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Frau F, Zaninello R, Salvi E, Ortu MF, Braga D, Velayutham D, Argiolas G, Fresu G, Troffa C, Bulla E, Bulla P, Pitzoi S, Piras DA, Glorioso V, Chittani M, Bernini G, Bardini M, Fallo F, Malatino L, Stancanelli B, Regolisti G, Ferri C, Desideri G, Scioli GA, Galletti F, Sciacqua A, Perticone F, Degli Esposti E, Sturani A, Semplicini A, Veglio F, Mulatero P, Williams TA, Lanzani C, Hiltunen TP, Kontula K, Boerwinkle E, Turner ST, Manunta P, Barlassina C, Cusi D, Glorioso N. Genome-wide association study identifies CAMKID variants involved in blood pressure response to losartan: the SOPHIA study. Pharmacogenomics 2014; 15:1643-52. [DOI: 10.2217/pgs.14.119] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Essential hypertension arises from the combined effect of genetic and environmental factors. A pharmacogenomics approach could help to identify additional molecular mechanisms involved in its pathogenesis. Aim: The aim of SOPHIA study was to identify genetic polymorphisms regulating blood pressure response to the angiotensin II receptor blocker, losartan, with a whole-genome approach. Materials & methods: We performed a genome-wide association study on blood pressure response in 372 hypertensives treated with losartan and we looked for replication in two independent samples. Results: We identified a peak of association in CAMK1D gene (rs10752271, effect size -5.5 ± 0.94 mmHg, p = 1.2 × 10-8). CAMK1D encodes a protein that belongs to the regulatory pathway involved in aldosterone synthesis. We tested the specificity of rs10752271 for losartan in hypertensives treated with hydrochlorothiazide and we validated it in silico in the GENRES cohort. Conclusion: Using a genome-wide approach, we identified the CAMK1D gene as a novel locus associated with blood pressure response to losartan. CAMK1D gene characterization may represent a useful tool to personalize the treatment of essential hypertension. Original submitted 7 May 2014; Revision submitted 29 July 2014
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Affiliation(s)
- Francesca Frau
- Hypertension & Related Disease Centre, AOU-University of Sassari, Sassari, Italy
- Department of Health Sciences, University of Milan at San Paolo Hospital, Milan, Italy
- Filarete Foundation, Genomics & Bioinformatics Unit, Milan, Italy
| | - Roberta Zaninello
- Hypertension & Related Disease Centre, AOU-University of Sassari, Sassari, Italy
| | - Erika Salvi
- Department of Health Sciences, University of Milan at San Paolo Hospital, Milan, Italy
- Filarete Foundation, Genomics & Bioinformatics Unit, Milan, Italy
| | - Maria Francesca Ortu
- Hypertension & Related Disease Centre, AOU-University of Sassari, Sassari, Italy
| | - Daniele Braga
- Department of Health Sciences, University of Milan at San Paolo Hospital, Milan, Italy
- Filarete Foundation, Genomics & Bioinformatics Unit, Milan, Italy
| | - Dinesh Velayutham
- Department of Health Sciences, University of Milan at San Paolo Hospital, Milan, Italy
- Filarete Foundation, Genomics & Bioinformatics Unit, Milan, Italy
| | - Giuseppe Argiolas
- Hypertension & Related Disease Centre, AOU-University of Sassari, Sassari, Italy
| | - Giovanni Fresu
- Hypertension & Related Disease Centre, AOU-University of Sassari, Sassari, Italy
| | - Chiara Troffa
- Hypertension & Related Disease Centre, AOU-University of Sassari, Sassari, Italy
| | | | - Patrizia Bulla
- Hypertension & Related Disease Centre, AOU-University of Sassari, Sassari, Italy
| | - Silvia Pitzoi
- Hypertension & Related Disease Centre, AOU-University of Sassari, Sassari, Italy
| | | | - Valeria Glorioso
- Hypertension & Related Disease Centre, AOU-University of Sassari, Sassari, Italy
| | - Martina Chittani
- Department of Health Sciences, University of Milan at San Paolo Hospital, Milan, Italy
- Filarete Foundation, Genomics & Bioinformatics Unit, Milan, Italy
| | | | - Michele Bardini
- Department of Internal Medicine, University of Pisa, Pisa, Italy
| | | | - Lorenzo Malatino
- Department of Medicine & Hypertension Center, University of Catania at Cannizzaro Hospital, Catania, Italy
| | - Benedetta Stancanelli
- Department of Medicine & Hypertension Center, University of Catania at Cannizzaro Hospital, Catania, Italy
| | | | - Claudio Ferri
- Department of Internal Medicine & Public Health, University of L'Aquila, L'Aquila, Italy
| | | | | | - Ferruccio Galletti
- Department of Clinical Medicine & Surgery, “Federico II University” Medical School, Napoli, Italy
| | - Angela Sciacqua
- Department of Medical & Surgical Sciences, Cardiovascular Disease Unit, University of Catanzaro “Magna Graecia”, Catanzaro, Italy
| | - Francesco Perticone
- Department of Medical & Surgical Sciences, Cardiovascular Disease Unit, University of Catanzaro “Magna Graecia”, Catanzaro, Italy
| | | | | | - Andrea Semplicini
- UOC Internal Medicine 1, SS. Giovanni e Paolo Hospital, Campo SS. Giovanni e Paolo, Venice, Italy
| | - Franco Veglio
- Division of Internal Medicine & Hypertension Center, Department of Medical Sciences, AO Città Salute e Scienza, University of Torino, Torino, Italy
| | - Paolo Mulatero
- Division of Internal Medicine & Hypertension Center, Department of Medical Sciences, AO Città Salute e Scienza, University of Torino, Torino, Italy
| | - Tracy A Williams
- Division of Internal Medicine & Hypertension Center, Department of Medical Sciences, AO Città Salute e Scienza, University of Torino, Torino, Italy
| | - Chiara Lanzani
- Università Vita Salute San Raffaele, Nephrology, Dialysis & Hypertension Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Timo P Hiltunen
- Department of Medicine, University of Helsinki & Helsinki University Central Hospital, Helsinki, Finland
| | - Kimmo Kontula
- Department of Medicine, University of Helsinki & Helsinki University Central Hospital, Helsinki, Finland
| | - Eric Boerwinkle
- Human Genetics & Institute of Molecular Medicine, University of Texas Health Science Center, Houston, TX, USA
| | - Stephen T Turner
- Division of Nephrology & Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Paolo Manunta
- Università Vita Salute San Raffaele, Nephrology, Dialysis & Hypertension Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Cristina Barlassina
- Department of Health Sciences, University of Milan at San Paolo Hospital, Milan, Italy
- Filarete Foundation, Genomics & Bioinformatics Unit, Milan, Italy
| | - Daniele Cusi
- Department of Health Sciences, University of Milan at San Paolo Hospital, Milan, Italy
- Filarete Foundation, Genomics & Bioinformatics Unit, Milan, Italy
| | - Nicola Glorioso
- Hypertension & Related Disease Centre, AOU-University of Sassari, Sassari, Italy
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Glorioso N, Herrera VLM, Didishvili T, Argiolas G, Troffa C, Bulla P, Bulla E, Ruiz-Opazo N. DEspR T/CATAAAA-box promoter variant decreases DEspR transcription and is associated with increased BP in Sardinian males. Physiol Genomics 2011; 43:1219-25. [PMID: 21862670 PMCID: PMC3217322 DOI: 10.1152/physiolgenomics.00012.2011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [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: 01/14/2011] [Accepted: 08/17/2011] [Indexed: 01/11/2023] Open
Abstract
Essential hypertension is highly prevalent in the elderly population, exceeding 70% in people older than 60 yr of age, and remains a leading risk factor for heart disease, stroke, and chronic renal disease. Elucidation of genetic determinants is critical but remains a challenge due to its complex, multifactorial pathogenesis. We investigated the role DEspR promoter variants, previously associated with male essential hypertension susceptibility, in blood pressure (BP) regulation. We detected a single nucleotide polymorphism within the DEspR 5'-regulatory region associated with increased BP in a male Sardinian cohort accounting for 11.0 mmHg of systolic BP (P<10(-15)) and 9.3 mmHg of diastolic BP (P<10(-15)). Sequence analysis of three normotensive subjects homozygous for the rs6535847 "normotension-associated T-allele" identified a canonical TATAAAA-box in contrast to a CATAAAA-motif in three hypertensive subjects homozygous for the rs6535847 "hypertension-associated C-allele." In vitro analysis detected decreased transcription activity with the CATAAAA-motif promoter-construct compared with the canonical TATAAAA-box promoter-construct. Although BP did not differ between DEspR+/- knockout male mice and wild-type littermates at 6 mo of age, radiotelemetric BP measurements in 18 mo old inbred DEspR+/- knockout male mice known to have decreased DEspR RNA and protein detected higher systolic, mean, and diastolic BPs in DEspR+/- mice compared with littermate wild-type controls (P<0.05). Our results demonstrate that promoter variants in DEspR associated with hypertension susceptibility and increased BP in Sardinian males affect transcription levels, which then affect BP in an age-dependent and male-specific manner. This finding is concordant with the late-onset and sex-specific characteristics of essential hypertension, thus reiterating the mandate for sex-specific analyses and treatment approaches for essential hypertension.
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Affiliation(s)
- Nicola Glorioso
- Hypertension and Related Diseases Center, Azienda Ospedaliero Universitaria-Università di Sassari, Sassari, Sardinia, Italy
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Filigheddu F, Argiolas G, Bulla E, Troffa C, Bulla P, Fadda S, Zaninello R, Degortes S, Frau F, Pitzoi S, Glorioso N. Clinical variables, not RAAS polymorphisms, predict blood pressure response to ACE inhibitors in Sardinians. Pharmacogenomics 2008; 9:1419-27. [DOI: 10.2217/14622416.9.10.1419] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: No definite factors predict blood pressure response to angiotensin-converting enzyme-inhibitors. The aim of this study was to test the association of gene polymorphisms of the renin–angiotensin–aldosterone system with essential hypertension and anthropometric variables, intermediate phenotypes and gene polymorphisms with blood pressure after fosinopril in a genetically homogeneous cohort. Methods: A total of 630 essential hypertension patients, not previously treated or out of antihypertensive treatment for at least 6 months versus 219 normotensives (genotype frequencies, χ2). A total of 191 patients were randomly assigned to fosinopril 20 mg/day. Samples for plasma renin activity and aldosterone, 24-h urinary sodium (flame photometry) were collected. Gene polymorphisms – angiotensin-converting enzyme (insertion/deletion), angiotensin II type 1-receptor (A1166C), aldosterone synthase (-344C/T) and angiotensinogen (-6A/G) – were analyzed by standard techniques. The association of anthropometric variables, intermediate phenotypes and gene polymorphisms with blood pressure after 4 weeks therapy was tested by univariate analysis and analysis of covariance model (Intercooled Stata SE 9.2). Results: No genetic polymorphisms were associated with essential hypertension, blood pressure response and intermediate phenotypes (p > 0.05). Systolic blood pressure after therapy was associated with baseline systolic blood pressure, age and sex. Conclusions: Our results confirm the difficulty in dissecting both essential hypertension and pharmacogenomics when analyzing the effect of single genes in complex multifactorial traits.
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Affiliation(s)
- Fabiana Filigheddu
- Hypertension and Cardiovascular Prevention Center, ASL n. 1, and Chair of Emergency, University of Sassari Medical School, Viale S.Pietro 8, 07100, Sassari, Italy
| | - Giuseppe Argiolas
- Hypertension and Cardiovascular Prevention Center, ASL n. 1, and Chair of Emergency, University of Sassari Medical School, Viale S.Pietro 8, 07100, Sassari, Italy
| | - Emanuela Bulla
- Hypertension and Cardiovascular Prevention Center, ASL n. 1, and Chair of Emergency, University of Sassari Medical School, Viale S.Pietro 8, 07100, Sassari, Italy
| | - Chiara Troffa
- Hypertension and Cardiovascular Prevention Center, ASL n. 1, and Chair of Emergency, University of Sassari Medical School, Viale S.Pietro 8, 07100, Sassari, Italy
| | - Patrizia Bulla
- Hypertension and Cardiovascular Prevention Center, ASL n. 1, and Chair of Emergency, University of Sassari Medical School, Viale S.Pietro 8, 07100, Sassari, Italy
| | - Simone Fadda
- Hypertension and Cardiovascular Prevention Center, ASL n. 1, and Chair of Emergency, University of Sassari Medical School, Viale S.Pietro 8, 07100, Sassari, Italy
| | - Roberta Zaninello
- Hypertension and Cardiovascular Prevention Center, ASL n. 1, and Chair of Emergency, University of Sassari Medical School, Viale S.Pietro 8, 07100, Sassari, Italy
| | - Simona Degortes
- Hypertension and Cardiovascular Prevention Center, ASL n. 1, and Chair of Emergency, University of Sassari Medical School, Viale S.Pietro 8, 07100, Sassari, Italy
| | - Francesca Frau
- Hypertension and Cardiovascular Prevention Center, ASL n. 1, and Chair of Emergency, University of Sassari Medical School, Viale S.Pietro 8, 07100, Sassari, Italy
| | - Silvia Pitzoi
- Hypertension and Cardiovascular Prevention Center, ASL n. 1, and Chair of Emergency, University of Sassari Medical School, Viale S.Pietro 8, 07100, Sassari, Italy
| | - Nicola Glorioso
- Hypertension and Cardiovascular Prevention Center, ASL n. 1, and Chair of Emergency, University of Sassari Medical School, Viale S.Pietro 8, 07100, Sassari, Italy
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Glorioso N, Argiolas G, Filigheddu F, Troffa C, Cocco F, Bulla E, Bulla P, Zaninello R, Degortes S, Pitzoi S, Frau F, Fadda S, Pinna Parpaglia P, Bernini G, Bardini M, Fallo F, Malatino L, Regolisti G, Ferri C, Cusi D, Sciacqua A, Perticone F, Degli Esposti E, Baraccani C, Parati G, Veglio F, Mulatero P, Williams TA, Macciardi F, Stancanelli B. Conceptual basis and methodology of the SOPHIA study. Pharmacogenomics 2008; 8:1497-509. [PMID: 18034615 DOI: 10.2217/14622416.8.11.1497] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
To clarify the role of gene polymorphisms on the effect of losartan and losartan plus hydrochlorothiazide on blood pressure (primary end point) and on cardiac, vascular and metabolic phenotypes (secondary end point) after 4, 8, 12, 16 and 48 weeks treatment, an Italian collaborative study - The Study of the Pharmacogenomics in Italian hypertensive patients treated with the Angiotensin receptor blocker losartan (SOPHIA) - on never-treated essential hypertensives (n = 800) was planned. After an 8 week run-in, losartan 50 mg once daily will be given and doubled to 100 mg at week +4 if blood pressure is more than 140/90 mmHg. Hydroclorothiazide 25 mg once daily at week +8 and amlodipine 5 mg at week +16 will be added if blood pressure is more than 140/90 mmHg. Cardiac mass (echocardiography), carotid intima-media thickness, 24 h ambulatory blood pressure, homeostatic model assessment (HOMA) index, microalbuminuria, plasma renin activity and aldosterone, endogenous lithium clearance, brain natriuretic peptide and losartan metabolites will be evaluated. Genes of the renin-angiotensin-aldosterone system, salt sensitivity, the beta-adrenergic system and losartan metabolism will be studied (Illumina custom arrays). A whole-genome scan will also be performed in half of the study cohort (1M array, Illumina 500 GX beadstation).
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Affiliation(s)
- N Glorioso
- University of Sassari, Hypertension and Cardiovascular Prevention Center - ASL n. 1, Viale S. Pietro, n. 8 07100-Sassari, Italy.
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