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Ebaid NF, Abdelkawy KS, Shehata MA, Salem HF, Magdy G, Hussein RRS, Elbarbry F. Effects of pharmacogenetics on pharmacokinetics and toxicity of doxorubicin in Egyptian breast cancer patients. Xenobiotica 2024; 54:160-170. [PMID: 38491961 DOI: 10.1080/00498254.2024.2330493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 03/11/2024] [Indexed: 03/18/2024]
Abstract
This study investigates the impact of single nucleotide polymorphisms in genes (SLC22A16 and CBR1) involved in the pharmacokinetics and toxicity of doxorubicin (DOX) in Egyptian female patients with breast cancer.Patients administered DOX (60 mg/m2) for 4 cycles every 3 weeks. The peak DOX plasma concentration was measured using a validated chromatographic method. The genotyping for the selected SNPs, SLC22A16 T > C (rs714368), and CBR1 C > T (rs20572), was performed by RT-PCR. Patients were monitored for hematological and cardiac toxicities.The variant carriers of CBR1 C > T (rs20572) exhibited significantly higher DOX concentration, but no significant association to DOX-induced hematological toxicity. On the other hand, SLC22A16 T > C (rs714368) had no significant influence on DOX plasma concentration, but was significantly correlated with lower risk of neutropenia (OR 0.31, 95% CI 0.12-0.75, p = 0.01) and leukopoenia (OR 0.18, 95% CI 0.07-0.5, p = 0.001). DOX-related cardiotoxicity was correlated with the cumulative dose of DOX (R = 0.238, p = 0.017), but not with any of the two examined SNPs.Genetic polymorphisms in SLC22A16 and CBR1 may explain the inter-individual variations in DOX pharmacokinetics and toxicity. Using pharmacogenetic testing is important to customise drug therapy for cancer patients treated with anthracyclines.
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Affiliation(s)
- N F Ebaid
- Clinical Pharmacy Department, Faculty of Pharmacy, Menoufia University, Al Minufiyah, Egypt
| | - K S Abdelkawy
- Clinical Pharmacy Department, Faculty of Pharmacy, Kafrelsheikh University, Kafr El-Sheikh, Egypt
| | - M A Shehata
- Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Menoufia University, Al Minufiyah, Egypt
| | - H F Salem
- Pharmaceutics and Industrial Pharmacy Department, Beni-Suef University, Beni Suef, Egypt
| | - G Magdy
- Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, Kafrelsheikh University, Kafr El-Sheikh, Egypt
| | - R R S Hussein
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni Suef, Egypt
| | - F Elbarbry
- Pacific University School of Pharmacy, Hillsboro, OR, USA
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2
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Boraey NF, Bebars MA, Wahba AA, Abd El Lateef HM, Attia MA, Elsayed AH, Rashed KA, Sorour EI, Ahmed MF, Abd-Elrehim GAB, Soliman AA, Shehab MMM, Elhindawy EM, Ibraheem AAA, Shehata H, Yousif YM, Hashem MIA, Ahmed AA, Emam AA, Gameil DM, Abdelhady EM, Abdelkhalek K, Morsi WEMA, Selim DM, Razek SA, Ashraf B, Saleh ASE, Eltrawy HH, Alanwar MI, Fouad RA, Omar WE, Nabil RM, Abdelhamed MR, Ibrahim MY, Malek MM, Afify MR, Alharbi MT, Nagshabandi MK, Tarabulsi MK, Qashqary ME, Almoraie LM, Salem HF, Rashad MM, El-Gaaly SAA, El-Deeb NA, Abdallah AM, Fakhreldin AR, Hassouba M, Massoud YM, Attaya MSM, Haridi MK. Association of ACE1 I/D polymorphism and susceptibility to COVID-19 in Egyptian children and adolescents. Pediatr Res 2024:10.1038/s41390-023-02982-8. [PMID: 38177248 DOI: 10.1038/s41390-023-02982-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 10/19/2023] [Accepted: 12/04/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND Given the sparse data on the renin-angiotensin system (RAS) and its biological effector molecules ACE1 and ACE2 in pediatric COVID-19 cases, we investigated whether the ACE1 insertion/deletion (I/D) polymorphism could be a genetic marker for susceptibility to COVID-19 in Egyptian children and adolescents. METHODS This was a case-control study included four hundred sixty patients diagnosed with COVID-19, and 460 well-matched healthy control children and adolescents. The I/D polymorphism (rs1799752) in the ACE1 gene was genotyped by polymerase chain reaction (PCR), meanwhile the ACE serum concentrations were assessed by ELISA. RESULTS The ACE1 D/D genotype and Deletion allele were significantly more represented in patients with COVID-19 compared to the control group (55% vs. 28%; OR = 2.4; [95% CI: 1.46-3.95]; for the DD genotype; P = 0.002) and (68% vs. 52.5%; OR: 1.93; [95% CI: 1.49-2.5] for the D allele; P = 0.032). The presence of ACE1 D/D genotype was an independent risk factor for severe COVID-19 among studied patients (adjusted OR: 2.6; [95% CI: 1.6-9.7]; P < 0.001. CONCLUSIONS The ACE1 insertion/deletion polymorphism may confer susceptibility to SARS-CoV-2 infection in Egyptian children and adolescents. IMPACT Recent studies suggested a crucial role of renin-angiotensin system and its biological effector molecules ACE1 and ACE2 in the pathogenesis and progression of COVID-19. To our knowledge, ours is the first study to investigate the association of ACE1 I/D polymorphism and susceptibility to COVID-19 in Caucasian children and adolescents. The presence of the ACE1 D/D genotype or ACE1 Deletion allele may confer susceptibility to SARS-CoV-2 infection and being associated with higher ACE serum levels; may constitute independent risk factors for severe COVID-19. The ACE1 I/D genotyping help design further clinical trials reconsidering RAS-pathway antagonists to achieve more efficient targeted therapies.
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Affiliation(s)
- Naglaa F Boraey
- Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Marwa A Bebars
- Department of Pediatrics, Princess Alexandra hospital, Harlow, UK
| | - Ali A Wahba
- Department of Pediatrics at SSMC (Sheikh Shakhbout Medical City, Abu Dhabi, UAE
| | | | - Mohamed Atif Attia
- Department of Pediatrics at SKMC (Sheikh khalifa Medical City, Abu Dhabi, UAE
| | - Ahmed H Elsayed
- Department of Pediatrics, Faculty of Medicine for Boys, Al-Azhar University, Al-Azhar, Egypt
| | - Khalid A Rashed
- Department of Pediatrics, Faculty of Medicine for Boys, Al-Azhar University, Al-Azhar, Egypt
| | - Ehab I Sorour
- Department of Pediatrics, Faculty of Medicine for Boys, Al-Azhar University, Al-Azhar, Egypt
| | - Mohamed F Ahmed
- Department of Pediatrics, Faculty of Medicine for Boys, Al-Azhar University, Al-Azhar, Egypt
| | | | - Attia A Soliman
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed M M Shehab
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Eman M Elhindawy
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed A A Ibraheem
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Hassan Shehata
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Yousif M Yousif
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mustafa I A Hashem
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Amani A Ahmed
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed A Emam
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
| | - Dalia M Gameil
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Eman M Abdelhady
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Khalil Abdelkhalek
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Walaa E M A Morsi
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Dalia M Selim
- Department of Pediatrics, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Suzan A Razek
- Department of Pediatrics, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Bassem Ashraf
- Department of Otorhinolaryngology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ahmed S E Saleh
- Department of Otorhinolaryngology, Faculty of Medicine, Benha University, Benha, Egypt
| | - Heba H Eltrawy
- Department of Chest diseases, Faculty of Medicine for Girls, Al-Azhar University, Al-Azhar, Egypt
| | - Mohamed I Alanwar
- Department of Cardiothoracic surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Rania A Fouad
- Department of Medical Biochemistry, College of Medicine, AlMaarefa University, Riyadh, Saudi Arabia
- Department of Medical Biochemistry, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Walaa E Omar
- Department of Medical Biochemistry, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Rehab M Nabil
- Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed R Abdelhamed
- Department of Clinical pathology, Faculty of Medicine for Boys, Al-Azhar University, Al-Azhar, Egypt
| | - Mona Yousri Ibrahim
- Department of Clinical pathology, Faculty of Medicine for Girls, Al-Azhar University, Al-Azhar, Egypt
| | - Mai M Malek
- Department of Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mona R Afify
- Department of Medical microbiology and Parasitology. Faculty of Medicine, University of Jeddah, Jeddah, 21589, Saudi Arabia
| | - Mohanned T Alharbi
- Department of Medical microbiology and Parasitology. Faculty of Medicine, University of Jeddah, Jeddah, 21589, Saudi Arabia
| | - Mohammed K Nagshabandi
- Department of Medical microbiology and Parasitology. Faculty of Medicine, University of Jeddah, Jeddah, 21589, Saudi Arabia
| | - Muyassar K Tarabulsi
- Department of Medical microbiology and Parasitology. Faculty of Medicine, University of Jeddah, Jeddah, 21589, Saudi Arabia
| | - Mohammed Esmail Qashqary
- Department of Family and community medicine, University Medical Center, University of Jeddah, Jeddah, Saudi Arabia
| | - Laila M Almoraie
- Department of Family and community medicine, University Medical Center, University of Jeddah, Jeddah, Saudi Arabia
| | - Hanan F Salem
- Department of Anesthesia, Faculty of Medicine, Benha University, Banha, Egypt
| | - Manal M Rashad
- Department of Anesthesia, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Sonya A A El-Gaaly
- Department of Internal Medicine, Faculty of Medicine, Ain-Shams University, Ain-Shams, Egypt
| | - Nahawand A El-Deeb
- Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Amany M Abdallah
- Department of Family Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed R Fakhreldin
- Department of Pediatrics, Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Mohamed Hassouba
- Department of Pediatrics, SUNY Downstate Health Science University, Kings County Hospital, Brooklyn, NY, USA
| | - Yasmine M Massoud
- Department of Tropical Medicine, Faculty of Medicine, Ain-Shams University, Ain-Shams, Egypt
| | - Mona S M Attaya
- Department of Pediatrics, Faculty of Medicine for Girls, Al-Azhar University, Al-Azhar, Egypt
| | - Mohammed K Haridi
- Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt
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Zakaraia HG, Salem HF, Mostafa MAA, Ali AM, Rabea H. Adding empagliflozin to sitagliptin plus metformin vs. adding sitagliptin to empagliflozin plus metformin as triple therapy in Egyptian patients with type 2 diabetes: a 12-week open trial. Eur Rev Med Pharmacol Sci 2023; 27:7289-7298. [PMID: 37606137 DOI: 10.26355/eurrev_202308_33300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
OBJECTIVE This study aimed to compare 12.5 mg empagliflozin effectiveness and safety vs. 50 mg sitagliptin twice daily as an add-on triple medication in Egyptians with type 2 diabetes. PATIENTS AND METHODS Patients with hemoglobin A1c (HbA1c) between 53 and 86 mmol/mol after receiving open-label either sitagliptin 50 mg (n = 85) or empagliflozin 12.5 mg (n = 85) twice daily for 12 weeks were afterward taken into account for the administration of open-label empagliflozin 12.5 mg (n = 40) and sitagliptin 50 mg (n = 28) respectively twice daily for another 12 weeks of treatment as an added-on triple therapy. Both groups of patients kept taking metformin and empagliflozin 12.5 mg or sitagliptin 50 mg twice daily as prescribed. The HbA1c change from baseline after 12 weeks of triple-added-on therapy was the main endpoint. RESULTS The sitagliptin group receiving empagliflozin saw a substantial drop in HbA1c, fasting and postprandial plasma glucose levels, body weight, and blood pressure compared to the starting point. As opposed to that, adding sitagliptin to the empagliflozin group non-significantly reduced HbA1c, fasting, and postprandial plasma glucose levels, and systolic blood pressure from baseline but significantly reduced body weight and diastolic blood pressure. Comparing the two groups, adding empagliflozin significantly reduced HbA1c, fasting, and postprandial plasma glucose levels (p < 0.001 for all except fasting plasma glucose level, p = 0.002). While the patient's weight and blood pressure were not significantly affected. CONCLUSIONS Empagliflozin was superior to sitagliptin in relation to glycemic control, weight, and systolic/diastolic blood pressure reduction.
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Affiliation(s)
- H G Zakaraia
- Clinical Pharmacy Department, Faculty of Pharmacy, University of Sadat City, Menoufia, Egypt.
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Essa NM, Elgendy MO, Gabr A, Mahmoud MM, Alharbi AA, Tashkandi HM, Salem HF, Harakeh S, Boshra MS. The efficacy of metformin as adjuvant to chemotherapy on IGF levels in non-diabetic female patients with progressive and non-progressive metastatic breast cancer. Eur Rev Med Pharmacol Sci 2023; 27:5200-5210. [PMID: 37318494 DOI: 10.26355/eurrev_202306_32638] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Some studies have shown that metformin inhibits the proliferation of breast cancer (BC) cells via multiple ways. One of these mechanisms is through the indirect control of the IGF-route mediated via the activation of the AMPK-LKB1 pathway in the liver, which leads to a decrease in blood glucose and insulin levels. The objective of this study was to investigate the effects of metformin as adjuvant to chemotherapy on IGF levels in female patients with progressive and non-progressive metastatic BC. PATIENTS AND METHODS In this trial, 107 women receiving chemotherapy for metastatic breast cancer (MBC) were divided into two groups: the metformin group received 500 mg of metformin twice daily, whereas the control group did not receive any metformin. All patients received chemotherapy according to the South Egypt Cancer Institute's (SECI) established regimen. The level of IGF-1 was determined in the blood at the initiation of therapy (baseline) and at six months post treatment. RESULTS No substantial differences were noted regarding IGF-1 levels in both groups at baseline (IGF-1 average level was 40.74 ± 36.16 vs. 32.06 ± 20.00 in the metformin and the placebo group, respectively, p = 0.462). While after six months, the mean IGF-1 level was 37.62 ± 31.35 vs. 39.12 ± 2 5.93 in the metformin and placebo groups, respectively, (p = 0.170). CONCLUSIONS Metformin as an adjuvant to chemotherapy in MBC patients had no significant effect on reducing IGF-l levels which promotes the inhibition of the proliferation of BC cells in MBC patients.
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Affiliation(s)
- N M Essa
- Department of Clinical Pharmacy, Faculty of Pharmacy, New Valley University, New Valley, Egypt.
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5
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Shafiek HK, El Lateef HMA, Boraey NF, Nashat M, Abd-Elrehim GAB, Abouzeid H, Hafez SFM, Shehata H, Elhewala AA, Abdel-Aziz A, Zeidan NMS, Soliman MM, Sallam MM, Nawara AM, Elgohary EA, Badr AI, Selim DM, Razek SA, Abdel Raouf BM, Elmikaty HA, Ibrahim LM, Shahin GH, Nabil RM, Ibrahim MAM, Salem HF, Moustafa AAM, Elshehawy NA, Abdel-Aziz MM, Eltrawy HH, Osman SF, Fouad RA, Afify MR, Mohamed MY, Yousif YM, Yousef AA, Arafa MA. Cytokine profile in Egyptian children and adolescents with COVID-19 pneumonia: A multicenter study. Pediatr Pulmonol 2021; 56:3924-3933. [PMID: 34536070 PMCID: PMC8661994 DOI: 10.1002/ppul.25679] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/20/2021] [Accepted: 09/16/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND To date, the cytokine profile in children and adolescent with novel coronavirus disease 2019 (COVID-19) has not been reported. OBJECTIVES We investigated serum levels of a panel of key cytokines in children and adolescent with COVID-19 pneumonia with a primary focus on "cytokine storm" cytokines such as interleukin (IL)-1β, IL-6, IL-17, IL-2, IL-4, IL-10, interferon (IFN-γ), tumor necrosis factor (TNF)-α, and two chemokines interferon-inducible protein-10 (IP-10) and IL-8. We also studied whether these cytokines could be potential markers for illness severity in COVID-19 pneumonia. METHODS Ninety-two symptomatic patients aged less than 18 years with confirmed COVID-19 pneumonia and 100 well-matched healthy controls were included in this multi-center study. For all patients, the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in respiratory fluid specimens was detected by real-time reverse-transcriptase polymerase chain reaction. We measured serum concentrations of studied cytokines by using flow cytometry. RESULTS Patients with COVID-19 had significantly higher median IL-1β, IL-6, IL-8, IL-10, IL-17, TNF-α, and IP-10 serum levels than did control children (all p < 0.01). Patients with severe COVID-19 pneumonia had significantly higher median IL-1β, IL-6, and IP-10 serum levels as compared with those with moderate COVID-19 pneumonia; all p < 0.01. ROC analysis revealed that three of the studied markers (IL-6, IL-1β, and IP-10) could predict severe COVID-19 pneumonia cases with the largest AUC for IL-6 of 0.893 (95% confidence interval: 0.84-0.98; p < 0.01). CONCLUSION Our study shows that pediatric patients with COVID-19 pneumonia have markedly elevated serum IL-1β, IL-6, IL-8, IL-10, IL-17, TNF-α, and IP-10 levels at the initial phase of the illness indicating a cytokine storm following SARS-CoV-2 infection. Moreover, serum IL-6, IL-1β, and IP-10 concentrations were independent predictors for severe COVID-19 pneumonia.
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Affiliation(s)
- Hala K Shafiek
- Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | | | - Naglaa F Boraey
- Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Mohamed Nashat
- Department of Pediatrics, Faculty of Medicine, Aswan University, Aswan, Egypt
| | | | - Heba Abouzeid
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Sahbaa F M Hafez
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Hassan Shehata
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed A Elhewala
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Alsayed Abdel-Aziz
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Nancy M S Zeidan
- Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt
| | | | - Mohammad M Sallam
- Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Abdalla M Nawara
- Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Elsayed A Elgohary
- Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Abdallah I Badr
- Department of Cardiothoracic Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Dalia M Selim
- Department of Pediatrics, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Suzan A Razek
- Department of Pediatrics, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Batoul M Abdel Raouf
- Department of Pediatrics, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Hani A Elmikaty
- Department of Pediatrics, National Research Centre, Cairo, Egypt
| | - Lamya M Ibrahim
- Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Gehan H Shahin
- Department of Clinical Pathology, Faculty of Medicine, Cairo University, Egypt
| | - Rehab M Nabil
- Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed A M Ibrahim
- Department of Clinical Pathology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Hanan F Salem
- Department of Anesthesia, Faculty of Medicine, Benha University, Banha, Egypt
| | - Ahmed A M Moustafa
- Department of Anesthesia, Faculty of Medicine, Benha University, Banha, Egypt
| | - Naglaa A Elshehawy
- Department of Anathesia, Faculty of Medicine, Al Azhar University, Egypt
| | - Marwa M Abdel-Aziz
- Department of Anathesia, Faculty of Medicine, Al Azhar University, Egypt
| | - Heba H Eltrawy
- Department of Chest Diseases, Faculty of Medicine for Girls, Al-Azhar University, Egypt
| | - Sherif F Osman
- Department of Radiology, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Rania A Fouad
- Department of Medical Biochemistry, Faculty of Medicine, Zagazig University, Zagazig, Egypt.,Department of Medical Biochemistry, College of Medicine, AlMaarefa University, Riyadh, Saudi Arabia
| | - Mona R Afify
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, University of Jeddah, Jeddah, Saudia Arabia
| | - Mohamed Y Mohamed
- Department of Psychiatry, Faculty of Medicine, Ain-Shams University, Egypt
| | - Yousif M Yousif
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Aly A Yousef
- Department of Pediatrics, Faculty of Medicine, Helwan University, Egypt
| | - Mohamed A Arafa
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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6
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Yousef AA, Mohamed FY, Boraey NF, Akeel NE, Soliman AA, Waked NM, Hashem MIA, Shehata H, Fahmy DS, Ismael A, Ibrahim LM, Ibrahim MAM, Salem HF, Yousry SM, Osman SF, Fouad RA, Enan ET, Attia MA, Afify MR, Zeidan NMS, Nashat M. Association of Plasminogen Activator Inhibitor 1 (PAI-1) 4G/5G Polymorphism and Susceptibility to SLE in Egyptian Children and Adolescents: A Multicenter Study. J Inflamm Res 2020; 13:1103-1111. [PMID: 33363394 PMCID: PMC7754263 DOI: 10.2147/jir.s277373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 10/27/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Plasminogen activator inhibitor-1 (PAI-1) is a key molecule residing at the nexus between thrombosis and inflammatory processes. Recently, PAI-1 and its gene expression have emerged as a potential candidate for autoimmune disorders such as SLE. OBJECTIVE To investigate whether the PAI-1 4G/5G polymorphism at position -675 could be a genetic marker for susceptibility to childhood-onset SLE and development of lupus nephritis among Egyptian children and adolescents. METHODS Three hundred fifty patients diagnosed with childhood-onset SLE and 350 well-matched healthy controls were included in this multi-center study. All subjects were genotyped for the PAI-1 promoter 4G/5G polymorphism at position -675 using PCR- restriction fragment length polymorphism (RFLP). Serum PAI-1 levels were measured by ELISA. RESULTS The PAI-1 (- 675) 4G/4G genotype was more represented in c-SLE patients, as compared to the control group (38% vs 23%; OR =2.7; [95% CI: 1.47-2.9]; P < 0.001). Patients carrying the PAI-1 4G/4G genotype or 4G allele were more likely to develop lupus nephritis (OR: 3.38; [95% CI: 1.9-5.9]; P <0.001, for the 4G/4G genotype and OR: 2.6; [95% CI: 1.85-3.67]; for the 4G allele; P < 0.01). The PAI-1 4G/4G genotype was associated with higher PAI-1 serum concentrations (mean; 86.6±22.7 ng/mL) as compared to those with a 4G/5G genotype (mean; 48.3±16.5 ng/mL) and the lowest for the 5G/5G genotype (mean; 34.7±11.4 ng/mL); P = 0.004. CONCLUSION The PAI-1 4G/5G polymorphism may confer susceptibility to childhood-onset SLE and development of lupus nephritis among Egyptian children and adolescents. Moreover, the PAI-1 4G/4G genotype and 4G allele were associated with higher PAI-1 serum levels and higher disease activity scores.
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Affiliation(s)
- Aly A Yousef
- Department of Pediatrics, Faculty of Medicine, Helwan University, Helwan, Egypt
| | - Faisal Y Mohamed
- Department of Pediatrics, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Naglaa F Boraey
- Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Nagwa E Akeel
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Attia A Soliman
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Nevin M Waked
- Department of Pediatrics, Faculty of Medicine, October 6 University, October 6, Egypt
| | - Mustafa I A Hashem
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Hassan Shehata
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Dalia S Fahmy
- Department of Rheumatology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ali Ismael
- Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Lamya M Ibrahim
- Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohamed A M Ibrahim
- Department of Clinical Pathology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Hanan F Salem
- Department of Anesthesia, Faculty of Medicine, Banha University, Banha, Egypt
| | - Sherif M Yousry
- Department of Clinical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Sherif F Osman
- Department of Radiology, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - Rania A Fouad
- Department of Medical Biochemistry, College of Medicine, El-Mareefa University, Riyadh, Kingdom of Saudi Arabia
- Department of Medical Biochemistry, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Eman T Enan
- Department of Pathology, College of Medicine, El-Mareefa University, Riyadh, Kingdom of Saudi Arabia
- Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt
| | - Mohammed A Attia
- Department of Clinical Pharmacology, College of Medicine, El-Mareefa University, Riyadh, Kingdom of Saudi Arabia
- Department of Clinical Pharmacology, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt
| | - Mona R Afify
- Department of Medical microbiology and Parasitology, Faculty of Medicine, University of Jeddah, Jeddah, 21589, Saudia Arabia
| | - Nancy M S Zeidan
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Nashat
- Department of Pediatrics, Faculty of Medicine, Aswan University, Aswan, Egypt
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