1
|
Bruno W, Dalmasso B, Barile M, Andreotti V, Elefanti L, Colombino M, Vanni I, Allavena E, Barbero F, Passoni E, Merelli B, Pellegrini S, Morgese F, Danesi R, Calò V, Bazan V, D'Elia AV, Molica C, Gensini F, Sala E, Uliana V, Soma PF, Genuardi M, Ballestrero A, Spagnolo F, Tanda E, Queirolo P, Mandalà M, Stanganelli I, Palmieri G, Menin C, Pastorino L, Ghiorzo P. Predictors of germline status for hereditary melanoma: 5 years of multi-gene panel testing within the Italian Melanoma Intergroup. ESMO Open 2022; 7:100525. [PMID: 35777164 PMCID: PMC9434136 DOI: 10.1016/j.esmoop.2022.100525] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/26/2022] [Accepted: 05/29/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The incidence of cutaneous melanoma is increasing in Italy, in parallel with the implementation of gene panels. Therefore, a revision of national genetic assessment criteria for hereditary melanoma may be needed. The aim of this study was to identify predictors of susceptibility variants in the largest prospective cohort of Italian high-risk melanoma cases studied to date. MATERIALS AND METHODS From 25 Italian centers, we recruited 1044 family members and germline sequenced 940 cutaneous melanoma index cases through a shared gene panel, which included the following genes: CDKN2A, CDK4, BAP1, POT1, ACD, TERF2IP, MITF and ATM. We assessed detection rate according to familial status, region of origin, number of melanomas and presence and type of non-melanoma tumors. RESULTS The overall detection rate was 9.47% (5.53% analyzing CDKN2A alone), ranging from 5.14% in sporadic multiple melanoma cases (spoMPM) with two cutaneous melanomas to 13.9% in familial cases with at least three affected members. Three or more cutaneous melanomas in spoMPM cases, pancreatic cancer and region of origin predicted germline status [odds ratio (OR) = 3.23, 3.15, 2.43, P < 0.05]. Conversely, age > 60 years was a negative independent predictor (OR = 0.13, P = 0.008), and was the age category with the lowest detection rate, especially for CDKN2A. Detection rate was 19% when cutaneous melanoma and pancreatic cancer clustered together. CONCLUSIONS Gene panel doubled the detection rate given by CDKN2A alone. National genetic testing criteria may need a revision, especially regarding age cut-off (60) in the absence of strong family history, pancreatic cancer and/or a high number of cutaneous melanomas.
Collapse
Affiliation(s)
- W Bruno
- IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy; University of Genoa, Department of Internal Medicine and Medical Specialties (DiMI), Genoa, Italy.
| | - B Dalmasso
- IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy
| | - M Barile
- IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy
| | - V Andreotti
- IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy
| | - L Elefanti
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - M Colombino
- Unit of Cancer Genetics, Institute of Genetics and Biomedical Research of the National Research Council (IRGB-CNR), Sassari, Italy
| | - I Vanni
- IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy; University of Genoa, Department of Internal Medicine and Medical Specialties (DiMI), Genoa, Italy
| | - E Allavena
- University of Genoa, Department of Internal Medicine and Medical Specialties (DiMI), Genoa, Italy
| | - F Barbero
- IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy
| | - E Passoni
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - B Merelli
- Oncology Unit, ASST Papa Giovanni XXIIII, Bergamo, Italy
| | - S Pellegrini
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy; Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padua, Padua, Italy
| | - F Morgese
- Oncology Unit, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - R Danesi
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy
| | - V Calò
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - V Bazan
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - A V D'Elia
- Institute of Medical Genetics, ASUFC University Hospital of Udine, Udine, Italy
| | - C Molica
- Medical Oncology Unit, S. Maria della Misericordia Hospital, Perugia, Italy
| | - F Gensini
- Department of Experimental and Clinical Biomedical Sciences 'Mario Serio', University of Florence, Florence, Italy
| | - E Sala
- Cytogenetics and Medical Genetics Unit, H San Gerardo ASST Monza, Monza, Italy
| | - V Uliana
- Medical Genetics Unit, AOU di Parma, Parma, Italy
| | - P F Soma
- Casa di Cura Gibiino, Catania, Italy
| | - M Genuardi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Medical Genetics Unit, Rome, Italy; Università Cattolica del Sacro Cuore, Department of Life Sciences and Public Health, Rome, Italy
| | - A Ballestrero
- IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy; University of Genoa, Department of Internal Medicine and Medical Specialties (DiMI), Genoa, Italy
| | - F Spagnolo
- IRCCS Ospedale Policlinico San Martino, Medical Oncology 2, Genoa, Italy
| | - E Tanda
- IRCCS Ospedale Policlinico San Martino, Medical Oncology 2, Genoa, Italy
| | - P Queirolo
- Division of Medical Oncology for Melanoma, Sarcoma, and Rare Tumors, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - M Mandalà
- Medical Oncology Unit, S. Maria della Misericordia Hospital, Perugia, Italy; Department of Surgery and Medicine, University of Perugia, Perugia, Italy
| | - I Stanganelli
- Skin Cancer Unit, IRCCS IRST Istituto Scientifico Romagnolo per lo Studio dei Tumori 'Dino Amadori' (IRST) IRCCS, Meldola, Italy; Dermatologic Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - G Palmieri
- Unit of Cancer Genetics, Institute of Genetics and Biomedical Research of the National Research Council (IRGB-CNR), Sassari, Italy
| | - C Menin
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - L Pastorino
- IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy; University of Genoa, Department of Internal Medicine and Medical Specialties (DiMI), Genoa, Italy
| | - P Ghiorzo
- IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy; University of Genoa, Department of Internal Medicine and Medical Specialties (DiMI), Genoa, Italy
| |
Collapse
|
2
|
Paganini I, Sestini R, Capone G, Putignano A, Contini E, Giotti I, Gensini F, Marozza A, Barilaro A, Porfirio B, Papi L. A novel PAX1
null homozygous mutation in autosomal recessive otofaciocervical syndrome associated with severe combined immunodeficiency. Clin Genet 2017; 92:664-668. [DOI: 10.1111/cge.13085] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 06/21/2017] [Accepted: 06/23/2017] [Indexed: 11/27/2022]
Affiliation(s)
- I. Paganini
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio,” Medical Genetics Unit; University of Florence; Florence Italy
| | - R. Sestini
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio,” Medical Genetics Unit; University of Florence; Florence Italy
| | - G.L. Capone
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio,” Medical Genetics Unit; University of Florence; Florence Italy
| | - A.L. Putignano
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio,” Medical Genetics Unit; University of Florence; Florence Italy
| | - E. Contini
- Diagnostic Genetics Unit; Careggi University Hospital; Florence Italy
| | - I. Giotti
- Diagnostic Genetics Unit; Careggi University Hospital; Florence Italy
| | - F. Gensini
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio,” Medical Genetics Unit; University of Florence; Florence Italy
| | - A. Marozza
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio,” Medical Genetics Unit; University of Florence; Florence Italy
- Medical Genetics Unit; Careggi University Hospital; Florence Italy
| | - A. Barilaro
- Neurology Unit; Careggi University Hospital; Florence Italy
| | - B. Porfirio
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio,” Medical Genetics Unit; University of Florence; Florence Italy
| | - L. Papi
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio,” Medical Genetics Unit; University of Florence; Florence Italy
| |
Collapse
|
3
|
Tavella K, Villanucci A, Vannini L, Rossi V, Fantechi B, Capone G, Putignano A, Gensini F, Porfirio B, Amunni G, Mazzei T, Mini E, Papi L. Retrospective analysis of 77 patients with ovarian cancer undergoing genetic testing for BRCA1 and BRCA2 mutations. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx429.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
4
|
Mannelli M, Simi L, Ercolino T, Gaglianò MS, Becherini L, Vinci S, Sestini R, Gensini F, Pinzani P, Mascalchi M, Guerrini L, Pratesi C, Nesi G, Torti F, Cipollini F, Bernini GP, Genuardi M. SDH Mutations in Patients Affected by Paraganglioma Syndromes: A Personal Experience. Ann N Y Acad Sci 2006; 1073:183-9. [PMID: 17102085 DOI: 10.1196/annals.1353.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Mutations in genes encoding mitochondrial succinate dehydrogenase (SDH) are frequently involved in the development of neural crest-derived (NCD) tumors, such as pheochromocytomas (PHEOs) or paragangliomas (PGLs). In this study we report the results of sequencing analysis in leukocyte DNA of patients affected by PHEO/PGL who turned out to be SDH mutation carriers. A nonsense germline heterozygous mutation (Q109X) was found in the exon 4 of the SDHD gene in the index cases of six unrelated families affected by PHEO/PGL. Haplotype analysis showed the presence of a founder effect. Affected patients showed high clinical variability, ranging from monolateral to bilateral glomus tumors, variably associated or not with PGLs or PHEOs. A novel missense SDHD variant, T112I, was also found in one of our families. A new missense G106D mutation, involving a highly conserved amino acid, was found in two sisters affected by bilateral glomus tumors. A P81L mutation associated with abdominal and head and neck PGL was detected in three families. A G12S variant of the SDHD gene was found in one patient affected by a PHEO. The finding of this variant in 3 of 100 control subjects suggests that it is a polymorphism and not a mutation. A novel IVS2-1G>T variant was found at intron 2 of SDHD gene in one patient affected by a glomus tumor. All the tumors associated with SDHD mutations were benign. Conversely, the only mutation we found in SDHB gene (IVS3+1G>A) was associated with a malignant PHEO.
Collapse
Affiliation(s)
- M Mannelli
- Endocrinology Section, Department of Clinical Physiopathology, University of Florence, Viale Pieraccini 6 50139, Florence, and Internal Medicine 2, Pistoia Hospital, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Simi L, Sestini R, Ferruzzi P, Gaglianò MS, Gensini F, Mascalchi M, Guerrini L, Pratesi C, Pinzani P, Nesi G, Ercolino T, Genuardi M, Mannelli M. Phenotype variability of neural crest derived tumours in six Italian families segregating the same founder SDHD mutation Q109X. J Med Genet 2006; 42:e52. [PMID: 16061558 PMCID: PMC1736123 DOI: 10.1136/jmg.2004.030353] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Mutations in genes coding for the mitochondrial complex II succinate dehydrogenase (SDH) subunits cause familial neural crest derived (NCD) tumours. METHODS Index cases from six apparently unrelated families affected by NCD tumours were analysed for mutations in the SDHB, SDHC, and SDHD genes. RESULTS The same nonsense germline heterozygous mutation (Q109X) in exon 4 of the SDHD gene was found in each of the six families. Overall, 43 heterozygotes were identified. These were evaluated for the presence of NCD tumours through radiological examination of the neck, thorax, and abdomen, and measurement of urinary metanephrines and plasma chromogranin A. A novel missense SDHD variant, T112I, which did not segregate with the Q109X mutation and was not associated with phenotypic manifestations, was observed in one of the families. Microsatellite analysis showed a common haplotype in all individuals heterozygous for the Q109X mutation, indicating a founder effect. Overall, 18 heterozygotes were clinically affected by at least one NCD tumour. Every affected patient inherited the germline mutation from the father, confirming SDHD maternal genomic imprinting. Penetrance of the paternally inherited mutation progressively increased from 33% to 83% at 30 and 60 years, respectively. Affected patients showed high clinical variability, ranging from monolateral to bilateral glomus tumours variably associated or not with paragangliomas or phaeochromocytomas. Loss of heterozygosity was observed in tumour cells isolated by laser capture microdissection. CONCLUSIONS This study shows that a single founder SDHD mutation is present in an area of central Italy and that this mutation is associated with widely variable interfamilial and intrafamilial expressivity.
Collapse
Affiliation(s)
- L Simi
- Section of Endocrinology, Department of Clinical Physiopathology, University of Florence Medical School, Florence, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Fedi S, Gensini F, Gori AM, Abbate R, Borsini W. Homocysteine and tissue factor pathway inhibitor levels in patients with Fabry's disease. J Thromb Haemost 2005; 3:2117-9. [PMID: 16102127 DOI: 10.1111/j.1538-7836.2005.01470.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
7
|
Fatini C, Pratesi G, Sofi F, Gensini F, Sticchi E, Lari B, Pulli R, Dorigo W, Azas L, Pratesi C, Gensini GF, Abbate R. ACE DD Genotype: A Predisposing Factor for Abdominal Aortic Aneurysm. Eur J Vasc Endovasc Surg 2005; 29:227-32. [PMID: 15694792 DOI: 10.1016/j.ejvs.2004.12.018] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2004] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To examine the role of polymorphisms in angiotensin converting enzyme (ACE, I/D) and angiotensin II receptor (AT1R, A1166C) in the development of abdominal aortic aneurysm (AAA). MATERIALS AND METHODS We investigated 250 consecutive patients, 217 males and 33 females (median age 72, range 50-83), undergone AAA elective repair and 250 healthy controls, comparable for sex and age. ACE and AT1R polymorphisms were studied by PCR-RFLP analysis. The genotype distribution was in Hardy-Weinberg equilibrium for all polymorphisms. RESULTS The genotype distribution and allele frequency of ACE I/D, but not AT1R A1166C polymorphism were significantly different between patients and controls (ACE I/D: p=0.0002 and p<0.0001, respectively, and AT1R A1166C: p=0.6 and p=0.4, respectively). An association between the ACE DD genotype and the predisposition to AAA was found (OR DD vs. ID+II=1.9 95% CI 1.3-2.9, p<0.0001). Multivariate analysis adjusted for age, sex, traditional vascular risk factors and other atherosclerotic localizations, showed ACE DD genotype to be independently related to the disease (OR DD vs. ID+II=2.4, 95% CI 1.3-4.2 p=0.003). CONCLUSIONS Our findings document that ACE DD genotype represents a susceptibility factor for AAA.
Collapse
Affiliation(s)
- C Fatini
- Department of Clinical and Surgical Critical Care, Thrombosis Centre, Degenerative and Neoplastic Diseases to Develop Novel Therapies, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Inwald D, Brown K, Gensini F, Malone M, Goldman A. Open lung biopsy in neonatal and paediatric patients referred for extracorporeal membrane oxygenation (ECMO). Thorax 2004; 59:328-33. [PMID: 15047954 PMCID: PMC1763824 DOI: 10.1136/thx.2003.010793] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND This study was undertaken to determine the usefulness, safety, and most appropriate timing of open lung biopsy in infants and children considered for and on extracorporeal membrane oxygenation (ECMO) for respiratory failure. METHODS A retrospective review of children referred for consideration of and placed on ECMO in our institution in the period 1996-2002. RESULTS 506 patients were referred, 15 (3%) of whom underwent antemortem open lung biopsy (eight neonatal, four paediatric, and three cardiac patients). In the neonatal group open lung biopsy contributed to clinical decision making in all patients. Four neonates had a fatal lung dysplasia (three alveolar capillary dysplasia and one surfactant protein B deficiency) and treatment was withdrawn. Of the other four neonates, two had pulmonary hypoplasia, one had pulmonary lymphangiectasia, and one had meconium aspiration with mild barotrauma. Treatment was continued in these four patients and two survived. In the paediatric group the biopsies were of clinical relevance in two infants with pertussis who had lung infarction on biopsy in whom treatment was withdrawn. In the other two paediatric patients the biopsies were equivocal, treatment was continued, but both patients died. In the cardiac group, who presented perioperatively with pulmonary hypertension, the biopsies excluded a fatal lung dysplasia and severe pulmonary vascular disease but all three infants died. One patient had non-fatal bleeding complications. CONCLUSION Open lung biopsy is clinically most useful when performed to diagnose fatal lung dysplasias in neonates and to confirm the presence of viable lung tissue in patients with acute lung injury due to pertussis infection.
Collapse
Affiliation(s)
- D Inwald
- Portex Unit, Institute of Child Health, London WC1N 1EH, UK.
| | | | | | | | | |
Collapse
|
9
|
Fatini C, Sofi F, Gensini F, Sticchi E, Lari B, Pratesi G, Pulli R, Dorigo W, Pratesi C, Gensini GF, Abbate R. Influence of eNOS Gene Polymorphisms on Carotid Atherosclerosis. Eur J Vasc Endovasc Surg 2004; 27:540-4. [PMID: 15079780 DOI: 10.1016/j.ejvs.2004.02.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Nitric oxide (NO) is an endothelium-derived relaxing factor which plays a role in atherogenetic events. Polymorphisms in the endothelial NO synthase gene (eNOS) influences the functional activity of the enzyme and affect the susceptibility to atherogenesis. In this study we determined whether T-786C, G894T and 4a/4b eNOS genetic variants may increase the susceptibility to carotid atherosclerosis. METHODS The study groups included 304 consecutive patients with severe carotid stenosis (>/=70%) and 544 control subjects. The eNOS polymorphisms were analysed by molecular biology techniques. RESULTS The genotype distribution and allele frequency of eNOS 4a/4b, but not T-786C and G894T, polymorphism was significantly different between patients and controls. Using logistic regression with adjustment for other risk factors, the 4a allele and the combined genotype 4a4a+4a4b/894TT+GT and -786CC+TC/894TT+GT were associated with carotid stenosis (OR=1.5, p=0.02; OR=1.8, p=0.01; OR=1.5, p=0.04, respectively). In a subset of patients (30 of 304) with no traditional risk factors for atherosclerosis, a relatively high incidence of the 4a allele and 4a4a+4a4b/-786CC+TC combined genotype was noted. DISCUSSION Our findings suggest that the 4a allele and the eNOS combined genotypes are independent predisposing factors to carotid atherosclerosis.
Collapse
Affiliation(s)
- C Fatini
- Department of Clinical and Surgical Critical Care, Section of Clinical Medicine, Thrombosis Centre, University of Florence, Florence, Italy
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Abbate R, Sofi F, Gensini F, Fatini C, Sticchi E, Fedi S. Thrombophilias as risk factors for disorders of pregnancy and fetal damage. Pathophysiol Haemos Thromb 2003; 32:318-21. [PMID: 13679665 DOI: 10.1159/000073589] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Inherited thrombophilias have been suggested as a possible condition of increased susceptibility to adverse pregnancy outcomes. Although there is no consensus on the association between the factor V Leiden mutation and early (less than 10 weeks) pregnancy loss, the evidence suggests an association between the mutation and second-, and third-trimester fetal loss and severe preeclampsia. At present the relationship between the prothrombin G20210A mutation and inherited thrombophilias and adverse pregnancy outcomes remains controversial. Due to the low prevalence, AT and PC deficiencies have been rarely found as the cause of complicated pregnancy, whereas increased risk for preeclampsia and fetal losses has been found in relation to PS deficiency. Concerning the association between pathological pregnancies and PAI-1 4G/5G deletion/insertion polymorphism, only few controversial data are available. A meta-analysis of ten case-control studies suggested an association between hyperhomocysteinemia, MTHFR C677T mutation and repeated pregnancy losses before 16 weeks. Recently a role for Angiotensin Converting Enzyme I/D polymorphism in obstetrical complications has been suggested.
Collapse
Affiliation(s)
- R Abbate
- Dipartimento Area Critica Medico-Chirurgica, Sezione Clinica Medica Generale e Cliniche Specialistiche-Centro Trombosi, Azienda Ospedaliera Careggi, Universita degli Studi Firenze, Italy.
| | | | | | | | | | | |
Collapse
|
11
|
Fatini C, Gensini F, Sticchi E, Battaglini B, Prisco D, Fedi S, Brunelli T, Marcucci R, Conti AA, Gensini GF, Abbate R. ACE DD genotype: an independent predisposition factor to venous thromboembolism. Eur J Clin Invest 2003; 33:642-7. [PMID: 12864773 DOI: 10.1046/j.1365-2362.2003.01185.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The renin angiotensin system affects haemostasis through different mechanisms; data on the possible role of angiotensin-converting enzyme I/D polymorphism in the pathogenesis of deep venous thrombosis are conflicting, and no information is available regarding the A1166C polymorphism of the angiotensin type 1 receptor gene. In order to investigate this issue, angiotensin-converting enzyme and AT1R polymorphisms were genotyped in 336 consecutive venous thromboembolism patients and 378 controls. MATERIALS AND METHODS Haemostasis-related risk factors have been evaluated by routine tests. Factor V Leiden, Factor II (G20210A), angiotensin-converting enzyme (I/D), and angiotensin type 1 receptor (A1166C) polymorphisms have been identified by molecular analysis. RESULTS We documented a significant association between angiotensin-converting enzyme DD genotype and venous thromboembolism (OR=2.19 95%CI 1.51-3.17 adjusted for acquired and haemostasis-related risk factors, P<0.0001); in patients with haemostasis-related risk factors, angiotensin-converting enzyme DD genotype modified the risk of venous thromboembolism in hyperhomocysteinaemic and Factor V Leiden patients and was associated with the risk of recurrent venous thromboembolism (OR=1.83 95%CI 1.06-3.17 P=0.03). In patients without haemostasis-related risk factors the angiotensin-converting enzyme DD genotype was still an independent predictor of venous thromboembolism (OR=3.29 95%CI 2.17-4.98 adjusted for acquired risk factors, P<0.0001). No significant association between the angiotensin type 1 receptor CC genotype and venous thromboembolism was found. CONCLUSIONS This study shows that angiotensin-converting enzyme DD genotype represents a susceptibility marker of thrombosis in subjects apparently without predisposing factors and traditional thrombophilic alterations, and increases the risk of venous thromboembolism in subjects in whom a thrombogenic condition occurs. Moreover, angiotensin-converting enzyme DD genotype may be considered a new predisposing factor to venous thromboembolism recurrence.
Collapse
Affiliation(s)
- C Fatini
- Department of Medical and Surgical Critical Care, University of Florence, Thrombosis Center, Azienda Ospedaliera Careggi, Florence, Italy
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Prisco D, Fatini C, Battaglini B, Gensini F, Fedi S, Falai M, Chioccioli M, Gori AM, Margheri M, Gensini GF. Angiotensin converting enzyme DD genotype affects the changes of plasma plasminogen activator inhibitor-1 activity after primary percutaneous transluminal coronary angioplasty in acute myocardial infarction patients. Int J Clin Lab Res 2001; 30:179-85. [PMID: 11289708 DOI: 10.1007/s005990070004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Angiotensin converting enzyme (ACE) DD genotype, and plasminogen activator inhibitor (PAI-1) 4G/4G genotype have been reported to affect PAI-1 activity in control subjects and atherosclerotic patients, but no data are available on the influence of angiotensin II type 1 receptor (AT1R) A1166C polymorphism on the inhibitor levels. The degree of fibrinolytic activation after percutaneous transluminal coronary angioplasty (PTCA) has been found to affect the risk of restenosis. The aim of this study was to investigate the possible influence of ACE I/D, AT1R A1166C, and PAI-1 4G/5G polymorphisms on the changes of PAI-1 activity after primary successful percutaneous transluminal angioplasty. In 29 consecutive acute myocardial infarction patients, undergoing primary successful angioplasty, genotyping of ACE I/D, AT1R A1166C, and PAI-1 4G/5G polymorphisms was performed by polymerase chain reaction and restriction fragment length polymorphism analysis, and PAI-1 plasma activity (chromogenic method) was assessed before and after angioplasty. Following angioplasty, PAI-1 activity increased in 10 of 29 patients and decreased or remained unchanged in 19 of 29. ACE DD genotype was significantly (P = 0.04) associated with an increase of PAI-1 activity post angioplasty (OR DD/ID+II = 6.5, CI 95% 4.83-8.22). Whereas no effect of PAI-1 4G/5G and AT1R A1166C polymorphisms on PAI-1 response to angioplasty was demonstrated, these data suggest that renin-angiotensin system genes are involved in the regulation of the fibrinolytic response to balloon injury, possibly affecting angiotensin converting enzyme activity. This interaction between the renin-angiotensin system and hemostasis may be a mechanism by which ACE DD genotype affects the risk of restenosis after percutaneous transluminal angioplasty.
Collapse
Affiliation(s)
- D Prisco
- Dipartimento dell'Area Critica Medico-Chirurgica, Universitá di Firenze , Florence, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Fatini C, Guazzelli R, Manetti P, Battaglini B, Gensini F, Vono R, Toncelli L, Zilli P, Capalbo A, Abbate R, Gensini GF, Galanti G. RAS genes influence exercise-induced left ventricular hypertrophy: an elite athletes study. Med Sci Sports Exerc 2000; 32:1868-72. [PMID: 11079515 DOI: 10.1097/00005768-200011000-00008] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The association of ACE I/D polymorphism with changes in LV mass in response to physical training has been observed, but no association has been found with AT1R A1166C polymorphism. We investigated the ACE I/D, AT1R A1166C, and AT1R CA microsatellite polymorphisms genotype distribution in elite athletes and whether the presence of AT1R C1166 variant, in addition to ACE D allele affects the training-induced LV mass alterations in elite trained athletes. METHODS The study population comprised 28 healthy players recruited from an Italian elite male soccer team and 155 healthy male subjects. LV mass, LV mass adjusted for body surface area, septal thickness, posterior wall, end-diastolic and end-systolic ventricular dimension, and ejection fraction were determined by echocardiography in pretrained period, at rest and 7 months later during the training. All subjects were genotyped for ACE I/D, AT1R A1166C, and CA microsatellite polymorphisms. RESULTS Training induced an LV mass increase in all but six athletes. The percentage of athletes in whom an increase of LV mass was found after training was statistically different in relation to the ACE D allele: no increase was observed in three of 24 D allele carriers and in three of four II genotype players (Fisher's exact test, P = 0.02). As AT1R is concerned, no increase was observed in 4 of 15 C allele carriers and in 2 of 13 AA genotype athletes (Fisher's exact test, P > 0.05). The contemporary presence of ACE D and AT1R C allele did not affect the changes after training. No difference has been observed in the CA microsatellite marker allele frequencies between athletes and controls (P = 0.46). CONCLUSION In this study, we provide the evidence that soccer play does not select athletes on genotype basis. Training-induced LV mass changes in male elite athletes are significantly associated with the presence of ACE D allele, but not of AT1R C allele.
Collapse
Affiliation(s)
- C Fatini
- Unità di Genetica Medica Dpt. Fisiopatol Clinica, Centro Medicina dello Sport, Università di Firenze, Florence, Italy
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Fatini C, Gensini F, Battaglini B, Prisco D, Cellai AP, Fedi S, Marcucci R, Brunelli T, Mello G, Parretti E, Pepe G, Abbate R. Angiotensin-converting enzyme DD genotype, angiotensin type 1 receptor CC genotype, and hyperhomocysteinemia increase first-trimester fetal-loss susceptibility. Blood Coagul Fibrinolysis 2000; 11:657-62. [PMID: 11085286 DOI: 10.1097/00001721-200010000-00010] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Complications of pregnancy have been found to be related with thrombophilic polymorphisms that explain about 30% of obstetric complications. We evaluated the angiotensin converting enzyme (ACE) and the angiotensin type 1 receptor (AT1R) gene polymorphisms in the renin-angiotensin system (RAS) as possible risk factors for fetal loss. Fifty-nine women with a history of three or more first-trimester fetal losses and 70 healthy women with a history of normal pregnancies were enrolled in this study. Thrombophilic factors, ACE insertion/deletion (I/D) and AT1R A1166C polymorphisms, prothrombin G20210A and factor V Leiden mutations were analyzed. At univariate and multivariate analysis, a significant association between ACE DD and AT1R CC genotype and fetal loss was observed. The effect of the ACE DD genotype on the risk of fetal loss was higher in AT1R C allele carriers. The prevalence of hyperhomocysteinemia (Hcy) (defined as baseline plasma levels higher than the 95% percentile; cut-off, 10.5 micromol/l per l) was significantly higher in women with fetal loss, and an association between Hcy and fetal loss was detected. All patients showed normal antithrombin, protein C, protein S, and plasminogen activator inhibitor-1 (PAI-1) values. The presence of one risk factor not associated with others was found in 33 out of 59 patients (56%); ACE DD genotype was the most prevalent risk factor. Our results identify new possible predictive markers for fetal loss in RAS polymorphisms and Hcy. Large-scale studies are warranted to attribute clinical relevance to these polymorphisms as risk factors for complicated pregnancies.
Collapse
MESH Headings
- Adult
- Female
- Fetal Death/etiology
- Genotype
- Humans
- Hyperhomocysteinemia/blood
- Hyperhomocysteinemia/complications
- Mutation
- Peptidyl-Dipeptidase A/adverse effects
- Peptidyl-Dipeptidase A/genetics
- Polymorphism, Genetic
- Pregnancy
- Pregnancy Complications, Hematologic/blood
- Pregnancy Complications, Hematologic/etiology
- Pregnancy Trimester, First
- Receptor, Angiotensin, Type 1
- Receptor, Angiotensin, Type 2
- Receptors, Angiotensin/genetics
- Receptors, Angiotensin/physiology
- Renin-Angiotensin System/genetics
- Thrombophilia/blood
- Thrombophilia/genetics
Collapse
Affiliation(s)
- C Fatini
- Dipartimento di Fisiopatologia Clinica, University of Florence, Italy
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Gensini F, Fatini C, Battaglini B, Falai M, Margheri M, Giglioli C, Pepe G, Chioccioli M, Abbate R, Gensini G. ACE I/D and AT1R A1166C polimorphisms in angiographically documented restenosis after primary coronary percutaneous transluminal angioplasty. Eur J Heart Fail 2000. [DOI: 10.1016/s1388-9842(00)80040-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- F. Gensini
- Genetica Medica Dpt Fisiopatol Clinica; Università di Firenze; Firenze Italy
| | - C. Fatini
- Genetica Medica Dpt Fisiopatol Clinica; Università di Firenze; Firenze Italy
| | - B. Battaglini
- Genetica Medica Dpt Fisiopatol Clinica; Università di Firenze; Firenze Italy
| | - M. Falai
- Clinica Medica Generale e Cardiologia; Universita di Firenze; Florence Italy
| | - M. Margheri
- Clinica Medica Generale e Cardiologia; Universita di Firenze; Florence Italy
| | - C. Giglioli
- Clinica Medica Generale e Cardiologia; Universita di Firenze; Florence Italy
| | - G. Pepe
- Clinica Medica Generale e Cardiologia; Universita di Firenze; Florence Italy
| | - M. Chioccioli
- Clinica Medica Generale e Cardiologia; Universita di Firenze; Florence Italy
| | - R. Abbate
- Clinica Medica Generale e Cardiologia; Universita di Firenze; Florence Italy
| | - G.F. Gensini
- Clinica Medica Generale e Cardiologia; Universita di Firenze; Florence Italy
| |
Collapse
|
16
|
Fatini C, Abbate R, Pepe G, Battaglini B, Gensini F, Ruggiano G, Gensini GF, Guazzelli R. Searching for a better assessment of the individual coronary risk profile. The role of angiotensin-converting enzyme, angiotensin II type 1 receptor and angiotensinogen gene polymorphisms. Eur Heart J 2000; 21:633-8. [PMID: 10731400 DOI: 10.1053/euhj.1999.1738] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Polymorphisms within renin angiotensin system genes have been investigated as risk factors for coronary artery disease in different populations with contradicting results. The aim of this study was to investigate the genotype distribution and the allele frequencies of ACE, AT1R and AGT gene polymorphisms as coronary artery disease factors and their synergistic effects on coronary risk in an Italian population. METHODS AND RESULTDS: In this study ACE, AT1R and AGT gene polymorphisms were investigated in 205 consecutive coronary artery disease patients and in 209 controls. These polymorphisms were analysed by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). The ACE D and AGT 235T allele, but not AT1R C allele, frequency was statistically significant in patients. An association between coronary artery disease and ACE DD, AT1R CC and AGT TT genotype, was found by univariate analysis (OR 2.06 P=0.0007, OR 2.49 P=0.009, OR 1.87 P=0. 019, respectively). At multivariate analysis ACE DD and AT1R CC genotype (OR 1.81 P=0.011, OR 2.61 P=0.011, respectively) remained associated with coronary heart disease. Subjects carrying the ACE DD genotype and AT1R C allele showed a stronger association with myocardial infarction (OR=4.02, P<0.0001). CONCLUSION Our report indicates the increased risk of coronary artery disease in the presence of ACE DD and AT1R CC genotypes independent of other risk factors, in Italian patients. The present study stresses the relevance of screening for genetic risk factors.
Collapse
Affiliation(s)
- C Fatini
- Dipartimento di Fisiopatologia Clinica, Unità di Genetica Medica, Florence, Italy
| | | | | | | | | | | | | | | |
Collapse
|
17
|
Gensini F, Battaglini B, Fatini C, Guazzelli R, Falai M, Chioccioli M, Simonetti I, Comeglio M, Giglioli C, Martinucci P, Gensini GF. [I/D polymorphism of the ACE gene and A1166C of the AT1R gene as risk factors for restenosis after coronary angioplasty]. Minerva Cardioangiol 1999; 47:516. [PMID: 10670180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Affiliation(s)
- F Gensini
- Unità di Genetica Medica, Università degli Studi, Firenze
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Fatini C, Gensini F, Battaglini B, Pepe G, Giusti B, Brunelli T, Gori AM, Alessandrello Liotta A, Rogolino A, Lapini I, Abbate R. [The C1166 allele of the AT1R gene associated with ACE DD phenotype increases the risk for deep venous thrombosis]. Minerva Cardioangiol 1999; 47:530. [PMID: 10670188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Affiliation(s)
- C Fatini
- Istituto di Clinica Medica Generale e Cardiologia AOC, Università degli Studi, Firenze
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Gensini F, Pazzagli M, Anichini M, Fatini C, Battaglini B, Lepori M, Giusti B, Pepe G, Guazzelli R, Marcucci R, Abbate R. [The genes that codify angiotensin converting enzyme and type 1 receptor for angiotensin II have a different effect on longevity]. Minerva Cardioangiol 1999; 47:517. [PMID: 10670181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Affiliation(s)
- F Gensini
- Dipartimento di Fisiopatologia Clinica, Università degli Studi, Firenze
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|