Castaldi Peter J, Hersh Craig P, Reilly John J, Silverman Edwin K
Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA.
Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Chest. 2009 Mar;135(3):737-744. doi: 10.1378/chest.08-1993. Epub 2008 Nov 18.
Hypoxemia, hypercarbia, and pulmonary arterial hypertension are known complications of advanced COPD. We sought to identify genetic polymorphisms associated with these traits in a population of patients with severe COPD from the National Emphysema Treatment Trial (NETT).
In 389 participants from the NETT Genetics Ancillary Study, single-nucleotide polymorphisms (SNPs) were genotyped in five candidate genes previously associated with COPD susceptibility (EPHX1, SERPINE2, SFTPB, TGFB1, and GSTP1). Linear regression models were used to test for associations among these SNPs and three quantitative COPD-related traits (Pao(2), Paco(2), and pulmonary artery systolic pressure). Genes associated with hypoxemia were tested for replication in probands from the Boston Early-Onset COPD Study.
In the NETT Genetics Ancillary Study population, SNPs in microsomal epoxide hydrolase (EPHX1) [p = 0.01 to 0.04] and serpin peptidase inhibitor, clade E, member 2 (SERPINE2) [p = 0.04 to 0.008] were associated with hypoxemia. One SNP within surfactant protein B (SFTPB) was associated with pulmonary artery systolic pressure (p = 0.01). In probands from the Boston Early-Onset COPD Study, SNPs in EPHX1 and in SERPINE2 were associated with the requirement for supplemental oxygen.
In participants with severe COPD, SNPs in EPHX1 and SERPINE2 were associated with hypoxemia in two separate study populations, and SNPs from SFTPB were associated with pulmonary artery pressure in the NETT participants.
低氧血症、高碳酸血症和肺动脉高压是晚期慢性阻塞性肺疾病(COPD)的已知并发症。我们试图在国家肺气肿治疗试验(NETT)中患有严重COPD的患者群体中识别与这些特征相关的基因多态性。
在NETT遗传学辅助研究的389名参与者中,对先前与COPD易感性相关的五个候选基因(EPHX1、SERPINE2、SFTPB、TGFB1和GSTP1)中的单核苷酸多态性(SNP)进行基因分型。使用线性回归模型来测试这些SNP与三个与COPD相关的定量特征(动脉血氧分压、动脉血二氧化碳分压和肺动脉收缩压)之间的关联。对与低氧血症相关的基因在波士顿早发型COPD研究的先证者中进行重复验证。
在NETT遗传学辅助研究人群中,微粒体环氧化物水解酶(EPHX1)中的SNP(p = 0.01至0.04)和丝氨酸蛋白酶抑制剂E家族成员2(SERPINE2)中的SNP(p = 0.04至0.008)与低氧血症相关。表面活性蛋白B(SFTPB)中的一个SNP与肺动脉收缩压相关(p = 0.01)。在波士顿早发型COPD研究的先证者中,EPHX1和SERPINE2中的SNP与补充氧气的需求相关。
在患有严重COPD的参与者中,EPHX1和SERPINE2中的SNP在两个独立的研究人群中与低氧血症相关,而SFTPB中的SNP在NETT参与者中与肺动脉压力相关。