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Rakic JM, Pullinger CR, Van Blarigan EL, Movsesyan I, Stock EO, Malloy MJ, Kane JP. APOL1 Risk Variants Associate With the Prevalence of Stroke in African American Current and Past Smokers. J Am Heart Assoc 2023; 12:e030796. [PMID: 38084718 PMCID: PMC10863786 DOI: 10.1161/jaha.123.030796] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/14/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND African American smokers have 2.5 times higher risk for stroke compared with nonsmokers (higher than other races). About 50% of the African American population carry 1 or 2 genetic variants (G1 and G2; rare in other races) of the apolipoprotein L1 gene (APOL1). Studies showed these variants may be associated with stroke. However, the role of the APOL1 risk variants in tobacco-related stroke is unknown. METHODS AND RESULTS In a cross-sectional study, we examined whether APOL1 risk variants modified the relationship between tobacco smoking and stroke prevalence in 513 African American adults recruited at University of California, San Francisco. Using DNA, plasma, and questionnaires we determined APOL1 variants, smoking status, and stroke prevalence. Using logistic regression models, we examined the association between smoking (ever versus never smokers) and stroke overall, and among carriers of APOL1 risk variants (1 or 2 risk alleles), and noncarriers, separately. Among participants, 41% were ever (current and past) smokers, 54% were carriers of the APOL1 risk variants, and 41 had a history of stroke. The association between smoking and stroke differed by APOL1 genotype (Pinteraction term=0.014). Among carriers, ever versus never smokers had odds ratio (OR) 2.46 (95% CI, 1.08-5.59) for stroke (P=0.034); OR 2.00 (95% CI, 0.81-4.96) among carriers of 1 risk allele, and OR 4.72 (95% CI, 0.62-36.02) for 2 risk alleles. Among noncarriers, smoking was not associated with a stroke. CONCLUSIONS Current and past smokers who carry APOL1 G1 and/or G2 risk variants may be more susceptible to stroke among the African American population.
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Affiliation(s)
- Jelena Mustra Rakic
- Cardiovascular Research InstituteUniversity of California, San FranciscoCAUSA
- Center for Tobacco Control Research and EducationUniversity of California, San FranciscoCAUSA
| | - Clive R. Pullinger
- Cardiovascular Research InstituteUniversity of California, San FranciscoCAUSA
- Department of Physiological NursingUniversity of California, San FranciscoCAUSA
| | - Erin L. Van Blarigan
- Department of Epidemiology and BiostatisticsUniversity of California, San FranciscoCAUSA
| | - Irina Movsesyan
- Cardiovascular Research InstituteUniversity of California, San FranciscoCAUSA
| | - Eveline Oestreicher Stock
- Cardiovascular Research InstituteUniversity of California, San FranciscoCAUSA
- Department of MedicineUniversity of California, San FranciscoCAUSA
| | - Mary J. Malloy
- Cardiovascular Research InstituteUniversity of California, San FranciscoCAUSA
- Department of MedicineUniversity of California, San FranciscoCAUSA
| | - John P. Kane
- Cardiovascular Research InstituteUniversity of California, San FranciscoCAUSA
- Department of MedicineUniversity of California, San FranciscoCAUSA
- Department of Biochemistry and BiophysicsUniversity of California, San FranciscoCAUSA
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2
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Rakic JM, Pullinger CR, Van Blarigan EL, Movsesyan I, Stock EO, Malloy MJ, Kane JP. APOL1 Risk Variants Associate with the Prevalence of Stroke in African American Current and Past Smokers. medRxiv 2023:2023.04.28.23289292. [PMID: 37162992 PMCID: PMC10168501 DOI: 10.1101/2023.04.28.23289292] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Introduction Among African Americans, tobacco smokers have 2.5 times higher risk for stroke compared to non-smokers; the tobacco-related stroke risk being higher than in other races/ethnicities. About one half of African Americans carry at least one of two genetic variants (G1 and G2; rare in other races) of apolipoprotein L1 (apoL1), a component of high-density lipoproteins. Several studies showed APOL1 G1/G2 risk variants associate with stroke. However, the role of APOL1 variants in tobacco-related stroke is unknown. Methods In a cross-sectional study, we examined whether APOL1 risk variants modify the relationship between smoking and stroke in 513 African American adults (median age 58 years, 52% female) recruited through the University of California, San Francisco Lipid Clinic. Using DNA, plasma, and questionnaires we determined APOL1 variants, smoking status, and history of stroke. Using unstratified and stratified multivariable logistic regression models we examined the association between smoking history (ever smokers vs. never smokers) and odds of stroke overall, and among carriers of risk variants and non-carriers, separately. Results Among participants, 41% were ever (current and past) smokers, 54% were carriers of the APOL1 risk variant, and 41 have had stroke. In all stroke cases, where full medical records were available, stroke types were determined to be an ischemic, and not hemorrhagic, stroke. The association of smoking history and stroke differed by APOL1 genotype status in the unstratified model (Pinteraction term=0.016). Among carriers of risk variants, ever smokers had odds ratio (OR) =2.88 for stroke compared to never smokers (P=0. 0.038). The OR for stroke comparing ever vs. never smokers showed a dose-response trend among carriers of one risk allele of 2.35 and two risk alleles of 4.96. Among non-carriers, smoking history was not associated with a stroke. Conclusion In conclusion, current and past smokers who carry APOL1 G1 and/or G2 risk variants may be more susceptible to stroke, in particular ischemic stroke, among African Americans.
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Affiliation(s)
- Jelena Mustra Rakic
- Cardiovascular Research Institute, University of California San Francisco, United States
- Center for Tobacco Control Research and Education, University of California San Francisco, United States
| | - Clive R. Pullinger
- Cardiovascular Research Institute, University of California San Francisco, United States
- Department of Physiological Nursing, University of California San Francisco, United States
| | - Erin L. Van Blarigan
- Department of Epidemiology and Biostatistics, University of California San Francisco, United States
| | - Irina Movsesyan
- Cardiovascular Research Institute, University of California San Francisco, United States
| | - Eveline Oestreicher Stock
- Cardiovascular Research Institute, University of California San Francisco, United States
- Department of Medicine, University of California San Francisco, United States
| | - Mary J. Malloy
- Cardiovascular Research Institute, University of California San Francisco, United States
- Department of Medicine, University of California San Francisco, United States
| | - John P. Kane
- Cardiovascular Research Institute, University of California San Francisco, United States
- Department of Medicine, University of California San Francisco, United States
- Department of Biochemistry and Biophysics, University of California San Francisco, United States
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3
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Dong W, Wong KHY, Liu Y, Levy-Sakin M, Hung WC, Li M, Li B, Jin SC, Choi J, Lopez-Giraldez F, Vaka D, Poon A, Chu C, Lao R, Balamir M, Movsesyan I, Malloy MJ, Zhao H, Kwok PY, Kane JP, Lifton RP, Pullinger CR. Whole-exome sequencing reveals damaging gene variants associated with hypoalphalipoproteinemia. J Lipid Res 2022; 63:100209. [PMID: 35460704 PMCID: PMC9126845 DOI: 10.1016/j.jlr.2022.100209] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 12/02/2022] Open
Abstract
Low levels of high density lipoprotein-cholesterol (HDL-C) are associated with an elevated risk of arteriosclerotic coronary heart disease. Heritability of HDL-C levels is high. In this research discovery study, we used whole-exome sequencing to identify damaging gene variants that may play significant roles in determining HDL-C levels. We studied 204 individuals with a mean HDL-C level of 27.8 ± 6.4 mg/dl (range: 4-36 mg/dl). Data were analyzed by statistical gene burden testing and by filtering against candidate gene lists. We found 120 occurrences of probably damaging variants (116 heterozygous; four homozygous) among 45 of 104 recognized HDL candidate genes. Those with the highest prevalence of damaging variants were ABCA1 (n = 20), STAB1 (n = 9), OSBPL1A (n = 8), CPS1 (n = 8), CD36 (n = 7), LRP1 (n = 6), ABCA8 (n = 6), GOT2 (n = 5), AMPD3 (n = 5), WWOX (n = 4), and IRS1 (n = 4). Binomial analysis for damaging missense or loss-of-function variants identified the ABCA1 and LDLR genes at genome-wide significance. In conclusion, whole-exome sequencing of individuals with low HDL-C showed the burden of damaging rare variants in the ABCA1 and LDLR genes is particularly high and revealed numerous occurrences in HDL candidate genes, including many genes identified in genome-wide association study reports. Many of these genes are involved in cancer biology, which accords with epidemiologic findings of the association of HDL deficiency with increased risk of cancer, thus presenting a new area of interest in HDL genomics.
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Affiliation(s)
- Weilai Dong
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
| | - Karen H Y Wong
- Cardiovascular Research Institute, University of California, San Francisco, CA, USA
| | - Youbin Liu
- Department of Cardiology, The Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Michal Levy-Sakin
- Cardiovascular Research Institute, University of California, San Francisco, CA, USA
| | - Wei-Chien Hung
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
| | - Mo Li
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Boyang Li
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Sheng Chih Jin
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA; Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Jungmin Choi
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA; Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Korea
| | | | - Dedeepya Vaka
- Institute for Human Genetics, University of California, San Francisco, CA, USA
| | - Annie Poon
- Institute for Human Genetics, University of California, San Francisco, CA, USA
| | - Catherine Chu
- Institute for Human Genetics, University of California, San Francisco, CA, USA
| | - Richard Lao
- Institute for Human Genetics, University of California, San Francisco, CA, USA
| | - Melek Balamir
- Department of Internal Medicine, Istanbul University, Istanbul, Turkey
| | - Irina Movsesyan
- Cardiovascular Research Institute, University of California, San Francisco, CA, USA
| | - Mary J Malloy
- Cardiovascular Research Institute, University of California, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, CA, USA; Department of Pediatrics, University of California, San Francisco, CA, USA
| | - Hongyu Zhao
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Pui-Yan Kwok
- Cardiovascular Research Institute, University of California, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, CA, USA; Department of Dermatology, University of California, San Francisco, CA, USA
| | - John P Kane
- Cardiovascular Research Institute, University of California, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, CA, USA; Department of Biochemistry and Biophysics, University of California, San Francisco, CA, USA
| | - Richard P Lifton
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
| | - Clive R Pullinger
- Cardiovascular Research Institute, University of California, San Francisco, CA, USA; Physiological Nursing, University of California, San Francisco, CA, USA.
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4
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Terrelonge M, LaHue SC, Tang C, Movsesyan I, Pullinger CR, Dubal DB, Leung J, Douglas VC. KIBRA, MTNR1B, and FKBP5 genotypes are associated with decreased odds of incident delirium in elderly post-surgical patients. Sci Rep 2022; 12:556. [PMID: 35017578 PMCID: PMC8752781 DOI: 10.1038/s41598-021-04416-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/10/2021] [Indexed: 12/19/2022] Open
Abstract
Despite the association between cognitive impairment and delirium, little is known about whether genetic differences that confer cognitive resilience also confer resistance to delirium. To investigate whether older adults without postoperative delirium, compared with those with postoperative delirium, are more likely to have specific single nucleotide polymorphisms (SNPs) in the FKBP5, KIBRA, KLOTHO, MTNR1B, and SIRT1 genes known to be associated with cognition or delirium. This prospective nested matched exploratory case–control study included 94 older adults who underwent orthopedic surgery and screened for postoperative delirium. Forty-seven subjects had incident delirium, and 47 age-matched controls were not delirious. The primary study outcome was genotype frequency for the five SNPs. Compared with participants with delirium, those without delirium had higher adjusted odds of KIBRA SNP rs17070145 CT/TT [vs. CC; adjusted odds ratio (aOR) 2.80, 95% confidence interval (CI) 1.03, 7.54; p = 0.04] and MTNR1B SNP rs10830963 CG/GG (vs. CC; aOR 4.14, 95% CI 1.36, 12.59; p = 0.01). FKBP5 SNP rs1360780 CT/TT (vs. CC) demonstrated borderline increased adjusted odds of not developing delirium (aOR 2.51, 95% CI 1.00, 7.34; p = 0.05). Our results highlight the relevance of KIBRA, MTNR1B, and FKBP5 in understanding the complex relationship between delirium, cognition, and sleep, which warrant further study in larger, more diverse populations.
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Affiliation(s)
- Mark Terrelonge
- Department of Neurology, School of Medicine, University of California, San Francisco, CA, USA.,Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Sara C LaHue
- Department of Neurology, School of Medicine, University of California, San Francisco, CA, USA. .,Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.
| | - Christopher Tang
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA, USA
| | - Irina Movsesyan
- Cardiovascular Research Institute, University of California, San Francisco, CA, USA
| | - Clive R Pullinger
- Cardiovascular Research Institute, University of California, San Francisco, CA, USA
| | - Dena B Dubal
- Department of Neurology, School of Medicine, University of California, San Francisco, CA, USA.,Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Jacqueline Leung
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA, USA
| | - Vanja C Douglas
- Department of Neurology, School of Medicine, University of California, San Francisco, CA, USA.,Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
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5
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Pullinger CR, O’Connor PM, Naya‐Vigne JM, Kunitake ST, Movsesyan I, Frost PH, Malloy MJ, Kane JP. Levels of Prebeta-1 High-Density Lipoprotein Are a Strong Independent Positive Risk Factor for Coronary Heart Disease and Myocardial Infarction: A Meta-Analysis. J Am Heart Assoc 2021; 10:e018381. [PMID: 33728928 PMCID: PMC8174380 DOI: 10.1161/jaha.120.018381] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background We previously showed that levels of prebeta-1 high-density lipoprotein (HDL), the principal acceptor of cholesterol effluxed from cells, including artery wall macrophages, are positively associated with coronary heart disease (CHD) and myocardial infarction (MI) risk. Methods and Results In a multiethnic follow-up cohort of 1249 individuals from University of California-San Francisco clinics, we determined the degree to which prebeta-1 HDL levels, both absolute and percentage of apolipoprotein AI, are associated with CHD and history of MI. Independent, strong, positive associations were found. Meta-analysis revealed for the absolute prebeta-1 HDL for the top tertile versus the lowest, unadjusted odds ratios of 1.90 (95% CI, 1.40-2.58) for CHD and 1.79 (95% CI, 1.35-2.36) for MI. For CHD, adjusting for established risk factors, the top versus bottom tertiles, quintiles, and deciles yielded sizable odds ratios of 2.37 (95% CI, 1.74-3.25, P<0.001), 3.20 (95% CI, 2.07-4.94, P<0.001), and 4.00 (95% CI, 2.11-7.58, P<0.001), respectively. Men and women were analyzed separately in a combined data set of 2507 individuals. The odds ratios for CHD and MI risk were similar. Higher levels of prebeta-1 HDL were associated with all 5 metabolic syndrome features. Addition of prebeta-1 HDL to these 5 features resulted in significant improvements in risk-prediction models. Conclusions Analysis of 2507 subjects showed conclusively that levels of prebeta-1 HDL are strongly associated with a history of CHD or MI, independently of traditional risk factors. Addition of prebeta-1 HDL can significantly improve clinical assessment of risk of CHD and MI.
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Affiliation(s)
- Clive R. Pullinger
- Cardiovascular Research InstituteUniversity of CaliforniaSan FranciscoCA
- Department of Physiological NursingUniversity of CaliforniaSan FranciscoCA
| | | | | | - Steven T. Kunitake
- Cardiovascular Research InstituteUniversity of CaliforniaSan FranciscoCA
| | - Irina Movsesyan
- Cardiovascular Research InstituteUniversity of CaliforniaSan FranciscoCA
| | - Philip H. Frost
- Cardiovascular Research InstituteUniversity of CaliforniaSan FranciscoCA
- Department of MedicineUniversity of CaliforniaSan FranciscoCA
| | - Mary J. Malloy
- Cardiovascular Research InstituteUniversity of CaliforniaSan FranciscoCA
- Department of MedicineUniversity of CaliforniaSan FranciscoCA
| | - John P. Kane
- Cardiovascular Research InstituteUniversity of CaliforniaSan FranciscoCA
- Department of MedicineUniversity of CaliforniaSan FranciscoCA
- Department of Biochemistry and BiophysicsUniversity of CaliforniaSan FranciscoCA
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6
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Dron JS, Dilliott AA, Lawson A, McIntyre AD, Davis BD, Wang J, Cao H, Movsesyan I, Malloy MJ, Pullinger CR, Kane JP, Hegele RA. Loss-of-Function
CREB3L3
Variants in Patients With Severe Hypertriglyceridemia. Arterioscler Thromb Vasc Biol 2020; 40:1935-1941. [DOI: 10.1161/atvbaha.120.314168] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objective:
Genetic determinants of severe hypertriglyceridemia include both common variants with small effects (assessed using polygenic risk scores) plus heterozygous and homozygous rare variants in canonical genes directly affecting triglyceride metabolism. Here, we broadened our scope to detect associations with rare loss-of-function variants in genes affecting noncanonical pathways, including those known to affect triglyceride metabolism indirectly.
Approach and Results:
From targeted next-generation sequencing of 69 metabolism-related genes in 265 patients of European descent with severe hypertriglyceridemia (≥10 mmol/L or ≥885 mg/dL) and 477 normolipidemic controls, we focused on the association of rare heterozygous loss-of-function variants in individual genes. We observed that compared with controls, severe hypertriglyceridemia patients were 20.2× (95% CI, 1.11–366.1;
P
=0.03) more likely than controls to carry a rare loss-of-function variant in
CREB3L3
, which encodes a transcription factor that regulates several target genes with roles in triglyceride metabolism.
Conclusions:
Our findings indicate that rare variants in a noncanonical gene for triglyceride metabolism, namely
CREB3L3
, contribute significantly to severe hypertriglyceridemia. Secondary genes and pathways should be considered when evaluating the genetic architecture of this complex trait.
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Affiliation(s)
- Jacqueline S. Dron
- From the Robarts Research Institute (J.S.D., A.A.D., A.L., A.D.M., J.W., H.C., R.A.H.), Western University, London, ON, Canada
- Department of Biochemistry (J.S.D., A.A.D., A.L., R.A.H.), Western University, London, ON, Canada
| | - Allison A. Dilliott
- From the Robarts Research Institute (J.S.D., A.A.D., A.L., A.D.M., J.W., H.C., R.A.H.), Western University, London, ON, Canada
- Department of Biochemistry (J.S.D., A.A.D., A.L., R.A.H.), Western University, London, ON, Canada
| | - Arden Lawson
- From the Robarts Research Institute (J.S.D., A.A.D., A.L., A.D.M., J.W., H.C., R.A.H.), Western University, London, ON, Canada
- Department of Biochemistry (J.S.D., A.A.D., A.L., R.A.H.), Western University, London, ON, Canada
| | - Adam D. McIntyre
- From the Robarts Research Institute (J.S.D., A.A.D., A.L., A.D.M., J.W., H.C., R.A.H.), Western University, London, ON, Canada
| | - Brent D. Davis
- Schulich School of Medicine and Dentistry, and Department of Computer Science (B.D.D.), Western University, London, ON, Canada
| | - Jian Wang
- From the Robarts Research Institute (J.S.D., A.A.D., A.L., A.D.M., J.W., H.C., R.A.H.), Western University, London, ON, Canada
| | - Henian Cao
- From the Robarts Research Institute (J.S.D., A.A.D., A.L., A.D.M., J.W., H.C., R.A.H.), Western University, London, ON, Canada
| | - Irina Movsesyan
- Cardiovascular Research Institute, University of California, San Francisco (I.M., M.J.M., C.R.P., J.P.K.)
| | - Mary J. Malloy
- Cardiovascular Research Institute, University of California, San Francisco (I.M., M.J.M., C.R.P., J.P.K.)
| | - Clive R. Pullinger
- Cardiovascular Research Institute, University of California, San Francisco (I.M., M.J.M., C.R.P., J.P.K.)
| | - John P. Kane
- Cardiovascular Research Institute, University of California, San Francisco (I.M., M.J.M., C.R.P., J.P.K.)
| | - Robert A. Hegele
- From the Robarts Research Institute (J.S.D., A.A.D., A.L., A.D.M., J.W., H.C., R.A.H.), Western University, London, ON, Canada
- Department of Biochemistry (J.S.D., A.A.D., A.L., R.A.H.), Western University, London, ON, Canada
- Department of Medicine (R.A.H.), Western University, London, ON, Canada
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7
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Dron JS, Wang J, McIntyre AD, Cao H, Robinson JF, Duell PB, Manjoo P, Feng J, Movsesyan I, Malloy MJ, Pullinger CR, Kane JP, Hegele RA. Partial LPL deletions: rare copy-number variants contributing towards severe hypertriglyceridemia. J Lipid Res 2019; 60:1953-1958. [PMID: 31519763 DOI: 10.1194/jlr.p119000335] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 09/09/2019] [Indexed: 01/31/2023] Open
Abstract
Severe hypertriglyceridemia (HTG) is a relatively common form of dyslipidemia with a complex pathophysiology and serious health complications. HTG can develop in the presence of rare genetic factors disrupting genes involved in the triglyceride (TG) metabolic pathway, including large-scale copy-number variants (CNVs). Improvements in next-generation sequencing technologies and bioinformatic analyses have better allowed assessment of CNVs as possible causes of or contributors to severe HTG. We screened targeted sequencing data of 632 patients with severe HTG and identified partial deletions of the LPL gene, encoding the central enzyme involved in the metabolism of TG-rich lipoproteins, in four individuals (0.63%). We confirmed the genomic breakpoints in each patient with Sanger sequencing. Three patients carried an identical heterozygous deletion spanning the 5' untranslated region (UTR) to LPL exon 2, and one patient carried a heterozygous deletion spanning the 5'UTR to LPL exon 1. All four heterozygous CNV carriers were determined to have multifactorial severe HTG. The predicted null nature of our identified LPL deletions may contribute to relatively higher TG levels and a more severe clinical phenotype than other forms of genetic variation associated with the disease, particularly in the polygenic state. The identification of novel CNVs in patients with severe HTG suggests that methods for CNV detection should be included in the diagnostic workup and molecular genetic evaluation of patients with high TG levels.
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Affiliation(s)
- Jacqueline S Dron
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5B7, Canada.,Departments of Biochemistry Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5B7, Canada
| | - Jian Wang
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5B7, Canada
| | - Adam D McIntyre
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5B7, Canada
| | - Henian Cao
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5B7, Canada
| | - John F Robinson
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5B7, Canada
| | - P Barton Duell
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR 97239
| | - Priya Manjoo
- Department of Medicine, Gordon and Leslie Diamond Centre, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
| | - James Feng
- Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA 94158
| | - Irina Movsesyan
- Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA 94158
| | - Mary J Malloy
- Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA 94158
| | - Clive R Pullinger
- Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA 94158
| | - John P Kane
- Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA 94158
| | - Robert A Hegele
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5B7, Canada .,Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5B7, Canada.,Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5B7, Canada
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8
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Quinn AG, Schwemberger R, Stock EO, Movsesyan I, Axtell A, Chang S, Ishida BY, Malloy MJ, Kane JP, Pullinger CR. Moderate statin treatment reduces prebeta-1 high-density lipoprotein levels in dyslipidemic patients. J Clin Lipidol 2017; 11:908-914. [PMID: 28558949 DOI: 10.1016/j.jacl.2017.04.118] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 04/21/2017] [Accepted: 04/25/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Elevated plasma levels of prebeta-1 high-density lipoprotein (HDL), the principal acceptor of cholesterol effluxed from macrophages, are associated with increased risk of atherosclerotic coronary heart disease and myocardial infarction. OBJECTIVE The objective of the study was to assess the effects on prebeta-1 HDL levels of 6-week moderate-dose statin treatment. METHODS We studied 101 patients (mean age 52.7 years; 53.5% female; 63 with primary hypercholesterolemia; 38 with combined hyperlipidemia) before and after treatment with statins. Mean atorvastatin potency equivalence was 23.6 mg/d. Prebeta-1 HDL plasma levels were measured by immunofixation of agarose gels using anti-apolipoprotein A-1 antibody. RESULTS We observed a 42.0% reduction of low-density lipoprotein cholesterol (181 ± 56 vs 105 mg/dL, P < .001). Triglyceride (TG) levels decreased by 22.3% (157 vs 122 mg/dL, P < .001), HDL cholesterol levels remained similar (56.0 vs 57.1, P = NS). Levels of prebeta-1 HDL were significantly reduced by 17.9% after statin treatment (mean 11.4 vs 9.4 mg apoA-1/dL, P < .001). The magnitude of this decrease was similar with each of 3 statins (atorvastatin, simvastatin, and rosuvastatin). The decrease in prebeta-1 HDL was strongly associated with the decline in TG, but not with the decline in low-density lipoprotein cholesterol. CONCLUSIONS The association of high prebeta-1 HDL with coronary heart disease identifies it as an inferential measure of the rate of cholesterol efflux from the artery wall. Our observations demonstrate a reduction of prebeta-1 HDL with statin therapy, partially reflecting the reduced TGs, and probably reflecting a direct beneficial impact on cholesterol efflux.
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Affiliation(s)
- Alex G Quinn
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Rachel Schwemberger
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Eveline Oestreicher Stock
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Irina Movsesyan
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Andrea Axtell
- Department of Surgery, Massachusetts General Hospital, Boston MA, USA
| | - Sunny Chang
- Department of Pediatrics, Stony Brook University Hospital, Stony Brook, NY, USA
| | - Brian Y Ishida
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Mary J Malloy
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - John P Kane
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, San Francisco, CA, USA; Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA, USA
| | - Clive R Pullinger
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA; Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA, USA.
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Zou J, Tran D, Baalbaki M, Tang LF, Poon A, Pelonero A, Titus EW, Yuan C, Shi C, Patchava S, Halper E, Garg J, Movsesyan I, Yin C, Wu R, Wilsbacher LD, Liu J, Hager RL, Coughlin SR, Jinek M, Pullinger CR, Kane JP, Hart DO, Kwok PY, Deo RC. An internal promoter underlies the difference in disease severity between N- and C-terminal truncation mutations of Titin in zebrafish. eLife 2015; 4:e09406. [PMID: 26473617 PMCID: PMC4720518 DOI: 10.7554/elife.09406] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [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: 06/13/2015] [Accepted: 10/15/2015] [Indexed: 12/13/2022] Open
Abstract
Truncating mutations in the giant sarcomeric protein Titin result in dilated cardiomyopathy and skeletal myopathy. The most severely affected dilated cardiomyopathy patients harbor Titin truncations in the C-terminal two-thirds of the protein, suggesting that mutation position might influence disease mechanism. Using CRISPR/Cas9 technology, we generated six zebrafish lines with Titin truncations in the N-terminal and C-terminal regions. Although all exons were constitutive, C-terminal mutations caused severe myopathy whereas N-terminal mutations demonstrated mild phenotypes. Surprisingly, neither mutation type acted as a dominant negative. Instead, we found a conserved internal promoter at the precise position where divergence in disease severity occurs, with the resulting protein product partially rescuing N-terminal truncations. In addition to its clinical implications, our work may shed light on a long-standing mystery regarding the architecture of the sarcomere. DOI:http://dx.doi.org/10.7554/eLife.09406.001 The heart is able to beat partly because of a large protein called Titin that helps to give heart muscle its elasticity. Mutations that shorten the gene that encodes Titin can cause part of the heart to become enlarged and weakened, a condition called dilated cardiomyopathy. Some people with shortened copies of this protein have a mild form of cardiomyopathy and are able to lead relatively normal lives. Others develop more severe symptoms that prevent the heart from pumping blood effectively and may even cause the individual to need a heart transplant. Genetic studies have revealed that mutations that shorten the Titin protein by disrupting the portion of the gene corresponding to the latter two-thirds of the protein (which encodes the so-called “C-terminal” end of the protein) cause more severe symptoms than mutations that occur near the start of the gene. But it is not clear why the location of the mutation matters. To investigate this problem, Zou et al. used a gene-editing tool called CRISPR to create genetically engineered zebrafish. These fish had mutations at one of six different points in the gene that encodes the zebrafish version of Titin. Just as with humans, mutations near the C-terminal end of the gene caused more severe muscle problems in the fish. Specifically, Zou et al. found that the worst disease was associated with mutations that occurred at or after a “promoter” region within the gene and near this C-terminal end. Normally, the promoter produces an independent smaller form of the Titin protein, which helps to reduce the severity of muscle problems in zebrafish that have mutations near the start of the gene. However, mutations near the C-terminal end of the gene also damage this smaller form, preventing this failsafe from working, and so lead to more severe symptoms. Zou et al. also found this promoter to be active in both mouse and human hearts. Future work will focus on learning how this smaller form of Titin works to help muscle develop and withstand stress and determine whether increasing its production can overcome the more severe forms of disease. DOI:http://dx.doi.org/10.7554/eLife.09406.002
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Affiliation(s)
- Jun Zou
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, United States
| | - Diana Tran
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, United States
| | - Mai Baalbaki
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, United States
| | - Ling Fung Tang
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, United States
| | - Annie Poon
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, United States
| | - Angelo Pelonero
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, United States
| | - Erron W Titus
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, United States
| | - Christiana Yuan
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, United States
| | - Chenxu Shi
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, United States
| | - Shruthi Patchava
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, United States
| | - Elizabeth Halper
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, United States
| | - Jasmine Garg
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, United States
| | - Irina Movsesyan
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, United States
| | - Chaoying Yin
- Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States.,McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, United States
| | - Roland Wu
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, United States.,Department of Medicine, University of California, San Francisco, San Francisco, United States
| | - Lisa D Wilsbacher
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, United States.,Department of Medicine, University of California, San Francisco, San Francisco, United States
| | - Jiandong Liu
- Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States.,McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, United States
| | - Ronald L Hager
- Department of Exercise Sciences, Brigham Young University, Provo, United States
| | - Shaun R Coughlin
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, United States.,Department of Medicine, University of California, San Francisco, San Francisco, United States
| | - Martin Jinek
- Department of Biochemistry, University of Zurich, Zurich, Switzerland
| | - Clive R Pullinger
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, United States.,Department of Physiological Nursing, University of California, San Francisco, San Francisco, United States
| | - John P Kane
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, United States.,Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, United States
| | - Daniel O Hart
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, United States.,Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, United States
| | - Pui-Yan Kwok
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, United States.,Department of Dermatology, University of California, San Francisco, San Francisco, United States.,Institute for Human Genetics, University of California, San Francisco, United States
| | - Rahul C Deo
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, United States.,Department of Medicine, University of California, San Francisco, San Francisco, United States.,Institute for Human Genetics, University of California, San Francisco, United States.,California Institute for Quantitative Biosciences, San Francisco, United States
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Pullinger CR, Stock EO, Movsesyan I, Malloy MJ, Frost PH, Tripuraneni R, Quinn AG, Ishida BY, Schaefer EJ, Asztalos BF, Kane JP. Identification and metabolic profiling of patients with lysosomal acid lipase deficiency. J Clin Lipidol 2015; 9:716-26.e1. [PMID: 26350820 DOI: 10.1016/j.jacl.2015.07.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [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: 04/28/2015] [Revised: 06/29/2015] [Accepted: 07/18/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND Lysosomal acid lipase (LAL), encoded by the LIPA gene, catalyzes the intracellular hydrolysis of cholesteryl esters and triglycerides in hepatocytes and macrophages. LIPA defects cause accumulation of these lipids in lysosomes. LAL deficiency (LAL D) presents and progresses as a continuum with dyslipidemia, hepatomegaly, and liver fibrosis. OBJECTIVE To improve the understanding of the genetic basis of LAL D, an underappreciated cause of dyslipidemia and cirrhosis, we studied DNA samples from patients with various phenotypes of dyslipidemia. METHODS Participants (N = 1357) were identified by lipid profiles and screened for the common disease causing LIPA exon 8 skipping splice-site mutation (c.894G>A; p.Ser275_Gln298del; rs116928232). RESULTS Six patients were heterozygous for this variant. Complete LIPA sequencing revealed a patient, subsequently confirmed to have LAL D, with a heterozygous frameshift mutation involving deletion of exon 4 (p.Gly77Valfs*17 c.230-106_c.428+541del). A family study revealed a sister with the same genotype and phenotype. Genetic, clinical, and lipoprotein profiles of these sisters plus 6 additional family members are reported. Profiles of 2 other LAL D patients monitored for 2 decades are presented. Cholesterol homeostasis was studied to investigate rates of cholesterol synthesis and absorption in 4 LAL D patients. High-density lipoprotein (HDL) subspecies were also analyzed. CONCLUSIONS We used this LIPA sequencing strategy (detection of the relatively common exon 8 variant followed by complete gene sequencing to identify additional mutations) as a means to further elucidate the genetic basis of LAL D among individuals with a suggestive clinical phenotype.
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Affiliation(s)
- Clive R Pullinger
- Cardiovascular Research Institute, University of California, San Francisco, CA, USA; Department of Physiological Nursing, University of California, San Francisco, CA, USA.
| | - Eveline Oestreicher Stock
- Cardiovascular Research Institute, University of California, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, CA, USA
| | - Irina Movsesyan
- Cardiovascular Research Institute, University of California, San Francisco, CA, USA
| | - Mary J Malloy
- Cardiovascular Research Institute, University of California, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, CA, USA
| | - Philip H Frost
- Cardiovascular Research Institute, University of California, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, CA, USA
| | | | | | | | | | | | - John P Kane
- Cardiovascular Research Institute, University of California, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, CA, USA; Department of Biochemistry and Biophysics
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11
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Stock EO, Quinn A, Pullinger C, Schwemberger R, Movsesyan I, Malloy MJ, Kane J. STATIN TREATMENT REDUCES PEBETA-1 HDL LEVELS IN DYSLIPIDEMIC PATIENTS. J Am Coll Cardiol 2015. [DOI: 10.1016/s0735-1097(15)61378-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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12
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Mak ACY, Pullinger CR, Tang LF, Wong JS, Deo RC, Schwarz JM, Gugliucci A, Movsesyan I, Ishida BY, Chu C, Poon A, Kim P, Stock EO, Schaefer EJ, Asztalos BF, Castellano JM, Wyss-Coray T, Duncan JL, Miller BL, Kane JP, Kwok PY, Malloy MJ. Effects of the absence of apolipoprotein e on lipoproteins, neurocognitive function, and retinal function. JAMA Neurol 2015; 71:1228-36. [PMID: 25111166 DOI: 10.1001/jamaneurol.2014.2011] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
IMPORTANCE The identification of a patient with a rare form of severe dysbetalipoproteinemia allowed the study of the consequences of total absence of apolipoprotein E (apoE). OBJECTIVES To discover the molecular basis of this rare disorder and to determine the effects of complete absence of apoE on neurocognitive and visual function and on lipoprotein metabolism. DESIGN, SETTING, AND PARTICIPANTS Whole-exome sequencing was performed on the patient's DNA. He underwent detailed neurological and visual function testing and lipoprotein analysis. Lipoprotein analysis was also performed in the Cardiovascular Research Institute, University of California, San Francisco, on blood samples from the proband's mother, wife, 2 daughters, and normolipidemic control participants. MAIN OUTCOME MEASURES Whole-exome sequencing, lipoprotein analysis, and neurocognitive function. RESULTS The patient was homozygous for an ablative APOE frameshift mutation (c.291del, p.E97fs). No other mutations likely to contribute to the phenotype were discovered, with the possible exception of two, in ABCC2 (p.I670T) and LIPC (p.G137R). Despite complete absence of apoE, he had normal vision, exhibited normal cognitive, neurological, and retinal function, had normal findings on brain magnetic resonance imaging, and had normal cerebrospinal fluid levels of β-amyloid and tau proteins. He had no significant symptoms of cardiovascular disease except a suggestion of myocardial ischemia on treadmill testing and mild atherosclerosis noted on carotid ultrasonography. He had exceptionally high cholesterol content (760 mg/dL; to convert to millimoles per liter, multiply by 0.0259) and a high cholesterol to triglycerides ratio (1.52) in very low-density lipoproteins with elevated levels of small-diameter high-density lipoproteins, including high levels of prebeta-1 high-density lipoprotein. Intermediate-density lipoproteins, low-density lipoproteins, and very low-density lipoproteins contained elevated apoA-I and apoA-IV levels. The patient's apoC-III and apoC-IV levels were decreased in very low-density lipoproteins. Electron microscopy revealed large lamellar particles having electron-opaque cores attached to electron-lucent zones in intermediate-density and low-density lipoproteins. Low-density lipoprotein particle diameters were distributed bimodally. CONCLUSIONS AND RELEVANCE Despite a profound effect on lipoprotein metabolism, detailed neurocognitive and retinal studies failed to demonstrate any defects. This suggests that functions of apoE in the brain and eye are not essential or that redundant mechanisms exist whereby its role can be fulfilled. Targeted knockdown of apoE in the central nervous system might be a therapeutic modality in neurodegenerative disorders.
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Affiliation(s)
- Angel C Y Mak
- Cardiovascular Research Institute, University of California, San Francisco
| | - Clive R Pullinger
- Cardiovascular Research Institute, University of California, San Francisco
| | - Ling Fung Tang
- Cardiovascular Research Institute, University of California, San Francisco
| | - Jinny S Wong
- Gladstone Institute of Cardiovascular Disease, San Francisco, California
| | - Rahul C Deo
- Cardiovascular Research Institute, University of California, San Francisco
| | - Jean-Marc Schwarz
- College of Osteopathic Medicine, Touro University California, Vallejo
| | | | - Irina Movsesyan
- Cardiovascular Research Institute, University of California, San Francisco
| | | | - Catherine Chu
- Cardiovascular Research Institute, University of California, San Francisco
| | - Annie Poon
- Cardiovascular Research Institute, University of California, San Francisco
| | - Phillip Kim
- Darin M. Camarena Health Centers, Madera, California
| | - Eveline O Stock
- Cardiovascular Research Institute, University of California, San Francisco
| | | | | | - Joseph M Castellano
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California
| | - Tony Wyss-Coray
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California7Center for Tissue Regeneration, Repair, and Restoration, VA Palo Alto Health Care System, Palo Alto, California
| | - Jacque L Duncan
- Department of Ophthalmology, University of California, San Francisco
| | - Bruce L Miller
- Memory and Aging Center, University of California, San Francisco
| | - John P Kane
- Cardiovascular Research Institute, University of California, San Francisco
| | - Pui-Yan Kwok
- Cardiovascular Research Institute, University of California, San Francisco
| | - Mary J Malloy
- Cardiovascular Research Institute, University of California, San Francisco
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13
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Pullinger C, Stock EO, Tripuraneni R, Movsesyan I, Malloy M, Frost P, Quinn A, Kane J. Identification, lipoprotein profiling and treatment of patients with lysosomal acid lipase deficiency. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Movsesyan I, Ahabekyan N, Bazukyan I, Madoyan R, Dalgalarrondo M, Chobert J, Popov Y, Haertlé T. Properties and Survival Under Simulated Gastrointestinal Conditions of Lactic Acid Bacteria Isolated from Armenian Cheeses and Matsuns. BIOTECHNOL BIOTEC EQ 2014. [DOI: 10.1080/13102818.2010.10817880] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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15
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Pullinger CR, Goldfine ID, Tanyolaç S, Movsesyan I, Faynboym M, Durlach V, Chiefari E, Foti DP, Frost PH, Malloy MJ, Brunetti A, Kane JP. Evidence that an HMGA1 gene variant associates with type 2 diabetes, body mass index, and high-density lipoprotein cholesterol in a Hispanic-American population. Metab Syndr Relat Disord 2013; 12:25-30. [PMID: 24148075 DOI: 10.1089/met.2013.0086] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND High-mobility group AT-hook 1 (HMGA1) is an important regulator of the insulin receptor gene. We have previously shown in three populations of white European ancestry that the HMGA1 gene variant rs146052672 (also designated IVS5-13insC) is associated with type 2 diabetes mellitus (T2DM). The aim of this study was to measure the frequency of this variant and to determine the degree of the association with T2DM and other features of the metabolic syndrome in a replication cohort of Hispanic Americans. METHODS This was a retrospective cohort study of well-characterized Hispanic-American participants analyzed in the Genomic Resource in Atherosclerosis (GRA) (Cardiovascular Research Institute, University of California, San Francisco). A total of 1144 individuals were studied, 320 of whom had T2DM. We examined associations of the rs146052672 SNP with T2DM, plasma lipids, lipoproteins, and body mass index (BMI). RESULTS In this Hispanic-American cohort, the HMGA1 rs146052672 minor allele (C-insertion) frequency (MAF) was 21.4% with a carrier frequency of 37.4%, considerably higher than we previously observed among GRA white Europeans (MAF 3.1%). The prevalence of the IVS5-13insC variant was significantly higher in those with T2DM compared to controls [42.2% vs. 35.5%; odds ratio (OR) 1.44 95% confidence interval (CI) 1.09-1.90, P=0.011). The variant was also associated with BMI (positively, P=0.045) and plasma high-density lipoprotein cholesterol (HDL-C) (negatively, P=0.047). CONCLUSIONS As we saw previously among white Europeans, a functional HMGA1 variant was associated with T2DM in individuals of Hispanic-American ethnicity and was present at a much higher frequency.
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Affiliation(s)
- Clive R Pullinger
- 1 Cardiovascular Research Institute and Department of Physiological Nursing, University of California , San Francisco, California
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Kane JP, Stock EO, Pullinger CR, Movsesyan I, Malloy MJ, Quinn A. Identifying Cases of Cholesteryl Ester Storage Disease in a Tertiary Lipid Clinic. J Clin Lipidol 2013. [DOI: 10.1016/j.jacl.2013.03.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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17
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Pullinger CR, Aouizerat BE, Gay C, Coggins T, Movsesyan I, Davis H, Kane JP, Portillo C, Lee KA. Metabolic abnormalities and coronary heart disease risk in human immunodeficiency virus-infected adults. Metab Syndr Relat Disord 2010; 8:279-86. [PMID: 20235745 DOI: 10.1089/met.2009.0094] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Metabolic syndrome is a combination of risk factors for cardiovascular disease and diabetes, It has been reported to be increased in human immunodeficiency virus (HIV)-infected individuals. METHODS In a cohort of HIV-infected adults we examined parameters that contribute to defining the metabolic syndrome and to estimating the 10-year risk of coronary heart disease (CHD). The study group consisted of 296 participants (217 men and 79 women) of mixed ethnicity with a mean age of 45.3 years. RESULTS There was an appreciable prevalence of metabolic syndrome (30.0%), with the frequency increasing to 42.5% in those over 50 years of age. Those with the metabolic syndrome had a lower viral load. More women had abdominal obesity (59.5%) than men (20.7%, P < 0.001). The frequency of elevated plasma glucose was higher in females (37.2%) compared to males (16.9%, P = 0.004). High frequencies of decreased high-density lipoprotein cholesterol (HDL-C) and elevated blood pressure were seen in both sexes. Hypertriglyceridemia was less prevalent in African Americans. In those under 50 years of age, the 10-year CHD risk score for men was double that for women (6.2% vs 2.7%, P < 0.001). In older participants, the risk was similar between the sexes, with a third having scores over 10%. CONCLUSIONS The prevalence of metabolic syndrome was higher than in most other HIV cohorts. Those with the syndrome had significantly lower viral loads. Mean 10-year Framingham Cardiovascular Risk (FCR) scores were nearly doubled for those with metabolic syndrome. Both researchers and clinicians should consider age as well as sex when assessing patients with HIV infection for risks associated with metabolic syndrome.
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Affiliation(s)
- Clive R Pullinger
- Cardiovascular Research Institute, University of California, San Francisco, CA 94143-0130, USA.
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18
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Tanyolaç S, Bremer AA, Hodoglugil U, Movsesyan I, Pullinger CR, Heiner SW, Malloy MJ, Kane JP, Goldfine ID. Genetic variants of the ENPP1/PC-1 gene are associated with hypertriglyceridemia in male subjects. Metab Syndr Relat Disord 2010; 7:543-8. [PMID: 19656007 DOI: 10.1089/met.2009.0027] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Hypertriglyceridemia is associated with insulin resistance, type 2 diabetes, and the metabolic syndrome. Membrane glycoprotein PC-1 (also termed ENPP1) is a direct insulin receptor inhibitor, and certain polymorphisms of the ENPP1/PC-1 gene have been associated with insulin resistance, type 2 diabetes, obesity, and diabetic complications. METHODS We examined the effect of 3 ENPP1/PC-1 variants (K121Q, rs1044498, and IVS20delT-11, rs1799774, and A-->G+1044TGA, rs7754561) on plasma triglyceride levels in 1112 subjects of non-Hispanic American white European ancestry. RESULTS Two of the ENPP1/PC-1 variants--A-->G+1044TGA (odds ratio [OR] 1.48, 95% confidence interval [CI], 1.54-1.82, P = 0.002) and IVS20delT-11 (OR 1.41, 95% CI, 1.08-1.84, P = 0.012)--were significantly associated with hypertriglyceridemia. Haplotype analyses also revealed an association with hypertriglyceridemia. In the variant analyses and in the haplotype analysis, the associations with hypertriglyceridemia were observed in male but not female subjects. Interestingly, the more widely studied K121Q ENPP1/PC-1 variant was not associated with hypertriglyceridemia in any group or subgroup analysis. CONCLUSION In the present study, we find that genetic variants of the ENPP1/PC-1 gene are associated with hypertriglyceridemia in male subjects, and may contribute to the development of the insulin resistance/metabolic syndrome in this population.
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Affiliation(s)
- Sinan Tanyolaç
- Diabetes Center and Department of Medicine, University of California, San Francisco, California 94115, USA
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Pullinger CR, Aouizerat BE, Movsesyan I, Durlach V, Sijbrands EJ, Nakajima K, Poon A, Dallinga-Thie GM, Hattori H, Green LL, Kwok PY, Havel RJ, Frost PH, Malloy MJ, Kane JP. An apolipoprotein A-V gene SNP is associated with marked hypertriglyceridemia among Asian-American patients. J Lipid Res 2008; 49:1846-54. [PMID: 18441017 DOI: 10.1194/jlr.p800011-jlr200] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Apolipoprotein A-V (apoA-V) is an important regulator of plasma levels of triglyceride (TG) in mice. In humans, APOA5 genetic variation is associated with TG in several populations. In this study, we determined the effects of the p.185Gly>Cys (c.553G>T; rs2075291) polymorphism on plasma TG levels in subjects of Chinese ancestry living in the United States and in a group of non-Chinese Asian ancestry. The frequency of the less common cysteine allele was 4-fold higher (15.1% vs. 3.7%) in Chinese high-TG subjects compared with a low-TG group (Chi-square = 20.2; P < 0.0001), corresponding with a 4.45 times higher risk of hypertriglyceridemia (95% confidence interval, 2.18-9.07; P < 0.001). These results were replicated in the non-Chinese Asians. Heterozygosity was associated, in the high-TG group, with a doubling of TG (P < 0.001), mainly VLDL TG (P = 0.014). All eleven TT homozygotes had severe hypertriglyceridemia, with mean TG of 2,292 +/- 447 mg/dl. Compared with controls, carriers of the T allele had lower postheparin lipoprotein lipase activity but not hepatic lipase activity. In Asian populations, this common polymorphism can lead to profound adverse effects on lipoprotein profiles, with homozygosity accounting for a significant number of cases of severe hypertriglyceridemia. This specific apoA-V variant has a pronounced effect on TG metabolism, the mechanism of which remains to be elucidated.
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Affiliation(s)
- Clive R Pullinger
- Cardiovascular Research Institute, University of California, San Francisco, CA, USA.
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Luke MM, Kane JP, Liu DM, Rowland CM, Shiffman D, Cassano J, Catanese JJ, Pullinger CR, Leong DU, Arellano AR, Tong CH, Movsesyan I, Naya-Vigne J, Noordhof C, Feric NT, Malloy MJ, Topol EJ, Koschinsky ML, Devlin JJ, Ellis SG. A polymorphism in the protease-like domain of apolipoprotein(a) is associated with severe coronary artery disease. Arterioscler Thromb Vasc Biol 2007; 27:2030-6. [PMID: 17569884 DOI: 10.1161/atvbaha.107.141291] [Citation(s) in RCA: 121] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The purpose of this study was to identify genetic variants associated with severe coronary artery disease (CAD). METHODS AND RESULTS We used 3 case-control studies of white subjects whose severity of CAD was assessed by angiography. The first 2 studies were used to generate hypotheses that were then tested in the third study. We tested 12,077 putative functional single nucleotide polymorphisms (SNPs) in Study 1 (781 cases, 603 controls) and identified 302 SNPs nominally associated with severe CAD. Testing these 302 SNPs in Study 2 (471 cases, 298 controls), we found 5 (in LPA, CALM1, HAP1, AP3B1, and ABCG2) were nominally associated with severe CAD and had the same risk alleles in both studies. We then tested these 5 SNPs in Study 3 (554 cases, 373 controls). We found 1 SNP that was associated with severe CAD: LPA I4399M (rs3798220). LPA encodes apolipoprotein(a), a component of lipoprotein(a). I4399M is located in the protease-like domain of apolipoprotein(a). Compared with noncarriers, carriers of the 4399M risk allele (2.7% of controls) had an adjusted odds ratio for severe CAD of 3.14 (confidence interval 1.51 to 6.56), and had 5-fold higher median plasma lipoprotein(a) levels (P=0.003). CONCLUSIONS The LPA I4399M SNP is associated with severe CAD and plasma lipoprotein(a) levels.
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Affiliation(s)
- May M Luke
- Celera, 1401 Harbor Bay Parkway, Alameda, CA 94502, USA.
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Khovidhunkit W, Hachem JP, Medzihradszky KF, Duchateau PN, Shigenaga JK, Moser AH, Movsesyan I, Naya-Vigne J, Kane JP, Feingold KR, Grunfeld C. Parotid secretory protein is an HDL-associated protein with anticandidal activity. Am J Physiol Regul Integr Comp Physiol 2005; 288:R1306-15. [PMID: 15637169 DOI: 10.1152/ajpregu.00007.2004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
High-density lipoprotein (HDL) is part of innate immunity, protecting against infection and inflammation. Using a proteomic approach, we identified an amino acid sequence in a hamster HDL protein that showed homology to rat and mouse parotid secretory protein (PSP), a salivary protein secreted from the parotid glands. We cloned the cDNA encoding a putative hamster homolog of rat and mouse PSP. Searches for conserved domains of the protein showed that the COOH terminus of hamster PSP contains a region homologous to the NH2termini of a family of HDL-associated proteins, including LPS-binding protein, cholesteryl ester transfer protein, and phospholipid transfer protein. In mice, PSP was also associated with HDL but was not detected in very-low-density lipoprotein, low-density lipoprotein, or lipoprotein-deficient sera. In addition to salivary glands, we found that PSP mRNA was expressed in lung, testis, and ovary. The level of PSP in HDL was increased after endotoxin injection in hamsters, but not in mice. Recombinant PSP inhibits growth of Candida albicans in culture. In summary, our results showed that PSP is a novel anticandidal protein associated with HDL.
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Affiliation(s)
- Weerapan Khovidhunkit
- Metabolism Sect., Dept. of Veterans Affairs Medical Center, 4150 Clement St., Box 111 F, San Francisco, CA 94121, USA
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Duchateau PN, Movsesyan I, Yamashita S, Sakai N, Hirano K, Schoenhaus SA, O'Connor-Kearns PM, Spencer SJ, Jaffe RB, Redberg RF, Ishida BY, Matsuzawa Y, Kane JP, Malloy MJ. Plasma apolipoprotein L concentrations correlate with plasma triglycerides and cholesterol levels in normolipidemic, hyperlipidemic, and diabetic subjects. J Lipid Res 2000; 41:1231-6. [PMID: 10946010] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
Apolipoprotein L is a newly recognized component of human plasma lipoproteins. Mainly associated with apoA-I-containing lipoproteins, it is a marker of distinct HDL subpopulations. In an effort to gain inference as to its as yet unknown function, we studied biological determinants of apoL levels in human plasma. The distribution of apoL in normal subjects is asymmetric, with marked skewing toward higher values. No difference was found in apoL concentrations between males and females, but we observed an elevation of apoL in primary hypercholesterolemia (10.1 vs. 8.5 microgram/mL in control), in endogenous hypertriglyceridemia (13.8 microgram/mL, P < 0.001), combined hyperlipidemia phenotype (18.7 g/mL, P < 0.0001), and in patients with type II diabetes (16.2 microgram/mL, P < 0.02) who were hyperlipidemic. Significant positive correlations were observed between apoL and the log of plasma triglycerides in normolipidemia (0.446, P < 0.0001), endogenous hypertriglyceridemia (0.435, P < 0.01), primary hypercholesterolemia (0.66, P < 0.02), combined hyperlipidemia (0.396, P < 0.04), hypo-alphalipoproteinemia (0.701, P < 0.005), and type II diabetes with hyperlipidemia (0.602, P < 0. 01). Apolipoprotein L levels were also correlated with total cholesterol in normolipidemia (0.257, P < 0.004), endogenous hypertriglyceridemia (0.446, P = 0.001), and non-insulin-dependent diabetes mellitus (NIDDM) (0.548, P < 0.02). No significant correlation was found between apoL and body mass index, age, sex, HDL-cholesterol or fasting glucose and glycohemoglobin levels. ApoL levels in plasma of patients with primary cholesteryl ester transfer protein deficiency significantly increased (7.1 +/- 0.5 vs. 5.47 +/- 0.27, P < 0.006).
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Affiliation(s)
- P N Duchateau
- Cardiovascular Research Institute, University of California, San Francisco, CA 94143, USA
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