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Karimian M, Yaqubi S, Karimian Z. The eNOS-G894T genetic polymorphism and risk of preeclampsia: A case-control study, an updated meta-analysis, and a bioinformatic assay. Cytokine 2023; 169:156283. [PMID: 37356259 DOI: 10.1016/j.cyto.2023.156283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 06/18/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVES Preeclampsia (PE) is a leading cause of maternal death worldwide and involves vascular endothelial dysfunction. The aim of this study was to investigate the association of the G894T polymorphism in the endothelial nitric oxide synthase (eNOS) gene and the risk of preeclampsia in a case-control design in an Iranian population, which was followed by a meta-analysis and an in silico approach. METHODS In the case-control study, 300 people including 135 pregnant women with preeclampsia and 165 healthy pregnant women were included. The genotype of G894T polymorphism was determined by the PCR-RFLP method. We searched authoritative scientific databases to find eligible studies for meta-analysis. The odds ratio with a 95% confidence interval was estimated to find the strength of the association of the mentioned polymorphism with the risk of preeclampsia. In addition, the effect of G894T transversion on eNOS gene function was evaluated by some bioinformatics tools. RESULTS Our case-control data showed that the G894T polymorphism is associated with an increased risk of preeclampsia. In the meta-analysis, 33 eligible studies were included, and the results showed that the G894T polymorphism is associated with an increased risk of preeclampsia in the overall analysis and some stratified analyses. In addition, the structural analysis showed that the G894T variant can affect the splicing process as well as the protein stability. CONCLUSIONS Based on the results, the aforementioned polymorphism may be a risk factor for preeclampsia and could be considered a potential molecular biomarker for screening susceptible individuals.
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Affiliation(s)
- Mohammad Karimian
- Department of Molecular and Cell Biology, Faculty of Basic Sciences, University of Mazandaran, Babolsar, Iran.
| | - Sahar Yaqubi
- Department of Molecular and Cell Biology, Faculty of Basic Sciences, University of Mazandaran, Babolsar, Iran
| | - Zahra Karimian
- Department of Midwifery, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
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Alanazi AS, Victor F, Rehman K, Khan YH, Yunusa I, Alzarea AI, Akash MSH, Mallhi TH. Pre-Existing Diabetes Mellitus, Hypertension and KidneyDisease as Risk Factors of Pre-Eclampsia: A Disease of Theories and Its Association with Genetic Polymorphism. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16690. [PMID: 36554576 PMCID: PMC9778778 DOI: 10.3390/ijerph192416690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 11/25/2022] [Accepted: 12/03/2022] [Indexed: 06/17/2023]
Abstract
Pre-existing diabetes, hypertension and kidney disorders are prominent risk factors of pre-eclampsia (PE). It is a multifactorial pregnancy disorder associated with high blood pressure, proteinuria, and multiorgan failure, which develops after the 20th week of pregnancy. It is one of the most feared pregnancy disorders, as it consumes thousands of fetomaternal lives per annum. According to clinical and pathological studies, the placenta appears to be a key player in the pathogenesis of PE; however, the exact origin of this disorder is still under debate. Defective placentation and angiogenesis are the hallmarks of PE progression. This angiogenic imbalance, together with maternal susceptibility, might determine the severity and clinical presentation of PE. This article comprehensively examines the mechanisms of pathogenesis of PE and current evidence of the factors involved in its progression. Finally, this article will explore the genetic association of PE, various candidate genes, their proposed mechanisms and variants involved in its pathogenesis.
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Affiliation(s)
- Abdullah Salah Alanazi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia
| | - Francis Victor
- Department of Pharmacy, University of Chenab, Gujrat 50700, Pakistan
| | - Kanwal Rehman
- Department of Pharmacy, The Women University, Multan 66000, Pakistan
| | - Yusra Habib Khan
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia
| | - Ismaeel Yunusa
- College of Pharmacy, University of South Carolina, Columbia, SC 29208, USA
| | | | | | - Tauqeer Hussain Mallhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia
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Gathiram P, Moodley J. The Role of the Renin-Angiotensin-Aldosterone System in Preeclampsia: a Review. Curr Hypertens Rep 2020; 22:89. [PMID: 32893333 DOI: 10.1007/s11906-020-01098-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW Preeclampsia (PE) is a complex human pregnancy-specific condition and is clinically characterized by new onset hypertension and proteinuria in the second half of pregnancy. The precise etiology of PE is unknown, but much of the pathophysiology has been elucidated, and it is accepted that the disorder is multifactorial in nature. Historically, because of the presence of proteinuria, the role of the renin-angiotensin-aldosterone system (RAAS) has been considered in the etiology of PE. However, the results of studies (including maternal circulatory angiotensin II, urinary angiotensinogen, plasma renin and prorenin, AT1 receptor antibodies, and gene polymorphisms) on the role of the RAAS in the etiology of PE have proved controversial. The purpose of this narrative review was to evaluate the contemporary literature on the RAAS and its role in the pathophysiology of pregnancy. RECENT FINDINGS The current review shows that although the RAAS has a role in the development of normal pregnancy, it does not have a significant role in the pathophysiology of PE except for the AT1-AA components. Despite many researchers having measured increases in s[P}RR and [P]RR, this may be independent of the RAAS. Our view is in keeping with contemporary thinking that the placenta rather than the RAAS plays a central role in elaborating pro-inflammatory factors (antiangiogenic and angiogenic) into the maternal circulation resulting in widespread endothelial dysfunction in all organ systems including the renal system.
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Affiliation(s)
- Premjith Gathiram
- Department of Family Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Jagidesa Moodley
- Department of Obstetrics and Gynaecology, Women's Health and HIV Research Group, University of KwaZulu-Natal, Durban, South Africa. .,College of Health Sciences, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.
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Liu Y, Li P. Meta-analysis of angiotensin-converting enzyme insersion/delection polymorphism and pre-eclampsia susceptibility. J Obstet Gynaecol Res 2020; 46:1744-1757. [PMID: 32643244 DOI: 10.1111/jog.14369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 05/13/2020] [Accepted: 06/10/2020] [Indexed: 01/11/2023]
Abstract
AIM In recent years, there were many studies on angiotensin-converting enzyme insersion/delection (ACE I/D) polymorphism and pre-eclampsia susceptibility, but the conclusion was still inconclusive. Our study is to explore the relationship between the ACE I/D polymorphism and the risk of pre-eclampsia. METHODS The literature on the relationship between ACE I/D gene polymorphism and Pre-eclampsia susceptibility was obtained by searching the databases of Wanfang, VIP, Medline, CNKI, Embase, Pubmed and Springerlink, which was published from the establishment of the databases to October 2019. Taking the odds ratio (OR) value and its 95% confidence interval (CI) as the effect size, the Meta-analysis was carried out by using stata 15.0 software. RESULTS Thirty articles, consisting of 3184 patients and 3912 controls, were included. The results showed that allele D was compared with allele I, with the OR value of 1.29 (95% CI: 1.12 ~ 1.50, P < 0.05). Subgroup analysis showed that in Caucasians, allele D was associated with OR of 1.28 (95% CI: 1.08 ~ 1.53, P < 0.05). There was no significant difference in Asians. There was statistical significance in recessive gene model and homozygous gene model, as well as in that of Asian and Caucasian. In homozygous model, there was statistical significance, but subgroup analysis showed there was no statistical significance in Asian and Caucasian. There was no statistical significance in dominant model and heterozygous model. CONCLUSION The polymorphism of ACE I/D gene was associated with the risk of pre-eclampsia. Allele D and genotype DD may increase the risk of Pre-eclampsia in pregnant women.
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Affiliation(s)
- Yun Liu
- Department of obstetrics, Tianjin Nankai Hospital, Tianjin, China
| | - Ping Li
- Department of obstetrics, Tianjin Nankai Hospital, Tianjin, China
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5
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Huang T, Yan Y, Li J, Chen H, Chen Z. An insertion-deletion polymorphism in angiotensin-converting enzyme is associated with a reduced risk of preeclampsia: an evidence-based meta-analysis from 44 studies. Hypertens Pregnancy 2020; 39:336-347. [PMID: 32484368 DOI: 10.1080/10641955.2020.1769644] [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: 10/24/2022]
Abstract
Objective An updated meta-analysis was performed to evaluate the relationship between an insertion/deletion (I/D) polymorphism in angiotensin-converting enzyme (ACE) and preeclampsia (PE) risk. Methods Pubmed, OVID and China National Knowledge Infrastructure databases were searched. Pooled odds ratios with 95% confidence intervals were calculated using fixed-effects or random-effects model. Results ACE I/D polymorphism decreased the risk of PE in overall analysis. Subgroup analysis revealed a significantly lower risk of PE with ACE I/D polymorphism in Asians, Caucasians. The decreased risk was also found in severe PE and early-onset PE. Conclusion ACE I/D polymorphism may protect against the development of PE.
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Affiliation(s)
- Ting Huang
- Department of Obstetrics, Chongqing Health Center for Women and Children , Chongqing, P.R. China
| | - Yu Yan
- Department of Obstetrics, Chongqing Health Center for Women and Children , Chongqing, P.R. China
| | - Jianxin Li
- Department of Obstetrics, Chongqing Health Center for Women and Children , Chongqing, P.R. China
| | - Hong Chen
- Department of Obstetrics, Chongqing Health Center for Women and Children , Chongqing, P.R. China
| | - Zhen Chen
- Department of Obstetrics, Chongqing Health Center for Women and Children , Chongqing, P.R. China
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Timokhina EV, Strizhakov AN, Ignatko IV, Belousova VS, Ibragimova SM. Genetic Aspects of Preeclampsia: The Role of Polymorphisms in the Genes of the Renin-Angiotensin System. BIOCHEMISTRY (MOSCOW) 2019; 84:181-186. [PMID: 31216977 DOI: 10.1134/s0006297919020093] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Preeclampsia (PE) is a severe complication that develops in 10% pregnant women. It is the leading cause of maternal and perinatal morbidity and mortality worldwide. The goal of this study was to reveal the frequency of polymorphisms in the angiotensin-converting enzyme gene (ACE I/D) and type 1 angiotensin II receptor gene (AGTR1 A1166C) in pregnant women with severe early- and late-onset PE. A retrospective case-control study of 55 pregnant women with PE (main group) and 30 patients with uncomplicated pregnancy (control group) was conducted. In the main group, we considered two subgroups - early-onset PE (20 patients) and late-onset PE (36 patients). The I/D polymorphism of the ACE gene is associated with the risk of developing PE. The presence of the D allele increases the risk of severe PE. In case of DD genotype, the probability of early-onset PE is 5 times higher than that of the late-onset PE. The analyzed data confirm the involvement of renin-angiotensin system in the PE development. We conclude that the ACE gene polymorphism is a genetic predictor of the early-onset severe PE. Studying the polymorphic loci of the ACE gene makes it possible to use them for the individualized prognosis of the development and course of PE in patients.
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Affiliation(s)
- E V Timokhina
- Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, 119991, Russia.
| | - A N Strizhakov
- Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, 119991, Russia
| | - I V Ignatko
- Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, 119991, Russia
| | - V S Belousova
- Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, 119991, Russia
| | - S M Ibragimova
- Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, 119991, Russia
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7
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Townsend R, Khalil A, Premakumar Y, Allotey J, Snell KIE, Chan C, Chappell LC, Hooper R, Green M, Mol BW, Thilaganathan B, Thangaratinam S. Prediction of pre-eclampsia: review of reviews. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2019; 54:16-27. [PMID: 30267475 DOI: 10.1002/uog.20117] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 08/23/2018] [Accepted: 08/26/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Primary studies and systematic reviews provide estimates of varying accuracy for different factors in the prediction of pre-eclampsia. The aim of this study was to review published systematic reviews to collate evidence on the ability of available tests to predict pre-eclampsia, to identify high-value avenues for future research and to minimize future research waste in this field. METHODS MEDLINE, EMBASE and The Cochrane Library including DARE (Database of Abstracts of Reviews of Effects) databases, from database inception to March 2017, and bibliographies of relevant articles were searched, without language restrictions, for systematic reviews and meta-analyses on the prediction of pre-eclampsia. The quality of the included reviews was assessed using the AMSTAR tool and a modified version of the QUIPS tool. We evaluated the comprehensiveness of search, sample size, tests and outcomes evaluated, data synthesis methods, predictive ability estimates, risk of bias related to the population studied, measurement of predictors and outcomes, study attrition and adjustment for confounding. RESULTS From 2444 citations identified, 126 reviews were included, reporting on over 90 predictors and 52 prediction models for pre-eclampsia. Around a third (n = 37 (29.4%)) of all reviews investigated solely biochemical markers for predicting pre-eclampsia, 31 (24.6%) investigated genetic associations with pre-eclampsia, 46 (36.5%) reported on clinical characteristics, four (3.2%) evaluated only ultrasound markers and six (4.8%) studied a combination of tests; two (1.6%) additional reviews evaluated primary studies investigating any screening test for pre-eclampsia. Reviews included between two and 265 primary studies, including up to 25 356 688 women in the largest review. Only approximately half (n = 67 (53.2%)) of the reviews assessed the quality of the included studies. There was a high risk of bias in many of the included reviews, particularly in relation to population representativeness and study attrition. Over 80% (n = 106 (84.1%)) summarized the findings using meta-analysis. Thirty-two (25.4%) studies lacked a formal statement on funding. The predictors with the best test performance were body mass index (BMI) > 35 kg/m2 , with a specificity of 92% (95% CI, 89-95%) and a sensitivity of 21% (95% CI, 12-31%); BMI > 25 kg/m2 , with a specificity of 73% (95% CI, 64-83%) and a sensitivity of 47% (95% CI, 33-61%); first-trimester uterine artery pulsatility index or resistance index > 90th centile (specificity 93% (95% CI, 90-96%) and sensitivity 26% (95% CI, 23-31%)); placental growth factor (specificity 89% (95% CI, 89-89%) and sensitivity 65% (95% CI, 63-67%)); and placental protein 13 (specificity 88% (95% CI, 87-89%) and sensitivity 37% (95% CI, 33-41%)). No single marker had a test performance suitable for routine clinical use. Models combining markers showed promise, but none had undergone external validation. CONCLUSIONS This review of reviews calls into question the need for further aggregate meta-analysis in this area given the large number of published reviews subject to the common limitations of primary predictive studies. Prospective, well-designed studies of predictive markers, preferably randomized intervention studies, and combined through individual-patient data meta-analysis are needed to develop and validate new prediction models to facilitate the prediction of pre-eclampsia and minimize further research waste in this field. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- R Townsend
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
| | - A Khalil
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
| | - Y Premakumar
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
| | - J Allotey
- Women's Health Research Unit, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - K I E Snell
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK
| | - C Chan
- Pragmatic Clinical Trials Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - L C Chappell
- Department of Women and Children's Health, King's College London, London, UK
| | - R Hooper
- Pragmatic Clinical Trials Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - M Green
- Action on Pre-eclampsia (APEC) Charity, Worcestershire, UK
| | - B W Mol
- Department of Obstetrics and Gynaecology, School of Medicine, Monash University, Melbourne, Australia
| | - B Thilaganathan
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
| | - S Thangaratinam
- Women's Health Research Unit, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Cristina Dos Santos Lopes A, Perucci LO, Gontijo Evangelista FC, Godoi LC, de Paula Sabino A, Gomes KB, Talvani A, Dusse LMS, Alpoim PN. Association among ACE, ESR1 polymorphisms and preeclampsia in Brazilian pregnant women. Mol Cell Probes 2019; 45:43-47. [PMID: 31028794 DOI: 10.1016/j.mcp.2019.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 03/25/2019] [Accepted: 04/22/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND Genetic, immune and environmental factors are involved in preeclampsia (PE) etiopathogenesis. Considering that hypertension and poor placental perfusion are important features in PE, polymorphisms in the angiotensin-converting enzyme (ACE) and estrogen nuclear receptor 1 (ESR1) genes could be involved in the predisposition and/or development of the disease. The aim of this study was to evaluate if polymorphisms in ACE and ESR1 genes were associated with PE occurrence. MATERIAL AND METHODS This case-control study included 209 Brazilian pregnant women (107 with severe PE and 102 normotensive controls). The polymorphisms were investigated by polymerase chain reaction (PCR) followed by polyacrylamide gel electrophoresis. RESULTS No significant difference between PE versus normotensive pregnant women, as well as early versus late PE, was observed when compared the allelic and genotypic frequencies of insertion/deletion polymorphism in intron 16 of the ACE gene and the single nucleotide polymorphisms (SNPs - rs2234693 and rs9340799) of the ESR1 gene. CONCLUSION This pioneer study involving Brazilian women showed no association among the studied polymorphisms and PE, which suggests that ins/del ACE and SNPs ESR1 do not contribute to this disease occurrence in Brazil.
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Affiliation(s)
- Ana Cristina Dos Santos Lopes
- Department of Clinical and Toxicological Analyses - Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Luiza Oliveira Perucci
- Nucleus of Research in Biological Sciences, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
| | | | - Lara Carvalho Godoi
- Department of Clinical and Toxicological Analyses - Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Adriano de Paula Sabino
- Department of Clinical and Toxicological Analyses - Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Karina Braga Gomes
- Department of Clinical and Toxicological Analyses - Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - André Talvani
- Department of Biological Sciences - Institute of Exact and Biological Sciences, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
| | - Luci Maria S Dusse
- Department of Clinical and Toxicological Analyses - Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
| | - Patrícia Nessralla Alpoim
- Department of Clinical and Toxicological Analyses - Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Giannakou K, Evangelou E, Papatheodorou SI. Genetic and non-genetic risk factors for pre-eclampsia: umbrella review of systematic reviews and meta-analyses of observational studies. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2018; 51:720-730. [PMID: 29143991 DOI: 10.1002/uog.18959] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/09/2017] [Accepted: 10/30/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To summarize evidence from the literature on genetic and non-genetic risk factors associated with pre-eclampsia (PE), assess the presence of statistical bias in the studies and identify risk factors for which there is robust evidence supporting their association with PE. METHODS PubMed and ISI Web of Science were searched from inception to October 2016, to identify systematic reviews and meta-analyses of observational studies examining associations between genetic or non-genetic risk factors and PE. For each meta-analysis, the summary-effect size was estimated using random-effects and fixed-effects models, along with 95% CIs and the 95% prediction interval. Between-study heterogeneity was expressed using the I2 statistic, and evidence of small-study effects (large studies had significantly more conservative results than smaller studies) and evidence of excess significance bias (too many studies with statistically significant results) were estimated. RESULTS Fifty-eight eligible meta-analyses were identified, which included 1466 primary studies and provided data on 130 comparisons of risk factors associated with PE, covering a wide range of comorbid diseases, genetic factors, exposure to environmental agents and biomarkers. Sixty-five (50%) associations had nominally statistically significant findings at P < 0.05, while 16 (12%) were significant at P < 10-6 . Sixty-five (50%) associations had large or very large heterogeneity. Evidence for small-study effects and excess significance bias was found in 10 (8%) and 26 (20%) associations, respectively. The only non-genetic risk factor with convincing evidence for an association with PE was oocyte donation vs spontaneous conception, which had a summary odds ratio of 4.33 (95% CI, 3.11-6.03), was supported by 2712 cases with small heterogeneity (I2 = 26%) and 95% prediction intervals excluding the null value, and without hints of small-study effects (P for Egger's test > 0.10) or excess of significance (P > 0.05). Of the statistically significant (P < 0.05) genetic risk factors for PE, only PAI-1 4G/5G (recessive model) polymorphism was supported by strong evidence for a contribution to the pathogenesis of PE. Eleven factors (serum iron level, pregnancy-associated plasma protein-A, chronic kidney disease, polycystic ovary syndrome, mental stress, bacterial and viral infections, cigarette smoking, oocyte donation vs assisted reproductive technology, obesity vs normal weight, severe obesity vs normal weight and primiparity) presented highly suggestive evidence for an association with PE. CONCLUSIONS A large proportion of meta-analyses of genetic and non-genetic risk factors for PE have caveats that threaten their validity. Oocyte donation vs spontaneous conception and PAI-1 4G/5G polymorphism (recessive model) showed the strongest consistent evidence for an association with risk for PE. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- K Giannakou
- Cyprus International Institute for Environmental & Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - E Evangelou
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - S I Papatheodorou
- Cyprus International Institute for Environmental & Public Health, Cyprus University of Technology, Limassol, Cyprus
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10
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Endothelial nitric oxide synthase gene G894T polymorphism and risk assessment for pregnancy-induced hypertension: evidence from 11 700 subjects. Hypertens Res 2016; 39:899-906. [PMID: 27465577 DOI: 10.1038/hr.2016.95] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 05/11/2016] [Accepted: 06/14/2016] [Indexed: 01/11/2023]
Abstract
Recent studies have reported the association between endothelial nitric oxide synthase (eNOS) gene G894T polymorphism and pregnancy-induced hypertension (PIH). However, the results have been inconsistent. We conducted a comprehensive meta-analysis to explore this association. A total of 36 case-control studies involving 4028 PIH cases and 7672 controls were ultimately included. In the overall analysis, no association was identified between eNOS gene G894T polymorphism and PIH risk in any of the genetic models. In the subgroup analysis, the results showed that T-allele carriers had a higher risk of PIH than those with the G allele in Asians (G vs. T: odds ratio (OR)=0.76, 95% confidence interval (CI)=0.63-0.91, P=0.002; GT+TT vs. GG: OR=1.32, 95% CI=1.09-1.59, P=0.004; TT vs. GT+GG: OR=1.96, 95% CI=1.26-3.06, P=0.003; TT vs. GG: OR=1.99, 95% CI=1.27-3.11, P=0.003; GT vs. GG: OR=1.23, 95% CI=1.05-1.43, P=0.009). For Latin American and African populations, the association between G894T polymorphism and susceptibility to PIH was only observed in the dominant model. However, no association was observed in Europeans and Americans. Therefore, eNOS gene G894T polymorphism was related to PIH risk, especially for Asians.
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11
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Acauan Filho BJ, Pinheiro da Costa BE, Ogando PB, Vieira MC, Antonello IC, Poli-de-Figueiredo CE. Serum nitrate and NOx levels in preeclampsia are higher than in normal pregnancy. Hypertens Pregnancy 2016; 35:226-33. [PMID: 27003519 DOI: 10.3109/10641955.2016.1139718] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To compare nitric oxide (NO) serum levels in women with and without preeclampsia. METHODS 106 women were classified into preeclampsia group (n = 40) and normotensive group (n = 66). NO content was measured in the serum. Clinical and laboratorial data were recorded for comparison. RESULTS Preeclampsia presented a significant increase in nitrate and NOx levels compared to the control group. Uric acid, gestational age, systolic and diastolic blood pressure, and creatinine showed correlation with nitrates and NOx. CONCLUSION Increase of NO was observed in preeclampsia women. Failure in the mechanism of action, dependent on cyclic GMP, may justify this finding.
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Affiliation(s)
- Breno José Acauan Filho
- a Programa de Pós-Graduação em Medicina e Ciências da Saúde, Instituto de Pesquisas Biomédicas - Hospital São Lucas/Faculdade de Medicina of Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil
| | - Bartira Ercilia Pinheiro da Costa
- a Programa de Pós-Graduação em Medicina e Ciências da Saúde, Instituto de Pesquisas Biomédicas - Hospital São Lucas/Faculdade de Medicina of Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil
| | - Patrícia Barcelos Ogando
- a Programa de Pós-Graduação em Medicina e Ciências da Saúde, Instituto de Pesquisas Biomédicas - Hospital São Lucas/Faculdade de Medicina of Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil
| | - Matias Costa Vieira
- a Programa de Pós-Graduação em Medicina e Ciências da Saúde, Instituto de Pesquisas Biomédicas - Hospital São Lucas/Faculdade de Medicina of Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil
| | - Ivan Carlos Antonello
- a Programa de Pós-Graduação em Medicina e Ciências da Saúde, Instituto de Pesquisas Biomédicas - Hospital São Lucas/Faculdade de Medicina of Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil
| | - Carlos Eduardo Poli-de-Figueiredo
- a Programa de Pós-Graduação em Medicina e Ciências da Saúde, Instituto de Pesquisas Biomédicas - Hospital São Lucas/Faculdade de Medicina of Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil
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Fatini C, Romagnuolo I, Sticchi E, Rossi L, Cellai AP, Rogolino A, Abbate R. ACE gene in pregnancy complications: Insights into future vascular risk. Hypertens Pregnancy 2016; 35:62-72. [DOI: 10.3109/10641955.2015.1115059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Cinzia Fatini
- Department of Experimental and Clinical Medicine, University of Florence, Thrombosis Centre, Largo Brambilla, Florence, Italy
| | - Ilaria Romagnuolo
- Department of Experimental and Clinical Medicine, University of Florence, Thrombosis Centre, Largo Brambilla, Florence, Italy
- Fiorgen Foundation, Sesto F.no, Florence, Italy
| | - Elena Sticchi
- Department of Experimental and Clinical Medicine, University of Florence, Thrombosis Centre, Largo Brambilla, Florence, Italy
| | - Lorenza Rossi
- Department of Experimental and Clinical Medicine, University of Florence, Thrombosis Centre, Largo Brambilla, Florence, Italy
| | - Anna Paola Cellai
- Department of Heart and Vessels, Thrombosis Centre, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla, Florence, Italy
| | - Angela Rogolino
- Department of Heart and Vessels, Thrombosis Centre, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla, Florence, Italy
| | - Rosanna Abbate
- Department of Experimental and Clinical Medicine, University of Florence, Thrombosis Centre, Largo Brambilla, Florence, Italy
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Gong FF, Hu CY, Lu SS, Qian ZZ, Feng F, Wu YL, Yang HY, Sun YH. Associations of Angiotensin-Converting Enzyme Insertion/Deletion, Angiotensin II Receptor A1166C, and Endothelial Nitric Oxide Synthase 4b/a Gene Polymorphisms With Pregnancy Hypertensive Disorders: A Meta-Analysis. J Clin Hypertens (Greenwich) 2015; 17:954-62. [DOI: 10.1111/jch.12606] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 04/30/2015] [Accepted: 05/01/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Feng-Feng Gong
- Department of Epidemiology and Health Statistics; School of Public Health; Anhui Medical University; Hefei Anhui China
- Center for Evidence-Based Practice; Anhui Medical University; Hefei Anhui China
| | - Cai-Yun Hu
- Department of Epidemiology and Health Statistics; School of Public Health; Anhui Medical University; Hefei Anhui China
- Center for Evidence-Based Practice; Anhui Medical University; Hefei Anhui China
| | - Shan-Shan Lu
- Department of Epidemiology and Health Statistics; School of Public Health; Anhui Medical University; Hefei Anhui China
- Center for Evidence-Based Practice; Anhui Medical University; Hefei Anhui China
| | - Zhen-Zhong Qian
- Department of Epidemiology and Health Statistics; School of Public Health; Anhui Medical University; Hefei Anhui China
- Center for Evidence-Based Practice; Anhui Medical University; Hefei Anhui China
| | - Fang Feng
- Department of Epidemiology and Health Statistics; School of Public Health; Anhui Medical University; Hefei Anhui China
- Center for Evidence-Based Practice; Anhui Medical University; Hefei Anhui China
| | - Yi-Le Wu
- Department of Epidemiology and Health Statistics; School of Public Health; Anhui Medical University; Hefei Anhui China
- Center for Evidence-Based Practice; Anhui Medical University; Hefei Anhui China
| | - Hui-Yun Yang
- Department of Epidemiology and Health Statistics; School of Public Health; Anhui Medical University; Hefei Anhui China
- Center for Evidence-Based Practice; Anhui Medical University; Hefei Anhui China
| | - Ye-Huan Sun
- Department of Epidemiology and Health Statistics; School of Public Health; Anhui Medical University; Hefei Anhui China
- Center for Evidence-Based Practice; Anhui Medical University; Hefei Anhui China
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14
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Sakar MN, Atay AE, Demir S, Bakir VL, Demir B, Balsak D, Akay E, Ulusoy AI, Verit FF. Association of endothelial nitric oxide synthase gene G894T polymorphism and serum nitric oxide levels in patients with preeclampsia and gestational hypertension. J Matern Fetal Neonatal Med 2014; 28:1907-11. [PMID: 25275587 DOI: 10.3109/14767058.2014.971748] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Pregnancy-induced hypertension is one of the most important cause of maternal-fetal morbidity and mortality. Pregnancy-related hypertensive disorders are usually associated with diminished nitric oxide (NO) levels. We aimed to evaluate the role of serum NO levels and eNOS gene G894T polymorphism on hypertensive disorders of pregnancy. METHODS Eighty patients with gestational hypertension or preeclampsia, and 80 healthy pregnants were enrolled to analyze serum NO levels and G894T polymorphism of the eNOS gene. NO level was analyzed by high-performance liquid chromatography (HPLC) method. The G894T polymorphism of the eNOS gene was determined by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). RESULTS There was no significant difference between groups in terms of G894T/eNOS genotype and allele frequencies (p > 0.05). Serum NO levels were significantly lower in the patients group. In the control group, subjects with thymine-thymine (TT) genotype had significantly lower NO levels when compared to subjects with guanine-guanine (GG) or guanine-thymine (GT) genotype (p < 0.05). CONCLUSIONS We failed to demonstrate an association between eNOS gene G894T polymorphism and serum NO levels in patients with pregnancy-induced hypertensive disorders. We established a relation between pregnancy-induced hypertension and low NO levels.
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Affiliation(s)
- Mehmet Nafi Sakar
- a Department of Obstetrics and Gynecology , Suleymaniye Maternity Education and Research Hospital , Istanbul , Turkey
| | - Ahmet Engin Atay
- b Department of Internal Medicine , Bagcilar Education and Research Hospital , Istanbul , Turkey
| | - Sureyya Demir
- c Department of Obstetrics and Gynecology , Haseki Education and Research Hospital , Istanbul , Turkey
| | - Vuslat Lale Bakir
- c Department of Obstetrics and Gynecology , Haseki Education and Research Hospital , Istanbul , Turkey
| | - Bulent Demir
- c Department of Obstetrics and Gynecology , Haseki Education and Research Hospital , Istanbul , Turkey
| | - Deniz Balsak
- d Department of Obstetrics and Gynecology , MH Diyarbakir Obstetrics and Gynecology Hospital , Diyarbakir , Turkey , and
| | - Emrullah Akay
- a Department of Obstetrics and Gynecology , Suleymaniye Maternity Education and Research Hospital , Istanbul , Turkey
| | - A Ibrahim Ulusoy
- e Department of General Surgery , Suleymaniye Maternity Education and Research Hospital , Istanbul , Turkey
| | - Fatma Ferda Verit
- a Department of Obstetrics and Gynecology , Suleymaniye Maternity Education and Research Hospital , Istanbul , Turkey
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15
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Krauspenhar B, Sontag F, Ronchi FA, Casarini DE, Poli-de-Figueiredo CE, Pinheiro da Costa BE. Angiotensin Converting Enzyme 90 kDa isoform: Biomarker for diagnosis of preeclampsia? Med Hypotheses 2014; 83:526-9. [PMID: 25257705 DOI: 10.1016/j.mehy.2014.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 09/10/2014] [Indexed: 10/24/2022]
Abstract
Preeclampsia (PE), one of the leading gestational hypertensive diseases, is characterized by increased blood pressure (⩾140/90mmHg) and pathological proteinuria after 20weeks gestation. It is a complex, multifactorial syndrome with an unestablished etiology and cure. The search continues for a biomarker that could assist in the early prediction or diagnosis of PE, reducing the rate of maternal and fetal mortality. Based on the findings of Casarini et al. that suggest the 90kDa isoform of the Angiotensin Converting Enzyme (ACE) as a possible marker of hypertension, we hypothesized that this isoform may be present in pregnant women with PE, since they present a transient and spontaneous model of systemic arterial hypertension in pregnancy. We believe, therefore, that pregnant women with pure PE (PPE) express the ACE 90kDa isoform in urine, as well as having elevated isoform enzymatic activity, during pregnancy only. Postpartum, with the normalization of blood pressure, the protein isoform would no longer be expressed. Pregnant women with superimposed preeclampsia (SPE) would present the ACE 90kDa isoform both during and after the gestation period, and its enzymatic activity would remain high as they are chronically hypertensive. It is expected that normotensive pregnant women do not present this isoform in their urine as elevated blood pressure levels do not occur. Both normotensive and PPE affected pregnant women with a family history of hypertension, will possibly express the ACE 90kDa isoform before pregnancy and may become hypertensive, only after some years, through the influence of environmental factors and/or other diseases. If our hypothesis is confirmed, it will allow differentiation of PPE and SPE sooner than 12weeks postpartum, which is currently the estimated period for confirmation of the specific diagnosis. Furthermore, it could be an early biomarker for predicting the disease, enabling the physician to choose the best clinical management. In addition, it would minimize the use of other methods as the biological sample for obtaining the marker is urine, a practical and effective test with good reproducibility. Finally, test results would enable a greater understanding of the mechanisms involved in gestational hypertension.
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Affiliation(s)
- Bruna Krauspenhar
- Graduate Program in Medicine and Health Sciences (Nephrology), School of Medicine, Institute of Biomedical Research, São Lucas Hospital, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
| | - Fernando Sontag
- Graduate Program in Medicine and Health Sciences (Nephrology), School of Medicine, Institute of Biomedical Research, São Lucas Hospital, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernanda A Ronchi
- Nephrology Division, Department of Medicine, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Dulce E Casarini
- Nephrology Division, Department of Medicine, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Carlos Eduardo Poli-de-Figueiredo
- Graduate Program in Medicine and Health Sciences (Nephrology), School of Medicine, Institute of Biomedical Research, São Lucas Hospital, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Bartira E Pinheiro da Costa
- Graduate Program in Medicine and Health Sciences (Nephrology), School of Medicine, Institute of Biomedical Research, São Lucas Hospital, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
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16
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Zawiejska A, Wender-Ozegowska E, Iciek R, Brazert J. Concentrations of endothelial nitric oxide synthase, angiotensin-converting enzyme, vascular endothelial growth factor and placental growth factor in maternal blood and maternal metabolic status in pregnancy complicated by hypertensive disorders. J Hum Hypertens 2014; 28:670-6. [PMID: 25186136 DOI: 10.1038/jhh.2014.42] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2013] [Revised: 03/20/2014] [Accepted: 04/29/2014] [Indexed: 01/21/2023]
Abstract
Hypertensive disorders of pregnancy (HDPs) are associated with altered maternal metabolism, impaired perinatal outcome and increased risk for remote maternal complications. The aim of our study was to analyse associations between circulating levels of angiogenic factors and markers of oxidative stress and metabolic status in women with HDP. Forty-six women in singleton pregnancies complicated by HDP and 30 healthy controls were enrolled in a prospective observational study. Serum concentrations of endothelial nitric oxide synthase (eNOS), angiotensin-converting enzyme, vascular endothelial growth factor (VEGF) and placental growth factor (PlGF) were measured in the third trimester and correlated with maternal anthropometrics and metabolic status. We found significantly lower eNOS levels in patients with severe hypertension vs controls, a strong association between eNOS and PlGF in the study group, a significant association between maternal prepregnancy body mass index (BMI) and VEGF levels and an inverse correlation between VEGF and PlGF. Maternal prepregnancy BMI was the only independent predictor for VEGF concentrations. We noted reduced levels of PlGF and eNOS and increased VEGF levels in women with severe hypertension/preeclampsia. First, different forms of HDP are associated with different alteration patterns in concentrations of angiogenic factors and markers of oxidative stress. Second, maternal prepregnancy BMI, but not body weight, is a significant predictor for VEGF levels in late pregnancy.
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Affiliation(s)
- A Zawiejska
- Department of Obstetrics and Women's Diseases, University of Medical Sciences, Poznan, Poland
| | - E Wender-Ozegowska
- Department of Obstetrics and Women's Diseases, University of Medical Sciences, Poznan, Poland
| | - R Iciek
- Department of Obstetrics and Women's Diseases, University of Medical Sciences, Poznan, Poland
| | - J Brazert
- Department of Obstetrics and Women's Diseases, University of Medical Sciences, Poznan, Poland
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17
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El-Sherbiny WS, Nasr AS, Soliman A. Endothelial nitric oxide synthase (eNOS) (Glu298Asp) and urotensin II (UTS2S89N) gene polymorphisms in preeclampsia: prediction and correlation with severity in Egyptian females. Hypertens Pregnancy 2013; 32:292-303. [DOI: 10.3109/10641955.2013.806539] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Yang J, Shang J, Zhang S, Li H, Liu H. The role of the renin-angiotensin-aldosterone system in preeclampsia: genetic polymorphisms and microRNA. J Mol Endocrinol 2013; 50:R53-66. [PMID: 23369849 DOI: 10.1530/jme-12-0216] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The compensatory alterations in the rennin-angiotensin-aldosterone system (RAAS) contribute to the salt-water balance and sufficient placental perfusion for the subsequent well-being of the mother and fetus during normal pregnancy and is characterized by an increase in almost all the components of RAAS. Preeclampsia, however, breaks homeostasis and leads to a disturbance of this delicate equilibrium in RAAS both for circulation and the uteroplacental unit. Despite being a major cause for maternal and neonatal morbidity and mortality, the pathogenesis of preeclampsia remains elusive, where RAAS has been long considered to be involved. Epidemiological studies have indicated that preeclampsia is a multifactorial disease with a strong familial predisposition regardless of variations in ethnic, socioeconomic, and geographic features. The heritable allelic variations, especially the genetic polymorphisms in RAAS, could be the foundation for the genetics of preeclampsia and hence are related to the development of preeclampsia. Furthermore, at a posttranscriptional level, miRNA can interact with the targeted site within the 3'-UTR of the RAAS gene and thereby might participate in the regulation of RAAS and the pathology of preeclampsia. In this review, we discuss the recent achievements of genetic polymorphisms, as well as the interactions between maternal and fetal genotypes, and miRNA posttranscriptional regulation associated with RAAS in preeclampsia. The results are controversial but utterly inspiring and attractive in terms of potential prognostic significance. Although many studies suggest positive associations with genetic mutations and increased risk for preeclampsia, more meticulously designed large-scale investigations are needed to avoid the interference from different variations.
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Affiliation(s)
- Jie Yang
- Department of Pathophysiology, School of Basic Medical Sciences, Capital Medical University, Beijing 100069, People's Republic of China
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19
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Zhou TB, Yin SS. Association of Endothelial Nitric Oxide Synthase Glu298Asp Gene Polymorphism with the Risk of End-Stage Renal Disease. Ren Fail 2013; 35:573-8. [PMID: 23464568 DOI: 10.3109/0886022x.2013.773834] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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20
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Morgan JA, Bombell S, McGuire W. Association of plasminogen activator inhibitor-type 1 (-675 4G/5G) polymorphism with pre-eclampsia: systematic review. PLoS One 2013; 8:e56907. [PMID: 23457639 PMCID: PMC3574018 DOI: 10.1371/journal.pone.0056907] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Accepted: 01/15/2013] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND AIMS Excessive generation of plasminogen activator inhibitor-type 1 (PAI-1) is implicated in the pathogenesis of pre-eclampsia and related conditions. The PAI-1 (-675 4G/5G) promoter polymorphism (rs1799889) affects transcriptional activity and is a putative genetic risk factor for pre-eclampsia. The aim of this study was identify, appraise and synthesise the available evidence for the association of the PAI-1 (-675 4G/5G) polymorphism with pre-eclampsia. METHODS Systematic review and random effects meta-analysis of genetic association studies. RESULTS We found 12 eligible genetic association studies in which a total of 1511 women with pre-eclampsia, eclampsia or HELLP syndrome and 3492 controls participated. The studies were generally small (median number of cases 102, range 24 to 403) and underpowered to detect plausible association sizes. Meta-analysis of all of the studies detected statistically significant gene-disease associations in the recessive [pooled odds ratio 1.28 (95% confidence interval 1.09, 1.50); population attributable risk 7.7%] and dominant [pooled odds ratio 1.21 (95% confidence interval 1.01, 1.44); population attributable risk 13.7%] models. We did not find evidence of statistical heterogeneity, funnel plot asymmetry or small study bias. CONCLUSIONS These data suggest that the fibrinolytic pathway regulated by the PAI-1 gene may contribute to the pathogenesis of pre-eclampsia and related conditions. This association, if confirmed in larger genetic association studies, may inform research efforts to develop novel interventions or help to prioritise therapeutic targets that merit evaluation in randomised clinical trials.
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Affiliation(s)
- Jessie A. Morgan
- Hull York Medical School & NIHR Centre for Reviews and Dissemination,University of York, York, United Kingdom
| | - Sarah Bombell
- Department of Obstetrics, Goulburn Base Hospital, New South Wales, Australia
| | - William McGuire
- Hull York Medical School & NIHR Centre for Reviews and Dissemination,University of York, York, United Kingdom
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21
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Rahimi Z, Malek-Khosravi S, Rahimi Z, Jalilvand F, Parsian A. MTHFR C677T and eNOS G894T variants in preeclamptic women: Contribution to lipid peroxidation and oxidative stress. Clin Biochem 2013; 46:143-7. [DOI: 10.1016/j.clinbiochem.2012.10.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2012] [Revised: 09/27/2012] [Accepted: 10/15/2012] [Indexed: 01/15/2023]
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Searching for genes involved in hypertension development in special populations: children and pre-eclamptic women. Where are we standing now? Clin Chem Lab Med 2013; 51:2253-69. [DOI: 10.1515/cclm-2013-0405] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 07/23/2013] [Indexed: 01/02/2023]
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23
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Zhao L, Bracken MB, Dewan AT, Chen S. Association between the SERPINE1 (PAI-1) 4G/5G insertion/deletion promoter polymorphism (rs1799889) and pre-eclampsia: a systematic review and meta-analysis. Mol Hum Reprod 2012. [PMID: 23180602 DOI: 10.1093/molehr/gas056] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The SERPINE1 -675 4G/5G promoter region insertion/deletion polymorphism (rs1799889) has been implicated in the pathogenesis of pre-eclampsia (PE), but the genetic association has been inconsistently replicated. To derive a more precise estimate of the association, a systematic review and meta-analysis was conducted. This study conformed to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed (MEDLINE), Scopus and HuGE Literature Finder literature databases were systematically searched for relevant studies. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for the allelic comparison (4G versus 5G) and genotypic comparisons following the co-dominant (4G/4G versus 5G/5G and 4G/5G versus 5G/5G), dominant (4G/4G+4G/5G versus 5G/5G) and recessive (4G/4G versus 4G/5G+5G/5G) genetic models. Between-study heterogeneity was quantified by I(2) statistics and publication bias was appraised with funnel plots. Sensitivity analysis was conducted to evaluate the robustness of meta-analysis findings. Meta-analysis of 11 studies involving 1297 PE cases and 1791 controls found a significant association between the SERPINE1 -675 4G/5G polymorphism and PE for the recessive genetic model (OR = 1.36, 95% CI: 1.13-1.64, P = 0.001), a robust finding according to sensitivity analysis. A low level of between-study heterogeneity was detected (I(2) = 20%) in this comparison, which may be explained by ethnic differences. Funnel plot inspection did not reveal evidence of publication bias. In conclusion, this study provides a comprehensive examination of the available literature on the association between SERPINE1 -675 4G/5G and PE. Meta-analysis results support this polymorphism as a likely susceptibility variant for PE.
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Affiliation(s)
- Linlu Zhao
- Center for Perinatal, Pediatric and Environmental Epidemiology, Yale Schools of Public Health and Medicine, New Haven, CT 06510, USA.
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Jamil K, Jayaraman A, Rao R, Raju S. In silico evidence of signaling pathways of notch mediated networks in leukemia. Comput Struct Biotechnol J 2012; 1:e201207005. [PMID: 24688641 PMCID: PMC3962152 DOI: 10.5936/csbj.201207005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 11/04/2012] [Accepted: 11/07/2012] [Indexed: 11/22/2022] Open
Abstract
Notch signaling plays a critical role in cell fate determination and maintenance of progenitors in many developmental systems. Notch receptors have been shown to be expressed on hematopoietic progenitor cells as well as to various degrees in peripheral blood T and B lymphocytes, monocytes, and neutrophils. Our aim was to understand the protein interaction network, using Notch1 protein name as query in STRING database and we generated a model to assess the significance of Notch1 associated proteins in Acute Lymphoblastic Leukemia (ALL). We further analyzed the expression levels of the genes encoding hub proteins, using Oncomine database, to determine their significance in leukemogenesis. Of the forty two hub genes, we observed that sixteen genes were underexpressed and eleven genes were overexpressed in T-cell Acute Lymphoblastic samples in comparison to their expression levels in normal cells. Of these, we found three novel genes which have not been reported earlier- KAT2B, PSEN1 (underexpressed) and CDH2 (overexpressed).These three identified genes may provide new insights into the abnormal hematopoietic process observed in Leukemia as these genes are involved in Notch signaling and cell adhesion processes. It is evident that experimental validation of the protein interactors in leukemic cells could help in the identification of new diagnostic markers for leukemia.
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Affiliation(s)
- Kaiser Jamil
- Centre for Biotechnology and Bioinformatics, School of Life sciences, Jawaharlal Nehru Institute of Advanced Studies (JNIAS), 6th Floor, Budha Bhawan, M.G. Road, Secunderabad 500003, Andhra Pradesh, India
| | - Archana Jayaraman
- Centre for Biotechnology and Bioinformatics, School of Life sciences, Jawaharlal Nehru Institute of Advanced Studies (JNIAS), 6th Floor, Budha Bhawan, M.G. Road, Secunderabad 500003, Andhra Pradesh, India
| | - Raghunatha Rao
- Oncology Department, Nizams Institute of Medical Sciences ( NIMS), Panjagutta, Hyderabad 500082, Andhra Pradesh, India
| | - Suryanarayana Raju
- Oncology Department, Nizams Institute of Medical Sciences ( NIMS), Panjagutta, Hyderabad 500082, Andhra Pradesh, India
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Topete-Reyes JF, Soto-Vargas J, Morán-Moguel MC, Dávalos-Rodríguez IP, Chávez-González EL, García-de la Torre I, Parra-Michel R, Medina-Pérez M, Jalomo-Martínez B, Salazar-Páramo M. Insertion/deletion polymorphism of the angiotensin-converting enzyme gene in lupus nephritis among Mexicans. Immunopharmacol Immunotoxicol 2012; 35:174-80. [DOI: 10.3109/08923973.2012.739175] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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26
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Zhou TB, Xu HL, Yin SS. Association between Endothelial Nitric Oxide Synthase Glu298Asp Gene Polymorphism and Diabetic Nephropathy Susceptibility. Ren Fail 2012; 35:173-8. [PMID: 23113598 DOI: 10.3109/0886022x.2012.734939] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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27
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Muniz L, Luizon MR, Palei ACT, Lacchini R, Duarte G, Cavalli RC, Tanus-Santos JE, Sandrim VC. eNOS tag SNP haplotypes in hypertensive disorders of pregnancy. DNA Cell Biol 2012; 31:1665-70. [PMID: 23062210 DOI: 10.1089/dna.2012.1768] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Haplotypes formed by polymorphisms (T-786C, rs2070744; a variable number of tandem repeats in intron 4, and Glu298Asp, rs1799983) of the eNOS gene were associated previously with gestational hypertension (GH) and preeclampsia (PE). However, no study has explored the Tag SNPs rs743506 and rs7830 in these disorders. The aim of the current study was to compare the distribution of the genotypes and haplotypes formed by the five eNOS polymorphisms mentioned among healthy pregnant (HP, n=122), GH (n=138), and PE (n=157). The haplotype formed by "C b G G C" was more frequent in HP compared to GH and PE (p=0.0071), which is supported by previous findings that demonstrated the association of the combination "C b G" with a higher level of nitrite (NO marker). Our results suggest a protective effect of the haplotype "C b G G C" against the development of hypertensive disorders of pregnancy.
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Affiliation(s)
- Ludmila Muniz
- Center of Postgraduation and Research - Santa Casa of Belo Horizonte, Belo Horizonte, Brazil
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28
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Yang Z, Wu Q, Shi Y, Nie Y, Wu K, Fan D. Epidermal growth factor 61A>G polymorphism is associated with risk of hepatocellular carcinoma: a meta-analysis. Genet Test Mol Biomarkers 2012; 16:1086-91. [PMID: 22852842 DOI: 10.1089/gtmb.2012.0050] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The association between hepatocellular carcinoma (HCC) and the 61A>G polymorphism in the epidermal growth factor (EGF) gene has been analyzed in several studies, but results have been inconsistent. The aim of this study was to integrate previous findings and explore whether this polymorphism is associated with susceptibility to HCC. A meta-analysis was performed by searching PubMed, Web of Science, and Cochrane Library databases. Data were extracted using predefined form and pooled odds ratios (OR) with 95% confidence intervals (CI) and were calculated to evaluate the strength of this association. Five studies involving 690 cases, 514 healthy controls, and 1419 controls with cancer-free liver diseases were identified. On the basis of healthy controls, the significant main effects on HCC risk were observed in a heterozygote comparison (OR=1.76, 95% CI 1.07-2.90, p=0.02) and a dominant genetic model (OR=1.65, 95% CI 1.03-2.66, p=0.04). On the basis of the controls with cancer-free liver diseases, a significantly increased risk of HCC was found in all the genetic models. Subgroup analyses stratified by ethnicity and etiology of HCC also showed positive associations. The EGF 61G allele is a risk factor for developing HCC without the influence of ethnic and etiological diversity.
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Affiliation(s)
- Zhiping Yang
- State Key Laboratory of Cancer Biology and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China
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Rahimi Z, Rahimi Z, Mozafari H, Parsian A. Preeclampsia and angiotensin converting enzyme (ACE) I/D and angiotensin II type-1 receptor (AT1R) A1166C polymorphisms: association with ACE I/D polymorphism. J Renin Angiotensin Aldosterone Syst 2012; 14:174-80. [PMID: 22719026 DOI: 10.1177/1470320312448950] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The aim of the present study was to investigate the association between angiotensin converting enzyme (ACE) insertion/deletion (I/D) and angiotensin II type-1 receptor (AT1R) A1166C polymorphisms with the risk of preeclampsia and lipid peroxidation in preeclamptic women from Western Iran. METHODS One hundred and ninety-eight preeclamptic women (128 women with mild and 70 with severe forms) and 100 age- and parity-matched controls were enrolled in this case-control study. RESULTS The presence of D allele of ACE was associated with a 1.8-fold increased risk of preeclampsia (p=0.002) in total preeclamptic patients. The frequency of AT1R AC+CC genotypes was higher in mild preeclamptic women (32%) compared to controls (27.2%) (p>0.05). In mild preeclamptic women with ID genotype, the level of total antioxidant capacity (TAC) was significantly decreased compared to those with II genotype. Also, there was a trend toward increasing malondialdehyde (MDA) and decreasing TAC levels in mild and severe preeclamptic women with AT1R AA through CC genotypes. CONCLUSIONS Our study indicates that lipid peroxidation and oxidative stress are involved in the development of preeclampsia that might be influenced by polymorphism in the renin-angiotensin-aldosterone system genes.
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Affiliation(s)
- Zohreh Rahimi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Iran.
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