Methylenetetrahydrofolate Reductase 677TT Research Articles

Role of Methylenetetrahydrofolate Reductase Gene Polymorphisms (C677T, A1298C, and G1793A) in the Development of Early Onset Vasculogenic Erectile Dysfunction

The methylenetetrahydrofolate reductase (MTHFR) gene plays a key role in the metabolism of folate and homocysteine (Hcy) and its mutations have been associated with high serum Hcy level. Elevated serum Hcy has been linked to impaired endothelial function and occlusive vascular disease. We studied the association among the different genotypes of all three MTHFR polymorphisms (C677T, A1298C, and G1793A) and the risk of early-onset vasculogenic erectile dysfunction (VED). We performed a case-control study of 114 men with early-onset VED and 228 age-matched controls. Genotyping of MTHFR gene polymorphisms was performed using polymerase chain reaction restriction fragment length polymorphism (PCR-RLFP) technique. We also measured plasma lipids, Hcy, folate, and vitamin B12 levels. Patients with early-onset VED had higher serum Hcy levels (12.29 ± 2.32 vs. 9.82 ± 2.35 μmol/L, p = 0.001) and higher prevalence of 677TT homozygocity compared to controls (15.8% vs. 11.4%, p = 0.01). Serum Hcy concentration was significantly higher in individuals with 677TT, 1298CC, and 1793GG genotypes. Subgroup analysis according to severity of ED (mild, moderate, and severe) showed that patients with severe VED had higher serum Hcy levels compared to patients with mild VED (13.48 ± 2.51 vs. 11.21 ± 2.32 μmol/L, p = 0.001). Odds ratio seems to demonstrate that individuals with the MTHFR 677TT genotype and the 677TT + 1298AC combined genotype had a 3.16- and 3.89-fold increased risk for developing VED, suggesting a possible association of MTHFR polymorphisms with the risk of early-onset VED.

Relationship between three polymorphisms of methylenetetrahydrofolate reductase (MTHFR C677T, A1298C, and G1793A) gene and risk of prostate cancer: A case–control study

We hypothesized that genetic polymorphisms in methylenetetrahydrofolate reductase (MTHFR) gene are associated with prostate cancer risk. We genotyped three MTHFR polymorphisms (C677T, A1298C, and G1793A) and measured serum total homocysteine (tHcy), folate, and vitamin B12 levels in a case-control study of 174 cases and 348 normal healthy controls. The cancer-free controls were frequency matched to the cases by age (±2 years), educational level, occupational status, ethnicity, and smoking status. We found that the MTHFR 677TT and 1298CC genotypes were associated with an about 40% reduction in risk of prostate cancer (adjusted OR = 0.59, 95% CI = 0.41-0.94, and adjusted OR = 0.58, 95% CI = 0.32-0.91, respectively) compared to the 677CC, and 1298AA genotypes. The combined variant genotypes of 1298AC + 677CC were associated with a 30% reduction in risk of prostate cancer (OR = 0.70; 95% CI = 0.53-0.79). In contrast, the variant genotypes of 1793GA + 677CT were associated with slightly increased risk for prostate cancer (OR = 1.64; 95% CI = 0.86-2.15). Regarding prostate cancer aggressiveness, the 677TT genotype was associated with more than 50% decreased risk of high-grade prostate cancer (Gleason score >7) compared with the 677CC and 677CT genotypes (OR = 0.35, 95% CI = 0.24-0.64; P = 0.001). There was no significant difference in plasma levels of tHcy, folate, and vitamin B12 between the two groups with any genotypes. These data suggest that all three MTHFR polymorphisms may play a pivotal role in the developing prostate cancer. Larger studies in different ethnic populations and incorporating dietary folate intake are needed to replicate our findings.

The association between methylene-tetrahydrofolate reductase gene polymorphism and lung cancer risk

This study aimed to determine the relation between methylene-tetrahydrofolate reductase (MTHFR) gene polymorphism and lung cancer risk and the frequency of this polymorphism. The study involved 64 lung cancer patients (the study group) with definitive diagnosis and 61 noncancerous subjects (the control group). MTHFR C677T and A1298C mutation analysis was made using DNA isolated from peripheric blood and multiplex PCR and reverse hybridization strip test. Eighty-four percent of the patients were male. The age, gender, and history of alcohol use of the patients and control group were statistically similar. While MTHFR 677T and 677C allele frequency was 0.33 and 0.67 in the patients respectively, it was 0.29 and 0.71 in the control group. The frequencies of MTHFR 1298C and 1298A were 0.33 and 0.67 in the patients, and it was 0.31 and 0.69 in the control group respectively. When MTHFR 677TT and 677CT genotypes were compared with 677CC genotype, lung cancer risk was 2.4 times higher in the 677TT genotype. When MTHFR 1298AC and 1298CC genotypes were compared with 1298AA genotype, lung cancer risk was 1.5 times higher in 1298CC genotype. According to the results, allele frequency of homozygote T and C was high in lung cancer patients. It was 3.05 and 1.29 times higher in smokers than in non-smokers, and 3.05 and 1.64 times higher in males than in females; 3.0 and 2.44 times higher in those with non-small cell lung cancer than in those with small-cell lung cancer.

Methylenetetrahydrofolate reductase C677T polymorphism in patients with gastric and colorectal cancer in a Korean population

BackgroundThis study was designed to investigate an association between the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism and the risk of gastric and colorectal cancer in the Korean population.MethodsWe conducted a population-based large-scale case-control study involving 2,213 patients with newly diagnosed gastric cancer, 1,829 patients with newly diagnosed colorectal cancer, and 1,700 healthy controls. Genotyping was performed with peripheral blood DNA for MTHFR C677T polymorphisms. The statistical significance was estimated by logistic regression analysis.ResultsThe MTHFR C677T frequencies of CC, CT, and TT genotypes were 35.2%, 47.5%, and 17.3% among stomach cancer, 34%, 50.5%, and 15.5% in colorectal cancer, and 31.8%, 50.7%, and 17.5% in the controls, respectively. The MTHFR 677TT genotype showed a weak opposite association with colorectal cancer compared to the homozygous CC genotype [adjusted age and sex odds ratio (OR) = 0.792, 95% confidence interval (CI) = 0.638-0.984, P = 0.035]. Subjects with the MTHFR 677CT showed a significantly reduced risk of gastric cancer compared whose with the 677CC genotype (age- and sex-adjusted OR = 0.810; 95% CI = 0.696-0.942, P = 0.006). We also observed no significant interactions between the MTHFR C677T polymorphism and smoking or drinking in the risk of gastric and colorectal cancer.ConclusionsThe T allele was found to provide a weak protective association with gastric cancer and colorectal cancer.

Choline Intake Exceeding Current Dietary Recommendations Preserves Markers of Cellular Methylation in a Genetic Subgroup of Folate-Compromised Men

Severe choline deficiency adversely affects cellular methylation and DNA integrity, with potentially serious implications for disease risk. As part of a 12-wk controlled choline intervention study conducted in folate-compromised Mexican-American men (n = 60; 18–55 y) differing in the methylenetetrahydrofolate reductase (MTHFR) C677T genotype (21 677CC, 29 677TT), this study evaluated the effects of varied choline intakes (300, 550, 1100, and 2200 mg/d) on the change (i.e. wk 12–0) in markers of cellular methylation and DNA integrity. Choline intake affected the change in plasma S-adenosylmethionine (P = 0.044), with decreases tending to be greater (P ≤ 0.08) in the 300 and 550 mg/d groups than in the 2200 mg/d group. Choline intake also interacted with the MTHFR C677T genotype to affect the change in genomic DNA methylation and DNA damage. In men with the MTHFR 677CC genotype, choline intake affected (P = 0.007) the change in DNA methylation, with a greater decrease (P < 0.02) in the 300 mg/d group than in the 1100 and 2200 mg/d groups. In men with the MTHFR 677CC genotype, choline intake also affected (P = 0.047) the change in DNA damage, with the increase tending to be greater (P = 0.07) in the 550 mg/d group than in the 2200 mg/d group. Choline intake did not affect these variables in men with the MTHFR 677TT genotype. Overall, these data suggest that choline intake exceeding current dietary recommendations preserves markers of cellular methylation and attenuates DNA damage in a genetic subgroup of folate-compromised men.

Abstract 911: Genetic variations in the one-carbon transfer pathway and aberrant DNA methylation in prostate cancer

Abstract Many molecular studies have indicated that genetic and epigenetic alterations are important for carcinogenesis in the prostate. Alterations in the one-carbon metabolism pathway can influence DNA synthesis and DNA methylation. Polymorphisms in the genes for the methylenetetrahydrofolate reductase (MTHFR), methionine synthase (MTR), methionine synthase reductase (MTRR), serine hydroxymethyltransferase (SHMT) have been reported to be associated with some forms of malignancies. In a case-control study of 300 cases and 240 controls, we investigated whether four common polymorphisms in the MTHFR (C677T and A1298T), MTR (A2756G), SHMT1 (C1420T), MTRR (A66G), reduced folate carrier (RFC-1, A80G), and methylenetetrahydrofolate-dehydrogenase (MTHFD, G1958A) may have a role in altering prostate cancer susceptibility. The genotype was mainly determined by the PCR-RFLP method. The MTHFR 677TT genotype was associated with a significant decrease in the risk with an adjusted odds ratio of 0.57 (95% confidence interval: 0.34-0.94). The RFC-1 80GG genotype was associated with a significant increase in the risk with an adjusted odds ratio of 1.75 (95% confidence interval: 1.07-2.87). However, the MTHFR A1298C, MTR A2756G and SHMT1 C1420T, MTRR A66G and MTHFD G1958A were not associated with prostate cancer risk. We also analyzed CpG island hypermethylation in five genes (GSTP1, RARβ2, AR, DAPK, TIMP-3 and hMLH1) and its association with these polymorphisms in 100 prostate cancers. However no significant association was detected. These findings suggest that polymorphism of the MTHFR may be involved in carcinogenesis of the prostate. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 911.

Methylene tetrahydrofolate reductase gene polymorphism in Egyptian children with acute lymphoblastic leukemia

Genetic variations of the enzymes involved in chemotherapy metabolism in cancer patients may play a role in determining relapse and toxicity risks. Methotrexate is a key drug in acute lymphoblastic leukemia (ALL) treatment; it inhibits DNA replication by blocking the conversion of 5,10 methylene tetrahydrofolate to 5-methylene tetrahydrofolate by methylene tetrahydrofolate reductase (MTHFR). MTHFR is central to folate metabolism and has two common functional polymorphisms (C677>T and A1298>C). The present study aimed to assess the prevalence of MTHFR polymorphisms C677>T and A1298>C in Egyptian children with ALL and the relation to the frequency of drug-induced complications and relapse rate. Forty ALL patients were included in the study. They were treated according to modified ALL-BFM 90 protocol, and were followed up for 3.1-6.5 years. The severity and duration of hepatic, mucosal and infectious complications during therapy were reported. MTHFR genotyping was done with a PCR-based restriction fragment length polymorphism assay. The MTHFR C677>T polymorphic allele frequencies were 40, 27.5, and 32.5% for TT, CT, and CC genotypes, respectively among the studied ALL patients. The MTHFR A1298>C polymorphic allele frequencies were 40, 35, and 25% for AA, AC, and CC genotypes, respectively. Methotrexate therapy was significantly associated with increased grade III/IV toxicity in TT genotype: diarrhea in 81.3%, oral mucositis in 81.3%, elevated transaminases in 87.5%, neutropenia in 78.7% compared to values of 7.7, 7.7, 15.3, and 7.7% in CC genotype, respectively (P < 0.0001, P < 0.0001, P < 0.0001, and P = 0.03). The 677 TT genotype was significantly associated with relapse in 5 years in 56.3%, compared to 18.2% in CT and 0% in CC alleles. The overall 5 years survival was significantly lower in 677 TT (50%) compared with CC genotypes (92.3%) (P = 0.001). No significant relation was found between MTHFR A1298C polymorphism and the risks of therapy induced complications or relapse rate in the studied ALL patients. MTHFR TT genotype is significantly associated with increased mucosal and hepatic toxicity during methotrexate therapy as well as increased relapse rate in childhood ALL. Because of the relatively high prevalence of the TT genotype in the studied Egyptian children with ALL, MTHFR gene polymorphisms should be studied in large multicenter studies; and dosage modification of methotrexate in the ALL treatment protocols should be considered based on the MTHFR gene pattern.

Association of Methylenetetrahydrofolate Reductase (MTHFR 677C&gt;T and 1298A&gt;C) Polymorphisms and Haplotypes with Silent Brain Infarction and Homocysteine Levels in a Korean Population

PurposeMethylenetetrahydrofolate reductase (MTHFR) is the main regulatory enzyme for homocysteine metabolism. In the present study, we evaluated whether the MTHFR 677C>T and 1298A>C gene polymorphisms are associated with SBI and plasma homocysteine concentration in a Korean population.Materials and MethodsWe enrolled 264 patients with SBI and 234 healthy controls in South Korea. Fasting plasma total homocysteine (tHcy) concentrations were measured, and genotype analysis of the MTHFR gene was carried out.ResultsThe plasma tHcy levels were significantly higher in patients with SBI than in healthy controls. Despite a significant association between the MTHFR 677TT genotype and hyperhomocysteinemia, the MTHFR 677C>T genotypes did not appear to influence susceptibility to SBI. However, odds ratios of the 1298AC and 1298AC + CC genotypes for the 1298AA genotype were significantly different between SBI patients and normal controls. The frequencies of 677C-1298A and 677C-1298C haplotypes were significantly higher in the SBI group than in the control group.ConclusionThis study demonstrates that the MTHFR 1298A>C polymorphism is a risk factor for SBI in a Korean population. The genotypes of 677C>T and 1298A>C polymorphisms interact additively, and increase the risk of SBI in Korean subjects.

MTHFR C677T and postmenopausal breast cancer risk by intakes of one-carbon metabolism nutrients: a nested case-control study

IntroductionThe C677T polymorphism of the methylenetetrahydrofolate reductase (MTHFR) gene has been hypothesized to increase breast cancer risk. However, results have been inconsistent, and few studies have reported the association by menopausal status or by intakes of nutrients participating in one-carbon metabolism. Our aims were to investigate whether MTHFR C677T was associated with postmenopausal breast cancer risk and whether this relation was modified by intakes of folate, methionine, vitamins B2, B6, and B12, and alcohol.MethodsWe studied 318 incident breast cancer cases and 647 age- and race-matched controls participating in a nested case-control study of postmenopausal women within the VITamins And Lifestyle (VITAL) cohort. Genotyping was conducted for MTHFR C677T and dietary and supplemental intakes were ascertained from a validated questionnaire. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional logistic regression.ResultsWe observed a 62% increased risk of breast cancer among postmenopausal women with the TT genotype (OR = 1.62; 95% CI: 1.05 to 2.48). Women with a higher number of variant T alleles had higher risk of breast cancer (P for trend = 0.04). Evidence of effect-modification by intakes of some B vitamins was observed. The most pronounced MTHFR-breast cancer risks were observed among women with the lowest intakes of dietary folate (P for interaction = 0.02) and total (diet plus supplemental) vitamin B6 (P for interaction = 0.01), with no significant increased risks among women with higher intakes.ConclusionsThis study provides support that the MTHFR 677TT genotype is associated with a moderate increase in risk of postmenopausal breast cancer and that this risk may be attenuated with high intakes of some one-carbon associated nutrients.

Genetic Polymorphisms of MTHFR and Aberrant Promoter Hypermethylation of the RASSF1A Gene in Bladder Cancer Risk in a Chinese Population

Epidemiological studies have shown that folate deficiency increases the risk of cancer by affecting DNA repair and methylation. Methylenetetrahydrofolate reductase (MTHFR) is a key enzyme in folate metabolism. In this study, it was hypothesized that MTHFR (C677T and A1298C) polymorphisms would be associated with bladder cancer and also with hypermethylation of the promoter of the Ras association domain family 1A (RASSF1A) gene. This hospital-based, case-control study of 312 bladder cancer patients and 325 cancer-free controls found that individuals carrying the MTHFR 677TT genotype had a 2.00-fold increased risk of bladder cancer compared with those carrying the 677CC genotype. None of the MTHFR A1298C polymorphisms alone were associated with bladder cancer, but the combined haplotype 677TT/1298AA was associated with a 2.27-fold increased risk compared with haplotype 677CC/1298AA. There was no association between MTHFR gene variants and methylation status of the RASSF1A gene in the 45 bladder cancer patients in whom this was studied. It is concluded that the MTHFR 677TT genotype and the TTAA haplotype may increase the risk of bladder cancer.

Mild hyperhomocysteinemia, C677T polymorphism on methylenetetrahydrofolate reductase gene and the risk of macroangiopathy in type 2 diabetes: a prospective study

The role of hyperhomocysteinemia as a risk factor for diabetic long-term complications has not been sufficiently evaluated in prospective studies, considering specific correlates of homocysteine (tHcy) concentration and traditional cardiovascular disease (CVD) risk factors. Fasting tHcy, vitamin B12 and folate plasma levels, the common methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism, as well as clinical and lifestyle information were assessed in 216 type 2 diabetic patients attending two outpatient clinics, who had a follow-up evaluation at 65 ± 9 months for the incidence of macroangiopathy. At basal evaluation, mild hyperhomocysteinemia (tHcy ≥ 15 μmol/l) was diagnosed in 21.3% of participants. At follow-up, hyperhomocysteinemia and the distribution of MTHFR C677T genotype did not significantly differ according to the incidence of macroangiopathy. Multiple variables adjusted ORs (95% CI) for CVD associated with mild hyperhomocysteinemia were 1.01 (0.37-2.82); P > 0.05; those associated with MTHFR TT genotype were 0.46 (0.15-1.38); P > 0.05. Although the prevalence of hyperhomocysteinemia was higher in diabetic men (26.9%) than in women (16.1%; P > 0.05), similar results were also observed in a separate sex-analysis. At the multivariate analysis, including in the model other potential CVD risk factors, only creatinine clearance was a significant risk factor for the development of macroangiopathy. In this cohort of diabetic subjects, mild hyperhomocysteinemia and the MTHFR TT genotype are not significant risk factors for the development of macroangiopathy; impaired renal function was confirmed as a significant predictor of this complication.

The C677T Methylenetetrahydrofolate Reductase Polymorphism and Insulin Resistance in Childhood Cancer Survivors.

Abstract 1400Poster Board I-422 Introduction:Childhood cancer survivors have increased risk for cardiovascular disease and insulin resistance. Methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism and low folate are associated with higher levels of homocysteine and changes in methylation status; these factors, in particular the TT and CT genotypes have been associated with insulin resistance in animal and human models. The CT genotype is present in about 25 % of the healthy US population. Vitamin B12 is an important co-factor in this association. The homocysteine/methionine ratio has been used as an indirect marker of methylation status and MTHFR function. Population and Methods:This analysis includes children (n=156) who survived ≥ 5-yrs following diagnosis of acute lymphoblastic leukemia (ALL) (n=55), acute myeloid leukemia (AML) (n=4), and non-Hodgkin's lymphoma (NHL) (n=13), central nervous system tumors (38) and other cancers (n=46). Mean age at diagnosis was 10.3 yrs (5.7-15.8) and mean age at evaluation was 15.0 yrs (9.9-17.9). Anthropometric measurements, blood pressure (BP), fasting glucose, insulin, lipids, folate, vitamin B12, homocysteine, and methionine were collected. Insulin resistance was assessed by euglycemic hyperinsulinemic clamp, adjusted for lean body mass (low Mlbm represents insulin resistance, less than 50% of distribution). Genetic polymorphisms, of MTHFR CC (wildtype) CT (heterozygous) and TT (homozygous) were identified; comparisons between MTHFR polymorphisms were adjusted for age, gender, and Tanner stage. Results:CC genotype was present in 44%, CT in 47.3 %, and TT in 8.7 % of survivors. Folate and B12 levels were lowest in the TT group, although not statistically significant (P value >0.05). Insulin resistance was most prevalent in the CT group and least prevalent in the TT group. The homocysteine/ methionine ratio was lowest in the CT group and highest in the TT group. Measures of adiposity were similar in all three groups (Table). Conclusion:This study suggests an increased frequency of the CT genotype in this study population of childhood cancer survivors compared to the healthy US population. Insulin resistance was most prevalent in the CT group; however, this was not associated with low levels of folate, B12, or high homocysteine/methionine ratio. The low frequency of insulin resistance in the TT group likely reflects the small number of participants with this genotype. Further study of these variables in larger populations is needed to provide sufficient power in assessing these relationships in childhood cancer survivors.TableMTHFR genotype, co-factors, and insulin resistanceCharacteristicMTHFR CCMTHFR CTMTHFR TTMTHFR c677t, n (%)66 (44%)71 (47.3%)13 (8.7%)BMI, kg/m222.322.122.4Folate16.216.015.8Vitamin B12532579501Homocysteine7.36.96.9Methionine2.42.52.1*IR, n (%)32 (45%)36 (51%)3 (4%)*Hcyst/Met ratio3.22.93.5*IR-insulin resistance, Hcyst-homocysteine, Met-methionine Disclosures:No relevant conflicts of interest to declare.

Meta- and Pooled Analyses of the Methylenetetrahydrofolate Reductase (MTHFR) C677T Polymorphism and Colorectal Cancer: A HuGE-GSEC Review

Worldwide, over 1 million cases of colorectal cancer (CRC) were reported in 2002, with a 50% mortality rate, making CRC the second most common cancer in adults. Certain racial/ethnic populations continue to experience a disproportionate burden of CRC. A common polymorphism in the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene has been associated with a lower risk of CRC. The authors performed both a meta-analysis (29 studies; 11,936 cases, 18,714 controls) and a pooled analysis (14 studies; 5,068 cases, 7,876 controls) of the C677T MTHFR polymorphism and CRC, with stratification by racial/ethnic population and behavioral risk factors. There were few studies on different racial/ethnic populations. The overall meta-analysis odds ratio for CRC for persons with the TT genotype was 0.83 (95% confidence interval (CI): 0.77, 0.90). An inverse association was observed in whites (odds ratio = 0.83, 95% CI: 0.74, 0.94) and Asians (odds ratio = 0.80, 95% CI: 0.67, 0.96) but not in Latinos or blacks. Similar results were observed for Asians, Latinos, and blacks in the pooled analysis. The inverse association between the MTHFR 677TT polymorphism and CRC was not significantly modified by smoking status or body mass index; however, it was present in regular alcohol users only. The MTHFR 677TT polymorphism seems to be associated with a reduced risk of CRC, but this may not hold true for all populations.

PO17-TU-01 CNS manifestations in systemic sclerosis: a case report

polymorphisms: the prothrombin 20210 G→A, factor V Leiden G 1691A, plasminogen activator inhibitor (PAI) −6754G/5G, fibrinogen −455G→A, platelet receptors: GPIB (−5) T→C, GPIIIA L33P T→ C, GP IA C807T, SELPLG M621 G→A, methylenetetrahydrofolate reductase (MTHFR) C677T, methionine synthase reductase (MTRR) A66G, coagulation factor VII 10976 G→A. At stroke pts studied data coagulogram tests and homocysteine level before anticoagulant therapy. REsults: Total frequency of prothrombin gene G20210A, factor V Leiden, MTHFR (C677T) and MTRR (A66G) mutations at stroke pts in 2.8 times is higher, than at healthy children. The polymorphisms in homocysteine metabolism genes met more often: MTRR (66GG) in 30.6% of cases, MTHFR (677TT) in 8.3% of cases. The homocysteine level at stroke pts exceeded the upper limit of normal age level and also was significantly elevated in at carriers of these genes: 10.29±1.55 mcmol/l vs 7.33±0.6 mcmol/l (p = 0.018). In coagulogram the anticoagulant system disorders (decrease of a protein C activity – in 22.7% of cases, protein S activity – in 13.6% and antithrombin III – in 12.5% of cases), and also increase of D-dimer level – in 21% of cases are found out. Conclusions: The impact prothrombotic disorders must be examined in relation to other established risk factors and potentially new therapeutic strategies. It is reasonable to measure the serum homocysteine level at ischemic stroke pts.

Evaluation of C677T and A1298C polymorphisms of the MTHFR gene as maternal risk factors for Down syndrome and congenital heart defects

Abnormal folate/homocysteine metabolism due to polymorphisms in genes involved in this pathway has been implicated as an etiologic factor in Down syndrome (DS). This case-control study aimed to evaluate the effect of maternal C677T and A1298C polymorphisms of the methylenetetrahydrofolate reductase (MTHFR) as risk factors for the development of DS and congenital heart defects (CHD). The distribution of these genotypic variants was similar between mothers of children with DS (n = 239) and control mothers of normal children (n = 197), but the combined genotypes 677CT or TT and 1298AA increased the risk of having offspring with DS (OR = 1.99; 95% CI 1.11-3.55). The presence of the 677T allele in case mothers resulted in a 2.07-fold higher odds of CHD in the offspring (P < 0.01). Among the 57 mothers of CHD-affected children with DS who carried the MTHFR 677CT or TT genotypes and did not have periconceptional folic acid intake, we observed a 2.26-fold increased odds (95% CI 1.25-4.09) of having any CHD-affected child with DS. Our results show that MTHFR genetic polymorphisms may be involved in the etiology of DS in our population when controlling for age. We noted a borderline significant association for the C677T polymorphism (P = 0.05). Maternal 677T allele may be associated with an increased occurrence of CHD in children with DS and we anticipate that women who carry this polymorphism would benefit from periconceptional folic acid supplementation. (c) 2009 Wiley-Liss, Inc.

BRIEF REPORT: Association between MTHFR 677C‐T polymorphism and alcohol dependence according to Lesch and Babor typology

Prior studies have associated 677C-T Methylenetetrahydrofolate reductase (MTHFR) gene polymorphism with decreased enzymatic activity and modified homocysteine regulation. This study determines and compares MTHFR 677C-T distribution and examines its consequences on homocysteine metabolism and alcohol dependence in alcoholic patients classified according to the Babor and Lesch typologies. MTHFR TT genotype was more prevalent in AD patients with milder alcohol dependence (Babor type A) and with Lesch type 3, associated with depression. MTHFR TT was also associated with hyperhomocysteinemia. Determining MTHFR 677C-T genotype, folate and vitamin B12 levels could assist physicians in identifying type 3 patients and improve addictions management.

Association of von Willebrand Factor Activity with ACE I/D and MTHFR C677T Polymorphisms in Migrainecha

Angiotensin-converting enzyme (ACE) insertion (I)/deletion (D) and methylenetetrahydrofolate reductase (MTHFR) C677T polymorphisms are linked to endothelial dysfunction and to cerebral white matter lesions. Objectives of this study were to determine if ACE and MTHFR gene polymorphisms are associated with von Willebrand factor (vWF) activity, an endothelial dysfunction marker, and with a distinct headache phenotype. We enrolled 64 women (18-50 years old) with International Classification of Headache Disorders, 2nd edn migraine without aura (MoA) and 61 with aura (MA). Genotypic frequencies: ACE DD 35%, ID 42%, II 23%, and MTHFR TT 17%, CT 40%, CC 43%. Those with ACE DD genotype had higher levels of vWF activity (152%) compared with ID and II genotypes. Levels were highest (179%) with combined ACE DD and MTHFR TT genotypes. ACE DD was associated with higher headache frequency, and MTHFR TT was associated with MA. In migraine, vWF activity may be a marker of endothelial-mediated genetic risk for ischaemic conditions.

Case-control Study of Methylenetetrahydrofolate Reductase Mutations and Hyperhomocysteinemia and Risk of Stroke

The association of factor V-Leiden and methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C mutations with stroke was investigated in 118 patients with stroke and 120 control subjects. MTHFR 677TT (P < .001) and 1298CC (P < .001), but not factor V-Leiden (P = .179), genotypes were associated with stroke. The C677T but not A1298C MTHFR mutation was associated with elevated homocysteine levels in patients and control subjects. In addition to hypertension, the significant predictors for stroke were MTHFR 677CT and TT and A1298CC genotypes, together with hyperhomocysteinemia, indicating a synergistic effect of MTHFR mutations with elevated homocysteine and other risk factors in pathogenesis of stroke.

Polygenic association with total homocysteine in the post-folic acid fortification era: The CARDIA study

Elevated plasma concentration of total homocysteine (tHcy) has been linked with many diseases. tHcy is associated with a variety of factors, including polymorphisms in genes involved in homocysteine metabolism. It is not clear whether US-mandated fortification of grain products with folic acid has affected the association of genetic variants with tHcy levels. We determined tHcy concentrations in sera from 997 Caucasians and 692 African Americans participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study before and after folic acid fortification. DNA was genotyped for variants present in four genes involved in homocysteine metabolism: cystathionine β-synthase (CBS) 844ins68, methionine synthase (MS) 2756A>G; methionine synthase reductase (MTRR) 66A>G and methylenetetrahydrofolate reductase (MTHFR) 677C>T and 1298A>C. A greater number of African Americans were homozygous for the MS 2756GG, MTRR 66GG and CBS 844ins68 genotypes compared to Caucasians, while prevalence of MTHFR 677TT and 1298CC genotypes was substantially lower in African Americans compared to Caucasians. The overall variance in tHcy levels at y 0, 7 and 15 that can be explained by the combined presence of all five variants increased slightly over time in Caucasians (17%, y 0; 21%, y 7; and 26%, y 15) and in African Americans (13%, y 0; 17% y 7; and 18% y 15) largely due to decrease in tHcy variance.

The TT Genotype of the C677T Polymorphism in the Methylentetrahydrofolate Reductase as a Risk Factor in Thrombotic Microangiopathies: Results From a Pilot Study

In this study, we assessed the potential role of the TT genotype of the gene of the methylenetetrahydrofolate reductase for the manifestation of thrombotic microangiopathies, enrolling 40 affected patients (mean age [+/- standard deviation] 35 +/- 11 years). As a result, the methylenetetrahydrofolate reductase 677TT genotype was more prevalent in patients with thrombotic microangiopathies compared with controls (adjusted odds ratio = 2.58, 95% confidence interval = 1.2-5.7, P = .018), particularly in those suffering from the hemolytic uremic syndrome. A hemolytic more severe clinical course of thrombotic microangiopathies in carriers of the methylenetetrahydrofolate reductase 677TT genotype was not observed. In summary, our findings suggest a significant influence of the methylenetetrahydrofolate reductase genotype on the manifestation of thrombotic microangiopathies. The 677 TT genotype of this polymorphism appears to be a risk factor for manifestation of these rare thrombotic disorders, possibly explained by endothelial activation and increased oxidative stress.