1
|
Marques LS, Boschiero MN, Sansone NMS, Brienze LR, Marson FAL. Epidemiological Profile of Hospitalized Patients with Cystic Fibrosis in Brazil Due to Severe Acute Respiratory Infection during the COVID-19 Pandemic and a Systematic Review of Worldwide COVID-19 in Those with Cystic Fibrosis. Healthcare (Basel) 2023; 11:1936. [PMID: 37444770 DOI: 10.3390/healthcare11131936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 06/19/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Since the onset of the coronavirus disease, COVID-19 pandemic, concern arose for those who might be at higher risk of a worse COVID-19 prognosis, such as those with cystic fibrosis (CF). In this context, we evaluated the features of hospitalized patients with CF due to severe acute respiratory infection (SARI) in Brazil and we also performed a systematic review including all the studies published from the beginning of the first case of COVID-19 (17 November 2019) to the date of this search (23 May 2022) which included, concomitantly, patients with CF and COVID-19 in the worldwide population. In our Brazilian data, we evaluated the period from December 2019 to March 2022, and we included 33 demographical and clinical patients' features. We classified the patients into groups: (G1) SARI due to another viral infection than severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (23; 5.4%), (G2) SARI due to an unknown etiological agent (286; 67.1%), and (G3) SARI due to SARS-CoV-2 infection (117; 27.5%). The individuals in G3 tended to be older, especially over 50 years old, and presented a higher prevalence of dyspnea, peripheral capillary oxygen saturation (SpO2) <95%, and cardiopathy. The highest prevalence for intensive care unit (ICU) treatment (52; 44.4%) and invasive mechanical ventilation (29; 24.8%) was for patients in G3. Almost half of the patients in G3 died (51; 43.6%); in contrast, none in G1 died. However, we observed 43 (15.0%) deaths in G2. In addition, 12 (4.2%) and one (0.9%) death not associated with SARI occurred, respectively, in the G2 and G3. The patients who died due to SARS-CoV-2 infection had a higher frequency of SpO2 <95% (46; 90.2%), ICU treatment (34; 66.7%), and invasive mechanical ventilation (27; 52.9%) when compared to those who recovered. The systematic review comprised a total of 31 papers published as observational studies. These studies comprised 661,386 patients in total, including children, adults, and elderly age groups. However, only 19,150 (2.9%) patients were diagnosed with CF and, from these patients, 2523 (0.4%) were diagnosed with both CF and COVID-19. It was observed that the most common outcome was the need for hospitalization (n = 322 patients with CF), and the need for oxygen support (n = 139 patients with CF). One hundred patients with CF needed intensive care units, fifty patients needed non-invasive mechanical ventilation support, and only three patients were described as receiving invasive mechanical ventilation support. Deaths were described in 38 patients with CF. Importantly, lung-transplanted patients with CF represented an increased risk of death in one publication; in accordance, another study described that lung transplantation and moderate to severe lung disease were independent risk factors for severe outcomes after SARS-CoV-2 infection. In contrast with the literature, in conclusion, Brazilian patients in G3 presented a severe phenotype, even though most of the other studies did not observe worse outcomes in patients with CF and COVID-19.
Collapse
Affiliation(s)
- Leonardo Souza Marques
- Laboratory of Molecular Biology and Genetics, São Francisco University, Bragança Paulista 12916-900, SP, Brazil
| | - Matheus Negri Boschiero
- Laboratory of Molecular Biology and Genetics, São Francisco University, Bragança Paulista 12916-900, SP, Brazil
| | | | - Letícia Rulli Brienze
- Laboratory of Molecular Biology and Genetics, São Francisco University, Bragança Paulista 12916-900, SP, Brazil
| | | |
Collapse
|
2
|
Atiku SM, Kasozi D, Campbell K. Single Nucleotide Variants (SNVs) of Angiotensin-Converting Enzymes (ACE1 and ACE2): A Plausible Explanation for the Global Variation in COVID-19 Prevalence. J Renin Angiotensin Aldosterone Syst 2023; 2023:9668008. [PMID: 37051471 PMCID: PMC10085651 DOI: 10.1155/2023/9668008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/02/2023] [Accepted: 03/10/2023] [Indexed: 04/07/2023] Open
Abstract
Background. Although it is common knowledge that the coronavirus disease of 2019 (COVID-19) and other viral infections have an uneven impact globally, the reasons for this are still indistinct. The absence of equivalent capacities worldwide in screening, testing, and reporting of cases is one of the ideas put forward to explain this discrepancy. The molecular developments are noteworthy, particularly the role played by single nucleotide polymorphisms (SNPs) in ACEs (ACE1 and ACE2). The virus can enter the host cell thanks to the transmembrane protein ACE2, which is a homolog of ACE1. Objectives. With a focus on the I/D genotype of ACE1 and the rs2285666 SNV of ACE2, we elucidated the prevalence of SNPs in ACE1 and ACE2 in various geographic locations. We examined the relationship between these SNPs and the global patterns of COVID-19 prevalence. Methods. 66 of the 127 articles obtained using PubMed, Google Scholar, and Google directly conformed to the search terms; geographical distribution of viral infections, the prevalence of COVID-19, ACE1, ACE2, SNPs, and prevalence of the DD genotype, and rs2285666. Results. The DD genotype of ACE1 and the rs2285666 SNV of ACE2 are vital in their gene expression and contribute greatly to viral disease susceptibility, development, and severity. There was generally a high prevalence of the DD genotype in Europe and America, where COVID-19 had a more devastating effect than in Asia and Africa. The prevalence of the SNV rs2285666 varied in the following order: East Asia> South Asia >America>Europe >Africa. However, there were conflicting agreements in the association of rs2285666 with COVID-19 susceptibility and prevalence. Conclusion. The ACE1 DD genotype and COVID-19 prevalence have been positively linked in a number of studies. The ACE2 rs2285666 SNV, however, has yielded no definitive results. To determine the relationship between these SNVs and COVID-19 incidence, more research is required.
Collapse
Affiliation(s)
- Saad Mahjub Atiku
- Department of Medical Laboratory Sciences, Department of Nursing and Midwifery, Faculty of Health Sciences, Muni University, P. O. Box 725 Arua, Uganda
- Department of Biochemistry, Habib Medical School Faculty of Health Sciences, Islamic University in Uganda, P. O. Box 7689 Kampala, Uganda
| | - Dennis Kasozi
- Department of Biochemistry and Sports Science, College of Natural Sciences, Makerere University Kampala, P. O. Box 7062 Kampala, Uganda
| | - Katrina Campbell
- Institute for Global Food Security, School of Biological Sciences, OG.076 / O2.037, 19 Chlorine Gardens, Queen’s University Belfast, BT9 5DL, UK
| |
Collapse
|
3
|
Mathew HR, Choi MY, Parkins MD, Fritzler MJ. Systematic review: cystic fibrosis in the SARS-CoV-2/COVID-19 pandemic. BMC Pulm Med 2021; 21:173. [PMID: 34016096 PMCID: PMC8135381 DOI: 10.1186/s12890-021-01528-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 05/06/2021] [Indexed: 12/15/2022] Open
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the development of life-threatening COVID-19 are believed to disproportionately affect certain at-risk populations. However, it is not clear whether individuals with cystic fibrosis (CF) are at a higher risk of COVID-19 or its adverse consequences. Recurrent respiratory viral infections are often associated with perturbation and pulmonary exacerbations of CF as evidenced by the significant morbidity observed in CF individuals during the 2009 H1N1 pandemic. The primary goal of this review was to systematically survey published accounts of COVID-19 in CF and determine if individuals with CF are disproportionally affected by SARS-CoV-2 and development of COVID-19. Methods We conducted a systematic literature search using EMBASE and Medline between April 28 and December 10, 2020. Six evaluable studies reporting on a total of 339 individuals with CF who developed COVID-19 were included in this study. Results We found that although individuals with CF generally experience acute exacerbations of lung disease from infectious agents, COVID-19 incidence estimates in CF appear to be lower than in the general population. However, there are reports of subsets of CF, such as those who had organ transplants, that may experience a more severe COVID-19 course. Potential protective mechanisms in the CF population include pre-pandemic social isolation practices, infection prevention and control knowledge, altered expression of angiotensin-converting enzyme, and the use of certain medications. Conclusions Although individuals with CF are at risk of acute exacerbations often precipitated by respiratory tract viral infections, published evidence to date indicated that individuals with CF do not experience higher risks of contracting SARS-CoV-2 infection. However, there is evidence that some subsets within the CF population, including those post-transplantation, may experience a more severe clinical course. As SARS-CoV-2 variants are identified and the pandemic goes through additional waves of disease outbreaks, ongoing monitoring of the risk of COVID-19 in individuals with CF is required.
Collapse
Affiliation(s)
- Hannah R Mathew
- Department of Biological Sciences, University of Calgary, Calgary, AB, Canada
| | - May Y Choi
- Cumming School of Medicine, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB, T2N 4N1, Canada
| | - Michael D Parkins
- Cumming School of Medicine, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB, T2N 4N1, Canada
| | - Marvin J Fritzler
- Cumming School of Medicine, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB, T2N 4N1, Canada.
| |
Collapse
|
4
|
Hui G, Cheng Z, Ran H, Ziwei W, Fang D. A Pooled Study of Angiotensin-Converting Enzyme Insertion/Deletion Gene Polymorphism in Relation to Risk, Pathology and Prognosis of Childhood Immunoglobulin A Vasculitis Nephritis. Biochem Genet 2020; 59:202-218. [PMID: 32980913 DOI: 10.1007/s10528-020-09999-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 09/18/2020] [Indexed: 11/30/2022]
Abstract
The angiotensin-converting enzyme (ACE) insertion/deletion (I/D) gene polymorphism has been inconsistently reported to be a risk factor for Childhood immunoglobulin A vasculitis (IgAV) nephritis. We comprehensively searched electronic databases as of Jan 2020. Nineteen studies with 1104 cases and 1589 controls were included. Sensitivity analyses based on different subgroups were performed. Further analyses were conducted for association of ACE polymorphism with disease severity and prognosis. Significant associations were found between ACE I/D polymorphism and childhood IgAV nephritis, with the strongest association in DD vs. II comparison (OR 1.72, 95% CI 1.21-2.46). Subgroup analyses generally showed significant results. Besides, ACE polymorphism was significantly associated with proteinuria (DD + DI vs. II: OR 2.22, 95% CI 1.14-4.33; DI + II vs. DD: OR 0.49, 95% CI 0.30-0.81) and worse prognosis (the strongest effect in DD + DI vs. II: OR 4.43, 95% CI 1.84-10.71) among children with IgAV nephritis. The ACE polymorphism seemed not to be associated with hematuria, hypertension, and renal pathology. This study suggested significant association of ACE gene polymorphism with the risk of IgAV nephritis in children. D allele in the ACE genotype could be a useful genetic marker to predict proteinuria and worse prognosis for childhood IgAV nephritis.
Collapse
Affiliation(s)
- Gao Hui
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China. .,MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China.
| | - Zhang Cheng
- Anhui Provincial Cancer Institute, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China
| | - Hua Ran
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China
| | - Wang Ziwei
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China
| | - Deng Fang
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China. .,MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China.
| |
Collapse
|
5
|
Stanton BA, Hampton TH, Ashare A. SARS-CoV-2 (COVID-19) and cystic fibrosis. Am J Physiol Lung Cell Mol Physiol 2020; 319:L408-L415. [PMID: 32668165 PMCID: PMC7518058 DOI: 10.1152/ajplung.00225.2020] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/06/2020] [Accepted: 07/06/2020] [Indexed: 12/16/2022] Open
Abstract
Cystic fibrosis (CF) is a genetic disease caused by mutations in the CFTR gene. Although viral respiratory tract infections are, in general, more severe in patients with CF compared with the general population, a small number of studies indicate that SARS-CoV-2 does not cause a worse infection in CF. This is surprising since comorbidities including preexisting lung disease have been reported to be associated with worse outcomes in SARS-CoV-2 infections. Several recent studies provide insight into why SARS-CoV-2 may not produce more severe outcomes in CF. First, ACE and ACE2, genes that play key roles in SARS-CoV-2 infection, have some variants that are predicted to reduce the severity of SARS-CoV-2 infection. Second, mRNA for ACE2 is elevated and mRNA for TMPRSS2, a serine protease, is decreased in CF airway epithelial cells. Increased ACE2 is predicted to enhance SARS-CoV-2 binding to cells but would increase conversion of angiotensin II, which is proinflammatory, to angiotensin-1-7, which is anti-inflammatory. Thus, increased ACE2 would reduce inflammation and lung damage due to SARS-CoV-2. Moreover, decreased TMPRSS2 would reduce SARS-CoV-2 entry into airway epithelial cells. Second, many CF patients are treated with azithromycin, which suppresses viral infection and lung inflammation and inhibits the activity of furin, a serine protease. Finally, the CF lung contains high levels of serine protease inhibitors including ecotin and SERPINB1, which are predicted to reduce the ability of TMPRSS2 to facilitate SARS-CoV-2 entry into airway epithelial cells. Thus, a variety of factors may mitigate the severity of SARS-CoV-2 in CF.
Collapse
Affiliation(s)
- Bruce A Stanton
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Thomas H Hampton
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Alix Ashare
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
- Section of Pulmonology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| |
Collapse
|
6
|
Abstract
PURPOSE OF REVIEW To compile data from the past 10 years regarding the role of modifying genes in cystic fibrosis (CF). RECENT FINDINGS CF is a model disease for understanding of the action of modifying genes. Although it is a monogenic (CFTR) autosomal recessive disease, CF presents with wide phenotypic variability. In CF, variability occurs with different intensity among patients by each organ, being organ-specific, resulting from the mutual interaction of environmental and genetic factors, including CFTR mutations and various other genes, most of which are associated with inflammatory processes. In individuals, using precision medicine, gene modification studies have revealed individualized responses to drugs depending on particular CFTR mutations and modifying genes, most of which are alternative ion channels. SUMMARY Studies of modifying genes in CF allow: understanding of clinical variability among patients with the same CFTR genotype; evaluation of precision medicine; understanding of environmental and genetic effects at the organ level; understanding the involvement of genetic variants in inflammatory responses; improvements in genetic counseling; understanding the involvement of genetic variants in inflammatory responses in lung diseases, such as asthma; and understanding the individuality of the person with the disease.
Collapse
|
7
|
Abstract
OBJECTIVE Pancreatic insufficiency (PI) in cystic fibrosis (CF) patients is a crucial clinical marker for severity and disease progression. In our study, 125 modifier genes and their SNPs were associated between CF patients with PI or pancreatic sufficiency. METHODS We prospectively evaluated 214 CF patients admitted at 1 hospital for a 2-year period. The PI status was associated with clinical variables and SNPs related with inflammatory response considering CFTR mutations. Open Array technique was used to perform the SNPs identification. RESULTS For PI risk, after correction by multiple test, in CF patients and 2 CFTR mutations class I, II, and/or III, there were 6 SNPs with positive association (P < 0.005). The odds ratio amplitude was 0.087 (95% confidence interval [CI], 0.004-0.544) for rs9870255*CG (CTNNB1 gene) to 11.06 (95% CI, 1.746-252.3) for rs729302*AA (IRF5 gene). For all CF patients at the same time, 9 SNPs showed positive association. The odds ratio amplitude was 0.144 (95% CI, 0.028-0.602) for rs2348071*AA (PSMA3 gene) to 5.809 (95% CI, 1.536-37.54) for rs11702779*AA (RUNX1 gene). In our data, we observed the interaction between CFTR mutations, rs9870255*CTNNB1, rs9378805*IRF4, and rs7664617*KCNIP4 to PI status. CONCLUSIONS Multiple SNPs in inflammatory response genes showed association with PI considering the CFTR mutations screening.
Collapse
|
8
|
Furlan LL, Ribeiro JD, Bertuzzo CS, Salomão Junior JB, Souza DRS, Marson FAL. Variants in the interleukin 8 gene and the response to inhaled bronchodilators in cystic fibrosis. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2017. [DOI: 10.1016/j.jpedp.2017.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
9
|
Variants in the interleukin 8 gene and the response to inhaled bronchodilators in cystic fibrosis. J Pediatr (Rio J) 2017; 93:639-648. [PMID: 28719800 DOI: 10.1016/j.jped.2017.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 03/29/2017] [Accepted: 01/09/2017] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE Interleukin 8 protein promotes inflammatory responses, even in airways. The presence of interleukin 8 gene variants causes altered inflammatory responses and possibly varied responses to inhaled bronchodilators. Thus, this study analyzed the interleukin 8 variants (rs4073, rs2227306, and rs2227307) and their association with the response to inhaled bronchodilators in cystic fibrosis patients. METHODS Analysis of interleukin 8 gene variants was performed by restriction fragment length polymorphism of polymerase chain reaction. The association between spirometry markers and the response to inhaled bronchodilators was evaluated by Mann-Whitney and Kruskal-Wallis tests. The analysis included all cystic fibrosis patients, and subsequently patients with two mutations in the cystic fibrosis transmembrane conductance regulator gene belonging to classes I to III. RESULTS This study included 186 cystic fibrosis patients. There was no association of the rs2227307 variant with the response to inhaled bronchodilators. The rs2227306 variant was associated with FEF50% in the dominant group and in the group with two identified mutations in the cystic fibrosis transmembrane conductance regulator gene. The rs4073 variant was associated with spirometry markers in four genetic models: co-dominant (FEF25-75% and FEF75%), dominant (FEV1, FEF50%, FEF75%, and FEF25-75%), recessive (FEF75% and FEF25-75%), and over-dominant (FEV1/FVC). CONCLUSIONS This study highlighted the importance of the rs4073 variant of the interleukin 8 gene, regarding response to inhaled bronchodilators, and of the assessment of mutations in the cystic fibrosis transmembrane conductance regulator gene.
Collapse
|
10
|
Hypertonic Saline as a Useful Tool for Sputum Induction and Pathogen Detection in Cystic Fibrosis. Lung 2017; 195:431-439. [DOI: 10.1007/s00408-017-0008-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 04/24/2017] [Indexed: 11/25/2022]
|
11
|
Furlan LL, Marson FAL, Ribeiro JD, Bertuzzo CS, Salomão Junior JB, Souza DRS. IL8 gene as modifier of cystic fibrosis: unraveling the factors which influence clinical variability. Hum Genet 2016; 135:881-94. [PMID: 27209008 DOI: 10.1007/s00439-016-1684-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 05/14/2016] [Indexed: 12/31/2022]
Abstract
The severity of cystic fibrosis (CF) is associated with classes of mutations in the CFTR gene (cystic fibrosis transmembrane regulator), physical environment and modifier genes interaction. The IL8 gene (interleukin 8), according to its respective polymorphisms, influences inflammatory responses. This study analyzed IL8 gene polymorphisms (rs4073, rs2227306 and rs2227307), by means of PCR/RFLP, and their association with pulmonary function markers and clinical severity scores in 186 patients with CF, considering the CFTR genotype. There was an association between rs2227307 and precocity of the disease. The severity of lung disease was associated with the following markers: transcutaneous arterial hemoglobin oxygen saturation (SaO2) (regardless of CFTR genotype, for the polymorphisms rs4073, rs2227306 and rs2227307); mucoid Pseudomonas aeruginosa (regardless of CFTR genotype, for the polymorphisms rs2227306 and rs2227307). Pulmonary function markers (SaO2 and spirometric variables) and clinical severity scores were also associated with IL8 gene polymorphisms. This study identified the IL8 gene, represented by rs4073 and rs2227306 polymorphisms, and particularly the rs2227307 polymorphism, as potentiating factors for the degree of variability in the severity of CF, especially in pulmonary clinical manifestation correlated with increased morbidity and mortality.
Collapse
Affiliation(s)
- Larissa Lazzarini Furlan
- Medical School of São José do Rio Preto, Avenida Brigadeiro Faria Lima, 5416, Vila São José, São José do Rio Preto, São Paulo, CEP 15090-000, Brazil
| | - Fernando Augusto Lima Marson
- Department of Medical Genetics, School of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, Campinas, São Paulo, CEP 13083-887, Brazil.
- Department of Pediatrics, School of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, Campinas, São Paulo, CEP 13083-887, Brazil.
| | - José Dirceu Ribeiro
- Department of Pediatrics, School of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, Campinas, São Paulo, CEP 13083-887, Brazil
| | - Carmen Sílvia Bertuzzo
- Department of Medical Genetics, School of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, Campinas, São Paulo, CEP 13083-887, Brazil
| | - João Batista Salomão Junior
- Department of Pediatrics and Department of Pediatrics Pneumology, University Hospital, Medical School of São José do Rio Preto, Avenida Brigadeiro Faria Lima, 5416, Vila São José, São José do Rio Preto, São Paulo, CEP 15090-000, Brazil
| | - Dorotéia Rossi Silva Souza
- Department of Molecular Biology, Research Center for Biochemistry and Molecular Biology, Medical School of São José do Rio Preto, Avenida Brigadeiro Faria Lima, 5416, Vila São José, São José do Rio Preto, São Paulo, CEP 15090-000, Brazil
| |
Collapse
|
12
|
Mauch RM, Kmit AHP, Marson FADL, Levy CE, Barros-Filho ADA, Ribeiro JD. Association of growth and nutritional parameters with pulmonary function in cystic fibrosis: a literature review. ACTA ACUST UNITED AC 2016. [PMID: 27181343 PMCID: PMC5176073 DOI: 10.1016/j.rppede.2016.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Objective: To review the literature addressing the relationship of growth and nutritional parameters with pulmonary function in pediatric patients with cystic fibrosis. Data source: A collection of articles published in the last 15 years in English, Portuguese and Spanish was made by research in electronic databases - PubMed, Cochrane, Medline, Lilacs and Scielo - using the keywords cystic fibrosis, growth, nutrition, pulmonary function in varied combinations. Articles that addressed the long term association of growth and nutritional parameters, with an emphasis on growth, with pulmonary disease in cystic fibrosis, were included, and we excluded those that addressing only the relationship between nutritional parameters and cystic fibrosis and those in which the aim was to describe the disease. Data synthesis: Seven studies were included, with a total of 12,455 patients. Six studies reported relationship between growth parameters and lung function, including one study addressing the association of growth parameters, solely, with lung function, and all the seven studies reported relationship between nutritional parameters and lung function. Conclusions: The review suggests that the severity of the lung disease, determined by spirometry, is associated with body growth and nutritional status in cystic fibrosis. Thus, the intervention in these parameters can lead to the better prognosis and life expectancy for cystic fibrosis patients.
Collapse
Affiliation(s)
- Renan Marrichi Mauch
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil.
| | | | | | - Carlos Emilio Levy
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil
| | | | - José Dirceu Ribeiro
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil
| |
Collapse
|
13
|
Mauch RM, Kmit AHP, Marson FADL, Levy CE, Barros-Filho ADA, Ribeiro JD. Association of growth and nutritional parameters with pulmonary function in cystic fibrosis: a literature review. REVISTA PAULISTA DE PEDIATRIA 2016; 34:503-509. [PMID: 27181343 DOI: 10.1016/j.rpped.2015.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 11/05/2015] [Accepted: 12/02/2015] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To review the literature addressing the relationship of growth and nutritional parameters with pulmonary function in pediatric patients with cystic fibrosis. DATA SOURCE A collection of articles published in the last 15 years in English, Portuguese and Spanish was made by research in electronic databases - PubMed, Cochrane, Medline, Lilacs and Scielo - using the keywords cystic fibrosis, growth, nutrition, pulmonary function in varied combinations. Articles that addressed the long term association of growth and nutritional parameters, with an emphasis on growth, with pulmonary disease in cystic fibrosis, were included, and we excluded those that addressing only the relationship between nutritional parameters and cystic fibrosis and those in which the aim was to describe the disease. DATA SYNTHESIS Seven studies were included, with a total of 12,455 patients. Six studies reported relationship between growth parameters and lung function, including one study addressing the association of growth parameters, solely, with lung function, and all the seven studies reported relationship between nutritional parameters and lung function. CONCLUSIONS The review suggests that the severity of the lung disease, determined by spirometry, is associated with body growth and nutritional status in cystic fibrosis. Thus, the intervention in these parameters can lead to the better prognosis and life expectancy for cystic fibrosis patients.
Collapse
Affiliation(s)
- Renan Marrichi Mauch
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil.
| | | | | | - Carlos Emilio Levy
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil
| | | | - José Dirceu Ribeiro
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil
| |
Collapse
|
14
|
Angiotensin-converting enzyme insertion/deletion gene polymorphism in cystic fibrosis patients. J Genet 2016; 95:193-6. [PMID: 27019450 DOI: 10.1007/s12041-015-0609-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
15
|
Oueslati S, Hadj Fredj S, Dakhlaoui B, Othmani R, Siala H, Messaoud T. Association of TGFB1 -509C/T polymorphism gene with clinical variability in cystic fibrosis patients: A case-control study. ACTA ACUST UNITED AC 2015; 63:175-8. [PMID: 26277914 DOI: 10.1016/j.patbio.2015.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 07/10/2015] [Indexed: 01/18/2023]
Abstract
PURPOSE In this work, we are interested to study the implication of -509C/T polymorphism, located in the promoter region of TGFB1 (transforming growth factor β1), in the phenotypic variability of CF patients. PATIENTS AND METHODS The present study enrolled 111 CF patients and 100 healthy control subjects. The study of the -509C/T polymorphism was performed using PCR-RFLP method. RESULTS We found that patients carried non-F508del homozygous mutation with TT genotype was associated to lung symptoms (P=0.04). This association was not found in the sub-groups of patients with F508del at homozygous state P=0.145. No association was found between this polymorphism and the variability of digestive, pancreatic and ileus meconial symptoms. CONCLUSION On the basis of our results, the -509C/T polymorphism of the TGFB1 gene seems to be a modulator factor of cystic fibrosis.
Collapse
Affiliation(s)
- S Oueslati
- Biochemistry Laboratory (Research Laboratory Haemoglobinopathies and Cystic Fibrosis), Children's Hospital, Bab Saadoun Square, 1007 Tunis, Tunisia.
| | - S Hadj Fredj
- Biochemistry Laboratory (Research Laboratory Haemoglobinopathies and Cystic Fibrosis), Children's Hospital, Bab Saadoun Square, 1007 Tunis, Tunisia
| | - B Dakhlaoui
- Biochemistry Laboratory (Research Laboratory Haemoglobinopathies and Cystic Fibrosis), Children's Hospital, Bab Saadoun Square, 1007 Tunis, Tunisia
| | - R Othmani
- Biochemistry Laboratory (Research Laboratory Haemoglobinopathies and Cystic Fibrosis), Children's Hospital, Bab Saadoun Square, 1007 Tunis, Tunisia
| | - H Siala
- Biochemistry Laboratory (Research Laboratory Haemoglobinopathies and Cystic Fibrosis), Children's Hospital, Bab Saadoun Square, 1007 Tunis, Tunisia
| | - T Messaoud
- Biochemistry Laboratory (Research Laboratory Haemoglobinopathies and Cystic Fibrosis), Children's Hospital, Bab Saadoun Square, 1007 Tunis, Tunisia
| |
Collapse
|
16
|
Nasal potential difference in cystic fibrosis considering severe CFTR mutations. DISEASE MARKERS 2015; 2015:306825. [PMID: 25667564 PMCID: PMC4312569 DOI: 10.1155/2015/306825] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 12/10/2014] [Accepted: 12/11/2014] [Indexed: 12/23/2022]
Abstract
The gold standard for diagnosing cystic fibrosis (CF) is a sweat chloride value above 60 mEq/L. However, this historical and important tool has limitations; other techniques should be studied, including the nasal potential difference (NPD) test. CFTR gene sequencing can identify CFTR mutations, but this method is time-consuming and too expensive to be used in all CF centers. The present study compared CF patients with two classes I-III CFTR mutations (10 patients) (G1), CF patients with classes IV-VI CFTR mutations (five patients) (G2), and 21 healthy subjects (G3). The CF patients and healthy subjects also underwent the NPD test. A statistical analysis was performed using the Mann-Whitney, Kruskal-Wallis, χ2, and Fisher's exact tests, α = 0.05. No differences were observed between the CF patients and healthy controls for the PDMax, Δamiloride, and Δchloride + free + amiloride markers from the NPD test. For the finger value, a difference between G2 and G3 was described. The Wilschanski index values were different between G1 and G3. In conclusion, our data showed that NPD is useful for CF diagnosis when classes I-III CFTR mutations are screened. However, if classes IV-VI are considered, the NPD test showed an overlap in values with healthy subjects.
Collapse
|
17
|
Coutinho CADAC, Marson FADL, Ribeiro AF, Ribeiro JD, Bertuzzo CS. Cystic fibrosis transmembrane conductance regulator mutations at a referral center for cystic fibrosis. J Bras Pneumol 2014; 39:555-61. [PMID: 24310628 PMCID: PMC4075877 DOI: 10.1590/s1806-37132013000500005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 09/17/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To determine the frequency of six mutations (F508del, G542X, G551D, R553X, R1162X, and N1303K) in patients with cystic fibrosis (CF) diagnosed, at a referral center, on the basis of abnormal results in two determinations of sweat sodium and chloride concentrations. METHODS This was a cross-sectional study involving 70 patients with CF. The mean age of the patients was 12.38 ± 9.00 years, 51.43% were female, and 94.29% were White. Mutation screening was performed with polymerase chain reaction (for F508del), followed by enzymatic digestion (for other mutations). Clinical analysis was performed on the basis of gender, age, ethnicity, pulmonary/gastrointestinal symptoms, and Shwachman-Kulczycki (SK) score. RESULTS All of the patients showed pulmonary symptoms, and 8 had no gastrointestinal symptoms. On the basis of the SK scores, CF was determined to be mild, moderate, and severe in 22 (42.3%), 17 (32.7%), and 13 (25.0%) of the patients, respectively. There was no association between F508del mutation and disease severity by SK score. Of the 140 alleles analyzed, F508del mutation was identified in 70 (50%). Other mutations (G542X, G551D, R553X, R1162X, and N1303K) were identified in 12 (7.93%) of the alleles studied. In F508del homozygous patients with severe disease, the OR was 0.124 (95% CI: 0.005-0.826). CONCLUSIONS In 50% of the alleles studied, the molecular diagnosis of CF was confirmed by identifying a single mutation (F508del). If we consider the analysis of the six most common mutations in the Brazilian population (including F508del), the molecular diagnosis was confirmed in 58.57% of the alleles studied.
Collapse
|
18
|
Coutinho CAAC, Marson FAL, Marcelino ARB, Bonadia LC, Carlin MP, Ribeiro AF, Ribeiro JD, Bertuzzo CS. TNF-alpha polymorphisms as a potential modifier gene in the cystic fibrosis. INTERNATIONAL JOURNAL OF MOLECULAR EPIDEMIOLOGY AND GENETICS 2014; 5:87-99. [PMID: 24959313 PMCID: PMC4065397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 03/21/2014] [Indexed: 06/03/2023]
Abstract
Modifier genes, as the TNF-α gene, can modulate the cystic fibrosis (CF) severity. Thus, -238G>A and -308G>A polymorphisms of TNF-α gene were analyzed as modifiers of CF. In this context, the present study enrolled 49 CF patients (diagnosis performed by sweat test and complete CFTR screening). The -238G>A polymorphism analysis was performed by ARMS-PCR, and -308G>A, by PCR-RFLP. In our data, the -238G>A polymorphism was not associated with clinical variability. The AA genotype for -308G>A polymorphism was a risk factor for early gastrointestinal symptoms (OR=5.98, 95%CI=1.06-49.68) and protection for the first Pseudomonas aeruginosa (OR=0.05, 95%CI=0.0003-0.007). For the first P. aeruginosa, GA genotype was a risk factor (OR=10.2, 95%CI=1.86-84.09); for the same genotype, the diagnosis was made in minor time than the AA genotype (p=0.031). Considering the -308G>A polymorphism alleles, the G allele was a risk factor for early pulmonary symptoms (OR=3.81, 95%CI=1.13-12.97) and P. aeruginosa (OR=66.77, 95%CI=15.18-482.7); however, the same allele showed better transcutaneous oxygen saturation (OR=9.24, 95%CI=1.53-206.1). The A allele was a protective factor for early pulmonary symptoms (OR=12.26, 95%CI=0.08-0.89) and P. aeruginosa (OR=12.15, 95%CI=0002-0007), however, the same allele was a risk factor for worst transcutaneous oxygen saturation (OR=7.01, 95%CI=1.14-157.4). As conclusion, the -308G>A polymorphism of the TNF-α gene was associated with the CF severity.
Collapse
Affiliation(s)
- Cyntia AAC Coutinho
- Department of Medical Genetics, Faculty of Medical Sciences, University of Campinas13081-970, P.O. Box: 6111, Campinas, SP, Brazil
| | - Fernando AL Marson
- Department of Medical Genetics, Faculty of Medical Sciences, University of Campinas13081-970, P.O. Box: 6111, Campinas, SP, Brazil
- Department of Pediatrics, School of Medical Sciences, University of Campinas13081-970, P.O. Box: 6111, Campinas, SP, Brazil
| | - Aline RB Marcelino
- Department of Medical Genetics, Faculty of Medical Sciences, University of Campinas13081-970, P.O. Box: 6111, Campinas, SP, Brazil
| | - Luciana C Bonadia
- Department of Medical Genetics, Faculty of Medical Sciences, University of Campinas13081-970, P.O. Box: 6111, Campinas, SP, Brazil
| | - Marcelo P Carlin
- Department of Medical Genetics, Faculty of Medical Sciences, University of Campinas13081-970, P.O. Box: 6111, Campinas, SP, Brazil
| | - Antonio F Ribeiro
- Department of Pediatrics, School of Medical Sciences, University of Campinas13081-970, P.O. Box: 6111, Campinas, SP, Brazil
| | - Jose D Ribeiro
- Department of Pediatrics, School of Medical Sciences, University of Campinas13081-970, P.O. Box: 6111, Campinas, SP, Brazil
| | - Carmen S Bertuzzo
- Department of Medical Genetics, Faculty of Medical Sciences, University of Campinas13081-970, P.O. Box: 6111, Campinas, SP, Brazil
| |
Collapse
|
19
|
Marson FADL, Bertuzzo CS, Ribeiro MÂGDO, Ribeiro AF, Ribeiro JD. Screening for F508del as a first step in the molecular diagnosis of cystic fibrosis. J Bras Pneumol 2014; 39:306-16. [PMID: 23857699 PMCID: PMC4075852 DOI: 10.1590/s1806-37132013000300007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 02/15/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE: To determine the relevance of screening for the F508del mutation of the cystic fibrosis transmembrane conductance regulator gene as a first step in the genetic diagnosis of cystic fibrosis (CF) by associating the genotype with various clinical variables. METHODS: We evaluated 180 CF patients regarding the F508del mutation. The clinical data were obtained from the medical records of the patients and from interviews with their parents or legal guardians. RESULTS: Of the 180 patients studied, 65 (36.1%) did not carry the F508del mutation (group 0 [G0]), 67 (37.2%) were F508del heterozygous (G1), and 48 (26.7%) were F508del homozygous (G2). All three groups showed associations with the clinical variables. Homozygosis was associated with younger patients, younger age at CF diagnosis, and younger age at the first isolation of Pseudomonas aeruginosa (PA), as well as with higher prevalence of pancreatic insufficiency (PI) and non-mucoid PA (NMPA) colonization. In comparison with G1+G2 patients, G0 patients were older; first experienced clinical symptoms, digestive disease, and pulmonary disease at an older age; were older at CF diagnosis and at first PA isolation; and had a lower prevalence of PI and meconium ileus, as well as of colonization by NMPA, mucoid PA, and Burkholderia cepacia. In G1 patients, values were intermediate for age at CF diagnosis; age at first PA isolation, first pulmonary symptoms, and first clinical manifestations; MPA colonization; and OR for PI. CONCLUSIONS: The identification of F508del in 63.9% of the patients studied showed that this can be a useful tool as a first step in the genetic diagnosis of CF. The F508del genotype was associated with clinical severity of the disease, especially with the variables related to CF onset.
Collapse
|
20
|
Marson FADL, Bertuzzo CS, Ribeiro AF, Ribeiro JD. Polymorphisms in the glutathione pathway modulate cystic fibrosis severity: a cross-sectional study. BMC MEDICAL GENETICS 2014; 15:27. [PMID: 24593045 PMCID: PMC3973994 DOI: 10.1186/1471-2350-15-27] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 02/17/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Cystic fibrosis (CF) clinically manifests with various levels of severity, which are thought to be modulated by mutations in the cystic fibrosis transmembrane conductance regulator gene (CFTR), modifier genes, and the environment. This study verified whether polymorphisms in modifier genes associated with glutathione (GSH) metabolism influence CF severity. METHODS A cross-sectional study of 180 CF patients was carried out from 2011 to 2012. We analyzed CFTR mutations, polymorphisms (GSTM1 and GSTT1 deletions, GSTP1 + 313A > G, GCLC-129C > T, and GCLC-3506A > G) in modifier genes and CF clinical severity as assessed by 28 clinical and laboratory variables. RESULTS Significant associations were found between modifier gene polymorphisms and particular phenotypes or genotype changes. These included GCLC-129C > T with a higher frequency of the Pseudomonas aeruginosa mucoid to CC genotype (p = 0.044), and GCLC-3506A > G with a higher frequency of the no-mucoid P. aeruginosa (NMPA) to AA genotype (p = 0.012). The GSTT1 deletion was associated with a higher frequency of the NMPA to homozygous deletion (p = 0.008), GSTP1 + 313A > G with a minor risk of osteoporosis (p = 0.036), and patient age ≤ 154 months (p = 0.044) with the AA genotype. The Bhalla score was associated with GCLC-3506A > G (p = 0.044) and GSTM1/GSTT1 deletion polymorphisms (p = 0.02), while transcutaneous hemoglobin oxygen saturation levels were associated with GSTT1 deletions (p = 0.048). CONCLUSION CF severity is associated with polymorphisms in GSH pathways and CFTR mutations.
Collapse
Affiliation(s)
- Fernando Augusto de Lima Marson
- Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas. Tessália Vieira de Camargo, 126. Cidade Universitária “Zeferino Vaz”, CEP: 13083-887 Campinas, São Paulo, Brazil
- Department of Medical Genetics, Faculty of Medical Sciences, University of Campinas. Tessália Vieira de Camargo, 126. Cidade Universitária “Zeferino Vaz”, CEP: 13083-887 Campinas, São Paulo, Brazil
| | - Carmen Silvia Bertuzzo
- Department of Medical Genetics, Faculty of Medical Sciences, University of Campinas. Tessália Vieira de Camargo, 126. Cidade Universitária “Zeferino Vaz”, CEP: 13083-887 Campinas, São Paulo, Brazil
| | - Antonio Fernando Ribeiro
- Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas. Tessália Vieira de Camargo, 126. Cidade Universitária “Zeferino Vaz”, CEP: 13083-887 Campinas, São Paulo, Brazil
| | - Jose Dirceu Ribeiro
- Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas. Tessália Vieira de Camargo, 126. Cidade Universitária “Zeferino Vaz”, CEP: 13083-887 Campinas, São Paulo, Brazil
| |
Collapse
|
21
|
Guillot L, Beucher J, Tabary O, Le Rouzic P, Clement A, Corvol H. Lung disease modifier genes in cystic fibrosis. Int J Biochem Cell Biol 2014; 52:83-93. [PMID: 24569122 DOI: 10.1016/j.biocel.2014.02.011] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 02/12/2014] [Accepted: 02/14/2014] [Indexed: 11/30/2022]
Abstract
Cystic fibrosis (CF) is recognized as a single gene disorder. However, a considerable diversity in its clinical phenotype has been documented since the description of the disease. Identification of additional gene alleles, so called "modifier genes" that directly influence the phenotype of CF disease became a challenge in the late '90ies, not only for the insight it provides into the CF pathophysiology, but also for the development of new potential therapeutic targets. One of the most studied phenotype has been the lung disease severity as lung dysfunction is the major cause of morbidity and mortality in CF. This review details the results of two main genetic approaches that have mainly been explored so far: (1) an "a priori" approach, i.e. the candidate gene approach; (2) a "without a priori" approach, analyzing the whole genome by linkage and genome-wide association studies (GWAS), or the whole exome by exome sequencing.
Collapse
Affiliation(s)
- Loic Guillot
- INSERM, UMR_S 938, CDR Saint-Antonie , Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR_s 938, CDR Saint-Antonie, Paris, France.
| | - Julie Beucher
- Centre Hospiyalo-Universitaire (CHU), Rennes, France
| | - Olivier Tabary
- INSERM, UMR_S 938, CDR Saint-Antonie , Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR_s 938, CDR Saint-Antonie, Paris, France
| | - Philippe Le Rouzic
- INSERM, UMR_S 938, CDR Saint-Antonie , Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR_s 938, CDR Saint-Antonie, Paris, France
| | - Annick Clement
- INSERM, UMR_S 938, CDR Saint-Antonie , Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR_s 938, CDR Saint-Antonie, Paris, France; Hôpital Trousseau, Pediatric Respiratory Department, AP-HP, Paris, France
| | - Harriet Corvol
- INSERM, UMR_S 938, CDR Saint-Antonie , Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR_s 938, CDR Saint-Antonie, Paris, France; Hôpital Trousseau, Pediatric Respiratory Department, AP-HP, Paris, France
| |
Collapse
|
22
|
de Lima Marson FA, Bertuzzo CS, Secolin R, Ribeiro AF, Ribeiro JD. Genetic interaction of GSH metabolic pathway genes in cystic fibrosis. BMC MEDICAL GENETICS 2013; 14:60. [PMID: 23758905 PMCID: PMC3685592 DOI: 10.1186/1471-2350-14-60] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Accepted: 06/07/2013] [Indexed: 11/26/2022]
Abstract
Background Cystic fibrosis (CF) is a monogenic disease caused by CFTR gene mutations, with clinical expression similar to complex disease, influenced by genetic and environmental factors. Among the possible modifier genes, those associated to metabolic pathways of glutathione (GSH) have been considered as potential modulators of CF clinical severity. In this way it is of pivotal importance investigate gene polymorphisms at Glutamate-Cysteine Ligase, Catalytic Subunit (GCLC), Glutathione S-transferase Mu 1 (GSTM1), Glutathione S-transferase Theta 1 (GSTT1), and Glutathione S-transferase P1 (GSTP1), which have been associated to the GSH metabolic pathway and CF clinical severity. Method A total of 180 CF’s patients were included in this study, which investigated polymorphisms in GCLC and GST genes (GCLC -129C>T and -3506A>G; GSTM1 and GSTT1 genes deletion, and GSTP1*+313A>G) by PCR and PCR-RFLP associating to clinical variables of CF severity, including variables of sex, clinical scores [Shwachman-Kulczycki, Kanga e Bhalla (BS)], body mass index, patient age, age for diagnosis, first clinical symptoms, first colonization by Pseudomonas aeruginosa, sputum’s microorganisms, hemoglobin oxygen saturation in the blood, spirometry and comorbidities. The CFTR genotype was investigated in all patients, and the genetic interaction was performed using MDR2.0 and MDRPT0.4.7 software. Results The analysis of multiple genes in metabolic pathways in diseases with variable clinical expression, as CF disease, enables understanding of phenotypic diversity. Our data show evidence of interaction between the GSTM1 and GSTT1 genes deletion, and GSTP1*+313A>G polymorphism with CFTR gene mutation classes, and BS (Balance testing accuracy= 0.6824, p= 0.008), which measures the commitment of bronchopulmonary segments by tomography. Conclusion Polymorphisms in genes associated with metabolism of GSH act on the CF’s severity.
Collapse
Affiliation(s)
- Fernando Augusto de Lima Marson
- Department of Pediatrics, Faculdade de Ciências Médicas, Universidade Estadual de Campinas-Unicamp, 13081-970, PO Box: 6111, Campinas, SP, Brazil.
| | | | | | | | | |
Collapse
|