Association Between Endothelial Nitric Oxide Synthase (eNOS) -786 T/C and 27-bp VNTR 4b/a Polymorphisms and Preeclampsia Development

Association of Endothelial Nitric Oxide Synthase Polymorphisms with Clinical Severity in Patients with COVID-19

Background/Objectives: To elucidate the factors that contribute to individual variability in the progression of COVID-19, experiments on endothelial nitric oxide synthase polymorphisms have been reported. Nitric oxide synthase (NOS3) is located in the endothelium and is involved in the regulation of inflammation and vascular homeostasis. In this study, we investigated the association between COVID-19 severity and NOS3 G894T and NOS3 27-bp VNTR 4b/a genetic polymorphisms. Methods: Patients with COVID-19 (n = 178) were divided into Group 1 (mild disease) and Group 2 (severe disease) based on oxygen saturation levels in room air (Group 1, SpO2 ≥ 93%, n = 107; and Group 2, SpO2 < 93%, n = 73) and hospitalization requirements. Genotyping was performed using polymerase chain reaction-restriction fragment length polymorphism analysis. Results: Overall, genotype and allele frequencies of the NOS3 genetic polymorphisms were similar across the two study groups (p > 0.05). However, the subgroup analysis showed a notable trend for the 4b/4a allele distribution between Groups 1 and 2. In the younger subgroup of patients (≤50 years old) without chronic obstructive pulmonary disease, Group 2 tended to have a higher frequency of the 4b allele than Group 1 (97.4% vs. 85.4% p = 0.06) and a higher occurrence of 4b/4b genotype (94.7% vs. 74.0%, p = 0.05). Additionally, a rarely observed 4c allele was detected only in two subjects within Group 2 but not in Group 1. Conclusions: These findings suggest a trend of association between COVID-19 severity and NOS3 27-bp VNTR 4b/a genetic polymorphism. Genetic analysis may reveal patient susceptibility to disease, prognosis risk factors, and drug responsiveness.

Association studies of vasoactive genes and preeclampsia in taiwan

BACKGROUND

Preeclampsia (PE) is a serious condition characterized by hypertension and proteinuria after 20 weeks of gestation. The exact cause of PE is unknown but may involve abnormalities in the renin-angiotensin-aldosterone system (RAAS) and endothelial nitric oxide synthase (eNOS). Genetic variations in angiotensinogen (AGT), angiotensin-converting enzyme (ACE), and eNOS genes have been associated with PE. This study aimed to investigate the potential of vasoactive-related gene polymorphisms as indicators of susceptibility to preeclampsia in Taiwanese women.

METHODS

A total of 109 women with severe PE and 150 controls from the Taiwanese population were genotyped for specific vasoactive gene polymorphisms, including M235T and T174M polymorphisms of AGT gene, insertion/deletion (I/D) polymorphism in ACE gene, and G894T (Glu298Asp) polymorphism and 27bp variable number of tandem repeats (VNTR 3/4/5) polymorphism of the eNOS gene. The association between genotype and disease was assessed using Chi-square tests.

RESULTS

The study found no significant differences in the M235T and T174M polymorphisms of AGT gene between the PE and control groups. However, haplotype frequencies for the M235T and T174M polymorphisms exhibited a significant association with PE. The genotype distributions of the I/D polymorphism of ACE gene showed a significant difference between PE and control groups. Additionally, no significant differences were detected in the polymorphisms of the eNOS gene between PE and control groups.

CONCLUSION

The findings of this study suggest that the AGT M235T-T174M haplotype and ACE insertion/deletion polymorphism may contribute to the development of preeclampsia and could serve as susceptibility markers for preeclampsia in Taiwanese women.

A systematic review and meta-analysis of the association between endothelial nitric oxide synthase (eNOS) rs2070744 polymorphism and preeclampsia

OBJECTIVE

Preeclampsia, characterized by hypertension and proteinuria, is a medical condition associated with maternal and fetal morbidity and mortality. Previous studies reported conflicting correlations between the eNOS rs2070744 variant and the occurrence of preeclampsia. Due to inconsistencies in findings, the purpose of the present meta-analysis was to explore the precise link between the eNOS rs2070744 variant and the development of preeclampsia.

METHODS

The articles were retrieved from various online sources, including Cochrane Library, Google Scholar, EMBASE, PubMed, and Web of Science databases up to February 2024. Data were analyzed by Review Manager (RevMan) 5.4. We adhered to the PRISMA 2020 guidelines to conduct this meta-analysis.

RESULTS

A total of 26 articles containing 3741 cases and 4920 controls were included for qualitative and quantitative data synthesis. In the overall population, we found a strong correlation between the eNOS rs2070744 variant and higher preeclampsia risk in recessive (CC vs. CT + TT: OR = 1.31, p = 0.017) dominant (CC + CT vs. TT: OR = 1.14, p = 0.051), co-dominant 2 (CC vs. TT: OR = 1.37, p = 0.011) and allelic (C vs. T: OR = 1.14, p = 0.022) models. Our study also explored similar outcomes among the Caucasian population in dominant (CC + CT vs. TT: OR = 1.16, p = 0.048), recessive (CC vs. CT + TT: OR = 1.46, p = 0.027), allele (C vs. T: OR = 1.18, p = 0.044), co-dominant 2 (CC vs. TT: OR = 1.53, p = 0.027), and co-dominant 3 (CC vs. CT: OR = 1.46, p = 0.002) models. Besides, a significant risk of preeclampsia in the African population was observed in co-dominant 2 (CC vs. TT: OR = 2.11, p = 0.009), dominant (CC + CT vs. TT: OR = 1.58, p = 0.002) and allelic (C vs. T: OR = 1.45, p = 0.001) models. However, no association of this polymorphism with preeclampsia risk was reported in Asian and mixed populations.

CONCLUSION

This study suggests a significant correlation between eNOS rs2070744 polymorphism and preeclampsia. However, more research on various ethnic groups is necessary to confirm the association.

NOS3 Gene Polymorphisms (rs2070744 and rs1799983) and Differentiated Thyroid Cancer: Investigating Associations with Clinical Outcomes

Differentiated thyroid cancer (DTC) is the most common endocrine malignancy, with genetic factors playing an important role in its development and progression. This study investigated the association between nitric oxide synthase 3 (NOS3) gene polymorphisms (-786T>C or rs2070744 and Glu298Asp or c.894T>G or rs1799983) and the clinical characteristics and outcomes of DTC, aiming to evaluate their potential as biomarkers for prognosis. A case-control study was conducted, enrolling 172 individuals from the Endocrinology Clinics of Târgu Mureș and Iași, Romania, between 2021 and 2023. This study included 88 patients with DTC and 84 healthy controls, matched for age and sex. DNA was extracted from blood samples, and the NOS3 polymorphisms were genotyped using TaqMan assays. Statistical analysis included chi-square tests with a significance level set at p < 0.05. The distribution of the rs2070744 and rs1799983 polymorphisms showed no significant differences between the patients with DTC and healthy controls (p = 0.387 and p = 0.329, respectively). Furthermore, no significant associations were found between these polymorphisms and key clinical outcomes such as biochemical control, structural control, or loco-regional metastases. Our findings indicate that NOS3 rs2070744 and rs1799983 gene polymorphisms do not significantly influence the clinical outcomes of DTC, suggesting their limited utility as biomarkers for DTC prognosis.

The effect of RNLS gene polymorphisms on preeclampsia susceptibility: a meta-analysis study

Aim: The authors designed a meta-analysis to find a comprehensive result of the impact of RNLS polymorphisms on preeclampsia (PE) susceptibility. Methods: The online databases PubMed, Scopus, and Google Scholar were employed for the purpose of literature search. Data analysis was conducted using STATA (ver. 12.0) and MetaGenyo web tool. Results: The findings showed that the RNLS rs10887800 polymorphism could increase risk of PE in allelic, codominant heterozygous and dominant genetic models. In addition, the analysis indicated that the RNLS rs2576178 polymorphism was associated with higher risk of PE in allelic, codominant homozygous, dominant, and recessive models. Conclusion: The findings of meta-analysis showed that the RNLS rs10887800 and rs2576178 polymorphisms could increase risk of PE in several genetic models.

Association between eNOS gene polymorphisms and the risk of unexplained recurrent spontaneous abortion in Yunnan province, China

BACKGROUND

Recurrent spontaneous abortion affects approximately 1-2% of reproductive-age women, with roughly half of RSA cases classified as unexplained recurrent spontaneous abortion (URSA). Genetic polymorphisms in eNOS gene have been shown to have significant implications across various disease processes. Nevertheless, the potential impact of eNOS gene polymorphisms on the susceptibility to URSA in Yunnan population has yet to be explored or documented.

OBJECTIVE

This study aims to investigate the potential association between specific variations in the eNOS gene (VNTR 4b/a, -786T > C, and +894G > T) and the risk of URSA in Yunnan population.

METHODS

A total of 243 URSA patients and 241 healthy females are involved in this study. We conducted amplification of the eNOS gene fragment and performed sanger sequencing to detect the specific eNOS gene polymorphisms, including VNTR 4b/a, -786T > C, and +894G > T. Using a multivariate logistic regression model, we evaluate the potential association between eNOS gene polymorphisms (VNTR 4b/a, -786T > C, and +894G > T) and the risk of URSA. Furthermore, serum NO levels were measured in URSA patients.

RESULTS

The presence of VNTR 4a, -786C, and +894T alleles was found to be associated with an increased risk of URSA. Additionally, our study revealed a significant association between the G-C-4b haplotype of the investigated eNOS gene polymorphisms and a predisposition to URSA. Notably, these eNOS polymorphisms were shown to reduce serum NO levels in URSA patients.

CONCLUSION

This study provides evidence supporting the association between eNOS gene polymorphisms, VNTR 4b/a, -786T > C, and +894G > T, and the occurrence of URSA in Yunnan Province, China.

Association of endothelial nitric oxide synthase gene variants in pre-eclampsia: an updated systematic review and meta-analysis

INTRODUCTION

Three common endothelial nitric oxide synthase (eNOS) gene variants are existed such as; G-894T, T-786C, and variable number tandem repeats in intron-4 (VNTR intron-4) which has been proposed to be linked with PE. However, there is still debate regarding the findings. To address this, a review was conducted to assess the potential association of eNOS gene variants at these positions with the risk of PE.

METHODS

PubMed, Scopus, Science Direct, Hinari, and African Journal Online databases and Google Scholar search engines were utilized to search studies published in English-language until 30 January 2023. The Joanna Briggs Institute Meta-Analysis instrument was used for data extraction process and the Newcastle-Ottawa Scale was used to appraise the quality of the included studies. Meta-regression analysis was conducted using Stata 14 statistical software. The pooled odds ratios (ORs) of fixed and random effect models were utilized to evaluate the association of eNOS gene polymorphism with the risk of PE at 95% CI. Publication bias was assessed using Egger's test and a funnel plot.

RESULTS

The study included 47 observational studies involving 13,795 pregnant women (6216 cases and 7579 controls). Pregnant women carrying TT and CC genotypes of eNOS gene at 894 and 786 positions were found to have a greater probability of developing PE as compared to GG and TT genotypes (OR = 1.54 vs. 1.43 and CI: 1.12 - 2.14 vs.1.02 - 2.00 at 95% CI), respectively. However, a significant association was not observed between aa genotype of eNOS gene in VNTR intron-4 region and risk of PE as compared to bb genotype (OR =1.26, 95% CI: 0.83 - 1.89). The allelic model of eNOS gene at all positions showed nonsignificant association with the risk of PE.

CONCLUSIONS

The women having eNOS gene variants at 894 and 786 positions showed a significant association with the risk of PE. Yet, the women having eNOS gene variant at intron-4 region showed nonsignificant association with the risk of PE. Thus, this study suggests that eNOS gene variants may play a role in the development of PE, but large-scale studies are required to inaugurate concrete evidence on the roles of eNOS gene variants in PE pathogenesis.

Association between endothelial nitric oxide synthase (eNOS) gene variants and nitric oxide production in preeclampsia: a case-control study in Ghana

Evidence suggests that a major cause of PE is endothelial dysfunction emanating from the reduced bioavailability of Nitric oxide (NO). Variants of endothelial nitric oxide synthase (eNOS) gene may lead to decreased NO levels. We explored the association between eNOS gene variants and nitric oxide levels among preeclamptic women in the Ghanaian population. This case-control study included 75 preeclamptic women and 75 healthy normotensive pregnant women attending antenatal care at the Nkawie-Toase Government Hospital, Ghana. A well-structured questionnaire was used to collect socio-demographic, obstetric and clinical data. Blood was obtained for DNA extraction; the gene variants were determined using PCR and RFLP. Preeclamptic women had significantly lower NO concentration compared to the normotensives (p < 0.0001) and was significantly different between VNTR variants (p < 0.0001). A significant difference in VNTR intron 4 distribution was also observed between the preeclamptic and normotensive women with 4c4c" (12.0%) and "4a4c" (1.3%) genotypes found predominantly in preeclamptic women (p < 0.0001). There was significantly higher distribution of "TC" genotype in preeclamptic women (44.0%) compared to normotensives (22.7%) (p = 0.019). However, possessing "4a4b" (cOR: 0.17, 95% CI 0.04-0.64) and "4b4b" (cOR: 0.09, 95% CI 0.02-0.38) significantly decreased the likelihood of experiencing preeclampsia by 83% and 91% respectively. Nitric oxide is reduced in preeclamptic women. NO levels in preeclampsia are altered by VNTR intron 4 variants but not T786C variants. Possessing VNTR intron 4 "4b" allele decreases the risk of PE while the "4c" allele increases the risk of PE. There is the need for eNOS variant screening and nitric oxide estimation among pregnant women for early prediction of women at risk of preeclampsia.

The eNOS-G894T genetic polymorphism and risk of preeclampsia: A case-control study, an updated meta-analysis, and a bioinformatic assay

OBJECTIVES

Preeclampsia (PE) is a leading cause of maternal death worldwide and involves vascular endothelial dysfunction. The aim of this study was to investigate the association of the G894T polymorphism in the endothelial nitric oxide synthase (eNOS) gene and the risk of preeclampsia in a case-control design in an Iranian population, which was followed by a meta-analysis and an in silico approach.

METHODS

In the case-control study, 300 people including 135 pregnant women with preeclampsia and 165 healthy pregnant women were included. The genotype of G894T polymorphism was determined by the PCR-RFLP method. We searched authoritative scientific databases to find eligible studies for meta-analysis. The odds ratio with a 95% confidence interval was estimated to find the strength of the association of the mentioned polymorphism with the risk of preeclampsia. In addition, the effect of G894T transversion on eNOS gene function was evaluated by some bioinformatics tools.

RESULTS

Our case-control data showed that the G894T polymorphism is associated with an increased risk of preeclampsia. In the meta-analysis, 33 eligible studies were included, and the results showed that the G894T polymorphism is associated with an increased risk of preeclampsia in the overall analysis and some stratified analyses. In addition, the structural analysis showed that the G894T variant can affect the splicing process as well as the protein stability.

CONCLUSIONS

Based on the results, the aforementioned polymorphism may be a risk factor for preeclampsia and could be considered a potential molecular biomarker for screening susceptible individuals.

Preeclampsia association of placental nucleotide variations in eNOS, VEGFA, and FLT-1 genes in Latin American pregnant women

INTRODUCTION

Preeclampsia is a leading cause of maternal and fetal morbidity in low- and middle-income countries, including those in Latin America. Placental vascular alterations are crucial in the pathophysiology of preeclampsia and few studies have evaluated nucleotide variations on genes associated with vascular regulation in the human placenta. This study aimed to evaluate whether placental nucleotide variations on eNOS, VEGFA, and FLT-1 genes are more frequently associated with preeclampsia in the Latin American population.

METHODS

This case-control study included placental tissue from 88 controls and 82 cases that were genotyped through Taqman probes for eNOS, VEGFA, and FLT-1 genes. The intergroup comparisons were analyzed with the Mann-Whitney U test. Genotype and allele frequencies were compared by the X² test. The association between the nucleotide variants with preeclampsia was evaluated through logistic regression analysis.

RESULTS

A significant association was observed for VEGFA SNV rs2010963 (OR 1.95; CI 95% 1.13-3.37), after adjusting for population substructure. The allele combination T, G, G, C, C, C (rs2070744, rs1799983, rs2010963, rs3025039, rs699947 and rs4769613 respectively), showed a negative association with preeclampsia (OR 0.08; CI 95% 0.01-0.93).

RESULTS

DISCUSSION

Placental SNV rs2010963 in the VEGFA gene was a risk factor for preeclampsia, while the allele combination T, G, G, C, C, C may represent potential protective factors for preeclampsia within Latin American women.

Pre-Existing Diabetes Mellitus, Hypertension and KidneyDisease as Risk Factors of Pre-Eclampsia: A Disease of Theories and Its Association with Genetic Polymorphism

Pre-existing diabetes, hypertension and kidney disorders are prominent risk factors of pre-eclampsia (PE). It is a multifactorial pregnancy disorder associated with high blood pressure, proteinuria, and multiorgan failure, which develops after the 20th week of pregnancy. It is one of the most feared pregnancy disorders, as it consumes thousands of fetomaternal lives per annum. According to clinical and pathological studies, the placenta appears to be a key player in the pathogenesis of PE; however, the exact origin of this disorder is still under debate. Defective placentation and angiogenesis are the hallmarks of PE progression. This angiogenic imbalance, together with maternal susceptibility, might determine the severity and clinical presentation of PE. This article comprehensively examines the mechanisms of pathogenesis of PE and current evidence of the factors involved in its progression. Finally, this article will explore the genetic association of PE, various candidate genes, their proposed mechanisms and variants involved in its pathogenesis.

STOX1 promotor region -922 T > C polymorphism is associated with Early-Onset preeclampsia

Preeclampsia (PE), affecting 5-8% of pregnancies, is a common pregnancy disease that has harmful effects on mother and foetus. It has been found that the STOX1 (Storkhead Box 1), which is a transcription factor, carries variants associated with PE. Previous studies showed that, there was a strong relationship between PE and STOX1 variants. Therefore, we hypothesised that variants in the promoter region of the gene may be related to the onset of PE. The aim of this study is to investigate the contribution of STOX1 gene promoter region variants to PE. The blood samples taken from 118 PE patients and 96 healthy pregnant women were analysed by Sanger sequencing method. Sequence analysis results showed that, there is a-922 T > C polymorphism (rs884181) in the promoter region of the STOX1 gene. This polymorphism was found to be statistically significant in individuals with early onset PE (p = 0.02) and in PE (p = 0.014) compared to the control group.IMPACT STATEMENTWhat is already known on this subject? As a result of whole-exon studies on the STOX1 gene, polymorphisms were found to disrupt the structure/expression/function of the gene and strengthen its relationship with PE and HELLP syndrome. A previous study by our team found an association between Y153H, the most common polymorphism of STOX1, and early onset PE.What do the results of this study add? In our study, it was aimed to investigate the effect of genetic modifications in STOX1 gene promoter region on PE through the maternal genotype. Because any change in the promoter region affects the expression level of the gene. Also, for the first time, sequence analysis of the promoter region of STOX1 is investigated in PE. The variations in STOX1 appear to be important in PE especially in Early Onset PE.What are the implications of these findings for clinical practice and/or further research? Although PE is a disease that occurs with pregnancy and shows its effects most during this period, women and children with a history of PE are more prone to various disorders, especially cardiovascular diseases in the following years. Therefore, understanding the pathogenesis of the disease is important for both prevention and treatment process. Variations on STOX1 appear to be important in terms of disease risk.

Genetic Background of Fetal Growth Restriction

Fetal growth restriction (FGR) is one of the most formidable challenges in present-day antenatal care. Pathological fetal growth is a well-known factor of not only in utero demise in the third trimester, but also postnatal morbidity and unfavorable developmental outcomes, including long-term sequalae such as metabolic diseases, diabetic mellitus or hypertension. In this review, the authors present the current state of knowledge about the genetic disturbances responsible for FGR diagnosis, divided into fetal, placental and maternal causes (including preeclampsia), as well as their impact on prenatal diagnostics, with particular attention on chromosomal microarray (CMA) and noninvasive prenatal testing technique (NIPT).