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Pussadhamma B, Wongvipaporn C, Wutthimanop A, Nuinoon M, Porntadavity S, Jeenduang N. Identification of a novel LDLR p.Glu179Met variant in Thai families with familial hypercholesterolemia and response to treatment with PCSK9 inhibitor. Sci Rep 2024; 14:6785. [PMID: 38514665 PMCID: PMC10957951 DOI: 10.1038/s41598-024-57069-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 03/14/2024] [Indexed: 03/23/2024] Open
Abstract
Familial hypercholesterolemia (FH) is a genetic disease characterized by elevated LDL-C levels. In this study, two FH probands and 9 family members from two families from northeastern Thailand were tested for LDLR, APOB, and PCSK9 variants by whole-exome sequencing, PCR-HRM, and Sanger sequencing. In silico analysis of LDLR was performed to analyse its structure‒function relationship. A novel variant of LDLR (c.535_536delinsAT, p.Glu179Met) was detected in proband 1 and proband 2 in homozygous and heterozygous forms, respectively. A total of 6 of 9 family members were heterozygous for LDLR p.Glu179Met variant. Compared with proband 2, proband 1 had higher baseline TC and LDL-C levels and a poorer response to lipid-lowering therapy combined with a PCSK9 inhibitor. Multiple sequence alignment showed that LDLR p.Glu179Met was located in a fully conserved region. Homology modelling demonstrated that LDLR p.Glu179Met variant lost one H-bond and a negative charge. In conclusion, a novel LDLR p.Glu179Met variant was identified for the first time in Thai FH patients. This was also the first report of homozygous FH patient in Thailand. Our findings may expand the knowledge of FH-causing variants in Thai population, which is beneficial for cascade screening, genetic counselling, and FH management to prevent coronary artery disease.
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Affiliation(s)
- Burabha Pussadhamma
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Queen Sirikit Heart Center of the Northeast, Khon Kaen University, Khon Kaen, Thailand
| | - Chaiyasith Wongvipaporn
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Queen Sirikit Heart Center of the Northeast, Khon Kaen University, Khon Kaen, Thailand
| | - Atthakorn Wutthimanop
- Department of Internal Medicine, Maharaj Nakhon Si Thammarat Hospital, Nakhon Si Thammarat, Thailand
| | - Manit Nuinoon
- School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
| | | | - Nutjaree Jeenduang
- School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand.
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Genetic Spectrum of Familial Hypercholesterolaemia in the Malaysian Community: Identification of Pathogenic Gene Variants Using Targeted Next-Generation Sequencing. Int J Mol Sci 2022; 23:ijms232314971. [PMID: 36499307 PMCID: PMC9736953 DOI: 10.3390/ijms232314971] [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: 09/28/2022] [Revised: 11/11/2022] [Accepted: 11/17/2022] [Indexed: 12/02/2022] Open
Abstract
Familial hypercholesterolaemia (FH) is caused by mutations in lipid metabolism genes, predominantly in low-density lipoprotein receptor (LDLR), apolipoprotein B (APOB), proprotein convertase subtilisin/kexin-type 9 (PCSK9) and LDL receptor adaptor protein 1 (LDLRAP1). The prevalence of genetically confirmed FH and the detection rate of pathogenic variants (PV) amongst clinically diagnosed patients is not well established. Targeted next-generation sequencing of LDLR, APOB, PCSK9 and LDLRAP1 was performed on 372 clinically diagnosed Malaysian FH subjects. Out of 361 variants identified, 40 of them were PV (18 = LDLR, 15 = APOB, 5 = PCSK9 and 2 = LDLRAP1). The majority of the PV were LDLR and APOB, where the frequency of both PV were almost similar. About 39% of clinically diagnosed FH have PV in PCSK9 alone and two novel variants of PCSK9 were identified in this study, which have not been described in Malaysia and globally. The prevalence of genetically confirmed potential FH in the community was 1:427, with a detection rate of PV at 0.2% (12/5130). About one-fourth of clinically diagnosed FH in the Malaysian community can be genetically confirmed. The detection rate of genetic confirmation is similar between potential and possible FH groups, suggesting a need for genetic confirmation in index cases from both groups. Clinical and genetic confirmation of FH index cases in the community may enhance the early detection of affected family members through family cascade screening.
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Vasilyev V, Zakharova F, Bogoslovskay T, Mandelshtam M. Familial Hypercholesterolemia in Russia: Three Decades of Genetic Studies. Front Genet 2020; 11:550591. [PMID: 33391333 PMCID: PMC7773754 DOI: 10.3389/fgene.2020.550591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/16/2020] [Indexed: 12/31/2022] Open
Abstract
The first studies of familial hypercholesterolemia (FH) in Russia go back to late 1980-ies. For more than 10 years the research in this field was carried out in Saint-Petersburg, the megapolis in the North-West Russia. Studies were focused on the search for causative mutations in low-density lipoprotein receptor gene (LDLR). Gradually the research was spread to Petrozavodsk in Karelia and in the XXI century two more centers contributed in investigations of genetics of FH, i.e., in Moscow and Novosibirsk. The best studied is the spectrum of mutations in LDLR, though genetic abnormalities in APOB and PCSK9 genes were also considered. Despite that some 40% mutations in LDLR found in Saint-Petersburg and Moscow are referred to as specific for Russian population, and this proportion is even higher in Karelia (ca. 70%), rapid introduction of NGS and intensifying genetic research all over the world result in continuous decrease of these numbers as "Slavic" mutations become documented in other countries. The samplings of genetically characterized patients in Russia were relatively small, which makes difficult to specify major mutations reflecting the national specificity of FH. Moreover, the majority of studies accomplished so far did not explore possible associations of certain mutations with ethnic origin of patients. By now the only exception is the study of Karelian population showing the absence of typical Finnish mutations in the region that borders on Finland. It can be concluded that the important primary research partly characterizing the mutation spectrum in FH patients both in the European and Siberian parts of Russia has been done. However, it seems likely that the most interesting and comprehensive genetic studies of FH in Russia, concerning various mutations in different genes and the variety of ethnic groups in this multi-national country, are still to be undertaken.
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Affiliation(s)
- Vadim Vasilyev
- Institute of Experimental Medicine, Saint Petersburg, Russia
- St. Petersburg State University, Saint Petersburg, Russia
| | - Faina Zakharova
- Institute of Experimental Medicine, Saint Petersburg, Russia
- St. Petersburg State University, Saint Petersburg, Russia
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Guo Q, Feng X, Zhou Y. PCSK9 Variants in Familial Hypercholesterolemia: A Comprehensive Synopsis. Front Genet 2020; 11:1020. [PMID: 33173529 PMCID: PMC7538608 DOI: 10.3389/fgene.2020.01020] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 08/10/2020] [Indexed: 01/22/2023] Open
Abstract
Autosomal dominant familial hypercholesterolemia (FH) affects approximately 1/250, individuals and potentially leads to elevated blood cholesterol and a significantly increased risk of atherosclerosis. Along with improvements in detection and the increased early diagnosis and treatment, the serious burden of FH on families and society has become increasingly apparent. Since FH is strongly associated with proprotein convertase subtilisin/kexin type 9 (PCSK9), increasing numbers of studies have focused on finding effective diagnostic and therapeutic methods based on PCSK9. At present, as PCSK9 is one of the main pathogenic FH genes, its contribution to FH deserves more explorative research.
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Affiliation(s)
- Qianyun Guo
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Department of Cardiology, Beijing Anzhen Hospital, Clinical Center for Coronary Heart Disease, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
| | - Xunxun Feng
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Department of Cardiology, Beijing Anzhen Hospital, Clinical Center for Coronary Heart Disease, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
| | - Yujie Zhou
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Department of Cardiology, Beijing Anzhen Hospital, Clinical Center for Coronary Heart Disease, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
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Tajamolian M, Kolahdouz P, Nikpour P, Forouzannia SK, Sheikhha MH, Yazd EF. A Rare Missense Mutation and a Polymorphism with High Frequency in LDLR Gene among Iranian Patients with Familial Hypercholesterolemia. Adv Biomed Res 2018. [PMID: 29531935 PMCID: PMC5841003 DOI: 10.4103/2277-9175.225927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background: Familial hypercholesterolemia (FH) is a disorder that is inherited by autosomal dominant pattern. The main cause of FH disease is the occurrence of mutations in low-density lipoprotein receptor (LDLR) gene sequence, as well as apolipoprotein B and proprotein convertase subtilisin/kexin type 9 genes, located in the next ranks, respectively. Materials and Methods: Forty-five unrelated Iranian patients with FH were screened using a high-resolution melting (HRM) method for exon 9 along with intron/exon boundaries of LDLR gene. Samples with shift in resultant HRM curves were compared to normal ones, sequenced, and analyzed. Results: Our findings revealed a missense mutation c. 1246C>T and a known variant IVS9-30C>T (rs1003723) that was recognized in 71% of the patients (22%: homozygous and 49%: heterozygous genotypes). In silico analysis, predicted the pathological effect of the c. 1246C>T mutation in LDLR protein structure, but IVS9-30C>T variant had no predicted effect on splice site and branch point function. Conclusion: FH is a hereditary type of hypercholesterolemia that leads to premature cardiovascular disease and atherosclerosis, and early diagnosis is needed. We detected a rare missense mutation (1246C>T) and a common single nucleotide polymorphism (SNP) in the Iranian population. These reports could help in the genetic diagnosis and counseling of FH patients.
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Affiliation(s)
- Masoud Tajamolian
- Department of Genetics, Faculty of Medicine, Yazd, Iran.,Medical Genetics Research Center, Yazd, Iran
| | | | - Parvaneh Nikpour
- Department of Genetics and Molecular Biology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Mohammad Hasan Sheikhha
- Department of Genetics, Faculty of Medicine, Yazd, Iran.,Yazd Clinical and Research Center for Infertility, Yazd, Iran
| | - Ehsan Farashahi Yazd
- Department of Genetics, Faculty of Medicine, Yazd, Iran.,Yazd Clinical and Research Center for Infertility, Yazd, Iran
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ArulJothi KN, Suruthi Abirami B, Devi A. Genetic spectrum of low density lipoprotein receptor gene variations in South Indian population. Clin Chim Acta 2017; 478:28-36. [PMID: 29269200 DOI: 10.1016/j.cca.2017.12.024] [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: 08/08/2017] [Revised: 12/14/2017] [Accepted: 12/17/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Low density lipoprotein receptor (LDLR) is a membrane bound receptor maintaining cholesterol homeostasis along with Apolipoprotein B (APOB), Proprotein Convertase Subtilisin/Kexin type 9 (PCSK9) and other genes of lipid metabolism. Any pathogenic variation in these genes alters the function of the receptor and leads to Familial Hypercholesterolemia (FH) and other cardiovascular diseases. OBJECTIVE This study was aimed at screening the LDLR, APOB and PCSK9 genes in Hypercholesterolemic patients to define the genetic spectrum of FH in Indian population. METHODS Familial Hypercholesterolemia patients (n=78) of South Indian Tamil population with LDL cholesterol and Total cholesterol levels above 4.9mmol/l and 7.5mmol/l with family history of Myocardial infarction were involved. DNA was isolated by organic extraction method from blood samples and LDLR, APOB and PCSK9 gene exons were amplified using primers that cover exon-intron boundaries. The amplicons were screened using High Resolution Melt (HRM) Analysis and the screened samples were sequenced after purification. RESULTS This study reports 20 variations in South Indian population for the first time. In this set of variations 9 are novel variations which are reported for the first time, 11 were reported in other studies also. The in silico analysis for all the variations detected in this study were done to predict the probabilistic effect in pathogenicity of FH. CONCLUSION This study adds 9 novel variations and 11 recurrent variations to the spectrum of LDLR gene mutations in Indian population. All these variations are reported for the first time in Indian population. This spectrum of variations was different from the variations of previous Indian reports.
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Affiliation(s)
- K N ArulJothi
- Cardiovascular Genetics Group, Department of Genetic Genetic Engineering, SRM University, India
| | - B Suruthi Abirami
- Cardiovascular Genetics Group, Department of Genetic Genetic Engineering, SRM University, India
| | - Arikketh Devi
- Cardiovascular Genetics Group, Department of Genetic Genetic Engineering, SRM University, India.
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Fairoozy RH, Futema M, Vakili R, Abbaszadegan MR, Hosseini S, Aminzadeh M, Zaeri H, Mobini M, Humphries SE, Sahebkar A. The Genetic Spectrum of Familial Hypercholesterolemia (FH) in the Iranian Population. Sci Rep 2017; 7:17087. [PMID: 29213121 PMCID: PMC5719081 DOI: 10.1038/s41598-017-17181-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 11/15/2017] [Indexed: 12/16/2022] Open
Abstract
Familial hypercholesterolemia (FH) is an autosomal dominant disorder associated with premature cardiovascular disease (CVD). Mutations in the LDLR, APOB, and PCSK9 genes are known to cause FH. In this study, we analysed the genetic spectrum of the disease in subjects from the Iranian population with a clinical diagnosis of FH. Samples were collected from 16 children and family members from five different cities of Iran. Probands were screened for mutations in the LDLR, APOB, and PCSK9 genes using next generation sequencing, with results confirmed by Sanger sequencing. The likely pathology of identified variants was examined using in silico tools. Of the probands, 14 had a clinical diagnosis of homozygous FH and two of heterozygous FH. No mutations were found in either APOB or PCSK9, but nine probands were homozygous for seven different LDLR mutations, with p.(Trp577Arg) occurring in three and p.Val806Glyfs*11 occurring in two patients. Two mutations were novel: p.(Leu479Gln) and p.(Glu668*). Seven probands with a clinical diagnosis of FH were mutation negative. This pilot study, integrating clinical and molecular-based techniques, begins to elucidate the FH heterogeneity and the mutation spectrum in the Iranian population. Such information is important for future disease management and cost savings.
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Affiliation(s)
- R H Fairoozy
- Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, United Kingdom.,Molecular Diagnostic Unit, Clinical Laboratory Department, King Abdullah Medical city in Makkah, Makkah, Saudi Arabia
| | - M Futema
- Centre for Cardiology in the Young, Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - R Vakili
- Department of Pediatric Endocrinology and Metabolism, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M R Abbaszadegan
- Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - S Hosseini
- Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M Aminzadeh
- Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - H Zaeri
- Neonatal and Children Health Research Centre, Golestan University of Medical Sciences, Gorgan, Iran
| | - M Mobini
- School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - S E Humphries
- Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, United Kingdom.
| | - A Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
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Sharifi M, Higginson E, Bos S, Gallivan A, Harvey D, Li KW, Abeysekera A, Haddon A, Ashby H, Shipman KE, Cooper JA, Futema M, Roeters van Lennep JE, Sijbrands EJG, Labib M, Nair D, Humphries SE. Greater preclinical atherosclerosis in treated monogenic familial hypercholesterolemia vs. polygenic hypercholesterolemia. Atherosclerosis 2017; 263:405-411. [PMID: 28549500 PMCID: PMC5567405 DOI: 10.1016/j.atherosclerosis.2017.05.015] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 04/27/2017] [Accepted: 05/12/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS Familial hypercholesterolemia (FH) is a common inherited disorder of low density lipoprotein-cholesterol (LDL-C) metabolism. It is associated with higher risk of premature coronary heart disease. Around 60% of patients with a clinical diagnosis of FH do not have a detectable mutation in the genes causing FH and are most likely to have a polygenic cause for their raised LDL-C. We assessed the degree of preclinical atherosclerosis in treated patients with monogenic FH versus polygenic hypercholesterolemia. METHODS FH mutation testing and genotypes of six LDL-C-associated single nucleotide polymorphisms (SNPs) were determined using routine methods. Those with a detected mutation (monogenic) and mutation-negative patients with LDL-C SNP score in the top two quartiles (polygenic) were recruited. Carotid intima media thickness (IMT) was measured by B-mode ultrasound and the coronary artery calcium (CAC) score was performed in three lipid clinics in the UK and the Netherlands. RESULTS 86 patients (56 monogenic FH, 30 polygenic) with carotid IMT measurement, and 166 patients (124 monogenic, 42 polygenic) with CAC score measurement were examined. After adjustment for age and gender, the mean of all the carotid IMT measurements and CAC scores were significantly greater in the monogenic than the polygenic patients [carotid IMT mean (95% CI): 0.74 mm (0.7-0.79) vs. 0.66 mm (0.61-0.72), p = 0.038 and CAC score mean (95%): 24.5 (14.4-41.8) vs. 2.65 (0.94-7.44), p = 0.0004]. CONCLUSIONS In patients with a diagnosis of FH, those with a monogenic cause have a higher severity of carotid and coronary preclinical atherosclerosis than those with a polygenic aetiology.
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Affiliation(s)
- Mahtab Sharifi
- Centre for Cardiovascular Genetics, University College London, The Rayne Institute, University Street, London, WC1E 6JF, UK; Department of Clinical Biochemistry, The Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK
| | - Elizabeth Higginson
- Department of Clinical Biochemistry, Russells Hall Hospital, The Dudley Group NHS Foundation Trust, West Midlands, DY1 2HQ, UK
| | - Sven Bos
- Department of Internal Medicine, Rotterdam, The Netherlands
| | - Angela Gallivan
- Department of Clinical Biochemistry, The Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK
| | - Darren Harvey
- Department of Clinical Biochemistry, The Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK
| | - Ka Wah Li
- Centre for Cardiovascular Genetics, University College London, The Rayne Institute, University Street, London, WC1E 6JF, UK
| | - Amali Abeysekera
- Department of Clinical Biochemistry, Russells Hall Hospital, The Dudley Group NHS Foundation Trust, West Midlands, DY1 2HQ, UK
| | - Angela Haddon
- Department of Clinical Biochemistry, Russells Hall Hospital, The Dudley Group NHS Foundation Trust, West Midlands, DY1 2HQ, UK
| | - Helen Ashby
- Department of Clinical Biochemistry, Russells Hall Hospital, The Dudley Group NHS Foundation Trust, West Midlands, DY1 2HQ, UK
| | - Kate E Shipman
- Department of Clinical Biochemistry, Russells Hall Hospital, The Dudley Group NHS Foundation Trust, West Midlands, DY1 2HQ, UK
| | - Jackie A Cooper
- Centre for Cardiovascular Genetics, University College London, The Rayne Institute, University Street, London, WC1E 6JF, UK
| | - Marta Futema
- Inherited Cardiovascular Diseases, Institute for Cardiovascular Science, University College London, Paul O'Gorman Building, 72 Huntley Street, London, WC1E 6DD, UK
| | | | | | - Mourad Labib
- Department of Clinical Biochemistry, Russells Hall Hospital, The Dudley Group NHS Foundation Trust, West Midlands, DY1 2HQ, UK
| | - Devaki Nair
- Department of Clinical Biochemistry, The Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK
| | - Steve E Humphries
- Centre for Cardiovascular Genetics, University College London, The Rayne Institute, University Street, London, WC1E 6JF, UK.
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Chiou KR, Charng MJ. Detection of common sequence variations of familial hypercholesterolemia in Taiwan using DNA mass spectrometry. J Clin Lipidol 2017; 11:386-393.e6. [DOI: 10.1016/j.jacl.2016.12.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 12/21/2016] [Accepted: 12/30/2016] [Indexed: 01/18/2023]
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Durst R, Ibe UK, Shpitzen S, Schurr D, Eliav O, Futema M, Whittall R, Szalat A, Meiner V, Knobler H, Gavish D, Henkin Y, Ellis A, Rubinstein A, Harats D, Bitzur R, Hershkovitz B, Humphries SE, Leitersdorf E. Molecular genetics of familial hypercholesterolemia in Israel–revisited. Atherosclerosis 2017; 257:55-63. [DOI: 10.1016/j.atherosclerosis.2016.12.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Revised: 12/10/2016] [Accepted: 12/16/2016] [Indexed: 10/20/2022]
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ArulJothi K, Whitthall R, Futema M, Humphries S, George M, Elangovan S, Nair DR, Devi A. Molecular analysis of the LDLR gene in coronary artery disease patients from the Indian population. Clin Biochem 2016; 49:669-674. [DOI: 10.1016/j.clinbiochem.2016.02.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2015] [Revised: 02/22/2016] [Accepted: 02/24/2016] [Indexed: 02/07/2023]
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Abstract
PURPOSE OF REVIEW To compare the European and US guidelines for familial hypercholesterolaemia, but also all the European and US position/consensus papers on heterozygous and homozygous familial hypercholesterolaemia published recently. RECENT FINDINGS It has been established that the prevalence of familial hypercholesterolaemia was previously markedly underestimated. The disease is characterized by a lifelong significant increase in LDL cholesterol (LDL-C) levels and therefore premature atherosclerotic cardiovascular disease. Recommendations on familial hypercholesterolaemia have been included as a special chapter in the recent European (European Society of Cardiology/European Atherosclerosis Society) guidelines on dyslipidaemia, whereas in the new US (American College of Cardiology/American Heart Association) lipid guidelines they have been included only generally and these guidelines avoid mentioning familial hypercholesterolaemia explicitly. Both of these guidelines recommend statins in high doses as the treatment option. However, in the American College of Cardiology/American Heart Association guidelines, there is no requirement to attain a specific LDL-C target which is different from the European Society of Cardiology/European Atherosclerosis Society guidelines. Although these two guidelines differ markedly in a number of aspects, they both stress the need to diagnose familial hypercholesterolaemia patients as early as possible and to treat them with intensive LDL-C-lowering therapy. SUMMARY All the guidelines and consensus papers stress that earlier diagnosis and effective treatment can markedly improve life expectancy among familial hypercholesterolaemia patients.
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Affiliation(s)
- Željko Reiner
- Department of Internal Medicine, School of Medicine, University Hospital Centre Zagreb, University of Zagreb, Zagreb, Croatia
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14
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Wang H, Ye J, Qian H, Zhou R, Jiang J, Ye L. High-resolution melting analysis of MED12 mutations in uterine leiomyomas in Chinese patients. Genet Test Mol Biomarkers 2015; 19:162-6. [PMID: 25615570 PMCID: PMC4361005 DOI: 10.1089/gtmb.2014.0273] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Somatic mutations in mediator complex subunit 12 (MED12) have emerged as a critical genetic change in the development of uterine leiomyomas. Studies, however, have focused largely on cohorts consisting of Caucasian patients. In this study, uterine leiomyomas from Chinese patients were examined for MED12 mutations. In addition, polymerase chain reaction (PCR)-based high-resolution melting analysis (HRMA) was compared with direct sequencing as a potentially more sensitive method for the detection of MED12 mutations. METHODS Tissue samples with the pathologies of uterine leiomyoma (n=181) and other endometrial diseases (n=157) were collected from Chinese patients at the Taizhou People's Hospital and Taizhou Polytechnic College (Taizhou City, China). Genomic DNA was prepared from all samples. Both PCR-based HRMA and PCR-based direct sequencing were used to detect MED12 mutations. RESULTS PCR-based HRMA and direct sequencing revealed MED12 mutations in 95/181 (52.5%) and 93/181 (51.4%) uterine leiomyomas, respectively. Nearly half of these mutations (46/93) were found in a single codon, codon 131. The coincidence rate between the two methods was 98.9% (179/181) so that no statistically significant difference was evident in the application of the methodologies (χ(2)=0.011, p=0.916). In addition, MED12 mutations were identified in 1/157 (4.17%) case of other endometrial pathologies by both methods. CONCLUSIONS MED12 mutations were closely associated with the development of uterine leiomyomas, as opposed to other uterine pathologies in Chinese patients, and PCR-based HRMA was found to be a reliable method for the detection of MED12 mutations.
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Affiliation(s)
- Hua Wang
- Department of Laboratory Medicine, Taizhou People's Hospital, Taizhou City, China
| | - Jun Ye
- Department of Laboratory Medicine, Taizhou People's Hospital, Taizhou City, China
| | - Hua Qian
- Department of Laboratory Medicine, Taizhou People's Hospital, Taizhou City, China
| | - Ruifang Zhou
- Taizhou Polytechnic College, Taizhou City, China
| | - Jun Jiang
- Taizhou Polytechnic College, Taizhou City, China
| | - Lihua Ye
- Department of Laboratory Medicine, Taizhou People's Hospital, Taizhou City, China
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Faiz F, Nguyen LT, van Bockxmeer FM, Hooper AJ. Genetic screening to improve the diagnosis of familial hypercholesterolemia. ACTA ACUST UNITED AC 2014. [DOI: 10.2217/clp.14.32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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16
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Reiner Ž. Impact of Early Evidence of Atherosclerotic Changes on Early Treatment in Children With Familial Hypercholesterolemia. Circ Res 2014; 114:233-5. [DOI: 10.1161/circresaha.113.302952] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Željko Reiner
- From the Division for Metabolic Diseases, Department of Internal Medicine, University Hospital Center Zagreb, School of Medicine, Zagreb University, Zagreb, Croatia
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Zhang ZH, Yang ZG, Chen FP, Kikuchi A, Liu ZH, Kuang LZ, Li WM, Song YZ, Kure S, Saheki T. Screening for Five Prevalent Mutations of SLC25A13 Gene in Guangdong, China: A Molecular Epidemiologic Survey of Citrin Deficiency. TOHOKU J EXP MED 2014; 233:275-81. [DOI: 10.1620/tjem.233.275] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Zhan-Hui Zhang
- Department of Pediatrics, The First Affiliated Hospital, Jinan University
- Central Laboratory, The First Affiliated Hospital, Jinan University
| | - Zhi-Gang Yang
- Department of Pediatrics, The First Affiliated Hospital, Jinan University
| | - Feng-Ping Chen
- Department of Laboratory Science, The First Affiliated Hospital, Jinan University
| | - Atsuo Kikuchi
- Department of Pediatrics, Tohoku University Graduate School of Medicine
| | - Zhen-Huan Liu
- Department of Pediatric Neurorehabilitation, Nanhai Maternity and Child Care Hospital, Guangzhou University of Chinese Medicine
| | - Li-Zhen Kuang
- Department of Laboratory Science, Nanhai Maternity and Child Care Hospital, Guangzhou University of Chinese Medicine
| | - Wei-Ming Li
- Department of Pediatrics, Maternal and Child Health Hospital of Qingyuan City
| | - Yuan-Zong Song
- Department of Pediatrics, The First Affiliated Hospital, Jinan University
| | - Shigeo Kure
- Department of Pediatrics, Tohoku University Graduate School of Medicine
| | - Takeyori Saheki
- Institute of Resource Development and Analysis, Kumamoto University
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Analysis of the frequency and spectrum of mutations recognised to cause familial hypercholesterolaemia in routine clinical practice in a UK specialist hospital lipid clinic. Atherosclerosis 2013; 229:161-8. [PMID: 23669246 PMCID: PMC3701838 DOI: 10.1016/j.atherosclerosis.2013.04.011] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 04/03/2013] [Accepted: 04/03/2013] [Indexed: 12/16/2022]
Abstract
Aim To determine the frequency and spectrum of mutations causing Familial Hypercholesterolaemia (FH) in patients attending a single UK specialist hospital lipid clinic in Oxford and to identify characteristics contributing to a high mutation detection rate. Methods 289 patients (272 probands) were screened sequentially over a 2-year period for mutations in LDLR, APOB and PCSK9 using standard molecular genetic techniques. The Simon Broome (SB) clinical diagnostic criteria were used to classify patients and a separate cohort of 409 FH patients was used for replication. Results An FH-causing mutation was found in 101 unrelated patients (LDLR = 54 different mutations, APOB p.(Arg3527Gln) = 10, PCSK9 p.(Asp374Tyr) = 0). In the 60 SB Definite FH patients the mutation detection rate was 73% while in the 142 with Possible FH the rate was significantly lower (27%, p < 0.0001), but similar (14%, p = 0.06) to the 70 in whom there was insufficient data to make a clinical diagnosis. The mutation detection rate varied significantly (p = 9.83 × 10−5) by untreated total cholesterol (TC) levels (25% in those <8.1 mmol/l and 74% in those >10.0 mmol/l), and by triglyceride levels (20% in those >2.16 mmol/l and 60% in those <1.0 mmol/l (p = 0.0005)), with both effects confirmed in the replication sample (p for trend = 0.0001 and p = 1.8 × 10−6 respectively). There was no difference in the specificity or sensitivity of the SB criteria versus the Dutch Lipid Clinic Network score in identifying mutation carriers (AROC respectively 0.73 and 0.72, p = 0.68). Conclusions In this genetically heterogeneous cohort of FH patients the mutation detection rate was significantly dependent on pre-treatment TC and triglyceride levels. 54 different LDLR mutations found in a cohort of 272 FH probands. The cohort was found to be genetically heterogeneous with no specific FH mutation. Mutation detection rate was highly dependent on pre-treatment TC and TG levels. No difference in specificity/sensitivity between 2 clinical FH diagnosis approaches. Inadequate LDL-C reduction marks the need for more effective lipid-lowering therapy.
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Futema M, Plagnol V, Whittall RA, Neil HAW, Humphries SE. Use of targeted exome sequencing as a diagnostic tool for Familial Hypercholesterolaemia. J Med Genet 2013; 49:644-9. [PMID: 23054246 PMCID: PMC3475071 DOI: 10.1136/jmedgenet-2012-101189] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Familial Hypercholesterolaemia (FH) is an autosomal dominant disease, caused by mutations in LDLR, APOB or PCSK9, which results in high levels of LDL-cholesterol (LDL-C) leading to early coronary heart disease. An autosomal recessive form of FH is also known, due to homozygous mutations in LDLRAP1. This study assessed the utility of an exome capture method and deep sequencing in FH diagnosis. METHODS Exomes of 48 definite FH patients, with no mutation detected by current methods, were captured by Agilent Human All Exon 50Mb assay and sequenced on the Illumina HiSeq 2000 platform. Variants were called by GATK and SAMtools. RESULTS The mean coverage of FH genes varied considerably (PCSK9=23x, LDLRAP1=36x, LDLR=56x and APOB=93x). Exome sequencing detected 17 LDLR mutations, including three copy number variants, two APOB mutations, missed by the standard techniques, two LDLR novel variants likely to be FH-causing, and five APOB variants of uncertain effect. Two variants called in PCSK9 were not confirmed by Sanger sequencing. One heterozygous mutation was found in LDLRAP1. CONCLUSIONS High-throughput DNA sequencing demonstrated its efficiency in well-covered DNA regions, in particular LDLR. This highly automated technology is proving to be effective for heterogeneous diseases and may soon replace laborious conventional methods. However, the poor coverage of gene promoters and repetitive, or GC-rich sequences, remains problematic, and validation of all identified variants is currently required.
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Affiliation(s)
- Marta Futema
- Centre for Cardiovascular Genetics, British Heart Foundation Laboratories, Institute Cardiovascular Science, University College London Medicine School, London WC1E 6JF, UK
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Pećin I, Whittall R, Futema M, Sertić J, Reiner Ž, Leigh SEA, Humphries SE. Mutation detection in Croatian patients with Familial Hypercholesterolemia. Ann Hum Genet 2012; 77:22-30. [DOI: 10.1111/j.1469-1809.2012.00735.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Accepted: 08/25/2012] [Indexed: 02/03/2023]
Affiliation(s)
- Ivan Pećin
- Department of Internal Medicine; University Hospital Center Zagreb; Croatia
| | - Ros Whittall
- Centre for Cardiovascular Genetics; British Heart Foundation Laboratories, The Rayne Building; Royal Free and University College London Medical School; London; WC1E 6JJ; UK
| | - Marta Futema
- Centre for Cardiovascular Genetics; British Heart Foundation Laboratories, The Rayne Building; Royal Free and University College London Medical School; London; WC1E 6JJ; UK
| | - Jadranka Sertić
- Center for Clinical and Laboratory Diagnostics; University Hospital Center Zagreb; Croatia
| | - Željko Reiner
- Department of Internal Medicine; University Hospital Center Zagreb; Croatia
| | - Sarah E. A. Leigh
- Centre for Cardiovascular Genetics; British Heart Foundation Laboratories, The Rayne Building; Royal Free and University College London Medical School; London; WC1E 6JJ; UK
| | - Steve E. Humphries
- Centre for Cardiovascular Genetics; British Heart Foundation Laboratories, The Rayne Building; Royal Free and University College London Medical School; London; WC1E 6JJ; UK
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Usifo E, Leigh SEA, Whittall RA, Lench N, Taylor A, Yeats C, Orengo CA, Martin ACR, Celli J, Humphries SE. Low-Density Lipoprotein Receptor Gene Familial Hypercholesterolemia Variant Database: Update and Pathological Assessment. Ann Hum Genet 2012; 76:387-401. [DOI: 10.1111/j.1469-1809.2012.00724.x] [Citation(s) in RCA: 159] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Aihara M, Yamamoto S, Nishioka H, Inoue Y, Hamano K, Oka M, Mizukami Y. Optimizing high-resolution melting analysis for the detection of mutations of GPR30/GPER-1 in breast cancer. Gene 2012; 501:118-26. [DOI: 10.1016/j.gene.2012.04.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 03/27/2012] [Accepted: 04/09/2012] [Indexed: 11/16/2022]
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Abstract
Familial hypercholesterolaemia (FH) is an autosomal dominant disorder characterised by increased plasma concentrations of low density lipoprotein (LDL) cholesterol leading to atherosclerosis and premature coronary heart disease (CHD) and death. The clinical diagnosis of FH is based on a personal and family history, physical examination findings and LDL-cholesterol concentrations. FH is primarily caused by mutations in the LDL-receptor gene (LDLR), and less frequently by mutations in genes for APOB and the more recently identified PCSK9. Lifestyle modification and pharmacotherapy can delay or prevent the onset of CHD in FH. It is estimated that only 20% of cases have been diagnosed in Australia and that the majority are inadequately treated. Screening options for FH include population screening (of children or adults), targeted screening of patients with premature CHD and their relatives, or opportunistic screening such as flagging laboratory lipid reports. Cascade screening, a form of targeted screening, is an ethically acceptable, cost-effective strategy for the identification of FH. However, for screening to be successful, medical practitioners need to be aware of the signs and diagnosis of FH and the benefits of early treatment.
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Catapano AL, Reiner Z, De Backer G, Graham I, Taskinen MR, Wiklund O, Agewall S, Alegria E, Chapman MJ, Durrington P, Erdine S, Halcox J, Hobbs R, Kjekshus J, Filardi PP, Riccardi G, Storey RF, Wood D. ESC/EAS Guidelines for the management of dyslipidaemias The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Atherosclerosis 2012; 217:3-46. [PMID: 21882396 DOI: 10.1016/j.atherosclerosis.2011.06.028] [Citation(s) in RCA: 441] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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He X, Xie F, Ren ZR. Rapid Detection of G1138A and G1138C Mutations of the FGFR3 Gene in Patients with Achondroplasia Using High-Resolution Melting Analysis. Genet Test Mol Biomarkers 2012; 16:297-301. [PMID: 22339077 DOI: 10.1089/gtmb.2011.0113] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Xiang He
- Shanghai Institute of Medical Genetics, Children's Hospital of Shanghai, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
- Key Lab of Embryo Molecular Biology, Ministry of Health, China, and Shanghai Lab of Embryo and Reproduction Engineering, Shanghai, People's Republic of China
| | - Feng Xie
- Department of Orthopedics, Children's Hospital of Shanghai, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Zhao-rui Ren
- Shanghai Institute of Medical Genetics, Children's Hospital of Shanghai, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
- Key Lab of Embryo Molecular Biology, Ministry of Health, China, and Shanghai Lab of Embryo and Reproduction Engineering, Shanghai, People's Republic of China
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Novel and recurrent LDLR gene mutations in Pakistani hypercholesterolemia patients. Mol Biol Rep 2012; 39:7365-72. [PMID: 22311046 DOI: 10.1007/s11033-012-1568-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Accepted: 01/25/2012] [Indexed: 10/14/2022]
Abstract
The majority of patients with the autosomal dominant disorder familial hypercholesterolemia (FH) carry novel mutations in the low density lipoprotein receptor (LDLR) that is involved in cholesterol regulation. In different populations the spectrum of mutations identified is quite different and to date there have been only a few reports of the spectrum of mutations in FH patients from Pakistan. In order to identify the causative LDLR variants the gene was sequenced in a Pakistani FH family, while high resolution melting analysis followed by sequencing was performed in a panel of 27 unrelated sporadic hypercholesterolemia patients. In the family a novel missense variant (c.1916T > G, p.(V639G)) in exon 13 of LDLR was identified in the proband. The segregation of the identified nucleotide change in the family and carrier status screening in a group of 100 healthy subjects was done using restriction fragment length polymorphism analysis. All affected members of the FH family carried the variant and none of the non-affected members nor any of the healthy subjects. In one of the sporadic cases, two sequence changes were detected in exon 9, one of these was a recurrent missense variant (c.1211C > T; p.T404I), while the other was a novel substitution mutation (c.1214 A > C; N405T). In order to define the allelic status of this double heterozygous individual, PCR amplified fragments were cloned and sequenced, which identified that both changes occurred on the same allele. In silico tools (PolyPhen and SIFT) were used to predict the effect of the variants on the protein structure, which predicted both of these variants to have deleterious effect. These findings support the view that there will be a novel spectrum of mutations causing FH in patients with hypercholesterolaemia from Pakistan.
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Analysis of polymorphisms in the lactotransferrin gene promoter and dental caries. Int J Dent 2011; 2011:571726. [PMID: 22190933 PMCID: PMC3235467 DOI: 10.1155/2011/571726] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 09/09/2011] [Accepted: 09/09/2011] [Indexed: 01/19/2023] Open
Abstract
Regarding host aspects, there has been strong evidence for a genetic component in the etiology of caries. The salivary protein lactotransferrin (LTF) exhibits antibacterial activity, but there is no study investigating the association of polymorphisms in the promoter region of LTF gene with caries. The objective of this study was firstly to search the promoter region of the human LTF gene for variations and, if existent, to investigate the association of the identified polymorphisms with dental caries in 12-year-old students. From 687 unrelated, 12-year-old, both sex students, 50 individuals were selected and divided into two groups of extreme phenotypes according to caries experience: 25 students without (DMFT = 0) and 25 with caries experience (DMFT ≥ 4). The selection of individuals with extreme phenotypes augments the chances to find gene variations which could be associated with such phenotypes. LTF gene-putative promoter region (+39 to −1143) of the selected 50 individuals was analyzed by high-resolution melting technique. Fifteen students, 8 without (DMFT = 0) and 7 with caries experience (mean DMFT = 6.28), presented deviations of the pattern curve suggestive of gene variations and were sequenced. However, no polymorphisms were identified in the putative promoter region of the LTF gene.
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Reiner Ž, Catapano AL, De Backer G, Graham I, Taskinen MR, Wiklund O, Agewall S, Alegría E, Chapman MJ, Durrington P, Erdine S, Halcox J, Hobbs RH, Kjekshus JK, Perrone Filardi P, Riccardi G, Storey RF, David W. [ESC/EAS Guidelines for the management of dyslipidaemias]. Rev Esp Cardiol 2011; 64:1168.e1-1168.e60. [PMID: 22115524 DOI: 10.1016/j.recesp.2011.09.014] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 09/16/2011] [Indexed: 01/15/2023]
Affiliation(s)
- Željko Reiner
- University Hospital Center Zagreb, School of Medicine, University of Zagreb, Salata 2, 10 000 Zagreb, Croacia.
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Reiner Z, Catapano AL, De Backer G, Graham I, Taskinen MR, Wiklund O, Agewall S, Alegria E, Chapman MJ, Durrington P, Erdine S, Halcox J, Hobbs R, Kjekshus J, Filardi PP, Riccardi G, Storey RF, Wood D. ESC/EAS Guidelines for the management of dyslipidaemias: The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J 2011; 32:1769-818. [PMID: 21712404 DOI: 10.1093/eurheartj/ehr158] [Citation(s) in RCA: 1932] [Impact Index Per Article: 148.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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