DD Allele Research Articles

The association between genetic polymorphisms in CYP19 and breast cancer risk in Korean women

Aromatase encoding by the CYP19 gene catalyzes the conversion of androgens to estrogens. In order to determine if polymorphisms of the CYP19 gene are associated with breast cancer risk, we analyzed the frequency of tetranucleotide (TTTA) tandem repeats and a 3-bp insertion (I)/deletion (D) polymorphism in intron 4 of the CYP19 gene in genomic DNA from 70 Korean breast cancer patients and 102 age-matched, healthy women. The 3-bp deletion allele was found more frequently in the breast cancer group than in the control group (p=0.001). Logistic regression analysis of the CYP 19 insertion/deletion (I/D) genotype showed a strong association between ID polymorphisms and breast cancer. The frequency of DD and ID alleles was significantly increased in the breast cancer group (DD genotype p=0.004, OR=12.81; and ID genotype p=0.005, OR=2.62). However, there were no differences in the genotype distributions of the (TTTA)n polymorphism of CYP19 between breast cancer patients and healthy controls. A positive association was noted between TTTA polymorphisms with 10 or more repeats and ER-negative tumors, as well as between lower repeat polymorphisms and ER-positive tumors (p=0.019). With respect to TTTA polymorphisms, we confirmed that the expression of aromatase in ER-positive MCF7 cells with 7-3 and 11 allele heterozygosity was significantly higher than in ER-negative MDA-MB231 cells with 11 allele homozygosity. These results suggest that 3-bp I/D polymorphisms of the CYP19 gene may be associated with breast cancer and that the (TTTA)n repeat genotype would be useful in selecting candidates for tamoxifen therapy, as well as predicting breast cancer risk in Korean women.

Effect of ID ACE gene polymorphism on dietary composition and obesity-related anthropometric parameters in the Czech adult population

The aim of this study was to investigate the possible associations between insertion/deletion (ID) polymorphism in angiotensin-converting enzyme (ACE) (dbSNP rs 4646994) with the food intake and body composition in the Czech non-obese, obese and extremely obese populations. A total of 453 various-weighted individuals were enrolled in the study and were according to their BMI assigned into following subgroups, such as obese (30 </= BMI < 40), morbidly obese (BMI >/=40) and non-obese (20 < BMI < 30) subjects. Both the obese cases and the non-obese controls underwent the identical subset of standardized examinations (BMI, % body fat, waist-to-hip ratio, skin fold thickness, native dietary composition examined by 7-day food records, etc.). No significant case-control differences in genotype distributions or allelic frequencies were observed. There were no differences in genotype frequencies between males and females either. The prevalence of obesity was significantly higher among subjects with the II genotype (42 %) when compared with those with DD (36%) and those with ID (37%) genotypes (P = 0.04). When compared with carbohydrate intake in the whole studied cohort, the odds ratios of carrying the DD allele in the morbidly obese cohort were 0.84 (95% CI 0.34, 2.10, P = 0.17), 0.27 (0.07, 0.98, P = 0.02), and 4.25 (1.44, 12.51, P = 0.005) in those individuals consuming <210, 210-260, and >260 g of carbohydrates/day, respectively. Based on our findings, the ID ACE polymorphism could represent a gene modulator of carbohydrate intake in morbidly obese Czech population; the strong significant effect of DD genotype was observed in the phenotypes of extreme obesity with the highest carbohydrate intake.

Distinct H-2 complex control of mortality, and immune responses to tuberculosis infection in virgin and BCG-vaccinated mice.

We have studied the impact of distinct haplotypes and of different alleles at specific H-2 loci on: (i) the susceptibility to lethal form of experimental tuberculosis; (ii) the level of DTH to mycobacterial antigens; (iii) the efficacy of vaccination with bacille Calmette-Guérin (BCG); and (iv) the IgG production and T cell proliferative response to H37Rv antigens. On the basis of median survival time (MST) following primary inoculation with lethal dose of Mycobacterium tuberculosis, susceptibility to infection associated with I-Ab and Db alleles, host resistance associated with I-Ak and Dd alleles. Mice bearing a disease-resistant phenotype also developed a vigorous DTH response. Vaccination with BCG before H37Rv infection significantly prolonged the survival time of both resistant and susceptible animals, except in B10.M (H-2f) mice. The latter exhibited intermediate resistance to infection before but slight decrease in the MST following a high-dose BCG vaccination. Distinct H-2 regulation of susceptibility to lethal infection and of BCG vaccination efficacy was confirmed in another relatively resistant H-2f-bearing strain A.CA, in which mortality occurred more rapidly in vaccinated compared with primarily infected animals. The expression of the H-2f haplotype was associated with a low DTH response to tuberculin following vaccination and subsequent lethal infection. The lack of BCG protection against Myco, tuberculosis challenge in B10.M mice associated with the high titre of specific IgG. In addition, these mice exhibited a unique ability to respond to 65-kD antigen by both IgG synthesis and T cell proliferation.

Dependence of endurance performance on ACE gene polymorphism in athletes

A group of elite 400-m distance runners carrying different alleles of the polymorphic angiotensinconverting enzyme (ACE) gene participated in an experiment that included aerobic exercise accompanied by measurement of the heart rate (HR) before, during, and after the exercise. Upon determination of the genotype for the ACE gene, the athletes were divided into three subgroups, carrying the II, ID, and DD alleles of the ACE gene. All athletes performed the same exercise: 25 min of running at an HR of 165–170 beats/min. The runners with the II genotype ran a significantly (p < 0.01) longer distance than the runners with the ID and DD genotypes. After the exercise, the HR recovery was the fastest in the runners with the II genotype.

Effects of ACE gene polymorphism on vitamin D therapy according to parathyroid hormone level in patients on hemodialysis

Medical management is still far from optimal in secondary hyperparathyroidism. This may be explained, at least in part, by genetic differences. The aim of this study was to evaluate the association of genetic influences of angiotensinconverting enzyme (ACE) gene polymorphisms with response to vitamin D therapy among patients on hemodialysis (HD). Eighty-two patients (female/male, 34/48; mean age, 47.5+/-15.3 y; HD duration time, 76.6+/-33.2 mo) with endstage renal disease who were on maintenance HD were included in the study. Five-year retrospective demographic, clinical, laboratory, and treatment data (5-y cumulative doses of phosphate-binding drugs and oral and intravenous cumulative doses of active vitamin D) were retrieved from patients' hospital records. ACE gene polymorphisms of patients were documented and were used to group patients as follows: The insertion/deletion polymorphism group (I/D) consisted of (1) group non-DD (n=43), who had the DI or II allele, and (2) group DD (n=39), who had the DD allele. Patients with the DD allele (group DD) of ACE gene polymorphism had (1) significantly elevated mean 5-y intact parathyroid hormone levels when compared with the non-DD group (P=.009), and (2) significantly elevated oral and intravenous 5-y cumulative doses of vitamin D. Oral and intravenous 5-y cumulative doses of vitamin D used in group DD patients were significantly higher than those in group I patients (P=.038 and P=.037, respectively). Knowledge of genetic differences among patients on HD may be useful to the clinician in planning treatment strategy. ACE gene polymorphism may have an effect on hyperparathyroidism, as is seen in patients on HD. Patients from this group who have resistant hyperparathyroidism may be candidates for ACE inhibitor therapy.

The genetics of left ventricular remodeling in competitive athletes

Left ventricular (LV) remodeling in competitive athletes is a complex phenomenon, in which genetic and environmental determinants are implicated. In recent years, several investigations have demonstrated an association between LV remodeling and the angiotensin-converting enzyme (ACE I/D) and/or angiotensinogen (AGT M/T) polymorphism, with athletes with the DD and/or TT alleles, respectively, showing the greatest increase in LV mass, independent from other determinants. However, the impact of the known genetic determinants on LV remodeling is at present incomplete, and comparative assessment of the genetic and environmental factors, such as the type and intensity of athletic conditioning, suggests that genetic determinants may explain up to one-quarter of the overall variability of LV dimensions. A better understanding of genetic factors may provide an insight into the pathways producing physiological cardiac remodeling, and will be important in understanding the intrinsic nature and clinical significance of the extreme LV morphologic changes observed in highly trained and elite athletes.

Renin-Angiotensin System Polymorphisms and Coronary Artery Surgery Patients

The frequencies of angiotensin-converting enzyme gene insertion/deletion, angiotensinogen-M253T, and angiotensin II type 1 receptor-A1166C polymorphisms were analyzed in 105 patients undergoing coronary artery bypass grafting (group 1) and a control group of 105 non-cardiac patients (group 2). Blood samples were obtained for biochemical analyses and DNA extraction. Genotyping was performed by polymerase-chain-reaction-based restriction analysis. According to the angiotensin-converting enzyme gene insertion/deletion polymorphism, 36.3% of patients in group 1 and 30.7% in group 2 were homozygous for the DD allele. This difference was not statistically significant. Angiotensin II type 1 receptor-A1166C genotype polymorphism was also not significantly different between the groups. The results showed the angiotensinogen-M235T polymorphism to be heterogenous. The MM homozygote frequency was significantly higher in controls (72.3%), whereas 80% of the TT homozygote frequency was in the surgical group ( p = 0.001). These results show that although there were no significant differences in angiotensin-converting enzyme gene insertion/deletion and angiotensin II type 1 receptor-A1166C genotype polymorphisms between the groups, angiotensinogen-M235T polymorphism of TT homozygote frequency was significantly associated with patients undergoing coronary artery bypass surgery.

An alternative fast and convenient genotyping method for the screening of angiotensin converting enzyme gene polymorphisms.

Insertion/deletion (I/D) polymorphisms in intron 16 of the angiotensin converting enzyme gene (ACE) are associated with the plasma angiotensin converting enzyme (ACE) levels, and individuals with the DD allele have been reported to be more susceptible to cardiovascular disease than those without. The conventional genotyping method for the screening of I/D polymorphisms, which involves polymerase chain reaction (PCR)-gel electrophoresis, is laborious and time-consuming. In this study, we assessed the use of TaqMan-PCR genotyping for the screening of I/D polymorphisms as a replacement for the conventional method. We genotyped seven single nucleotide polymorphisms (SNPs) in linkage disequilibrium (LD) with the I/D polymorphisms, and calculated the LD coefficients of the I/D polymorphisms. We found that three polymorphisms, rs4331, rs4334 and rs4341, exhibited the highest LD coefficients (D' = 1.000; r2 = 0.967) and that the genotyping of rs4341 by the TaqMan-PCR method yielded the best discrimination among the different genotypes. Genotyping of 511 samples took only 2 h and the amount of DNA required for each test was only 6 ng by the TaqMan-PCR method using rs4341. In the course of this study, we identified a novel additional polymorphism (a deletion of six amino acids) in exon 13, near rs4316. The deletion allele encoded the testicular ACE, but not the plasma ACE. We concluded that genotyping of the rs4341 ACE polymorphism by the TaqMan-PCR method is a fast and convenient alternative method for direct I/D genotyping. We also concluded that testicular ACE may manifest a deletion of six amino acids that may result in deleterious function of this enzyme.

Deletion allele of the angiotensin-converting enzyme gene as a risk factor for pneumonia in elderly patients

PurposeAspiration due to an age-related reduction in cough is a major cause of pneumonia in elderly persons. Because the insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene (ACE) has been associated with the cough reflex, we studied whether this genetic polymorphism was also associated with the risk of pneumonia. Subjects and methodsWe studied 1011 elderly inpatients (221 men and 790 women, mean [± SD] age of 82 ± 7 years) in a long-term care hospital. The association between the ACE I/D polymorphism and the incidence of pneumonia (defined using specific criteria that included radiographic abnormalities) was assessed during an 8-month period that excluded the winter. Data were analyzed using proportional hazards models, with adjustment for age, sex, and other potential confounders. ResultsDuring follow-up, 87 cases (9%) of pneumonia occurred, 38 of which were fatal. The ACE DD allele (vs. ID + II) was associated with an increased risk of pneumonia (relative risk [RR] = 2.9; 95% confidence interval [CI]: 1.7 to 4.8, P < 0.001) and fatal pneumonia [RR = 4.4; 95% CI: 2.1 to 9.0; P < 0.0001). ConclusionThe ACE D allele is an independent risk factor for pneumonia in elderly persons.

A stable single-chain variable fragment expressing transfectoma demonstrates induction of idiotype-specific cytotoxic T-cells during early growth stages of a murine B-lymphoma.

The idiotypic determinants associated with the variable regions of antibody molecules are known to function as tumor-associated antigens (TAAs). However, there is no clear-cut evidence documenting their efficacy in inducing TAA-specific cytotoxic T-lymphocytes (CTLs). In most previous studies, idiopeptides were implicated in elicitation of TAA-specific CD4+ T-cells. Using a murine B-cell lymphoma, 2C3, we earlier demonstrated induction of splenic CD4+ and CD8+ T-lymphocytes directed to idiotypic Ig of the tumor. In the present study, we provide more direct evidence of the existence of Id-specific CTLs in the spleens of 2C3 bearing BALB/c mice using an scFv-transfectoma, P815A4, as a target. While both P815A4 and 2C3 cells were equally susceptible to cytolysis by the effector cells, lysis was evident only during early tumor progression. Moribund animals at the late stage of tumor growth failed to demonstrate any significant cytotoxic immune response against either tumor. Antibodies to MHC class I alleles Kd, Dd, Ld, beta2m and CD8 molecules all inhibited cytotoxicity. The CTL population from early tumor-bearers recognized 2C3 tumor in the context of all major H-2d alleles; however, in case of P815A4 cells, it was restricted to Kd and Dd alleles only. Based on these antibody inhibition studies, it appears that the idiopeptides generated in both tumors are in some way different, yet they were recognized equally by CTLs not only from the tumor-bearers but also by CTLs from 2C3-hyperimmune mice. It appears that scFv-containing transfectomas expressing antibody variable region epitopes would be useful for both elucidating CTL-defined idiopeptides and monitoring TAA-specific CTL response in tumor-bearing animals.

An Insertion/Deletion Polymorphism in Intron 18 of the Type B Human Natriuretic Peptide Receptor Gene Is Not Associated with Cerebral Infarction.

The natriuretic peptide (NP) system may play a crucial role in the development of cardiovascular and renal diseases. C-type NP dilates arteries and lowers blood pressure, and it inhibits the proliferation of vascular smooth muscle cells via the type B NP receptor (NPRB). We determined and analyzed the structure of the NPRB gene and found an insertion/deletion (I/D) polymorphism in intron 18. In this experiment, we studied this I/D polymorphism in the NPRB gene in 241 subjects, including 118 patients with cerebral infarction (the CI group) and 123 control subjects (the non-CI group). Our goal was evaluate the association of this polymorphism with cerebral infarction. Our findings showed that genotype frequencies of the I/D polymorphism were in Hardy-Weinberg equilibrium. The frequencies for the II, ID, and DD alleles were 0.569, 0.374, and 0.057, respectively, in the non-CI group and 0.576, 0.356, and 0.068, respectively, in the CI group. No association was found between this polymorphism and cerebral infarction. These results suggest that this polymorphism in the NPRB gene is not linked to a pathogenic CI gene.

Influence of gene polymorphisms of the renin-angiotensin system on clinical outcome in heart failure among the Chinese

Background An association between the DD allele of the angiotensin-converting enzyme gene and a poorer outcome in patients with heart failure has been found in whites. The DD allele frequency is lower in Chinese, but the M235T variant of the angiotensinogen gene is more common in Chinese than whites; it is not known to what extent polymorphisms of the renin-angiotensin system affect clinical status or prognosis in Chinese patients with heart failure. Methods We assessed the relations among polymorphism of the angiotensin-converting enzyme gene, angiotensinogen M235T (AGT) gene, and angiotensin type I receptor A1166C gene with left ventricular systolic function, left and right ventricular diastolic function, serum angiotensin-converting enzyme, plasma aldosterone and atrial natriuretic peptide levels at presentation, and clinical outcome at 1 year (survival, hospital admissions) in a cohort of Chinese patients with typical systolic heart failure (n = 82). Results We confirmed the low prevalence of the angiotensin-converting DD and the angiotensin type I receptor CC genotypes, and high prevalence of the AGT TT genotype in Chinese subjects compared with whites. There was no relation between the various gene polymorphisms and survival at 1 year assessed by multiple regression or Cox regression survival analysis. The AC variant of the angiotensin type I receptor gene was associated with morbidity over a 1-year period (hospital admissions) and increased baseline aldosterone levels, but none of the other polymorphisms correlated with systolic or diastolic function, aldosterone or atrial natriuretic peptide levels. By multiple regression for effects on mortality rate, only atrial natriuretic peptide and age were significant. Conclusions In Chinese patients with heart failure, polymorphisms of the renin-angiotensin system do not appear to be related to survival or severity, probably because of the different prevalence of these genotypes in the Chinese. Thus this study illustrates that large interethnic differences in the frequencies of genotype polymorphisms of the renin-angiotensin system exist and results from one ethnic group cannot be extrapolated to another. (Am Heart J 1999;137:653-7.)

Host Genetic Determinants of Vaccine-Induced Eosinophilia During Respiratory Syncytial Virus Infection

In BALB/c mice, sensitization with the attachment protein (G) of respiratory syncytial virus (RSV) leads to CD4+ T cell-mediated lung eosinophilia during subsequent challenge with RSV. To determine the host genetic influences on this model of lung eosinophilia, we tested 15 different inbred mouse strains. Eosinophilia developed in all H-2d (BALB/c, DBA/2n, and B10.D2), but not in H-2k (CBA/Ca, CBA/J, C3H, BALB.K, or B10.BR) mouse strains. Among H-2b mice, 129 and BALB.B developed eosinophilia, whereas C57BL/6 and C57BL/10 did not. Testing first generation crosses between sensitive and resistant strains showed that eosinophilia developed in all H-2dxk (n = 5), irrespective of background genes, but not in H-2dxb (n = 2) mice. In vivo depletion of CD8+ T cells or IFN-gamma rendered C57BL/6, but not BALB.K mice, susceptible to eosinophilia. Analysis of B10 recombinant mice showed that the Dd allele (in B10.A(5R) mice) prevented CD8+ T cell accumulation in the lung, resulting in intense lung eosinophilia. However, the Db allele (in B10.A(2R) and B10.A(4R) mice) supported CD8+ T cell expansion and prevented eosinophilia. Intracellular cytokine staining showed that lung eosinophilia correlated with reduced IFN-gamma and increased IL-10 expression in lung T cells. These results are compatible with the unifying model that Th2 cells mediate the disease but can be inhibited by CD8+ T cells secreting IFN-gamma. Our findings have important implications for the development of protective, nonpathogenic vaccines for RSV disease.

Generation of cytotoxic T lymphocytes against immunorecessive epitopes after multiple immunizations with adenovirus vectors is dependent on haplotype.

Currently, adenovirus (Ad) is being considered as a vector for the treatment of cystic fibrosis as well as other diseases. However, the cytotoxic T lymphocyte (CTL) response to Ad could limit the effectiveness of such approaches. Since the CTL response to virus infection is often focused on one or a few immunodominant epitopes, one approach to circumvent this response is to create vectors that lack these immunodominant epitopes. The effectiveness of this approach was tested by immunizing mice with human group C adenoviruses. Three mouse strains (C57BL/10SnJ [H-2b], C3HeB/FeJ [H-2k], and BALB/cByJ [H-2d]) were immunized with wild-type Ad or Ad vectors lacking the immunodominant antigen(s), and the CTL responses were measured. In C57BL/10 (B10) mice, a single inoculation intraperitoneally (i.p.) led to the recognition of an immunodominant antigen in E1A. When B10 mice were inoculated multiple times either i.p. or intranasally with wild-type Ad or an Ad vector lacking most of the E1 region, subdominant epitopes outside this region were recognized. In contrast, C3H mice inoculated with wild-type Ad recognized an epitope mapping within E1B. When inoculated twice with Ad vectors lacking both E1A and E1B, no immunorecessive epitopes were recognized. The immune response to Ad in BALB/c mice was more complex. CTLs from BALB/c mice inoculated i.p. with wild-type Ad recognized E1B in the context of the major histocompatibility complex (MHC) class I Dd allele and a region outside E1 associated with the Kd allele. When BALB/c mice were inoculated with E1-deleted Ad vectors, only the immunodominant Kd-restricted epitope was recognized, and Dd-restricted CTLs did not develop. This report indicates that the emergence of CTLs against immunorecessive epitopes following multiple administrations of Ad vectors lacking immunodominant antigens is dependent on haplotype and could present an obstacle to gene therapy in an MHC-diverse human population.

The deletion polymorphism of the angiotensin-converting enzyme gene is related to phenotypic differences in human arteries.

We hypothesized that angiotensin-converting enzyme (ACE) insertion/deletion polymorphism may be related to arterial phenotypic differences that could explain the adverse effects of deletion polymorphism. Accordingly, contractile responses to angiotensin I and II (0.1 nmol.1(-1)-1 micromol.1(-1), endothelium-dependent relaxation to methacholine (0.01-100 micromol.1(-1), and the effect of NG-monomethyl-L-arginine (L-NMMA; 100 micromol.1(-1) on phenylephrine (10 micromol.1(-1) induced contraction, were studied in isolated rings of internal mammary arteries obtained from patients undergoing coronary bypass surgery. The results were analysed according to the ACE genotype of the patient (II, n = 8; ID, n = 11; DD, n = 9) as well as the presence/absence of either allele. The arteries from patients with the D allele (ID/DD) displayed a lower sensitivity to methacholine (P < 0.05 vs II), which suggested that the capacity of the endothelium for nitric oxide release in response to stimulation was also lower. By contrast, the increase in phenylephrine-induced contraction, by pre-incubation with L-NMMA, was more pronounced in the group with the DD allele (31 +/- 5%) than with the ID (11 +/- 11%) and II alleles (1 +/- 11%, P < 0.05 vs DD), which suggested a higher level of basal nitric oxide release. Finally, the differences in the responses to angiotensin I and II, which were used to evaluate the vascular conversion of angiotensin I, indicated that the level of angiotensin I conversion was higher in patients with the D allele (ID/DD, P < 0.05 vs II). The findings of this study indicate that ACE insertion/deletion polymorphism is related to arterial phenotypic differences in endothelial function and angiotensin I conversion.

Association between Deletion Polymorphism of the Angiotensin-Converting Enzyme Gene and Cerebral Atherosclerosis

We investigated deletion polymorphism in the gene for angiotensin-converting enzyme in patients with angiographically verified cerebral atherosclerosis. Genotypes were determined by the polymerase chain reaction with oligonucleotide flanking of the polymorphic region of intron 16 of the angiotensin-converting enzyme gene. Results of angiotensin-converting enzyme genotyping showed 46% of 50 studied patients to be homozygous for the DD allele, whose prevalence was significantly increased as compared with a group of controls without atherosclerotic changes. In this control group, the following genotypes were observed (%): II = 24, ID = 52 and DD = 24. The frequency of the I and D alleles in the group of patients with cerebral atherosclerosis was 0.28 and 0.72, respectively, whereas in the group without atherosclerosis it was 0.50 for both. Furthermore, in the present study, the DD genotype was associated with a high level of serum angiotensin-converting enzyme activity, total and LDL-cholesterol and triacylglycerol. A newly established association between DD genotype and cerebral atherosclerosis, detected even in our small group, supports the view that angiotensin-converting enzyme polymorphism might be indicative of the development of cerebral atherosclerosis.

Enhanced pressor response to angiotensin I in normotensive men with the deletion genotype (DD) for angiotensin-converting enzyme.

The insertion (I)/deletion (D) polymorphism of the human angiotensin-converting enzyme gene has emerged as a genetic risk factor for ischemic heart disease. However, the functional consequences of this polymorphism in humans are not known. Ten normotensive men with the DD genotype and 10 with the II genotype participated in a study in which pressor responses to stepwise infusions of incremental doses of angiotensin I (Ang I) and Ang II and Ang II production during Ang I infusion were measured. Pressor responses were expressed as PD20, which reflects the angiotensin dose required to raise mean blood pressure by 20 mm Hg. The PD20 for Ang I in subjects with the DD genotype was significantly lower than that in II genotype subjects (8.8 versus 14.8 ng/kg per minute, P = .0091), whereas the PD20 for Ang II between the two groups did not differ significantly. The ratio of PD20 for Ang I and Ang II in DD subjects was significantly lower than that in II subjects (0.85 versus 0.96, P = .0452), and the venous levels of Ang II during Ang I infusion in DD subjects were significantly higher than those in II subjects (P < .01). Our study has shown increased pressor responsiveness to Ang I, probably as a consequence of the generation of increased Ang II levels, in subjects homozygous for the DD allele of the angiotensin-converting enzyme gene. This result may be relevant to the reported adverse cardiovascular risk conferred by the D allele, as it provides a mechanistic rationale for the association between this polymorphism and cardiovascular disease.

729-6 Deletion Polymorphism of the Angiotensin-Converting Enzyme Gene is Associated with Concentric Remodeling of the Left Ventricle

There is polymorphism in the angiotensin-converting enzyme (ACE) gene, defined by the insertion (I allele) or deletion (D allele) of a 287 base pairalu repeat sequence. The DD genotype is associated with myocardial infarction, cardiomyopathy and LVH on ECG. LVH and concentric remodeling, [increased relative wall thickness (RWT)], significantly increase cardiovascular morbidity and mortality. The current studies were performed to evaluate the relationship between the DD genotype and echocardiographic findings in an untreated, multi-racial population referred for evaluation of suspected arterial hypertension. 2-D directed M-mode echocardiograms and awake ambulatory blood pressure (BP) monitoring were performed in 37 patients. LV mass (g/m 2 )and RWT (sum of septal and posterior wall/LV internal dimension) were assessed in a blinded fashion using the Penn convention. Body mass index (BMI, kg/m 2 ) was measured. ACE genotype was determined by polymerase chain reaction amplification of DNA prepared from leukocytes using primers that encompass the a/u repeat sequence. Subjects were divided into two groups based on genotype: group 1 (DD genotype, n = 14,); group 2 (ID or II genotype, n = 23): RWT LV mass Systolic BP Age BMI Group 1 0.40 ± 0.03 * 102 ± 41 151 ± 16 50 ± 11 28 ± 3 Group 2 0.32 ± 0.01 94 ± 21 146 ± 15 45 ± 9 29 ± 5 * p &lt; 0.03 RWT was significantly increased (*p &lt; 0.03) in patients with the DD genotype (group 1). LV mass, systolic BP, age and BMI did not differ between groups; LVH was present in only 2 patients in each group. In multivariate analysis, after accounting for the effect of age, race, sex and body mass index, concentric remodeling (RWT) and systolic BP were independently related to the DD genotype (p &lt; 0.003, and p &lt; 0.03, respectively). Thus the DD genotype may be associated with concentric LV remodeling, a geometric pattern associated with increased cardiovascular risk. Screening for the DD allele may allow early identification of subjects at increased risk for this geometric pattern and future cardiovascular disease.

997-84 Idiopathic Dilated Cardiomyopathy and the Insertion/Deletion Polymorphism of the Angiotensin Converting Enzyme Gene

Activity of the cardiovascular renin-angiotensin systems may be involved in cardiac remodelling and fibrosis. The absence (Deletion [D]) of a 287 base pair marker in the angiotensin converting enzyme (ACE) gene (intron 16) has been shown to be associated with raised serum ACE levels, and DD genotype may be a risk factor for the development of end-stage heart failure due to cardiomyopathy. We have therefore examined the relationship between ACE genotype, the presence of idiopathic dilated cardiomyopathy (IDC), and markers of disease severity. We studied 364 control subjects (age 54 ± 3 years) and 99 consecutive patients (41 ± 14 years) with idiopathic dilated cardiomyopathy (IDC) (left ventricular ejection fraction 25 ± 11%). 42 were in New York Heart Association Classification (NYHA) I, 17 in class II, 25 in class III, 15 in class IV. DNA was isolated from blood samples, and ACE genotype determined by specific polymerase chain reaction and separation of amplified fragments by agarose gel electrophoresis. We also compared ACE genotype distribution to that in previously reported European controls. Functional status, clinical course over 28 ± 33 months, and outcome were all documented. Cardiac morphology and function, and evidence of rhythm disturbance were non-invasively determined. ACE genotype distribution and allele frequencies in the control group, IDC group, and European controls did not differ significantly (p &gt; 0.1 in all cases.) No markers of disease severity or progression other than duration of symptoms prior to diagnosis and the number of ventricular ectopic beats/hour were significantly associated with the presence of the DD alleles. In contrast to previously published reports, we are unable to find evidence to support an association between ACE genotype and either the diagnosis of IDC perse, or clinical disease progression.

Interactions between a novel cell surface glycoprotein and the H‐2K and H‐2D antigens on myeloma tumor cells

AbstractPrevious studies have shown that when a subline of plasmacytoma LPC‐1 is grown in ascites form, the tumor cells harvested after 10–12 days (“late” cells) are resistant to lysis by cytotoxic T lymphocytes (CTL), apparently because the cell surface H‐2‐encoded molecules are blocked by a trypsin‐sensitive glycoprotein of approximately 160 kdaltons. The glycoprotein (gp 160) is produced, and accumulates on the cell surface, as the growing cells enter the stationary phase. In contrast, LPC‐1 cells harvested from the peritoneal cavity early in the transplantation cycle (ca. 4 days), while in exponential growth (“early” cells), have far less gp 160 and are susceptible to lysis by CTL. It is shown that, compared with early cells, the late LPC‐1 cells are far less effective in adsorbing antibodies to products of the H‐2 Kd and H‐2 Dd alleles, but only slightly less effective in adsorbing antibodies to la antigen, and fully effective in adsorbing antibodies to several antigens not related to H‐2 (e.g. PC.1, gp70, gp100, B220). The differences suggest that gp160 might preferentially block H‐2‐encoded molecules (especially K and D)Gp160 was also detected on another myeloma, MOPC 315 OPEC, a subline of MOPC 315, where it also appeared to block H‐2 molecules but not PC.1. Additional evidence for an interaction between gp160 and H‐2 molecules was obtained when sonicated membrane fragments were used to elicit secondary CTL responses to H‐2 in culture. The response could be elicited by fragments from early but not from late LPC‐1 cells, unless the late cells were treated with subtilisin (to remove gp 160) before sonication.