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Kumar Ramanathan AS, Karuppiah B, Vijayan M, Raju K, Mani D, Chinniah R, Thirunavukkarasu M, Malini Ravi P, Illiayaraja Krishnan J, Senguttuvan P. Effect of angiotensin converting enzyme gene I/D polymorphism in South Indian children with nephrotic syndrome. J Biomed Res 2019; 33:201-207. [PMID: 30333281 PMCID: PMC6551426 DOI: 10.7555/jbr.32.20150095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Nephrotic syndrome is one of the most common childhood kidney diseases. It is mostly found in the age group of 2 to 8 years. Around 10%–15% of nephrotic syndrome cases are non-responders of steroid treatment (SRNS). Angiotensin converting enzyme (ACE) (I/D) gene association studies are important for detecting kidney disease and herein we assessed the association of ACE (I/D) polymorphism with nephrotic syndrome in South Indian children. We recruited 260 nephrotic syndrome (162 boys and 98 girls) and 218 (140 boys and 78 girls) control subjects. ACE I/D polymorphism was analyzed by PCR using genotype allele specific primers. In ACE (I/D), we did not find significant association for the ungrouped data of nephrotic syndrome children and the control subjects. Kidney biopsies were done in 86 nephrotic syndrome cases (minimal change disease, n=51; focal segmental glomerulosclerosis, n=27; diffuse mesangial proliferation, n=8). We segregated them into the minimal change disease / focal segmental glomerulosclerosis groups and observed that the ACE
‘D’ allele was identified with borderline significance in cases of focal segmental glomerulosclerosis and the ‘I’ allele was assessed as having very weak association in cases of minimal change disease. ‘II’ genotype was weakly associated with minimal change disease. Gender specific analysis revealed weak association of ‘ID’ genotype with female nephrotic syndrome in females. Dominant expression of DD genotype was observed in males with nephrotic syndrome. Our finding indicated that ACE (I/D) has moderate association with focal segmental glomerulosclerosis. However, due to the limited number of biopsy proven focal segmental glomerulosclerosis subjects enrolled, further studies are required to confirm these results.
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Affiliation(s)
- Aravind Selvin Kumar Ramanathan
- Department of Pediatric Nephrology, Institute of Child Health and Hospital for Children, Chennai, Tamil Nadu 600008, India.,Department of Medical Genetics, The Tamil Nadu Dr. M.G.R. Medical University, Chennai, Tamil Nadu 600032, India
| | - Balakrishnan Karuppiah
- Department of Immunology, School of Biological Sciences, Madurai Kamaraj University, Madurai, Tamil Nadu 625021, India
| | - Murali Vijayan
- Department of Biotechnology and Genetic Engineering, Bharathidasan University, Tiruchirappalli, Tamil Nadu 620024, India
| | - Kamaraj Raju
- Department of Immunology, School of Biological Sciences, Madurai Kamaraj University, Madurai, Tamil Nadu 625021, India
| | - Dhivakar Mani
- Department of Immunology, School of Biological Sciences, Madurai Kamaraj University, Madurai, Tamil Nadu 625021, India
| | - Rathika Chinniah
- Department of Immunology, School of Biological Sciences, Madurai Kamaraj University, Madurai, Tamil Nadu 625021, India
| | - Manikandan Thirunavukkarasu
- Department of Biotechnology and Genetic Engineering, Bharathidasan University, Tiruchirappalli, Tamil Nadu 620024, India
| | - Padma Malini Ravi
- Department of Immunology, School of Biological Sciences, Madurai Kamaraj University, Madurai, Tamil Nadu 625021, India
| | | | - Prabha Senguttuvan
- Department of Pediatric Nephrology, Institute of Child Health and Hospital for Children, Chennai, Tamil Nadu 600008, India.,Department of Pediatric Nephrology, Dr. Mehta's Children's Hospital, Chennai, Tamil Nadu 600031, India
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Monajemzadeh M, Hesami M, Shahsiah R, Vasei M, Hooshmand S, Tanzifi P, Hajizadeh N, Ataei N, Mehrkash M, Javadi Larijani F, Moghtaderi M, Bazargani B, Khorvash R, Soleimanifar N. Angiotensin-Converting Enzyme Gene Polymorphism in Children with Idiopathic Nephrotic Syndrome, Effect on Biopsy Findings. Fetal Pediatr Pathol 2017; 36:265-275. [PMID: 28481137 DOI: 10.1080/15513815.2017.1287229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Angiotensin converting enzyme (ACE) converts angiotensin I into angiotensin II. The ACE gene shows an I/D polymorphism, which correlates with ACE concentrations. The aim of this study is to evaluate the distribution of the ACE I/D genotype in children with idiopathic nephrotic syndrome (INS) and healthy controls and study the effect of this polymorphism on clinical and pathologic findings. METHODS ACE gene I/D polymorphism of 104 patients with INS and 119 controls were determined. RESULTS The DD, ID, and II genotypes were found in 58.7%, 22.1%, and 19.2% of the patients, and in 79.8%, 2.5%, and 17.6% of controls, respectively (p > 0.05). The ID genotype was seen more frequently in patients resistant to treatment. CONCLUSION The observed differences with previous reports suggest the influence of the genetic background on disease course. The ACE I/D gene polymorphism's role seems to be more important in renal disease progression than susceptibility.
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Affiliation(s)
| | - Mahshid Hesami
- a Tehran University of Medical Sciences , Pathology , Tehran , Iran
| | - Reza Shahsiah
- a Tehran University of Medical Sciences , Pathology , Tehran , Iran
| | - Mohammad Vasei
- a Tehran University of Medical Sciences , Pathology , Tehran , Iran
| | | | - Parin Tanzifi
- a Tehran University of Medical Sciences , Pathology , Tehran , Iran
| | | | | | - Mehryar Mehrkash
- a Tehran University of Medical Sciences , Pathology , Tehran , Iran
| | | | | | - Behnaz Bazargani
- a Tehran University of Medical Sciences , Pathology , Tehran , Iran
| | - Reza Khorvash
- a Tehran University of Medical Sciences , Pathology , Tehran , Iran
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Tabel Y, Berdeli A, Mir S, Serdaroğlu E, Yilmaz E. Effects of Genetic Polymorphisms of the Renin-Angiotensin System in Children with Nephrotic Syndrome. J Renin Angiotensin Aldosterone Syst 2016; 6:138-44. [PMID: 16525944 DOI: 10.3317/jraas.2005.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background. The renin-angiotensin system (RAS) has been considered to be responsible for the pathogenesis or progression of many diseases which may or may not be related to kidney. Genetic polymorphisms of the various components of the RAS have been associated with differences in the clinical course of several disease states in adults and children.Objectives. The purpose of our study was to investigate RAS gene polymorphisms in patients with steroid resistant primary focal segmental glomerulosclerosis (FSGS) and nephrotic syndrome responding to steroid therapy. Furthermore, we aimed to investigate whether there was an association between polymorphic alleles and responses to steroid therapy, the degree of renal dysfunction, and prevalence of end-stage renal disease (ESRD).Material and methods. One hundred and fifty-eight children with the diagnosis of nephrotic syndrome were recruited from the Nephrology unit in the Department of Paediatrics of Ege University. Forty-nine of them were classified as renal biopsy-proven FSGS and 102 patients were considered to have response to steroid treatment. Renal functional impairment was detected in 19 subjects with FSGS and end-stage renal insufficiency in 13 patients. The control group consisted of 287 healthy adult subjects. Angiotensin-converting enzyme (ACE), angiotensin II type 1 receptor (AT1R) and angiotensinogen (AGT) gene polymorphisms were determined by the polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) technique. Statistical significance was regarded as p<0.05.Results. There were no statistically significant differences for the C allele of AT1R or the T allele of AGT genes between the children with nephrotic syndrome and control group, but on the other hand statistically significant differences were detected for D allele of ACE gene. There was no significant relationship detected between the D allele of ACE, the C allele of AT1R or the T allele of AGT genes and response to steroid therapy, extent of renal dysfunction and the progression to ESRD. However, there was a significant relationship between T allele of AGT gene and resistance to steroid treatment (OR; 4,837, 95% CI; 1,723—13,577, p=0.01), renal dysfunction (OR; 3,189, 95% CI; 0,999—10,182, p=0.041) and progression to ESRD (OR; 3,852, 95% CI; 1,057—14,040, p=0.03).Conclusion. In this study, the angiotensino gene -235T allele was found to be related with steroid resistance, renal dysfunction and progression of ESRD in nephrotic syndrome.
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Affiliation(s)
- Yilmaz Tabel
- Department of Pediatric Nephrology, Ege University School of Medicine, Ismir, Turkey.
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Batinić D, Sertić J, Ćorić M, Konjevoda P, Batinić D, Milošević D. Angiotensin-converting enzyme genotype is not a significant genetic risk factor for idiopathic nephrotic syndrome in Croatian children. Nephron Clin Pract 2015; 130:29-34. [PMID: 25997642 DOI: 10.1159/000382036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 04/01/2015] [Indexed: 11/19/2022] Open
Abstract
AIM The association of the angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism with idiopathic nephrotic syndrome (INS) is controversial. Only scarce information on European populations is available. The aim of the study was to investigate the distribution of the ACE gene I/D polymorphism and its impact on INS in children from Croatia. MATERIALS AND METHODS Ninety-five children with INS were investigated: 30 with minimal change disease (MCD), 35 with mesangial proliferative glomerulonephritis (MesPGN) and 30 with focal segmental glomerulosclerosis (FSGS). The control group consisted of 73 healthy adults. ACE gene was analyzed using the PCR method. The results were correlated with clinical features, renal morphology and response to immunosuppresive therapy. RESULTS There was no correlation of ACE genotype with gender, age of the disease onset, level of proteinuria, presence of hematuria or hypertension, and GFR at onset of the disease. No statistically significant differences in ACE genotype or allele frequencies between the controls and whole group of patients, MCD group, MesPGN group, FSGS group, steroid sensitive (SS) patients, steroid resistant (SR) patients, as well as each other, were found, although DD genotype tended to be more frequent in FSGS patients, SR patients, and frequent relapsers. Among 11 children treated with cyclophosphamide the D allele was significantly higher among non-responders (p = 0.003). CONCLUSION DD genotype is not a genetic risk factor for acquiring INS nor significant phenotype modifier regarding to clinical and pathohistological picture and response to steroids in Croatian children. The potential application of ACE genotyping in predicting cyclophosphamide response deserves further investigation.
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Affiliation(s)
- Danko Batinić
- Department of Pediatric Nephrology, Clinical Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
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Hanna MOF, Shahin RMH, Meshaal SS, Kostandi IF. Susceptibility and progression of end stage renal disease are not associated with angiotensin II type 1 receptor gene polymorphism. J Recept Signal Transduct Res 2014; 35:381-5. [PMID: 25316403 DOI: 10.3109/10799893.2014.956757] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
CONTEXT The role of the angiotensin II type 1 receptor (AT1R) gene polymorphism, A1166C, has been shown to be associated with end stage renal disease (ESRD) and its progression. There is also some evidence that HLA class II alleles are associated with ESRD independent of other factors. OBJECTIVE To examine the association between AT1R gene polymorphism in the susceptibility and progression to ESRD in patients with chronic renal failure and to investigate if the AT1R genotypes and HLA-DR alleles predict the time to ESRD. MATERIALS AND METHODS Genotyping was performed in 50 ESRD patients and 44 control subjects for the AT1R A1166C gene polymorphism using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). ESRD patients were examined for HLA-DRB1 alleles according to a reverse hybridization line probe assay. RESULTS Allele and genotype frequencies of the AT1R polymorphism did not differ significantly between ESRD patients and controls. Furthermore, there was no association between the AT1R gene polymorphism or HLA-DRB1 alleles with the time to the occurrence of end stage failure. DISCUSSION AND CONCLUSION We concluded that the AT1R genotype does not contribute to the genetic susceptibility of ESRD and is not associated with progression of chronic kidney failure to ESRD.
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Affiliation(s)
| | | | | | - Inas F Kostandi
- b Department of Internal Medicine , Faculty of Medicine, Cairo University , Kasr Al Ainy , Cairo , Egypt
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Mohd R, Wahab ZA, Cader R, Gafor HA, Radzi AM, Shah SA, Tong NKC. Angiotensin-converting enzyme gene polymophism in adult primary focal segmental glomerulosclerosis. J Clin Med Res 2014; 6:245-51. [PMID: 24883149 PMCID: PMC4039095 DOI: 10.14740/jocmr1550w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2013] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Primary focal segmental glomerulosclerosis (FSGS) accounts for a third of biopsy-proven primary glomerulonephritis in Malaysia. Pediatric studies have found the insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene to be associated with renal disease progression. The aim of this study was to determine the prevalence of the ACE (I/D) genotypes in adult primary FSGS and its association with renal outcome on follow-up. METHODS Prospective observational study involving primary FSGS patients was conducted. Biochemical and urine tests at the time of study were compared to the time of the diagnosis and disease progression analyzed. ACE gene polymorphism was identified using polymerase chain reaction amplification technique and categorized into II, ID and DD genotypes. RESULTS Forty-five patients with a median follow-up of 3.8 years (interquartile range: 1.8 - 5.6) were recruited. The commonest genotype was II (n = 23, 51.1%) followed by ID (n = 19, 42.2%) and DD (n = 3, 6.7%). The baseline characteristics were comparable between the II and non-II groups at diagnosis and at study recruitment except that the median urine protein-creatinine index was significantly lower in the II group compared to the non-II group (0.02 vs. 0.04 g/mmol (P = 0.03). Regardless of genotypes, all parameters of renal outcome improved after treatment. CONCLUSION The II followed by ID genotypes were the predominant ACE gene alleles in our FSGS. Although the D allele has been reported to have a negative impact on renal outcome, treatment appeared to be more important than genotype in preserving renal function in this cohort.
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Affiliation(s)
- Rozita Mohd
- Department of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Zaimi Abdul Wahab
- Department of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Rizna Cader
- Department of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Halim A. Gafor
- Department of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | | | - Shamsul Azhar Shah
- Department of Community Health, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Norella Kong Chiew Tong
- Department of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
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Zhou TB, Ou C, Qin YH, Su LN, Lei FY, Huang WF, Zhao YJ, Pang YS, Yang KP. Association of angiotensin converting enzyme insertion/deletion gene polymorphism with idiopathic nephrotic syndrome susceptibility in children: a meta-analysis. J Renin Angiotensin Aldosterone Syst 2011; 12:601-10. [PMID: 21946394 DOI: 10.1177/1470320311422578] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background and objective: Angiotensin converting enzyme (ACE) gene contains either an insertion (I) allele or a deletion (D) allele forming three potential genotypes: II, ID and DD. The D allele or DD genotype has been reported to be associated with higher plasma ACE level. An assessment of the association between ACE I/D gene polymorphism and idiopathic nephrotic syndrome (INS) susceptibility in children is still controversial. This meta-analysis was performed to evaluate the association between ACE I/D gene polymorphism and the onset of INS. Method: A predefined literature search and selection of eligible relevant studies were performed to collect data from electronic databases, and eligible investigations were synthesized using the meta-analysis method. Results: Nine investigations were identified for the analysis of association between ACE I/D gene polymorphism and INS risk in children, including six in Asians, one study for Caucasians and two for Africans. There was positive association between D allele or DD genotype and INS susceptibility in Asians (OR = 1.75, p = 0.01; OR = 2.01, p = 0.02), but not for Caucasian children and Africans (for Caucasians, D: OR=1.35, p = 0.27, DD: OR = 0.95, p = 0.91; for Africans, D: OR = 1.70, p = 0.56, DD: OR = 1.60, p = 0.73). Furthermore, II homozygous seemed to play a positive role against INS onset for Asians (OR = 0.59, p = 0.02), but the link between II genotype and INS risk was not observed in Caucasian children and Africans (Caucasians: OR = 0.31, p = 0.06; Africans: OR = 0.50, p = 0.59). Conclusions: D allele and DD homozygous might become significant genetic molecular markers for INS susceptibility in Asian children, but the association was not observed in Caucasians or Africans. However, the conclusion from our study cannot be sustained and more investigations on larger sample in different populations are required to further clarify the role of D allele or DD homozygous in the onset of INS in difference races.
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Affiliation(s)
- Tian-Biao Zhou
- Department of Pediatrics, The First Affiliated Hospital of GuangXi Medical University, NanNing, China
| | - Chao Ou
- Department of Experimental Pathology, The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Yuan-Han Qin
- Department of Pediatrics, The First Affiliated Hospital of GuangXi Medical University, NanNing, China
| | - Li-Na Su
- Department of Pediatrics, The First Affiliated Hospital of GuangXi Medical University, NanNing, China
| | - Feng-Ying Lei
- Department of Pediatrics, The First Affiliated Hospital of GuangXi Medical University, NanNing, China
| | - Wei-Fang Huang
- Department of Pediatrics, The First Affiliated Hospital of GuangXi Medical University, NanNing, China
| | - Yan-Jun Zhao
- Department of Pediatrics, The First Affiliated Hospital of GuangXi Medical University, NanNing, China
| | - Yu-Sheng Pang
- Department of Pediatrics, The First Affiliated Hospital of GuangXi Medical University, NanNing, China
| | - Kun-Peng Yang
- Department of Internal Medicine, Township Health Centers of ShilLing in LongQuan district, ChengDu, China
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Zhou TB, Qin YH, Su LN, Lei FY, Huang WF, Zhao YJ, Pang YS. Insertion/Deletion (I/D) Polymorphism of Angiotensin-Converting Enzyme Gene in Steroid-Resistant Nephrotic Syndrome for Children: A Genetic Association Study and Meta-analysis. Ren Fail 2011; 33:741-8. [PMID: 21787164 DOI: 10.3109/0886022x.2011.589954] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Zhou TB, Qin YH, Su LN, Lei FY, Huang WF, Zhao YJ, Pang YS, Yang KP. The association between angiotensin-converting enzyme insertion/deletion gene variant and risk of focal segmental glomerulosclerosis: a systematic review and meta-analysis. J Renin Angiotensin Aldosterone Syst 2011; 12:624-33. [PMID: 21652690 DOI: 10.1177/1470320311410584] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The association of the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) gene polymorphism with the risk of focal segmental glomerulosclerosis (FSGS) is still controversial. A meta-analysis was performed to evaluate the association between ACE I/D gene polymorphism and FSGS susceptibility. METHOD We performed a predefined literature search and selection of eligible relevant studies to collect data from electronic databases. RESULTS In total, 12 articles were identified for the analysis of the association between ACE I/D gene polymorphism and FSGS risk. One report included an investigation in Arab and Jewish populations separately. Thus, there were seven reports in Asians, two in Caucasians, one in Africans, two in Arabs and one in Jews. In Asians, there was a markedly positive association between the D allele or DD genotype and FSGS susceptibility (p = 0.008; p = 0.002), and the II genotype may play a protective role against FSGS onset (p = 0.002). However, a link between ACE I/D gene polymorphism and FSGS risk was not found in Caucasians, Africans, Arabs or Jews (Caucasians: D: p = 0.11, DD: p = 0.19, II: p = 0.70; Africans: D: p = 0.40, DD: p = 0.49, II: p = 0.61; Arabs: D: p = 0.34, DD: p = 0.10, II: p = 0.42; Jews: D: p = 0.90, DD: p = 0.97, II: p = 0.83). CONCLUSION The D allele or DD homozygosity may become a significant genetic molecular marker for the onset of FSGS in Asians, but not for Caucasians, Africans, Arabs or Jews.
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Affiliation(s)
- Tian-Biao Zhou
- Department of Pediatrics, The First Affiliated Hospital of GuangXi Medical University, NanNing, China.
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Saber-Ayad M, Sabry S, Abdel-Latif I, Nabil H, El-Azm SA, Abdel-Shafy S. Effect of angiotensin-converting enzyme gene insertion/deletion polymorphism on steroid resistance in Egyptian children with idiopathic nephrotic syndrome. J Renin Angiotensin Aldosterone Syst 2010; 11:111-8. [DOI: 10.1177/1470320309359021] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Introduction. The presence of the deletion (D) allele in the angiotensin-converting enzyme (ACE) gene has been reported as a probable genetic risk factor for idiopathic nephrotic syndrome (INS), but its role in determining resistance to steroid therapy remains to be evaluated. Methods. Fifty-one patients were enrolled in the study and received oral steroids. The pattern of response to steroid therapy was determined. A group of 50 healthy adults served as a control group. The genotypes for ACE insertion (I)/D polymorphism were analysed using a PCR-based method. Results. Twenty patients were steroid sensitive (SS) and 31 were non-SS. The presence of hypertension at presentation was significantly related to steroid unresponsiveness. Among the SS group, the frequencies of the II, ID, and DD genotypes of the ACE gene were 20% (n=4), 65% (n=13), and 15% (n=3), respectively, while the frequencies among the non-SS group were 19.4% (n=6), 74.2% (n=23), and 6.5% (n=2), respectively. The differences between the two groups were not statistically significant (Chi square=0.59). Conclusion. The current study on Egyptian children with INS reveals no association between the ACE gene I/D polymorphism and clinical parameters, histological findings, and steroid resistance.
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Affiliation(s)
- Maha Saber-Ayad
- Department of Pharmacology, Faculty of Medicine, Cairo University, Giza, Egypt,
| | - Samar Sabry
- Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Inas Abdel-Latif
- Department of Biochemistry, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Hanaa Nabil
- Department of Pharmacology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Soheir Abo El-Azm
- Department of Pharmacology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Sanaa Abdel-Shafy
- Department of Clinical Pathology, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt
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Akman B, Tarhan Ç, Arat Z, Sezer S, Özdemir F. Renin-Angiotensin System Polymorphisms: A Risk Factor for Progression to End-Stage Renal Disease in Vesicoureteral Reflux Patients. Ren Fail 2009; 31:196-200. [DOI: 10.1080/08860220802669826] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Rudnicki M, Mayer G. Significance of genetic polymorphisms of the renin–angiotensin–aldosterone system in cardiovascular and renal disease. Pharmacogenomics 2009; 10:463-76. [DOI: 10.2217/14622416.10.3.463] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The angiotensin converting enzyme (ACE) is a component of the renin–angiotensin–aldosterone system (RAAS). The RAAS – involved primarily in blood pressure and sodium homeostasis – is activated in many renal and cardiovascular diseases, and therapy with ACE inhibitors and other blockers of the RAAS has proven to be clinically beneficial. Plasma and tissue levels of ACE are at least partially determined by a genetic polymorphism based on the presence (insertion [I]) or absence (deletion [D]) of a 287 base pair element in intron 16. In particular Asian subjects with the DD genotype (and increased ACE activity) have been reported to be at higher risk for cardiovascular disorders and nephropathy. Numerous studies evaluated the role of the ACE I/D polymorphism as well as other genetic variants of the RAAS in the context of RAAS inhibitor therapy. However, as race and environmental factors, such as salt intake also affect treatment response most studies were underpowered leading to conflicting results.
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Affiliation(s)
- Michael Rudnicki
- Department of Internal Medicine IV, (Nephrology and Hypertension), Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
| | - Gert Mayer
- Department of Internal Medicine IV, (Nephrology and Hypertension), Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
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Mottl AK, Shoham DA, North KE. Angiotensin II type 1 receptor polymorphisms and susceptibility to hypertension: a HuGE review. Genet Med 2008; 10:560-74. [PMID: 18641512 PMCID: PMC4993203 DOI: 10.1097/gim.0b013e3181809613] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The angiotensin II type 1 receptor (AGTR1) plays an integral role in blood pressure control, and is implicated in the pathogenesis of hypertension. Polymorphisms within this gene have been extensively studied in association with hypertension; however, findings are conflicting. To clarify these data, we conducted a systematic review of association studies of AGTR1 polymorphisms and hypertension, and performed a meta-analysis of the rs5186 variant. Results show that the currently available literature is too heterogeneous to draw meaningful conclusions. The definition of hypertension and gender composition of individual studies helps to explain this heterogeneity. Although the structure and splicing pattern of AGTR1 would suggest a likely effect of polymorphisms within the promoter region on gene function, few studies have been conducted thus far. In conclusion, there is insufficient evidence that polymorphisms in the AGTR1 gene are risk factors for hypertension. However, most studies are inadequately powered, and larger well-designed studies of haplotypes are warranted.
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Affiliation(s)
- Amy K Mottl
- Division of Nephrology and Hypertension, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA.
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Ruggenenti P, Bettinaglio P, Pinares F, Remuzzi G. Angiotensin converting enzyme insertion/deletion polymorphism and renoprotection in diabetic and nondiabetic nephropathies. Clin J Am Soc Nephrol 2008; 3:1511-25. [PMID: 18550651 DOI: 10.2215/cjn.04140907] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Despite the huge amount of studies looking for candidate genes, the ACE gene remains the unique, well-characterized locus clearly associated with pathogenesis and progression of chronic kidney disease, and with response to treatment with drugs that directly interfere with the renin angiotensin system (RAS), such as angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor antagonists (ARA). The II genotype is protective against development and progression of type I and type II nephropathy and is associated with a slower progression of nondiabetic proteinuric kidney disease. ACE inhibitors are particularly effective at the stage of normoalbuminuria or microalbuminuria in both type I and type II diabetics with the II genotype, whereas the DD genotype is associated with a better response to ARA therapy in overt nephropathy of type II diabetes and to ACE inhibitors in male patients with nondiabetic proteinuric nephropathies. The role of other RAS or non-RAS polymorphisms and their possible interactions with different ACE I/D genotypes are less clearly defined. Thus, evaluating the ACE I/D polymorphism is a reliable tool to identify patients at risk and those who may benefit the most of renoprotective therapy with ACE inhibitors or ARA. This may guide pharmacologic therapy in individual patients and help design clinical trials in progressive nephropathies. Moreover, it might help optimize prevention and intervention strategies at population levels, in particular, in countries where resources are extremely limited and 1 million patients continue to die every year of cardiovascular or renal disease.
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Affiliation(s)
- Piero Ruggenenti
- Clinical Research Centre for Rare Diseases Aldo e Cele Daccò, Mario Negri Institute for Pharmacological Research, Villa Camozzi, Ranica, Italy
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Serdaroglu E, Mir S, Berdeli A, Aksu N, Bak M. ACE gene insertion/deletion polymorphism in childhood idiopathic nephrotic syndrome. Pediatr Nephrol 2005; 20:1738-43. [PMID: 16208534 DOI: 10.1007/s00467-005-2010-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2005] [Revised: 04/22/2005] [Accepted: 05/20/2005] [Indexed: 10/25/2022]
Abstract
The aim of this study was to determine the distribution of angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism, and its effects on clinical, laboratory, histological findings, treatment responses and progression to end-stage renal disease in childhood idiopathic nephrotic syndrome (NS). 227 children diagnosed with idiopathic NS were included in the study. Eighty-three of patients were steroid resistant and 77 of patients were focal segmental glomerulosclerosis. The control group was consisted of 287 unrelated healthy adult volunteers. ACE gene I/D polymorphism were analyzed by using PCR based method. In the entire group of children with NS, the frequencies of the II, ID, and DD genotypes of ACE gene were 13.7%, 38.3% and 48%, respectively. D allele frequency was higher in NS group than control group (0.67 vs. 0.56, p=0.001). Percentage of frequent relapser patients was found more frequently in ID or DD genotype (38.7%) than II genotype (15%) when only steroid sensitive patients were evaluated (p=0.045). The D-allele frequency was 0.65, 0.69 and 0.68 respectively in focal segmental glomerulosclerosis, biopsy proven minimal change and entire minimal change group (p>0.05) and 0.69 and 0.64 respectively in steroid sensitive and resistant groups (p>0.05). D allele frequency was not significantly different in patients with or without end-stage renal disease (0.64 vs. 0.67 respectively, p>0.005) when 115 patients who were at least five year follow-up were evaluated. The D allele frequency was higher in NS patients than healthy controls and DD or ID genotype was related with frequent relapses. ACE gene I/D polymorphism was not important in laboratory and histological findings and progression of the disease in children with NS.
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Affiliation(s)
- Erkin Serdaroglu
- Department of Pediatric Nephrology, Ege University Medical School, Izmir, Turkey.
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Chung FM, Yang YH, Chen CH, Lin CC, Shieh TY. Angiotensin-converting enzyme gene insertion/deletion polymorphism is associated with risk of oral precancerous lesion in betel quid chewers. Br J Cancer 2005; 93:602-6. [PMID: 16136034 PMCID: PMC2361601 DOI: 10.1038/sj.bjc.6602746] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
To investigate whether angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism is related to the risk of oral precancerous lesions (OPL) in Taiwanese subjects who chew betel quid, a total of 61 betel quid chewers having OPL were compared with 61 asymptomatic betel quid chewers matched for betel quid chewing duration and dosage. The frequency of homozygote for ACE D variant is significantly higher in the case subjects than that of the controls (44.3 vs 24.6%; P=0.0108). The adjusted odds ratio of the D homozygous for the risk of OPL is 8.10 (95% confidence interval (CI)=2.04–32.19, P=0.003). In the allelic base analysis, the D allele is also significantly associated with higher risk of OPL. When grouping the study subjects by smoking status, the association between ACE I/D polymorphism and risk of OPL was only observed in nonsmokers. Our results support the theory that genetic factors may contribute to the susceptibility of OPL and suggest that smoking and genetic factors may be differently involved in the development of OPL.
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Affiliation(s)
- F-M Chung
- Department of Clinical Research, Pingtung Christian Hospital, Pingtung 900, Taiwan
- Graduate Institute of Dental Sciences, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Y-H Yang
- Graduate Institute of Oral Health Sciences, College of Dental Medicine, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung 807, Taiwan
- Statistical Analysis Laboratory, Department of Clinical Research, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung 807, Taiwan
| | - C-H Chen
- Graduate Institute of Dental Sciences, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - C-C Lin
- Graduate Institute of Dental Sciences, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - T-Y Shieh
- Graduate Institute of Oral Health Sciences, College of Dental Medicine, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung 807, Taiwan
- Graduate Institute of Oral Health Sciences, College of Dental Medicine, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung 807, Taiwan. E-mail:
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Kuppusamy UR, Indran M, Ahmad T, Wong SW, Tan SY, Mahmood AA. Comparison of oxidative damage in Malaysian end-stage renal disease patients with or without non-insulin-dependent diabetes mellitus. Clin Chim Acta 2005; 351:197-201. [PMID: 15563890 DOI: 10.1016/j.cccn.2004.09.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2004] [Revised: 09/21/2004] [Accepted: 09/21/2004] [Indexed: 11/17/2022]
Abstract
BACKGROUND Comparisons of oxidative indices and total antioxidant status between end-stage renal disease (ESRD) patients with or without diabetes is scant, especially in the Asian population. METHOD The assays were carried out according to known established protocols. RESULT The present study showed that ESRD patients with or without non-insulin-dependent diabetes mellitus (NIDDM) did not have any significant differences in antioxidant enzyme activities, advanced glycated end products (AGE), advanced oxidized protein products (AOPP) and ferric reducing ability of plasma (FRAP), indicating that hyperglycemia does not exacerbate oxidative damage in ESRD. The regulation of catalase and glutathione peroxidase is also altered in ESRD. Elevated FRAP was observed in both ESRD groups (with and without NIDDM). The dialysis process did not alter the antioxidant enzyme activities but decreased AGEs and FRAP and increased AOPP levels. CONCLUSION Oxidative stress is present in ESRD but this is not significantly exacerbated by hyperglycemia. The contribution of components in the pathology of renal failure towards oxidative stress exceeds that of hyperglycemia.
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Affiliation(s)
- U R Kuppusamy
- Department of Molecular Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
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Bantis C, Heering PJ, Luther Y, Aker S, Kuhr N, Grabensee B, Ivens K. Influence of cytokine gene polymorphisms on focal segmental glomerulosclerosis. Am J Nephrol 2004; 24:427-31. [PMID: 15308875 DOI: 10.1159/000080186] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2004] [Accepted: 07/08/2004] [Indexed: 11/19/2022]
Abstract
BACKGROUND Recently, polymorphisms of cytokine genes have been associated with modified gene expression and increased cytokine production. We evaluated the influence of TGF-beta(1) gene Arg(25)-->Pro, TNF alpha gene G-308A and IL-6 gene G-174C polymorphisms on the clinical manifestations of focal segmental glomerulosclerosis (FSGS). METHODS The clinical course of 71 patients with biopsy-proven primary FSGS followed up for 6.0 +/- 4.4 years was studied. Patients were classified according to the slope of reciprocal serum creatinine into slow (n = 49) and fast (n = 22) progressors. One hundred healthy volunteers were analysed as controls. Genetic polymorphisms were determined by PCR amplification. RESULTS The genotype distribution of the studied polymorphisms was similar in patients and controls (n.s.). Age, initial renal function, proteinuria and blood pressure did not differ significantly between patients with different genotypes (n.s.). The investigated polymorphisms were not associated with the progression of FSGS as shown by the similar genotype frequencies among slow and fast progressors (n.s.) and the renal survival in the Kaplan-Meier analysis (n.s.). CONCLUSION Our results indicate that TGF-beta(1) gene Arg(25)-->Pro, TNF alpha gene G-308A and IL-6 gene G-174C polymorphisms are not risk factors or markers of progression in focal segmental glomerulosclerosis.
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Affiliation(s)
- Christos Bantis
- Department of Nephrology, Heinrich-Heine University of Düsseldorf, DE-40225 Düsseldorf, Germany
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