Genetic polymorphism in the pregnancy-associated plasma protein-A associated with acute myocardial infarction

Systematic review and meta-analysis of association of polymorphisms in inflammatory cytokine genes with coronary artery disease

BACKGROUND

It has comprehensively been acknowledged that a genetic contribution, especially in immune inflammatory players, such as interleukin (IL)-6 and tumor necrosis factor (TNF)-α, are critically involved in the pathophysiology of coronary artery disease (CAD). This meta-analysis study aimed to reach a conclusive understanding of the role of genetic polymorphisms, including IL6 gene C572G (rs1800796) and G174C (rs1800795) as well as TNFA gene G238A (rs361525) and G308A (rs1800629) in susceptibility to CAD.

METHODS

Two major databases, namely MEDLINE and Scopus, were searched to find the studies surveying the mentioned polymorphisms and CAD susceptibility up to July 2020. Association comparison between the polymorphisms and CAD susceptibility were assessed using pooled odds ratio (OR) and their corresponding 95% confidence interval (CI).

RESULTS

This meta-analysis study was conducted on 69 papers (73 population studies), comprising 5062 patients and 8446 controls for IL6 gene rs1800796 (17 studies), 13801 patients and 16215 controls for IL6 gene rs1800795 (38 studies), 1439 patients and 2850 controls for TNFA gene rs361525 (5 studies), and 5051 patients and 3958 controls for TNFA gene rs1800629 (13 studies), according to inclusion and exclusion criteria. There were statistically positive association between all genetic comparisons of IL6 gene rs1800795 polymorphism and the CAD risk. Moreover, the recessive model (CC vs. CG + GG) in IL6 gene rs1800796 polymorphism had marginally significant association with decreased risk of CAD. None of the TNFA gene polymorphisms were associated with CAD risk.

CONCLUSIONS

The meta-analysis revealed the positive association of IL6 gene rs1800795 polymorphism in susceptibility to CAD.

PAPP-A and the IGF system in atherosclerosis: what's up, what's down?

Pregnancy-associated plasma protein-A (PAPP-A) is a metalloproteinase with a well-established role in releasing bioactive insulin-like growth factor-1 (IGF-1) from IGF-binding protein-2, -4, and -5 by proteolytic processing of these. The IGF system has repeatedly been suggested to be involved in the pathology of atherosclerosis, and both PAPP-A and IGF-1 are proposed biomarkers and therapeutic targets for this disease. Several experimental approaches based on atherosclerosis mouse models have been undertaken to obtain causative and mechanistic insight to the role of these molecules in atherogenesis. However, reports seem conflicting. The literature suggests that PAPP-A is detrimental, while IGF-1 is beneficial. This raises important questions that need to be addressed. Here we summarize the various studies and discuss potential underlying explanations for this seemingly inconsistency with the objective of better understanding complexities and limitations when manipulating the IGF system in mouse models of atherosclerosis. A debate clarifying what's up and what's down is highly warranted going forward with the ultimate goal of improving atherosclerosis therapy by targeting the IGF system.

Promoter Polymorphism (-174, G/C) of Interleukin-6 and Arterial Thromboembolic Events: A Meta-Analysis

Background

Ischemic stroke and myocardial infarction are fatal diseases and are among the top 10 causes of death in Korea, including arterial thromboembolic events. Many previous studies have described the function of interleukin-6 (IL-6) in arterial thromboembolic events and the association between promoter single-nucleotide polymorphism (SNP) (rs1800795; −174, G/C) of the IL-6 gene. However, these results were controversial. Therefore, we performed a meta-analysis to more precisely assess the association between the SNP of the IL-6 gene and susceptibility to arterial thromboembolic events.

Material/Methods

We used PubMed, Embase, Google Scholar, and Korean Studies Information Service System (KISS) electronic databases. Comprehensive Meta-analysis software (Corporation, NJ) was used to evaluate the relationship between rs1800795 SNP of IL-6 gene and risk of arterial thromboembolic events. Odds ratio (OR), 95% confidence interval (CI), and P value were also calculated. The 13 eligible studies were analyzed in the meta-analysis.

Results

The present meta-analysis found that rs1800795 SNP of IL-6 gene is not significantly associated with susceptibility to arterial thromboembolic events (C allele vs. G allele, OR=1.04, 95% CI=0.91–1.19, P=0.619; CC vs. CG+GG, OR=1.09, 95% CI=0.91–1.31, P=0.364; CC+CG vs. GG, OR=0.97, 95% CI=0.78–1.21, P=0.763, respectively), and the SNP of IL-6 gene also did not show any significant association with ischemic stroke or myocardial infarction (P>0.05 in each model).

Conclusions

We found that rs1800795 SNP of IL-6 gene was not related to arterial thromboembolic events. However, further study will be needed to confirm these results.

Association between Interleukin-6 gene -572G>C polymorphism and coronary heart disease

The association of the Interleukin 6 (IL-6) -572G>C polymorphism and risk of coronary heart disease (CHD) have been implicated in a large number of investigations, but the results remain debatable. This meta-analysis was performed to provide more compelling evidence for the connection between the IL-6 -572G>C polymorphism and CHD risk. Studies eligible for this meta-analysis were identified through electronic search of PubMed, EMBASE, and CNKI. The fixed effects model was performed to summarize an odds ratio (OR) with 95 % confidence interval (CI). The meta-analysis of 3,985 patients and 7,153 controls from 17 studies showed that the CC genotype carriers had 0.84-fold lower risk of developing CHD when compared with the carriers with the GC+GG genotypes (OR(CC vs. GC+GG) = 0.84; 95% CI = 0.75-0.95; P = 0.414; I(2) = 3.5%). The decreased risk of CHD was also found in Asians (OR = 0.87; 95% CI = 0.77-0.98; P = 0.227; I(2) = 22.7%) and Caucasians (OR = 0.60; 95% CI = 0.40-0.92; P = 0.958; I(2) = 0) under the same genetic comparison. The results of our meta-analysis revealed that the IL-6 -572G>C polymorphism may be linked with risk of CHD in a protective model.

Pregnancy-associated plasma protein A gene polymorphism in pregnant women with preeclampsia and intrauterine growth restriction

Preeclampsia (PE) and intrauterine growth restriction (IUGR) are still among the most commonly researched titles in perinatology. To shed light on their etiology, new prevention and treatment strategies are the major targets of studies. In this study, we aimed to investigate the relation between gene polymorphism of one of the products of trophoblasts, pregnancy-associated plasma protein A (PAPP-A) and PE/IUGR.A total of 147 women (IUGR, n = 61; PE, n = 47; IUGR + PE, n = 37; eclampsia, n = 2) were compared with 103 controls with respect to the sequencing of exon 14 of the PAPP-A gene to detect (rs7020782) polymorphism. Genotypes "AA" and "CC" were given in the event of A or C allele homozygosity and "AC" in A and C allele heterozygosity. Our findings revealed that the rate of AA, CC homozygotes, and AC heterozygotes did not differ between groups. Moreover, there was no difference in the distribution of PAPP-A genotypes among the patients with IUGR, PE, IUGR + PE, or eclampsia. Finally, birth weight, rate of the presence of proteinuria, and total protein excretion on 24-hour urine were similar in the subgroups of AA, AC, and CC genotypes in the study group. Our study demonstrated no association between PAPP-A gene rs7020782 polymorphism and PE/IUGR.

Correlation of single nucleotide polymorphisms in the pregnancy-associated plasma protein-A gene with carotid plaques

Background

Pregnancy-associated plasma protein A (PAPP-A) is abundantly expressed in carotid plaques. This study investigated the association between single nucleotide polymorphisms (SNPs) of PAPP-A and the presence of carotid plaques.

Methods

A total of 408 patients with carotid plaques and 493 controls were included in the study. All subjects were Southern Chinese Han. Carotid plaques were analyzed by computer tomography angiography. PAPP-A SNPs were identified by ligase detection reaction-polymerase chain reaction analysis. The PAPP-A genotypes rs3747823, rs7020782, and rs13290387 were analyzed.

Results

The rs7020782 C allele genotype correlated with an increased risk of developing carotid plaques under the dominant, recessive, and additive models (adjusted odds ratios: 2.60, 2.36, and 3.48, respectively; P ≤ 0.001). Only C allele-carrying genotypes correlated with a significantly increased risk of carotid plaque based on studies stratified by age and sex under the dominant model. rs7020782 remained significantly associated with the risk of carotid plaque calcification after adjusting for age and potential confounders (adjusted odds ratio, 1.89; 95 % confidence interval, 1.17–3.08; P = 0.010).

Conclusions

This study found, for the first time, that the A˃C variation of rs7020782 might be an independent risk factor for carotid plaque development and calcification. The determination of such genotypes could provide a new tool for identifying individuals at high risk for carotid atherosclerosis.

Electronic supplementary material

The online version of this article (doi:10.1186/s12872-015-0041-1) contains supplementary material, which is available to authorized users.

Genetic relationship between serum pregnancy-associated plasma protein-A gene polymorphism and ischemic cerebrovascular disease in a Northern Han Chinese population

The present study recruited 193 patients with ischemic cerebrovascular disease from Inpatient and Outpatient Departments at the Affiliated Hospital of Qingdao University Medical College, China from August 2008 to May 2010, as well as 120 healthy volunteers from the Medical Examination Center at the Affiliated Hospital of Qingdao University Medical College, China, who served as controls for this study. Patients and control subjects were from the Han population in northern China. Enzyme- linked immunosorbent assay analysis revealed increased levels of serum pregnancy-associated plasma protein-A (PAPP-A) in ischemic cerebrovascular disease patients compared with healthy controls. In addition, the patients exhibited greater frequency of genotype CC and C alleles in a missense A/C (Tyr/Ser) polymorphism (dbSNP: rs7020782) of exon 14 in the PAPP-A gene. Multiple-factor logistic regression analysis on correction of age, gender, history of smoking, hypertension, diabetes mellitus, hypercholesteremia, and ischemic stroke family history showed that the risk for ischemic cerebrovascular disease in the population without the A allele at the A/C genetic locus in exon 14 of the PAPP-A was 2-folds greater than the population expressing the A allele. These experimental findings suggested that ischemic cerebrovascular disease correlated with the C allele in exon 14 of PAPP-A. In addition, the A allele is likely a protective gene; individuals carrying the A allele were less prone to ischemic cerebrovascular disease compared with individuals without the A allele.

The associations between the MCP-1 -2518 A/G polymorphism and ischemic heart disease and ischemic stroke: a meta-analysis of 28 research studies involving 21,524 individuals

Epidemiologic studies have been performed to explore the relationship between MCP-1 polymorphism and ischemic heart disease (IHD) and ischemic stroke (IS). But, the results are not consistent. Because of the poor effect of each individual study, we've performed a systematic review and a meta-analysis. A comprehensive search was carried out from PubMed, Embase, Foreign Medical Journal Service (FMJS), China National Knowledge Infrastructure and Wanfang Data. Odds ratios (OR) with 95% confidence interval (CI) were used to evaluate the strength of associations between the MCP-1 A-2518G polymorphism (rs1024611) and IHD and IS susceptibilities. The pooled OR was calculated by the allelic model (G vs A), the additive model (GG vs AA), the dominant model (GG+GA vs AA) and the recessive model (GG vs AA+GA), respectively. The homogeneity among studies was checked using Cochrane Q statistic. The stability of results was checked by one-way sensitivity analysis. The publication bias between studies was examined by Begg's funnel plots and Egger's test. 28 eligible case-control studies met all the criteria and were involved in the present meta-analysis, including a total of 8,901 cases and 12,623 controls. Overall, the MCP-1 A-2518G polymorphism was significantly associated with the IHD susceptibility. The pooled OR was 1.27 (95% CI 1.09-1.48, P = 0.002) in the dominant model, 1.20 (95% CI 1.07-1.35, P = 0.001) in the allelic model, 1.25 (95% CI 1.05-1.50, P = 0.015) in the recessive model and 1.39 (95% CI 1.10-1.75, P = 0.005) in the additive model. At the same time, the MCP-1 A-2518G polymorphism was significantly associated with the IS susceptibility. The pooled OR was 1.72 (95% CI 1.12-2.65, P = 0.013) in the dominant model, 1.39 (95% CI 1.12-1.74, P = 0.003) in the allelic model, 1.59 (95% CI 1.30-1.93, P = 0.000) in the recessive model, and 2.33 (95% CI 1.76-3.08, P = 0.000) in the additive model, respectively. No significant publication bias was found in the present meta-analysis. The results of the present meta-analysis suggest that MCP-1 gene A-2518G polymorphism may be associated with the IHD and IS susceptibilities. But the positive result exists in relatively small sample size subgroup.

Pregnancy-associated plasma protein A (PAPP-A) and preeclampsia

Pregnancy-associated plasma protein A (PAPP-A) is a key regulator of insulin-like growth factor bioavailability essential for normal fetal development. In maternal blood, this protein increases with gestational age and then rapidly decreases after delivery. It is routinely used for Down syndrome screening in the first trimester of pregnancy, and its decrease compared to a normal pregnancy indicates an increased risk for both chromosomal anomalies and adverse pregnancy outcomes. It belongs to a group of biomarkers that predict later preeclampsia development, primarily early onset preeclampsia; however, it should be combined with a Doppler ultrasonography of the uterine artery (pulsatile index) and other biochemical and maternal factors to achieve a higher detection rate with an acceptable false positivity rate. Some studies have demonstrated an even more pronounced decrease of PAPP-A in the early second trimester of pregnancy in women who subsequently develop preeclampsia compared with women who do not develop preeclampsia. Conversely, during the last trimester of pregnancy, its concentration increases even more in patients with preeclampsia than in patients without. It is also detectable at very low levels in nonpregnant individuals, and a higher concentration indicates an adverse effect in patients with acute coronary syndromes or stable atherosclerotic disease and in patients with end-stage renal disease who are being treated with hemodialysis.

Cys327Cys polymorphism of the PAPP-A gene (pregnancy associated plasma protein A) is related to mortality of long term hemodialysis patients

OBJECTIVES

PAPP-A is an independent mortality predictor of long term hemodialysis patients and a prognostic marker of acute coronary syndrome in general population. Cys327Cys PAPP-A polymorphism (SNP) (rs12375498) was found to be of significance in preeclampsia and the C allele of the PAPP-A C/G SNP (rs13290387) was defined as an independent risk factor for acute myocardial infarction. The aim of the study was to test the role of these PAPP-A SNPs in long term hemodialysis patients.

DESIGN AND METHODS

The studied group consisted of 464 subjects - 319 long term hemodialysis patients (183 men, 136 women, 62±14years) and 145 controls (65 men, 80 women, 49±14years). A subgroup of 211 hemodialysis patients (118 men, 93 women, 63±13years) was prospectively followed up for 4.5years. During the follow up, 111 patients died, 51 of them due to cardiovascular events. PAPP-A SNPs were analyzed by DNA sequencing and serum PAPP-A was measured by TRACE.

RESULTS

Both SNPs were in Hardy-Weinberg equilibrium. Allelic and genotype frequencies did not differ between patients and controls and were not related to serum PAPP-A concentrations. Cys327Cys SNP was significant for patients' survival (HR (95% CI): 1.616 (1.110-2.353), nominal p=0.012, corrected p=0.036) while C/G SNP was not.

CONCLUSIONS

Our study shows for the first time the significance of Cys327Cys PAPP-A SNP (rs12375498) for overall mortality of long term hemodialysis patients. Although it does not influence the concentration of PAPP-A it still could affect the correct function of this enzyme which has to be clarified in further studies.

Common polymorphisms in the interleukin-6 gene and myocardial infarction risk: a meta-analysis

BACKGROUND

Interleukin-6 (IL-6) plays a critical role in the development and progression of cardiovascular disease. Emerging evidence suggests that two common polymorphisms (-174 G/C and -572 G/C) in the IL-6 gene might have an impact on an individual's susceptibility to myocardial infarction (MI), but individually published results are inconclusive. This meta-analysis aimed to derive a more precise estimation of the relationship between IL-6 -174 G/C and -572 G/C polymorphisms and MI risk.

METHOD

An extensive literary search for relevant studies was conducted in PubMed, Embase, Web of Science, Cochrane Library, CISCOM, CINAHL, Google Scholar, China BioMedicine (CBM), and China National Knowledge Infrastructure (CNKI) databases from their inception through August 1st, 2013. A meta-analysis was then performed using the STATA 12.0 software. The crude odds ratios (OR) with 95% confidence intervals (CI) were calculated.

RESULTS

Eleven case-control studies were included with a total of 10,252 subjects, including 5429 MI patients and 4823 healthy controls. Our meta-analysis results indicated that IL-6 -174 G/C polymorphism may increase the risk of MI (C allele vs. G allele: OR=1.07, 95% CI: 1.01-1.14, p=0.018; GC+CC vs. GG: OR=1.14, 95% CI: 1.04-1.24, p=0.003; respectively). However, our results showed no significant association between IL-6 -572 G/C polymorphism and MI risk (C allele vs. G allele: OR=0.88, 95% CI: 0.75-1.03, p=0.098; GC+CC vs. GG: OR=0.87, 95% CI: 0.70-1.07, p=0.173; respectively). No publication bias was detected in this meta-analysis.

CONCLUSION

The current meta-analysis suggests that IL-6 -174 G/C polymorphism may contribute to MI susceptibility. Thus, detection of IL-6 -174 G/C polymorphisms may be a promising biomarker for the early detection of MI. However, IL-6 -572 G/C polymorphism may not associate with the risk of MI.

Association of pregnancy-associated plasma protein-A gene polymorphism with ischemic stroke in northern Chinese Han population

OBJECTIVES

The pregnancy-associated plasma protein-A (PAPP-A), belonging to the metalloproteinase superfamily, plays an important role in destabilization of atherosclerotic plaques. The aim of this study is to evaluate whether PAPP-A gene polymorphism is associated with the risk of ischemic stroke (IS) in northern Chinese Han populations.

METHODS

A total of 368 patients with IS and 374 aged-matched healthy controls in a Chinese Han population were included in the case-control study. The single-nucleotide polymorphism (SNP) IVS6+95 (rs13290387) in the PAPP-A gene was analyzed by the polymerase chain reaction-ligation detection reaction (PCR-LDR) method.

RESULTS

Compared with the GG+CG genotype, the frequencies of the CC genotype of IVS6+95 (rs13290387) in the patients with IS were significantly higher than those in the controls (P  =  0·026). After adjusting the confounding risk factors of IS (age, gender, smoking, alcohol drinking, hypertension, diabetes mellitus, and hyperlipidemia) by the multivariate logistic analysis, this significant correlation still remained (P  =  0·010).

DISCUSSION

The CC genotype of IVS6+95 (rs13290387) was associated with increased incidence of IS in northern Chinese Han populations. This is an initial study to indicate that PAPP-A (rs13290387) might contribute to IS susceptibility in northern Chinese Han populations.

Association of the CCR5Δ32 polymorphism and its ligand RANTES-403G/A polymorphism with coronary artery disease: a meta-analysis

INTRODUCTION

To explore the relationship between polymorphisms in the RANTES and CCR5 genes and the risk of coronary artery disease (CAD).

MATERIALS AND METHODS

We conducted a meta-analysis on two genetic variants (RANTES-403G/A and CCR5Δ32). Publication bias was tested by the Egger's regression test and Begg's test. Sensitivity analysis and subgroup analyses were performed to explore the heterogeneity among studies.

RESULTS

No significant association of RANTES-403G/A polymorphism and CAD risk was observed (dominant model: RR=1.02, 95%CI=0.90-1.06; recessive model: RR=1.27, 95%CI=0.90-1.80). However, after excluding the study conducted by Yangsoo et al., the pooled relative ratio (RR) in the dominant model suggested that the RANTES-403G/A polymorphism was positively associated with CAD risk. The subgroup analyses found that a positive relationship between the polymorphism and CAD risk was restricted to the Caucasian population. A meta-analysis of studies on the CCR5Δ32 polymorphism showed no significant association with CAD risk both in dominant (RR=1.05, 95%CI=0.92-1.21) and recessive (RR=1.27, 95%CI=0.90-1.80) models. Moreover, no association was identified in the subgroup analyses.

CONCLUSIONS

The RANTES-403G/A polymorphism is not associated with CAD risk, but does most likely increase CAD risk in Caucasians. Moreover, no relationship between the CCR5∆32 polymorphism and risk of CAD was found.

RANTES gene G-403A polymorphism and coronary artery disease: a meta analysis of observational studies

Objective

The G-403A polymorphism in RANTES gene may be involved in the development of coronary artery disease (CAD) through increasing RANTES-mediated leukocyte trafficking and activation. However, studies investigating the relationship between G-403A polymorphism and CAD yielded contradictory and inconclusive results. In order to shed some light on these inconsistent findings, a meta analysis was performed to clarify the role of G-403A polymorphism of RANTES gene in the susceptibility of CAD.

Methods

A systemic literature search of PubMed and EMBASE was conducted from their inception to March 23, 2012, to retrieve related studies. In addition, Conference Proceedings Citation Index-Science was searched, authors of relevant studies were contacted, and reference lists of the included studies and their related citations in PubMed were reviewed for additional pertinent studies.

Results

A total of 8 eligible studies were identified, with a total of 4252 CAD cases and 2150 controls. There was no evidence of significant association between G-403A polymorphism and CAD risk in any genetic model or pairwise comparisons (additive model: OR = 1.046, 95% CI = 0.883–1.239, I² = 65.9%; recessive model: OR = 1.140, 95% CI = 0.774–1.678, I² = 53.1%; dominant model: OR = 1.000, 95% CI = 0.820–1.21), I² = 62.6%; AA vs GG: OR = 1.141, 95% CI = 0.734–1.773, I² = 61.2%; GA vs GG: OR = 0.993, 95% CI = 0.800–1.232, I² = 64.6%). Subgroup analysis and meta regression indicated that ethnicity and genotyping method accounted for the significant heterogeneity among studies. In the stratified analysis by ethnic group, G-403A polymorphism was found to be associated with increased CAD risk in Caucasian population whereas its protective role was observed in Asian population in some but not all comparisons.

Conclusion

Data from the current meta-analysis do not support the existence of a relationship between G-403A polymorphism and the development of CAD, and large sample size study employing unified genotyping method is needed to further evaluate the influence of G-403A polymorphism on susceptibility of CAD.

Polymorphisms of -174G>C and -572G>C in the interleukin 6 (IL-6) gene and coronary heart disease risk: a meta-analysis of 27 research studies

OBJECTIVE

Elevated serum IL-6 level is a risk factor for coronary heart disease (CHD). The -174 G>C and -572 G>C polymorphisms in the IL-6 gene have previously been shown to modulate IL-6 levels. But the association between the -174 G>C and -572 G>C polymorphisms and the risk of CHD is still unclear. A meta-analysis of all eligible studies was carried out to clarify the role of IL-6 gene polymorphisms in CHD.

METHODS AND RESULTS

PubMed, EMBASE, Vip, CNKI and CBM-disc were searched for eligible articles in English and Chinese that were published before October 2010. 27 studies involving 11580 patients with CHD and 17103 controls were included. A meta-analysis was performed for the included articles using the RevMan 5.0 and Stata 10.0 softwares. Overall, the -174 C allele was not significantly associated with CHD risk (ORs = 1.04, 95%CI = 0.98 to 1.10) when compared with the -174 G allele in the additive model, and meta-analysis under other genetic models (dominant, recessive, CC versus GG, and GC versus GG) also did not reveal any significant association. On the contrary, the -572 C allele was associated with a decreased risk of CHD when compared with the -572 G allele (ORs = 0.79, 95%CI = 0.68 to 0.93). Furthermore, analyses under the recessive model (ORs = 0.69, 95% = 0.59 to 0.80) and the allele contrast model (genotype of CC versus GG, ORs = 0.49, 95% = 0.35 to 0.70) yielded similar results. However, statistical significance was not found when the meta-analysis was restricted to studies focusing on European populations, studies with large sample size, and cohort studies by using subgroup analysis.

CONCLUSIONS

The -174 G>C polymorphism in the IL-6 gene is not significantly associated with increased risks of CHD. However, The -572 G>C polymorphism may contribute to CHD development. Future investigations with better study design and large number of subjects are needed.

Association of pregnancy-associated plasma protein A polymorphism with preeclampsia - a pilot study

OBJECTIVES

The aim of the study was to investigate genetic and biochemical background of PAPP-A (pregnancy-associated plasma protein A) in patients with risk pregnancies.

DESIGN AND METHODS

Five PAPP-A gene polymorphisms and PAPP-A maternal serum levels were studied together in 165 women in third trimester pregnancies complicated with threatening preterm labor (n=98), preeclampsia (n=35), intrauterine growth restriction (n=34) and ICP (intrahepatic cholestasis of pregnancy) (n=15). 114 healthy pregnant women served as controls.

RESULTS

Preeclamptic patients had significantly higher frequency of TT genotype of Cys327Cys polymorphism compared to controls (p<0.01). Patients with ICP had increased serum levels of PAPP-A compared to controls and correlation analysis showed significant relationship between PAPP-A and CRP (C-reactive protein) in the patients with intrauterine growth restriction (r=0.49, p=0.007).

CONCLUSION

Our study indicates the association of TT genotype of Cys327Cys polymorphism of the PAPP-A gene with preeclampsia. However, further study with larger groups of preeclamptic patients is needed to confirm our results.

Haplotype-based association of four lymphotoxin-alpha gene polymorphisms with the risk of coronary artery disease in Han Chinese

Lymphotoxin-alpha (LTA), a pro-inflammatory cytokine, has been implicated in the pathogenesis of coronary atherosclerosis. Meanwhile, association of some single nucleotide polymorphisms (SNPs) of LTA gene with coronary artery disease (CAD) has been evaluated; however, the results are irreproducible. We therefore investigated the relationship between four SNPs of LTA gene and CAD in Han Chinese: G+10A (rs1800683, 5'-untranslated region), A+80C (rs2239704, 5'-untranslated region), T+496C (Cys13Arg, rs2229094, exon 2), and C+804A (Thr26Asn, rs1041981, exon 3). Genotyping was performed in 438 CAD patients and 330 healthy controls. Single-locus analysis showed that the genotype and allele frequencies of G+10A polymorphism exhibited marginal differences between CAD patients and controls, although no statistical significance was observed after the Bonferroni correction. Logistic regression analysis revealed that GG genotype of G+10A polymorphism was significantly associated with the risk of CAD under the dominant mode, whereas no significant association was detected between A+80C polymorphism and CAD. In contrast, individuals carrying TT or TC genotype of T+496C polymorphism showed a decreased CAD risk relative to those with CC genotype under the recessive mode. Likewise, CC genotype of C+804A polymorphism was associated with a protective effect on CAD under the dominant mode. Further, in haplotype analysis, the haplotype G-C-T-C (in order of rs1800683, rs2239704, rs2229094 and rs1041981) was significantly associated with a decreased risk of CAD after assigning the most common haplotype A-C-T-A as a reference. In conclusion, we show a protective effect of the haplotype G-C-T-C on the occurrence of CAD, suggesting the involvement of LTA in CAD pathogenesis.

Lack of association between lymphotoxin-alpha, galectin-2 polymorphisms and coronary artery disease: a meta-analysis

OBJECTIVE

Previous case-control studies suggested the single nucleotide polymorphisms of lymphotoxin-alpha (LTA) gene and galectin-2 (LGASL2) gene are associated with coronary artery disease and myocardial infarction. However, other studies did not confirm this relationship. The objective was to assess the relationship of LTA gene, LGALS2 gene and coronary artery disease, using a meta-analysis.

METHODS

Databases, including PubMed, EMbase, CBM and CNKI, were searched to get the genetic association studies. Data were extracted by two authors and pooled odds ratio (OR) and 95% confidence interval (CI) were calculated.

RESULT

The meta-analysis included 20640 (LTA-A252G) and 10552 (LGALS2-C3279T) cases, 15388 (A252G) and 10545 (C3279T) controls. The pooled OR of 252G was 1.02 (95%CI: 0.97-1.07) compared to wild type allele in dominant model, and was 1.00 (95%CI: 0.94-1.07) in recessive model. The pooled OR of 3279T was 0.95 (95%CI: 0.89-1.01) compared to wild type allele in dominant model, and was 0.89 (95%CI: 0.78-1.00) in recessive model. None of the polymorphisms was found to associate with coronary artery disease.

CONCLUSION

In present study, the LTA gene and LGALS2-C3279T are not associated with coronary artery disease.

Personalized Medicine in Coronary Artery Disease: Insights From Genomic Research

Prior clinical studies have demonstrated that a family history of coronary artery disease (CAD) is associated with future cardiovascular events. Although there are several Mendelian disorders that are associated with CAD, most common forms of CAD are believed to be multifactorial and the result of many genes with small individual effects. The identification of these genes and their variation would be very helpful for the prediction, prevention, and management of CAD; linkage analysis or candidate gene case-control studies have been largely unsuccessful. On the contrary, recent advances in genomic techniques have generated a large amount of deoxyribonucleic acid (DNA)-based information. The link between CAD and inflammation and biological pathways has been highlighted. In particular, several genome-wide association studies have replicated a novel gene marker on chromosome 9p21. The information gained from genomic studies, in combination with clinical data, is expected to refine personalized approaches to assess risk and guide management for CAD. Genetic risk scores derived from several functional single nucleotide polymorphisms (SNPs) or haplotypes in multiple genes may improve the prediction of CAD. Despite the complexity of CAD genetics, steady progress is expected.

Candidate gene polymorphisms and the 9p21 locus in acute coronary syndromes

It is now widely accepted that the classic environmental risk factors for atherosclerosis only partly explain the incidence of coronary artery disease and the development of acute coronary syndromes. Therefore, genetic factors that vary among human populations seem to be involved in the clinical manifestations of such patients. Substantial data suggest that a significant proportion of genetic polymorphisms involved in endothelial function, inflammation, lipid metabolism, thrombosis and fibrinolysis are often present in patients with acute coronary syndromes. In particular, a common variant on chromosome 9p21 was recently identified to affect the risk of myocardial infarction. Here, we review the progress of candidate gene studies and genome-wide association studies in identifying the genetic bases of complex cardiovascular diseases such as acute coronary syndromes.

Pregnancy-associated plasma protein-A (PAPP-A) and cardiovascular risk

The search for markers to improve risk prediction for individuals at risk of developing serious cardiovascular events is ongoing. New markers of coronary artery disease progression have been identified in recent years, among which, circulating levels of pregnancy-associated plasma protein-A (PAPP-A) offer an interesting profile. PAPP-A may play a role in the development of atherosclerotic lesions and represent also a marker of atheromatous plaque instability and extent of cardiovascular disease. PAPP-A has been shown to be a marker of adverse outcome in both acute coronary syndrome and stable coronary disease patients. The present article reviews currently available evidence supporting a role for PAPP-A as a marker of cardiovascular risk and discusses some of the pitfalls that may limit its use in clinical practice.