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Bararu Bojan I, Dobreanu S, Vladeanu MC, Ciocoiu M, Badescu C, Plesoianu C, Filip N, Iliescu D, Frasinariu O, Bojan A, Tudor R, Badulescu OV. The Etiology of the Thrombotic Phenomena Involved in the Process of Coronary Artery Disease-What Is the Role of Thrombophilic Genes in the Development of This Pathology? Int J Mol Sci 2024; 25:5228. [PMID: 38791267 PMCID: PMC11120830 DOI: 10.3390/ijms25105228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 05/06/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024] Open
Abstract
Cardiovascular diseases, among which includes coronary artery disease, represent one of the most important causes of mortality and morbidity worldwide. Research aimed at determining the risk factors involved recognizes a group of "traditional" risk factors, but also more recent studies identified over 100 "novel" ones which may have a role in the disease. Among the latter is the thrombophilia profile of a patient, a pathology well-established for its involvement in venous thromboembolism, but with less studied implications in arterial thrombosis. This paper reviews the literature, explaining the pathophysiology of the thrombophilia causes associated most with coronary thrombosis events. Results of several studies on the subject, including a meta-analysis with over 60,000 subjects, determined the significant involvement of factor V Leiden, prothrombin G20210A mutation, plasminogen activator inhibitor-1 and antiphospholipid syndrome in the development of coronary artery disease. The mechanisms involved are currently at different stages of research, with some already established and used as therapeutic targets.
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Affiliation(s)
- Iris Bararu Bojan
- Department of Pathophysiology, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania; (I.B.B.); (N.F.); (O.V.B.)
| | - Stefan Dobreanu
- Recuperare Hospital Iasi, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania (C.B.)
| | - Maria Cristina Vladeanu
- Department of Pathophysiology, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania; (I.B.B.); (N.F.); (O.V.B.)
| | - Manuela Ciocoiu
- Department of Pathophysiology, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania; (I.B.B.); (N.F.); (O.V.B.)
| | - Codruta Badescu
- Recuperare Hospital Iasi, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania (C.B.)
| | - Carmen Plesoianu
- Department of Internal Medicine, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania
| | - Nina Filip
- Department of Pathophysiology, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania; (I.B.B.); (N.F.); (O.V.B.)
| | - Dan Iliescu
- Department of Internal Medicine, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania
| | - Otilia Frasinariu
- Department of Pediatry, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania
| | - Andrei Bojan
- Department of Surgical Sciences, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania
| | - Razvan Tudor
- Department of Orthopedy, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania
| | - Oana Viola Badulescu
- Department of Pathophysiology, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania; (I.B.B.); (N.F.); (O.V.B.)
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Xu Y, Feng H, Zhang L, Li Y, Chi F, Ren L. Prevalence and clinical correlates of hyperhomocysteinemia in Chinese urban population with hypertension. Front Endocrinol (Lausanne) 2024; 15:1369997. [PMID: 38444590 PMCID: PMC10912325 DOI: 10.3389/fendo.2024.1369997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 02/05/2024] [Indexed: 03/07/2024] Open
Abstract
Context The coexistence of hypertension and elevated homocysteine (Hcy) levels has a mutually reinforcing impact on the susceptibility to cardio-cerebrovascular disease. Objective The aim was to assess the prevalence, clinical correlation, and demographic characteristics of hyperhomocysteinemia (HHcy) within the Chinese urban population with hypertension. Methods A cohort of 473 individuals with hypertension were selected from four communities in Shenzhen, China. Demographic attributes, clinical profiles, and lifestyle behaviors were gathered and compared between individuals with and without HHcy. A logistic regression model was employed to examine potential factors associated with the prevalence of HHcy. Correlation between Hcy levels and clinical characteristics was assessed through multiple linear regression analysis. Results The prevalence of HHcy in the population with hypertension was 31.3%. In comparison to individuals without HHcy, those with HHcy exhibited a higher proportion of males, a higher prevalence of smoking and alcohol consumption, and a higher proportion of cases with the homozygous (TT) genotype at the MTHFR C677T polymorphism. Moreover, individuals with HHcy had lower levels of folic acid (FA), and lower fruit and vitamin B12 intake. Furthermore, the risk factors for HHcy were male (B = 1.430, OR = 4.179) and MTHFR (TT) (B = 1.086, OR = 2.961). In addition, the multiple linear regression analysis revealed a significant association between Hcy levels and gender (B = -2.784, P = 0.004), MTHFR genotypes (B = 1.410, P = 0.005), and FA levels (B = -0.136, P = 0.030). Conclusion The high prevalence of HHcy among hypertensive patients in this Chinese urban population underscores the necessity for interventions targeting modifiable risk factors such as dietary choices and lifestyle practices.
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Affiliation(s)
| | | | | | | | | | - Lijie Ren
- Department of Neurology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
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Reagan AM, Christensen KE, Graham LC, Bedwell AA, Eldridge K, Speedy R, Figueiredo LL, Persohn SC, Bottiglieri T, Nho K, Sasner M, Territo PR, Rozen R, Howell GR. The 677C > T variant in methylenetetrahydrofolate reductase causes morphological and functional cerebrovascular deficits in mice. J Cereb Blood Flow Metab 2022; 42:2333-2350. [PMID: 36050860 PMCID: PMC9670012 DOI: 10.1177/0271678x221122644] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 06/30/2022] [Accepted: 07/12/2022] [Indexed: 02/03/2023]
Abstract
Vascular contributions to cognitive impairment and dementia (VCID) particularly Alzheimer's disease and related dementias (ADRDs) are increasing; however, mechanisms driving cerebrovascular decline are poorly understood. Methylenetetrahydrofolate reductase (MTHFR) is a critical enzyme in the folate and methionine cycles. Variants in MTHFR, notably 677 C > T, are associated with dementias, but no mouse model existed to identify mechanisms by which MTHFR677C > T increases risk. Therefore, MODEL-AD created a novel knock-in (KI) strain carrying the Mthfr677C > T allele on the C57BL/6J background (Mthfr677C > T) to characterize morphology and function perturbed by the variant. Consistent with human clinical data, Mthfr677C > T mice have reduced enzyme activity in the liver and elevated plasma homocysteine levels. MTHFR enzyme activity is also reduced in the Mthfr677C > T brain. Mice showed reduced tissue perfusion in numerous brain regions by PET/CT as well as significantly reduced vascular density, pericyte number and increased GFAP-expressing astrocytes in frontal cortex. Electron microscopy revealed cerebrovascular damage including endothelial and pericyte apoptosis, reduced luminal size, and increased astrocyte and microglial presence in the microenvironment. Collectively, these data support a mechanism by which variations in MTHFR perturb cerebrovascular health laying the foundation to incorporate our new Mthfr677C > T mouse model in studies examining genetic susceptibility for cerebrovascular dysfunction in ADRDs.
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Affiliation(s)
| | - Karen E Christensen
- Departments of Human Genetics and Pediatrics, McGill University,
Research Institute of the Health Center, Montreal, QC, Canada
| | | | - Amanda A Bedwell
- Department of Medicine, Division of Clinical Pharmacology,
Indiana University School of Medicine, Indianapolis, IN, USA
| | - Kierra Eldridge
- Department of Medicine, Division of Clinical Pharmacology,
Indiana University School of Medicine, Indianapolis, IN, USA
| | - Rachael Speedy
- Department of Medicine, Division of Clinical Pharmacology,
Indiana University School of Medicine, Indianapolis, IN, USA
| | - Lucas L Figueiredo
- Department of Medicine, Division of Clinical Pharmacology,
Indiana University School of Medicine, Indianapolis, IN, USA
| | - Scott C Persohn
- Department of Medicine, Division of Clinical Pharmacology,
Indiana University School of Medicine, Indianapolis, IN, USA
| | - Teodoro Bottiglieri
- Center of Metabolomics, Institute of Metabolic Disease, Baylor
Scott & White Research Institute, Dallas, TX, USA
| | - Kwangsik Nho
- Center for Neuroimaging, Indiana Alzheimer’s Disease Research
Center, Department of Radiology and Imaging Sciences, Indiana University School
of Medicine, Indianapolis, IN, USA
| | | | - Paul R Territo
- Department of Medicine, Division of Clinical Pharmacology,
Indiana University School of Medicine, Indianapolis, IN, USA
| | - Rima Rozen
- Departments of Human Genetics and Pediatrics, McGill University,
Research Institute of the Health Center, Montreal, QC, Canada
| | - Gareth R Howell
- The Jackson Laboratory, Bar Harbor, ME, USA
- Graduate School of Biomedical Sciences, Tufts University School
of Medicine, Boston, MA, USA
- Graduate School of Biomedical Sciences and Engineering,
University of Maine, Orono, ME, USA
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Optical Coherence Tomography Angiography as a Noninvasive Assessment of Cerebral Microcirculatory Disorders Caused by Carotid Artery Stenosis. DISEASE MARKERS 2021; 2021:2662031. [PMID: 34326905 PMCID: PMC8277520 DOI: 10.1155/2021/2662031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/17/2021] [Indexed: 11/18/2022]
Abstract
Purpose Using retinal optical coherence tomography angiography (OCTA), we aimed to investigate the changes in important indicators of cerebral microcirculatory disorders, such as the properties of the radial peripapillary capillaries, vascular complexes, and the retinal nerve fiber layer, caused by carotid stenosis and postoperative reperfusion. Methods In this prospective longitudinal cohort study, we recruited 40 carotid stenosis patients and 89 healthy volunteers in the First Affiliated Hospital of Harbin Medical University (Harbin, China). Eyes with ipsilateral carotid stenosis constituted the experimental group, while the fellow eyes constituted the contralateral eye group. Digital subtraction angiography, CT perfusion imaging (CTP), and OCTA examinations were performed in all subjects. The vessel density of the radial peripapillary capillaries (RPC), superficial retinal vascular complexes (SVC), deep vascular complexes (DVC), choriocapillaris (CC), and the thickness of the retinal nerve fiber layer (RNFL) were assessed. Propensity-matched analysis was undertaken to adjust for covariate imbalances. Intergroup comparative analysis was conducted, and the paired sample t-test was used to evaluate the preoperative and postoperative changes in OCTA variables. Results The ocular vessel density in the experimental group was significantly lower than that in the control group (RPC: 55.95 vs. 57.24, P = 0.0161; SVC: 48.65 vs. 52.22, P = 0.0006; DVC: 49.65 vs. 57.50, P < 0.0001). Participants with severe carotid stenosis have reduced contralateral ocular vessel density (RPC 54.30; SVC 48.50; DVC 50.80). Unilateral stenosis removal resulted in an increase in vessel density on both sides, which was detected by OCTA on the 4th day (RPC, P < 0.0001; SVC, P = 0.0104; DVC, P = 0.0104). Moreover, the ocular perfusion was consistent with that established by CTP. Conclusion OCTA can be used for sensitive detection and accurate evaluation of decreased ocular perfusion caused by carotid stenosis and may thus have the potential for application in noninvasive detection of cerebral microcirculation disorders. This trial is registered with NCT04326842.
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Li CX, Liu YG, Che YP, Ou JL, Ruan WC, Yu YL, Li HF. Association Between MTHFR C677T Polymorphism and Susceptibility to Autism Spectrum Disorders: A Meta-Analysis in Chinese Han Population. Front Pediatr 2021; 9:598805. [PMID: 33777860 PMCID: PMC7987783 DOI: 10.3389/fped.2021.598805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 01/08/2021] [Indexed: 12/22/2022] Open
Abstract
Prior studies have examined the influence of MTHFR C677T on autism susceptibility, however, there are no consensus conclusions and specific analyses of a Chinese population. This meta-analysis included a false-positive report probability (FPRP) test to comprehensively evaluate the association of MTHFR C677T polymorphism with autism susceptibility among a Chinese Han population. A large-scale literature retrieval was conducted using various databases including PubMed, Embase, Wan Fang, and the Chinese National Knowledge Infrastructure (CNKI) up to July 31, 2020, with a total of 2,258 cases and 2,073 controls included. The strength of correlation was assessed by odds ratios (ORs) and 95% confidence intervals (95% CIs). MTHFR C677T showed a significant correlation with increased ASD susceptibility under all genetic models (T vs. C, OR = 1.89, 95% CI 1.28 to 2.79; TT vs. CC: OR = 2.44, 95% CI 1.43 to 4.15; CT vs. CC, OR = 1.73; 95% CI 1.19 to 2.51; CT + TT vs. CC: OR = 2.03, 95% CI 1.31 to 3.15; TT vs. CT + CC, OR = 1.95, 95% CI 1.21 to 3.13). Stratification analysis by region also revealed a consistent association in the Northern Han subgroup, but not in the Southern Han subgroup. Pooled minor allele frequency (MAF) of 30 studies were 45% in Northern Han and 39% in Southern Han. To avoid a possible "false positive report," we further investigated the significant associations observed in the present meta-analysis using the FPRP test, which consolidated the results. In conclusion, MTHFR C677T polymorphism is associated with the increased risk of autism in China, especially in Northern Han. For those mothers and children who are generally susceptible to autism, prenatal folate and vitamin B12 may reduce the risk that children suffer from autism, especially in Northern Han populations. In the future, more well-designed studies with a larger sample size are expected.
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Affiliation(s)
- Chen-Xi Li
- Department of Rehabilitation, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Yi-Guang Liu
- Department of Linguistics, Zhejiang University, Hangzhou, China
| | - Yue-Ping Che
- Department of Rehabilitation, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Jian-Lin Ou
- Department of Rehabilitation Medicine, the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Wen-Cong Ruan
- Department of Rehabilitation, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Yong-Lin Yu
- Department of Rehabilitation, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Hai-Feng Li
- Department of Rehabilitation, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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Yahyaoui R, Blasco-Alonso J, Gonzalo-Marín M, Benito C, Serrano-Nieto J, González-Gallego I, Ruiz-Sala P, Pérez B, González-Lamuño D. Metabolic Serendipities of Expanded Newborn Screening. Genes (Basel) 2020; 11:genes11091018. [PMID: 32872442 PMCID: PMC7565434 DOI: 10.3390/genes11091018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 08/20/2020] [Accepted: 08/27/2020] [Indexed: 01/11/2023] Open
Abstract
Incidental findings on newborn screening (NBS) are results that are not the target of screening within a given NBS program, but rather are found as a result of the screening and resulting diagnostic workup for that target. These findings may not have an immediate clinical impact on the newborn, but are sometimes an additional benefit of NBS programs and may be considered secondary targets of NBS programs. This work describes four case reports that had incidental findings on the NBS, which eventually led to the diagnosis of another metabolic disease instead of the one that was initially suspected. The first case was a new defect in the cationic amino acid transporter-2 (CAT-2), which was oriented as an arginase-1 deficiency in the newborn. The second case was a maternal glutaric aciduria type 1 (GA-1) that mimicked a carnitine transporter deficiency in the newborn. The third report was a case of lysinuric protein intolerance (LPI), which appeared as high levels of citrulline on the NBS. The fourth case was a mother with homocystinuria that was diagnosed during the biochemical study of vitamin B12 status. All cases provide new or interesting data that will help guide differential diagnosis in the future.
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Affiliation(s)
- Raquel Yahyaoui
- Laboratory of Metabolic Disorders, Hospital Regional Universitario de Málaga, 29011 Málaga, Spain
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain; (J.B.-A.); (M.G.-M.)
- Correspondence: ; Tel.: +34-687806035
| | - Javier Blasco-Alonso
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain; (J.B.-A.); (M.G.-M.)
- Pediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital Regional Universitario de Málaga, 29011 Málaga, Spain;
| | - Montserrat Gonzalo-Marín
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain; (J.B.-A.); (M.G.-M.)
- Endocrinology and Nutrition Unit, Hospital Regional Universitario de Málaga, 29011 Málaga, Spain
| | - Carmen Benito
- Department of Genetics, Hospital Regional Universitario de Málaga, 29011 Málaga, Spain;
| | - Juliana Serrano-Nieto
- Pediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital Regional Universitario de Málaga, 29011 Málaga, Spain;
| | - Inmaculada González-Gallego
- Unit of Metabolic Disorders, Centro de Bioquímica y Genética Clínica, Hospital Universitario Virgen de la Arrixaca, 30120 Murcia, Spain;
| | - Pedro Ruiz-Sala
- Centro Diagnóstico de Enfermedades Moleculares (CEDEM), Centro de Biología Molecular, Universidad Autónoma de Madrid, CIBERER, IdiPAZ, 28049 Madrid, Spain; (P.R.-S.); (B.P.)
| | - Belén Pérez
- Centro Diagnóstico de Enfermedades Moleculares (CEDEM), Centro de Biología Molecular, Universidad Autónoma de Madrid, CIBERER, IdiPAZ, 28049 Madrid, Spain; (P.R.-S.); (B.P.)
| | - Domingo González-Lamuño
- Department of Pediatrics, University of Cantabria-University Hospital Marqués de Valdecilla, 39008 Santander, Spain;
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