PubMed · 10112710
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A F Poussaint. 1990. Looking ahead: problems and solutions.. https://pubmed.ncbi.nlm.nih.gov/10112710/
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BACKGROUND: Glomerular filtration rate (GFR) is a heritable trait, and hyperfiltration (GFR increment in remnant nephrons) may accelerate renal functional decline in chronic kidney disease (CKD). Mesangial and vascular smooth myocytes control GFR by contraction, dependent on voltage-gated Ca(2+) influx, which is controlled by the regulatory β₁-subunit (KCNMB1) of large-conductance heteromeric K+ ('BK') channels. KCNMB1 gain-of-function variant Glu65Lys results in generalized vasorelaxation and thus protection against systemic hypertension. Here we asked whether the Glu65Lys variant influences GFR, in the basal state or during progressive renal decline. METHODS: We explored Glu65Lys effects on GFR in three populations spanning two ethnicities and two diseases (hypertension and nephrosclerosis). GFR was either estimated (eGFR from serum creatinine) or directly measured (iothalamate clearance). RESULTS: The 65Lys variant was relatively common, occurring on ∼5-10% of chromosomes in different biogeographic ancestry groups, and 65Lys carriers exhibited higher eGFR in two primary care populations: extreme BP values in Kaiser clinics (p = 0.029, accounting for ∼0.2% of trait variance), or treated hypertensives in VA clinics (p = 0.017, accounting for ∼0.9% of trait variance). In blacks with progressive renal disease (NIDDK AASK), 65Lys carriers displayed a steeper slope in GFR chronic decline (p = 0.030, accounting for ∼0.4% of trait variance), and Glu65Lys genotype also predicted time of onset of renal failure (log rank p = 0.019). CONCLUSIONS: Common KCNMB1 gain-of-function variant Glu65Lys influences GFR, and 65Lys carriers exhibit not only elevated baseline GFR, but also more rapid GFR decline (and consequent development of renal failure) in CKD. The results suggest that profiling patients at Glu65Lys can assist in gauging renal prognosis as well as selection of rational therapy in hypertension with progressive renal disease.
Human CYP2A6 is a cytochrome P450 (CYP) isoform responsible for the metabolism of nicotine, coumarin, tegafur, and valproic acid, and metabolic activation of nitrosamines. Genetic polymorphisms of the CYP2A6 gene are a major causal factor of the large interindividual differences in nicotine metabolism. In the present study, we identified a novel allele, termed CYP2A6*20, in an African-American population. The allele possesses the deletion of two nucleotides in exon 4 resulting in a frame-shift from codon 196 and an early stop codon at 220 (exon 5) as well as three synonymous SNPs of G51A (G51A in cDNA), T5684C (T1191C), and C6692G (C1546G, 3'-untranslated region). The allele frequency in the African-American population (n=96) was 1.6% (95% confidence interval, 0.6-4.5%). In contrast, the CYP2A6*20 allele was not found in Caucasians (European-American) (n=185), Japanese (n=184) and Korean (n=209) populations. To investigate the effects of the polymorphism on the enzymatic activities, we expressed a wild type or variant (deletion of two nucleotides) CYP2A6 together with NADPH-CYP reductase in Escherichia coli. SDS-PAGE and immunoblot analyses demonstrated that truncated CYP2A6 protein was produced from the variant allele, although detected mRNA was the predicted size by reverse transcriptional-polymerase chain reaction. Coumarin 7-hydroxylation and nicotine C-oxidation, which are typical CYP2A6 activities, were completely abolished in the E. coli membrane expressing the variant allele. In vivo nicotine metabolism was evaluated using the cotinine/nicotine ratio 2 h after the chewing of one piece of nicotine gum. Two CYP2A6*1/CYP2A6*20 heterozygotes and a single CYP2A6*17/CYP2A6*20 heterozygote revealed lower cotinine/nicotine ratios compared with CYP2A6*1/CYP2A6*1 subjects (1.6 and 4.5, and 1.8 versus 9.5+/-5.4, n=52, respectively). We found a novel CYP2A6*20 allele in African-American subjects which codes a truncated protein lacking enzymatic activity.
BACKGROUND: In the United States, blacks with colorectal carcinoma (CRC) presented with more advanced-stage disease and had higher mortality rates compared with non-Hispanic whites. Data regarding other races/ethnicities were limited, especially for Asian/Pacific Islander and Hispanic white subgroups. METHODS: Using data from 11 population-based cancer registries that participate in the Surveillance, Epidemiology and End Results program, the authors evaluated the relation among 18 different races/ethnicities and disease stage and mortality rates among 154,103 subjects diagnosed with CRC from 1988 to 2000. RESULTS: Compared with non-Hispanic whites, blacks, American Indians, Chinese, Filipinos, Koreans, Hawaiians, Mexicans, South/Central Americans, and Puerto Ricans were 10-60% more likely to be diagnosed with Stage III or IV CRC. Alternatively, Japanese had a 20% lower risk of advanced-stage CRC. With respect to mortality rates, blacks, American Indians, Hawaiians, and Mexicans had a 20-30% greater risk of mortality, whereas Chinese, Japanese, and Indians/Pakistanis had a 10-40 % lower risk. CONCLUSIONS: The authors observed numerous racial/ethnic disparities in the risks of advanced-stage cancer and mortality among patients with CRC, and there was considerable variation in these risks across Asian/Pacific Islander and Hispanic white subgroups. Although the etiology of these disparities was multifactorial, developing screening and treatment programs that target racial/ethnic populations with elevated risks of poor CRC outcomes may be an important means of reducing these disparities.