CBS promoter hypermethylation increases the risk of hypertension and stroke

OBJECTIVES

Cystathionine β-synthase is a major enzyme in the metabolism of plasma homocysteine. Hyperhomocysteinemia is positively associated with hypertension and stroke. The present study was performed to examine the possible effects of Cystathionine β-synthase promoter methylation on the development of hypertension and stroke.

METHODS

Using quantitative methylation-specific PCR, we determined the Cystathionine β-synthase methylation levels in 218 healthy individuals and 132 and 243 age- and gender-matched stroke and hypertensive patients, respectively. The relative changes in Cystathionine β-synthase promoter methylation were analyzed using the 2-ΔΔCt method. The percent of the methylated reference of Cystathionine β-synthase was used to represent the Cystathionine β-synthase promoter methylation levels.

RESULTS

In this study, the Cystathionine β-synthase promoter methylation levels of hypertensive and stroke participants were both higher than that of the healthy individuals (median percentages of the methylated reference were 50.61%, 38.05% and 30.53%, respectively, all p<0.001). Multivariable analysis showed that Cystathionine β-synthase promoter hypermethylation increased the risk of hypertension [odds ratio, OR (95% confidence interval, CI)=1.035 (1.025-1.045)] and stroke [OR (95% CI)=1.015 (1.003-1.028)]. The area under the curve of Cystathionine β-synthase promoter methylation was 0.844 (95% CI: 0.796-0.892) in male patients with hypertension and 0.722 (95% CI: 0.653-0.799) in male patients with stroke.

CONCLUSION

Cystathionine β-synthase promoter hypermethylation increases the risk of hypertension and stroke, especially in male patients.

Mechanisms of hyperhomocysteinemia induced skeletal muscle myopathy after ischemia in the CBS-/+ mouse model

Although hyperhomocysteinemia (HHcy) elicits lower than normal body weights and skeletal muscle weakness, the mechanisms remain unclear. Despite the fact that HHcy-mediated enhancement in ROS and consequent damage to regulators of different cellular processes is relatively well established in other organs, the nature of such events is unknown in skeletal muscles. Previously, we reported that HHcy attenuation of PGC-1α and HIF-1α levels enhanced the likelihood of muscle atrophy and declined function after ischemia. In the current study, we examined muscle levels of homocysteine (Hcy) metabolizing enzymes, anti-oxidant capacity and focused on protein modifications that might compromise PGC-1α function during ischemic angiogenesis. Although skeletal muscles express the key enzyme (MTHFR) that participates in re-methylation of Hcy into methionine, lack of trans-sulfuration enzymes (CBS and CSE) make skeletal muscles more susceptible to the HHcy-induced myopathy. Our study indicates that elevated Hcy levels in the CBS-/+ mouse skeletal muscles caused diminished anti-oxidant capacity and contributed to enhanced total protein as well as PGC-1α specific nitrotyrosylation after ischemia. Furthermore, in the presence of NO donor SNP, either homocysteine (Hcy) or its cyclized version, Hcy thiolactone, not only increased PGC-1α specific protein nitrotyrosylation but also reduced its association with PPARγ in C2C12 cells. Altogether these results suggest that HHcy exerts its myopathic effects via reduction of the PGC-1/PPARγ axis after ischemia.

Synergy of homocysteine, microRNA, and epigenetics: a novel therapeutic approach for stroke

Homocysteine (Hcy) is a thiol-containing amino acid formed during methionine metabolism. Elevated level of Hcy is known as hyperhomocysteinemia (HHcy). HHcy is an independent risk factor for cerebrovascular diseases such as stroke, dementia, Alzheimer's disease, etc. Stroke, which is caused by interruption of blood supply to the brain, is one of the leading causes of death and disability in a number of people worldwide. The HHcy causes an increased carotid artery plaque that may lead to ischemic stroke but the mechanism is currently not well understood. Though mutations or polymorphisms in the key genes of Hcy metabolism pathway have been well elucidated in stroke, emerging evidences suggested epigenetic mechanisms equally play an important role in stroke development such as DNA methylation, chromatin remodeling, RNA editing, noncoding RNAs (ncRNAs), and microRNAs (miRNAs). However, there is no review available yet that describes the role of genetics and epigenetics during HHcy in stroke. The current review highlights the role of genetics and epigenetics in stroke during HHcy and the role of epigenetics in its therapeutics. The review also highlights possible epigenetic mechanisms, potential therapeutic molecules, putative challenges, and approaches to deal with stroke during HHcy.

An Efficient Method to Evaluate Intermolecular Interaction Energies in Large Systems Using Overlapping Multicenter ONIOM and the Fragment Molecular Orbital Method

We propose an approach based on the overlapping multicenter ONIOM to evaluate intermolecular interaction energies in large systems and demonstrate its accuracy on several representative systems in the complete basis set limit at the MP2 and CCSD(T) level of theory. In the application to the intermolecular interaction energy between insulin dimer and 4'-hydroxyacetanilide at the MP2/CBS level, we use the fragment molecular orbital method for the calculation of the entire complex assigned to the lowest layer in three-layer ONIOM. The developed method is shown to be efficient and accurate in the evaluation of the protein-ligand interaction energies.

The role of community-based surveillance in health outcomes measurement

Summary

SETTING

Community Health Planning and Service (CHPS) strategy was started in Ashanti Region in 2001. It aimed to improve geographic access to comprehensive health care. The Region used community-based surveillance (CBS) as an entry point.

OBJECTIVES

were to obtain baseline data and define the magnitude and extent of specific health outcomes.

DESIGN

Districts were divided into health zones and health workers (HWs) assigned. CBS Volunteers were identified, trained to register households, births, deaths, diseases and vaccinations. The Regional level tracked the implementation process and HEALTH OUTCOMES which were evaluated after a year.

RESULTS

Two hundred and eighty-two (282) zones were created, 1-8 per sub-district with populations 1,029-43,998 and communities 1-29. 86.2% zones had HWs assigned, 40.6% resident. Most HWs (89.3%) were community health nurses. 65.7% zones had health institutions, 20.6% chemical shops and 83.7% basic drugs. 2,325 (91%) communities had registers and 2,278 CBS volunteers. Twenty-six thousand, three hundred and sixty (26,360) births were registered (CBR 10.2/1000pop), deaths 5,694 (CDR 2.6/1000pop), Under-one deaths 967 (IMR 36.4/1000Lbs), child deaths 229 (CMR 8.3/1000Lbs), under-5 deaths 1,196 (U5MR 47.1/1000Lbs) and maternal deaths 76 (MMR 288.3/100,000Lbs). Reported diseases included AFP 18, Neonatal tetanus 38, Buruli Ulcer 80 and Guinea worm 34. The challenges were in data management and use.

CONCLUSIONS

We conclude that health institutional data may only represent the ear of the hippopotamus and complimented by CBS, health outcomes can be well defined in the CHPS concept and thus contribute immensely to community action with stakeholders.