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Chen WC, Chen YC, Chen YH, Liu TY, Tsai CH, Tsai FJ. Identification of novel genetic susceptibility loci for calcium-containing kidney stone disease by genome-wide association study and polygenic risk score in a Taiwanese population. Urolithiasis 2024; 52:94. [PMID: 38896256 DOI: 10.1007/s00240-024-01577-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/04/2024] [Indexed: 06/21/2024]
Abstract
Approximately 80% of kidney stone diseases contain calcium. Inherited genetic factors are among the variables that influence the development of calcium-containing kidney stone diseases (CKSD). Previous genome-wide association studies (GWAS) on stone diseases have been reported worldwide; however, these are not focused on calcium-containing stones. We conducted a GWAS to identify germline genetic polymorphisms associated with CKSD in a Medical Center in Taiwan; hence, this study was based primarily on a hospital-based database. CKSD was diagnosed using the chart records. Patients infected with urea-splitting-microorganisms and those with at least two urinary pH value below 5.5 were excluded. None of the patients had cystic stones based on stone analysis. Those over 40 years of age with no history of CKSD and no microscopic hematuria on urinalysis were considered as controls. The DNA isolated from the blood of 14,934 patients (63.7% male and 36.3% female) with CKSD and 29,868 controls (10,830 men and 19,038 women) at a medical center was genotyped for approximately 714,457 single nucleotide polymorphisms (SNPs) with minor allele frequency of ≥ 0.05. We used PLINK 1.9 to calculate the polygenic risk score (PRS) to investigate the association between CKSD and controls. The accuracy of the PRS was verified by dividing it into the training and testing groups. The statistical analyses were calculated with the area under the curve (AUC) using IBM SPSS version 22. We identified 432 susceptibility loci that reached a genome-wide threshold of P < 1.0 × 10- 5. A total of 132 SNPs reached a threshold of P < 5 × 10- 8 using a stricter definition of significance on chromosomes 4, 13, 16, 17, and 18. At the top locus of our study, SNPs in DGKH, PDILT, BCAS3, and ABCG2 have been previously reported. RN7SKP27, HDAC4, PCDH15, AP003068.2, and NFATC1 were novel findings in this study. PRS was adjusted for sex and age, resulting in an AUC of 0.65. The number of patients in the top quartile of PRS was 1.39 folds in the risk of CKSD than patients in the bottom quartile. Our data identified the significance of GWAS for patients with CKSD in a hospital-based study. The PRS also had a high AUC for discriminating patients with CKSD from controls. A total of 132 SNP loci of SNPs significantly associated with the development of CKSD. This first survey, which focused on patients with CKSD, will provide novel insights specific to CKSD and its potential clinical biomarkers.
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Affiliation(s)
- Wen-Chi Chen
- Department of Urology, Department of Medical Research, Department of Medical Genetics, Million-Person Precision Medicine Initiative, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, School of Chinese Medicine, College of Chinese Medicine, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Yu-Chia Chen
- Department of Urology, Department of Medical Research, Department of Medical Genetics, Million-Person Precision Medicine Initiative, China Medical University Hospital, Taichung, Taiwan
| | - Yung-Hsiang Chen
- Department of Urology, Department of Medical Research, Department of Medical Genetics, Million-Person Precision Medicine Initiative, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, School of Chinese Medicine, College of Chinese Medicine, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Ting-Yuan Liu
- Department of Urology, Department of Medical Research, Department of Medical Genetics, Million-Person Precision Medicine Initiative, China Medical University Hospital, Taichung, Taiwan
| | - Chang-Hai Tsai
- Department of Urology, Department of Medical Research, Department of Medical Genetics, Million-Person Precision Medicine Initiative, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, School of Chinese Medicine, College of Chinese Medicine, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Fuu-Jen Tsai
- Department of Urology, Department of Medical Research, Department of Medical Genetics, Million-Person Precision Medicine Initiative, China Medical University Hospital, Taichung, Taiwan.
- Graduate Institute of Integrated Medicine, School of Chinese Medicine, College of Chinese Medicine, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
- Division of Medical Genetics, China Medical University Children's Hospital, Taichung, Taiwan.
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Wigner P, Grębowski R, Bijak M, Szemraj J, Saluk-Bijak J. The Molecular Aspect of Nephrolithiasis Development. Cells 2021; 10:1926. [PMID: 34440695 PMCID: PMC8393760 DOI: 10.3390/cells10081926] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/24/2021] [Accepted: 07/27/2021] [Indexed: 01/06/2023] Open
Abstract
Urolithiasis is the third most common urological disease after urinary tract infections and prostate diseases, and it is characterised by an occurrence rate of about 15%, which continues to rise. The increase in the incidence of kidney stones observed in recent decades, is most likely caused by modifications in dietary habits (high content of protein, sodium and sugar diet) and lifestyle (reduced physical activity) in all industrialised countries. Moreover, men are more likely than women to be diagnosed with kidney stones. A growing body of evidence suggests that inflammation, oxidant-antioxidant imbalance, angiogenesis, purine metabolism and urea cycle disorders may play a crucial role in nephrolithiasis development. Patients with urolithiasis were characterised by an increased level of reactive oxygen species (ROS), the products of lipid peroxidation, proinflammatory cytokines as well as proangiogenic factors, compared to controls. Furthermore, it has been shown that deficiency and disorders of enzymes involved in purine metabolism and the urea cycle might be causes of deposit formation. ROS generation suggests that the course of kidney stones might be additionally potentiated by inflammation, purine metabolism and the urea cycle. On the other hand, ROS overproduction may induce activation of angiogenesis, and thus, allows deposit aggregation.
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Affiliation(s)
- Paulina Wigner
- Department of General Biochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska 141/143, 90-236 Lodz, Poland;
| | - Radosław Grębowski
- Department of Urology, Provincial Integrated Hospital in Plock, Medyczna 19, 09-400 Plock, Poland;
- Department of Medical Biochemistry, Medical University of Lodz, Mazowiecka 6/8, 90-001 Lodz, Poland;
| | - Michal Bijak
- Biohazard Prevention Centre, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska 141/143, 90-236 Lodz, Poland;
| | - Janusz Szemraj
- Department of Medical Biochemistry, Medical University of Lodz, Mazowiecka 6/8, 90-001 Lodz, Poland;
| | - Joanna Saluk-Bijak
- Department of General Biochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska 141/143, 90-236 Lodz, Poland;
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Atmoko W, Raharja PAR, Birowo P, Hamid ARAH, Taher A, Rasyid N. Genetic polymorphisms as prognostic factors for recurrent kidney stones: A systematic review and meta-analysis. PLoS One 2021; 16:e0251235. [PMID: 33956883 PMCID: PMC8101940 DOI: 10.1371/journal.pone.0251235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 04/22/2021] [Indexed: 11/25/2022] Open
Abstract
Genetic polymorphisms have been suggested as risk factors affecting the occurrence and recurrence of kidney stones, although findings regarding the latter remain inconclusive. We performed this systematic review and meta-analysis to clarify the associations between genetic polymorphisms and recurrent kidney stones. PubMed, SCOPUS, EMBASE, and Cochrane Library databases were searched through May 28th, 2020 to identify eligible studies. The Quality in prognostic studies (QUIPS) tool was used to evaluate bias risk. Allelic frequencies and different inheritance models were assessed. All analyses were performed using Review manager 5.4. A total of 14 studies were included for meta-analysis, assessing urokinase (ApaL1) and vitamin D receptor (VDR) (ApaI, BsmI, FokI, and TaqI) gene polymorphisms. The ApaLI polymorphism demonstrated protective association in the recessive model [odds ratio (OR) 0.45, P < 0.01] albeit higher risk among Caucasians in the heterozygous model (OR 16.03, P < 0.01). The VDR-ApaI polymorphism showed protective association in the dominant model (OR 0.60, P < 0.01). Among Asians, the VDR-FokI polymorphism recessive model showed significant positive association (OR 1.70, P < 0.01) and the VDR-TaqI polymorphism heterozygous model exhibited protective association (OR 0.72, P < 0.01). The VDR-BsmI polymorphism was not significantly associated with recurrent kidney stones in any model. Urokinase-ApaLI (recessive model), VDR-ApaI (dominant model), and VDR-TaqI (heterozygous model) polymorphisms were associated with decreased recurrent kidney stone risk whereas urokinase-ApaLI (heterozygous model) and VDR-FokI polymorphisms were associated with increased risk among Caucasians and Asians, respectively. These findings will assist in identifying individuals at risk of kidney stone recurrence.
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Affiliation(s)
- Widi Atmoko
- Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Putu Angga Risky Raharja
- Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Ponco Birowo
- Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | | | - Akmal Taher
- Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Nur Rasyid
- Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
- * E-mail:
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Association of urokinase and Vitamin D receptor genes SNPs and urolithiasis in an Iraqi population. Meta Gene 2020. [DOI: 10.1016/j.mgene.2020.100679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Characterizing the Association Between Toll-like Receptor Subtypes and Nephrolithiasis With Renal Inflammation in an Animal Model. Urology 2017; 111:238.e1-238.e5. [PMID: 29054721 DOI: 10.1016/j.urology.2017.09.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/17/2017] [Accepted: 09/26/2017] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To show experimentally induced renal stone disease and to evaluate secondary inflammatory responses in vivo, and to characterize changes in the expression of Toll-like receptor (TLR) subtypes in this model. METHODS Twenty 5- to 6-week-old male Wistar rats were divided into control and hyperoxaluria groups (n = 10 per group) and were supplied with normal water or 1% ethylene glycol, respectively, for 16 weeks. The animals were then placed in metabolic cages, and urine was collected for a 24-hour urine oxalate level evaluation. Following sacrifice, rats were subjected to bilateral nephrectomy and both kidneys were histopathologically evaluated. A 1-mm3 biopsy section from the right kidney of each rat was subjected to real-time polymerase chain reaction of the TLR expression. RESULTS At the end of week 16, the hyperoxaluria group had a higher mean 24-hour urine oxalate level (1.91) than the control group (0.29) (P <.05) and a remarkably increased deposition of renal CaOx crystals (15/20) than the control group (0/20) (P <.05), which was universally accompanied by inflammation (15/15). Twelve and no rats in the hyperoxaluria and control groups, respectively, had macroscopically visible renal pelvic stones (P <.05). Quantitative real-time polymerase chain reaction revealed significant decreases in the expression of several TLRs, particularly TLR11 and TLR7. Decreases in TLR1, TLR3, and TLR6 expressions and an increase in the TLR2 expression did not differ significantly between the groups. CONCLUSION We believe that is the first evaluation of TLR expression associated with renal stone formation in an animal model of inflammation. These results might lead to novel TLR-based treatments for nephrolithiasis and related inflammatory renal damage.
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Chou YH, Juo SHH, Chiu YC, Liu ME, Chen WC, Chang CC, Chang WP, Chang JG, Chang WC. A Polymorphism of the
ORAI1
Gene is Associated With the Risk and Recurrence of Calcium Nephrolithiasis. J Urol 2011; 185:1742-6. [PMID: 21420116 DOI: 10.1016/j.juro.2010.12.094] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Indexed: 10/18/2022]
Affiliation(s)
- Yii-Her Chou
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
- Department of Urology, College of Medicine, Kaohsiung, Taiwan, Republic of China
| | - Suh-Hang Hank Juo
- Department of Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
- Department of Medical Genetics, College of Medicine, Kaohsiung, Taiwan, Republic of China
| | - Yi-Ching Chiu
- Department of Medical Genetics, College of Medicine, Kaohsiung, Taiwan, Republic of China
| | - Mu-En Liu
- Department of Medical Genetics, College of Medicine, Kaohsiung, Taiwan, Republic of China
| | - Wei-Chiao Chen
- Department of Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
- Department of Medical Genetics, College of Medicine, Kaohsiung, Taiwan, Republic of China
- Center of Excellence for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China
| | - Chen-Chia Chang
- Department of Medical Genetics, College of Medicine, Kaohsiung, Taiwan, Republic of China
| | - Wei-Pin Chang
- Department of Healthcare Management, Yuanpei University, HsinChu, Taiwan, Republic of China
| | - Jan-Gowth Chang
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
- Department of Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
- Center of Excellence for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China
| | - Wei-Chiao Chang
- Department of Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
- Department of Medical Genetics, College of Medicine, Kaohsiung, Taiwan, Republic of China
- Center of Excellence for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China
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Lin Y, Mao Q, Zheng X, Chen H, Yang K, Xie L. Vitamin D Receptor Genetic Polymorphisms and the Risk of Urolithiasis: A Meta-Analysis. Urol Int 2011; 86:249-55. [DOI: 10.1159/000323949] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Vezzoli G, Terranegra A, Arcidiacono T, Soldati L. Genetics and calcium nephrolithiasis. Kidney Int 2010; 80:587-93. [PMID: 20962745 DOI: 10.1038/ki.2010.430] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Calcium nephrolithiasis is one of the most prevalent uronephrologic disorders in the western countries. Studies in families and twins evidenced a genetic predisposition to calcium nephrolithiasis. Family-based or case-control studies of single-candidate genes evidenced the possible involvement of calcium-sensing receptor (CASR), vitamin D receptor (VDR), and osteopontin (OPN) gene polymorphisms in stone formation. The only high-throughput genome-wide association study identified claudin 14 (CLDN14) gene as a possible major gene of nephrolithiasis. Specific phenotypes were related with these genes: CASR gene in normocitraturic patients, VDR gene in hypocitraturic patients with severe clinical course, and CLDN14 gene in hypercalciuric patients. The pathogenetic weight of these genes remains unclear, but an alteration of their expression may occur in stone formers. Technological skills, accurate clinical examination, and a detailed phenotype description are the basis to get new insight about the genetic basis of nephrolithiasis.
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Affiliation(s)
- Giuseppe Vezzoli
- Nephrology and Dialysis Unit, San Raffaele Scientific Institute, via Olgettina 60, Milan, Italy.
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