Suárez-Santisteban Miguel A, Santos-Díaz Gracia, García-Bernalt Vanesa, Pérez-Pico Ana M, Mingorance Esther, Mayordomo Raquel, Dorado Pedro
Biosanitary University Research Institute (INUBE), University of Extremadura, Badajoz, Spain; Service of Nephrology, Virgen del Puerto Hospital, Plasencia, Spain.
Biosanitary University Research Institute (INUBE), University of Extremadura, Badajoz, Spain.
Nefrologia (Engl Ed). 2024 May-Jun;44(3):382-395. doi: 10.1016/j.nefroe.2024.01.020. Epub 2024 Mar 5.
There are evidence indicating that some metabolites of arachidonic acid produced by cytochromes P450 (CYP) and epoxide hydroxylase (EPHX2), such as hydroxyeicosatetraenoic acids (HETEs), epoxyeicosatrienoic acids (EETs) or dihydroxyeicosatrienoic acids (DHETEs), play an important role in blood pressure regulation and they could contribute to the development of hypertension (HT) and kidney damage. Therefore, the main aim of the study was to evaluate whether the genetic polymorphisms of CYP2C8, CYP2C9, CYP2J2, CYP4F2, CYP4F11 and EPHX2, responsible for the formation of HETEs, EETs and DHETEs, are related to the progression of impaired renal function in a group of patients with hypertension.
151HT patients from a hospital nephrology service were included in the study. Additionally, a group of 87 normotensive subjects were involved in the study as control group. For HT patients, a general biochemistry analysis, estimated glomerular filtration rate and genotyping for different CYPs and EPHX2 variant alleles was performed.
CYP4A11 rs3890011, rs9332982 and EPHX2 rs41507953 polymorphisms, according to the dominant model, presented a high risk of impaired kidney function, with odds ratios (OR) of 2.07 (1.00-4.32; P=0.049) 3.02 (1.11-8.23; P=0.030) and 3.59 (1.37-9.41; P=0.009), respectively, and the EPHX2 rs1042032 polymorphism a greater risk according to the recessive model (OR=6.23; 95% CI=1.50-25.95; P=0.007). However, no significant differences in allele frequencies between HT patients and in normotensive subjects for any of the SNP analysed. In addition, the patients with diagnosis of dyslipidemia (n=90) presented higher frequencies of EPHX2 K55R (rs41507953) and *35A>G (rs1042032) variants than patients without dyslipidemia, 4% vs. 14% (P=0.005) and 16 vs. 27% (P=0.02), respectively.
In this study has been found higher odds of impaired renal function progression associated with rs3890011 and rs9332982 (CYP4A11) and rs41507953 and rs1042032 (EPHX2) polymorphisms, which may serve as biomarkers for improve clinical interventions aimed at avoiding or delaying, in chronic kidney disease patients, progress to end-stage kidney disease needing dialysis or kidney transplant.
有证据表明,细胞色素P450(CYP)和环氧化物水解酶(EPHX2)产生的花生四烯酸的某些代谢产物,如羟基二十碳四烯酸(HETEs)、环氧二十碳三烯酸(EETs)或二羟基二十碳三烯酸(DHETEs),在血压调节中起重要作用,它们可能导致高血压(HT)的发生和肾脏损害。因此,本研究的主要目的是评估负责HETEs、EETs和DHETEs形成的CYP2C8、CYP2C9、CYP2J2、CYP4F2、CYP4F11和EPHX2的基因多态性是否与一组高血压患者肾功能损害的进展有关。
本研究纳入了一家医院肾内科的151例高血压患者。此外,一组87名血压正常的受试者作为对照组参与研究。对高血压患者进行了一般生化分析、估计肾小球滤过率以及不同CYP和EPHX2变异等位基因的基因分型。
根据显性模型,CYP4A11 rs3890011、rs9332982和EPHX2 rs41507953多态性呈现出肾功能受损的高风险,比值比(OR)分别为2.07(1.00 - 4.32;P = 0.049)、3.02(1.11 - 8.23;P = 0.030)和3.59(1.37 - 9.41;P = 0.009),而根据隐性模型,EPHX2 rs1042032多态性风险更高(OR = 6.23;95% CI = 1.50 - 25.95;P = 0.007)。然而,在所分析的任何单核苷酸多态性中,高血压患者和血压正常受试者之间的等位基因频率没有显著差异。此外,诊断为血脂异常的患者(n = 90)中,EPHX2 K55R(rs41507953)和*35A>G(rs1042032)变异的频率高于无血脂异常的患者,分别为4%对14%(P = 0.005)和16%对27%(P = 0.02)。
在本研究中发现,与rs3890011和rs9332982(CYP4A11)以及rs41507953和rs1042032(EPHX2)多态性相关的肾功能损害进展几率更高,这可能作为生物标志物,用于改善旨在避免或延缓慢性肾病患者进展到需要透析或肾移植的终末期肾病的临床干预措施。