomics 2017; 18:416-429. [PMID: 29081697 PMCID: PMC5635647 DOI: 10.2174/1389202918666170426165226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 04/12/2016] [Accepted: 04/29/2016] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The study of variations in genes involved in the different events that trigger the atherogenic process, such as lipid metabolism (modification of LDL-cholesterol), endothelial function and hypertension, immune response (recruitment of macrophages and foam cell formation) and stability of atherosclerotic plaques (thrombosis), established the risk for suffering a vascular disorder. A total of 2455 cases over 50 years of age were genotyped for a panel of 19 SNPs in 15 genes encoding for proteins involved in the atherogenic process. This study shows the relevance of polymorphisms in APOB (odds ratio (OR), 1.17; 95% confidence interval (95% CI), 0.74-1.85), APOC3 (OR, 1.33; 95% CI, 0.82-2.17) and APOE (OR, 1.75; 95% CI, 1.09-2.80), as genetic risk markers for hypercholesterolemia; polymorphisms in ACE (OR, 1.68; 95% CI, 0.32-8.77) and AGT (OR, 1.74; 95% CI, 0.97-3.14) for hypertension; and in APOE*3/*4 (OR, 2.06; 95% CI, 1.70-2.51) and APOE*4/*4 (OR, 3.08; 95% CI, 1.85-5.12) as unambiguous markers of dementia. RESULT Our results also showed the transversal importance of proinflammatory cytokines in different stages of atherogenesis, with special relevance of IL6 (OR, 1.39; 95% CI, 0.56-3.49) and TNF (OR, 1.40; 95% CI, 0.92-2.15) related to hypercholesterolemia and hypertension. The set of markers involved in this genetic risk panel makes it a powerful tool in the management of patients with different vascular disorders.
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Affiliation(s)
- Juan C. Carril
- EuroEspes Biomedical Research Center, Institute of Medical Science and Genomic Medicine. 15165-Bergondo, Corunna, Spain; Genomic Medicine. Camilo José Cela University 28692-Madrid, Spain
| | - Ramón Cacabelos
- EuroEspes Biomedical Research Center, Institute of Medical Science and Genomic Medicine. 15165-Bergondo, Corunna, Spain; Genomic Medicine. Camilo José Cela University 28692-Madrid, Spain
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Tácito LHB, Yamada LN, de Souza Pinhel MA, Yugar-Toledo JC, Souza DRS. Influence of Apolipoprotein E on the Lipid Profile and Postprandial Triglyceride Levels in Brazilian Postmenopausal Women With Artery Disease. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2017; 11:1179546817731110. [PMID: 28974920 PMCID: PMC5613840 DOI: 10.1177/1179546817731110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 08/22/2017] [Indexed: 11/16/2022]
Abstract
This study confirms the association of risk factors for coronary artery disease (CAD) and the apoE polymorphisms, specifically related to the APOE*4 allele, with coronary disease in postmenopausal women. Significantly altered values of the lipid profile were found in patients when compared with controls, independent of the presence of the APOE*4 allele. However, the controls showed higher high-density lipoprotein cholesterol (HDL-C) levels and reduced triglyceride (TG) levels, differing significantly from patients. In this case, the study of subgroups, considering the APOE*3/3 and APOE*3/4 genotypes, suggests that the APOE*4 allele is not implicated in the variations of the lipid profile of patients and determined an increase in the production levels of HDL-C and a reduction in TG highly benefiting the control group compared with APOE*3/3 genotype. The metabolic kinetics of TG, although with the same pattern between groups, and the presence of the APOE*4 allele are suggested to be associated with accelerated clearance compared with APOE*3 allele in non-CAD group.
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Affiliation(s)
- Lúcia Helena Bonalume Tácito
- Endocrinology Division, Internal Medicine Department, State Medical School of São José Rio Preto (FAMERP), São José do Rio Preto, Brazil
| | - Lilian Nakachima Yamada
- Molecular Biology and Biochemistry Department, State Medical School of São José Rio Preto (FAMERP), São José do Rio Preto, Brazil
| | - Marcela Augusta de Souza Pinhel
- Molecular Biology and Biochemistry Department, State Medical School of São José Rio Preto (FAMERP), São José do Rio Preto, Brazil
| | - Juan Carlos Yugar-Toledo
- Internal Medicine Department, State Medical School of São José Rio Preto (FAMERP), São José do Rio Preto, Brazil
| | - Dorotéia Rossi Silva Souza
- Molecular Biology and Biochemistry Department, State Medical School of São José Rio Preto (FAMERP), São José do Rio Preto, Brazil
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Masemola ML, Alberts M, Urdal P. Apolipoprotein E genotypes and their relation to lipid levels in a rural South African population 1. Scand J Public Health 2016; 69:60-5. [PMID: 17676504 DOI: 10.1080/14034950701355635] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Aims: Genetic variation at the apolipoprotein E (apoE) locus is an important determinant of plasma lipids. The aim of the present study was to evaluate the association between apolipoprotein E genotype and plasma lipid levels among a rural black population in South Africa. Methods: Lipid levels and apoE genotypes were studied in 505 volunteer subjects (363 women, 142 men) resident in the Dikgale demographic surveillance site. Results: Allele frequencies were found to be 0.190 for ε2, 0.518 for ε3, and 0.293 for ε4, indicating a relatively low frequency of the ε3 allele and a high frequency of the ε4 allele. To determine the effect of apoE polymorphism on lipid levels three groups were formed: namely ε2-, ε3-, and ε4-expressing groups. A significant effect of the apoE genotype on total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)/Total cholesterol (TC) ratio, and triglycerides was observed. LDL-C was significantly lower and the HDL-C/TC ratio was significantly higher in the ε2 group compared with the ε3 and ε4 groups. Triglyceride levels were significantly higher in the ε2 group than in the ε3 group. Conclusions: With the unfavourable apoE allele distribution, and the lifestyle changes taking place in rural South African populations, preventive strategies need to be developed to limit a potential epidemic of cardiovascular disease in the black population of South Africa.
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Giassakis G, Veletza S, Papanas N, Heliopoulos I, Piperidou H. Apolipoprotein E and First-ever Ischaemic Stroke in Greek Hospitalized Patients. J Int Med Res 2016; 35:127-33. [PMID: 17408064 DOI: 10.1177/147323000703500114] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The association between apolipoprotein E (ApoE) polymorphism and stroke is still controversial. This study investigated the potential association between ApoE genotypes and stroke subtypes, and risk factors for ischaemic stroke in Greek patients hospitalized with their first-ever ischaemic stroke. One hundred patients (70 men and 30 women; mean age ± SD 60.7 ± 9.8 years) were included in the study. The control group comprised 96 age-and sex-matched healthy volunteers. Cerebral infarction was classified as atherothrombotic, cardio-embolic or lacunar small-vessel stroke. The three common ApoE alleles (E2, E3 and E4) were determined using the seminested polymerase chain reaction. No significant difference in the ApoE alleles was found between patients and controls. Similarly, there was no significant association between ApoE alleles and stroke subtypes, common risk factors for ischaemic stroke and neck vessel stenosis. Although the sample size was small, these results do not support a role for ApoE polymorphism in the pathogenesis of ischaemic stroke.
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Affiliation(s)
- G Giassakis
- Department of Neurology, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece.
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Zhan Y, Yang YT, You HM, Cao D, Liu CY, Zhou CJ, Wang ZY, Bai SJ, Mu J, Wu B, Zhan QL, Xie P. Plasma-based proteomics reveals lipid metabolic and immunoregulatory dysregulation in post-stroke depression. Eur Psychiatry 2014; 29:307-15. [PMID: 24853294 DOI: 10.1016/j.eurpsy.2014.03.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Revised: 03/23/2014] [Accepted: 03/26/2014] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Post-stroke depression (PSD) is the most common psychiatric complication facing stroke survivors and has been associated with increased distress, physical disability, poor rehabilitation, and suicidal ideation. However, the pathophysiological mechanisms underlying PSD remain unknown, and no objective laboratory-based test is available to aid PSD diagnosis or monitor progression. METHODS Here, an isobaric tags for relative and absolute quantitation (iTRAQ)-based quantitative proteomic approach was performed to identify differentially expressed proteins in plasma samples obtained from PSD, stroke, and healthy control subjects. RESULTS The significantly differentiated proteins were primarily involved in lipid metabolism and immunoregulation. Six proteins associated with these processes--apolipoprotein A-IV (ApoA-IV), apolipoprotein C-II (ApoC-II), C-reactive protein (CRP), gelsolin, haptoglobin, and leucine-rich alpha-2-glycoprotein (LRG)--were selected for Western blotting validation. ApoA-IV expression was significantly upregulated in PSD as compared to stroke subjects. ApoC-II, LRG, and CRP expression were significantly downregulated in both PSD and HC subjects relative to stroke subjects. Gelsolin and haptoglobin expression were significantly dysregulated across all three groups with the following expression profiles: gelsolin, healthy control>PSD>stroke subjects; haptoglobin, stroke>PSD>healthy control. CONCLUSIONS Early perturbation of lipid metabolism and immunoregulation may be involved in the pathophysiology of PSD. The combination of increased gelsolin levels accompanied by decreased haptoglobin levels shows promise as a plasma-based diagnostic biomarker panel for detecting increased PSD risk in post-stroke patients.
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Affiliation(s)
- Y Zhan
- Chongqing Key Laboratory of Neurobiology, Chongqing, China; Institute of Neuroscience, Chongqing Medical University, Chongqing, China
| | - Y-T Yang
- Department of Neurology, The First Affiliated Hospital at Chongqing Medical University, 1, Yixue Road, Yuzhong District, Chongqing, 400016, China; Chongqing Key Laboratory of Neurobiology, Chongqing, China; Institute of Neuroscience, Chongqing Medical University, Chongqing, China
| | - H-M You
- Chongqing Key Laboratory of Neurobiology, Chongqing, China; Institute of Neuroscience, Chongqing Medical University, Chongqing, China
| | - D Cao
- Department of Neurology, The First Affiliated Hospital at Chongqing Medical University, 1, Yixue Road, Yuzhong District, Chongqing, 400016, China; Chongqing Key Laboratory of Neurobiology, Chongqing, China; Institute of Neuroscience, Chongqing Medical University, Chongqing, China
| | - C-Y Liu
- Chongqing Key Laboratory of Neurobiology, Chongqing, China; Institute of Neuroscience, Chongqing Medical University, Chongqing, China
| | - C-J Zhou
- Department of Neurology, The First Affiliated Hospital at Chongqing Medical University, 1, Yixue Road, Yuzhong District, Chongqing, 400016, China; Chongqing Key Laboratory of Neurobiology, Chongqing, China; Institute of Neuroscience, Chongqing Medical University, Chongqing, China
| | - Z-Y Wang
- Chongqing Key Laboratory of Neurobiology, Chongqing, China; Institute of Neuroscience, Chongqing Medical University, Chongqing, China
| | - S-J Bai
- Chongqing Key Laboratory of Neurobiology, Chongqing, China; Institute of Neuroscience, Chongqing Medical University, Chongqing, China
| | - J Mu
- Department of Neurology, The First Affiliated Hospital at Chongqing Medical University, 1, Yixue Road, Yuzhong District, Chongqing, 400016, China; Chongqing Key Laboratory of Neurobiology, Chongqing, China; Institute of Neuroscience, Chongqing Medical University, Chongqing, China
| | - B Wu
- Chongqing Key Laboratory of Neurobiology, Chongqing, China; Institute of Neuroscience, Chongqing Medical University, Chongqing, China
| | - Q-L Zhan
- Department of Neurology, The Fifth People's Hospital of Chongqing, Chongqing, China
| | - P Xie
- Department of Neurology, The First Affiliated Hospital at Chongqing Medical University, 1, Yixue Road, Yuzhong District, Chongqing, 400016, China; Chongqing Key Laboratory of Neurobiology, Chongqing, China; Institute of Neuroscience, Chongqing Medical University, Chongqing, China.
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Járomi L, Csöngei V, Polgár N, Rappai G, Szolnoki Z, Maász A, Horvatovich K, Sáfrány E, Sipeky C, Magyari L, Melegh B. Triglyceride level-influencing functional variants of the ANGPTL3, CILP2, and TRIB1 loci in ischemic stroke. Neuromolecular Med 2011; 13:179-86. [PMID: 21691831 DOI: 10.1007/s12017-011-8149-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Accepted: 06/02/2011] [Indexed: 12/19/2022]
Abstract
Stroke is a common multifactorial disease, and the third leading cause of death worldwide, which results in serious long-term mental and physical disability among survivors. The role of affected triglyceride metabolism in the development of ischemic stroke is under extensive investigations. Here, we examined three SNPs, rs12130333 located within the ANGPTL3 locus; rs16996148 residing at the CILP2 gene locus; and rs17321515 at the TRIB1 locus, which were originally reported in association with decreased triglyceride levels; therefore, we investigated their possible protective effect against the development of ischemic stroke. A total of 459 Caucasian stroke patients, stratified as large-vessel, small-vessel, and mixed stroke groups, and 168 control subjects were genotyped using PCR-RFLP methods. As a result, we could not detect any differences in triglyceride or total cholesterol levels in relation to any allelic variants of rs16996148, rs17321515, or rs12130333 SNPs. No correlation was found between the minor alleles rs16996148-T (P = 0.881), rs17321515-G (P = 0.070), or rs12130333-T allele (P = 0.757) and the risk for development of stroke. The data presented here suggest different scale of effect of triglyceride modifier alleles and also their variable susceptibility or protective nature.
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Affiliation(s)
- Luca Járomi
- Department of Medical Genetics, University of Pécs, Szigeti út 12, 7624, Pécs, Hungary
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15
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Verghese PB, Castellano JM, Holtzman DM. Apolipoprotein E in Alzheimer's disease and other neurological disorders. Lancet Neurol 2011; 10:241-52. [PMID: 21349439 DOI: 10.1016/s1474-4422(10)70325-2] [Citation(s) in RCA: 582] [Impact Index Per Article: 44.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Apolipoprotein E (APOE) is a 299-aminoacid protein encoded by the APOE gene. Three common polymorphisms in the APOE gene, ɛ2, ɛ3, and ɛ4, result in a single aminoacid change in the APOE protein. APOE ɛ2, ɛ3, and ɛ4 alleles strongly alter, in a dose-dependent manner, the likelihood of developing Alzheimer's disease and cerebral amyloid angiopathy. In particular, APOE ɛ4 is associated with increased risk for Alzheimer's disease whereas APOE ɛ2 is associated with decreased risk. The effects of APOE genotype on risk of these diseases are likely to be mediated by differential effects of APOE on amyloid-β accumulation in the brain and its vasculature. Response to treatment for Alzheimer's disease might differ according to APOE genotype. Because convincing evidence ties the APOE genotype to risk of Alzheimer's disease and cerebral amyloid angiopathy, APOE has been studied in other neurological diseases. APOE ɛ4 is associated with poor outcome after traumatic brain injury and brain haemorrhage, although the mechanisms underlying these associations are unclear. The possibility that APOE has a role in these and other neurological diseases has been of great interest, but convincing associations have not yet emerged.
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Affiliation(s)
- Philip B Verghese
- Department of Neurology, Hope Center for Neurological Disorders, and the Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St Louis, MO, USA
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16
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İlhan A, Alioǧlu Z, Adanir M, Özmenoǧlu M, Örem A. Association of levels of lipoprotein (a) and other lipoproteins with cerebrovascular disease in the Turkish population. Eur J Neurol 2011. [DOI: 10.1111/j.1468-1331.1996.tb00226.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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17
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Abstract
AIM Apolipoprotein E (APOE) has been regarded as the principal susceptibility gene linked with Alzheimer's disease, also suggesting a relationship with depression in the elderly population. Thus, the purpose was to investigate the association of APOE polymorphisms with depression in elderly adults. METHODS APOE polymorphisms were determined in a Mexican population-based sample older than 60 years (n=1566) using 5' exonuclease TaqMan genotyping assays. RESULTS The distribution of the APOE allele and genotype frequencies was similar in patients with and without depression. There was no significant association between the presence of alleles or genotypes and depression and anxiety (Short Anxiety Screening Test) considering several combinations of other features. However, patients with the APOE*4 allele presented more thinking and concentration impairment than those patients with the APOE*3 allele. CONCLUSION Genetic variation at the APOE gene may contribute to some depressive symptoms in late-onset depression, rather than being a specific risk factor.
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18
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Stankovic S, Majkic-Singh N. Genetic aspects of ischemic stroke: coagulation, homocysteine, and lipoprotein metabolism as potential risk factors. Crit Rev Clin Lab Sci 2010; 47:72-123. [DOI: 10.3109/10408361003791520] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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19
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Coto-Segura P, Coto E, Alvarez V, Morales B, Soto-Sánchez J, Corao AI, Santos-Juanes J. Apolipoprotein epsilon4 allele is associated with psoriasis severity. Arch Dermatol Res 2010; 302:145-9. [PMID: 19911187 DOI: 10.1007/s00403-009-1002-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2009] [Revised: 10/26/2009] [Accepted: 10/27/2009] [Indexed: 01/26/2023]
Abstract
Many reports provided strong evidence of the influence of genetic factors in the pathogenesis of psoriasis (Ps). A higher prevalence of lipid disorders in psoriatic patients has been reported. Because apolipoprotein E (apoE) is involved in lipid metabolism, APOE gene variants could be candidates to influence Ps-risk. However, data about the potential influence of the APOE genotypes in Ps are inconclusive. Our objective was to investigate the relationship between the common APOE-epsilon2/epsilon3/epsilon4 variation and Ps in a Caucasian population. Our study involved 331 unrelated Ps-patients and 400 healthy controls. Patients and controls were genotyped for the APOE-epsilon2/epsilon3/epsilon4 polymorphism, and allele and genotype frequencies were statistically compared between the two groups and between patients according to disease severity. Mean lipid values were also compared between the APOE genotypes. Allele and genotype frequencies did not differ between patients and controls. APOE-epsilon4 carriers were significantly more frequent in patients with severe Ps compared to controls (P = 0.003) and to non-severe Ps (P = 0.017). No significant difference in mean lipid values was found between the APOE genotypes. The APOE-epsilon4 allele could be a risk factor for developing a severe form of psoriasis.
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Affiliation(s)
- Pablo Coto-Segura
- Dermatology II Department, Hospital Universitario Central de Asturias, Celestino Villamil s/n, 33006 Oviedo, Spain
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Abstract
Circulatory disease accounts for fifteen million deaths each year, of which stroke accounts for four and a half million- with an estimated nine million stroke survivors annually. The overall incidence rate of stroke is 2 to 2.5 per thousand adults with an approximate prevalence of 5 per thousand and an estimated 5-year risk of stroke recurrence of 15 to 40 percent. Conventional risk factors for stroke include: increasing age, hypertension, diabetes mellitus, smoking, increased body mass index, ischemic heart disease, heart failure, atrial fibrillation and lack of physical activity. Age is the strongest risk factor for both ischemic and haemorrhagic stroke with its incidence doubling for each successive decade after the age of fifty-five years. However, there is a substantial portion of patients with significant cerebrovascular disease who do not have any of these stroke risk-factors, leading to the speculation that there are other factors that have not been identified yet So as to improve diagnosis and treatment strategies, as well as to reduce the related public health burden, it could be helpful to successfully identify its extremely complex genetic determinants (polygenic, multiple genes play a role). Pharmacogenetics is the field of pharmacology that deals with the influence of genetic variation on drug response by correlating gene expression and gene variants with the efficacy or toxicity of drugs. The principle drugs in stroke medicine are antithrombotics. The aim of this paper was to review the most commonly used drugs for stroke such as rtPA in the acute phase as well as antiplatelets and wafarin for secondary prophylaxis.
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Affiliation(s)
- Antonia M R Billeci
- University of Perugia, Santa Maria della Misericordia Hospital, Sant'Andrea delle Fratte, Italy.
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21
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Tasdemir N, Tamam Y, Toprak R, Tamam B, Tasdemir MS. Association of Apolipoprotein E Genotype and Cerebrovascular Disease Risk Factors in a Turkish Population. Int J Neurosci 2009; 118:1109-29. [DOI: 10.1080/00207450701769190] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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22
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Tamam Y, Tasdemir N, Toprak R, Tamam B, Iltumur K. Apolipoprotein E genotype in patients with cerebrovascular diseases and its effect on the disease outcome. Int J Neurosci 2009; 119:919-35. [PMID: 19466630 DOI: 10.1080/00207450802686350] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
A total of 100 hospitalized stroke patients and 30 healthy controls were included in a study aiming to determine the predictive role of ApoE genotype polymorphism for stroke outcome in the Turkish population. The most frequent ApoE genotype was epsilon3/3 reflecting Asian population polymorphic distribution. ApoE polymorphism in the Eastern Turkish population was found to be independent of stroke type, OSCP subtypes of infarction, localization of hemorrhage, severity of carotid artery stenosis, and resultant stroke outcome. Distinct polymorphic results in populations from nearby regions suggest a multifactorial pathogenesis and presence of very complex genetic factors in the development of stroke and stroke outcome.
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Affiliation(s)
- Yusuf Tamam
- Department of Neurology, Medical School Dicle University, Diyarbakir, Turkey.
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23
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Brenner DA, Alberts MJ, Amarenco P. Clinical genetic issues in stroke. HANDBOOK OF CLINICAL NEUROLOGY 2009; 92:355-372. [PMID: 18790284 DOI: 10.1016/s0072-9752(08)01918-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- David A Brenner
- University of Alabama at Birmingham, Comprehensive Stroke Center, Birmingham, AL 35249, USA.
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Del Saz-Saucedo P, Maestre-Moreno JF, Arenillas-Lara JF. [Intracranial atherosclerosis]. Med Clin (Barc) 2008; 131:141-52. [PMID: 18601827 DOI: 10.1157/13124100] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Until recently, intracranial atheromatosis was a probably underdiagnosed clinicopathological entity that was rarely studied in depth. In the last years the advance and expansion in the use of non-invasive diagnostic tools have led intracranial atheromatosis to the front page among the most prevalent causes of stroke worldwide. Important efforts have been accomplished with the aim of identifying markers of poor outcome, which, besides the underlying mechanisms of cerebral ischemia in these patients, are the most important factors on which clinical and therapeutic decisions should be based. To date, the therapeutic armamentarium is scarce and far from optimun, regarding medical and endovascular measures. In this review we address the most important aspects of the natural history and cure treatment of intracranial atheromatosis.
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Affiliation(s)
- Pablo Del Saz-Saucedo
- Servicio de Neurología, Hospital Universitario Virgen de las Nieves, Granada, España.
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25
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Abstract
Stroke is a leading cause of morbidity and mortality in western populations, with up to 40% of survivors not expected to recover independence from severe disabilities. This equates to an immense financial burden on health systems worldwide. Hence further education is required to inform individuals of the risks to promote secondary prevention strategies in future generations. Stroke is a heterogeneous, multifactorial disease regulated by modifiable and nonmodifiable risk factors. Modifiable factors include a history of high blood pressure, diabetes mellitus and coronary heart disease. Nonmodifiable factors include age, sex and race. Other less-well documented risk factors include geographic location, socioeconomic status and alcoholism. Approximately 80% of stroke events could be reduced by making simple lifestyle modifications. Further studies are required to clarify the role and interplay of the risk factors outlined to give a more comprehensive understanding of stroke and to aid and drive the development of more effective stroke prevention programs, in high risk groups.
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Affiliation(s)
- Claire L Allen
- Division of Stroke Medicine, Clinical Sciences Building, University of Nottingham, Hucknall Road, Nottingham NG5 1PB, UK.
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26
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Li XX, Liu JP, Cheng JQ, Han SH, Geng YJ, Wei S, Gao ST, Huang DN, Nie SF. Intercellular adhesion molecule-1 gene K469E polymorphism and ischemic stroke: a case-control study in a Chinese population. Mol Biol Rep 2008; 36:1565-71. [PMID: 18791855 DOI: 10.1007/s11033-008-9351-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2008] [Accepted: 08/26/2008] [Indexed: 11/24/2022]
Abstract
BACKGROUND Intercellular adhesion molecule-1 (ICAM-1) was involved in the pathogenetic mechanisms responsible for ischemic stroke (IS). Population-based sample have revealed gene-gender interaction in blood pressure which is major risk for IS. We sought to evaluate whether ICAM-1 K469E polymorphism was involved in the causation of IS and whether it was different between female and male. METHODS A 1:1 case-control study was conducted. The K469E polymorphism of ICAM-1 gene were analyzed by polymerase chain reaction (PCR) and restriction enzyme analysis in Chinese patients with IS (n = 309) and elderly subjects without IS (n = 309). RESULTS ICAM-1 K469E polymorphism was significantly associated with IS. Interestingly, a further analysis stratified by sex found that there was significance between 469E genotypes and IS in female, but not in male. Multiple regression analysis revealed that ICAM-1 K469E polymorphism was still significantly associated with IS, compared with ICAM-1 KK genotype in all population (OR = 1.60, P = 0.030). Stratified by sex, EE combined EK was contributory factor to IS in female (OR = 3.03, P = 0.004), but not in male. After adjustment for confounding factors, the interaction between female and ICAM-1 EK/EE genotypes was found (OR = 3.54, P = 0.001). CONCLUSIONS It is suggested that the ICAM-1 469E allele may be important in the pathogenesis of ischemic stroke, especially in female but not in male.
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Affiliation(s)
- Xiao Xia Li
- Department of Epidemiology and Statistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, Hubei, 430030, China
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Maasz A, Kisfali P, Jaromi L, Horvatovich K, Szolnoki Z, Csongei V, Safrany E, Sipeky C, Hadarits F, Melegh B. Apolipoprotein A5 Gene IVS3+G476A Allelic Variant Confers Susceptibility for Development of Ischemic Stroke. Circ J 2008; 72:1065-70. [DOI: 10.1253/circj.72.1065] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Anita Maasz
- Department of Medical Genetics and Child Development, University of Pecs
| | - Peter Kisfali
- Department of Medical Genetics and Child Development, University of Pecs
| | - Luca Jaromi
- Department of Medical Genetics and Child Development, University of Pecs
| | | | - Zoltan Szolnoki
- Department of Neurology and Neurophysiology, Pandy Kalman County Hospital
| | - Veronika Csongei
- Department of Medical Genetics and Child Development, University of Pecs
| | - Eniko Safrany
- Department of Medical Genetics and Child Development, University of Pecs
| | - Csilla Sipeky
- Department of Medical Genetics and Child Development, University of Pecs
| | | | - Bela Melegh
- Department of Medical Genetics and Child Development, University of Pecs
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Lai CL, Liu CK, Lin RT, Tai CT. Association of Apolipoprotein E Polymorphism with Ischemic Stroke Subtypes in Taiwan. Kaohsiung J Med Sci 2007; 23:491-7. [DOI: 10.1016/s1607-551x(08)70006-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Ranga GS, Kalra OP, Tandon H, Gambhir JK, Mehrotra G. Effect of aspirin on lipoprotein(a) in patients with ischemic stroke. J Stroke Cerebrovasc Dis 2007; 16:220-4. [PMID: 17845920 DOI: 10.1016/j.jstrokecerebrovasdis.2007.05.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2006] [Revised: 03/26/2007] [Accepted: 05/08/2007] [Indexed: 11/18/2022] Open
Abstract
Hyperlipidemia and increased serum lipoprotein (Lp)(a) are independent risk factors for atherosclerosis and its complications. Serum Lp(a) concentration is not influenced by most lipid-lowering therapies other than niacin. Recently aspirin also has been reported to decrease its levels. In the current study, we evaluated the serum levels of Lp(a) and lipids in 25 patients with first-ever diagnosed ischemic stroke, aged 21 to 60 years, and compared their levels with an equal number of age- and sex-matched healthy control subjects. In addition, the effect of aspirin on Lp(a) levels was studied by estimating its levels after 4 weeks of daily treatment with 150 mg of aspirin. Both groups were comparable regarding their anthropometric measurements and routine laboratory parameters except that erythrocyte sedimentation rate was higher in the patients. Serum lipids were not significantly different between the two groups, although Lp(a) levels were significantly higher in the patients (27.40 +/- 22.30 mg/dL) as compared with the control subjects (14.68 +/- 11.75 mg/dL) (P = .005). Twenty of 25 patients (80%) had serum Lp(a) levels of more than 10 mg/dL, whereas only 11 of 25 control subjects (44%) had serum Lp(a) levels of more than 10 mg/dL (P = .009). After 4 weeks of treatment with aspirin, Lp(a) levels declined significantly (46.24%) from baseline 27.40 +/- 22.30 mg/dL to 14.73 +/- 10.47 mg/dL (P < .001). Patients with baseline levels greater than 25 mg/dL showed greater decline (55.63%) compared with those with levels less than 25 mg/dL (26.63%) (P = .008). Results of our study confirm that aspirin lowers the increased Lp(a) levels in patients with ischemic stroke.
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Affiliation(s)
- Gajender Singh Ranga
- Department of Medicine, University College of Medical Sciences (University of Delhi) and Guru Teg Bahadur Hospital, Delhi, India.
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30
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Havasi V, Szolnoki Z, Talián G, Bene J, Komlósi K, Maász A, Somogyvári F, Kondacs A, Szabó M, Fodor L, Bodor A, Melegh B. Apolipoprotein A5 gene promoter region T-1131C polymorphism associates with elevated circulating triglyceride levels and confers susceptibility for development of ischemic stroke. J Mol Neurosci 2007; 29:177-83. [PMID: 16954607 DOI: 10.1385/jmn:29:2:177] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2005] [Revised: 11/30/1999] [Accepted: 02/03/2006] [Indexed: 11/11/2022]
Abstract
The possible pathogenic role of triglycerides (TG) in the development of ischemic stroke is still under extensive investigation. Recently, apolipoprotein (apo)A5 gene promoter region T-1131C polymorphism has been shown to associate with elevated serum TG levels. In the current work, a total of 302 subjects were classified as being large vessel-associated, small vessel-associated, or belonging to a mixed group of ischemic stroke-affected patients. The level of TG was increased in all groups (p < 0.01). The apoA5-1131C allele frequency was approximately twofold in all groups of stroke patients compared with the controls (5 vs 10-12%; p < 0.05); and the apoA5-1131C allele itself was also found to associate with increased TG levels in all groups. In a multivariate logistic regression analysis model adjusted for differences in age, gender, serum cholesterol, hypertension, presence of diabetes mellitus, smoking and drinking habits, and ischemic heart disease, a significantly increased risk of developing stroke disease was found in patients carrying the apoA5-1131C allele (p < 0.05; odds ratio OR = 2.1 [1.3-4.7]); this association was also proven for all subtypes of the stroke. The results presented here suggest that the apoA5-1131C allele is an independent risk factor for the development of stroke. Being that apoA5 gene is under the control of the peroxisome proliferator-activated receptor alpha, theoretically, the current observations also can have long-term therapeutic consequences.
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Affiliation(s)
- Viktória Havasi
- Department of Medical Genetics and Child Development, University of Pécs, Pécs, Hungary
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32
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Everett BM, Kurth T, Buring JE, Ridker PM. The relative strength of C-reactive protein and lipid levels as determinants of ischemic stroke compared with coronary heart disease in women. J Am Coll Cardiol 2006; 48:2235-42. [PMID: 17161253 PMCID: PMC2442907 DOI: 10.1016/j.jacc.2006.09.030] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2006] [Revised: 09/06/2006] [Accepted: 09/11/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVES We sought to determine the relative strength of high-sensitivity C-reactive protein (hs-CRP) and lipid levels as markers for future ischemic stroke compared with coronary heart disease (CHD) in women. BACKGROUND Although hs-CRP and lipid levels are established risk determinants for vascular disease, the relative strength of these biomarkers for ischemic stroke compared with CHD is uncertain. METHODS Among 15,632 initially healthy women who were followed for a 10-year period, we compared hs-CRP, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoproteins A-I and B100, and lipid ratios as determinants of ischemic stroke compared with CHD. RESULTS After adjustment for age, smoking status, blood pressure, diabetes, and obesity, the hazard ratios (HRs) and 95% confidence intervals (CIs) for the third versus the first tertile for future ischemic stroke compared with CHD were, respectively, 1.91 (95% CI 1.13 to 3.21) and 2.26 (95% CI 1.64 to 3.12) for TC, 1.29 (95% CI 0.83 to 2.02) and 2.09 (95% CI 1.53 to 2.85) for LDL-C, 0.57 (95% CI 0.36 to 0.92) and 0.38 (95% CI 0.27 to 0.52) for HDL-C, 1.72 (95% CI 1.03 to 2.86) and 2.93 (95% CI 2.04 to 4.21) for non-HDL-C, and 2.76 (95% CI 1.51 to 5.05) and 1.66 (95% CI 1.17 to 2.34) for hs-CRP. Of the lipid ratios, that of TC to HDL-C had the largest HR for both future ischemic stroke and CHD (HR 1.95 [95% CI 1.16 to 3.26] and 4.20 [95% CI 2.79 to 6.32], respectively). CONCLUSIONS In this large prospective cohort of initially healthy women, lipid levels are significant risk determinants for ischemic stroke, but with a magnitude of effect smaller than that observed for CHD. High-sensitivity CRP associates more closely with ischemic stroke than with CHD. Concomitant evaluation of lipid levels and hs-CRP may improve risk assessment for stroke as well as CHD. (The Women's Health Study; http://www.clinicaltrials.gov/ct/show/NCT00000479/; NCT00000479).
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Affiliation(s)
- Brendan M Everett
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02215, USA.
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Moreno JA, López-Miranda J, Pérez-Jiménez F. Influencia de los factores genéticos y ambientales en el metabolismo lipídico y riesgo cardiovascular asociado al gen apoE. Med Clin (Barc) 2006; 127:343-51. [PMID: 16987455 DOI: 10.1157/13092316] [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: 11/21/2022]
Abstract
The apolipoprotein E (ApoE) plays an important role in lipid metabolism. This apoprotein presents three major isoforms (apoE2, apoE3 and apoE4) that modulate lipid levels. Carriers of the apoE4 allele have higher total and LDL-cholesterol plasma concentration and a greater coronary risk, particularly for myocardial infarction. Nevertheless, not all the people with this allele develop the disease, which suggests that other genetic or environmental factors are necessary for its total expression. In this review, we will analyze the importance of several polymorphisms in the apoE gene promoter region, as well as various environmental factors, including diet, in the association of this gene with lipid metabolism and cardiovascular risk.
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Affiliation(s)
- Juan Antonio Moreno
- Unidad de Lípidos y Aterosclerosis, Hospital Universitario Reina Sofía, Córdoba, España
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Bhatia M, Howard SC, Clark TG, Neale R, Qizilbash N, Murphy MFG, Rothwell PM. Apolipoproteins as Predictors of Ischaemic Stroke in Patients with a Previous Transient Ischaemic Attack. Cerebrovasc Dis 2006; 21:323-8. [PMID: 16490941 DOI: 10.1159/000091537] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2004] [Accepted: 10/27/2005] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Weak associations between total and LDL cholesterol and ischaemic stroke compared with coronary heart disease (CHD) are at odds with the similar effectiveness of statin drugs in preventing ischaemic stroke and CHD, suggesting that other lipid sub-fractions that are affected by statins might be better predictors of ischaemic stroke. Apolipoprotein B levels are reduced by statins and are a stronger predictor of CHD than total and LDL cholesterol in patients both on and off statins. However, there are very few published data on apolipoproteins and stroke risk and no studies in patients with previous transient ischaemic attack (TIA). METHODS We performed a prospective cohort study of the associations of baseline total cholesterol, LDL, HDL, apolipoproteins A1 and B (apo A1; apo B) and risk of ischaemic stroke in 261 patients with previous TIA. Cox proportional hazards models were used to determine crude and multivariate-adjusted hazard ratios (HR) above versus below median values at 10-years follow-up. RESULTS The apo B/apo A1 ratio was the strongest independent predictor of ischaemic stroke (HR=2.94, 95% CI 1.43-5.88, p=0.003) followed by apo B (HR=2.26, 95% CI 1.16-4.38, p=0.02). The associations between total cholesterol, LDL, HDL, LDL/HDL ratio and apo A1 and ischaemic stroke risk did not reach statistical significance. CONCLUSIONS Apo B and the apo B/apo A1 ratio are predictive of ischaemic stroke in patients with previous TIA. Further studies are required to determine whether the prognostic value of apolipoprotein levels is maintained in patients on statins.
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Affiliation(s)
- M Bhatia
- Stroke Prevention Research Unit, Radcliffe Infirmary, Centre for Statistics in Medicine, University of Oxford, UK
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Hénon H, Pasquier F, Leys D. Poststroke Dementia. Cerebrovasc Dis 2006; 22:61-70. [PMID: 16645268 DOI: 10.1159/000092923] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2005] [Accepted: 10/12/2005] [Indexed: 11/19/2022] Open
Abstract
The association between stroke and dementia is frequent. The prevalence of poststroke dementia (PSD) ranges from 6 to 32%, depending on the population studied, the criteria used for the diagnosis of dementia, and the time interval between the stroke and the neuropsychological assessment. The risk of PSD is high immediately after stroke and remains higher than in controls in stroke patients nondemented 3 months after stroke. Not all cases of PSD are vascular in origin, with about one third of demented patients diagnosed as having Alzheimer's disease plus stroke. The pathophysiology of PSD is probably multifactorial, with an influence of vascular lesions, associated Alzheimer's lesions and white matter changes. The risk of dementia is higher in older patients and in patients with preexisting cognitive decline - no dementia, severe stroke, a history of stroke, white matter changes and cerebral atrophy. The influence of stroke location, vascular risk factors and silent infarcts remains to be determined. PSD adversely influences the outcome in stroke patients.
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Affiliation(s)
- H Hénon
- Department of Neurology, Stroke Unit, Lille University Hospital, Lille, France
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Arenillas JF, Alvarez-Sabín J. Basic Mechanisms in Intracranial Large-Artery Atherosclerosis: Advances and Challenges. Cerebrovasc Dis 2005; 20 Suppl 2:75-83. [PMID: 16327256 DOI: 10.1159/000089359] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Intracranial large-artery atherosclerosis is a major cause of ischemic stroke worldwide. Patients affected by this disease are at a high risk of suffering recurrent ischemic events despite antithrombotic therapy. Progression and a greater extent of intracranial atherosclerosis imply a higher risk for recurrence. Studies performed by our group in patients with symptomatic intracranial large-artery atherosclerosis have shown that: (1) C-reactive protein predicts its progression and recurrence, suggesting that inflammation may play a deleterious role in this condition; (2) a high level of the anti-angiogenic endostatin is also associated with a progressive and recurrent intracranial atherosclerosis, which might support a beneficial role for angiogenesis in this group of patients; and (3) elevated lipoprotein(a) concentration and diabetes mellitus characterize those patients with a higher number of intracranial stenoses.
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Affiliation(s)
- Juan F Arenillas
- Neurovascular Unit, Department of Neurology, Vall d'Hebron University Hospital, Barcelona, Spain.
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Cerrato P, Baima C, Grasso M, Lentini A, Bosco G, Cassader M, Gambino R, Cavallo Perin P, Pagano G, Fornengo P, Imperiale D, Bergamasco B, Bruno G. Apolipoprotein E Polymorphism and Stroke Subtypes in an Italian Cohort. Cerebrovasc Dis 2005; 20:264-9. [PMID: 16123547 DOI: 10.1159/000087709] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2004] [Accepted: 06/07/2005] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Studies have indicated that apolipoprotein E (ApoE)-epsilon4 is a risk factor for ischemic cerebrovascular diseases (ICVD), but the existence of this association is still controversial. The aims of this study were: (1) to compare ApoE genotype and allele frequencies in Italian cases with ICVD and in healthy control subjects and (2) to compare ApoE allele frequencies among ischemic stroke subtypes. METHODS A hospital-based cohort of 302 Italian subjects with ICVD and 228 healthy subjects have been recruited to investigate the role of ApoE polymorphisms as risk factors for ICVD. TOAST criteria were employed to stratify ICVD cases by subtypes. RESULTS No significant differences in ApoE genotype and allele frequencies were found between cases and control subjects. The frequency of ApoE-epsilon4 was lower in cases than in control subjects (6% vs. 10.1%), although not significantly. No differences in ApoE genotype and allele frequencies were evident among ICVD subtypes. However, out of 36 ApoE-epsilon4 alleles 23 (3.7%) were found in subjects with ICVD related to primary degenerative arterial disease related to large vessel disease and small vessel disease, and 13 (2.1%) in remaining subjects. Using logistic regression analysis we assessed whether ApoE-epsilon4 allele was independently associated with risk of ICVD related to a primary degenerative arterial disease compared to other ICVD subtypes. While classical risk factors were significantly associated with higher risk for ICVD due to large vessel disease and small vessel disease than other ICVD subtypes, the role of ApoE-epsilon4 allele was not significant (OR 1.25, 95% CI 0.57-2.74). CONCLUSION Our study shows similar ApoE-epsilon4 genotype and allele frequencies in patients with ICVD and in control subjects. No differences were found among different ICVD subtypes either.
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Affiliation(s)
- P Cerrato
- Department of Neuroscience, University of Turin, Turin, Italy.
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Bhatia M, Rothwell PM. A Systematic Comparison of the Quality and Volume of Published Data Available on Novel Risk Factors for Stroke versus Coronary Heart Disease. Cerebrovasc Dis 2005; 20:180-6. [PMID: 16088113 DOI: 10.1159/000087202] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2005] [Accepted: 04/19/2005] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND To identify new treatments to prevent stroke, it is important that we have reliable data on potential novel risk factors. METHODS We studied seven novel vascular risk factors [apo-lipoprotein (b), C-reactive protein, Chlamydia pneumoniae, fibrin-D dimer, fibrinogen, Helicobacter pylori and lipoprotein (a)] and compared the amount of published data on their relations with ischaemic stroke versus acute coronary events by systematic review of all studies published up to 2003. RESULTS From a total of 22,875 abstracts reviewed, 266 eligible studies were identified (167 case-control studies and 99 cohort studies). Two hundred and eleven (79%) studies included coronary events as an outcome for the purpose of a risk factor analysis. In 186 (70%) studies, coronary events were the only outcome that was analysed. Only 73 (27%) studies included stroke or TIA as an outcome event, and only 45 studies (17%) reported risk factor analyses for ischaemic stroke separately. These results were qualitatively consistent across the risk factors studied and the relative lack of data on risk factors for stroke was even greater in prospective cohort studies. CONCLUSION Data on novel risk factors for stroke are lacking compared with the equivalent data for acute coronary events, and there are very few data on specific subtypes of ischaemic stroke.
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Affiliation(s)
- Meena Bhatia
- Stroke Prevention Research Unit, University Department of Clinical Neurology, Radcliffe Infirmary, Oxford, UK
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Gromadzka G, Barańska-Gieruszczak M, Ciesielska A, Sarzyńska-Dlugosz I, Członkowska A. APOE genotype and serum cholesterol in predicting risk for early death from ischemic stroke in men and women. Cerebrovasc Dis 2005; 20:291-8. [PMID: 16131797 DOI: 10.1159/000087927] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2004] [Accepted: 06/07/2005] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND We recently discovered that APOE epsilon3/epsilon4 genotype in men and APOE epsilon2/epsilon3 genotype in women are associated with increased risk of death from ischemic stroke (IS). One of the main physiological roles of apolipoprotein E is participation in cholesterol metabolism. A significant association of low serum cholesterol level with increased risk of death from stroke was documented. So, we aimed to establish if an association exists between APOE genotype, serum cholesterol and 1-month mortality in IS. METHODS We studied 666 patients (330 men, 336 women) with a diagnosis of IS. Total serum cholesterol (TC) was measured with the method of Abbott Spectrum (USA). APOE genotyping was performed by PCR-RFLP method. RESULTS The highest frequency of low serum TC was associated with APOE epsilon2/epsilon3 genotype (both in men and in women). Low serum TC was associated with increased mortality rate only in women; this effect was evident only in females not possessing APOE epsilon2/epsilon3. Female patients with APOE epsilon2/epsilon3 genotype had high 1-month mortality rate independently from serum TC. In multiple regression analyses APOE epsilon3/epsilon4 genotype in men and APOE epsilon2/epsilon3 genotype in women predicted risk of death independently from serum TC and also from other potential pre- and post-stroke prognostic factors. CONCLUSION APOE epsilon3/epsilon4 genotype in men and APOE epsilon2/epsilon3 in women are associated with increased 30-day mortality in stroke. This effect seems be independent from serum cholesterol.
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Affiliation(s)
- Grazyna Gromadzka
- Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland.
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Um JY, Kim HM, Park HS, Joo JC, Kim KY, Kim YK, Hong SH. Candidate genes of cerebral infarction and traditional classification in Koreans with cerebral infarction. Int J Neurosci 2005; 115:743-56. [PMID: 16019571 DOI: 10.1080/00207450590524421] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Sasang constitutional medicine is a major branch of Korean traditional Oriental medicine. The differences of disease susceptibility to be shown in Sasang constitution may be due to genetic factors. Therefore, the authors examined relationship between candidate genes of cerebral infarction (CI) and Sasang constitution. The homozygous deletion allele of the angiotensin converting enzyme gene (ACE/DD), homozygous threonine allele of the angiotensinogen gene (AGN/TT), and the e4 allele of the apolipoprotein E gene (ApoE/e4) are reported to be associated with ischemic heart disease. CI is another atherosclerotic disease; and the effects of these polymorphisms on CI have been confusing. This study investigated whether ACE/DD, AGN/TT, and ApoE/e4 genotypes are associated with CI and whether genetic risk is enhanced by Sasang constitutional classification. The authors ascertained these genotypes in patients with CI (N=211), diagnosed by brain computed tomography. Control subjects for the infarction group were randomly selected from 319 subjects matched for age, sex, and history of hypertension with patients. The ACE/DD genotype was not associated with CI. However, there was significant association between ApoE polymorphism and CI (chi2=15.089, p<.05). Furthermore, frequency of AGN/TT genotype was higher in the patients with CI than in the controls (chi2=20.072, p<.05). The frequency of T allele was 0.91 in patients and 0.82 in controls (chi2=17.237, p<.05). However, Sasang constitutional classification did not increase the relative risk for CI in the subjects with ApoE/e4 or AGN/T allele. These results suggest that ApoE and AGN polymorphism predict CI, but Sasang constitutional classification does not enhance the risk for CI associated with ApoE/e4 or AGN/TT in a Korean population.
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Affiliation(s)
- Jae-Young Um
- Department of Pharmacology, College of Oriental Medicine, Kyung Hee University, Seoul, South Korea
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Duzenli S, Pirim I, Gepdiremen A, Deniz O. Apolipoprotein E polymorphism and stroke in a population from eastern Turkey. J Neurogenet 2004; 18:365-75. [PMID: 15370197 DOI: 10.1080/01677060490500294] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Human apolipoprotein E (apo E) alleles are polymorphic with significantly different frequencies among different ethnic groups and have been associated with increased risk of coronary heart disease, and postulated as a major genetic susceptibility locus for Alzheimer's disease. Studies undertaken in different populations have shown different association patterns between apo E genotype and stroke. The aim of this study was to determine the risk of apo E genotype in stroke patients living in the eastern part of Turkey. The apo E genotypes and allele frequencies of 229 individuals from the same geographic area were determined by polymerase chain reaction and restriction fragment length polymorphism, of which 103 were patients with a documented history of stroke without other apparent dementia and 126 age-matched healthy subjects as a control group. A reduced E3/4 genotype frequency was found in subjects with stroke and the E2/3 genotype frequency was elevated in patients with previous stroke. There was no association between apo E epsilon4 allele and stroke. The APOE alleles had divergent effects in this population. Association between APOE (the gene) alleles and stroke in this population may be altered due to interaction with other genetic effects. The effects of APOE alleles and genotypes require further study in different populations.
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Affiliation(s)
- Selma Duzenli
- Ataturk University, Medical Faculty, Department of Medical Biology and Genetics, Erzurum, Turkey.
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Um JY, Moon KS, Lee KM, Cho KH, Heo Y, Moon BS, Kim HM. Polymorphism of angiotensin-converting enzyme, angiotensinogen, and apolipoprotein E genes in Korean patients with cerebral infarction. J Mol Neurosci 2004; 21:23-8. [PMID: 14500990 DOI: 10.1385/jmn:21:1:23] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2002] [Accepted: 01/15/2003] [Indexed: 11/11/2022]
Abstract
The homozygous deletion allele of the angiotensin-converting enzyme gene (ACE/DD), homozygous threonine allele of the angiotensinogen gene (AGN/TT), and the epsilon4 allele of the apolipoprotein E gene (apoE/epsilon4) are reported to be associated with ischemic heart disease. Cerebral infarction (CI) is another atherosclerotic disease, and the effects of these polymorphisms on CI have been confusing. The frequency of the DD genotype of the ACE gene, but not the TT genotype of the AGN gene and the epsilon4 allele of ApoE, was significantly higher in subjects with than those without CI in Japan. In this study, we investigated whether ACE/DD, AGN/TT, and apoE/epsilon4 genotypes are associated with CI and whether genetic risk is enhanced by the effect of one upon another. We ascertained these genotypes in patients with CI (n = 365), diagnosed by brain computed tomography. Control subjects for the infarction group were randomly selected from 319 subjects matched for age, gender, and history of hypertension with patients. The ACE/DD genotype was not associated with CI. Frequency of the AGN/TT genotype was higher in patients with CI than in controls (chi2 = 12.287, p < 0.05). The frequency of t allele was 0.88 in patients and 0.82 in controls (chi2 = 11.041, p < 0.05; odds ratio, 1.7). Furthermore, the AGN/TT genotype increased the relative risk for CI in subjects with the ACE/DD genotype (chi2 = 7.8, p < 0.05; odds ratio, 1.9). There was no significant association between apoE/epsilon4 and CI. These results suggest that AGN/TT predicts CI and ACE/DD enhances the risk for CI associated with AGN/TT in a Korean population.
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Affiliation(s)
- Jae-Young Um
- Department of Pharmacology, College of Oriental Medicine, Kyung Hee University, 1 Hoegi-Dong, Dongdaemun-Gu, Seoul 130-701, South Korea
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Watanabe T, Koba S, Kawamura M, Itokawa M, Idei T, Nakagawa Y, Iguchi T, Katagiri T. Small dense low-density lipoprotein and carotid atherosclerosis in relation to vascular dementia. Metabolism 2004; 53:476-82. [PMID: 15045695 DOI: 10.1016/j.metabol.2003.11.020] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Vascular dementia (VaD) and Alzheimer's disease (AD) are the most common causes of dementia in the elderly. The aim of this study was to investigate carotid atherosclerosis, serum lipid profiles, and atherogenic hormone levels in nondiabetic Japanese men with VaD or AD. Carotid artery intima-media thickness (IMT) and plaque, serum lipid and lipoprotein profiles, including low-density lipoprotein (LDL) particle size, as well as insulin-like growth factor-I (IGF-I, somatomedin C) and testosterone levels, were determined in 34 patients with AD, 37 patients with VaD, and 63 healthy male controls. Age, body mass index, systolic and diastolic blood pressure, and fasting plasma glucose, hemoglobin A(1c) (HbA(1c)), triglyceride, high-density lipoprotein (HDL)-cholesterol, and apolipoproteins (apo) A-I, B, and E levels did not differ significantly among the 3 groups. However, the mean value of carotid IMT, the frequency of atherosclerotic plaque deposition, the serum levels of LDL-cholesterol, lipoprotein(a), and lipid peroxides, and the incidence of small dense LDL (particle diameter </= 25.5 nm) were increased significantly in VaD patients compared with AD patients or controls. VaD patients had a close reverse correlation between carotid IMT and LDL particle diameter, which were statistically proven independent risk factors for VaD. In contrast, AD patients had significantly lower serum levels of IGF-I and testosterone than either VaD patients or controls. Our results indicate that VaD is associated with atherogenic dyslipidemia, in particular, small dense LDL and carotid atherosclerosis, whereas AD is associated with hyposomatomedinemia and hypogonadism rather than atherosclerosis.
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Affiliation(s)
- Takuya Watanabe
- Third Department of Internal Medicine, Showa University School of Medicine, Division of Internal Medicine, Showa University Karasuyama Hospital, Tokyo, Japan
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Treger I, Froom P, Ring H, Friedman G. Association between apolipoprotein E4 and rehabilitation outcome in hospitalized ischemic stroke patients. Arch Phys Med Rehabil 2003; 84:973-6. [PMID: 12881819 DOI: 10.1016/s0003-9993(03)00043-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the value of apolipoprotein E4 (APOE*E4) allele in predicting discharge impairment and disability in ischemic stroke patients after acute rehabilitation. DESIGN Prospective study comparing results of rehabilitation in patients with different APOE genotypes. SETTING Acute neurologic rehabilitation department in Israel. PARTICIPANTS One hundred one consecutive patients 75 years old or less with a first ischemic stroke. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE Impairment, as measured by the National Institutes of Health Stroke Scale (NIHSS), and disability, as assessed with the FIM trade mark instrument. RESULTS On admission, there was no significant difference in the FIM or NIHSS measurements between the apo E4 group and other patients, but the prevalence of aphasia was 2.07 times more frequent in those with the APOE*E4 genotype (95% confidence interval, 0.98-4.4). A logistic regression model demonstrated that score measurements on admission were highly predictive of the NIHSS score at discharge (receiver operator curve=96.1%), whereas the presence of the APOE*E4 genotype did not add significantly to the model in predicting poorer rehabilitation treatment outcome as measured by the FIM or the NIHSS. CONCLUSIONS The presence of the apo E4 allele did not predict a poorer outcome of rehabilitation treatment after ischemic stroke, but it was associated with an increased prevalence of aphasia. Further studies are warranted to confirm this association.
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Affiliation(s)
- Iuly Treger
- Lowenstein Rehabilitation Center, Ra'anana, Israel
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Kehoe PG. The renin-angiotensin-aldosterone system and Alzheimer s disease? J Renin Angiotensin Aldosterone Syst 2003; 4:80-93. [PMID: 12806589 DOI: 10.3317/jraas.2003.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Epidemiological studies from the last decade have begun to produce evidence that the perceived joint occurrence of vascular disease and Alzheimer's disease (AD), both common elderly disorders more often believed to occur by chance due to their high prevalence, may now actually have a more pathological significance. The following review discusses some of this evidence and the implications for cognitive decline and the development of AD and how a well-known cardiovascular risk factor gene, the apolipoprotein E (APOE) gene, plays a significant role in the molecular genetics of AD. It also introduces and discusses recent and compelling evidence for the involvement of another well-known cardiovascular risk factor gene, the angiotensin-converting enzyme (ACE1) gene, in the pathogenesis of AD. This role is suggested in terms of recent molecular genetic association evidence implicating the ACE1 insertion/deletion (indel) polymorphism, a more recent large haplotype study that greatly extends the ACE1 indel evidence and incorporates knowledge accrued from previous cardiovascular disease-focused ACE1 haplotype studies. Finally, this paper discusses very recent biological evidence that further supports a role for ACE1 and hypothesises a number of readily testable mechanisms by which the ACE1 enzyme and other components of the renin-angiotensin-aldosterone system may be implicated in increased risk and/or the progression of AD.
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Affiliation(s)
- Patrick G Kehoe
- Department of Care of the Elderly, University of Bristol, Bristol, BS16 1LE, UK.
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Hata Y, Mabuchi H, Saito Y, Itakura H, Egusa G, Ito H, Teramoto T, Tsushima M, Tada N, Oikawa S, Yamada N, Yamashita S, Sakuma N, Sasaki J. Report of the Japan Atherosclerosis Society (JAS) Guideline for Diagnosis and Treatment of Hyperlipidemia in Japanese adults. J Atheroscler Thromb 2003; 9:1-27. [PMID: 12238634 DOI: 10.5551/jat.9.1] [Citation(s) in RCA: 146] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
This paper described the Guideline for Diagnosis and Management of Hyperlipidemias for Prevention of Atherosclerosis proposed by The Japan Atherosclerosis Society (JAS) Guideline Investigating Committee (1,995-2,000) under the auspices of the JAS Board of Directors. 1) The guideline defines the diagnostic criteria for serum total cholesterol (Table 1), LDL-cholesterol (Table 1), triglycerides (Table 4) and HDL-cholesterol (Table 7). It also indicates the desirable range (Table 1), the initiation levels of management (Table 2) and the target levels of treatment (Table 2) for total and LDL-cholesterol. 2) Though both total and LDL-cholesterol are shown as atherogenic parameter in the guideline, the use of LDL-cholesterol, rather than total cholesterol, is encouraged in daily medical practice and lipid-related studies, because LDL-cholesterol is more closely related to atherosclerosis. 3) Elevated triglycerides and low HDL-cholesterol are included in the risk factors, since no sufficient data have been accumulated to formulate the guideline for these two lipid disorders. 4) Emphasis is laid on evaluation of risk factors of each subject before starting any kind of treatment (Table 2). 5) This guideline is applied solely for adults (age 20-64). Lipid abnormalities in children or the youth under age 19, and the elderly with an age over 65 have to be evaluated by their own standard. 6) This part of the guideline gives only the diagnostic aspects of hyperlipidemias. The part of management and treatment will follow in the second section of the guideline that will be published in future.
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Souza DRS, Campos BF, Arruda EFD, Yamamoto LJ, Trindade DM, Tognola WA. Influence of the polymorphism of apolipoprotein E in cerebral vascular disease. ARQUIVOS DE NEURO-PSIQUIATRIA 2003; 61:7-13. [PMID: 12715012 DOI: 10.1590/s0004-282x2003000100002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
UNLABELLED The genetic heterogeneity of apolipoprotein E (apo E) has been associated with lipid profile and atherothrombotic stroke, however this association remains inconclusive. OBJECTIVE To evaluate the relationship between the isoforms of apo E and atherothrombotic stroke, by ascertaining the frequency of its alleles and genotypes associated with the lipid profile in patients with stroke. METHOD A total of 207 individuals were divided into two groups, consisting of 107 patients with stroke and 100 individuals without clinical symptoms of the disease. Blood samples were taken from patients and controls for molecular investigation of the apo E (epsilon2, epsilon3 and epsilon4 alleles) for the analysis of the lipid profile. RESULTS The epsilon3 allele was the most common and its prevalence was significantly higher in patients (0.93) compared to the controls (0.86; p=0.024). The epsilon2 allele was rarely seen specifically in patients (0.02 versus 0.05 in controls, p=0.191). The epsilon4 allele was not associated with stroke showing a reduced frequency in patients (0.05) when compared to controls (0.09; p=0.011). Although higher average levels of lipid profile were found in patients when compared to controls, with statistical significance for the values of total cholesterol (TC) (203.6 mg/dL +/- 57.98 and 181.9 mg/dL +/- 68.47 respectively; p=0.003) and low-density lipoprotein cholesterol (LDLc) (131.4mg/dL +/- 52.60 and 116 mg/dL +/- 56.38, respectively; p=0.014), these were independent of the presence of the epsilon4 allele. In control group the higher TC and LDLc values occurred in the absence of the epsilon4 allele, confirming the conflicting effect of the alleles of apo E on the plasmatic lipids and atherothrombotic stroke. CONCLUSION The isoforms of apo E cannot be regarded as an isolated risk factor for stroke and do not show association with lipid profile in this study.
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Affiliation(s)
- Dorotéia R S Souza
- Departamento de Biologia Molecular, Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, SP, Brasil.
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Kim JS, Han SR, Chung SW, Kim BS, Lee KS, Kim YI, Yang DW, Kim KS, Kim JW. The apolipoprotein E epsilon4 haplotype is an important predictor for recurrence in ischemic cerebrovascular disease. J Neurol Sci 2003; 206:31-7. [PMID: 12480082 DOI: 10.1016/s0022-510x(02)00361-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine whether a specific apolipoprotein E (APOE) allele is a predictor for ischemic cerebrovascular disease (ICVD). BACKGROUND The role of APOE in atherosclerosis has been a focus of intensive research. The APOE epsilon4 allele is overrepresented in Alzheimer's disease, atherosclerosis, ischemic heart disease, and ICVD. Also, epsilon4 carriers have higher cholesterol levels than non-epsilon4 carriers. METHODS We performed a prospective, longitudinal study on patients who have ICVD. The patients were recruited from St. Mary Hospital, Korea, and investigated for ICVD through interviews and by reviewing their medical records and neuroimaging studies. APOE genotypes were determined for each patient. RESULTS 20 of the 91 enrolled patients had recurrent ICVD, yielding a 3-year cumulative recurrence rate of 22%. Carriers of the epsilon4 allele had a 3-year recurrence rate of 53%, as compared with only 16% for patients who had the APOE non-epsilon4 allele (the risk ratio was 4.11; the 95% CI was 1.49-11.32; P<0.01). CONCLUSIONS Our results make possible the identification of patients with ICVD who are at high risk for recurrence by assessing their APOE genotype. Also, this data might be clinically useful in methods for assessing potential strategies for prevention.
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Affiliation(s)
- Joong-Seok Kim
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Abstract
The relationship between apolipoprotein (apo) E and vascular disease has been the subject of a considerable amount of research. However, this relationship is far from clearly defined. This deficiency appears to be due to a multitude of factors. Among these are differences in ethnicity, age (and possibly gender), diagnostic criteria, and environmental factors (eg, diet and smoking) that have contributed to the contradictory findings. Several diseases and their treatment may also influence this relationship. There are also documented interactions between apo E genotypes and other genes or vascular risk factors. One possible clinically relevant application of identifying the apo E genotype could be to assess the response to a particular drug treatment. It may also be that apo E polymorphism will become a good predictor of vascular death (eg, from myocardial infarction or stroke) rather than an indicator of the risk of developing vascular disease but without an acute ischemic event. More research is required to define the place of apo E genotyping in the management of vascular disease in its various forms. Whatever the future brings, the evaluation of apo E genotypes will need to be rapid, cheap, and technically undemanding before this investigation becomes widely available and clinically relevant.
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Affiliation(s)
- Genovefa Kolovou
- Cardiology Department, Onassis Cardiac Surgery Centre, Athens, Greece
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