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Shah SZH, Rashid A, Majeed A, Ghafoor T, Azam N. Sanger Sequencing Reveals Novel Variants in GLO-1, ACE, and CBR1 Genes in Patients of Early and Severe Diabetic Nephropathy. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1540. [PMID: 39336582 PMCID: PMC11433688 DOI: 10.3390/medicina60091540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Revised: 09/08/2024] [Accepted: 09/18/2024] [Indexed: 09/30/2024]
Abstract
Background and Objectives: Diabetes is a global health issue, with approximately 50% of patients developing diabetic nephropathy (DN) and 25% experiencing early and severe forms of the disease. The genetic factors contributing to rapid disease progression in a subset of these patients are unclear. This study investigates genetic variations in the GLO-1, CBR-1, and ACE genes associated with early and severe DN. Materials and Methods: Sanger DNA sequencing of the exons of CBR1, GLO1, and ACE genes was conducted in 113 patients with early and severe DN (defined as occurring within 10 years of the diagnosis of diabetes and with eGFR < 45 mL/min/1.73 m2) and 100 controls. The impact of identified genetic variations was analyzed using computational protein models created in silico with SWISS-Model and SWISS-Dock for ligand binding interactions. Results: In GLO1, two heterozygous missense mutations, c.102G>T and c.147C>G, and one heterozygous nonsense mutation, c.148G>T, were identified in patients. The SNP rs1049346 (G>A) at location 6:38703061 (GRCh38) was clinically significant. The c.147C>G mutation (C19S) was associated with ligand binding disruption in the GLO1 protein, while the nonsense mutation resulted in a truncated, non-functional protein. In CBR1, two heterozygous variations, one missense c.358G>A, and one silent mutation c.311G>C were observed, with the former (D120N) affecting the active site. No significant changes were noted in ACE gene variants concerning protein structure or function. Conclusions: The study identifies four novel and five recurrent mutations/polymorphisms in GLO1, ACE, and CBR1 genes associated with severe DN in Pakistani patients. Notably, a nonsense mutation in GLO1 led to a truncated, non-functional protein, while missense mutations in GLO1 and CBR1 potentially disrupt enzyme function, possibly accelerating DN progression.
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Affiliation(s)
- Syed Zubair Hussain Shah
- Department of Biochemistry and Molecular Biology, Army Medical College, National University of Medical Sciences, Rawalpindi 46000, Pakistan; (A.R.); (A.M.)
| | - Amir Rashid
- Department of Biochemistry and Molecular Biology, Army Medical College, National University of Medical Sciences, Rawalpindi 46000, Pakistan; (A.R.); (A.M.)
| | - Asifa Majeed
- Department of Biochemistry and Molecular Biology, Army Medical College, National University of Medical Sciences, Rawalpindi 46000, Pakistan; (A.R.); (A.M.)
| | - Tariq Ghafoor
- Armed Forces Bone Marrow Transplant Center, Rawalpindi 46000, Pakistan;
| | - Nadeem Azam
- Pak Emirates Military Hospital, Rawalpindi 46000, Pakistan
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Kim NY, Kim JE, Choi CH, Chung KH. Chronic kidney disease in postmenopausal women is associated with tooth loss. Menopause 2024; 31:663-668. [PMID: 38860929 DOI: 10.1097/gme.0000000000002375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
OBJECTIVE Menopause is characterized by changes in reproductive hormone levels that can negatively affect bone. Chronic kidney disease (CKD) and tooth loss are also important and common health issues after menopause. This study aimed to evaluate the association between CKD and tooth loss in postmenopausal women. METHODS The study evaluated 64,971 participants who participated in the Korean National Health and Nutrition Examination Survey (KNHANES) from 2010-2018, including postmenopausal women, aged 40 to 79 years. Participants were divided into two groups based on the number of teeth in their dentition (≥20 and <20). MAIN OUTCOME MEASURES The association between CKD and tooth loss was analyzed using multivariate logistic regression. Age, income, education, smoking, alcohol intake, body mass index, hypertension, diabetes, annual oral examination, toothbrushing, and the use of oral care products were considered. Subgroup analyses were further conducted according to age (40-65 yr and 66-79 yr). RESULTS After adjusting for covariates, CKD and estimated glomerular filtration rate were significantly associated with having ≥20 teeth (PT20; CKD: odds ratio [OR] 1.41, 95% confidence interval [CI] 1.04-1.90; estimated glomerular filtration rate (10 mL/min/1.73 m 2 ): OR 0.90, 95% CI 0.86-0.94). Importantly, the association between CKD and PT20 was significant in postmenopausal women, aged 66 to 79 years (OR 1.45, 95% CI 1.05-2.01). CONCLUSIONS In postmenopausal women, CKD and tooth loss may be associated. The association is significant in postmenopausal women, aged 66 to 79 years.
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Affiliation(s)
- Na-Yeong Kim
- From the Department of Preventive and Public Health Dentistry, Chonnam National University School of Dentistry, Gwangju, Republic of Korea
| | - Ji-Eun Kim
- From the Department of Preventive and Public Health Dentistry, Chonnam National University School of Dentistry, Gwangju, Republic of Korea
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Adamson WE, Noyes H, Johnson P, Cooper A, Monckton DG, Ogunsola J, Beckett-Hill G, Sullivan M, Mark P, Parekh RS, MacLeod A. Phenome-wide analysis reveals epistatic associations between APOL1 variants and chronic kidney disease and multiple other disorders. EBioMedicine 2024; 101:105000. [PMID: 38360481 PMCID: PMC10944146 DOI: 10.1016/j.ebiom.2024.105000] [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: 06/26/2023] [Revised: 01/21/2024] [Accepted: 01/23/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND APOL1 variants G1 and G2 are common in populations with recent African ancestry. They are associated with protection from African sleeping sickness, however homozygosity or compound heterozygosity for these variants is associated with chronic kidney disease (CKD) and related conditions. What is not clear is the extent of associations with non-kidney-related disorders, and whether there are clusters of diseases associated with individual APOL1 genotypes. METHODS Using a cohort of 7462 UK Biobank participants with recent African ancestry, we conducted a phenome-wide association study investigating associations between individual APOL1 genotypes and conditions identified by the International Classification of Disease phenotypes. FINDINGS We identified 27 potential associations between individual APOL1 genotypes and a diverse range of conditions. G1/G2 compound heterozygotes were specifically associated with 26 of these conditions (all deleteriously), with an over-representation of infectious diseases (including hospitalisation and death resulting from COVID-19). The analysis also exposed complexities in the relationship between APOL1 and CKD that are not evident when risk variants are grouped together: G1 homozygosity, G2 homozygosity, and G1/G2 compound heterozygosity were each shown to be associated with distinct CKD phenotypes. The multi-locus nature of the G1/G2 genotype means that its associations would go undetected in a standard genome-wide association study. INTERPRETATION Our findings have implications for understanding health risks and better-targeted detection, intervention, and therapeutic strategies, particularly in populations where APOL1 G1 and G2 are common such as in sub-Saharan Africa and its diaspora. FUNDING This study was funded by the Wellcome Trust (209511/Z/17/Z) and H3Africa (H3A/18/004).
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Affiliation(s)
- Walt E Adamson
- School of Biodiversity, One Health, and Veterinary Medicine, University of Glasgow, United Kingdom; Wellcome Centre for Integrative Parasitology, University of Glasgow, United Kingdom; TrypanoGEN+ Research Group, Uganda, Member of the H3Africa Consortium, South Africa.
| | - Harry Noyes
- TrypanoGEN+ Research Group, Uganda, Member of the H3Africa Consortium, South Africa; Centre for Genomic Research, University of Liverpool, United Kingdom
| | - Paul Johnson
- School of Biodiversity, One Health, and Veterinary Medicine, University of Glasgow, United Kingdom
| | - Anneli Cooper
- School of Biodiversity, One Health, and Veterinary Medicine, University of Glasgow, United Kingdom; Wellcome Centre for Integrative Parasitology, University of Glasgow, United Kingdom
| | - Darren G Monckton
- School of Molecular Biosciences, University of Glasgow, United Kingdom
| | - John Ogunsola
- School of Biodiversity, One Health, and Veterinary Medicine, University of Glasgow, United Kingdom; Wellcome Centre for Integrative Parasitology, University of Glasgow, United Kingdom
| | - Georgia Beckett-Hill
- School of Biodiversity, One Health, and Veterinary Medicine, University of Glasgow, United Kingdom
| | - Michael Sullivan
- School of Cardiovascular and Metabolic Health, University of Glasgow, United Kingdom
| | - Patrick Mark
- School of Cardiovascular and Metabolic Health, University of Glasgow, United Kingdom
| | - Rulan S Parekh
- Women's College Hospital, Hospital for Sick Children and University of Toronto, Canada
| | - Annette MacLeod
- School of Biodiversity, One Health, and Veterinary Medicine, University of Glasgow, United Kingdom; Wellcome Centre for Integrative Parasitology, University of Glasgow, United Kingdom; TrypanoGEN+ Research Group, Uganda, Member of the H3Africa Consortium, South Africa.
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Nonterah CW. Systems Connected to Inequities in Access to Kidney Transplantation and the Value of Intersectionality. Transpl Int 2024; 37:11658. [PMID: 38344260 PMCID: PMC10853452 DOI: 10.3389/ti.2024.11658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 01/10/2024] [Indexed: 02/15/2024]
Abstract
Patients from minoritized backgrounds based on race/ethnicity, gender, sexuality, and other social identities are more likely to experience inequities in access in kidney transplantation. Although these inequities have been reported over the decades, limited research focuses on the experiences of patients with intersecting minoritized social statuses and the mechanisms that contribute to their reduced access to transplantation. Intersectionality, a framework for understanding the ways in which multiple social identities represent interacting systems of oppression and privilege, offers a nuanced approach for understanding the experiences of patients diagnosed with end-stage organ disease with intersecting social identities. This article outlines complex systems that perpetuate inequities by highlighting the value of intersectionality in studying disparate outcomes to transplant and providing recommendations for the transplant community. This article aligns with the ESOT call for action to promote equity in transplantation worldwide.
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Affiliation(s)
- Camilla W. Nonterah
- Department of Psychology, University of Richmond, Richmond, VA, United States
- Department of Psychiatry, Virginia Commonwealth University Health System, Richmond, VA, United States
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Kasozi RN, Meeusen JW, Lieske JC. Estimating glomerular filtration rate with new equations: can one size ever fit all? Crit Rev Clin Lab Sci 2023; 60:549-559. [PMID: 37259709 PMCID: PMC10592396 DOI: 10.1080/10408363.2023.2214812] [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: 02/27/2023] [Revised: 04/25/2023] [Accepted: 05/13/2023] [Indexed: 06/02/2023]
Abstract
Glomerular filtration rate (GFR) is thought to be the best overall indicator of kidney health. On an individual patient basis, a working knowledge of GFR is important to understand the future risk for chronic kidney disease (CKD) progression, enhanced risk for cardiovascular disease and death, and for optimal medical management including the dosing of certain drugs. Although GFR can be directly measured using exogenous compounds that are eliminated by the kidney, these methods are not scalable for repeated and routine use in clinical care. Thus, in most circumstances GFR is estimated, termed estimated GFR (eGFR), using serum biomarkers that are eliminated by the kidney. Of these, serum creatinine, and to a lesser extent cystatin C, are most widely employed. However, the resulting number is simply a population average for an individual of that age and sex with a given serum creatinine and/or cystatin C, while the range of potential GFR values is actually quite large. Thus, it is important to consider characteristics of a given patient that might make this estimate better or worse in a particular case. In some circumstances, cystatin C or creatinine might be the better choice. Ultimately it is difficult, if not impossible, to have an eGFR equation that performs equally well in all populations. Thus, in certain cases it might be appropriate to directly measure GFR for high consequence medical decision-making, such as approval for kidney donation or prior to certain chemotherapeutic regimens. In all cases, the eGFR thresholds of CKD stage should not be viewed as absolute numbers. Thus, clinical care should not be determined solely by CKD stage as determined by eGFR alone, but rather by the combination of an individual patient's likely kidney function together with their current clinical situation.
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Affiliation(s)
- Ramla N. Kasozi
- Department of Family Medicine, Mayo Clinic, Jacksonville, FL
| | - Jeffrey W. Meeusen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - John C. Lieske
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
- Department of Internal Medicine, Division of Nephrology and Hypertension Mayo Clinic, Rochester, MN
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Avilez ND, Nolazco JI, Chang SL, Reis LO. Urological impact of race-free estimated glomerular filtration rate equations. Int Braz J Urol 2023; 49:665-667. [PMID: 37903003 PMCID: PMC10947618 DOI: 10.1590/s1677-5538.ibju.2023.9913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 09/10/2023] [Indexed: 11/01/2023] Open
Affiliation(s)
- Natália Dalsenter Avilez
- Universidade Estadual de CampinasCampinasSPBrasilUroScience, Universidade Estadual de Campinas (Unicamp). Campinas, SP, Brasil;
| | - José Ignacio Nolazco
- Harvard Medical SchoolBrigham and Women's HospitalDivision of Urological SurgeryBostonMAUSADivision of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School. Boston, MA, USA;
- Universidad AustralHospital Universitario AustralProvincia de Buenos AiresArgentinaServicio de Urología, Hospital Universitario Austral, Universidad Austral. Provincia de Buenos Aires, Argentina;
| | - Steven Lee Chang
- Harvard Medical SchoolBrigham and Women's HospitalDivision of Urological SurgeryBostonMAUSADivision of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School. Boston, MA, USA;
- Dana-Farber Cancer InstituteLank Center for Genitourinary OncologyBostonMAUSALank Center for Genitourinary Oncology, Dana-Farber Cancer Institute. Boston, MA, USA;
| | - Leonardo O. Reis
- Universidade Estadual de CampinasCampinasSPBrasilUroScience, Universidade Estadual de Campinas (Unicamp). Campinas, SP, Brasil;
- Pontifícia Universidade Católica de CampinasFaculdade de Ciências da VidaDepartamento de Oncologia UrológicaCampinasSPBrasilDepartamento de Oncologia Urológica, Faculdade de Ciências da Vida, Pontifícia Universidade Católica de Campinas (PUC-Campinas). Campinas, SP, Brasil
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Estimated glomerular filtration rate equations: one size does not fit all. AIDS 2023; 37:845-847. [PMID: 36919789 DOI: 10.1097/qad.0000000000003502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
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Selvarajah S, Adil HS, Ekechi C. Race, ethnicity, and ill health: making the non-modifiable modifiable. Lancet 2022; 400:2008-2009. [PMID: 36502824 DOI: 10.1016/s0140-6736(22)02460-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Sujitha Selvarajah
- Race & Health, Institute for Global Health, University College London, London, UK; St George's Hospital NHS Foundation Trust, London, UK.
| | - Haleema Sadia Adil
- Race Equality Taskforce, Royal College of Obstetricians and Gynaecologists, London, UK; University College London Medical School, London, UK
| | - Christine Ekechi
- Queen Charlotte's & Chelsea Hospital, Imperial NHS Healthcare Trust, London, UK
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