[Study of the association between the polymorphism of the TNF-α gene and prostate cáncer]. / Estudio de la asociación entre el polimorfismo del gen TNFα y el cáncer de próstata.

BACKGROUND: Prostate cancer is the third cause of cancer death in men in the Western hemisphere and the second cause of cancer death in Zulian men from Venezuela. OBJECTIVE: To determine whether polymorphisms 308 and 238 of the tumor necrosis factor alpha (TNF-α) gene are associated with prostate cancer. METHODS: The DNA that was extracted from the peripheral blood of 40 patients with prostatic specific antigen and 40 controls was amplified by PCR plus digestion with enzymes NcoI and MspI. RESULTS: In the patients, genotypes of the TNF-α-238 polymorphism were observed in 90% GG and 10% GA; in controls, in 97.5% GG and 2.5% GA, odds ratio (OR) = 4,000 for GA. In the patients, genotypes of TNF-α-308 polymorphism were identified in 85% GG and 15% GA, and in controls in 72.5% GG and 27.5% GA, OR = 0.545 for GA and 1.172 for GG. The allelic frequencies for TNF-α-238 in patients were 95% for G and 5% for A; in controls, 98.75% for G and 1.25% for A, with OR = 4,000 for A. The allelic frequencies for TNF-α-308 in the patients were 92.5% for G and 7.5% for A. CONCLUSIONS: There weren't any statistically significant associations. The allele A of the TNF-α-238 polymorphism resulted in a considerable risk factor for prostate cancer.

Antecedentes: El cáncer de próstata es la tercera causa de muerte por cáncer en hombres del hemisferio occidental y la segunda en zulianos de Venezuela. Objetivo: Determinar si los polimorfismos 308 y 238 del gen TNFα están asociados con cáncer de próstata. Métodos: El ADN extraído de sangre periférica de 40 pacientes con antígeno prostático específico y 40 controles fue amplificado por reacción en cadena de la polimerasa más digestión con enzimas NcoI y MspI. Resultados: Respecto al polimorfismo 238 del gen TNFα, en los pacientes se observó 90 % de genotipo GG y 10 % de GA; en los controles, 97.5 % de GG y 2.5 % de GA, razón de momios (RM) = 4.000 para GA. En cuanto al polimorfismo 308, en los pacientes se identificó 85 % de genotipo GG y 15 % de GA; y en los controles, 72.5 % de GG y 27.5 % de GA, RM = 0.545 para GA y 1.172 para GG. Las frecuencias alélicas de TNFα-238 en los pacientes fue de 95 % de G y 5 % de A; en los controles, 98.75 % de G y 1.25 % de A, con RM = 4.000 para A. Las frecuencias alélicas para TNFα-308 en los pacientes fueron 92.5 % de G y 7.5 % de A. Conclusiones: No existieron asociaciones estadísticamente significativas. El alelo A del polimorfismo 238 del gen TNF-α resultó de riesgo para cáncer de próstata.

Effect of the parental origin of the X-chromosome on the clinical features, associated complications, the two-year-response to growth hormone (rhGH) and the biochemical profile in patients with turner syndrome.

BACKGROUND: It is possible that genes on the X chromosome are expressed differently depending of its parental origin. The objective of this study was to determine the influence of the parental origin of the X-chromosome on phenotypic variability, response to rhGH and on the biochemical profile of TS patients. METHODS: This was a cross-sectional multicenter correlational study carried out over three years in six Latin-American university hospitals. Unrelated 45,X TS patients (n = 93; 18.3 ± 8.5 years )) were evaluated. A subgroup (n = 34) of the patients were prospectively treated with rhGH over two years. DNA profiles of patients and their mothers were compared to determine the parental origin of the retained X-chromosome through 10 polymorphic X-chromosome-STRs. The association with clinical features, biochemical profiles and anthropometric data at the beginning and after two years of rhGH treatment was determined. RESULTS: Seventy two percent of patients retained the maternal X chromosome (Xm). A trend towards significance between maternal height and patients final height (p ≤ 0.07) in 45,Xm subjects was observed. There was no correlation between paternal height and patient height. No differences were detected between both groups in regard to dysmorphic features, classical malformations or increase in the height-SDS after rhGH. There were higher levels of triglycerides, total and LDL cholesterol in patients >20 years who retained the Xm. CONCLUSIONS: The parental origin of the retained X chromosome may influence lipid metabolism in TS patients, but its effect on growth seems to be minimal. No parental-origin-effect on the phenotypic features, associated anomalies and on the growth response to rhGH was found in 45,X TS individuals.

[Uterine artery score in patients with systemic lupus erythematous as a predictor of intrauterine growth restriction]. / Indice de arterias uterinas en pacientes con lupus eritematoso sistémico como predictor de restricción del crecimiento intrauterino.

BACKGROUND: Because of its high prevalence in the female population and its high incidence in reproductive age, Systemic Lupus Erythematosus can complicate pregnancy causing miscarriage, fetal death, preeclampsia, fetal growth restriction (up to 25%) and preterm birth. Doppler ultrasonography measures the flow in the uterine arteries, which is reduced in patients with preeclampsia and FGR, and thus is an ideal method for identifying pregnant women with a high risk of developing an adverse perinatal outcome. OBJECTIVE: Identify if Doppler ultrasound predicts FGR in patients with systemic lupus erythematosus. PATIENTS AND METHOD: In this observational, transversal, prospective study carried out from June 1st, 2010 to November 30th, 2010, in patients who had already been diagnosed with SLE, a complete clinical history was registered, blood samples taken and Doppler of uterine arteries between 18 and 23 gestation weeks taken (measuring the pulsatility index) RESULTS: Of the 17 women in the study, 6 patients had a PI equal or greater than 1.45 (35.29%), of whom in 5 cases (29.41%), the product had FGR. Therefore the sensitivity of this test is 100%, with a specificity of 91%, a predictive positive value of 83% and a predictive negative value of 100%. With a p of 0.0010, which is considered extremely significant, and a confidence interval of 95%. CONCLUSIONS: There exists a high association between an abnormal PI and the development of FGR. Abnormal Doppler ultrasound of uterine arteries is useful for predicting FGR in pregnant women with SLE.

GHR and VDR genes do not contribute to the growth hormone (GH) response in GH deficient and Turner syndrome patients.

We have prospectively assessed the influence of GHR and VDR gene polymorphisms on the response to rhGH therapy in Venezuelan children with growth hormone deficiency (GHD, n=28) and Turner syndrome (TS, n=25). Clinical data during rhGH treatment were compared in GH and TS patients with different genotypes. PCR amplifications were performed to obtain the genotype frequencies of the polymorphisms. Clinical data at the start of treatment and rhGH doses were indistinguishable among patients with GHD or TS with different GHR or VDR genotypes. After the first two years of rhGH treatment, clinical data in both GHD and TS patients were not different according GHR or VDR genotypes. In addition, there was no significant difference among the subjects when both these genotypes were combined. Gene polymorphisms in low penetrance genes do not contribute to the rhGH therapy response in patients with GHD and TS.

Polimorfismos intragénicos de los genes de los factores VIII y IX y su utilidad en el diagnóstico indirecto de portadoras de hemofilias A y B / Intragenic polymorphisms of factor VIII and IX genes and their utility in the indirect diagnosis of carriers of haemophilias A and B

Las Hemofilias A y B se consideran enfermedades hereditarias ligadas al sexo debidas a mutaciones en los genes que codifican para los factores VIII y IX respectivamente, ocasionando deficiencia en los niveles de la concentración plasmática de estas proteínas y cuyos roles son los de participar activamente en el mecanismo de la coagulación sanguínea. Se han reportado diversas mutaciones responsables de la alteración de estos genes; razón por la cual resulta poco práctico la aplicación de un método de diagnóstico molecular directo para la identificación de mujeres portadoras, por ello, una estrategia diagnóstica apropiada es el análisis indirecto de polimorfismos ligados al gen. El objetivo de este trabajo fue identificar mujeres portadoras en diversas familias con antecedentes de HA y HB residentes del estado Zulia, en Venezuela, caracterizando polimorfismos intragénicos de los genes del factor VIII y factor IX, los cuales permitieron asignar haplotipos y diagnosticar o descartar el estado portador al 95 por ciento de las mujeres que requerían el estudio para HA y al 100 por ciento para HB.

Haemophilia A and B are considered sex-linked inherited diseases caused by mutations in genes that encode factors VIII and IX, respectively. This results in the deficiency of these proteins plasma levels which are actively involved in the mechanism of blood coagulation. It has been reported that several mutations are responsible for the alteration of these genes, which is why the application of a molecular diagnostic method for the direct identification of female carriers is impractical. An appropriate diagnostic strategy is the indirect analysis of polymorphisms linked to the gene. The aim of this study was to identify female carriers in different families with history of HA and HB that live in Zulia State, Venezuela, characterizing intragenic gene polymorphisms of the clotting factors VIII and IX, which helped to identify and assign haplotypes, to diagnose or to exclude the carrying condition, to 95 percent of women who were needing the study for HA and to 100 percent for HB.

[Intragenic polymorphisms of factor VIII and IX genes and their utility in the indirect diagnosis of carriers of Haemophilias A and B]. / Polimorfismos intragénicos de los genes de los factores VIII y IX y su utilidad en el diagnóstico indirecto de portadoras de Hemofilias A y B.

Haemophilia A and B are considered sex-linked inherited diseases caused by mutations in genes that encode factors VIII and IX, respectively. This results in the deficiency of these proteins plasma levels which are actively involved in the mechanism of blood coagulation. It has been reported that several mutations are responsible for the alteration of these genes, which is why the application of a molecular diagnostic method for the direct identification of female carriers is impractical. An appropriate diagnostic strategy is the indirect analysis of polymorphisms linked to the gene. The aim of this study was to identify female carriers in different families with history of HA and HB that live in Zulia State, Venezuela, characterizing intragenic gene polymorphisms of the clotting factors VIII and IX, which helped to identify and assign haplotypes, to diagnose or to exclude the carrying condition, to 95% of women who were needing the study for HA and to 100% for HB.

[G138A polymorphism of the RNASEL gene and its association with the development of prostate cancer. Preliminary study]. / Polimorfismo G1385A del gen RNASEL y su asociación con el desarrollo de cáncer de próstata. Estudio preliminar.

Prostate Cancer (CAP), is a complex disease with a multifactorial origin. It is characterized by heterogenous patterns of growth of neoplasic tissue, varying widely in its progression, age of beginning and therapy response. It is considered as the second most common cause of death by cancer in men and, it has been estimated, that one of five, suffers of CAP through the course of his life. The genetic etiology of neoplasic transformation of normal prostate cells is still not known; nevertheless, investigations in epidemiology have demonstrated a strong genetic component in its development, suggesting so much a pattern of mendelian inheritance as the presence of loci of susceptibility throughout the human genome. It has been described a cromosomic location related to the CAP in locus 1q24-25, denominated HPC1, where the gene RNASEL is located, and the seggregation of its alleles has been associated with the development of CAP in numerous familiar groups. The RNASEL gene codifies for a ribonuclease protein that degrades vi-ral and cellular ARN and takes part in the apoptosis. A decrease of the enzymatic activity up to three times in carriers of the G1385A polymorphism of this gene has been reported, and the same has been associated frequently with the development of CAP. Using a variant of the Polymerase Chain Reaction, Allele specific amplification, this investigation had as objective to determine the association between variant G1385A and CAP, in a sample of 103 masculine individuals with and without CAP, pertaining to the population of Maracaibo, Venezuela. An association between these variants and CAP could not be demonstrated.

Polimorfismo G1385A del gen RNASEL y su asociación con el desarrollo de cáncer de próstota: estudio preliminar / G138A polymorphism of the RANASEL gene and its association with the development of prostate cancer: preliminary study

El cáncer de Próstata (CAP), es una enfermedad compleja de origen multifactorial. Se caracteriza por patrones heterogéneos de crecimiento de tejido neoplásico, que varían ampliamente en su progresión, edad de aparición y respuesta al tratamiento. Se considera la segunda causa más común de muerte por malignidad en hombres y se estima que uno de cada cinco padece de CAP en el curso de su vida. La etiología genética de la transformación neoplásica de las células prostáticas normales aún es desconocida, sin embargo, investigaciones epidemiológicas han demostrado un fuerte componente genético en su desarrollo, y sugieren tanto un patrón de herencia mendeliana como la presencia de loci de susceptibilidad a lo largo del genoma humano. Se ha descrito una región cromosómica relacionada con el CAP denominada como HPC1, en el locus 1q24-25, donde se ubica el gen RNASEL, y las mutaciones en el mismo, se han asociado con la presencia del CAP en múltiples grupos familiares. EL gen RNASEL codifica para una ribonucleasa que degrada ARN viral y celular y que interviene en la apoptosis. Se ha reportado disminución de la actividad enzimática de hasta tres veces en portadores del polimorfismo G1385A de este gen, y la misma se ha asociado frecuentemente con el desarrollo del CAP. Mediante la utilización de una variante de la Reacción en Cadena de la Polimerasa (RCP), una amplificación alelo específica, se estudiaron 103 individuos masculinos con y sin CAP pertenecientes a la población de Maracaibo, Venezuela, evidenciándose ausencia de asociación.

Prostate Cancer (CAP), is a complex disease with a multifactorial origin. It is characterized by heterogenous patterns of growth of neoplasic tissue, varying widely in its progression, age of beginning and therapy response. It is considered as the second most common cause of death by cancer in men and, it has been estimated, that one of five, suffers of CAP through the course of his life. The genetic etiology of neoplasic transformation of normal prostate cells is still not known; nevertheless, investigations in epidemiology have demonstrated a strong genetic component in its development, suggesting so much a pattern of mendelian inheritance as the presence of loci of susceptibility throughout the human genome. It has been described a cromosomic location related to the CAP in locus 1q24-25, denominated HPC1, where the gene RNASEL is located, and the seggregation of its alleles has been associated with the development of CAP in numerous familiar groups. The RNASEL gene codifies for a ribonuclease protein that degrades viral and cellular ARN and takes part in the apoptosis. A decrease of the enzymatic activity up to three times in carriers of the G1385A polymorphism of this gene has been reported, and the same has been associated frequently with the development of CAP. Using a variant of the Polymerase Chain Reaction, Allele specific amplification, this investigation had as objective to determine the association between variant G1385A and CAP, in a sample of 103 masculine individuals with and without CAP, pertaining to the population of Maracaibo, Venezuela, An association between these variants and CAP could not be demonstrated.

Distribución de las frecuencias alélicas y genotípicas del polimorfismo GHRd3 en pacientes venezolanos con talla baja

Objetivos. La deleción (GHRd3) o inserción (GHRfl) del exón 3 es un polimorfismo común en el gen del receptor de la hormona de crecimiento (GHR) en los seres humanos. La presencia del alelo GHRd3 se ha asociado con el grado de respuesta de terapia con Hormona de Crecimiento Recombinante Humana (rhGH). El objetivo de este estudio fue determinar las frecuencias alélicas y genotípicas de este polimorfismo en un grupo de 69 niños venezolanos con talla baja que estaban recibiendo rhGH. Métodos. Se extrajo DNA a través de la técnica del método combinado Fenol/Sevag e Inorgánica. Se determinó el genotipo del exón 3 del gen GHR usando tanto PCR- monoplex como PCR-multiplex. Resultados. Entre los pacientes con talla baja la frecuencia genotípica se distribuyó de la siguiente manera: GHRfl/GHRfl (55%) GHRfl/GHRd3 (35%) y GHRd3/GHRd3 (10%) y la frecuencia alélica fue de 0,27 para GHRd3 y 0,73 para GHRfl. Para el grupo testigo la frecuencia genotípica se distribuyo así: GHRfl/GHRfl (56%), GHRfl/ GHRd3 (30%) y GHRd3/GHRd3 (14%) y la frecuencia alélica era de 0,29 para GHRd3 y 0,71 para GHRfl. Las características clínicas basales de los pacientes con talla baja eran similares entre los diferentes genotipos encontrados en el grupo de estudio. Conclusiones. La proporción del genotipo y los alelos del gen GHR fueron similares entre el grupo testigo y los pacientes con talla baja, lo que traduce que la etiología de la talla baja no obedece a este polimorfismo.

Objective. The deletion (GHRd3) or insertion (GHRfl) of exon 3 is a common polymorphism in the receptor growth hormone gene (GHR) in humans. The presence of the allele GHRd3 has been associated with the degree of responsiveness to therapy with recombinant human Growth Hormone (rhGH). The aim of this study was to determine the genotypic and allele frequencies of this polymorphism in a group of 69 Venezuelan children with short stature who were receiving rhGH. Methods. Genomic DNA was extracted from blood lymphocytes using combined method Fenol/SEVAG + Salting out. The GHR-exon 3 was genotyped using both PCR monoplex and multiplex assays. Results. Among patients with short stature, genotype frequency was distributed as follows: GHRfl/GHRfl (55%), GHRfl/GHRd3 (35%) and GHRd3/GHRd3 (10%) and allele frequency for GHRd3 and GHRfl was 0.27 and 0.73, respectively. For the control group, genotype frequency was distributed as follows: GHRfl/GHRfl (56%), GHRfl/GHRd3 (30%) and GHRd3/GHRd3 (14%) and allele frequency for GHRd3 and GHRfl was 0.29 and 0.71, respectively. The baseline clinical features of patients with short stature were similar among different genotypes found in the study group. Conclusions. The proportion of genotype and allele of the GHR gene were similar between the control group and patients with short stature, which translates that the etiology of short stature is not due to this polymorphism.