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Alshahrani S. Renin-angiotensin-aldosterone pathway modulators in chronic kidney disease: A comparative review. Front Pharmacol 2023; 14:1101068. [PMID: 36860293 PMCID: PMC9970101 DOI: 10.3389/fphar.2023.1101068] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/10/2023] [Indexed: 02/16/2023] Open
Abstract
Chronic kidney disease presents a health challenge that has a complex underlying pathophysiology, both acquired and inherited. The pharmacotherapeutic treatment options available today lower the progression of the disease and improve the quality of life but cannot completely cure it. This poses a challenge to the healthcare provider to choose, from the available options, the best way to manage the disease as per the presentation of the patient. As of now, the recommended first line of treatment to control the blood pressure in chronic kidney disease is the administration of renin-angiotensin-aldosterone system modulators. These are represented mainly by the direct renin inhibitor, angiotensin-converting enzyme inhibitors, and angiotensin II receptor blockers. These modulators are varied in their structure and mechanisms of action, hence showing varying treatment outcomes. The choice of administration of these modulators is determined by the presentation and the co-morbidities of the patient, the availability and affordability of the treatment option, and the expertise of the healthcare provider. A direct head-to-head comparison between these significant renin-angiotensin-aldosterone system modulators is lacking, which can benefit healthcare providers and researchers. In this review, a comparison has been drawn between the direct renin inhibitor (aliskiren), angiotensin-converting enzyme inhibitors, and angiotensin II receptor blockers. This can be of significance for healthcare providers and researchers to find the particular loci of interest, either in structure or mechanism, and to intervene as per the case presentation to obtain the best possible treatment option.
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Affiliation(s)
- Saeed Alshahrani
- Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Jizan, Saudi Arabia
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2
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ZHU YX, LIU G. The relationship between the insertion/deletion gene polymorphism of ACE and atrial fibrillation in Chinese population: a meta-analysis. FOOD SCIENCE AND TECHNOLOGY 2022. [DOI: 10.1590/fst.36020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Yu-xiang ZHU
- Chinese Academy of Medical Sciences & Peking Union Medical College, China
| | - Gang LIU
- Chinese Academy of Medical Sciences & Peking Union Medical College, China
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Kouhpayeh HR, Tabasi F, Dehvari M, Naderi M, Bahari G, Khalili T, Clark C, Ghavami S, Taheri M. Association between angiotensinogen (AGT), angiotensin-converting enzyme (ACE) and angiotensin-II receptor 1 (AGTR1) polymorphisms and COVID-19 infection in the southeast of Iran: a preliminary case-control study. TRANSLATIONAL MEDICINE COMMUNICATIONS 2021; 6:26. [PMID: 34805533 PMCID: PMC8596349 DOI: 10.1186/s41231-021-00106-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 10/31/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The COVID-19 pandemic remains an emerging public health crisis with serious adverse effects. The disease is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV--2) infection, targeting angiotensin-converting enzyme-2 (ACE2) receptor for cell entry. However, changes in the renin-angiotensin system (RAS) balance alter an individual's susceptibility to COVID-19 infection. We aimed to evaluate the association between AGT rs699 C > T, ACE rs4646994 I/D, and AGTR1 rs5186 C > A variants and the risk of COVID-19 infection and the severity in a sample of the southeast Iranian population. METHODS A total of 504 subjects, including 258 COVID-19 positives, and 246 healthy controls, were recruited. Genotyping of the ACE gene rs4646994, and AGT rs699, and AGTR1 rs5186 polymorphisms was performed by polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism (PCR-RFLP), respectively. RESULTS Our results showed that the II genotype of ACE rs4646994 and the I allele decreased the risk of COVID-19 infection. Moreover, we found that the TC genotype and C allele of AGT rs699 increased the risk of COVID-19 infection. The AGTR1 rs5186 was not associated with COVID-19 infection. Also, we did not find any association between these polymorphisms and the severity of the disease. However, we found a significantly higher age and prevalence of diabetes and hypertension in patients with severe disease than a non-severe disease. CONCLUSIONS These findings suggest that ACE rs4646994 and AGT rs699 polymorphisms increase the risk of COVID-19 infection in a southeast Iranian population.
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Affiliation(s)
- Hamid Reza Kouhpayeh
- Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Farhad Tabasi
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
- Department of Clinical Biochemistry, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mohammad Dehvari
- Genetics of Non-communicable Disease Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mohammad Naderi
- Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Gholamreza Bahari
- Children and Adolescent Health Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Tahereh Khalili
- Department of Clinical Biochemistry, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Courtney Clark
- Department of Human Anatomy and Cell Science, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB Canada
| | - Saeid Ghavami
- Department of Human Anatomy and Cell Science, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB Canada
| | - Mohsen Taheri
- Genetics of Non-communicable Disease Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
- Department of Genetic, School of Medicine, Zahedan University of Medical Sciences, Zahedan, 9816743463 Iran
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Yan Z, Fan Y, Meng Z, Huang C, Liu M, Zhang Q, Song K, Jia Q. The relationship between red blood cell distribution width and metabolic syndrome in elderly Chinese: a cross-sectional study. Lipids Health Dis 2019; 18:34. [PMID: 30704536 PMCID: PMC6357446 DOI: 10.1186/s12944-019-0978-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 01/17/2019] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Metabolic syndrome (MS) is a group of risk factors which includes hypertension, hyperglycemia, abnormal cholesterol levels, and obesity. Red blood cell distribution width (RDW) is a parameter that reflects the heterogeneity of erythrocyte volume. But the relationship between MS and RDW is intricate and remains poorly understood. We hypothesized that high RDW was associated with MS via inflammation. Our study aimed to investigate the association between RDW and MS in Chinese elderly large cohort. If RDW had a strong correlation with MS, RDW could become a predictor of MS? METHODS We recruited 10,887 ostensibly healthy participants aged from 60 to 93 (5795 male, 5092 female). Associations between RDW and other variables were assessed by Pearson correlation. Crude and adjusted odds ratio for MS with 95% confidence intervals was calculated by binary logistic regression models. RESULTS In elderly Chinese, RDW was significantly higher in males than in females. The prevalence of both men and women decreased with the rise of RDW. For both sexes, RDW demonstrated positive correlations with age, systolic blood pressure (0.070 in males,0.058 in females), high density lipoprotein(0.027in males,0.064 in females), negative correlations with triglycerides (- 0.120 in males,-0.074 in females) and fasting glucose (- 0.048 in males,-0.016 in females). Notably, we detected the associated reduced risks at the the third and fourth quartile of RDW in males. In women, there was no statistical significance. CONCLUSION We found the adjusted odds ratios of MS was lower at the third and fourth quartile of RDW in males.
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Affiliation(s)
- Ziyu Yan
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, 300052, Tianjin, People's Republic of China
| | - Yaguang Fan
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, 300052, Tianjin, People's Republic of China
| | - Zhaowei Meng
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, 300052, Tianjin, People's Republic of China.
| | - Chao Huang
- University of Hull, Allam Medical Building, Cottingham Road, Hull, HU6 7RX, UK
| | - Ming Liu
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| | - Qing Zhang
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| | - Kun Song
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| | - Qiyu Jia
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
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Synergic predisposing effect of G894T (eNOS), 4G/5G (PAI) and T1131C (APOA5) polymorphisms to myocardial infarction. GENE REPORTS 2018. [DOI: 10.1016/j.genrep.2018.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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6
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Emamian M, Hasanian SM, Tayefi M, Bijari M, Movahedian Far F, Shafiee M, Avan A, Heidari-Bakavoli A, Moohebati M, Ebrahimi M, Darroudi S, Zamani P, Azarpazhooh MR, Nematy M, Safarian M, Ferns GA, Esmaeili H, Parizadeh MR, Ghayour-Mobarhan M. Association of hematocrit with blood pressure and hypertension. J Clin Lab Anal 2017; 31. [PMID: 28105697 DOI: 10.1002/jcla.22124] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 12/01/2016] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Hypertension (HTN) is a risk factor for stroke, renal failure, and cardiovascular disease. The association between biochemical and hematological parameters with high blood pressure may provide a more precise approach to risk prediction conferred by HTN in these patients. OBJECTIVE The aim of current study was to explore whether biochemical and hematological parameters are associated with HTN in a cohort study with a 7-year follow-up. MATERIALS AND METHODS A total of 9808 individuals were enrolled and recruited as part of the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD) cohort study, and biochemical and hematological factors were measured in all subjects. Univariate and multivariate logistic regression analysis were performed to determine the association of biochemical and hematological parameters with HTN. RESULTS Several biochemical parameters including fasting plasma glucose (FBG), serum high-sensitivity C-reactive protein (hs-CRP), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and uric acid were increased in hypertensive participants. In contrast, serum high-density lipoprotein cholesterol (HDL-C) was lower in hypertensive individuals. Furthermore, we demonstrated that hematological parameters including white blood cell (WBC) count, red blood cell (RBC) count, hemoglobin (HGB), hematocrit (HCT), and mean corpuscular hemoglobin (MCH) were higher in the hypertensive group compared to the control group. But mean corpuscular volume (MCV), and red cell distribution width (RDW), were decreased in the hypertensive group. Furthermore, our results strongly suggested that among these parameters, hematocrit was the independent risk factor for hypertension in the population. CONCLUSION We demonstrated the association of altered biochemical and hematological factors with hypertension supporting the value of emerging markers for early prediction of high blood pressure in prone individuals.
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Affiliation(s)
- Marzieh Emamian
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mahdi Hasanian
- Department of Medical Biochemistry, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Microanatomy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Tayefi
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Biostatistics & Epidemiology, School of Health, Management & Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Moniba Bijari
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Faeze Movahedian Far
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mojtaba Shafiee
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Avan
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Heidari-Bakavoli
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Moohebati
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahmoud Ebrahimi
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sousan Darroudi
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Parvin Zamani
- Department of Medical Biotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahmoud Reza Azarpazhooh
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Nematy
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Safarian
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex, UK
| | - Habibollah Esmaeili
- Department of Biostatistics & Epidemiology, School of Health, Management & Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Reza Parizadeh
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Medical Biochemistry, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Medical Biochemistry, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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7
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Życzkowski M, Żywiec J, Nowakowski K, Paradysz A, Grzeszczak W, Gumprecht J. Estimation of the relationship between the polymorphisms of selected genes: ACE, AGTR1, TGFβ1 and GNB3 with the occurrence of primary vesicoureteral reflux. Int Urol Nephrol 2016; 49:387-397. [PMID: 27988909 PMCID: PMC5321692 DOI: 10.1007/s11255-016-1483-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 12/07/2016] [Indexed: 12/31/2022]
Abstract
PURPOSE Etiopathogenesis of VUR is composite and not fully understood. Many data indicate the importance of genetic predisposition. The aim of this study was to establish the relationship of selected polymorphisms: 14094 polymorphism of the ACE, polymorphism rs1800469 of TGFβ-1, rs5443 gene polymorphism of the GNB3 and receptor gene polymorphism rs5186 type 1 AGTR1 with the occurrence of the primary vesicoureteral reflux. MATERIAL The study included 190 children: 90 with the primary VUR confirmed with the voiding cystourethrogram and excluded secondary VUR and a control group of 100 children without a history of the diseases of the genitourinary tract. METHODS The study was planned in the scheme: "tested case versus control." Genomic DNA was isolated from the leukocytes of peripheral blood samples. The results were statistically analyzed in the Statistica 10 using χ 2 test and analysis of the variance Anova. RESULTS Any of the four studied polymorphisms showed no difference in the distribution of genotypes between patients with primary vesicoureteral reflux and the control group. In patients with VUR and TT genotype polymorphism rs5443 GNB3 gene, the glomerular filtration rate was significantly higher than in patients with genotype CC or CT. CONCLUSIONS (1) No relationship was found between the studied polymorphisms (14094 ACE gene, rs1800469 gene TGFβ1, GNB3 gene rs5443, rs5186 AGTR1 gene) and the occurrence of primary vesicoureteral reflux. (2) TT genotype polymorphism rs5443 GNB3 gene may be a protective factor for the improved renal function in patients with primary vesicoureteral reflux in patients with genotype CC or CT.
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Affiliation(s)
- Marcin Życzkowski
- Department of Urology, School of Medicine with Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Joanna Żywiec
- Department of Internal Medicine, Diabetology and Nephrology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Krzysztof Nowakowski
- Department of Urology, School of Medicine with Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Andrzej Paradysz
- Department of Urology, School of Medicine with Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Władyslaw Grzeszczak
- Department of Internal Medicine, Diabetology and Nephrology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Janusz Gumprecht
- Department of Internal Medicine, Diabetology and Nephrology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
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Iyngkaran P, Thomas MC, Johnson R, French J, Ilton M, McDonald P, Hare DL, Fatkin D. Contextualizing Genetics for Regional Heart Failure Care. Curr Cardiol Rev 2016; 12:231-42. [PMID: 27280306 PMCID: PMC5011192 DOI: 10.2174/1573403x12666160606123103] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 12/18/2015] [Accepted: 01/11/2016] [Indexed: 12/21/2022] Open
Abstract
Congestive heart failure (CHF) is a chronic and often devastating cardiovascular disorder with no cure. There has been much advancement in the last two decades that has seen improvements in morbidity and mortality. Clinicians have also noted variations in the responses to therapies. More detailed observations also point to clusters of diseases, phenotypic groupings, unusual severity and the rates at which CHF occurs. Medical genetics is playing an increasingly important role in answering some of these observations. This developing field in many respects provides more information than is currently clinically applicable. This includes making sense of the established single gene mutations or uncommon private mutations. In this thematic series which discusses the many factors that could be relevant for CHF care, once established treatments are available in the communities; this section addresses a contextual role for medical genetics.
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Crkvenac Gregorek A, Gornik KC, Polancec DS, Dabelic S. Association of 1166A>C AT1R, -1562C>T MMP-9, ACE I/D, and CCR5Δ32 Polymorphisms with Abdominal Aortic Aneurysm in Croatian Patients. Genet Test Mol Biomarkers 2016; 20:616-623. [DOI: 10.1089/gtmb.2016.0158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Andrea Crkvenac Gregorek
- Division of Vascular Surgery, Clinical Department of Surgery, University Hospital Center Zagreb, Zagreb, Croatia
| | - Kristina Crkvenac Gornik
- Division of Cytogenetics, Clinical Department for Laboratory Diagnostics, University Hospital Center Zagreb, Zagreb, Croatia
| | | | - Sanja Dabelic
- Department of Biochemistry and Molecular Biology, Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
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Mokretar K, Velinov H, Postadzhiyan A, Apostolova M. Association of Polymorphisms in Endothelial Nitric Oxide Synthesis and Renin-Angiotensin-Aldosterone System with Developing of Coronary Artery Disease in Bulgarian Patients. Genet Test Mol Biomarkers 2015; 20:67-73. [PMID: 26670794 DOI: 10.1089/gtmb.2015.0195] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
AIM The purpose of this study was to evaluate the association of common polymorphisms in endothelial nitric oxide synthesis (eNOS; G894T) and renin-angiotensin-aldosterone system (angiotensin converting enzyme [ACE]-I/D, angiotensinogen-T704C, and angiotensin II receptor type 1-A1166C) as risk factors in the pathogenesis of coronary artery disease (CAD) in Bulgarian patients. METHODS This study included 171 patients with CAD and 123 control subjects. Polymerase chain reaction-restriction fragment length polymorphism was used for studying the single-nucleotide polymorphisms. Statistical analysis was performed using statistical software PASW for Windows. RESULTS A significantly higher percentage of the eNOS T894 allele was found in patients with acute coronary syndrome (ACS), compared to controls (p = 0.006) and patients with stable angina pectoris (SAP, p = 0.005). Results from a binary regression analysis suggested that eNOS T allele and ACE D allele carriers were more likely to develop ACS than controls (T allele odds ratio [OR] 2.585, p = 0.024; D allele OR 3.585, p = 0.046) and patients with SAP (T allele OR 2.955, p = 0.009; D allele OR 2.703, p = 0.05). Exploratory evaluation of gene-gene combinations showed a significant association between eNOS-G894T/ACE-I/D and ACS compared to controls (p = 0.022) and patients with SAP (p = 0.017). CONCLUSIONS The eNOS G894T and ACE I/D polymorphisms are associated with an increased risk of developing ACS after adjusting for classical risk factors for atherosclerosis in the Bulgarian cohort.
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Affiliation(s)
- Katya Mokretar
- 1 Medical and Biological Research Laboratory, Roumen Tzanev Institute of Molecular Biology , Bulgarian Academy of Science, Sofia, Bulgaria
| | - Hristo Velinov
- 1 Medical and Biological Research Laboratory, Roumen Tzanev Institute of Molecular Biology , Bulgarian Academy of Science, Sofia, Bulgaria
| | - Arman Postadzhiyan
- 2 University Hospital "St. Anna, " Clinic of Cardiology, Sofia, Bulgaria
| | - Margarita Apostolova
- 1 Medical and Biological Research Laboratory, Roumen Tzanev Institute of Molecular Biology , Bulgarian Academy of Science, Sofia, Bulgaria
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Cargnin S, Quaglia M, Canonico PL, Stratta P, Terrazzino S. Impact of recipient ACE I/D genotype on kidney function in renal transplant patients: a meta-analysis of cross-sectional and longitudinal studies. Pharmacogenomics 2015; 16:1887-902. [DOI: 10.2217/pgs.15.119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Aim: To perform a systematic review and meta-analysis of studies evaluating the influence of recipient angiotensin-converting enzyme insertion/deletion (ACE I/D) polymorphism on kidney function in renal transplant recipients. Materials & methods: A comprehensive search was performed through PubMed, Web of Knowledge and Cochrane databases up to December 2014. The methodological quality of identified studies was assessed using the MINORS criteria. Results: A total of 15 studies evaluating the role of recipient ACE I/D were included in the meta-analysis. In overall analyzes and subsequent subgroup and sensitivity analyzes, no evidence emerged of an effect of ACE I/D on serum creatinine levels, creatinine clearance or glomerular filtration rate. Conclusion: Although further investigation is still needed to determine the role of donor ACE genotype, recipient ACE I/D does not play a significant role on kidney function in renal transplant patients.
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Affiliation(s)
- Sarah Cargnin
- Dipartimento di Scienze del Farmaco & Centro di Ricerca Interdipartimentale di Farmacogenetica e Farmacogenomica (CRIFF), Università del Piemonte Orientale “A. Avogadro”, Largo Donegani 2, 28100 Novara, Italy
| | - Marco Quaglia
- Department of Translational Medicine, Nephrology & Kidney Transplant Unit, University of Eastern Piedmont, Novara, Italy
| | - Pier Luigi Canonico
- Dipartimento di Scienze del Farmaco & Centro di Ricerca Interdipartimentale di Farmacogenetica e Farmacogenomica (CRIFF), Università del Piemonte Orientale “A. Avogadro”, Largo Donegani 2, 28100 Novara, Italy
| | - Piero Stratta
- Department of Translational Medicine, Nephrology & Kidney Transplant Unit, University of Eastern Piedmont, Novara, Italy
| | - Salvatore Terrazzino
- Dipartimento di Scienze del Farmaco & Centro di Ricerca Interdipartimentale di Farmacogenetica e Farmacogenomica (CRIFF), Università del Piemonte Orientale “A. Avogadro”, Largo Donegani 2, 28100 Novara, Italy
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12
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Yokoyama H, Araki S, Watanabe S, Honjo J, Okizaki S, Yamada D, Shudo R, Shimizu H, Sone H, Haneda M. Prevalence of resistant hypertension and associated factors in Japanese subjects with type 2 diabetes. Diabetes Res Clin Pract 2015; 110:18-25. [PMID: 26361860 DOI: 10.1016/j.diabres.2015.08.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 08/04/2015] [Accepted: 08/18/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The prevalence of treatment resistant hypertension (RH) depends on methods used for blood pressure (BP) measurements, goals of BP, and therapeutic efforts in terms of medication and adherence. We focused on diabetic subjects and explored the prevalence of RH in primary care practice. METHODS In 1737 subjects with type 2 diabetes who continued regular visits, office BP was evaluated by multiple measurements over one year. RH was defined as using more than four antihypertensive drugs or failure to achieve the goal with three antihypertensive drugs from different classes. The RH prevalence was investigated with BP goals <130/80 and 140/90 mmHg. RESULTS The percentage of subjects who achieved BP goals <130/80 and 140/90 were 70.5% and 93.8% with adherence to medication ≥95%, and the corresponding prevalence rates of RH in treated subjects were 28.4% and 21.8%, respectively. Factors independently associated with RH were age (odds ratio 1.02 [95% CI 1.01-1.04]), body mass index (1.10 [1.06-1.13]), variability in systolic BP (1.06 [1.02-1.09]), triglycerides (2.86 [1.34-6.11]), macroalbuminuria (3.33 [2.03-5.48]), estimated glomerular filtration rate (0.98 [0.97-0.99]), retinopathy (1.91 [1.39-2.61]), and family history of hypertension (1.85 [1.23-2.21]). Worsening albuminuria and glomerular filtration rate enhanced the prevalence of RH in a graded manner. CONCLUSION Careful estimation of office BP values over one year with a high achievement of BP goals and adequate adherence revealed that the prevalence of RH in type 2 diabetes is high. RH was characterized by accumulation of cardiovascular genetic and environmental risks.
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Affiliation(s)
- H Yokoyama
- Jiyugaoka Medical Clinic, Internal Medicine, Obihiro, Japan.
| | - S Araki
- Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - S Watanabe
- Jiyugaoka Medical Clinic, Internal Medicine, Obihiro, Japan
| | - J Honjo
- Jiyugaoka Medical Clinic, Internal Medicine, Obihiro, Japan; Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - S Okizaki
- Jiyugaoka Medical Clinic, Internal Medicine, Obihiro, Japan; Department of Endocrinology, Diabetes and Metabolism, Kitasato University School of Medicine, Sagamihara, Japan
| | - D Yamada
- Jiyugaoka Medical Clinic, Internal Medicine, Obihiro, Japan
| | - R Shudo
- Jiyugaoka Medical Clinic, Internal Medicine, Obihiro, Japan
| | - H Shimizu
- Jiyugaoka Medical Clinic, Internal Medicine, Obihiro, Japan
| | - H Sone
- Jiyugaoka Medical Clinic, Internal Medicine, Obihiro, Japan; Department of Internal Medicine, Niigata University, Faculty of Medicine, Niigata, Japan
| | - M Haneda
- Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
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Kelly TN, Raj D, Rahman M, Kretzler M, Kallem RR, Ricardo AC, Rosas SE, Tao K, Xie D, Hamm LL, He J. The role of renin-angiotensin-aldosterone system genes in the progression of chronic kidney disease: findings from the Chronic Renal Insufficiency Cohort (CRIC) study. Nephrol Dial Transplant 2015; 30:1711-8. [PMID: 25906781 DOI: 10.1093/ndt/gfv125] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 03/31/2015] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND We conducted single-marker, gene- and pathway-based analyses to examine the association between renin-angiotensin-aldosterone system (RAAS) variants and chronic kidney disease (CKD) progression among Chronic Renal Insufficiency Cohort study participants. METHODS A total of 1523 white and 1490 black subjects were genotyped for 490 single nucleotide polymorphisms (SNPs) in 12 RAAS genes as part of the ITMAT-Broad-CARe array. CKD progression phenotypes included decline in estimated glomerular filtration rate (eGFR) over time and the occurrence of a renal disease event, defined as incident end-stage renal disease or halving of eGFR from baseline. Mixed-effects models were used to examine SNP associations with eGFR decline, while Cox proportional hazards models tested SNP associations with renal events. Gene- and pathway-based analyses were conducted using the truncated product method. All analyses were stratified by race, and a Bonferroni correction was applied to adjust for multiple testing. RESULTS Among white and black participants, eGFR declined an average of 1.2 and 2.3 mL/min/1.73 m(2)/year, respectively, while renal events occurred in a respective 11.5 and 24.9% of participants. We identified strong gene- and pathway-based associations with CKD progression. The AGT and RENBP genes were consistently associated with risk of renal events in separate analyses of white and black participants (both P < 1.00 × 10(-6)). Driven by the significant gene-based findings, the entire RAAS pathway was also associated with renal events in both groups (both P < 1.00 × 10(-6)). No single-marker associations with CKD progression were observed. CONCLUSIONS The current study provides strong evidence for a role of the RAAS in CKD progression.
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Affiliation(s)
- Tanika N Kelly
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Dominic Raj
- Medical Faculty Associates, George Washington University, Washington, DC 20037, USA
| | - Mahboob Rahman
- University Hospitals Case Medical Center, Case Western Reserve University, Louis Stokes Cleveland VA Medical Center, Cleveland, OH 44106, USA
| | | | - Radhakrishna R Kallem
- University of Pennsylvania, Translational Research Center, Philadelphia, PA 19104, USA
| | - Ana C Ricardo
- University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Sylvia E Rosas
- Joslin Diabetes Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Kaixiang Tao
- The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Dawei Xie
- The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Lotuce Lee Hamm
- Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Jiang He
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA Tulane University School of Medicine, New Orleans, LA 70112, USA
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Luo M, Li ZZ, Li YY, Chen LZ, Yan SP, Chen P, Hu YY. Relationship between red cell distribution width and serum uric acid in patients with untreated essential hypertension. Sci Rep 2014; 4:7291. [PMID: 25464864 PMCID: PMC4252898 DOI: 10.1038/srep07291] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 11/11/2014] [Indexed: 12/14/2022] Open
Abstract
We assessed whether red cell distribution width (RDW) is associated with serum uric acid (UA) level in a group of 512 patients with newly diagnosed hypertension, recruited in Beijing. Patients were divided into high uric acid group and low uric acid group according to the median (334.9 μmol/L) of serum uric acid. Compared with the low uric acid group, the patients with high uric acid had higher red blood cell count (P < 0.001) and RDW (P = 0.032). The multiple linear regression analysis showed that RDW (P = 0.001) was positively correlated with uric acid level after the adjustment of related factors. Stepwise multiple logistic regression model confirmed that RDW (odds ratio: OR = 1.75) was independent determinants of high serum uric acid as well as sex (OR = 6.03), triglycerides (OR = 1.84), and Blood Urea Nitrogen (BUN, OR = 1.30). RDW may be independently associated with serum UA level in patients with newly diagnosed hypertension. To firmly establish the causal role of RDW in the incidence of high uric acid level among hypertensive patients, large cohort studies are needed.
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Affiliation(s)
- Min Luo
- Institute of Integrated Traditional Chinese and Western Medicine, Key Laboratory of Traditional Chinese Medicine Gan Organ of SATCM, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410078 China
| | - Zhan-Zhan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan Province, 410078 China
| | - Yan-Yan Li
- Department of emergency, Chinese Medicine Hospital of Henan Province, Zhengzhou, Henan Province, 450002 China
| | - Li-Zhang Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan Province, 410078 China
| | - Shi-Peng Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan Province, 410078 China
| | - Peng Chen
- Xiangya Medical School, Central South University, Changsha, Hunan Province, 410078 China
| | - Ying-Yun Hu
- Hunan provincial tumor hospital, Changsha, Hunan Province, 410013 China
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Mineralocorticoid receptor antagonists attenuate pulmonary inflammation and bleomycin-evoked fibrosis in rodent models. Eur J Pharmacol 2013; 718:290-8. [DOI: 10.1016/j.ejphar.2013.08.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 07/25/2013] [Accepted: 08/26/2013] [Indexed: 01/14/2023]
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Identification of RAS genotypes that modulate blood pressure change by outdoor temperature. Hypertens Res 2013; 36:540-5. [DOI: 10.1038/hr.2012.218] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Molnár AÀ, Tárnoki ÀD, Tárnoki DL, Kulcsár Z, Littvay L, Garami Z, Préda I, Kiss RG, Bérczi V, Lannert À, Monos E, Nádasy GL. Heritability of Venous Biomechanics. Arterioscler Thromb Vasc Biol 2013; 33:152-7. [DOI: 10.1161/atvbaha.112.300062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective—
Altered venous biomechanics may contribute to the pathogenesis of venous diseases, and their heritability is less known.
Methods and Results—
Seventy-eight monozygotic twin pairs (aged 42.4±16.8 years) and 24 same-sex dizygotic twin pairs (aged 50.5±16.1 years) were examined. Anteroposterior and mediolateral diameters of the common femoral vein were measured by ultrasonography. Measurements were made both in supine and in standing body positions, with or without controlled forced expiration (Valsalva test). High correlation of diameter, capacity, and distensibility values was found between twin pairs. The univariate heritability (A), shared (C), and unshared (E) environmental effects model has shown 39.3% genetic component of the variance of low pressure, 37.9% of high-pressure venous capacity, and 36.4% of maximal capacity changes, even after elimination of sex, age, and body weight effects. Bivariate Cholesky analysis revealed substantial covariance of inherited body weight and venous capacity components (57.0%–81.4%).
Conclusion—
Femoral vein capacity and elasticity depend ≈30% to 40% on genetic factors, and this value in the standing body position can reach 50%. A relatively high genetic covariance was found between weight and femoral vein capacity and elasticity. Our work might yield some new insights into the inheritance of venous diseases that are associated with altered venous biomechanics and help elucidate the involved genes.
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Affiliation(s)
- Andrea Àgnes Molnár
- From the Research Group for Inflammation Biology and Immunogenomics of Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary (A.A.M., Z.K., I.P., R.G.K.); Military Hospital, Department of Cardiology, Budapest, Hungary (A.A.M., Z.K., I.P., R.G.K.); Department of Radiology and Oncotherapy (A.D.T., D.L.T., V.B.), Faculty of Pharmacy (À.L.), and Experimental Research Department and Department of Human Physiology (E.M., G.L.N.), Semmelweis University, Budapest, Hungary; Central
| | - Àdám Domonkos Tárnoki
- From the Research Group for Inflammation Biology and Immunogenomics of Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary (A.A.M., Z.K., I.P., R.G.K.); Military Hospital, Department of Cardiology, Budapest, Hungary (A.A.M., Z.K., I.P., R.G.K.); Department of Radiology and Oncotherapy (A.D.T., D.L.T., V.B.), Faculty of Pharmacy (À.L.), and Experimental Research Department and Department of Human Physiology (E.M., G.L.N.), Semmelweis University, Budapest, Hungary; Central
| | - Dávid László Tárnoki
- From the Research Group for Inflammation Biology and Immunogenomics of Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary (A.A.M., Z.K., I.P., R.G.K.); Military Hospital, Department of Cardiology, Budapest, Hungary (A.A.M., Z.K., I.P., R.G.K.); Department of Radiology and Oncotherapy (A.D.T., D.L.T., V.B.), Faculty of Pharmacy (À.L.), and Experimental Research Department and Department of Human Physiology (E.M., G.L.N.), Semmelweis University, Budapest, Hungary; Central
| | - Zoltán Kulcsár
- From the Research Group for Inflammation Biology and Immunogenomics of Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary (A.A.M., Z.K., I.P., R.G.K.); Military Hospital, Department of Cardiology, Budapest, Hungary (A.A.M., Z.K., I.P., R.G.K.); Department of Radiology and Oncotherapy (A.D.T., D.L.T., V.B.), Faculty of Pharmacy (À.L.), and Experimental Research Department and Department of Human Physiology (E.M., G.L.N.), Semmelweis University, Budapest, Hungary; Central
| | - Levente Littvay
- From the Research Group for Inflammation Biology and Immunogenomics of Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary (A.A.M., Z.K., I.P., R.G.K.); Military Hospital, Department of Cardiology, Budapest, Hungary (A.A.M., Z.K., I.P., R.G.K.); Department of Radiology and Oncotherapy (A.D.T., D.L.T., V.B.), Faculty of Pharmacy (À.L.), and Experimental Research Department and Department of Human Physiology (E.M., G.L.N.), Semmelweis University, Budapest, Hungary; Central
| | - Zsolt Garami
- From the Research Group for Inflammation Biology and Immunogenomics of Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary (A.A.M., Z.K., I.P., R.G.K.); Military Hospital, Department of Cardiology, Budapest, Hungary (A.A.M., Z.K., I.P., R.G.K.); Department of Radiology and Oncotherapy (A.D.T., D.L.T., V.B.), Faculty of Pharmacy (À.L.), and Experimental Research Department and Department of Human Physiology (E.M., G.L.N.), Semmelweis University, Budapest, Hungary; Central
| | - István Préda
- From the Research Group for Inflammation Biology and Immunogenomics of Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary (A.A.M., Z.K., I.P., R.G.K.); Military Hospital, Department of Cardiology, Budapest, Hungary (A.A.M., Z.K., I.P., R.G.K.); Department of Radiology and Oncotherapy (A.D.T., D.L.T., V.B.), Faculty of Pharmacy (À.L.), and Experimental Research Department and Department of Human Physiology (E.M., G.L.N.), Semmelweis University, Budapest, Hungary; Central
| | - Róbert Gábor Kiss
- From the Research Group for Inflammation Biology and Immunogenomics of Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary (A.A.M., Z.K., I.P., R.G.K.); Military Hospital, Department of Cardiology, Budapest, Hungary (A.A.M., Z.K., I.P., R.G.K.); Department of Radiology and Oncotherapy (A.D.T., D.L.T., V.B.), Faculty of Pharmacy (À.L.), and Experimental Research Department and Department of Human Physiology (E.M., G.L.N.), Semmelweis University, Budapest, Hungary; Central
| | - Viktor Bérczi
- From the Research Group for Inflammation Biology and Immunogenomics of Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary (A.A.M., Z.K., I.P., R.G.K.); Military Hospital, Department of Cardiology, Budapest, Hungary (A.A.M., Z.K., I.P., R.G.K.); Department of Radiology and Oncotherapy (A.D.T., D.L.T., V.B.), Faculty of Pharmacy (À.L.), and Experimental Research Department and Department of Human Physiology (E.M., G.L.N.), Semmelweis University, Budapest, Hungary; Central
| | - Àgnes Lannert
- From the Research Group for Inflammation Biology and Immunogenomics of Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary (A.A.M., Z.K., I.P., R.G.K.); Military Hospital, Department of Cardiology, Budapest, Hungary (A.A.M., Z.K., I.P., R.G.K.); Department of Radiology and Oncotherapy (A.D.T., D.L.T., V.B.), Faculty of Pharmacy (À.L.), and Experimental Research Department and Department of Human Physiology (E.M., G.L.N.), Semmelweis University, Budapest, Hungary; Central
| | - Emil Monos
- From the Research Group for Inflammation Biology and Immunogenomics of Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary (A.A.M., Z.K., I.P., R.G.K.); Military Hospital, Department of Cardiology, Budapest, Hungary (A.A.M., Z.K., I.P., R.G.K.); Department of Radiology and Oncotherapy (A.D.T., D.L.T., V.B.), Faculty of Pharmacy (À.L.), and Experimental Research Department and Department of Human Physiology (E.M., G.L.N.), Semmelweis University, Budapest, Hungary; Central
| | - György László Nádasy
- From the Research Group for Inflammation Biology and Immunogenomics of Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary (A.A.M., Z.K., I.P., R.G.K.); Military Hospital, Department of Cardiology, Budapest, Hungary (A.A.M., Z.K., I.P., R.G.K.); Department of Radiology and Oncotherapy (A.D.T., D.L.T., V.B.), Faculty of Pharmacy (À.L.), and Experimental Research Department and Department of Human Physiology (E.M., G.L.N.), Semmelweis University, Budapest, Hungary; Central
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Angiotensinogen gene polymorphisms and food-intake behavior in young, normal female subjects in Japan. Nutrition 2012; 29:60-5. [PMID: 22858200 DOI: 10.1016/j.nut.2012.03.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Revised: 03/17/2012] [Accepted: 03/19/2012] [Indexed: 02/07/2023]
Abstract
OBJECTIVE We examined whether angiotensinogen (AGT) gene polymorphisms are associated with food preferences in young, normal female subjects. METHODS Fifty-two young, normal female subjects (21-22 y old) were recruited. After a 12-h fast, blood samples were obtained to examine the AGT gene polymorphisms (rs699 and rs7079), angiotensin-converting enzyme (ACE) insertion (I)/deletion (D), and adrenergic β3 receptor (ADRB3) gene polymorphisms (rs4994). A trained dietitian interviewed the participants to determine the portion size and frequency of food eaten for 1 wk by using the established questionnaire FFQg 3.0. RESULTS The genotypes of the AGT Met235Thr polymorphisms were TT:TC:CC = 2:19:31 (T:C = 0.22:0.78). The genotypes of AGT rs7079 were CC:CA:AA = 26:21:5 (C:A = 0.70:0.30), and those of ACE were DD:DI:II = 5:28:19 (D/I = 0.37:0.63). The genotypes of ADRB3 Trp64Arg were TT:TC:CC = 38:11:3 (T:C = 0.84:0.16). The total caloric intake was greater for those with the MM/MT genotype of AGT Met235Thr than for those with the TT genotype (1993 versus 1698 kcal/d, P < 0.05). The consumption of total lipids, cholesterol, and unsaturated free fatty acids was also higher in those with the MM/MT genotype of AGT Met235Thr than in those with the TT genotype. However, the AGT polymorphism (rs7079) and the ACE I/D were not associated with food preferences. In contrast, the subjects with ADRB3 Trp64 tended to show a high energy intake and preferences for proteins and lipids including fatty acids and cholesterol. They ate more fish and meat. Multiple regression analysis showed that the energy intake in subjects with the MM/MT genotype was independently determined by total lipids (B = 11.7, P < 0.0001) and carbohydrates (B = 4.6, P < 0.0001). CONCLUSIONS The AGT Met235Thr polymorphism was significantly associated with a higher caloric intake owing to total fat and carbohydrate consumption.
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Abstract
PURPOSE OF REVIEW The kallikrein-kinin system (KKS) constitutes a complex multienzyme cascade that produces several bioactive kinin peptides and their derivatives including bradykinin. In addition to the classical notion of the KKS as a potent vasodilator and a mediator of inflammatory responses, recent studies suggest a link between the KKS and oxidative stress. A number of established mouse models with altered levels of KKS components opened the way to evaluate precise functions of the KKS. Here we review recent findings on the role of the KKS in cardiovascular diseases and chronic kidney diseases, and discuss potential benefits of KKS activation in these diseases. RECENT FINDINGS Deletion of both B1R and B2R in a diabetic mouse model exacerbates its renal phenotypes, suggesting that the KKS exerts protective effects on diabetic nephropathy by suppressing oxidative stress, presumably via nitric oxide and prostaglandins. SUMMARY Accumulating evidence has highlighted the importance of the KKS as a protective system against oxidative stress and organ damage in the heart and kidney. The activation of the KKS by angiotensin I-converting enzyme inhibitors and vasopeptidase inhibitors is likely to be beneficial in senescence-associated cardiovascular diseases and chronic kidney diseases.
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Delles C, Padmanabhan S. Genetics and hypertension: is it time to change my practice? Can J Cardiol 2012; 28:296-304. [PMID: 22482397 DOI: 10.1016/j.cjca.2012.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Revised: 02/05/2012] [Accepted: 02/06/2012] [Indexed: 12/16/2022] Open
Abstract
Recent advances in genotyping technology and in particular a number of large-scale genome-wide association studies have helped to unravel the genetic basis of hypertension. Although our knowledge is still far from being complete it is important to ask how genetic findings could be translated to clinical practice. In a first step we summarize the strategies to dissect the genetics of hypertension from candidate gene studies to genome-wide association studies and recent sequencing experiments. The greatest hope in this context is the development of new drugs that are based on newly discovered pathophysiological principles. We describe examples where significant therapeutic effects are achieved with agents targeting pathways that contribute only small amounts to the genetic variability of a phenotype. There are good reasons to believe that new drugs will be developed based on genetic data in hypertension. We also highlight the potential for pharmacogenetics and risk stratification. The former is not currently supported by a larger body of evidence, but well designed studies are under way. The latter needs to follow the same principles for evaluation of other novel biomarkers of cardiovascular risk and is unlikely to influence clinical practice in the next few years.
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Affiliation(s)
- Christian Delles
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland, United Kingdom.
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Koika V, Georgopoulos NA, Piouka A, Roupas ND, Karela A, Armeni AK, Katsantoni E, Panidis D. Increased frequency of the DI genotype of the angiotensin-I converting enzyme and association of the II genotype with insulin resistance in polycystic ovary syndrome. Eur J Endocrinol 2012; 166:695-702. [PMID: 22223701 DOI: 10.1530/eje-11-0894] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The polycystic ovary syndrome (PCOS) is a common and complex disease with unclear pattern of inheritance, characterized by an androgen excess, while hyperinsulinemia and insulin resistance (IR) are common features of the syndrome. The angiotensin I converting enzyme (ACE) insertion (I)/deletion (D) gene polymorphism was proved to be involved in many pathophysiological conditions, including hypertension and IR. DESIGN The purpose of this study was to evaluate the involvement of the ACE gene polymorphism in the pathogenesis of PCOS. METHODS In a case-control association study involving 801 PCOS women and 266 healthy controls, hormonal determinations and ACE polymorphism genotyping were performed. The PCOS women were classified into three groups: Group A presented biochemical hyperandrogenism, combined with anovulation and polycystic ovarian morphology; Group B, clinical hyperandrogenism combined with anovulation and polycystic ovarian morphology; and Group C, chronic anovulation and polycystic ovarian morphology. RESULTS A significant increase in the frequency of the DI genotype of the ACE polymorphism was detected in PCOS women as a whole (P=0.035), in PCOS Group A (P=0.039) and Group B (P=0.010), while there was no difference in Group C (P=0.939). Significant difference was also observed in hyperandrogenic PCOS women as a whole (Group A+B) (P=0.017). The II genotype was positively correlated with HOMA-IR and QUICKI and with fasting insulin and glucose/insulin ratio in these groups. CONCLUSIONS The association study of the ACE I/D polymorphism in PCOS women demonstrates an increase in the DI genotype incidence and an association of the II genotype with IR.
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Affiliation(s)
- Vasiliki Koika
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Patras Medical School, University Hospital, Patras, Greece
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Do ACE (rs4646994) and αADDUCIN (rs4961) gene polymorphisms predict the recurrence of hypertensive intracerebral hemorrhage? Neurol Sci 2011; 33:1071-7. [DOI: 10.1007/s10072-011-0903-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Accepted: 12/14/2011] [Indexed: 10/14/2022]
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Oikonen M, Tikkanen E, Juhola J, Tuovinen T, Seppälä I, Juonala M, Taittonen L, Mikkilä V, Kähönen M, Ripatti S, Viikari J, Lehtimäki T, Havulinna AS, Kee F, Newton-Cheh C, Peltonen L, Schork NJ, Murray SS, Berenson GS, Chen W, Srinivasan SR, Salomaa V, Raitakari OT. Genetic variants and blood pressure in a population-based cohort: the Cardiovascular Risk in Young Finns study. Hypertension 2011; 58:1079-85. [PMID: 22025373 DOI: 10.1161/hypertensionaha.111.179291] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Clinical relevance of a genetic predisposition to elevated blood pressure was quantified during the transition from childhood to adulthood in a population-based Finnish cohort (N=2357). Blood pressure was measured at baseline in 1980 (age 3-18 years) and in follow-ups in 1983, 1986, 2001, and 2007. Thirteen single nucleotide polymorphisms associated with blood pressure were genotyped, and 3 genetic risk scores associated with systolic and diastolic blood pressures and their combination were derived for all of the participants. Effects of the genetic risk score were 0.47 mm Hg for systolic and 0.53 mm Hg for diastolic blood pressures (both P<0.01). The combination genetic risk score was associated with diastolic blood pressure from age 9 years onward (β=0.68 mm Hg; P=0.015). Replications in 1194 participants of the Bogalusa Heart Study showed essentially similar results. The participants in the highest quintile of the combination genetic risk score had a 1.82-fold risk of hypertension in adulthood (P<0.0001) compared with the lowest quintile, independent of a family history of premature hypertension. These findings show that genetic variants are associated with preclinical blood pressure traits in childhood; individuals with several susceptibility alleles have, on average, a 0.5-mm Hg higher blood pressure, and this trajectory continues from childhood to adulthood.
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Affiliation(s)
- Mervi Oikonen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, PO Box 52, FI-20521 Turku, Finland.
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Integration of detailed modules in a core model of body fluid homeostasis and blood pressure regulation. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2011; 107:169-82. [DOI: 10.1016/j.pbiomolbio.2011.06.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2011] [Accepted: 06/20/2011] [Indexed: 11/23/2022]
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Elshamaa MF, Sabry SM, Bazaraa HM, Koura HM, Elghoroury EA, Kantoush NA, Thabet EH, Abd-El Haleem DA. Genetic polymorphism of ACE and the angiotensin II type1 receptor genes in children with chronic kidney disease. J Inflamm (Lond) 2011; 8:20. [PMID: 21859496 PMCID: PMC3167745 DOI: 10.1186/1476-9255-8-20] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2010] [Accepted: 08/23/2011] [Indexed: 01/20/2023] Open
Abstract
AIM AND METHODS We investigated the association between polymorphisms of the angiotensin converting enzyme-1 (ACE-1) and angiotensin II type one receptor (AT1RA1166C) genes and the causation of renal disease in 76 advanced chronic kidney disease (CKD) pediatric patients undergoing maintenance hemodialysis (MHD) or conservative treatment (CT). Serum ACE activity and creatine kinase-MB fraction (CK-MB) were measured in all groups. Left ventricular mass index (LVMI) was calculated according to echocardiographic measurements. Seventy healthy controls were also genotyped. RESULTS The differences of D allele and DI genotype of ACE were found significant between MHD group and the controls (p = 0.0001). ACE-activity and LVMI were higher in MHD, while CK-MB was higher in CT patients than in all other groups. The combined genotype DD v/s ID+II comparison validated that DD genotype was a high risk genotype for hypertension .~89% of the DD CKD patients were found hypertensive in comparison to ~ 61% of patients of non DD genotype(p = 0.02). The MHD group showed an increased frequency of the C allele and CC genotype of the AT1RA1166C polymorphism (P = 0.0001). On multiple linear regression analysis, C-allele was independently associated with hypertension (P = 0.04). CONCLUSION ACE DD and AT1R A/C genotypes implicated possible roles in the hypertensive state and in renal damage among children with ESRD. This result might be useful in planning therapeutic strategies for individual patients.
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Affiliation(s)
| | - Samar M Sabry
- Pediatric Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hafez M Bazaraa
- Pediatric Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hala M Koura
- Pediatric Department, National Research Centre, Cairo, Egypt
| | - Eman A Elghoroury
- Clinical & Chemical Pathology Department, National Research Centre, Cairo, Egypt
| | - Nagwa A Kantoush
- Clinical & Chemical Pathology Department, National Research Centre, Cairo, Egypt
| | - Eman H Thabet
- Clinical & Chemical Pathology Department, National Research Centre, Cairo, Egypt
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[Individual renal hemodynamic response to chronic angiotensin II receptor blockade and the influence on the renin-angiotensin system gene polymorphisms]. ACTA ACUST UNITED AC 2011; 63:630-7. [PMID: 21446090 DOI: 10.2298/mpns1010630d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Our study was aimed at determining whether the polymorphism of genes for different components of the renin-angiotensin-aldosterone system could influence the renal hemodynamic response to losartan treatment. MATERIAL AND METHOD The study included 35 patients with type I diabetes mellitus and persistent albuminuria, genotyped for the 1166 A/C polymorphism gene for the angiotensin II type 1 receptor and I/D polymorphism of the angiotensin-converting enzyme gene. The participants were divided into groups according to the combinations of A or C allele: AA, AC, CC; and according to the combinations of I or D allele: II, ID and DD genotype. The patients received losartan therapy for 12 weeks. The renal hemodynamic measurements were determined at baseline and after the examination period. RESULTS Losartan therapy significantly reduced the filtration fraction from the baseline by 0.018 +/- 0.024 (p = 0.012) only in the AC genotype. The glomerular filtration rate remained unchanged in all genotype groups. A significant increase in the effective renal plasma flow was obtained only in AC genotype (544 +/- 88 vs 575 +/- 90 ml/min; p = 0.02), while significant reductions in the renal vascular resistance were found in AA group (115 +/- 25 vs 95 +/- 21 mmHg x l(-1) x min(-1), p = 0.001) and in AC group (118 +/- 30 vs 101 +/- 28 mmHg x l(-1) x min(-1); p = 0.001). A significant reduction of the glomerular filtration rate by 8 +/- 10 ml/min was obtained only in the DD genotype (p = 0.016), and only the DD genotype achieved a significant reduction of the filtration fraction by 0.019 +/- 0,022 (p = 0.008). The most pronounced increase of the effective renal plasma flow was found only in the ID genotype (536 +/- 75 vs 591 +/- 63 ml/min; p = 0.01). The reduction of the renal vascular resistance was independent of ACE gene polymorphism. CONCLUSION Our study shows that individual renal vascular response to losartan treatment in diabetic patients with persistent albuminuria, could be influenced by genetic polymorphisms.
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Liu T, Korantzopoulos P, Xu G, Shehata M, Li D, Wang X, Li G. Association between angiotensin-converting enzyme insertion/deletion gene polymorphism and atrial fibrillation: a meta-analysis. Europace 2011; 13:346-354. [PMID: 21076147 DOI: 10.1093/europace/euq407] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023] Open
Abstract
AIMS Recent observations have raised concerns regarding the activation of the renin-angiotensin system and the development of atrial fibrillation (AF). Some initial studies indicated an association between an angiotensin-converting enzyme insertion/deletion (ACE I/D) polymorphism and AF, however, the results have been inconsistent. Our aim was to perform a meta-analysis of relevant studies to assess the validity of this association. METHODS AND RESULTS PubMed, Cochrane clinical trials database, and EMBASE were searched through July 2009, and a manual search was also performed. Of the 68 initially identified studies, 18 case-control studies with 7577 patients were finally analysed. No statistically significant associations were found between the ACE I/D polymorphism and AF risk in the genetic additive model and dominant model, whereas a significant association was observed in the recessive model. A significant heterogeneity between individual studies was evident in all three models. Subgroup analyses showed a strong association between the ACE I/D polymorphism and hypertensive AF without significant heterogeneity. CONCLUSION Our meta-analysis suggests that there is insufficient evidence to demonstrate an association between ACE I/D polymorphism and AF risk. However, there seems to be a significant association between ACE I/D gene polymorphic variation and AF in patients with hypertension. Additional studies are warranted to further explore this association in ethnically diverse populations and varied cardiovascular substrates.
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Affiliation(s)
- Tong Liu
- Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, People's Republic of China
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Agirbasli M, Guney AI, Ozturhan HS, Agirbasli D, Ulucan K, Sevinc D, Kirac D, Ryckman KK, Williams SM. Multifactor dimensionality reduction analysis of MTHFR, PAI-1, ACE, PON1, and eNOS gene polymorphisms in patients with early onset coronary artery disease. ACTA ACUST UNITED AC 2011; 18:803-9. [PMID: 21450592 DOI: 10.1177/1741826711398806] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Association studies in the Turkish population have investigated the single locus effects of different gene polymorphisms on coronary artery disease (CAD). CAD is a complex polygenic disease that involves complex interactions among multiple genetic and environmental conditions. DESIGN We evaluated associations of five candidate genetic polymorphisms (methylene tetrahydrofolate reductase C677T, plasminogen activator inhibitor 4G/5G, endothelial nitric oxide synthase (eNOS) 3-27 base pair repeat, insertion, or deletion of a 287 bp Alu repeat sequence polymorhism of angiotensin I converting enzyme, and paraoxonase Gln192Arg PON1 polymorphisms) with the presence and extent of early onset CAD. METHODS DNA was isolated and amplified from 90 consecutive patients with angiographically proven early onset CAD (ages 41 ± 5 for men, 49 ± 7 for women) and also from 90 control subjects with no significant coronary obstruction angiographically (ages 42 ± 5 for men, 48 ± 6 for women). Multifactor dimensionality reduction (MDR) analysis was performed to identify a model of CAD based on both genetic and conventional risk factors. RESULTS MDR analysis detected a significant model with four genes (prediction success ∼ 61%, p = 0.03). When the total number of the conventional risk factors is analysed with the candidate polymorphisms, a different model is identified that includes three of the four genes from the above model and achieves a similar prediction of CAD as the gene only model. CONCLUSION These data indicate that gene-gene and gene-environmental risk interactions form significant models in predicting early onset CAD.
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Affiliation(s)
- M Agirbasli
- Department of Cardiology, Faculty of Medicine, Marmara University, Istanbul, Turkey.
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Abstract
For cancers to develop, sustain and spread, the appropriation of key homeostatic physiological systems that influence cell growth, migration and death, as well as inflammation and the expansion of vascular networks are required. There is accumulating molecular and in vivo evidence to indicate that the expression and actions of the renin-angiotensin system (RAS) influence malignancy and also predict that RAS inhibitors, which are currently used to treat hypertension and cardiovascular disease, might augment cancer therapies. To appreciate this potential hegemony of the RAS in cancer, an expanded comprehension of the cellular actions of this system is needed, as well as a greater focus on translational and in vivo research.
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Affiliation(s)
- Amee J George
- School of Biomedical Sciences, The University of Queensland, St. Lucia, Queensland 4072, Australia
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Pallet N, Legendre C. Deciphering calcineurin inhibitor nephrotoxicity: a pharmacological approach. Pharmacogenomics 2010; 11:1491-501. [DOI: 10.2217/pgs.10.137] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The calcineurin inhibitors ciclosporin and tacrolimus are used to prevent acute rejection of solid organs after transplantation. Their use can lead to chronic renal damage characterized by progressive and irreversible deterioration of renal function associated with interstitial fibrosis, tubular atrophy, arteriolar hyalinosis and glomerulosclerosis. Many approaches to better understand the mechanisms of this toxicity are in use. The aim of these approaches is to find biomarkers of early kidney injury and potential therapeutic targets. Despite these efforts, the biological processes leading to calcineurin inhibitor nephrotoxicity remain poorly understood. Furthermore, the diagnosis of chronic renal damage remains inaccurate without definitive diagnostic tools, no effective prevention exists and a therapy to treat the damage has yet to be developed. In this article, theories of pharmacodynamics, pharmacokinetics, therapeutic drug monitoring and pharmacogenetics are synthesized in ways that may improve the understanding of mechanisms leading to calcineurin inhibitor toxicity. The importance of global approaches such as toxicogenomics is emphasized to characterize early cellular responses implicated in calcineurin inhibitor nephrotoxicity.
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Affiliation(s)
| | - Christophe Legendre
- Necker Hospital & Paris Descartes University, 149, rue de Sèvres, 75015, Paris, France
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Alves AJ, Eynon N, Oliveira J, Goldhammer E. RAAS and adrenergic genes in heart failure: Function, predisposition and survival implications. World J Cardiol 2010; 2:187-97. [PMID: 21160750 PMCID: PMC2998917 DOI: 10.4330/wjc.v2.i7.187] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Revised: 06/17/2010] [Accepted: 06/24/2010] [Indexed: 02/06/2023] Open
Abstract
It is well appreciated that several neurohormones and signaling cascades are activated that promote long-term deterioration of cardiac function and structure. Activation of the renin-angiotensin-aldosterone system (RAAS) and the adrenergic system is closely related to heart failure. Common gene variants that encode neurohormonal, adrenergic and intracellular proteins have been demonstrated to modulate the course and consequences of heart failure. However, the literature is replete with conflicting results and it remains uncertain as to whether particular gene variants predispose heart failure. Therefore, the main purpose of this review was to discuss the effects of single nucleotide polymorphisms (SNPs) that are located in genes encoding elements of the RAAS and the adrenergic system on the predisposition to and survival from heart failure. Most studies indicate that common SNPs encoding elements of the RAAS and the adrenergic system do not predispose individuals to heart failure. Conversely, it has been demonstrated that ARB1 Arg389Gly, GRK5 Gln41Leu, ACE I/D, CYP11B2 C-344T and AGTR1 A+1166C modulate pharmacological responses and have a considerable impact on cardiac-related survival. It should not be expected, however, that a single polymorphism determines survival, given that multiple gene products and environmental factors contribute to the pathogenesis of heart failure. Therefore, future studies should consider the interaction effects of multiple genes in populations that are as homogeneous as possible with respect to environmental characteristics.
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Affiliation(s)
- Alberto J Alves
- Alberto J Alves, José Oliveira, The Research Centre in Physical Activity, Health and Leisure, University of Porto, Faculty of Sport, 4200-450 Porto, Portugal
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Current Opinion in Endocrinology, Diabetes & Obesity. Current world literature. Curr Opin Endocrinol Diabetes Obes 2010; 17:293-312. [PMID: 20418721 DOI: 10.1097/med.0b013e328339f31e] [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] [Indexed: 11/25/2022]
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PharmGKB summary: very important pharmacogene information for angiotensin-converting enzyme. Pharmacogenet Genomics 2010; 20:143-6. [PMID: 19898265 DOI: 10.1097/fpc.0b013e3283339bf3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Chung CM, Wang RY, Chen JW, Fann CSJ, Leu HB, Ho HY, Ting CT, Lin TH, Sheu SH, Tsai WC, Chen JH, Jong YS, Lin SJ, Chen YT, Pan WH. A genome-wide association study identifies new loci for ACE activity: potential implications for response to ACE inhibitor. THE PHARMACOGENOMICS JOURNAL 2010; 10:537-44. [PMID: 20066004 DOI: 10.1038/tpj.2009.70] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Because angiotensin-converting enzyme (ACE) activity is implicated widely in biological systems, we aimed to identify its novel quantitative trait loci for the purposes of understanding ACE activity regulation and pharmacogenetics relating to ACE inhibitor (ACEI). We performed a two-stage genome-wide association study: (1) from 400 young-onset hypertension (YOH) subjects and (2) a confirmation study with an additional 623 YOH subjects. In the first stage, eight single nucleotide polymorphisms (SNPs) of the ACE structural gene and one SNP of ABO genes were significantly associated with ACE activity. SNP rs4343 in exon17 near the well-known insertion/deletion polymorphism had the strongest association. We confirmed in the second stage that three SNPs: rs4343 in ACE gene (P=3.0 x 10⁻²⁵), rs495828 (P=3.5 x 10⁻⁸) and rs8176746 (P=9.3 x 10⁻⁵) in ABO gene were significantly associated with ACE activity. We further replicated the association between ABO genotype/blood types and ACE activity in an independent YOH family study (428 hypertension pedigrees), and showed a potential differential blood pressure response to ACEI in subjects with varied numbers of ACE-activity-raising alleles. These findings may broaden our understanding of the mechanisms controlling ACE activity and advance our pharmacogenetic knowledge on ACEI.
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Affiliation(s)
- C-M Chung
- Division of Molecular Medicine, Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Wong WB, Carlson JJ, Thariani R, Veenstra DL. Cost effectiveness of pharmacogenomics: a critical and systematic review. PHARMACOECONOMICS 2010; 28:1001-13. [PMID: 20936884 DOI: 10.2165/11537410-000000000-00000] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
The use of pharmacogenetic testing in clinical practice is limited thus far. A potential barrier to the widespread implementation of pharmacogenetic testing is the lack of evidence on whether testing provides good value for money. The objective of this review was to provide a systematic and critical review of economic evaluations of pharmacogenetic testing. A literature search using publically available databases was performed for articles published up to October 2009. To be included, studies had to meet the definition of being a pharmacogenomic study (defined as use of information on human genetic variation to target drug therapy) and an economic evaluation (defined as an evaluation of both costs and clinical outcomes). Articles that met these criteria were subsequently reviewed and graded using the Quality of Health Economic Studies (QHES) instrument. Lastly, the evidence for biomarker validity and utility were qualitatively assessed using expert opinion. A total of 34 articles were identified using our defined criteria. The most common disease category was thromboembolic-related diseases (26%), while the most common biomarkers were thiopurine methyltransferase and cytochrome P450 2C9 (18% each). Almost all studies were published after 2004 (91%). Two types of studies were identified: cost-effectiveness studies and cost-utility studies, with roughly half of the overall studies being cost-utility studies (53%) and a majority of these published within the last 3 years. The average quality score was 77 (range 29-99). Of the biomarkers reviewed, it was estimated that most had demonstrated clinical validity, but only two had demonstrated clinical utility. Despite a recent increase in the number of economic evaluations of pharmacogenetic applications, further studies examining the clinical validity and utility of these biomarkers are needed to support cost-effectiveness assessments.
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Affiliation(s)
- William B Wong
- University of Washington, Pharmaceutical Outcomes Research and Policy Program, Department of Pharmacy, Seattle, Washington 98195-7630, USA
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Delles C, McBride MW, Graham D, Padmanabhan S, Dominiczak AF. Genetics of hypertension: from experimental animals to humans. Biochim Biophys Acta Mol Basis Dis 2009; 1802:1299-308. [PMID: 20035862 PMCID: PMC2977068 DOI: 10.1016/j.bbadis.2009.12.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Accepted: 12/15/2009] [Indexed: 12/17/2022]
Abstract
Essential hypertension affects 20 to 30% of the population worldwide and contributes significantly to cardiovascular mortality and morbidity. Heridability of blood pressure is around 15 to 40% but there are also substantial environmental factors affecting blood pressure variability. It is assumed that blood pressure is under the control of a large number of genes each of which has only relatively mild effects. It has therefore been difficult to discover the genes that contribute to blood pressure variation using traditional approaches including candidate gene studies and linkage studies. Animal models of hypertension, particularly in the rat, have led to the discovery of quantitative trait loci harbouring one or several hypertension related genes, but translation of these findings into human essential hypertension remains challenging. Recent development of genotyping technology made large scale genome-wide association studies possible. This approach and the study of monogenic forms of hypertension has led to the discovery of novel and robust candidate genes for human essential hypertension, many of which require functional analysis in experimental models.
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Affiliation(s)
- Christian Delles
- BHF Glasgow Cardiovascular Research Centre, University of Glasgow, UK
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