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Cruz-Ortíz BL, Hernández-Zamora E, Reyes-Maldonado E, Rodríguez-Olivas AO, Rubio-Lightbourn J, Martínez-Ramírez CO, Castro-Hernández C, Lezama-Palacios R, Casas-Avila L. Bone Remodeling and Bone Structural Genes in Legg-Calvé-Perthes Disease: The OPG rs2073618 and IL-6 rs1800795 Are Associated with High Risk in Mexican Patients. DNA Cell Biol 2024; 43:288-297. [PMID: 38648538 DOI: 10.1089/dna.2023.0411] [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] [Indexed: 04/25/2024] Open
Abstract
Legg-Calve-Perthes disease (LCPD) is an idiopathic avascular necrosis of the pediatric femoral head. Bone remodeling and bone structural genes have the potential to contribute to the progression of LCPD when there is disequilibrium between bone resorption and bone formation. A case-control study was performed to search for associations of several common polymorphisms in the genes Receptor Activator for Nuclear Factor κappa B (RANK), Receptor Activator for Nuclear Factor κappa B Ligand (RANKL), osteoprotegerin (OPG), interleukin (IL)-6, and type 1 collagen (COL1A1) with LCPD susceptibility in Mexican children. A total of 23 children with LCPD and 46 healthy controls were genotyped for seven polymorphisms (rs3018362, rs12585014, rs2073618, rs1800795, rs1800796, rs1800012, and rs2586498) in the RANK, RANKL, OPG, IL-6, and COL1A1 genes by real-time polymerase chain reaction with TaqMan probes. The variant allele (C) of IL-6 rs1800795 was associated with increased risk of LCPD (odds ratio [OR]: 3.8, 95% confidence interval [CI]: [1.08-13.54], p = 0.033), adjusting data by body mass index (BMI) and coagulation factor V (FV), the association with increased risk remained (OR: 4.9, 95% CI: [1.14-21.04], p = 0.025). The OPG polymorphism rs2073618, specifically GC-GG carriers, was associated with a more than fourfold increased risk of developing LCPD (OR: 4.34, 95% CI: [1.04-18.12], p = 0.033) when data were adjusted by BMI-FV. There was no significant association between RANK rs3018362, RANKL rs12585014, IL-6 rs1800796, COL1A1 rs1800012, and rs2586498 polymorphisms and LCPD in a sample of Mexican children. The rs1800975 and rs2037618 polymorphisms in the IL-6 and OPG genes, respectively, are informative markers of increased risk of LCPD in Mexican children.
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Affiliation(s)
- Blanca Lucía Cruz-Ortíz
- Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Ciudad de México, México
| | | | - Elba Reyes-Maldonado
- Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Ciudad de México, México
| | | | - Julieta Rubio-Lightbourn
- Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, México
| | | | - Clementina Castro-Hernández
- Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Ruth Lezama-Palacios
- Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Ciudad de México, México
| | - Leonora Casas-Avila
- Medicina Genómica, Instituto Nacional de Rehabilitación, Ciudad de México, México
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Matuszewska A, Sygacz O, Matuszewski Ł, Stec S, Grzegorzewski A, Gągała J. Association between Polymorphism eNOS4, tPA, Factor V Leiden, Prothrombin, and Methylenetetrahydrofolate Reductase and the Occurrence of Legg-Calvé-Perthes Disease. J Clin Med 2023; 12:5209. [PMID: 37629250 PMCID: PMC10455469 DOI: 10.3390/jcm12165209] [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: 07/07/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Legg-Calvé-Perthes (LCPD) disease is a complex condition affecting the femoral head's epiphysis in children. It occurs with a prevalence ranging from 0.4 to 29.0 cases per 100,000 children under the age of 15. It involves various factors, including genes associated with coagulation and fibrinolysis, pro-inflammatory factors, and vasoactive substances. METHODS We investigated the relationship between genetic mutations associated with coagulation and vascular disorders and the occurrence of LCPD in Polish patients. We performed a study involving 25 patients with LCPD and 100 healthy controls. All subjects were genotyped for eNOS4, Factor V Leiden, prothrombin, tPA25, and MTHFR polymorphism. RESULTS The analysis revealed that the frequencies of eNOS4 genotypes were significantly different in LCPD patients than in the control group (p = 0.018). The frequencies of 4a allele were significantly higher in patients with LCPD than in the healthy population (26% vs. 9%, p = 0.0012). There were no significant differences in genotype and allele frequencies for Factor V Leiden, prothrombin tPA 25, and MTHFR gene polymorphisms between patients with LCPD and the controls. CONCLUSIONS Genotype and allele frequencies of eNOS4 were significantly higher in patients with LCPD. These findings suggest a potential association between the eNOS gene polymorphism and an increased risk of developing LCPD.
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Affiliation(s)
- Anna Matuszewska
- Department of Biochemistry, Maria Curie-Skłodowska University, 20-033 Lublin, Poland
| | - Oliwer Sygacz
- Department of Paediatric Orthopaedics and Rehabilitation, Medical University of Lublin, 20-059 Lublin, Poland; (O.S.); (Ł.M.); (S.S.)
| | - Łukasz Matuszewski
- Department of Paediatric Orthopaedics and Rehabilitation, Medical University of Lublin, 20-059 Lublin, Poland; (O.S.); (Ł.M.); (S.S.)
| | - Szymon Stec
- Department of Paediatric Orthopaedics and Rehabilitation, Medical University of Lublin, 20-059 Lublin, Poland; (O.S.); (Ł.M.); (S.S.)
| | - Andrzej Grzegorzewski
- Clinic of Orthopaedics and Paediatric Orthopaedic, Medical University of Łódź, 90-419 Lodz, Poland
| | - Jacek Gągała
- Orthopedic Surgery and Traumatology Department, Medical University of Lublin, 20-059 Lublin, Poland;
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Hernández-Zamora E, Rodríguez-Olivas AO, Rosales-Cruz E, Galicia-Alvarado MA, Zavala-Hernández C, Reyes-Maldonado E. Prothrombin Time and Coagulation Factor IX as Hemostatic Risk Markers for Legg- Calvé-Perthes Disease. Clin Appl Thromb Hemost 2023; 29:10760296221151166. [PMID: 36650707 PMCID: PMC9869215 DOI: 10.1177/10760296221151166] [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] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Legg-Calvé-Perthes disease (LCPD) is a pediatric disorder that occurs due to the avascular necrosis of the femoral head and affects the range of motion of the hip in various degrees. Its etiology is still unknown, although it has been associated with coagulation abnormalities, however, the lack of reproducibility in the results in various studies has created a controversy as to whether hemostasis disorders are related to LCPD. On the other hand, there is little information on laboratory studies that could facilitate the diagnosis and treatment of LCPD. METHODS Blood and plasma samples were tested from 25 patients with LCPD and 50 healthy controls, matched by sex and age. Cellular markers were evaluated through complete blood count, as well as coagulation times, coagulation factors activity, antithrombotic proteins, and homocysteine concentration. RESULTS After assessing activity value frequencies in each group, the results showed more significant activity in some of the biological risk markers of thrombophilia, presenting a substantial difference in prothrombin time↘, FV↗, FVIII↗, FIX↗, and Hcy↗. These values imply that there may be hypercoagulable states in patients, which can cause thrombotic events. CONCLUSIONS Diminished prothrombin time and increase in FV activity, FVIII, FIX, and Hcy concentration support the hypothesis that microthrombi formation in small-caliber vessels could be causing avascularity and femoral necrosis, which are traits of LCPD. In addition, based on our results, we believe that the laboratory studies carried out are very useful in the diagnosis and treatment of LCPD.
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Affiliation(s)
- Edgar Hernández-Zamora
- Genomic Medicine, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra (INR-LGII), México City, México
| | - Armando Odiseo Rodríguez-Olivas
- Morphology Department, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional (ENCB, IPN), México City, México,Armando Odiseo Rodríguez-Olivas, Morphology Department, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional (ENCB, IPN), Prolongación de Carpio y Plan de Ayala s/n, Col. Santo Tomás, Miguel Hidalgo, C.P. 11340, Mexico City, Mexico.
| | - Erika Rosales-Cruz
- Morphology Department, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional (ENCB, IPN), México City, México
| | | | | | - Elba Reyes-Maldonado
- Morphology Department, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional (ENCB, IPN), México City, México,Elba Reyes-Maldonado, Morphology Department, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional (ENCB, IPN), Prolongación de Carpio y Plan de Ayala s/n, Col. Santo Tomás, Miguel Hidalgo, C.P. 11340, Mexico City, Mexico.
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Hong P, Zhao X, Liu R, Rai S, Song Y, Xu R, Li J. Perthes Disease in a Child With Osteogenesis Imperfecta From a Rare Genetic Variant: A Case Report. Front Genet 2022; 13:920950. [PMID: 35873455 PMCID: PMC9304686 DOI: 10.3389/fgene.2022.920950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/06/2022] [Indexed: 12/02/2022] Open
Abstract
Background: Although certain genetic components have been reported as contributing factors for Perthes disease, its etiology remains unclear. We present a rare case of Perthes disease in a child with osteogenesis imperfecta (OI) caused by a mutation in the COL1A1 gene (NM_000088):exon25:c.1726C>T, (p.Gln576X). Case presentations: A 7-year-old boy was initially treated at our medical facility in March 2016 with a history of chronic pain in right hip joint and limping for a year. He was diagnosed as Perthes disease in the right hip joint. He underwent acetabular osteotomy and ipsilateral proximal femoral varus osteotomy for better containment. During the follow-ups, the right hip demonstrated a normal range of motion without pain, and the pelvic X-ray demonstrated Stulberg Type II hip joint with a round femoral head. In the latest admission in 2022, he suffered from a right femoral shaft fracture after petty violence. After reviewing his medical history, he was suspected of having OI. The whole exome sequencing demonstrated a gene mutation in COL1A1 (OMIM 166200) and confirmed the diagnosis of OI. Telescopic nailing was used to treat the femoral shaft fracture. After the nailing of the right femur, the appearance of the lower extremity seemed normal and symmetrical. Conclusion: This study revealed that there might be an association between OI and Perthes disease. Our case report enriches the phenotypes of osteogenesis imperfecta and provides insight into the pathogenesis of LCPD.
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Affiliation(s)
- Pan Hong
- Department of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaolong Zhao
- Department of Orthopaedics, First Hospital of Wuhan, Wuhan, China
| | - Ruikang Liu
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Saroj Rai
- Department of Orthopaedics and Trauma Surgery, Karama Medical Center, Dubai, United Arab Emirates
| | - Yingying Song
- Medical Department of Hubei University of Science and Technology, Xianning, China
| | - Ruijing Xu
- Department of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Ruijing Xu, ; Jin Li,
| | - Jin Li
- Department of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Ruijing Xu, ; Jin Li,
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