Lelonek Malgorzata, Pietrucha Tadeusz, Matyjaszczyk Monika, Goch Jan Henryk
Department of Cardiology, I Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, Sterling Str. 1/3, 91-425 Lodz, Poland.
Circ J. 2008 Apr;72(4):558-62. doi: 10.1253/circj.72.558.
Mutation T/C inside codon 131 of the gene encoding the alpha subunit of Gs protein (GNAS1) causes the increased activation of adenyl cyclase, which plays an important role in cardiovascular regulation. The aim of the present study was to evaluate GNAS1 T/C,Ile 131 mutation's manifestation in syncopal patients regarding head-up tilt test (HUTT) results.
In 137 syncopal patients (without any other diseases) the silent T/C,Ile 131 mutation within the GNAS1 codon on chromosome 20 q was identified. This mutation consists of the presence (+) or absence (-) of a target site for endonuclease FokI (Promega). Ninety-six patients (70%) with positive HUTT had a higher FokI+ allele frequency compared with those with negative tilting results (49% vs 27%, X(2)=12.05; p<0.001). In positive tilted patients, the studied mutation had significant influence on blood pressure (p<0.05). When comparing positive HUTT with vasodepressore component, cardioinhibition results and negative HUTT, the frequencies of the FokI+ allele were decreased among these groups: 53%, 36% and 27%, respectively.
An association between positive tilting and mutation C/T,Ile 131 within the GNAS1 codon was found. The predisposition to vasovagal syncope seems to be associated with the GNAS1 FokI+ allele.
编码Gs蛋白α亚基的基因(GNAS1)第131密码子内的T/C突变会导致腺苷酸环化酶激活增加,这在心血管调节中起重要作用。本研究的目的是根据直立倾斜试验(HUTT)结果评估GNAS1 T/C、Ile 131突变在晕厥患者中的表现。
在137例晕厥患者(无其他疾病)中,鉴定出20号染色体q上GNAS1密码子内的沉默T/C、Ile 131突变。该突变由核酸内切酶FokI(Promega)靶位点的存在(+)或缺失(-)组成。与倾斜试验结果为阴性的患者相比,HUTT结果为阳性的96例患者(70%)具有更高的FokI+等位基因频率(49%对27%,X²=12.05;p<0.001)。在倾斜试验结果为阳性的患者中,所研究的突变对血压有显著影响(p<0.05)。当比较HUTT阳性与血管减压成分、心脏抑制结果及HUTT阴性时,这些组中FokI+等位基因频率降低:分别为53%、36%和27%。
发现倾斜试验阳性与GNAS1密码子内的C/T、Ile 131突变之间存在关联。血管迷走性晕厥的易感性似乎与GNAS1 FokI+等位基因有关。