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Tornio A, Bigossi M, Siddiqui MK, Kennedy G, Melhem A, Chourasia MK, Maroteau C, Pola R, Chasman DI, Doney ASF, Palmer CNA. The cholesterol-lowering effect of statins is modified by LILRB5 intolerance genotype: Results from a recruit-by-genotype clinical trial. Front Pharmacol 2023; 14:1090010. [PMID: 36998609 PMCID: PMC10043296 DOI: 10.3389/fphar.2023.1090010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/23/2023] [Indexed: 03/17/2023] Open
Abstract
Background/Aims: Statin intolerance leads to poor adherence to statin therapy, resulting in a failure to achieve desired cholesterol reduction and adverse outcomes. The LILRB5 Asp247Gly genotype has been identified as being associated with statin intolerance and statin-induced myalgia. We conducted a randomized clinical trial to examine its role in immune response through T regulatory cell aggregation and in achieving cholesterol reduction targets.Methods: A double-blind, cross-over, recruit-by-genotype trial was undertaken. A total of 18 participants who had either the Asp247Asp (T/T) genotype or the Gly247Gly (C/C) genotype were recruited to the study. Participants were randomised to receive placebo or atorvastatin 80 mg daily for 28 days. Following a washout period of 3 weeks, they were then switched to the opposite treatment. Biochemical and immunological measurements as well as interviews were performed prior to and after both treatment periods. Within genotype group comparisons were performed using repeated measures Wilcoxon tests. Two-way repeated measures ANOVA with genotype and treatment as factors were used to compare changes in biochemical parameters between groups during placebo and atorvastatin periods.Results: Individuals with the Asp247Asp genotype had a greater increase in creatine kinase (CK) compared to those with Gly247Gly genotype in response to atorvastatin (p = 0.03). Those with Gly247Gly genotype had a mean non-HDL cholesterol reduction of 2.44 (95% CI:1.59 – 3.29) mmol/L while in Asp247Asp genotype group the mean reduction was 1.28 (95%CI: 0.48 – 2.07) mmol/L. The interaction between the genotype and atorvastatin treatment for total cholesterol (p = 0.007) and non-HDL cholesterol response was significant (p = 0.025). Immunological assessment showed no significant changes in aggregation of T regulatory cells by genotype.Conclusion: The Asp247Gly variant in LILRB5, previously associated with statin intolerance, was associated with differential increases in creatine kinase and total cholesterol and non-HDL cholesterol-lowering response to atorvastatin. Taken together, these results suggest that this variant could have utility in precision cardiovascular therapy.
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Affiliation(s)
- Aleksi Tornio
- Integrative Physiology and Pharmacology, Institute of Biomedicine, University of Turku, Turku, Finland
- Unit of Clinical Pharmacology, Turku University Hospital, Turku, Finland
- Pat Macpherson Centre for Pharmacogenomics and Pharmacogenetics, Division of Population Health & Genomics, School of Medicine, University of Dundee, Dundee, United Kingdom
| | - Margherita Bigossi
- Pat Macpherson Centre for Pharmacogenomics and Pharmacogenetics, Division of Population Health & Genomics, School of Medicine, University of Dundee, Dundee, United Kingdom
- Section of Internal Medicine and Thromboembolic Diseases, Department of Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Moneeza K. Siddiqui
- Pat Macpherson Centre for Pharmacogenomics and Pharmacogenetics, Division of Population Health & Genomics, School of Medicine, University of Dundee, Dundee, United Kingdom
- *Correspondence: Moneeza K. Siddiqui,
| | - Gwen Kennedy
- Pat Macpherson Centre for Pharmacogenomics and Pharmacogenetics, Division of Population Health & Genomics, School of Medicine, University of Dundee, Dundee, United Kingdom
| | - Ala’a Melhem
- Pat Macpherson Centre for Pharmacogenomics and Pharmacogenetics, Division of Population Health & Genomics, School of Medicine, University of Dundee, Dundee, United Kingdom
| | - Mehul K. Chourasia
- Pat Macpherson Centre for Pharmacogenomics and Pharmacogenetics, Division of Population Health & Genomics, School of Medicine, University of Dundee, Dundee, United Kingdom
| | - Cyrielle Maroteau
- Pat Macpherson Centre for Pharmacogenomics and Pharmacogenetics, Division of Population Health & Genomics, School of Medicine, University of Dundee, Dundee, United Kingdom
| | - Roberto Pola
- Section of Internal Medicine and Thromboembolic Diseases, Department of Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Daniel I. Chasman
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Alexander S. F. Doney
- Pat Macpherson Centre for Pharmacogenomics and Pharmacogenetics, Division of Population Health & Genomics, School of Medicine, University of Dundee, Dundee, United Kingdom
| | - Colin N. A. Palmer
- Pat Macpherson Centre for Pharmacogenomics and Pharmacogenetics, Division of Population Health & Genomics, School of Medicine, University of Dundee, Dundee, United Kingdom
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Fernández-Torres J, Martínez-Nava GA, Zamudio-Cuevas Y, Barbier OC, Narváez-Morales J, Martínez-Flores K. Ancestral contribution of the muscle-specific creatine kinase (CKM) polymorphism rs4884 in the knee osteoarthritis risk: a preliminary study. Clin Rheumatol 2020; 40:279-285. [PMID: 32557253 DOI: 10.1007/s10067-020-05238-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/24/2020] [Accepted: 06/10/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION/OBJECTIVES Articular cartilage and periarticular muscle tissues are strongly affected during knee osteoarthritis (OA). Creatine kinase (CK) is an enzyme expressed in several tissues, but the isoform CK-MM is specific of skeletal muscle, and its serum concentration is used as a biomarker of muscle damage. Genetic variants of the CKM gene have been associated with various pathologies, but to date, there are no reports of association with OA. Due to the rs4884 polymorphism being well represented in the Mexican population, it is used as an ancestry informative marker; thus, the goal of this preliminary report was to evaluate the association of this polymorphism in primary knee OA Mexican patients. METHOD Eighty-seven patients with primary knee OA were compared with 107 healthy controls. Serum CK-MM was determined using the dot blot system, and genotyping was performed using the OpenArray system. Logistic regression models were used to assess the association between the rs4884 polymorphism and OA susceptibility adjusting by gender, age, and body mass index. RESULTS There were no significant differences in serum CK-MM values between patients and controls. The GG genotype and the G allele had a higher frequency in the control group compared with the OA group (24.3% vs. 12.6%, OR = 0.34, 95% CI = 0.14-0.84, P = 0.019; and 40.2% vs. 28.2%, OR = 0.51, 95% CI = 0.32-0.82, P = 0.005, respectively). CONCLUSIONS Our results suggest a protection role of the rs4884 polymorphism against knee OA development; further studies are required to confirm it. Key Points • CK-MM enzyme catalyzes the conversion of creatine and ATP to create phosphocreatine and ADP; this reaction is reversible. • In tissues that consume ATP rapidly, such as skeletal muscle, the phosphocreatine serves as an important energy reservoir. • During knee OA, peripheral muscle tissues of the joint may be affected. • The rs4884 polymorphism of the CKM gene may participate as a protective factor in the development of OA.
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Affiliation(s)
- Javier Fernández-Torres
- Synovial Fluid Laboratory, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Calzada México-Xochimilco 289, Colonia Arenal de Guadalupe, Tlalpan, 14389, Mexico City, Mexico.,Biology Department, Facultad de Química, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria, Coyoacán, 04510, Mexico City, Mexico
| | - Gabriela Angélica Martínez-Nava
- Synovial Fluid Laboratory, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Calzada México-Xochimilco 289, Colonia Arenal de Guadalupe, Tlalpan, 14389, Mexico City, Mexico
| | - Yessica Zamudio-Cuevas
- Synovial Fluid Laboratory, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Calzada México-Xochimilco 289, Colonia Arenal de Guadalupe, Tlalpan, 14389, Mexico City, Mexico
| | - Olivier Christophe Barbier
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados (CINVESTAV) del Instituto Politécnico Nacional, Av. IPN #2508, Colonia San Pedro Zacatenco, 07360, Gustavo A Madero, CP 07360, Mexico City, Mexico
| | - Juana Narváez-Morales
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados (CINVESTAV) del Instituto Politécnico Nacional, Av. IPN #2508, Colonia San Pedro Zacatenco, 07360, Gustavo A Madero, CP 07360, Mexico City, Mexico
| | - Karina Martínez-Flores
- Synovial Fluid Laboratory, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Calzada México-Xochimilco 289, Colonia Arenal de Guadalupe, Tlalpan, 14389, Mexico City, Mexico.
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Brewster LM. Letter by Brewster Regarding Article, " CKM Glu83Gly Is Associated With Blunted Creatine Kinase Variation, but Not With Myalgia". CIRCULATION. CARDIOVASCULAR GENETICS 2017; 10:CIRCGENETICS.117.001938. [PMID: 28974516 DOI: 10.1161/circgenetics.117.001938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Lizzy M Brewster
- Department of Internal Medicine, Amsterdam Institute for Global Health and Development, University of Amsterdam, Amsterdam, The Netherlands
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de Denus S, Tardif JC, Dubé MP. CKing Precision in the Interpretation of Diagnostic Biomarkers. CIRCULATION. CARDIOVASCULAR GENETICS 2017; 10:CIRCGENETICS.117.001874. [PMID: 28790156 DOI: 10.1161/circgenetics.117.001874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Simon de Denus
- From the Research Center, Montreal Heart Institute, Montreal, Quebec, Canada (S.d.D., J.-C.T., M.-P.D.); Université de Montréal Beaulieu-Saucier Pharmacogenomics Center, Montreal, Quebec, Canada (S.d.D., J.-C.T., M.-P.D.); and Faculties of Pharmacy (S.d.D.) and Medicine (J.-C.T., M.-P.D.), Université de Montréal, Montreal, Quebec, Canada.
| | - Jean-Claude Tardif
- From the Research Center, Montreal Heart Institute, Montreal, Quebec, Canada (S.d.D., J.-C.T., M.-P.D.); Université de Montréal Beaulieu-Saucier Pharmacogenomics Center, Montreal, Quebec, Canada (S.d.D., J.-C.T., M.-P.D.); and Faculties of Pharmacy (S.d.D.) and Medicine (J.-C.T., M.-P.D.), Université de Montréal, Montreal, Quebec, Canada
| | - Marie-Pierre Dubé
- From the Research Center, Montreal Heart Institute, Montreal, Quebec, Canada (S.d.D., J.-C.T., M.-P.D.); Université de Montréal Beaulieu-Saucier Pharmacogenomics Center, Montreal, Quebec, Canada (S.d.D., J.-C.T., M.-P.D.); and Faculties of Pharmacy (S.d.D.) and Medicine (J.-C.T., M.-P.D.), Université de Montréal, Montreal, Quebec, Canada
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