Abstract

Considering the predominant role of rare variants of the Bone morphogenetic protein 9 (BMP9) gene in the occurrence of idiopathic pulmonary arterial hypertension (IPAH), here we conducted a case-control study, together with functional validation, to explore the relationships between variants of the BMP9 gene and development of IPAH. We found minor alleles of rs3740297 (OR: 0.72, 95% CI: 0.59-0.87, P=7.77×10-5) and rs7923671 (OR: 0.76, 95% CI: 0.62-0.93, P=0.009) were significantly associated with decreased risk of IPAH. Minor alleles of rs3740297 and rs7923671 were significantly associated with increased plasma level of BMP9 in both IPAH cases and controls (P<0.001). An allele of rs7923671 showed higher relative luciferase activity compared to that containing G allele (P<0.001). Mechanism exploration found that pulmonary artery smooth muscle cells (PASMC) cell line transfected with rs3740297 C allele construct, miR-149 mimic, and antagomir miR-149 showed more sensitive change of the relative luciferase activity and BMP9 expression. This means minor allele T of rs3740297 could significantly decrease susceptibility of IPAH in Chinese population, possibly by increasing BMP9 expression through losing a miR-149 binding site. Our study provides evidence for genetic associations between two specific variants in the BMP9 gene and plasma level of BMP9, occurrence of IPAH.

Highlights

  • Pulmonary arterial hypertension (PAH), a severe vasculopathy characterized by progressive narrowing and obliteration of the pulmonary arterioles, resulted in heart failure and premature death, and had raised the public concerns [1,2,3]

  • Among the five SNPs, we found minor alleles of rs3740297 (OR: 0.72, 95% confidence intervals (CIs): 0.59-0.87, P=7.77×10-5) and rs7923671 (OR: 0.76, 95% CI: 0.620.93, P=0.009) were significantly associated with decreased risk of idiopathic PAH (IPAH)

  • We found minor alleles of rs3740297 and rs7923671 were significantly associated with increased plasma level of Bone morphogenetic protein 9 (BMP9) in both IPAH cases and controls (P

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Summary

Introduction

Pulmonary arterial hypertension (PAH), a severe vasculopathy characterized by progressive narrowing and obliteration of the pulmonary arterioles, resulted in heart failure and premature death, and had raised the public concerns [1,2,3]. Growing evidence revealed multiple genetic and environmental mechanisms contributed to PAH development, including the incapacitation or mutation of the bone morphogenetic protein receptor type-2 (BMPR2) gene, epigenetic abnormality, or the sex hormone imbalance, the exact pathogenesis still remains unclear [6]. These factors could only explain a fraction of PAH cases, suggesting additional PAH genes awaiting exploration [6, 7]. Wang et al [9] conducted an exome-wide gene-based burden analysis and reported that the rare coding mutations in BMP9 gene occurred in 6.7% of idiopathic PAH (IPAH) cases, ranking this gene second to the BMPR2 gene. Considering the predominant role of rare variants of the BMP9 gene in www.aging-us.com

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