Correlation of interaction between genetic polymorphisms with thrombin activity in plasma and pathological stages of esophageal carcinoma / 西安交通大学学报(医学版)

Objective To investigate the correlation of interaction between polymorphisms of prothrombin gene G20210A in 3' untranslated region and tissue factor pathway inhibitor (TFPI) gene C399T in 5' untranslated region with thrombin activity in plasma and the pathological stages of esophageal carcinoma.Methods Based on TNM method,we selected 198 patients with stage Ⅰ esophageal carcinoma,198 with stage Ⅱ,198 with stage Ⅲ,and 198 with stage Ⅳ from the First Affiliated Hospital of Xinxiang Medical College from May 2011 to August 2015 for this study;198 patients with esophageal carcinoma of stage 0 served as the control group.The thrombin activity in plasma were determined by chromogenic substrate assay.The genetic polymorphisms of prothrombin gene G20210A in 3' untranslated region and TFPI gene C399T in 5' untranslated region in peripheral blood leukocytes of the above-mentioned patients were analyzed by PCR-RFLP technique.Unconditional logistic regression model and single factor analysis were performed to calculate the adjusted odds ratios (OR) and 95％ confidence intervals (95％ CI) of polymorphisms prothrombin gene G20210A and TFPI gene C399T polymorphisms and to analyze the interaction of nucleotide polymorphisms with thrombin activity in plasma and the pathological stages of esophageal carcinoma.Results The frequencies of G20210A (GA),G20210A (AA),C399T (CT) and C399T (TT) were 24.24％,26.77％,24.24％ and 25.76％ in stage Ⅰ group;34.34％,37.37％,34.85％ and 36.36％ in stage Ⅱ group;39.90％,42.93％,40.41％ and 41.92％ in stage Ⅲ group;45.45％,46.97％,45.35％ and 46.46 in stage Ⅳ group;and 13.64％,14.14％,13.13％ and 13.64％ in stage 0 group,respectively.Statistical tests showed significant difference in the frequencies among each group (all P＜0.01).The risks of invasion and metastasis of esophageal carcinoma significantly increased in the subjects with G20210A,in those with G20210A(AA) genotype,in those with C399T (CT) genotype and in those with C399T (TT) genotype.Combined analysis of the polymorphisms showed that percentage of G20210A (AA)/C399T (TT) in stage Ⅰ group,stage Ⅱ group,stage Ⅲ group,stage Ⅳ group and stage 0 group was 7.07％,14.14％,18.18％,21.71％ and 1.52％,respectively,and statistical tests showed significant difference in the frequency among each group (all P＜0.01).People who carried G20210A(AA)/C399T(TT) had higher risks of invasion and metastasis of esophageal carcinoma,and statistical analysis suggested a positive interaction between G20210A (AA) and C399T (TT) in increasing the risks of invasion and metastasis of esophageal carcinoma (All γ＞ 1).Likewise,there were also positive interactions in the pathogenesis of invasion and metastasis of esophageal carcinoma between G20210A (GA) and C399T (TT),G20210A (GA) and C399T(CT),G20210A (AA) and C399T (CT) (All γ＞1).The thrombin activities in plasma in stage Ⅰ,Ⅱ,Ⅲ and Ⅳ groups were all significantly higher than those in stage 0 group,and there were significant differences among stage Ⅰ,stage Ⅱ,stage Ⅲ and stage Ⅳ in thrombin activities (all P＜0.01).Patients with mutation genotype had significantly higher thrombin activities than those with wild homozygous in the same TNM stage.Conclusion G20210A and C399T gene mutations are the risk factors in the invasion and metastasis of esophageal carcinoma.Significant interactions between G20210A and C399T mutations increase the risk of invasion and metastasis of esophageal carcinoma,which may be closely related to their increased thrombin activities in plasma.

Mutación g20210a del gen de la protrombina: presentación clínica en dos gestantes / G20210a mutation of the prothrombin gene: clinical presentation in two pregnant women

La trombofilia hereditaria es una enfermedad genética que resulta de dos o más mutaciones en genes involucrados en el sistema hemostático, con variabilidad en la penetrancia del fenotipo trombótico. Entre los genes mutados asociados al incremento del riesgo de trombosis venosa se encuentra la mutación G20210A del gen de la protrombina. Se presentan los casos de dos pacientes jóvenes embarazadas que acudieron a la consulta de Hemostasia del Instituto de Hematología e Inmunología. Una, con historia personal de enfermedad tromboembólica (ETE) asociada al uso de anticonceptivos orales; y la otra, con antecedentes familiares de ETE e historia personal de abortos recurrentes. A ambas pacientes se les realizó estudio de trombofilia en el que se detectó la mutación G20210A del gen de la protrombina en estado heterocigoto. Recibieron seguimiento médico multidisciplinario y tratamiento profiláctico con aspirina a bajas dosis hasta la semana 34 de la gestación; y heparina de bajo peso molecular durante la gestación y seis semanas después del parto. Se lograron dos nacimientos sin complicaciones obstétricas ni fetales. La expresión de gen de la protrombina G20210A es variable, incluso dentro de una misma familia, y puede estar influenciada por factores de riesgo adquiridos, como el uso de anticonceptivos orales, el embarazo y el puerperio(AU)

Hereditary thrombophilia is a genetic disease that results from two or more mutations in genes involved in the hemostatic system, with variable penetrance of the thrombotic phenotype. Among the mutated genes associated with increased risk of venous thrombosis is mutation G20210A prothrombin gene. We present two pregnant young patients who attended the Haemostasis outpatient service at the Institute of Hematology and Immunology. One of them, with personal history of thromboembolic disease (TED) associated with use of oral contraceptives; and the other one, with a family history of TED and personal history of recurrent abortions. In both patients´ thrombophilia studies the G20210A mutation in the prothrombin gene in heterozygous state was detected. The patients received multidisciplinary medical monitoring and prophylactic treatment with low-dose aspirin until week 34 of gestation, and low molecular weight heparin during pregnancy and six weeks after delivery. Two births without obstetric or fetal complications were achieved. The gene expression of prothrombin G20210A is variable, even within the same family and may be influenced by acquired risk factors such as the use of oral contraceptives, pregnancy and the postpartum period(AU)

Mutações predisponentes à trombofilia em indivíduos de Minas Gerais - Brasil com suspeita clínica de trombose / Predisposing thrombophilic mutations in individuals with clinical suspicion of thrombosis from Minas Gerais, Brazil

A trombose é reconhecidamente uma doença de caráter multifatorial. Sua ocorrência está intimamente relacionada à presença de fatores genéticos e adquiridos que concorrem isoladamente ou em associação para o seu desencadeamento. No entanto, a frequência dos fatores genéticos pode variar de acordo com a origem étnica e com outros aspectos epidemiológicos dos grupos de indivíduos e populações estudadas. No Brasil, dados referentes a indivíduos brasileiros e em especial do estado de Minas Gerais são escassos. O objetivo do presente estudo foi investigar a frequência das mutações fator V Leiden e G20210A no gene protrombina em 1.103 indivíduos com suspeita clínica de trombofilia, empregando a técnica da reação em cadeia da polimerase seguida de restrição enzimática (PCR-RFLP). Os dados foram analisados usando-se o programa Epi Info versão 6.04. A amostra consistiu de 76,16 por cento mulheres e 23,84 por cento homens, com média de idade de 43,06± 14,65. A mutação fator V Leiden foi observada em heterozigose em 7,52 por cento dos indivíduos e em 0,36 por cento em homozigose. A mutação G20210A no gene da protrombina apresentou-se em heterozigose em 5,90 por cento dos indivíduos e em homozigose em 0,18 por cento. O presente trabalho mostra a importância dos testes genéticos conforme o perfil da população analisada, ressaltando informações epidemiológicas da população brasileira e benefícios clínicos.

Thrombosis is known to be a multifactorial disease. Its incidence is directly related to the presence of genetic and acquired factors that concur separately or in association to its appearance. However, the frequency of genetic factors can vary according to ethnic background and with other epidemiological aspects of populations. Data from Brazilian individuals and especially those from the State of Minas Gerais are scarce. The present study aims at investigating the frequencies of the factor v Leiden and the G20210G prothrombin gene mutations of 1103 individuals with clinical suspicion of thrombophilia employing the Polymerase Chain Reaction technique followed by enzymatic restriction (PCR-RFLP). The data were analyzed using the Epi Info computer program version 6.04. The sample constituted of 76.16 percent women and 23.84 percent men, with an average age of 43.06 ± 14.65 years. The factor V Leiden mutation was observed as heterozygosis in 7.5 percent of individuals and as homozygosis in 0.36 percent. The G20210A prothrombin gene mutation appeared as heterozygosis in 5.90 percent of the individuals and as homozygosis in 0.18 percent. The present study shows the importance of genetic tests taking into account the profile of the studied population, and stressing the epidemiological information of the Brazilian population and the clinical benefits.

MTHFR, prothrombin and Factor V gene variants in Turkish patients with coronary artery stenosis

Many epidemiological studies have reported an association between hemostatic factors and risk of both coronary and peripheral artery diseases. Using polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) analysis, we investigated the association between coronary artery disease and polymorphisms in the methylenetetrahydrofolate reductase (MTHFR C677T and A1298C), prothrombin (G20210A), and factor V (A4070G) genes. We screened these gene variants in 174 subjects who had undergone coronary angiography - 115 patients with patent coronary artery disease (grade 3 vessel disease, i.e., significant coronary stenosis), and 59 healthy controls with grade 0 vessel disease. The analysis of our data did not show any statistically significant association between coronary artery disease (CAD) and the investigated polymorphisms.

The study of the relationship between cerebral infarction in the young patients and prothrombin gene G20210A mutation / 临床神经病学杂志

Objective To investigate the relationship between the G20210A mutation of prothrombin gene and cerebral infarclion(CI) in young patients. Methods The frequency of G20210A gene mutation of prothrombin in 40 young CI patients and 48 controls were studied by polymerase chain reaction (PCR) followed by Mnl- I and Hind-Ⅲ restriction enzyme analysis. Results No prothrombin gene G20210A mutation was found in both patients and controls. Conclusion The G20210A gene mutation of prothrombin was not the risk factor of this group of young CI patients.