Aldosterone synthase (CYP11B2)­344T/C polymorphism and renoprotective response to losartan treatment in diabetic nephropathy

Objective. It has been suggested that an aldosterone synthase gene polymorphism (CYP11B2 ­344T/C) is predictive of the blood pressure lowering effect of angiotensin II receptor blockers in essential hypertension. We investigated whether this polymorphism is predictive of reductions in blood pressure and albuminuria and preservation of glomerular filtration rate (GFR) during short‐term and long‐term treatment with losartan in 57 hypertensive type‐1 diabetic patients with diabetic nephropathy. Material and methods. After a 4‐week washout period, patients received losartan (100 mg o.d.) and were followed for a mean follow‐up of 36 months. At baseline, after 2 and 4 months, and every 6 months thereafter, GFR (⁵¹Cr‐EDTA‐clearance), albuminuria and 24‐h blood pressure were determined. The CYP11B2 ­344T/C polymorphism was determined by standard polymerase chain reaction (PCR). Results. The TT, CT and CC genotypes were found in 28 %, 58 % and 14 % of patients, respectively. At baseline albuminuria and blood pressure did not differ between genotype groups. Plasma aldosterone levels (geometric mean (95 % CI)) were similar at baseline: 87 (60–125), 77 (53–112), and 89 (49–161) pg mL^?1 and during follow‐up (not significant). After initiation of losartan treatment, comparable mean (SE) reductions in blood pressure and albuminuria were seen in patients with TT, CT and CC genotypes (p >0.6 between groups). After long‐term follow‐up, there was a tendency towards a difference in systolic blood pressure reduction (p = 0.07, one‐way ANOVA), suggesting a poorer response in patients with the CC genotype. No significant difference in rate of decline in GFR (median (range)) was seen between groups (TT, CT, CC): 4.2 (?1.0 to 16.0), 3.2 (?1.6 to 13.8) and 2.6 (?0.1 to 11.0) mL min^?1year^?1, respectively (p = 0.5). Conclusions. Compared to a previous smaller study of angiotensin II receptor blockade in essential hypertension, we could not confirm that CYP11B2 ­344T/C genotypes contribute towards explaining the observed variability in response to treatment with angiotensin II receptor blockers, which could be due to lack of power.     

LNA-taqman探针实时荧光PCR快速检测CYP4F2-C1347T,CYP2C9*3,VKORC1-C1173T与VKORC1-G1639A基因多态性方法的建立

目的建立一种基于LNA-taqman探针实时荧光PCR检测华法林剂量相关基因型维生素K单氧酶CYP4F2,维生素K环氧化物还原酶复合体亚单位1(VKORC1)和细胞色素P4502C9(CYP2C9)的方法。方法针对CYP4F2-1347CT,CYP2C9*3,VKORC1-1173CT与VKORC1-1639GA四个单核苷酸多态性(SNP)位点,分别设计一套等位基因特异性探针与引物,并对LNA-taqman探针特异性进行评价。提取150例接受华法林治疗患者外周血样本基因组DNA进行检测,同时对部分实时荧光PCR产物样品进行验证。结果 (1)LNA-taqman探针检测方法特异性高,没有交叉性。(2)150例患者中,CYP4F2-1347CT基因型CC,CT和TT分别有87,56和7例,各占58%,37.3%和4.7%;CYP2C9*3基因型*1/*1和*1/*3分别有142和8例,各占94.7%和5.3%,未检出纯合子*3/*3基因型;VKORC1-1173CT基因型TT,TC和CC分别有127,20和3例,各占84.7%,13.3%和2%;VKORC1-1639GA基因型AA,AG和GG分别有124,23和3例,各占82.7%,15.3%和2%。结论基于LNA-taqman探针的实时荧光PCR分型方法具有操作简便,价格低廉,结果准确可靠等特点,适于临床实验室对CYP4F2,CYP2C9*3,VKORC1的基因分型。     

AT1R 1166A/C和CYP11B2-344C/T基因多态性与湖南汉族原发性高血压的相关性

摘要：目的：探讨血管紧张素Ⅱ-1型受体（AT1R）1166A/C和醛固酮合酶（CYP11B2）-344T/C基因多态性与原发性高血压(EH)的相关性。 方法：用限制性片段长度多态性聚合酶链反应（PCR-RFLP）对100例EH患者和100例体检健康者AT1R 1166A/C和CYP11B2-344T/C基因多态性进行检测。 结果：EH组AT1R 1166A/C AC型和C等位基因的频率高于健康对照组;AC基因型的血压值、TG,TC,LDL-C均明显高于AA基因型。HDL-C低于AA型CYP11B2各基因型频率和等位基因频率无显著性差异（P＞0.05）。各组内等位基因T的频率高于等位基因C（P＜0.05）。两基因联合分析显示,相对于AA-TT联合基因型,同时携带AC-CT联合基因型的人群患高血压的危险性增加了2.25倍。 结论：AT1R 1166A/C多态性与EH易感性相关,CYP11B2-344T/C基因多态性与EH无关,携带T1R 1166A C型基因以及AC-CT联合基因型的人群患高血压的危险性大。     

Changes of plasma endothelin, thromboxame B2and 6-keto-PGF1αin patients with coronary heart disease after PTCA

Objective To explore the regularity of changes of plasma endothelin (ET), throm-boxame B2(TXB2) and 6-keto-prostaglandin F1α(6-keto-PGF1α) and restenosis after percutaneous transluminal angioplasty (PTCA) in patients with coronary heart disease. Methods Radioimmunoas-say was applied to measuring plasma levels of ET, TXB2and 6-keto-PGF1αat 0,30 min, 1 day and 3 days after PTCA in 41 patients with coronary heart disease. Results The level of ET in the patients with coronary heart disease was significantly decreased in 30 minutes after PTCA (P＜0.05), but no significant difference was observed in 1 day and 3 days after PTCA (P>0.05). The level of plasma TXB2has no statistical difference after PTCA in 30minutes, 1 day and 3 days (P>0.05). The level of 6-keto-prostaglandin F1α(6-keto-PGF1α) of the patients with coronary heart disease was significantly declined in 30 minutes after PTCA (P<0.05) ,but no significant difference was observed in 1 day and 3 days after PTCA (P>0.05). Conclusion PTCA may lead to fluctuation of plasma levels of ET, TXB2and 6-keto-PGF1αThe clarification of changing regularity of these vasoactive substances contrib-utes to prevention of acute artery occlusion or restenosis after PTCA.     

SILEN-C3, a Phase 2 Randomized Trial with Faldaprevir plus Pegylated Interferon α-2a and Ribavirin in Treatment-Naive Hepatitis C Virus Genotype 1-Infected Patients

Faldaprevir is an investigational hepatitis C virus (HCV) NS3/4A protease inhibitor which, when administered for 24 weeks in combination with pegylated interferon α-2a and ribavirin (PegIFN/RBV) in treatment-naive patients in a prior study (SILEN-C1; M. S. Sulkowski et al., Hepatology 57:2143–2154, 2013, doi:10.1002/hep.26276), achieved sustained virologic response (SVR) rates of 72 to 84%. The current randomized, open-label, parallel-group study compared the efficacy and safety of 12 versus 24 weeks of 120 mg faldaprevir administered once daily, combined with 24 or 48 weeks of PegIFN/RBV, in 160 treatment-naive HCV genotype 1 patients. Patients with maintained rapid virologic response (HCV RNA of <25 IU/ml at week 4 and undetectable at weeks 8 and 12) stopped all treatment at week 24, otherwise they continued PegIFN/RBV to week 48. SVR was achieved by 67% and 74% of patients in the 12-week and 24-week groups, respectively. Virologic response rates were lower in the 12-week group from weeks 2 to 12, during which both groups received identical treatment. SVR rates were similar in both groups for patients achieving undetectable HCV RNA. Most adverse events were mild or moderate, and 6% of patients in each treatment group discontinued treatment due to adverse events. Once-daily faldaprevir at 120 mg for 12 or 24 weeks with PegIFN/RBV resulted in high SVR rates, and the regimen was well tolerated. Differences in the overall SVR rates between the 12-week and 24-week groups were not statistically significant and possibly were due to IL28B genotype imbalances; IL28B genotype was not tested, as its significance was not known at the time of the study. These results supported phase 3 evaluation. (This study has been registered at ClinicalTrials.gov under registration no. {"type":"clinical-trial","attrs":{"text":"NCT00984620","term_id":"NCT00984620"}}NCT00984620).