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Ukonmaanaho EM, Dell'Anna S, Hakonen A, Wartiovaara-Kautto U, Kakko S, Rab MAE, van Oirschot B, Kraatari-Tiri M, van Wijk R, Rahikkala E. Biallelic hexokinase 1 (HK1) variants causative of non-spherocytic haemolytic anaemia: A case series with emphasis on the HK1 promoter variant and literature review. Br J Haematol 2024; 204:2040-2048. [PMID: 38415930 DOI: 10.1111/bjh.19368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 01/21/2024] [Accepted: 02/16/2024] [Indexed: 02/29/2024]
Abstract
The hexokinase (HK) enzyme plays a key role in red blood cell energy production. Hereditary non-spherocytic haemolytic anaemia (HNSHA) caused by HK deficiency is a rare disorder with only 12 different disease-associated variants identified. Here, we describe the clinical features and genotypes of four previously unreported patients with hexokinase 1 (HK1)-related HNSHA, yielding two novel truncating HK1 variants. The patients' phenotypes varied from mild chronic haemolytic anaemia to severe infantile-onset transfusion-dependent anaemia. Three of the patients had mild haemolytic disease caused by the common HK1 promoter c.-193A>G variant combined with an intragenic HK1 variant, emphasizing the importance of including this promoter variant in the haemolytic disease gene panels. HK activity was normal in a severely affected patient with a homozygous HK1 c.2599C>T, p.(His867Tyr) variant, but the affinity for ATP was reduced, hampering the HK function. In cases of HNSHA, kinetic studies should be considered in the functional studies of HK. We reviewed the literature of previously published patients to provide better insight into this rare disease and add to the understanding of genotype-phenotype correlation.
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Affiliation(s)
- Elli-Maija Ukonmaanaho
- Division of Pediatric Hematology and Oncology, Oulu University Hospital, Oulu, Finland
- University of Helsinki, Helsinki, Finland
| | - Silvia Dell'Anna
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Anna Hakonen
- Department of Clinical Genetics, HUSLAB, HUS Diagnostic Center, Helsinki University Hospital, Helsinki, Finland
| | | | - Sakari Kakko
- Department of Hematology, Oulu University Hospital, Oulu, Finland
| | - Minke A E Rab
- Central Diagnostic laboratory, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Brigitte van Oirschot
- Central Diagnostic laboratory, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Minna Kraatari-Tiri
- Department of Clinical Genetics, Oulu University Hospital, Oulu, Finland
- Research Unit of Clinical Medicine and Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Richard van Wijk
- Central Diagnostic laboratory, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Elisa Rahikkala
- Department of Clinical Genetics, Oulu University Hospital, Oulu, Finland
- Research Unit of Clinical Medicine and Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
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Paavola T, Bergmann U, Kuusisto S, Kakko S, Savolainen MJ, Salonurmi T. Distinct Fatty Acid Compositions of HDL Phospholipids Are Characteristic of Metabolic Syndrome and Premature Coronary Heart Disease-Family Study. Int J Mol Sci 2021; 22:ijms22094908. [PMID: 34066314 PMCID: PMC8124224 DOI: 10.3390/ijms22094908] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/29/2021] [Accepted: 05/01/2021] [Indexed: 02/07/2023] Open
Abstract
HDL particles can be structurally modified in atherosclerotic disorders associated with low HDL cholesterol level (HDL-C). We studied whether the lipidome of the main phosphatidylcholine (PC), lysophosphatidylcholine (LPC) and sphingomyelin (SM) species of HDL2 and HDL3 subfractions is associated with premature coronary heart disease (CHD) or metabolic syndrome (MetS) in families where common low HDL-C predisposes to premature CHD. The lipidome was analyzed by LC-MS. Lysophosphatidylcholines were depleted of linoleic acid relative to more saturated and shorter-chained acids containing species in MetS compared with non-affected subjects: the ratio of palmitic to linoleic acid was elevated by more than 30%. A minor PC (16:0/16:1) was elevated (28–40%) in MetS. The contents of oleic acid containing PCs were elevated relative to linoleic acid containing PCs in MetS; the ratio of PC (16:0/18:1) to PC (16:0/18:2) was elevated by 11–16%. Certain PC and SM ratios, e.g., PC (18:0/20:3) to PC (16:0/18:2) and a minor SM 36:2 to an abundant SM 34:1, were higher (11–36%) in MetS and CHD. The fatty acid composition of certain LPCs and PCs displayed a characteristic pattern in MetS, enriched with palmitic, palmitoleic or oleic acids relative to linoleic acid. Certain PC and SM ratios related consistently to CHD and MetS.
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Affiliation(s)
- Timo Paavola
- Research Center for Internal Medicine, Department of Internal Medicine, Oulu University Hospital and University of Oulu, 90200 Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, 90200 Oulu, Finland
| | - Ulrich Bergmann
- Protein Analysis Core Facility, Biocenter Oulu, University of Oulu, 90570 Oulu, Finland
| | - Sanna Kuusisto
- Computational Medicine, Faculty of Medicine, Biocenter Oulu, University of Oulu, 90570 Oulu, Finland
- NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, 70210 Kuopio, Finland
| | - Sakari Kakko
- Research Center for Internal Medicine, Department of Internal Medicine, Oulu University Hospital and University of Oulu, 90200 Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, 90200 Oulu, Finland
| | - Markku J Savolainen
- Research Center for Internal Medicine, Department of Internal Medicine, Oulu University Hospital and University of Oulu, 90200 Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, 90200 Oulu, Finland
| | - Tuire Salonurmi
- Research Center for Internal Medicine, Department of Internal Medicine, Oulu University Hospital and University of Oulu, 90200 Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, 90200 Oulu, Finland
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Sorigue M, Prusila RE, Jauhiainen J, Mercadal S, Postila A, Salmi P, Tanhua T, Tikkanen S, Kakko S, Kuitunen H, Pollari M, Nystrand I, Kuusisto ME, Vasala K, Jantunen E, Korkeila E, Karihtala P, Sancho JM, Turpeenniemi-Hujanen T, Kuittinen O. Incidence of solid cancer in patients with follicular lymphoma. Acta Oncol 2019; 58:1564-1569. [PMID: 31368395 DOI: 10.1080/0284186x.2019.1643918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Introduction: Patients with follicular lymphoma (FL) have classically had a higher risk of solid cancers than the general population, but there is little data available in patients diagnosed and treated with modern day regimens.Material and methods: We conducted a retrospective multicenter study assessing the cumulative incidence of solid cancers other than nonmelanoma skin cancer in patients with FL between 1997 and 2016 and determined the standardized incidence ratio (SIR) to compare the incidence of solid cancers with that of the general populationResults: Among 1002 FL patients with 7 years of median follow-up, we found 74 solid cancers (most common breast [n = 19], lung and colon [n = 9 each]). The cumulative incidence was 3.8% at 5 years (95%CI 2.6-5.2) from the time of diagnosis and 4.4% at 5 years (95%CI 3.1-5.9%) from the time of front-line treatment. Although a comparison of all front-line strategies did not reveal differences in the risk of solid cancers, patients treated with anthracycline-based regimens appeared to have a lower incidence than those treated with bendamustine-based strategies (2.8% vs. 6.9%). However, patients receiving the former regimen were younger than the latter. On multivariable analysis, older age was correlated with the incidence of solid cancer and bendamustine-based treatment was of borderline significance. SIR for any solid cancer was 1.22 (95%CI 0.91-1.64), indicating no increased risk of solid cancer in patients with FL over that of the general population. However, on subgroup analyses, female patients treated with bendamustine-based strategies appeared to have a greater risk (SIR 3.85 [95%CI 1.45-10.27])Discussion: The incidence of solid cancer in this cohort of patients with FL was low and not greater than in the general population. However, the risk may be greater in female patients treated with bendamustine.
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Affiliation(s)
- Marc Sorigue
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Barcelona, Spain
| | - Roosa E.I. Prusila
- Medical Research Center, Oulu University Hospital and Cancer and Translational Research Unit, University of Oulu, Oulu, Finland
- Department of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland
| | - Jyrki Jauhiainen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Santiago Mercadal
- Department of Hematology, ICO-Hospital Duran i Reynals, Hospitalet de Llobregat, Spain
| | - Aleksi Postila
- Medical Research Center, Oulu University Hospital and Cancer and Translational Research Unit, University of Oulu, Oulu, Finland
- Department of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland
| | - Petteri Salmi
- Medical Research Center, Oulu University Hospital and Cancer and Translational Research Unit, University of Oulu, Oulu, Finland
- Department of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland
| | - Taru Tanhua
- Medical Research Center, Oulu University Hospital and Cancer and Translational Research Unit, University of Oulu, Oulu, Finland
- Department of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland
| | - Susanna Tikkanen
- Medical Research Center, Oulu University Hospital and Cancer and Translational Research Unit, University of Oulu, Oulu, Finland
- Department of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland
| | - Sakari Kakko
- Department of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland
| | - Hanne Kuitunen
- Medical Research Center, Oulu University Hospital and Cancer and Translational Research Unit, University of Oulu, Oulu, Finland
- Department of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland
| | - Marjukka Pollari
- Department of Oncology, Tampere University Hospital, Tampere, Finland
| | - Ilja Nystrand
- Department of Oncology, University of Turku and Turku University Hospital, Turku, Finland
| | - Milla E.L. Kuusisto
- Medical Research Center, Oulu University Hospital and Cancer and Translational Research Unit, University of Oulu, Oulu, Finland
- Siunsote – Hospital District of North Carelia, Joensuu, Finland
| | - Kaija Vasala
- Department of Oncology and Radiotherapy, Central Finland Central Hospital, Jyvaskyla, Finland
| | - Esa Jantunen
- Siunsote – Hospital District of North Carelia, Joensuu, Finland
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine, Faculty of Health Medicine, University of Eastern Finland, Kuopio, Finland
| | - Eija Korkeila
- Department of Oncology, University of Turku and Turku University Hospital, Turku, Finland
| | - Peeter Karihtala
- Medical Research Center, Oulu University Hospital and Cancer and Translational Research Unit, University of Oulu, Oulu, Finland
- Department of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland
| | - Juan-Manuel Sancho
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Barcelona, Spain
| | - Taina Turpeenniemi-Hujanen
- Medical Research Center, Oulu University Hospital and Cancer and Translational Research Unit, University of Oulu, Oulu, Finland
- Department of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland
| | - Outi Kuittinen
- Department of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland
- Institute of Clinical Medicine, Faculty of Health Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Oncology, Kuopio University Hospital, Kuopio, Finland
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Luoma S, Anttila P, Säily M, Lundan T, Heiskanen J, Siitonen T, Kakko S, Putkonen M, Ollikainen H, Terävä V, Sankelo M, Partanen A, Launonen K, Räsänen A, Sikiö A, Suominen M, Bazia P, Kananen K, Lievonen J, Selander T, Pelliniemi TT, Ilveskero S, Huotari V, Mäntymaa P, Tienhaara A, Jantunen E, Silvennoinen R. RVD induction and autologous stem cell transplantation followed by lenalidomide maintenance in newly diagnosed multiple myeloma: a phase 2 study of the Finnish Myeloma Group. Ann Hematol 2019; 98:2781-2792. [PMID: 31673775 PMCID: PMC6900265 DOI: 10.1007/s00277-019-03815-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 10/08/2019] [Indexed: 01/25/2023]
Abstract
Autologous stem cell transplantation (ASCT) combined with novel agents is the standard treatment for transplant-eligible, newly diagnosed myeloma (NDMM) patients. Lenalidomide is approved for maintenance after ASCT until progression, although the optimal duration of maintenance is unknown. In this trial, 80 patients with NDMM received three cycles of lenalidomide, bortezomib, and dexamethasone followed by ASCT and lenalidomide maintenance until progression or toxicity. The primary endpoint was the proportion of flow-negative patients. Molecular response was assessed if patients were flow-negative or in stringent complete response (sCR). By intention to treat, the overall response rate was 89%. Neither median progression-free survival nor overall survival (OS) has been reached. The OS at 3 years was 83%. Flow-negativity was reached in 53% and PCR-negativity in 28% of the patients. With a median follow-up of 27 months, 29 (36%) patients are still on lenalidomide and 66% of them have sustained flow-negativity. Lenalidomide maintenance phase was reached in 8/16 high-risk patients but seven of them have progressed after a median of only 6 months. In low- or standard-risk patients, the outcome was promising, but high-risk patients need more effective treatment approach. Flow-negativity with the conventional flow was an independent predictor for longer PFS.
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Affiliation(s)
- Sini Luoma
- Comprehensive Cancer Center, Department of Hematology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
| | - Pekka Anttila
- Comprehensive Cancer Center, Department of Hematology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Marjaana Säily
- Hematology-Oncology Unit, Oulu University Hospital, Oulu, Finland
| | - Tuija Lundan
- Department of Clinical Chemistry and TYKSLAB, University of Turku and Turku University Hospital, Turku, Finland
| | - Jouni Heiskanen
- Comprehensive Cancer Center, Department of Hematology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Timo Siitonen
- Hematology-Oncology Unit, Oulu University Hospital, Oulu, Finland
| | - Sakari Kakko
- Hematology-Oncology Unit, Oulu University Hospital, Oulu, Finland
| | - Mervi Putkonen
- Hematology Unit, Turku University Hospital, Turku, Finland
| | - Hanna Ollikainen
- Department of Medicine, Satakunta Central Hospital, Pori, Finland
| | - Venla Terävä
- Hematology Unit, Tampere University Hospital, Tampere, Finland
| | - Marja Sankelo
- Hematology Unit, Tampere University Hospital, Tampere, Finland
| | - Anu Partanen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
- Department of Medicine, Mikkeli Central Hospital, Mikkeli, Finland
| | - Kirsi Launonen
- Hematology-Oncology Unit, Oulu University Hospital, Oulu, Finland
- Department of Medicine, Länsi-Pohja Central Hospital, Kemi, Finland
| | - Anu Räsänen
- Department of Medicine, Kymenlaakso Central Hospital, Kotka, Finland
| | - Anu Sikiö
- Department of Medicine, Central Finland Central Hospital, Jyväskylä, Finland
| | - Merja Suominen
- Department of Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland
| | - Piotr Bazia
- Department of Medicine, Kainuu Central Hospital, Kajaani, Finland
| | | | - Juha Lievonen
- Comprehensive Cancer Center, Department of Hematology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Tuomas Selander
- Science Service Center, Kuopio University Hospital, Kuopio, Finland
| | | | | | - Virva Huotari
- Fimlab Laboratories Ltd., Tampere, Finland
- NordLab Oulu, Oulu University Hospital, Oulu, Finland
| | - Pentti Mäntymaa
- Laboratory of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
| | - Anri Tienhaara
- Department of Clinical Chemistry and TYKSLAB, University of Turku and Turku University Hospital, Turku, Finland
| | - Esa Jantunen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine/Internal Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, North Carelia Hospital District, Joensuu, Finland
| | - Raija Silvennoinen
- Comprehensive Cancer Center, Department of Hematology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
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Prusila REI, Sorigue M, Jauhiainen J, Mercadal S, Postila A, Salmi P, Tanhua T, Tikkanen S, Kakko S, Kuitunen H, Pollari M, Nystrand I, Kuusisto MEL, Vasala K, Jantunen E, Korkeila E, Karihtala P, Sancho J, Turpeenniemi‐Hujanen T, Kuittinen O. Risk of secondary haematological malignancies in patients with follicular lymphoma: an analysis of 1028 patients treated in the rituximab era. Br J Haematol 2019; 187:364-371. [DOI: 10.1111/bjh.16090] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 05/21/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Roosa E. I. Prusila
- Medical Research Centre and Cancer and Translational Research Unit University of Oulu and Oulu University Hospital Oulu Finland
| | - Marc Sorigue
- Department of Haematology ICO‐Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras Badalona Spain
| | - Jyrki Jauhiainen
- Department of Applied Physics University of Eastern Finland Kuopio Finland
| | - Santiago Mercadal
- Department of Haematology ICO‐Hospital Duran i Reynals, Hospitalet de Llobregat Barcelona Spain
| | - Aleksi Postila
- Medical Research Centre and Cancer and Translational Research Unit University of Oulu and Oulu University Hospital Oulu Finland
| | - Petteri Salmi
- Medical Research Centre and Cancer and Translational Research Unit University of Oulu and Oulu University Hospital Oulu Finland
| | - Taru Tanhua
- Medical Research Centre and Cancer and Translational Research Unit University of Oulu and Oulu University Hospital Oulu Finland
| | - Susanna Tikkanen
- Medical Research Centre and Cancer and Translational Research Unit University of Oulu and Oulu University Hospital Oulu Finland
| | - Sakari Kakko
- Department of Haematology Oulu University Hospital Oulu Finland
| | - Hanne Kuitunen
- Medical Research Centre and Cancer and Translational Research Unit University of Oulu and Oulu University Hospital Oulu Finland
| | - Marjukka Pollari
- Department of Oncology Tampere University Hospital Tampere Finland
| | - Ilja Nystrand
- Department of Oncology Turku University Hospital Turku Finland
| | - Milla E. L. Kuusisto
- Medical Research Centre and Cancer and Translational Research Unit University of Oulu and Oulu University Hospital Oulu Finland
- Siunsote – Hospital District of North Carelia Joensuu Finland
| | - Kaija Vasala
- Department of Oncology and Radiotherapy Central Finland Central Hospital Jyväskylä Finland
| | - Esa Jantunen
- Siunsote – Hospital District of North Carelia Joensuu Finland
- Department of Medicine Kuopio University Hospital Kuopio Finland
- Institute of Clinical Medicine, Faculty of Health Medicine University of Eastern Finland Kuopio Finland
| | - Eija Korkeila
- Department of Oncology Turku University Hospital Turku Finland
| | - Peeter Karihtala
- Medical Research Centre and Cancer and Translational Research Unit University of Oulu and Oulu University Hospital Oulu Finland
| | - Juan‐Manuel Sancho
- Department of Haematology ICO‐Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras Badalona Spain
| | - Taina Turpeenniemi‐Hujanen
- Medical Research Centre and Cancer and Translational Research Unit University of Oulu and Oulu University Hospital Oulu Finland
| | - Outi Kuittinen
- Medical Research Centre and Cancer and Translational Research Unit University of Oulu and Oulu University Hospital Oulu Finland
- Institute of Clinical Medicine, Faculty of Health Medicine University of Eastern Finland Kuopio Finland
- Department of Oncology Kuopio University Hospital Kuopio Finland
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Mäkitie RE, Hackl M, Niinimäki R, Kakko S, Grillari J, Mäkitie O. Altered MicroRNA Profile in Osteoporosis Caused by Impaired WNT Signaling. J Clin Endocrinol Metab 2018; 103:1985-1996. [PMID: 29506076 DOI: 10.1210/jc.2017-02585] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [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] [Received: 11/28/2017] [Accepted: 02/26/2018] [Indexed: 12/16/2022]
Abstract
CONTEXT WNT signaling is fundamental to bone health, and its aberrant activation leads to skeletal pathologies. The heterozygous missense mutation p.C218G in WNT1, a key WNT pathway ligand, leads to severe early-onset and progressive osteoporosis with multiple peripheral and spinal fractures. Despite the severe skeletal manifestations, conventional bone turnover markers are normal in mutation-positive patients. OBJECTIVE This study sought to explore the circulating microRNA (miRNA) pattern in patients with impaired WNT signaling. DESIGN AND SETTING A cross-sectional cohort study at a university hospital. PARTICIPANTS Altogether, 12 mutation-positive (MP) subjects (median age, 39 years; range, 11 to 76 years) and 12 mutation-negative (MN) subjects (35 years; range, 9 to 59 years) from two Finnish families with WNT1 osteoporosis due to the heterozygous p.C218G WNT1 mutation. METHODS AND MAIN OUTCOME MEASURE Serum samples were screened for 192 miRNAs using quantitative polymerase chain reaction. Findings were compared between WNT1 MP and MN subjects. RESULTS The pattern of circulating miRNAs was significantly different in the MP subjects compared with the MN subjects, with two upregulated (miR-18a-3p and miR-223-3p) and six downregulated miRNAs (miR-22-3p, miR-31-5p, miR-34a-5p, miR-143-5p, miR-423-5p, and miR-423-3p). Three of these (miR-22-3p, miR-34a-5p, and miR-31-5p) are known inhibitors of WNT signaling: miR-22-3p and miR-34a-5p target WNT1 messenger RNA, and miR-31-5p is predicted to bind to WNT1 3'UTR. CONCLUSIONS The circulating miRNA pattern reflects WNT1 mutation status. The findings suggest that the WNT1 mutation disrupts feedback regulation between these miRNAs and WNT1, providing insights into the pathogenesis of WNT-related bone disorders. These miRNAs may have potential in the diagnosis and treatment of osteoporosis.
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Affiliation(s)
- Riikka E Mäkitie
- Folkhälsan Institute of Genetics and University of Helsinki, Helsinki, Finland
| | | | - Riitta Niinimäki
- Department of Children and Adolescents, Oulu University Hospital, and PEDEGO Research Unit, University of Oulu, Oulu, Finland
| | - Sakari Kakko
- Internal Medicine and Clinical Research Center, University of Oulu, Oulu, Finland
| | - Johannes Grillari
- Christian Doppler Laboratory on Biotechnology of Skin Aging, Department of Biotechnology, University of Natural Resources and Life Sciences Vienna, Vienna, Austria
| | - Outi Mäkitie
- Folkhälsan Institute of Genetics and University of Helsinki, Helsinki, Finland
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Center for Molecular Medicine, Karolinska Institutet and Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
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7
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Mäkitie RE, Niinimäki R, Kakko S, Honkanen T, Kovanen PE, Mäkitie O. Defective WNT signaling associates with bone marrow fibrosis-a cross-sectional cohort study in a family with WNT1 osteoporosis. Osteoporos Int 2018; 29:479-487. [PMID: 29147753 DOI: 10.1007/s00198-017-4309-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 11/07/2017] [Indexed: 01/28/2023]
Abstract
UNLABELLED This study explores bone marrow function in patients with defective WNT1 signaling. Bone marrow samples showed increased reticulin and altered granulopoiesis while overall hematopoiesis was normal. Findings did not associate with severity of osteoporosis. These observations provide new insight into the role of WNT signaling in bone marrow homeostasis. INTRODUCTION WNT signaling regulates bone homeostasis and survival and self-renewal of hematopoietic stem cells. Aberrant activation may lead to osteoporosis and bone marrow pathology. We aimed to explore bone marrow findings in a large family with early-onset osteoporosis due to a heterozygous WNT1 mutation. METHODS We analyzed peripheral blood samples, and bone marrow aspirates and biopsies from 10 subjects with WNT1 mutation p.C218G. One subject was previously diagnosed with idiopathic myelofibrosis and others had no previously diagnosed hematologic disorders. The findings were correlated with the skeletal phenotype, as evaluated by number of peripheral and spinal fractures and bone mineral density. RESULTS Peripheral blood samples showed no abnormalities in cell counts, morphology or distributions but mild increase in platelet count. Bone marrow aspirates (from 8/10 subjects) showed mild decrease in bone marrow iron storages in 6 and variation in cell distributions in 5 subjects. Bone marrow biopsies (from 6/10 subjects) showed increased bone marrow reticulin (grade MF-2 in the myelofibrosis subject and grade MF-1 in 4 others), and an increase in overall, and a shift towards early-phase, granulopoiesis. The bone marrow findings did not associate with the severity of skeletal phenotype. CONCLUSIONS Defective WNT signaling associates with a mild increase in bone marrow reticulin and may predispose to myelofibrosis, while overall hematopoiesis and peripheral blood values are unaltered in individuals with a WNT1 mutation. In this family with WNT1 osteoporosis, bone marrow findings were not related to the severity of osteoporosis.
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Affiliation(s)
- R E Mäkitie
- Folkhälsan Institute of Genetics, University of Helsinki, P.O. Box 63, FIN-00014, Helsinki, Finland.
| | - R Niinimäki
- Department of Children and Adolescents, Oulu University Hospital and Oulu University, Oulu, Finland
| | - S Kakko
- Internal Medicine and Clinical Research Center, University of Oulu, Oulu, Finland
| | - T Honkanen
- Department of Hematology, Päijät-Häme Central Hospital, Lahti, Finland
| | - P E Kovanen
- HUSLAB, Helsinki University Hospital and Department of Pathology, University of Helsinki, Helsinki, Finland
| | - O Mäkitie
- Folkhälsan Institute of Genetics, University of Helsinki, P.O. Box 63, FIN-00014, Helsinki, Finland
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Center for Molecular Medicine, Karolinska Institutet and Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
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8
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Paavola T, Kuusisto S, Jauhiainen M, Kakko S, Kangas-Kontio T, Metso J, Soininen P, Ala-Korpela M, Bloigu R, Hannuksela ML, Savolainen MJ, Salonurmi T. Impaired HDL2-mediated cholesterol efflux is associated with metabolic syndrome in families with early onset coronary heart disease and low HDL-cholesterol level. PLoS One 2017; 12:e0171993. [PMID: 28207870 PMCID: PMC5313225 DOI: 10.1371/journal.pone.0171993] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 01/30/2017] [Indexed: 12/18/2022] Open
Abstract
Objective The potential of high-density lipoproteins (HDL) to facilitate cholesterol removal from arterial foam cells is a key function of HDL. We studied whether cholesterol efflux to serum and HDL subfractions is impaired in subjects with early coronary heart disease (CHD) or metabolic syndrome (MetS) in families where a low HDL-cholesterol level (HDL-C) predisposes to early CHD. Methods HDL subfractions were isolated from plasma by sequential ultracentrifugation. THP-1 macrophages loaded with acetyl-LDL were used in the assay of cholesterol efflux to total HDL, HDL2, HDL3 or serum. Results While cholesterol efflux to serum, total HDL and HDL3 was unchanged, the efflux to HDL2 was 14% lower in subjects with MetS than in subjects without MetS (p<0.001). The efflux to HDL2 was associated with components of MetS such as plasma HDL-C (r = 0.76 in men and r = 0.56 in women, p<0.001 for both). The efflux to HDL2 was reduced in men with early CHD (p<0.01) only in conjunction with their low HDL-C. The phospholipid content of HDL2 particles was a major correlate with the efflux to HDL2 (r = 0.70, p<0.001). A low ratio of HDL2 to total HDL was associated with MetS (p<0.001). Conclusion Our results indicate that impaired efflux to HDL2 is a functional feature of the low HDL-C state and MetS in families where these risk factors predispose to early CHD. The efflux to HDL2 related to the phospholipid content of HDL2 particles but the phospholipid content did not account for the impaired efflux in cardiometabolic disease, where a combination of low level and poor quality of HDL2 was observed.
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Affiliation(s)
- Timo Paavola
- Department of Internal Medicine, Institute of Clinical Medicine and Biocenter Oulu, University of Oulu, Oulu, Finland and Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Sanna Kuusisto
- Department of Internal Medicine, Institute of Clinical Medicine and Biocenter Oulu, University of Oulu, Oulu, Finland and Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Matti Jauhiainen
- Genomics and Biomarkers Unit, National Institute for Health and Welfare, Biomedicum, Helsinki, Finland
| | - Sakari Kakko
- Department of Internal Medicine, Institute of Clinical Medicine and Biocenter Oulu, University of Oulu, Oulu, Finland and Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Tiia Kangas-Kontio
- Department of Internal Medicine, Institute of Clinical Medicine and Biocenter Oulu, University of Oulu, Oulu, Finland and Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Jari Metso
- Genomics and Biomarkers Unit, National Institute for Health and Welfare, Biomedicum, Helsinki, Finland
| | - Pasi Soininen
- Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland
- NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Mika Ala-Korpela
- Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland
- NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland
- Oulu University Hospital, Oulu, Finland
- Computational Medicine, School of Social and Community Medicine & Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Risto Bloigu
- Medical Informatics and Statistics Research Group, University of Oulu, Oulu, Finland
| | - Minna L. Hannuksela
- Department of Internal Medicine, Institute of Clinical Medicine and Biocenter Oulu, University of Oulu, Oulu, Finland and Medical Research Center, Oulu University Hospital, Oulu, Finland
- Department of Clinical Chemistry, Institute of Diagnostics, University of Oulu, Oulu, Finland
| | - Markku J. Savolainen
- Department of Internal Medicine, Institute of Clinical Medicine and Biocenter Oulu, University of Oulu, Oulu, Finland and Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Tuire Salonurmi
- Department of Internal Medicine, Institute of Clinical Medicine and Biocenter Oulu, University of Oulu, Oulu, Finland and Medical Research Center, Oulu University Hospital, Oulu, Finland
- * E-mail:
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9
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Paavola T, Kuusisto S, Kangas-Kontio T, Metso J, Jauhiainen M, Hannuksela M, Savolainen M, Kakko S, Salonurmi T. Impaired cholesterol efflux into hdl2 in metabolic syndrome. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.534] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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10
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Huusko T, Salonurmi T, Taskinen P, Liinamaa J, Juvonen T, Pääkkö P, Savolainen M, Kakko S. Elevated messenger RNA expression and plasma protein levels of osteopontin and matrix metalloproteinase types 2 and 9 in patients with ascending aortic aneurysms. J Thorac Cardiovasc Surg 2013; 145:1117-1123. [DOI: 10.1016/j.jtcvs.2012.04.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 03/15/2012] [Accepted: 04/06/2012] [Indexed: 10/28/2022]
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Huusko TJ, Santaniemi M, Kakko S, Taskinen P, Ukkola O, Kesäniemi YA, Savolainen MJ, Salonurmi T. Long telomeres in blood leukocytes are associated with a high risk of ascending aortic aneurysm. PLoS One 2012; 7:e50828. [PMID: 23209831 PMCID: PMC3510165 DOI: 10.1371/journal.pone.0050828] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 10/25/2012] [Indexed: 01/12/2023] Open
Abstract
Ascending aortic aneurysm is a connective tissue disorder. Even though multiple novel gene mutations have been identified, risk profiling and diagnosis before rupture still represent a challenge. There are studies demonstrating shorter telomere lengths in the blood leukocytes of abdominal aortic aneurysm patients. The aim of this study was to measure whether relative telomere lengths are changed in the blood leukocytes of ascending aortic aneurysm patients. We also studied the expression of telomerase in aortic tissue samples of ascending aortic aneurysms. Relative lengths of leukocyte telomeres were determined from blood samples of patients with ascending aortic aneurysms and compared with healthy controls. Telomerase expression, both at the level of mRNA and protein, was quantified from the aortic tissue samples. Mean relative telomere length was significantly longer in ascending aortic aneurysm blood samples compared with controls (T/S ratio 0.87 vs. 0.61, p<0.001). Expressions of telomerase mRNA and protein were elevated in the aortic aneurysm samples (p<0.05 and p<0.01). Our study reveals a significant difference in the mean length of blood leukocyte telomeres in ascending aortic aneurysm and controls. Furthermore, expression of telomerase, the main compensating factor for telomere loss, is elevated at both the mRNA and protein level in the samples of aneurysmal aorta. Further studies will be needed to confirm if this change in telomere length can serve as a tool for assessing the risk of ascending aortic aneurysm.
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Affiliation(s)
- Tuija J Huusko
- Institute of Clinical Medicine, Department of Internal Medicine, Clinical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.
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Nissinen AE, Laitinen LM, Kakko S, Helander A, Savolainen MJ, Hörkkö S. Low plasma antibodies specific for phosphatidylethanol in alcohol abusers and patients with alcoholic pancreatitis. Addict Biol 2012; 17:1057-67. [PMID: 21309928 DOI: 10.1111/j.1369-1600.2010.00279.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [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: 12/11/2022]
Abstract
Phosphatidylethanol (PEth) is a group of alcohol-modified phospholipids present in cell membranes after heavy drinking. Our aim was to demonstrate the presence of human plasma antibodies binding to PEth and to address their specificity and value in detecting subjects engaged in heavy alcohol consumption. Antibodies to PEth were analyzed in plasma from heavy drinkers (n=20), patients with alcoholic pancreatitis (n=58) and control subjects (n=24), using chemiluminescent immunoassay. Heavy drinkers and patients with alcoholic pancreatitis demonstrated significantly lower levels of plasma IgG, IgA and IgM titers to PEth compared with controls (P<0.001). The specificity of the antibodies to PEth was demonstrated with competitive liquid phase immunoassays and flow cytometry. The plasma IgG, but not IgA or IgM, titers to PEth in heavy drinkers correlated with the whole blood PEth concentration determined by liquid chromatography-mass spectrometry (r=0.655, P=0.002). Compared with traditional markers for alcohol abuse (aspartate aminotransferase, gamma-glutamyl transpeptidase and mean corpuscular volume), receiver operating characteristic curve analysis showed that a low plasma IgA to PEth had the highest area under the curve (AUC 0.940, P<0.001). In conclusion, plasma IgG, IgA and IgM antibodies binding specifically to PEth were found in subjects of all study groups. Subjects with heavy alcohol consumption showed markedly lower plasma immunoglobulin levels to PEth, potentially making them useful as a biomarker to distinguish heavy from moderate alcohol use.
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Hautala T, Kakko S, Siitonen T, Säily M, Koistinen P, Koskela M. Clinical Candida krusei isolates remain susceptible during extensive exposure to antifungal drugs. Med Mycol 2010; 48:79-84. [PMID: 19194820 DOI: 10.3109/13693780902725276] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We have previously reported a Candida krusei outbreak during which a number of our patients were infected or colonized by several different closely related Candida krusei genotypes. The treatment response in many of our patients was at best modest and the patients remained positive for Candida krusei. We speculated that extended exposure to antifungals in patients with an incomplete treatment response might lead to the conditions for selection of drug resistance in the multiple Candida krusei clones. Therefore, we followed the in vitro susceptibility of the Candida krusei isolates taken from our patients before and during the antifungal treatment. A total of 28 Candida krusei isolates from 11 patients with prolonged exposure to antifungal medication were analyzed for their in vitro susceptibility to commonly used drugs. We found that MIC(50) values of all Candida krusei isolates was 12 microg/ml for fluconazole, 0.19 microg/ml for voriconazole, 1.0 microg/ml for amphotericin B, and 1.0 microgt/ml for caspofungin with the corresponding MIC(90) values being 16 microg/ml, 0.5 microg/ml, 2.0 microg/ml, and 1.0 micro/ml, respectively. Extended antifungal exposure did not change these MIC values. We conclude that resistance development in Candida krusei during prolonged antifungal treatment may not be common and the treatment failure of our patients was not likely due to the development of drug resistance by the etiologic agent.
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Affiliation(s)
- Timo Hautala
- Department of Internal Medicine, Oulu University Hospital, Oulu, Finland.
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Kangas-Kontio T, Huotari A, Ruotsalainen H, Herzig KH, Tamminen M, Ala-Korpela M, Savolainen MJ, Kakko S. Genetic and environmental determinants of total and high-molecular weight adiponectin in families with low HDL-cholesterol and early onset coronary heart disease. Atherosclerosis 2010; 210:479-85. [DOI: 10.1016/j.atherosclerosis.2009.12.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Revised: 12/02/2009] [Accepted: 12/13/2009] [Indexed: 01/16/2023]
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15
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Sofat R, Hingorani AD, Smeeth L, Humphries SE, Talmud PJ, Cooper J, Shah T, Sandhu MS, Ricketts SL, Boekholdt SM, Wareham N, Khaw KT, Kumari M, Kivimaki M, Marmot M, Asselbergs FW, van der Harst P, Dullaart RPF, Navis G, van Veldhuisen DJ, Van Gilst WH, Thompson JF, McCaskie P, Palmer LJ, Arca M, Quagliarini F, Gaudio C, Cambien F, Nicaud V, Poirer O, Gudnason V, Isaacs A, Witteman JCM, van Duijn CM, Pencina M, Vasan RS, D'Agostino RB, Ordovas J, Li TY, Kakko S, Kauma H, Savolainen MJ, Kesäniemi YA, Sandhofer A, Paulweber B, Sorli JV, Goto A, Yokoyama S, Okumura K, Horne BD, Packard C, Freeman D, Ford I, Sattar N, McCormack V, Lawlor DA, Ebrahim S, Smith GD, Kastelein JJP, Deanfield J, Casas JP. Separating the mechanism-based and off-target actions of cholesteryl ester transfer protein inhibitors with CETP gene polymorphisms. Circulation 2009; 121:52-62. [PMID: 20026784 DOI: 10.1161/circulationaha.109.865444] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Cholesteryl ester transfer protein (CETP) inhibitors raise high-density lipoprotein (HDL) cholesterol, but torcetrapib, the first-in-class inhibitor tested in a large outcome trial, caused an unexpected blood pressure elevation and increased cardiovascular events. Whether the hypertensive effect resulted from CETP inhibition or an off-target action of torcetrapib has been debated. We hypothesized that common single-nucleotide polymorphisms in the CETP gene could help distinguish mechanism-based from off-target actions of CETP inhibitors to inform on the validity of CETP as a therapeutic target. METHODS AND RESULTS We compared the effect of CETP single-nucleotide polymorphisms and torcetrapib treatment on lipid fractions, blood pressure, and electrolytes in up to 67 687 individuals from genetic studies and 17 911 from randomized trials. CETP single-nucleotide polymorphisms and torcetrapib treatment reduced CETP activity and had a directionally concordant effect on 8 lipid and lipoprotein traits (total, low-density lipoprotein, and HDL cholesterol; HDL2; HDL3; apolipoproteins A-I and B; and triglycerides), with the genetic effect on HDL cholesterol (0.13 mmol/L, 95% confidence interval [CI] 0.11 to 0.14 mmol/L) being consistent with that expected of a 10-mg dose of torcetrapib (0.13 mmol/L, 95% CI 0.10 to 0.15). In trials, 60 mg of torcetrapib elevated systolic and diastolic blood pressure by 4.47 mm Hg (95% CI 4.10 to 4.84 mm Hg) and 2.08 mm Hg (95% CI 1.84 to 2.31 mm Hg), respectively. However, the effect of CETP single-nucleotide polymorphisms on systolic blood pressure (0.16 mm Hg, 95% CI -0.28 to 0.60 mm Hg) and diastolic blood pressure (-0.04 mm Hg, 95% CI -0.36 to 0.28 mm Hg) was null and significantly different from that expected of 10 mg of torcetrapib. CONCLUSIONS Discordance in the effects of CETP single-nucleotide polymorphisms and torcetrapib treatment on blood pressure despite the concordant effects on lipids indicates the hypertensive action of torcetrapib is unlikely to be due to CETP inhibition or shared by chemically dissimilar CETP inhibitors. Genetic studies could find a place in drug-development programs as a new source of randomized evidence for drug-target validation in humans.
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Affiliation(s)
- Reecha Sofat
- Centre for Clinical Pharmacology, Department of Medicine, University College London, London, United Kingdom
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Immonen I, Seitsonen S, Tommila P, Kangas-Kontio T, Kakko S, Savolainen ER, Savolainen MJ, Liinamaa MJ. Vascular endothelial growth factor gene variation and the response to photodynamic therapy in age-related macular degeneration. Ophthalmology 2009; 117:103-8. [PMID: 19896188 DOI: 10.1016/j.ophtha.2009.06.037] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2008] [Revised: 06/14/2009] [Accepted: 06/18/2009] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To evaluate the role of vascular endothelial growth factor (VEGF) gene polymorphisms in exudative age-related macular degeneration (AMD). DESIGN Retrospective, comparative case series. PARTICIPANTS Patients with recent exudative AMD (n = 162) and age-matched subjects without AMD (n = 85). METHODS Fluorescein angiography (FA), clinical examination, and single nucleotide polymorphism (SNP) genotyping. MAIN OUTCOME MEASURES The frequencies of 3 VEGF gene SNPs were analyzed, 1 at the promoter site (rs699947, A-->C) and 2 intronic SNPs (rs2146323, A-->C, and rs3025033, A-->G), in relation to the risk of AMD, to choroidal neovascular (CNV) lesion size and configuration, and to the anatomic response to photodynamic therapy (PDT). These SNPs were chosen to cover all the haploblocks of the VEGF gene. The 86 patients who had undergone PDT were classified as either PDT responders or PDT nonresponders based on the outcome of PDT after the last treatment session. For the PDT responders, the treating physician had deemed the lesion to be clinically dry and without leakage from CNV in FA at a visit scheduled at least 12 weeks after the last PDT treatment. For the PDT nonresponders, the PDT sessions had been discontinued by the treating retina specialist because of an apparently poor response and a still exudative lesion after several PDT sessions. RESULTS The presence of exudative AMD or lesion size or configuration was not associated with the SNPs studied here. The frequencies of the rs699947 were significantly different in PDT nonresponders and PDT responders. The AA, AC, and CC genotypes were 14%, 39%, and 46%, respectively, in PDT nonresponders, compared with 40%, 48%, and 12%, respectively, in the PDT responders (P = 0.0008). The corresponding frequencies for the rs2146323 AA, AC, and CC genotypes were 4%, 32%, and 64%, respectively, in nonresponders and 24%, 38%, and 38%, respectively, in responders (P = 0.0369). The genotypes of the rs3025033 SNP were distributed evenly between the responders and nonresponders. CONCLUSIONS The VEGF gene polymorphic SNPs at rs699947 and rs2146323 are strong determinants of the anatomic outcome after PDT, but the SNPs studied were not associated with the presence of exudative AMD or with the CNV lesion size or configuration. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Ilkka Immonen
- Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland
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Kaikkonen KS, Kakko S, Kortelainen ML, Tapanainen JM, Savolainen MJ, Antero Kesäniemi Y, Huikuri HV, Savolainen ER. The –1C to T polymorphism in the annexin A5 gene is not associated with the risk of acute myocardial infarction or sudden cardiac death in middle‐aged Finnish males. Scandinavian Journal of Clinical and Laboratory Investigation 2009; 65:133-40. [PMID: 16025836 DOI: 10.1080/00365510510013550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE A common polymorphism (-1C to T) in the translation initiation sequence of annexin A5 (ANV) gene has recently been associated with a decreased risk of acute myocardial infarction (AMI). The aim of the present study was to analyze the association between the ANV genepolymorphism and the risk of AMI and ischemic sudden cardiac death (SCD) in middle-aged Finnish males. MATERIAL AND METHODS A case-control study involving three distinct groups of subjects was carried out: (1) victims of SCD (n=98), (2) survivors of AMI (n=212), and (3) randomly selected control subjects without any history of coronary heart disease (n=243). The ANV polymorphism was genotyped in each study group. RESULTS Among the control group of healthy Finnish males the prevalence rates of the CC, CT, and TT genotypes were 83.1%, 15.2%, and 1.6%, respectively. Among the survivors of AMI, the prevalence rates of CC, CT, and TT were 79.7%, 20.3%, and 0%, respectively, and among the victims of SCD 83.7%, 16.3%, and 0%, respectively. No significant differences in the genotype or allele distributions were observed between the study groups. CONCLUSION The -1C to T polymorphism in the ANV gene is not associated with the risk of AMI or SCD in middle-aged Finnish males.
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Affiliation(s)
- K S Kaikkonen
- Division of Cardiology, Department of Internal Medicine, University of Oulu, Finland
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18
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Kangas-Kontio T, Tapanainen JM, Huikuri H, Savolainen ER, Päivänsalo M, Kauma H, Kesäniemi YA, Savolainen MJ, Kakko S. Variation in the vascular endothelial growth factor gene, carotid intima-media thickness and the risk of acute myocardial infarction. Scand J Clin Lab Invest 2009; 69:335-43. [PMID: 19089753 DOI: 10.1080/00365510802607520] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Vascular endothelial growth factor (VEGF) is a potent angiogenic growth factor, but its role in atherogenesis is still unclear. Our goal was to study whether three variants of the VEGF gene, previously associated with VEGF production, are linked to atherosclerosis defined as carotid intima-media thickness (IMT) and as the risk of acute myocardial infarction (AMI). MATERIAL AND METHODS Three VEGF gene single nucleotide polymorphisms (SNPs) (-2578A>C rs699947, -634C>G rs2010963 and +936C>T rs3025039) were genotyped in 516 control subjects of the OPERA (Oulu Project Elucidating Risk of Atherosclerosis) cohort and in 251 survivors of AMI. In the OPERA cohort, the genotyped SNPs were analysed for their association with IMT. The SNPs were also analysed for their association with the risk of AMI, a complication of advanced atherosclerosis. In addition, haplotype frequencies and their associated effects on IMT and on the risk of AMI were estimated. RESULTS None of the single genotyped polymorphisms was significantly associated with overall IMT or with the risk of AMI. However, the haplotype CCC was associated with higher overall IMT without plaques in women (p = 0.01, haplotypic effect +0.03 mm), the haplotype CCT with higher IMT without plaques in the internal carotid artery in men (p = 0.001, +0.11), while the haplotype AGT was associated with reduced AMI risk (p = 0.015, OR = 0.46). CONCLUSIONS Variation in the VEGF gene is weakly associated with IMT and the risk of AMI, but the effect can only be observed when the information of the SNPs is combined by constructing haplotypes.
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Affiliation(s)
- Tiia Kangas-Kontio
- Institute of Clinical Medicine, Department of Internal Medicine, Oulu University Hospital and Biocenter Oulu, Finland
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Hautala T, Kakko S, Siitonen T, Saily M, Koistinen P, Koskela M. Clinical Candida krusei isolates remain susceptible during extensive exposure to antifungal drugs. Med Mycol 2009. [DOI: 10.1080/13693780902725276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Huusko TJ, Liisanantti MK, Nissinen AE, Kakko S, Savolainen ER, Vuoristo JT, Savolainen MJ. Effects of phosphatidylethanol on mouse adipocyte differentiation and expression of stearoyl-CoA desaturase 1. Alcohol Clin Exp Res 2007; 31:376-82. [PMID: 17295720 DOI: 10.1111/j.1530-0277.2006.00332.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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
BACKGROUND Phosphatidylethanol (PEth) is an aberrant phospholipid formed in vivo only in the presence of ethanol. In circulation PEth is associated with lipoproteins and is transferred from one lipoprotein to another. Lipoprotein-associated PEth affects endothelial and smooth muscle cells of blood vessels, but its effects on other cell types have not been explored. Adipocytes have a central role in metabolic syndrome and obesity. In this study we tested whether lipoprotein-associated PEth affects stearoyl-CoA desaturase 1 (SCD1) which plays a major role in lipid-mediated signaling in the differentiation of adipocytes. METHODS Mouse 3T3-L1 preadipocytes were differentiated to adipocytes in the presence of high-density lipoproteins (HDL) isolated from the plasma of healthy volunteers or PEth-containing HDL modified in vitro. After incubation, fat accumulation, SCD1 mRNA expression, SCD1 protein content, and fatty acid composition of adipocytes were determined. RESULTS Phosphatidylethanol-containing HDL particles inhibited adipocyte differentiation and decreased the 18:1/18:0 ratio of cellular fatty acids by 28% compared with native HDL particles. Moreover, PEth-containing HDL reduced the SCD1 protein content by 39%. CONCLUSIONS Lipoprotein-associated PEth may mediate the effects of ethanol on SCD1 and differentiation of preadipocytes to adipocytes.
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Affiliation(s)
- Tuija J Huusko
- Department of Internal Medicine, Clinical Research Center, University of Oulu, Oulu, Finland
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Koistinen P, Ruuska S, Saily M, Kakko S, Siitonen P, Siitonen T, Savolainen MJ, Kinnula VL, Savolainen ER. An association between manganese superoxide dismutase polymorphism and outcome of chemotherapy in acute myeloid leukemia. Haematologica 2006; 91:829-32. [PMID: 16769586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
Manganese superoxide dismutase (MnSOD) protects cells against oxidative stress by eliminating superoxides. Hypothetically, decreased MnSOD levels in cancer might lead to increased oxidative stress and, thus, to increased sensitivity of cells to chemotherapy agents. Eighty-nine patients with acute myeloid leukemia (AML) were analyzed for a functional C to T polymorphism of MnSOD, which could potentially lead to decreased enzyme concentrations inside mitochondria. A significant survival advantage (p=0.02) was observed for those AML patients carrying T-containing alleles of MnSOD compared to the patients with the CC genotype. These preliminary results may indicate an important role for genetic factors regulating the cellular redox state in determining the outcome of leukemia chemotherapy.
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Affiliation(s)
- Pirjo Koistinen
- Department of Internal Medicine, University of Oulu, Finland.
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Kärppä M, Herva R, Moslemi AR, Oldfors A, Kakko S, Majamaa K. Spectrum of myopathic findings in 50 patients with the 3243A>G mutation in mitochondrial DNA. Brain 2005; 128:1861-9. [PMID: 15857931 DOI: 10.1093/brain/awh515] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [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: 11/14/2022] Open
Abstract
Myopathy is a typical clinical finding among patients with the 3243A>G mutation in mitochondrial DNA (mtDNA), but the variability in such findings has not been properly established. We have previously determined the prevalence of patients with 3243A>G in a defined population in northern Finland and characterized a group of patients who represent a good approximation to a population-based cohort. We report here on examinations performed on patients belonging to this cohort in order to determine the frequency of myopathy and to evaluate the clinical, histological, ultrastructural and single fibre mtDNA variability in muscle involvement. Fifty patients with 3243A>G underwent a thorough structured interview and clinical examination. Muscle histology, ultrastructure and single fibre analysis were examined in a subset of patients. A clinical diagnosis of myopathy was made in 50% of cases [95% confidence interval (CI), 36-64] and abnormalities in muscle histology were found in 72% (95% CI, 55-86). Moderate limb weakness leading to functional impairment was the most common myopathic sign, but mild weakness, ptosis and external ophthalmoplegia could also be found. The presence of intramitochondrial crystals and cytochrome c oxidase (COX)-negative fibres and variation in mitochondrial size and shape were more common in the muscles of the myopathic patients. Longitudinal variations in mutation heteroplasmy were examined in single muscle fibres from two severely affected patients. Although the total variation in mutation heteroplasmy along four ragged red fibres (RRFs) was small, the mutation heteroplasmy in five 10 microm segments was clearly lower (median 68%, range 64-74%) than that in the neighbouring segments. There were also segments with deviant mutation load in histologically normal fibres in one patient. The highest incidence of myopathy was in the fifth decade of life, but, apart from age, no other clinical variables such as gender, muscle heteroplasmy, physical inactivity or diabetes were associated with an increased risk of myopathy. The clinical presentation of myopathy is highly variable in patients with 3243A>G.
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Affiliation(s)
- Mikko Kärppä
- Department of Neurology, University of Oulu, Finland
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Boekholdt SM, Sacks FM, Jukema JW, Shepherd J, Freeman DJ, McMahon AD, Cambien F, Nicaud V, de Grooth GJ, Talmud PJ, Humphries SE, Miller GJ, Eiriksdottir G, Gudnason V, Kauma H, Kakko S, Savolainen MJ, Arca M, Montali A, Liu S, Lanz HJ, Zwinderman AH, Kuivenhoven JA, Kastelein JJP. Cholesteryl ester transfer protein TaqIB variant, high-density lipoprotein cholesterol levels, cardiovascular risk, and efficacy of pravastatin treatment: individual patient meta-analysis of 13,677 subjects. Circulation 2005; 111:278-87. [PMID: 15655129 DOI: 10.1161/01.cir.0000153341.46271.40] [Citation(s) in RCA: 221] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Several studies have reported that the cholesteryl ester transfer protein (CETP) TaqIB gene polymorphism is associated with HDL cholesterol (HDL-C) levels and the risk of coronary artery disease (CAD), but the results are inconsistent. In addition, an interaction has been implicated between this genetic variant and pravastatin treatment, but this has not been confirmed. METHODS AND RESULTS A meta-analysis was performed on individual patient data from 7 large, population-based studies (each >500 individuals) and 3 randomized, placebo-controlled, pravastatin trials. Linear and logistic regression models were used to assess the relation between TaqIB genotype and HDL-C levels and CAD risk. After adjustment for study, age, sex, smoking, body mass index (BMI), diabetes, LDL-C, use of alcohol, and prevalence of CAD, TaqIB genotype exhibited a highly significant association with HDL-C levels, such that B2B2 individuals had 0.11 mmol/L (0.10 to 0.12, P<0.0001) higher HDL-C levels than did B1B1 individuals. Second, after adjustment for study, sex, age, smoking, BMI, diabetes, systolic blood pressure, LDL-C, and use of alcohol, TaqIB genotype was significantly associated with the risk of CAD (odds ratio=0.78 [0.66 to 0.93]) in B2B2 individuals compared with B1B1 individuals (P for linearity=0.008). Additional adjustment for HDL-C levels rendered a loss of statistical significance (P=0.4). Last, no pharmacogenetic interaction between TaqIB genotype and pravastatin treatment could be demonstrated. CONCLUSIONS The CETP TaqIB variant is firmly associated with HDL-C plasma levels and as a result, with the risk of CAD. Importantly, this CETP variant does not influence the response to pravastatin therapy.
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Affiliation(s)
- S M Boekholdt
- Department of Cardiology, Academic Medical Center, Academic Medical Center, Amsterdam, The Netherlands
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Kinnula VL, Lehtonen S, Koistinen P, Kakko S, Savolainen M, Kere J, Ollikainen V, Laitinen T. Two functional variants of the superoxide dismutase genes in Finnish families with asthma. Thorax 2004; 59:116-9. [PMID: 14760150 PMCID: PMC1746944 DOI: 10.1136/thorax.2003.005611] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Functional polymorphisms in the genes encoding superoxide dismutases (SOD)-that is, superoxide scavenging antioxidant enzymes-may play an important role in the development of inflammatory airway diseases such as asthma. METHODS The allele frequencies of two missense polymorphisms of SOD genes (Ala16Val in MnSOD (SOD2) and Arg213Gly in ECSOD (SOD3)) were investigated in Finnish patients with asthma and compared with family based controls. Both variants have been shown to be functionally interesting in the lung. The polymorphism at the exon-intron 3 boundary of a third SOD, CuZnSOD (SOD1), was also included in the analysis. RESULTS None of the SOD genetic variants studied appeared to be major genetic regulators in the development of asthma. We could exclude all models of inheritance that increased the risk of asthma more than 1.2 fold for MnSOD*Val (frequency of allele 0.74 in the population) and more than 6.6 fold for ECSOD*Gly213 (frequency of allele 0.03 in the population) compared with non-carriers. For the intronic polymorphism in CuZnSOD, a relative risk of more than 3.3 (frequency of allele 0.10 in the population) could be excluded. CONCLUSIONS It is highly unlikely that the functionally important genetic variants Ala16Val and Arg213Gly of SODs play a major role in the genetic susceptibility of asthma.
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Affiliation(s)
- V L Kinnula
- Department of Internal Medicine, University of Oulu and Oulu University Hospital, Finland.
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Kakko S, Räisänen T, Tamminen M, Airaksinen J, Groundstroem K, Juvonen T, Ylitalo A, Uusimaa P, Savolainen MJ. Candidate locus analysis of familial ascending aortic aneurysms and dissections confirms the linkage to the chromosome 5q13-14 in Finnish families. J Thorac Cardiovasc Surg 2003; 126:106-13. [PMID: 12878945 DOI: 10.1016/s0022-5223(03)00037-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [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: 11/28/2022]
Abstract
OBJECTIVE The purpose of the study was to carry out a candidate gene analysis in families with familial thoracic aortic aneurysms and dissections. METHODS The study material consisted of 11 Finnish families (with 115 members genotyped) who underwent echocardiographic examination for measurement of the aortic root diameter. Selected candidate genes included the loci for Marfan and Ehlers-Danlos syndromes, the genes of matrix metalloproteinases 3 and 9 and tissue inhibitor of metalloproteinase 2 as well two loci on the chromosomes 5q13-14 and 11q23.2-q24, previously found to be linked to the disease. RESULTS The chromosomal locus 5q13-14 was linked to the disease risk (nonparametric linkage score 3.0, P =.005) confirming the previous linkage. Other candidate genes and loci were excluded as major loci in these families. CONCLUSIONS The identification of the gene at chromosomal location 5q13-14 causing the development of such diseases would give us important knowledge on the pathogenesis of the disease and enable the identification of subjects at risk. This in turn would lead to appropriate treatment before the occurrence of fatal complications and, likely, to the development of new treatment methods.
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Affiliation(s)
- Sakari Kakko
- Department of Internal Medicine and Biocenter Oulu, University of Oulu, Finland
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Kakko S, Päivänsalo M, Koistinen P, Kesäniemi YA, Kinnula VL, Savolainen MJ. The signal sequence polymorphism of the MnSOD gene is associated with the degree of carotid atherosclerosis. Atherosclerosis 2003; 168:147-52. [PMID: 12732398 DOI: 10.1016/s0021-9150(03)00091-1] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.5] [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: 10/27/2022]
Abstract
Redox-state of the cells of vascular walls is an important determinant of atherosclerosis. Manganese superoxide dismutase (MnSOD) is an essential anti-oxidant enzyme working in mitochondria of mammalian cells. A potentially functional amino acid polymorphism (Ala16Val) has been described in the signal sequence of the enzyme. The aim of the current study was to test whether the signal sequence polymorphism of the MnSOD would be associated with the degree of carotid atherosclerosis. The polymorphism was genotyped in a sample of 989 middle-aged hypertensive and control subjects. Carotid atherosclerosis was quantified as intima-media thickness (IMT) by ultrasound. The signal sequence polymorphism was found to be a minor determinant of carotid IMT explaining 1.3% of the overall variation, the Val allele associated with the higher IMT. In women, a significant interaction with plasma levels of low-density lipoprotein (LDL) cholesterol was detected, since LDL cholesterol levels were positively correlated with carotid IMT only in the carriers of the Val allele and the Val allele was associated with higher IMT only in the subjects with highest plasma levels of LDL cholesterol. In conclusion, the signal sequence polymorphism of the MnSOD gene is a minor determinant of carotid IMT pointing out the importance of redox-balance in the atherogenesis.
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Affiliation(s)
- Sakari Kakko
- Department of Internal Medicine and Biocenter Oulu, University of Oulu, P.O. 5000, Finland.
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27
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Kakko S, Kelloniemi J, von Rohr P, Hoeschele I, Tamminen M, Brousseau ME, Kesäniemi YA, Savolainen MJ. ATP-binding cassette transporter A1 locus is not a major determinant of HDL-C levels in a population at high risk for coronary heart disease. Atherosclerosis 2003; 166:285-90. [PMID: 12535741 DOI: 10.1016/s0021-9150(02)00232-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [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: 10/27/2022]
Abstract
ATP-binding cassette transporter A1 (ABCA1) transports cellular cholesterol to lipid-poor apolipoproteins. Mutations in the ABCA1 gene are linked to rare phenotypes, familial hypoalphalipoproteinemia (FHA) and Tangier disease (TD), characterized by markedly decreased plasma high-density lipoprotein cholesterol (HDL-C) levels. The aim was to test if the ABCA1 locus is a major locus regulating HDL-C levels in the homogenous Finnish population with a high prevalence of coronary heart disease (CHD). Firstly, the ABCA1 locus was tested for linkage to HDL-C levels in 35 families with premature CHD and low HDL-C levels. Secondly, 62 men with low HDL-C levels and CHD were screened for the five mutations known to cause FHA. Thirdly, polymorphisms of the ABCA1 gene were tested for an association with HDL-C levels in a population sample of 515 subjects. The ABCA1 locus was not linked to HDL-C levels in the CHD families, and no carriers of the FHA mutations were found. The AA596 genotype was associated with higher HDL-C levels compared with the GG and GA genotypes in the women, but not in the men. The G596A genotypes explained 4% and the A2589G genotypes 3% of the variation in plasma HDL-C levels in women. The data suggest that the ABCA1 locus is of minor importance in the regulation of HDL-C in Finns.
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Affiliation(s)
- Sakari Kakko
- Department of Internal Medicine and Biocenter Oulu, University of Oulu, P.O. BOX 5000, 90014, Oulu, Finland.
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Abstract
BACKGROUND As thrombosis is an essential factor in the pathogenesis of acute myocardial infarction (AMI), the genes of proteins affecting haemostasis are good candidate genes for AMI. DESIGN Associations of the known polymorphisms of the coagulation factor VII (FVII) gene (R353Q), the coagulation factor XIII (FXIII) gene (V34L) and the glycoprotein Ia (Gp1a) gene (C807T) with the occurrence of AMI were studied in 142 AMI survivors and 142 age- and sex-matched control subjects. RESULTS Among those who smoked, the L34 allele of the amino acid FXIII polymorphism was less common in the AMI patients (16%) than in the controls (27%) (P = 0.06), suggesting a possible interaction of AMI risk between the FXIII genotype and smoking status. No differences in the allele or genotype frequencies of the studied polymorphisms were seen between the whole study groups. Logistic regression analysis showed the carriers of the L34 allele of the FXIII amino acid polymorphism to have a significantly (P = 0.03) lower AMI risk compared with those homozygous for the V34 allele (odds ratio = 0.54, 95% confidence interval 0.31-0.93). CONCLUSION The L34 allele of the amino acid polymorphism of the FXIII gene is associated with a decreased risk of AMI, and this protecting association seems to be more pronounced in smokers.
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Affiliation(s)
- S Kakko
- Department of Internal Medicine, University of Oulu, PO Box 5000, FIN-90014, Oulu, Finland.
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Kakko S, Tamminen M, Päivänsalo M, Kauma H, Rantala AO, Lilja M, Reunanen A, Kesäniemi YA, Savolainen MJ. Variation at the cholesteryl ester transfer protein gene in relation to plasma high density lipoproteins cholesterol levels and carotid intima-media thickness. Eur J Clin Invest 2001; 31:593-602. [PMID: 11454014 DOI: 10.1046/j.1365-2362.2001.00859.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [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 Cholesteryl ester transfer protein (CETP) plays a major role in lipoprotein metabolism. We have screened the CETP gene for mutations and polymorphisms regulating high density lipoproteins cholesterol (HDL-C) levels and the development of atherosclerosis, and found some polymorphisms (I405V and R451Q) to have minor effects. DESIGN The purpose of this study was to investigate the combined effect of the several polymorphisms of the CETP gene so far found on HDL-C levels and carotid intima-media thickness (IMT), and, in addition, to study whether the recently found functional polymorphism in the promoter region of the CETP gene (C to A, - 629 relative to the first transcribed nucleotide) explains the previous associations due to linkage disequilibrium. The genotypes were determined in a population sample of 481 men and women. RESULTS There were no significant differences in plasma CETP activity or carotid IMT between the genotypes of the promoter polymorphism. The women with the CC genotype of the promoter polymorphism had the lowest HDL-C levels (P < 0.001), but no such difference was seen in men. Detected polymorphisms of the CETP gene explained about 8% of the variation in HDL-C in women and about 7 and 10% of the variation in carotid IMT in women and men, respectively. The associations of the promoter, I405V and R451Q-A373P polymorphisms with HDL-C and carotid IMT seemed to be independent of each other. The associations with IMT were independent of total HDL-C levels, suggesting that HDL subfractions may have more effect on IMT. CONCLUSION The CETP gene locus was found to be polymorphic and its polymorphisms explained a reasonable proportion of the variation in the degree of carotid atherosclerosis.
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Affiliation(s)
- S Kakko
- University of Oulu, Oulu, Finland, National Public Health Institute, Helsinki, Finland.
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Abstract
Thioredoxin (Trx) with a redoxactive dithiol together with NADPH and thioredoxin reductase (TrxR) is a major disulfide reductase regulating cellular redox state and cell proliferation and possibly contributing to the drug resistance of malignant cells. We assessed the Trx system in malignant pleural mesothelioma cell lines, in nonmalignant pleural mesothelium and in biopsies of malignant pleural mesothelioma. The mRNA and immunoreactive proteins of Trx and cytosolic and mitochondrial TrxR were positive in all four human mesothelioma cell lines investigated. Six cases of nonmalignant, histologically healthy pleural mesothelium showed no Trx or TrxR immunoreactivity, whereas immunohistochemistry on 26 biopsies of human malignant pleural mesothelioma showed positive Trx in all cases and positive TrxR in 23 (88%) of the cases. Moderate or strong immunoreactivity for Trx or TrxR was detected in 85% (22 cases) and 61% (14 cases) of the mesothelioma cases, respectively. Both Trx and TrxR staining patterns were mainly diffuse and cytoplasmic, but in 39% of the mesothelioma cases prominent nuclear staining could also be detected. Although staining for Trx and TrxR was seen in tumor cells, no significant association could be demonstrated between Trx or TrxR expression and tumor cell proliferation or apoptosis in the biopsies of mesothelioma. There was no significant association between the intensity of Trx or TrxR immunoreactivity and patient survival, which may possibly be related to moderate or intense Trx and TrxR reactivity in most of the cases. Although the Trx system may have an important role in the drug resistance of malignant mesothelioma, these studies also suggest that multiple factors contribute to the promotion, cell proliferation and apoptosis of malignant mesothelioma cells in vivo.
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Affiliation(s)
- K Kahlos
- Department of Internal Medicine, University of Oulu, Kajaanintie 50, FIN-90220, Oulu, Finland
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Kakko S, Tamminen M, Päivänsalo M, Kauma H, Rantala AO, Lilja M, Reunanen A, Kesäniemi YA, Savolainen MJ. Cholesteryl ester transfer protein gene polymorphisms are associated with carotid atherosclerosis in men. Eur J Clin Invest 2000; 30:18-25. [PMID: 10619997 DOI: 10.1046/j.1365-2362.2000.00595.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [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: 11/20/2022]
Abstract
BACKGROUND The cholesteryl ester transfer protein (CETP) is involved in the reverse cholesterol transport and is therefore a candidate gene for atherosclerosis. DESIGN The prevalences of the I405V and the R451Q polymorphisms were studied in a population sample of 515 men and women. Genotypes were determined by PCR and carotid atherosclerosis by ultrasonography as the mean intima-media thickness (IMT) of the carotid arteries. RESULTS The Q451 allele was associated with significantly lower intima media thickness in men (P = 0.001). The Q451 allele was, in our earlier study, associated with high plasma CETP activity in men. The VV405 genotype was associated with lower plasma CETP activity compared with the II405 genotype (P < 0.01 for the difference). In the general linear model general factorial procedure the interaction between alcohol consumption and the I405V genotype on IMT was significant (P = 0.013) in men, and when the interaction term was taken into the model the I405V genotype also significantly affected IMT (P = 0.008). The VV405 genotype seems to be most harmful for men with the highest alcohol consumption. CONCLUSIONS We describe two polymorphisms of the CETP gene associated with intima media thickness in men. A significant interaction was found between alcohol consumption and the I405V genotype on IMT.
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Affiliation(s)
- S Kakko
- University of Oulu, Oulu, Finland.
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Gudnason V, Kakko S, Nicaud V, Savolainen MJ, Kesäniemi YA, Tahvanainen E, Humphries S. Cholesteryl ester transfer protein gene effect on CETP activity and plasma high-density lipoprotein in European populations. The EARS Group. Eur J Clin Invest 1999; 29:116-28. [PMID: 10092998 DOI: 10.1046/j.1365-2362.1999.00412.x] [Citation(s) in RCA: 95] [Impact Index Per Article: 3.8] [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 Variation at the cholesteryl ester transfer protein (CETP) gene locus has been implicated in determining the levels and activity of CETP, apoAI and high-density lipoprotein (HDL) plasma concentration and the risk of developing coronary artery disease. STUDY DESIGN The effects of two common polymorphisms of CETP, TaqIB in intron 1 and isoleucine 405 to valine (I405-->V) in exon 14, were examined in a sample of 822 men age 18-28 years from 11 countries in Europe who had participated in a study (the European Atherosclerosis Research Study II) of the offspring of myocardial infarction sufferers before the age of 55 years and age-matched control subjects. RESULTS The frequency of the rare TaqIB allele (B2) and the rare V405 allele was 0.44 and 0.28 respectively and was the same in different regions of Europe. There was a moderate linkage disequilibrium between the two polymorphisms in all the regions (D' = +0.31, P < 0.001), explained by the preferential association between the two common alleles, B1 and I405. There was a statistically significant association of the rare alleles for both the polymorphisms with lower activity of CETP (P < 0.001), 11.2% lower for the TaqIB and 7.0% lower for the I405-->V polymorphism. The TaqIB polymorphism explained 9.1% (P < 0.001) and I405-->V explained 3.7% (P < 0.001) of the variance in CETP activity, and in combination these genotypes explained 12.0% of the variance (P < 0.001). Overall, subjects whose fathers had had an early coronary heart disease had 2.4% higher plasma CETP activity than those without such family history, which became statistically significant when adjusted for the effect of the genotypes (P = 0.015), but the significance disappeared after adjustment for the effect of lipids. There was a statistically significant effect of the TaqIB polymorphism on both plasma HDL cholesterol and apoAI level (P < 0.001), with those homozygous for the rare B2 allele having the highest level. Those individuals homozygous for the rare V405 allele had the highest HDL and apoAI levels, although these effects only reached statistical significance for HDL (P < 0.03). CONCLUSION These results suggest that the TaqIB and I405-->V polymorphisms represent two independent functional variations in the CETP gene that may affect the activity of CETP and thus plasma levels of HDL.
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Kakko S, Tamminen M, Kesäniemi YA, Savolainen MJ. R451Q mutation in the cholesteryl ester transfer protein (CETP) gene is associated with high plasma CETP activity. Atherosclerosis 1998; 136:233-40. [PMID: 9543093 DOI: 10.1016/s0021-9150(97)00201-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [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: 02/07/2023]
Abstract
Cholesteryl ester transfer protein (CETP), as a candidate gene for dyslipoproteinemia and coronary heart disease, was studied in 105 men with low plasma concentrations of high density lipoprotein cholesterol (HDL-C) and established coronary heart disease as well as in 515 randomly selected men and women. A one-nucleotide substitution (G to A) in exon 15, which changes arginine (451) to glutamine in CETP protein, was detected by PCR-SSCP and direct sequencing and screened in the population sample by a simple PCR-based restriction assay. In the random population sample the allele frequency of the R451Q mutation was 1.9%. Men heterozygous for the R451Q mutation (n = 7) had 27% higher CETP activity than age-, body mass index-, smoking- and alcohol consumption-matched controls with normal genotype (n = 21; P = 0.003). Women heterozygous for the R451Q mutation (n = 7) had 16% lower total cholesterol compared to matched controls (n = 21; P = 0.07), but no such difference was detected in men. In the random population sample the correlation between plasma total cholesterol level and CETP activity was 0.19 (P = 0.044), both in men and women. When women with total cholesterol over 5.2 mmol/l were excluded from analysis, heterozygotes (n = 4) had plasma CETP activity of 113 nmol/h/ml plasma, whereas those of normal genotype (n = 12) had 103 nmol/h/ml plasma, but this difference was not statistically significant. Women heterozygous for the R451Q mutation and consuming less than 10 g alcohol a week had 23% lower HDL-C compared to women with the normal genotype (P = 0.032). In conclusion, we describe a mutation in the CETP gene associated with high plasma CETP activity in men and with low total cholesterol in women. Further studies are needed to evaluate the effect of mutation on the risk of coronary heart disease.
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Affiliation(s)
- S Kakko
- Department of Internal Medicine and Biocenter Oulu, University of Oulu, Finland
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Tamminen M, Kakko S, Kesäniemi YA, Savolainen MJ. A polymorphic site in the 3' untranslated region of the cholesteryl ester transfer protein (CETP) gene is associated with low CETP activity. Atherosclerosis 1996; 124:237-47. [PMID: 8830936 DOI: 10.1016/0021-9150(96)05833-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [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: 02/02/2023]
Abstract
The exon 16 of the cholesteryl ester transfer protein (CETP) gene was screened for possible mutations in patients with low plasma high-density lipoprotein cholesterol (HDL-C) levels and established coronary heart disease. 115 men who had undergone coronary bypass surgery were compared with a random population sample of 515 subjects. A single G to A substitution at base pair 1696 was found in the 3' untranslated region of the CETP gene. Among the patients with low HDL-C, the plasma CETP activity was 29% lower (P = 0.002) in the subjects homozygous for the mutation than in those with other genotypes. The same effect was observed in the random population sample (P = 0.02). The mutation did not affect the plasma lipid or lipoprotein values, although the mean HDL-C tended to be slightly higher and the ratio of cholesterol content in the apo B-containing lipoproteins to HDL-C slightly lower in the homozygotes compared with the other genotypes. In conclusion, we describe a prevalent mutation at the CETP gene locus associated with low plasma CETP activity. Our results support previous findings suggesting that the genes in chromosome 16 may be important in the regulation of reverse cholesterol transport and in protection against coronary heart disease.
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Affiliation(s)
- M Tamminen
- Department of Internal Medicine, University of Oulu, Finland
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