Fumihiko Takeuchi | Search PubMed

PubMed2026

Genome-Wide Association Study of Contrast Media Hypersensitivity in Japanese Patients.

Iodinated contrast media (ICM), commonly used in radiological tests such as coronary angiography, can cause hypersensitivity reactions (HSRs). The mechanism of ICM HSRs is thought to be complex; while IgE-mediated allergic reactions appear to be involved, the details remain unclear. This study aims to elucidate the pathogenesis of ICM HSRs through genetic analysis. To date, a few case-control studies have been conducted exclusively on East Asians, but the results have been inconclusive and have not been replicated.We conducted a multistage GWAS for ICM HSRs in Japanese individuals. The study population comprised 153 cases with ICM HSRs (ranging from mild to severe form), 632 controls with no history of ICM-induced allergies, and < 38,721 individuals from the general population. We identified genome-wide significant association signals in the HLA region and also found that these signals originated from the three HLA alleles-B*52:01, C*12:02, DRB1*15:02-previously reported in a Korean candidate gene study. Using instrumental variable analysis with a polygenic score for pediatric asthma (PGSasthma) as a proxy, we demonstrated that ICM HSRs are associated with the allergic predisposition thought to be shared by asthma and ICM HSRs. There was a significant difference in the distribution of PGSasthma between ICM HSR patients and non-disease controls (per-SD odds ratio: 1.26, P = 0.021).Our genome-wide approach shows that HLA alleles are among the genetic factors underlying ICM HSRs. Furthermore, it provides evidence for the potential usefulness of predicting the risk of developing ICM HSRs based on allergic predisposition.

Allergic predisposition↗

PubMed2026

The presence or absence of standard modifiable cardiovascular risk factors in patients with myocardial infarction impacts long-term but not 30-day mortality: a UK Biobank prospective cohort study.

AIMS: Prior studies reported higher early mortality after acute myocardial infarction (MI) in patients without standard modifiable cardiovascular risk factors (SMuRFs), warranting further validation. We aimed to evaluate whether SMuRF-absence is associated with increased 30-day cardiovascular mortality following MI. METHODS AND RESULTS: We conducted a population-based cohort study using UK Biobank data (n = 487 177). Incident MI cases occurring between 2006 and 2022 were identified through linkage to hospital and death registries. Standard modifiable cardiovascular risk factors (diabetes, hypertension, hypercholesterolaemia, current smoker) were defined at baseline and continuously assessed until MI onset. Thirty-day mortality following MI was estimated using Cox proportional hazards models, adjusted for sociodemographic, clinical, and cardiogenomic variables, were used to estimate 30-day mortality risks. Logistic regression model was used to estimate mortality risk at 10 years post-MI. Among 15 463 patients experiencing an MI (1034 without SMuRFs), SMuRF-absence was not significantly associated with 30-day mortality (HR: 0.82, 95% CI: 0.65-1.04, P = 0.103). Propensity score-matched analyses supported these findings (HR: 0.95, 95% CI: 0.69-1.29, P = 0.729). Further analyses stratified by distinct time intervals (2006-2022) revealed no significant modification of this association by advancements in acute MI management. Interaction analyses indicated no significant effect modification by sex, age, socioeconomic status, or period of MI occurrence. However, extended analysis to 10 years revealed that SMuRF absence was significantly associated with lower long-term mortality (OR: 0.61, 95% CI: 0.49-0.75, P < 0.01). CONCLUSION: In this population-based cohort, SMuRF status significantly impacted long-term but not short-term mortality following MI, indicating early survival is predominantly driven by acute-phase factors rather than baseline cardiovascular risk profiles.

Humans↗