Abstract

Because nitric oxide and endothelial dysfunction could play a role in the pathogenesis of idiopathic restless legs syndrome (RLS), as was suggested by some preliminary data, we investigated the possible association between the rs2070744 variants in the endothelial nitric oxide synthase (eNOS or NOS3) gene (chromosome 7q36.1) and the risk for RLS in a Caucasian Spanish population. We assessed the frequencies of NOS3 single nucleotide polymorphisms (SNPs) rs2070744, rs1799983, and rs79467411 genotypes and allelic variants in 273 patients with idiopathic RLS and 325 healthy controls using a TaqMan-based qPCR assay. We also analyzed the possible influence of genotype frequency on age at onset of RLS symptoms, gender, family history of RLS, and response to drugs commonly used in the treatment of RLS such as dopaminergic drugs, clonazepam, and GABAergic drugs. The frequencies of genotypes and allelic variants were not associated with the risk for RLS and were not influenced by gender, age, and positive family history of RLS. We identified weak statistical associations of the SNP rs1799983 with the response to dopamine agonists (Pc = 0.018 for the rs1799983 G/T genotype) and of the SNP rs79467411 with the response to clonazepam (Pc = 0.018 for the rs79467411 G allele), although these findings should be cautiously interpreted and require further confirmation. These associations aside, our findings suggest that common NOS3 SNPs are not associated with the risk for idiopathic RLS in Caucasian Spanish people.

Highlights

  • Restless legs syndrome (RLS) or Willis-Ekbom disease (WED) is a high prevalence neurological disorder (Koo, 2015) mainly characterized by sensorimotor symptoms, with well-established diagnostic criteria (Allen et al, 2014)

  • Because decreased NOS3 expression is related to endothelial dysfunction (Napoli and Ignarro, 2001; Napoli et al, 2006), we investigated the possible association between the rs2070744, rs 1799983, and rs79467411 single nucleotide polymorphisms (SNPs) in the NOS3 gene and the risk for restless legs syndrome (RLS) in Caucasian Spanish people

  • We identified a statistically significant increased frequency of patients with the rs1799983 (G/T) genotype in patients not responding to dopamine agonists (DAs), as compared with patients who responded to these drugs (p 0.002)

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Summary

INTRODUCTION

Restless legs syndrome (RLS) or Willis-Ekbom disease (WED) is a high prevalence neurological disorder (Koo, 2015) mainly characterized by sensorimotor symptoms, with well-established diagnostic criteria (Allen et al, 2014). This study involved 273 patients diagnosed with idiopathic RLS according to the International Restless Legs Syndrome Study Group (IRLSSG) diagnostic criteria (Allen et al, 2014), after exclusion of secondary causes as was described elsewhere (Jiménez-Jiménez et al, 2017b), and 325 age- and sex-matched healthy controls. The promoter rs2070744 SNP was included in the study because it has several clinical associations and it is related to increased mRNA expression (Kittel-Schneider et al, 2015) The two missense NOS3 SNPs were selected according to their allele frequencies in public databases such as the Genome Aggregation Database (gnomAD; https://gnomad.broadinstitute.org/), because both displayed minor allele frequencies higher than, or around, 10%, which is adequate to reach a high statistical power.

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