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Sienkiewicz-Szłapka E, Fiedorowicz E, Król-Grzymała A, Kordulewska N, Rozmus D, Cieślińska A, Grzybowski A. The Role of Genetic Polymorphisms in Diabetic Retinopathy: Narrative Review. Int J Mol Sci 2023; 24:15865. [PMID: 37958858 PMCID: PMC10650381 DOI: 10.3390/ijms242115865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/23/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
Diabetic retinopathy (DR) is renowned as a leading cause of visual loss in working-age populations with its etiopathology influenced by the disturbance of biochemical metabolic pathways and genetic factors, including gene polymorphism. Metabolic pathways considered to have an impact on the development of the disease, as well as genes and polymorphisms that can affect the gene expression, modify the quantity and quality of the encoded product (protein), and significantly alter the metabolic pathway and its control, and thus cause changes in the functioning of metabolic pathways. In this article, the screening of chromosomes and the most important genes involved in the etiology of diabetic retinopathy is presented. The common databases with manuscripts published from January 2000 to June 2023 have been taken into consideration and chosen. This article indicates the role of specific genes in the development of diabetic retinopathy, as well as polymorphic changes within the indicated genes that may have an impact on exacerbating the symptoms of the disease. The collected data will allow for a broader look at the disease and help to select candidate genes that can become markers of the disease.
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Affiliation(s)
- Edyta Sienkiewicz-Szłapka
- Department of Biochemistry, Faculty of Biology and Biotechnology, University of Warmia and Mazury, 10-719 Olsztyn, Poland; (E.S.-S.); (E.F.); (A.K.-G.); (N.K.); (D.R.)
| | - Ewa Fiedorowicz
- Department of Biochemistry, Faculty of Biology and Biotechnology, University of Warmia and Mazury, 10-719 Olsztyn, Poland; (E.S.-S.); (E.F.); (A.K.-G.); (N.K.); (D.R.)
| | - Angelika Król-Grzymała
- Department of Biochemistry, Faculty of Biology and Biotechnology, University of Warmia and Mazury, 10-719 Olsztyn, Poland; (E.S.-S.); (E.F.); (A.K.-G.); (N.K.); (D.R.)
| | - Natalia Kordulewska
- Department of Biochemistry, Faculty of Biology and Biotechnology, University of Warmia and Mazury, 10-719 Olsztyn, Poland; (E.S.-S.); (E.F.); (A.K.-G.); (N.K.); (D.R.)
| | - Dominika Rozmus
- Department of Biochemistry, Faculty of Biology and Biotechnology, University of Warmia and Mazury, 10-719 Olsztyn, Poland; (E.S.-S.); (E.F.); (A.K.-G.); (N.K.); (D.R.)
| | - Anna Cieślińska
- Department of Biochemistry, Faculty of Biology and Biotechnology, University of Warmia and Mazury, 10-719 Olsztyn, Poland; (E.S.-S.); (E.F.); (A.K.-G.); (N.K.); (D.R.)
| | - Andrzej Grzybowski
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Gorczyczewskiego 2/3, 61-553 Poznań, Poland;
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VEGF and eNOS genes polymorphism features in patients with diabetes mellitus with and without initial non-proliferative diabetic retinopathy. ACTA BIOMEDICA SCIENTIFICA 2021. [DOI: 10.29413/abs.2021-6.6-1.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The endothelial NO synthase (eNOS) and vascular endothelial growth factor (VEGF) imbalance and the polymorphism of these genes may be the predisposition for diabetic retinopathy (DR) development and progression.The aim: to analyze VEGF (rs699947 and rs3025039) and eNOS (rs2070744) genes polymorphism and their combinations in patients with type 2 diabetes mellitus (DM2) with and without initial non-proliferative DR.Materials and methods. The study included 200 patients with type 2 diabetes (155 women and 45 men, age – 43–70 years): 111 people without and 89 people with DR. The polymorphism of the regulatory regions of VEGF (rs699947 and rs3025039) and eNOS (rs2070744) genes was studied using restriction fragment length polymorphism analysis and TaqMan Real-Time PCR by. Statistical processing was carried out using the software packages Statistica 10.0, SPSS Statistics 23 and the package of original programs for volumetric processing of bioinformation.Results. The VEGF-2578 heterozygosity and two complex genotypes – VEGF-2578CA:VEGF+936CC and NOS3-786CT:VEGF-2578CA:VEGF+936CC – signifi cantly decreased in patients with DR. The predisposition to early DR development to minor genotype of eNOS gene in the NOS3-786CC:VEGF+936CT complex and signifi cantly decreased the homozygous wild-type eNOS genotype in DM2 patients with ophthalmopathology were shown. NOS3-86TT:VEGF2578AA genotype signifi cantly decreased in group with retinopathy developing and the glycated hemoglobin high level.Conclusion. Along with the clinical risk factors for the development of DR in DM2, the genetic polymorphism of the regulatory regions of the genes analyzed by us has a signifi cant weight. When analyzing potential genetic markers, it is important to consider possible joint epistatic/hypostatic effects. The complex analysis of polymorphic gene can help early prognosis of the DR development.
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Mihoubi E, Bouldjennet F, Raache R, Amroun H, Azzouz M, Benazouz N, Touil-Boukoffa C, Attal N. [T-786C endothelial nitric oxide gene polymorphism and type 1 diabetic retinopathy in the Algerian population]. J Fr Ophtalmol 2019; 42:579-585. [PMID: 30962068 DOI: 10.1016/j.jfo.2018.11.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 11/18/2018] [Accepted: 11/19/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Diabetic retinopathy (DR) results from interactions between genetic and environmental factors. We were interested in the endothelial nitric oxide gene (eNOS), given the involvement of this enzyme in functional alterations in the retinal microvasculature in diabetes. The goal of our study was to assess the association of T-786C endothelial nitric oxide synthase (eNOS) gene polymorphism with diabetic retinopathy in the Algerian population. PATIENTS AND METHODS Our study enrolled 110 patients with and without DR. All subjects were genotyped for the T786C eNOS polymorphism using the PCR-RFLP method. We also investigated the association between this polymorphism and certain clinical and laboratory characteristics of patients with DR. RESULTS A significant increase in the frequency of the CC genotype is noted in subjects without DR (P=0.03). We also report a significant increase in the frequencies of the TT+TC genotypes in individuals with DR (P=0.03). However, the association between the different genotypes and clinical or laboratory profiles in patients with DR reveals that the NO level is lower in subjects carrying the TT genotype (P=0.039). CONCLUSION Our preliminary results suggest that the CC genotype could confer protection from type 1 diabetic retinopathy in the Algerian population, while the T allele seems to confer susceptibility.
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Affiliation(s)
- E Mihoubi
- Équipe cytokines et NO synthases/immunité et pathogénie, laboratoire de biologie cellulaire et moléculaire (LBCM), faculté des sciences biologiques, USTHB, BP 32, El Alia, 16111, Alger, Algérie; Département d'immunologie, institut Pasteur d'Algérie, route du Petit-Staouéli, Delly Brahim, Algérie.
| | - F Bouldjennet
- Équipe cytokines et NO synthases/immunité et pathogénie, laboratoire de biologie cellulaire et moléculaire (LBCM), faculté des sciences biologiques, USTHB, BP 32, El Alia, 16111, Alger, Algérie; Faculté des sciences, université M'Hamed Bougara de Boumerdès, avenue de l'indépendance, 35000 Boumerdès, Algérie
| | - R Raache
- Équipe cytokines et NO synthases/immunité et pathogénie, laboratoire de biologie cellulaire et moléculaire (LBCM), faculté des sciences biologiques, USTHB, BP 32, El Alia, 16111, Alger, Algérie
| | - H Amroun
- Laboratoire central de biologie. CHU N'fissa Hamoud, Hussein Dey, route de Bachdjerah, el magharia, 16008, Alger, Algérie
| | - M Azzouz
- Service de diabétologie, CHU Mustapha Bacha, Alger, Algérie
| | - N Benazouz
- Service d'ophtalmologie, CHU Beb el Oued, Alger, Algérie
| | - C Touil-Boukoffa
- Équipe cytokines et NO synthases/immunité et pathogénie, laboratoire de biologie cellulaire et moléculaire (LBCM), faculté des sciences biologiques, USTHB, BP 32, El Alia, 16111, Alger, Algérie
| | - N Attal
- Équipe cytokines et NO synthases/immunité et pathogénie, laboratoire de biologie cellulaire et moléculaire (LBCM), faculté des sciences biologiques, USTHB, BP 32, El Alia, 16111, Alger, Algérie
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Erdogan M, Kulaksizoglu M, Tetik A, Solmaz S, Kucukaslan AS, Eroglu Z. The relationship of the endothelial nitric oxide synthase (eNOS) and vascular endothelial growth factor (VEGF) gene polymorphism in Turkish type 2 diabetic patients with and without diabetic foot ulcers. Foot (Edinb) 2018; 37:5-10. [PMID: 30321858 DOI: 10.1016/j.foot.2018.06.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 05/27/2018] [Accepted: 06/25/2018] [Indexed: 02/04/2023]
Abstract
OBJECTIVE This study aims to evaluate the influence of eNOS G894T and VEGF C936T gene polymorphism in diabetic foot ulcers. METHOD We studied 50 patients with diabetic foot ulcers and 57 diabetic patients without diabetic foot ulcer and a control group of 75 healthy individuals. RESULTS The genotype eNOS distribution did not differ between Type 2 Diabetic Patients group and Diabetic Foot Ulcer group (P>0.05). The frequency of the polymorphic T allele in Type 2 Diabetic Patients were significantly higher than the control group (42.3% and 24.5%, respectively)(p<0.01). The frequency of the polymorphic T allele between the Type 2 Diabetic Patients and Diabetic Foot Ulcer group was similar (p>0.05). The genotype VEGF distribution did not differ between Type 2 Diabetic Patients group and Diabetic Foot Ulcer group (P>0.05). The frequency of the polymorphic T allele between the Type 2 Diabetic Patients and Diabetic Foot Ulcer group was similar for both groups (p>0.05). CONCLUSION Polymorphism of eNOS G894T is not a risk factor for diabetic foot ulcer formation. T allele is a risk factor for diabetes, but T allele is not a risk factor for diabetic foot ulcer formation. Polymorphism of VEGF C936T and T allele are not risk factors for diabetes occurence and diabetic foot formation.
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Affiliation(s)
- Mehmet Erdogan
- Ege University Medical School, Department of Endocrinology and Metabolic Diseases, Bornova, 35100 Izmir, Turkey.
| | - Mustafa Kulaksizoglu
- Necmettin Erbakan University Medical School, Department of Endocrinology and Metabolic Diseases, Konya, Turkey
| | - Asli Tetik
- Ege University Medical School, Department of Medical Biology, Bornova, Izmir, Turkey
| | - Soner Solmaz
- Numune Education and Research Hospital, Internal Medicine, Adana, Turkey
| | - Ali Sahin Kucukaslan
- Ege University Medical School, Department of Medical Biology, Bornova, Izmir, Turkey
| | - Zuhal Eroglu
- Ege University Medical School, Department of Medical Biology, Bornova, Izmir, Turkey
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Cao M, Tian Z, Zhang L, Liu R, Guan Q, Jiang J. Genetic association of AKR1B1 gene polymorphism rs759853 with diabetic retinopathy risk: A meta-analysis. Gene 2018; 676:73-78. [DOI: 10.1016/j.gene.2018.07.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 06/12/2018] [Accepted: 07/05/2018] [Indexed: 11/27/2022]
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Ben Khedher MR, Abid M, Jamoussi K, Hammami M. Comprehensive insight into functional interaction between GNB3 C825T and eNOS T-786C, G894T gene polymorphisms and association with susceptibility to diabetic erectile dysfunction. Andrology 2018; 6:865-873. [DOI: 10.1111/andr.12543] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 07/14/2018] [Accepted: 07/18/2018] [Indexed: 01/05/2023]
Affiliation(s)
- M. R. Ben Khedher
- Laboratory of Nutrition, Functional Food and Vascular Health; Department of Biochemistry; Faculty of Medicine of Monastir; University of Monastir; Monastir Tunisia
| | - M. Abid
- Unit of Obesity and Metabolic Syndrome; Department of Endocrinology; University Hospital Hedi Chaker; Sfax Tunisia
| | - K. Jamoussi
- Biochemistry Laboratory; University Hospital Hedi Chaker; Sfax Tunisia
| | - M. Hammami
- Laboratory of Nutrition, Functional Food and Vascular Health; Department of Biochemistry; Faculty of Medicine of Monastir; University of Monastir; Monastir Tunisia
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Tabatabaei-Malazy O, Khodaeian M, Bitarafan F, Larijani B, M Amoli M. Polymorphisms of Antioxidant Genes as a Target for Diabetes Management. INTERNATIONAL JOURNAL OF MOLECULAR AND CELLULAR MEDICINE 2017; 6:135-147. [PMID: 29682485 PMCID: PMC5898637 DOI: 10.22088/acadpub.bums.6.3.135] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 06/29/2017] [Indexed: 12/16/2022]
Abstract
Diabetes mellitus (DM) is one of the most important health problems with increasing prevalence worldwide. Oxidative stress, a result of imbalance between reactive oxygen species (ROS) generation and antioxidant defense mechanisms has been demonstrated as the main pathology in DM. Hyperglycemia-induced ROS productions can induce oxidative stress through four major molecular mechanisms including the polyol pathway, advanced glycation end- products formation, activation of protein kinase C isoforms, and the hexosamine pathways. In the development of type 2 DM (T2DM) and its complications, genetic and environmental factors play important roles. Therefore, the aim of this review was to focus on the assessment of single-nucleotide polymorphisms within antioxidant enzymes including superoxide dismutase, catalase, glutathione peroxidase, glutathione-S-transferase, nitric oxide synthase, and NAD(P)H oxidase and their association with T2DM. The results would be helpful in understanding the mechanisms involved in pathogenesis of disease besides discovering new treatment approaches in management of DM.
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Affiliation(s)
- Ozra Tabatabaei-Malazy
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrnoosh Khodaeian
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bitarafan
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa M Amoli
- Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular -Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Armenis I, Kalotychou V, Tzanetea R, Kollia P, Kontogeorgiou Z, Anastasopoulou D, Mantzourani M, Samarkos M, Pantos K, Konstantopoulos K, Rombos I. Prognostic value of T786C and G894T eNOS polymorphisms in sickle cell disease. Nitric Oxide 2017; 62:17-23. [DOI: 10.1016/j.niox.2016.11.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 11/08/2016] [Accepted: 11/13/2016] [Indexed: 11/29/2022]
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Priščáková P, Minárik G, Repiská V. Candidate gene studies of diabetic retinopathy in human. Mol Biol Rep 2016; 43:1327-1345. [PMID: 27730450 PMCID: PMC5102952 DOI: 10.1007/s11033-016-4075-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 09/09/2016] [Indexed: 12/13/2022]
Abstract
Diabetic retinopathy (DR) is a multifactorial disease with complex pathophysiology. It is the main cause of blindness among the people in productive age. The purpose of this literature review is to highlight recent achievements in the genetics of diabetic retinopathy with particular focus on candidate gene studies. We summarized most of the available published data about candidate genes for diabetic retinopathy with the goal to identify main genetic aspects. We conclude that genetic studies reported contradictory findings and no genetic variants meet criteria of a diagnostic marker, or significantly elucidate the root of DR development. Based on these findings it is important to continue with the research in the field of DR genetics, mainly due to the fact that currently new possibilities and approaches associated with utilization of next-generation sequencing are available.
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Affiliation(s)
- Petra Priščáková
- Faculty of Medicine, Institute of Medical Biology, Genetics and Clinical Genetics, University Hospital Bratislava, Comenius University in Bratislava, Sasinkova 4, 81108, Bratislava, Slovakia
| | - Gabriel Minárik
- Medirex Group Academy n.o., Galvaniho 17/C, 82016, Bratislava, Slovakia
| | - Vanda Repiská
- Faculty of Medicine, Institute of Medical Biology, Genetics and Clinical Genetics, University Hospital Bratislava, Comenius University in Bratislava, Sasinkova 4, 81108, Bratislava, Slovakia.
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Zuo C, Li M, Zhang X, Chen H, Su Y, Wu K, Wen F. ENOS polymorphisms in neovascular age-related macular degeneration and polypoidal choroidal vasculopathy in a Chinese Han population. Ophthalmic Genet 2016; 37:394-399. [DOI: 10.3109/13816810.2015.1107598] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Chengguo Zuo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Meng Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiongze Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Hui Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yu Su
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Kunfang Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Feng Wen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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Momeni A, Chaleshtori MH, Saadatmand S, Kheiri S. Correlation of Endothelial Nitric Oxide Synthase Gene Polymorphism (GG, TT and GT Genotype) with Proteinuria and Retinopathy in Type 2 Diabetic Patients. J Clin Diagn Res 2016; 10:OC32-5. [PMID: 27042499 DOI: 10.7860/jcdr/2016/14975.7291] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 07/27/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Nephropathy is the most important leading cause of end stage renal failure in type 2 diabetic patients, so numerous studies were done to diagnose and evaluate risk factors of diabetic nephropathy (DN). Some gene polymorphisms may be associated with progression or regression of DN, so the aim of this study was to compare prevalence of eNOS gene polymorphism in diabetic patients with controls and its association with diabetic nephropathy. MATERIALS AND METHODS In a cross-sectional study, 94 type 2 diabetic patients and 94 normal participants were enrolled. Patients without retinopathy were excluded from this study. For all of the patients, fasting blood sugar (FBS), 2 hours post-prandial (BS), Blood Urea Nitrogen (BUN), Creatinine (Cr), 24 hours urine protein were measured in the case group. Endothelial nitric oxide synthetase gene polymorphism was evaluated in the case and control groups. RESULTS There was no significant difference based on age and sex between patients in case and control groups. GG genotype of eNOS was less common in the patient group compared to control group. There was no difference between prevalence of TT, GT or GG genotype based on age and sex. There was no correlation between diabetic retinopathy or proteinuria and genotypes of eNOs. CONCLUSION The study showed that in type 2 diabetic patients, NOS gene polymorphism was more common compared to normal population; however, there is no correlation between this gene polymorphism and proteinuria or retinopathy in these patients.
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Affiliation(s)
- Ali Momeni
- Associate Professor, Department of Nephrology, Nephrology Division of Internal medicine Department, Shahrekord University of Medical Sciences , Shahrekord, Iran
| | - Morteza Hashemzadeh Chaleshtori
- Professor, Department of Human Genetics, Cellular and Molecular research center, Shahrekord University of Medical Sciences , Shahrekord, Iran
| | - Saeed Saadatmand
- Internist, Department of Internal Medicine Department, Shahrekord University of Medical Sciences , Shahrekord, Iran
| | - Soleiman Kheiri
- Associate Professor, Department of Biostatics, Clinical Biochemistry Research Center, Shahrekord University of Medical Sciences , Iran
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Association between genetic polymorphisms of ACE & eNOS and diabetic nephropathy. Mol Biol Rep 2014; 42:27-33. [PMID: 25227524 DOI: 10.1007/s11033-014-3736-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 09/10/2014] [Indexed: 11/27/2022]
Abstract
Diabetic nephropathy (DN) is the leading cause of end-stage renal disease, with multiple genetic and environmental factors involving in its etiology. ACE and eNOS gene were considered to have important roles in the development and progression of DN. In this study, a case-control study was carried out to investigate the effects of 7 SNPs in ACE gene and 2 SNPs in eNOS gene in the development of DN in Northern China.7 SNPs including A240T, A2350G, A5466C, A2215G, T3892C, C1237T and C3409T of ACE gene and 2 SNPs (G894T and T786C) of eNOS gene were genotyped by polymerase chain reaction restriction fragment length polymorphism method. 431 type 2 diabetic patients with nephropathy (cases) were compared to 420 type 2 diabetic patients without nephropathy (controls) in the study. Data were analyzed by SPSS 17.0 and HaploView software. The frequency distribution of A2350G, 4 haplotyps in ACE gene and G894T in eNOS gene were demonstrated to be different between case and control groups significantly. Whereas other SNPs and haplotypes had no differences in two cohorts. The results revealed that variations of ACE and eNOS gene had association with DN, which indicated ACE and eNOS gene may play an important role in pathogenesis of DN in Northern Chinese Han population.
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Kuo JZ, Wong TY, Rotter JI. Challenges in elucidating the genetics of diabetic retinopathy. JAMA Ophthalmol 2014; 132:96-107. [PMID: 24201651 DOI: 10.1001/jamaophthalmol.2013.5024] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
IMPORTANCE In the past decade, significant progress in genomic medicine and technologic developments has revolutionized our approach to common complex disorders in many areas of medicine, including ophthalmology. A disorder that still needs major genetic progress is diabetic retinopathy (DR), one of the leading causes of blindness in adults. OBJECTIVE To perform a literature review, present the current findings, and highlight some key challenges in DR genetics. DESIGN, SETTING, AND PARTICIPANTS We performed a thorough literature review of the genetic factors for DR, including heritability scores, twin studies, family studies, candidate gene studies, linkage studies, and genome-wide association studies (GWASs). MAIN OUTCOME MEASURES Environmental and genetic factors for DR. RESULTS Although there is clear demonstration of a genetic contribution in the development and progression of DR, the identification of susceptibility loci through candidate gene approaches, linkage studies, and GWASs is still in its infancy. The greatest obstacles remain a lack of power because of small sample size of available studies and a lack of phenotype standardization. CONCLUSIONS AND RELEVANCE The field of DR genetics is still in its infancy and is a challenge because of the complexity of the disease. This review outlines some strategies and lessons for future investigation to improve our understanding of this complex genetic disorder.
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Affiliation(s)
- Jane Z Kuo
- Medical Genetics Institute and Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California2Department of Ophthalmology, University of California San Diego, La Jolla3Department of Ophthalmology, Chang Gung Memorial Hospital and
| | - Tien Y Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore5Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jerome I Rotter
- Medical Genetics Institute and Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California6Institute for Translational Genomics and Population Sciences, Los Angeles Bio Medical Research Institute, Harbor-UCLA Medical Center, To
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Simó-Servat O, Hernández C, Simó R. Genetics in diabetic retinopathy: current concepts and new insights. Curr Genomics 2014; 14:289-99. [PMID: 24403848 PMCID: PMC3763680 DOI: 10.2174/13892029113149990008] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 06/25/2013] [Accepted: 06/25/2013] [Indexed: 01/05/2023] Open
Abstract
There is emerging evidence which indicates the essential role of genetic factors in the development of diabetic retinopathy (DR). In this regard it should be highlighted that genetic factors account for 25-50% of the risk of developing DR. Therefore, the use of genetic analysis to identify those diabetic patients most prone to developing DR might be useful in designing a more individualized treatment. In this regard, there are three main research strategies: candidate gene studies, linkage studies and Genome-Wide Association Studies (GWAS). In the candidate gene approach, several genes encoding proteins closely related to DR development have been analyzed. The linkage studies analyze shared alleles among family members with DR under the assumption that these predispose to a more aggressive development of DR. Finally, Genome-Wide Association Studies (GWAS) are a new tool involving a massive evaluation of single nucleotide polymorphisms (SNP) in large samples. In this review the available information using these three methodologies is critically analyzed. A genetic approach in order to identify new candidates in the pathogenesis of DR would permit us to design more targeted therapeutic strategies in order to decrease this devastating complication of diabetes. Basic researchers, ophthalmologists, diabetologists and geneticists should work together in order to gain new insights into this issue.
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Affiliation(s)
- Olga Simó-Servat
- Diabetes and Metabolism Research Unit. Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Spain
| | - Cristina Hernández
- Diabetes and Metabolism Research Unit. Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Spain; ; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Spain
| | - Rafael Simó
- Diabetes and Metabolism Research Unit. Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Spain; ; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Spain
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Cheema BS, kohli HS, Sharma R, Bhansali A, Khullar M. Endothelial nitric oxide synthase gene polymorphism and type 2 diabetic retinopathy among Asian Indians. Acta Diabetol 2012; 49:481-8. [PMID: 23085930 DOI: 10.1007/s00592-012-0437-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 10/08/2012] [Indexed: 01/09/2023]
Abstract
Endothelial nitric oxide synthase (eNOS) has been shown to play an essential role in retinal vascular function, and disequilibrium in its production can lead to diabetic retinopathy (DR). Genetic polymorphisms of eNOS gene have been suggested to play a role in nitric oxide (NO) abnormalities which may contribute to the development and progression of DR. In view of the variable results that have been reported for the association between eNOS gene polymorphisms and DR, the present study was designed to study the association and interaction between eNOS gene polymorphisms and the development and progression of DR in Asian Indian type 2 diabetes mellitus patients (T2DM). We screened 1,720 T2DM patients, belonging to two independently ascertained cohorts out of which 1,446 were genotyped for three polymorphisms of eNOS (two SNPs: T-786C, G894T and one 27-bp repeat polymorphism in intron 4 (27VNTR)) using validated PCR-RFLP assays. In both the cohorts, consistently lower prevalence and decreased risk of DR was observed in patients with ba, aa and ba + aa genotype of 27VNTR (a/b), C-a-G and C-a-T haplotype (allele of T-786C, 27VNTR a/b and G894T) carrying "C" allele of T-786C and "a" allele of 27VNTR (a/b). Also, mean NO levels in T2DM subjects carrying ba + aa genotype were higher as compared to bb genotype. Our results suggest that eNOS genotypes 27VNTR carrying "aa" genotype is an independent protective factor for DR and is associated with low risk of DR.
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Affiliation(s)
- Balneek Singh Cheema
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Zhao S, Li T, Zheng B, Zheng Z. Nitric oxide synthase 3 (NOS3) 4b/a, T-786C and G894T polymorphisms in association with diabetic retinopathy susceptibility: a meta-analysis. Ophthalmic Genet 2012; 33:200-7. [PMID: 22506535 DOI: 10.3109/13816810.2012.675398] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIMS To assess the association between the NOS3 4b/a, T-786C and G894T polymorphisms and diabetic retinopathy (DR) susceptibility. MATERIALS AND METHODS Twenty-one studies covering 8,111 subjects were included. The fixed or random effect model used was based on heterogeneity. RESULTS A significant association of the intron 4a allele in the NOS3 4b/a polymorphism with reduced risk of DR was found in dominant (OR 0.778, 95% CI 0.654-0.926) and additive (OR 0.809, 95% CI 0.698-0.937) models. Subgroup analysis revealed that the intron 4a allele additive model (OR 0.807, 95% CI 0.697-0.935) was associated with DR risk in type 2 diabetic patients. We also found a marginally significant association of the C allele in the T-786C polymorphism with reduced risk of proliferative DR. In contrast, no statistically significant association was observed between the G894T polymorphism and DR risk, either in the overall or subgroup analyses. CONCLUSIONS The intron 4a allele of the 4b/a polymorphism in the eNOS gene has protective effects against DR, especially in type 2 diabetic patients. The C allele of the T-786C polymorphism may be a protective factor for proliferative DR. However, the G894T polymorphism does not appear to influence the development of DR. This conclusion warrants confirmation by further studies.
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Affiliation(s)
- Shuzhi Zhao
- Department of Ophthalmology, First People's Hospital of Shanghai, Shanghai Jiaotong University, Shanghai, China
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Miranda-Massari JR, Gonzalez MJ, Jimenez FJ, Allende-Vigo MZ, Duconge J. Metabolic correction in the management of diabetic peripheral neuropathy: improving clinical results beyond symptom control. CURRENT CLINICAL PHARMACOLOGY 2011; 6:260-73. [PMID: 22082324 PMCID: PMC3682498 DOI: 10.2174/157488411798375967] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2011] [Revised: 06/07/2011] [Accepted: 09/23/2011] [Indexed: 12/28/2022]
Abstract
Current Clinical Management Guidelines of Diabetic Peripheral Neuropathy (DPN) are based on adequate glucose control and symptomatic pain relief. However, meticulous glycemic control could delay the onset or slow the progression of diabetic neuropathy in patients with DM type 2, but it does not completely prevent the progression of the disease. Complications of DPN as it continues its natural course, produce increasing pain and discomfort, loss of sensation, ulcers, infections, amputations and even death. In addition to the increased suffering, disability and loss of productivity, there is a very significant economic impact related to the treatment of DPN and its complications. In USA alone, it has been estimated that there are more than 5,000,000 patients suffering from DPN and the total annual cost of treating the disease and its complications is over $10,000 million dollars. In order to be able to reduce complications of DPN, it is crucial to improve or correct the metabolic conditions that lead to the pathology present in this condition. Pathophysiologic mechanisms implicated in diabetic neuropathy include: increased polyol pathway with accumulation of sorbitol and reduced Na+/K+-ATPase activity, microvascular damage and hypoxia due to nitric oxide deficit and increased oxygen free radical activity. Moreover, there is a decrease in glutathione and increase in homocysteine. Clinical trials in the last two decades have demonstrated that the use of specific nutrients can correct some of these metabolic derangements, improving symptom control and providing further benefits such as improved sensorium, blood flow and nerve regeneration. We will discuss the evidence on lipoic acid, acetyl-L-carnitine, benfotiamine and the combination of active B vitamins L-methylfolate, methylcobalamin and piridoxal-6-phosphate. In addition, we discuss the role of metformin, an important drug in the management of diabetes, and the presence of specific polymorphic genes, in the risk of developing DPN and how metabolic correction can reduce these risks.
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Affiliation(s)
- Jorge R. Miranda-Massari
- RECNAC 2 Project, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
- School of Pharmacy, Department of Pharmacy Practice, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
| | - Michael J. Gonzalez
- RECNAC 2 Project, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
- Graduate School of Public Health, Department of Human Development, Nutrition Program, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
| | - Francisco J. Jimenez
- School of Pharmacy, Department of Pharmacy Practice, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
| | - Myriam Z. Allende-Vigo
- School of Medicine, Department of Endocrinology, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
| | - Jorge Duconge
- RECNAC 2 Project, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
- Pharmaceutical Sciences, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
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Mehrab-Mohseni M, Tabatabaei-Malazy O, Hasani-Ranjbar S, Amiri P, Kouroshnia A, Bazzaz JT, Farahani-Shrhabi M, Larijani B, Amoli MM. Endothelial nitric oxide synthase VNTR (intron 4 a/b) polymorphism association with type 2 diabetes and its chronic complications. Diabetes Res Clin Pract 2011; 91:348-52. [PMID: 21256614 DOI: 10.1016/j.diabres.2010.12.030] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2010] [Revised: 12/18/2010] [Accepted: 12/21/2010] [Indexed: 11/15/2022]
Abstract
UNLABELLED SUBJECT AND AIMS: Endothelial derived nitric oxide (eNOS) is involved in several functions playing important role in development of type 2 diabetes and insulin resistance. The aim of this study was to examine the association between eNOS intron 4 VNTR polymorphism and type 2 diabetes in an Iranian population. METHODS A total of 220 patients with type 2 diabetes and 96 healthy control subjects were recruited from the same area. Genotyping was performed using PCR. RESULTS A significant difference was found in genotype frequencies of eNOS polymorphism between patients and controls (aa+ab vs. bb p=0.02, OR 2.0 95% CI; 1.05-3.96). Also allele a frequency was significantly increased in patients with diabetes compared with controls (p=0.007, OR 2.1 95% CI; 1.19-4.08). We found that in patients with diabetic neuropathy the frequency of 'a' allele was significantly increased compared to the controls p=0.03, OR=1.8 95% CI (1.00-3.7). Both genotype and allele frequencies were significantly different between patients who were complication free compared to the controls [aa+ab vs. bb p=0.007, OR=2.6 95% CI (1.2-5.8) and p=0.001, OR=2.8 95% CI (1.4-5.9)] respectively with the a allele conferring the risk. CONCLUSION The association between eNOS VNTR polymorphism and T2DM seems to be stronger in patients without diabetic complications indicating diverse effect of eNOS polymorphism on diabetes and diabetic microvascular complications.
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