Deoxyribonucleic Acid Copy Number Aberrations in Vasospastic Angina Patients Using an Array Comparative Genomic Hybridization
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ORIGINAL ARTICLE Print ISSN 1738-5520 / On-line ISSN 1738-5555 DOI 10.4070/kcj.2011.41.7.385 Copyright © 2011 The Korean Society of Cardiology Open Access Deoxyribonucleic Acid Copy Number Aberrations in Vasospastic Angina Patients Using an Array Comparative Genomic Hybridization Suk Min Seo, MD1, Yoon Seok Koh, MD1, Hae Ok Jung, MD1, Jin Soo Choi, MD2, Pum Joon Kim, MD1, Sang Hong Baek, MD1, Ho-Joong Youn, MD1, Kweon-Haeng Lee, MD3, and Ki-Bae Seung, MD1 1Cardiovascular Center and Cardiology Division, 2Catholic Neuroscience Center, 3Department of Pharmacology, College of Medicine, The Catholic University of Korea, Seoul, Korea ABSTRACT Background and Objectives: Vasospastic angina (VA) is a specific type of coronary artery disease and develops as a result of coronary artery spasm. Recently, a few studies have revealed that VA caused by coronary artery spasm is related to genetic traits. The objective of this study was to use the recently developed technique of array comparative genomic hybridization (CGH) to screen the genetic aberrations of VA. Subjects and Methods: To identify candidate genes that might be causally involved in the pathogenesis of VA, genomic deoxyribonucleic acids were extracted from whole blood of 28 patients with VA who presented at Department of Cardiology at Seoul St. Mary’s Hospital, Seoul, Korea. The copy number profiles of these patients was then analyzed using array CGH and reverse transcriptase (RT) quantitative polymerase chain reaction (PCR). Results: Array CGH revealed gains in 31 different regions, with losses in the 4q35.2, 7q22.1, 10q26.3, 15q11.2, 16p13.11, 17p11.2 and 19q13.3 regions (more than 32% aberration in these regions). Several loci were found to be frequently including gains of 5p and 11q (50% of samples). The most common losses were found in 7q (54% of samples). Copy number aberrations in chromosomal regions were detected and corresponding genes were confirmed by RT quantitative PCR. The fold change levels were highest in the CTDP1 (18q23), HDAC10 (22q13.33), KCNQ1 (11p15.5-p15.4), NINJ2 (12p13.33), NOTCH2 (1p12-p11.2), PCSK6 (15q26.3), SDHA (5p15.33), and MUC17 (7q22.1) genes. Conclusion: Many candidate chromosomal regions that might be related to the pathogenesis of VA were detected by array CGH and should be systematically investi- gated to establish the causative and specific genes for VA.( Korean Circ J 2011;41:385-393) KEY WORDS: Array comparative genomic hybridization; Vasospastic angina. Introduction fibrillation or electro mechanical dissociation, and even sud- den cardiac death.1) The incidence of VA is higher in Asians Vasospastic angina (VA), also called Prinzmetal’s angina or than Caucasians or Blacks,2)3) which strongly suggests that ge- variant angina, is a specific type of coronary artery disease and netic traits might be involved in the pathogenesis of VA.4-11) is developed due to not atherosclerosis but coronary artery Studies have shown that the loss of Kir6.1 {pore-forming spasm. This disease can cause acute coronary syndrome, in- inwardly rectifying K+ (Kir) channel subunit} or SUR2 (sulfo- cluding acute myocardial infarction, ventricular tachycardia, nylurea receptor regulatory subunit of KATP channel) by re- Received: September 10, 2010 lated gene deletions in mice induced VA.4)5) So far, only these Revision Received: November 5, 2010 two genes have been shown to be associated with gene copy Accepted: December 16, 2010 Correspondence: Hae Ok Jung, MD, Cardiovascular Center and Car- number alterations. Other investigations showed gene poly- diology Division, College of Medicine, The Catholic University of Korea, morphisms6-8) and functional expression9-11) in VA. Related 505 Banpo-dong, Seocho-gu, Seoul 137-040, Korea Tel: 82-2-2258-1302, Fax: 82-2-591-1506 gene polymorphisms in VA included an endothelial nitric 6) 7) E-mail: [email protected] oxide synthase gene, adrenergic receptor gene, and the pa- 8) 9) • The authors have no financial conflicts of interest. raoxonase 1 gene. The Rho-associated kinase gene and se- 10)11) cc This is an Open Access article distributed under the terms of the Cre- rotonin receptor (5-HT1Dβ) gene were also shown to be re- ative Commons Attribution Non-Commercial License (http://creativecom- lated to VA by their functional expression. To date, there have mons.org/licenses/by-nc/3.0) which permits unrestricted non-commer- cial use, distribution, and reproduction in any medium, provided the origi- been no studies on deoxyribonucleic acid (DNA) copy num- nal work is properly cited. ber alterations in the whole human genome among patients 385 386 DNA Copy Number Aberrations in Vasospastic Angina with VA. The recent development of array-comparative ge- Table 1. The clinical characteristics of patients with vasospastic angina nomic hybridization (CGH) provides a means to quantita- tively measure DNA copy number aberrations and to map Characteristic Value them directly to genomic sequences.12-14) Also, tiling resolu- Number of samples 28 tion DNA microarrays comprised of large-insert genomic Age, mean±standard deviation (years) 56.4±11.4 clones such as bacterial artificial chromosomes (BACs) are a Male (%) 20 (71.4) very useful and accurate method for detecting genomic ab- Current smoker (%) 11 (39.3) 15)16) errations in many genetic diseases. Furthermore, array- Current alcohol drinking (%) 14 (50) CGH with BAC clones, has been proven to be a very useful and accurate tool for detecting genomic aberrations in whole fer (BioPrime® DNA Labeling System, Invitrogen, Carlsbad, blood samples for schizophrenia, epilepsy and mental retar- CA, USA) at 98-100°C for 5 minutes, and then cooled on ice dation,17-19) as well as in tissue from some cancers.20-24) Both for 5 minutes. The denatured DNA was differentially labeled fluorescencein situ hybridization (FISH) and real-time poly- with 3 μL of 1 mM Cy3- and Cy5-conjugated dCTP by ran- merase chain reaction (RT-PCR) have also been applied em- dom primed labeling (Perkin Elmer, Waltham, MA, USA). pirically to confirm array-CGH results.17)18)21-24) The mixture was incubated with a Klenow fragment at 37°C In the study presented here, we analyzed genomic DNA copy overnight. After labeling, unincorporated nucleotides were number aberrations in whole blood from 28 patients with removed using MicroSpinTM G-50 columns (Amersham Bio- VA using array CGH. Genetic aberrations, for a subset of gain- sciences, Buckinghamshire, UK). Cy3- and Cy5-labeled test ed or lost gene, were confirmed by RT-PCR. DNA and reference DNA were mixed with 50 μL of human Cot-1 DNA for blocking of repeat sequences. After purifica- Subjects and Methods tion, this mixture was resolved in hybridization buffer (Mac- rogen) containing yeast tRNA for blocking of non-specific nu- Clinical description cleotides binding. Peripheral blood samples were collected from 28 patients After the MACArrayTM-Karyo 4K BAC-chip was prehy- with VA at the Department of Cardiology at Seoul St. Mary’s bridized in hybridization buffer with salmon sperm DNA Hospital, Seoul, Korea. In this study, the diagnosis of VA was for 1 hour, chips were hybridized with the purification mix- made when patients met all of the following criteria: 1) re- ture. It was then incubated for 72 hours in the 37°C hybridiz- petitive burning or squeezing retrosternal chest pain, 2) def- ation chamber (BioMicro systems, Salt Lake City, UT, USA). inite positive response by coronary angiography with intra After hybridization was complete, array chips were washed in coronary acetylcholine provocation test, 3) no significant athe- 50% formamide-2x SSC at 46°C for 15 minutes, and 0.1% rosclerotic stenosis in coronary artery (<50% narrowing of SDS-2x SSC at 46°C for 30 minutes. Next, the chips were wa- the coronary luminal diameter) according to quantitative co- shed in 50% sodium phosphate-0.1% NP40 for 15 minutes ronary angiography. Blood samples were collected from 8 followed by washing with 2x SSC for 15 minutes at room women and 20 men, aged 34-71 years (mean age±standard temperature. After spin drying, hybridized arrays were scann- deviation, 56.44±11.4 in years). The clinical characteristics ed with a GenepixTM (Axon Instruments, Sunnyvale, CA, USA). of the patients are shown in Table 1. Genomic DNA was extr- acted using a Puregene DNA isolation kit (Qiagen, Hilden, Data analysis Germany). Reference DNA was pooled from 10 gender-mat- Raw signal intensities from the arrays were measured us- ched (male), normal, healthy control subjects. All patients gave ing the MAC Viewer v1.6.3 software (Macrogen). Log2 (Cy3 written informed consent to participate in this study. The pro- intensity/Cy5 intensity ratios) were normalized by using the tocol of this study was approved by the institutional review median of fluorescence ratios computed from the houseke- board of Seoul St. Mary’s Hospital, The Catholic University eping DNA control fragments linearly distributed across the of Korea. genome. Measurements flagged as unreliable by MAC Vie- wer v1.6.3 were removed from subsequent analysis. The th- Array comparative genomic hybridization reshold corresponds to 2 standard deviation (SD) values from Array CGH analyses were conducted on 28 individual sam- the mean. The information on each individual clone was ob- ples using commercial MACArrayTM Karyo 4K BAC-chips tained from the UCSC Genome Bioinformatics database (Macrogen, Seoul, Korea) with 4,030 BAC clones, in dupli- (May 2004 freeze, http://genome.ucsc.edu). cate, on the whole human genome with a resolution of about 1 Mbp. Array CGH was performed as described previous- Reverse transcriptase quantitative polymerase ly.25) Briefly, 500-700 ng target and reference DNAs were de- chain reaction natured in the presence of random primer and reaction buf- To confirm the level of genomic imbalances identified by Suk Min Seo, et al.