Association between CYP4A11 and EPHX2 genetic polymorphisms and chronic kidney disease progression in hypertensive patients.

BACKGROUND: There are evidence indicating that some metabolites of arachidonic acid produced by cytochromes P450 (CYP) and epoxide hydroxylase (EPHX2), such as hydroxyeicosatetraenoic acids (HETEs), epoxyeicosatrienoic acids (EETs) or dihydroxyeicosatrienoic acids (DHETEs), play an important role in blood pressure regulation and they could contribute to the development of hypertension (HT) and kidney damage. Therefore, the main aim of the study was to evaluate whether the genetic polymorphisms of CYP2C8, CYP2C9, CYP2J2, CYP4F2, CYP4F11 and EPHX2, responsible for the formation of HETEs, EETs and DHETEs, are related to the progression of impaired renal function in a group of patients with hypertension. METHODS: 151HT patients from a hospital nephrology service were included in the study. Additionally, a group of 87 normotensive subjects were involved in the study as control group. For HT patients, a general biochemistry analysis, estimated glomerular filtration rate and genotyping for different CYPs and EPHX2 variant alleles was performed. RESULTS: CYP4A11 rs3890011, rs9332982 and EPHX2 rs41507953 polymorphisms, according to the dominant model, presented a high risk of impaired kidney function, with odds ratios (OR) of 2.07 (1.00-4.32; P=0.049) 3.02 (1.11-8.23; P=0.030) and 3.59 (1.37-9.41; P=0.009), respectively, and the EPHX2 rs1042032 polymorphism a greater risk according to the recessive model (OR=6.23; 95% CI=1.50-25.95; P=0.007). However, no significant differences in allele frequencies between HT patients and in normotensive subjects for any of the SNP analysed. In addition, the patients with diagnosis of dyslipidemia (n=90) presented higher frequencies of EPHX2 K55R (rs41507953) and *35A>G (rs1042032) variants than patients without dyslipidemia, 4% vs. 14% (P=0.005) and 16 vs. 27% (P=0.02), respectively. CONCLUSIONS: In this study has been found higher odds of impaired renal function progression associated with rs3890011 and rs9332982 (CYP4A11) and rs41507953 and rs1042032 (EPHX2) polymorphisms, which may serve as biomarkers for improve clinical interventions aimed at avoiding or delaying, in chronic kidney disease patients, progress to end-stage kidney disease needing dialysis or kidney transplant.

First-year health degree students in the dissection room: Analysis of adaptation to practical classes.

Human anatomy is a core subject that students of all health degrees are required to pass. Practical classes with human cadavers are a widely used educational resource in medicine, but are less frequent in other health degrees. Determining how first-year podiatry, nursing, and physiotherapy students cope with human anatomy practical classes and identifying the presence of physical reactions and possible causes of distress they experience in the dissection room are essential steps in designing a guidance plan to address students' needs. A questionnaire was distributed to 172 first-year students in non-medical health degrees immediately after their first visit to the dissection room. The questionnaire comprised 29 Yes/No questions to determine students' physical reactions, causes of distress and coping methods. The most frequent physical reactions were disgust, uneasiness and nausea. The main causes of distress were the smell of the cadavers, the smell of the dissection room and the sight of the cadavers. The coping methods used were being with friends, eating before the practical class and practicing beforehand with anatomical atlases and CDs. No significant differences were found between gender and the three variables analyzed (number of physical reactions, number of causes of distress and number of coping methods) (p-value >0.216), although differences were found between the type of health degree and the number of physical reactions and causes of distress (p-values = 0.028 and 0.001, respectively).