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Toncheva D, Mihailova-Hristova M, Vazharova R, Staneva R, Karachanak S, Dimitrov P, Simeonov V, Ivanov S, Balabanski L, Serbezov D, Malinov M, Stefanovic V, Čukuranović R, Polenakovic M, Jankovic-Velickovic L, Djordjevic V, Jevtovic-Stoimenov T, Plaseska-Karanfilska D, Galabov A, Djonov V, Dimova I. NGS nominated CELA1, HSPG2, and KCNK5 as candidate genes for predisposition to Balkan endemic nephropathy. BIOMED RESEARCH INTERNATIONAL 2014; 2014:920723. [PMID: 24949484 PMCID: PMC4052113 DOI: 10.1155/2014/920723] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 04/16/2014] [Accepted: 04/30/2014] [Indexed: 01/06/2023]
Abstract
Balkan endemic nephropathy (BEN) is a familial chronic tubulointerstitial disease with insidious onset and slow progression leading to terminal renal failure. The results of molecular biological investigations propose that BEN is a multifactorial disease with genetic predisposition to environmental risk agents. Exome sequencing of 22 000 genes with Illumina Nextera Exome Enrichment Kit was performed on 22 DNA samples (11 Bulgarian patients and 11 Serbian patients). Software analysis was performed via NextGene, Provean, and PolyPhen. The frequency of all annotated genetic variants with deleterious/damaging effect was compared with those of European populations. Then we focused on nonannotated variants (with no data available about them and not found in healthy Bulgarian controls). There is no statistically significant difference between annotated variants in BEN patients and European populations. From nonannotated variants with more than 40% frequency in both patients' groups, we nominated 3 genes with possible deleterious/damaging variants--CELA1, HSPG2, and KCNK5. Mutant genes (CELA1, HSPG2, and KCNK5) in BEN patients encode proteins involved in basement membrane/extracellular matrix and vascular tone, tightly connected to process of angiogenesis. We suggest that an abnormal process of angiogenesis plays a key role in the molecular pathogenesis of BEN.
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Affiliation(s)
- D. Toncheva
- Department of Medical Genetics, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria
- Genomics Laboratory of Malinov Clinic, 1620 Sofia, Bulgaria
| | - M. Mihailova-Hristova
- Department of Medical Genetics, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria
| | - R. Vazharova
- Genomics Laboratory of Malinov Clinic, 1620 Sofia, Bulgaria
| | - R. Staneva
- Department of Medical Genetics, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria
| | - S. Karachanak
- Department of Medical Genetics, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria
| | - P. Dimitrov
- Vratza District Hospital, 66 “Vtori Iuni” Boulevard, 3000 Vratza, Bulgaria
| | - V. Simeonov
- Faculty of Medicine, University of Nis, Univerzitetski trg 2, 18000 Nis, Serbia
| | - S. Ivanov
- Genomics Laboratory of Malinov Clinic, 1620 Sofia, Bulgaria
| | - L. Balabanski
- Genomics Laboratory of Malinov Clinic, 1620 Sofia, Bulgaria
| | - D. Serbezov
- Genomics Laboratory of Malinov Clinic, 1620 Sofia, Bulgaria
| | - M. Malinov
- Genomics Laboratory of Malinov Clinic, 1620 Sofia, Bulgaria
| | - V. Stefanovic
- Faculty of Medicine, University of Skopje, Macedonian Academy of Sciences and Arts, Bul. Krste Misirkov 2, P.O. Box 428, 1000 Skopje, Macedonia
| | - R. Čukuranović
- Faculty of Medicine, University of Skopje, Macedonian Academy of Sciences and Arts, Bul. Krste Misirkov 2, P.O. Box 428, 1000 Skopje, Macedonia
| | - M. Polenakovic
- Institute of Microbiology, Bulgarian Academy of Sciences, 26 Georgi Bonchev Street, 1113 Sofia, Bulgaria
| | - L. Jankovic-Velickovic
- Faculty of Medicine, University of Skopje, Macedonian Academy of Sciences and Arts, Bul. Krste Misirkov 2, P.O. Box 428, 1000 Skopje, Macedonia
| | - V. Djordjevic
- Faculty of Medicine, University of Skopje, Macedonian Academy of Sciences and Arts, Bul. Krste Misirkov 2, P.O. Box 428, 1000 Skopje, Macedonia
| | - T. Jevtovic-Stoimenov
- Institute of Microbiology, Bulgarian Academy of Sciences, 26 Georgi Bonchev Street, 1113 Sofia, Bulgaria
| | - D. Plaseska-Karanfilska
- Institute of Microbiology, Bulgarian Academy of Sciences, 26 Georgi Bonchev Street, 1113 Sofia, Bulgaria
| | - A. Galabov
- National Center of Public Health and Analyses, 15 Acad. Ivan Evst. Geshov Boulevard, 1431 Sofia, Bulgaria
| | - V. Djonov
- Institute of Anatomy, Bern University, Baltzerstrass 2, 3012 Bern, Switzerland
| | - I. Dimova
- Department of Medical Genetics, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria
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Staneva R, Rukova B, Hadjidekova S, Nesheva D, Antonova O, Dimitrov P, Simeonov V, Stamenov G, Cukuranovic R, Cukuranovic J, Stefanovic V, Polenakovic M, Dimova I, Hlushchuk R, Djonov V, Galabov A, Toncheva D. Whole genome methylation array analysis reveals new aspects in Balkan endemic nephropathy etiology. BMC Nephrol 2013; 14:225. [PMID: 24131581 PMCID: PMC3852817 DOI: 10.1186/1471-2369-14-225] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 10/11/2013] [Indexed: 11/17/2022] Open
Abstract
Background Balkan endemic nephropathy (BEN) represents a chronic progressive interstitial nephritis in striking correlation with uroepithelial tumours of the upper urinary tract. The disease has endemic distribution in the Danube river regions in several Balkan countries. DNA methylation is a primary epigenetic modification that is involved in major processes such as cancer, genomic imprinting, gene silencing, etc. The significance of CpG island methylation status in normal development, cell differentiation and gene expression is widely recognized, although still stays poorly understood. Methods We performed whole genome DNA methylation array analysis on DNA pool samples from peripheral blood from 159 affected individuals and 170 healthy individuals. This technique allowed us to determine the methylation status of 27 627 CpG islands throughout the whole genome in healthy controls and BEN patients. Thus we obtained the methylation profile of BEN patients from Bulgarian and Serbian endemic regions. Results Using specifically developed software we compared the methylation profiles of BEN patients and corresponding controls and revealed the differently methylated regions. We then compared the DMRs between all patient-control pairs to determine common changes in the epigenetic profiles. SEC61G, IL17RA, HDAC11 proved to be differently methylated throughout all patient-control pairs. The CpG islands of all 3 genes were hypomethylated compared to controls. This suggests that dysregulation of these genes involved in immunological response could be a common mechanism in BEN pathogenesis in both endemic regions and in both genders. Conclusion Our data propose a new hypothesis that immunologic dysregulation has a place in BEN etiopathogenesis.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Draga Toncheva
- Department of Medical Genetics, Medical University of Sofia, 1421 2Zdrave str, Sofia, Bulgaria.
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Milićević D, Jurić V, Stefanović S, Jovanović M, Janković S. Survey of slaughtered pigs for occurrence of ochratoxin A and porcine nephropathy in Serbia. Int J Mol Sci 2008; 9:2169-2183. [PMID: 19330066 PMCID: PMC2635621 DOI: 10.3390/ijms9112169] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2008] [Revised: 10/29/2008] [Accepted: 10/31/2008] [Indexed: 11/17/2022] Open
Abstract
Samples of blood, kidney and liver were randomly selected from slaughtered pigs (n=90) and analyzed for ochratoxin A by HPLC. In addition, in order to obtain information on the occurrence of nephropathy, histological examinations were carried out. Of the 90 liver samples, 26.6% contained OTA in the range of 0.22-14.5 ng/g. The incidence of OTA in serum and kidney were very similar (31%, 33.3%), with a maximum concentration of 220.8 ng/mL, and 52.5 ng/g, respectively. Histopathological examination of kidneys confirmed tubulopathies with edema and cell vacuolization. In addition, hemorrhages and necrosis of proximal kidney tubules' cells were found.
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Affiliation(s)
- Dragan Milićević
- Institute of Meat Hygiene and Technology, Kaćanskog 13, 11000 Belgrade, Serbia
| | - Verica Jurić
- Department for Animal Sciences, Faculty of Agriculture, University of Novi Sad, Trg Dositeja Obradovića 10, 21000 Novi Sad, Serbia. E-Mail:
| | - Srđan Stefanović
- Institute of Meat Hygiene and Technology, Kaćanskog 13, 11000 Belgrade, Serbia
| | - Milijan Jovanović
- Department of Pathomorphology, Faculty of Veterinary Medicine, University of Belgrade, Bulevar Oslobo enja 18, 11000 Beograd, Serbia. E-Mail:
| | - Saša Janković
- Institute of Meat Hygiene and Technology, Kaćanskog 13, 11000 Belgrade, Serbia
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Abstract
The study of Balkan endemic nephropathy (BEN) in the affected localities of southern Serbia shows population-genetic difference between samples of BEN affected individuals and control group consisting of non-affected individuals from the same localities. Detailed population-genetic study in village Chepure, which includes 20 large families where BEN is present in 646 (from first to fourth degree) relatives of probands, shows a familial character of disease as well as significant genetic influences in expression of the illness. Our study of genetic homozygosity degree includes an analysis of the presence, distribution and individual combination of 20 to 30 selected genetically controlled morphophysiological traits in the sample of BEN patients and in the control-healthy group. Assuming that BEN is genetically controlled disease, we made a hypothesis that an increased homozygosity level, as well as the changed variability among the patients, could be populationgenetic parameter for the prediction of the illness. Taking into consideration our experience, as well as the experience of numerous scientists who studied the nature of the inheritance of mono-and oligo-genically controlled qualitative traits, we applied a methodology to estimate the proportion of such homozygously recessive characters (HRC-test). This population-genetic study did not only show statistically significant difference of the mean values of genetic homozygosity (BEN: 8.7 ± 0.3; control: 7.6 ± 0.3), but of the differences in the type of distribution too, as well as the differences in the presence of certain individual combinations of such traits.
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Affiliation(s)
- D Marinkovic
- 1Serbian Academy of Sciences and Arts, Belgrade, 11000 Serbia
| | - S Cvjeticanin
- 2Institute of Human Genetics, School of Medicine, University of Belgrade, Belgrade, 11000 Serbia
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Toncheva D, Galabov AS, Laich A, Atanassova S, Kamarinchev B, Dimitrov T, Fuchs D. Urinary neopterin concentrations in patients with Balkan endemic nephropathy (BEN). Kidney Int 2003; 64:1817-21. [PMID: 14531816 DOI: 10.1046/j.1523-1755.2003.00280.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Balkan endemic nephropathy (BEN) is of great clinical importance in restricted areas of Bulgaria, Serbia, Croatia, Bosnia, Herzegovina, and Romania, since the etiology of BEN is still unknown. METHODS In urine samples from 48 patients (41 females and 7 males, aged 65.6 +/- 6.87 years) with BEN living in an endemic area of Vratza district, Bulgaria, neopterin concentrations were measured by high-pressure liquid chromatography (HPLC) and compared with other clinical and laboratory investigations, including creatinine, hemoglobin, and erythrocyte sedimentation rates (ESRs). RESULTS Urinary neopterin concentrations were 263 +/- 128 (mean +/- SD; range, 78 to 786 micromol/mol creatinine), 24 (50%) of BEN patients presented with increased concentrations as compared to the established normal ranges. Average ESRs were increased (1 hour, 29.0 +/- 14.7 mm/hour) and hemoglobin was decreased (109.3 +/- 16.4 g/L). Hemoglobin correlated inversely with ESRs (rs = -0.787 and -0.780) and creatinine concentrations (r = -0.690, all P < 0.001), but not with neopterin concentrations. Neopterin concentrations also did not correlate with serum creatinine levels. There existed an age relationship of ESR, creatinine, and hemoglobin, but not of neopterin. Neopterin concentrations were slightly lower in five females with low titers of antibodies against local B1 hantavirus strain (P < 0.05). CONCLUSION The findings can support an immune-mediated inflammatory process in the pathogenesis of BEN only in a subgroup of patients.
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Affiliation(s)
- Draga Toncheva
- Institute of Medical Chemistry and Biochemistry, Leopold Franzens University, Innsbruck, Austria
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Dimitrov PS, Simeonov VA, Stein AD. Balkan endemic nephropathy in Vratza, Bulgaria, 1964-1987: an epidemiologic analysis of population-based disease registers. Eur J Epidemiol 2001; 17:847-53. [PMID: 12081104 PMCID: PMC7087956 DOI: 10.1023/a:1015653608151] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Balkan Endemic Nephropathy (BEN), first described in 1956 in Vratza region, Bulgaria, may result from prolonged, chronic exposure to environmental toxicants, but the underlying etiologic factors remain elusive. There has been no recent systematic characterization of the epidemiology of this disease. Recently, it has been suggested that the incidence of the disease is decreasing. We therefore abstracted data from registers of patients in 21 affected villages and the town of Vratza, Bulgaria maintained from 1964 through 1987. In 1964, the prevalence of BEN was 6.0 per 1000 inhabitants; among residents of the affected villages, the prevalence was 12.3 per 1000. From 1965 to 1975 the incidence rate was 0.7 per 1,000 person-years, and from 1976 to 1987 the incidence rate was 0.3 per 1,000 person-years (rate ratio 0.43; p < 0.001). Incidence was much lower in Vratza town; among residents of affected villages, the period-specific rates were 1.7 and 0.8 per 1,000 per year, respectively (rate ratio 0.47; p < 0.01). These trends were consistent across all villages for which registers were maintained. Median survival following registration increased from 2.0 to 5.0 years over the same period (p < 0.001). BEN appears to be decreasing in incidence in this region.
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Affiliation(s)
- P S Dimitrov
- Department of Epidemiology and Institute for International Health Michigan State University, USA
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