Intra-Erythrocyte Cation Concentrations in Relation to the C1797T B-Adducin Polymorphism in a General Population
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Journal of Human Hypertension (2007) 21, 387–392 & 2007 Nature Publishing Group All rights reserved 0950-9240/07 $30.00 www.nature.com/jhh ORIGINAL ARTICLE Intra-erythrocyte cation concentrations in relation to the C1797T b-adducin polymorphism in a general population T Richart1, L Thijs1, T Kuznetsova1, V Tikhonoff1,2, L Zagato3, P Lijnen1, R Fagard1, J Wang4, G Bianchi3 and JA Staessen1 1Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, Studies Coordinating Centre, University of Leuven, Leuven, Belgium; 2Department of Clinical and Experimental Medicine, University of Padua, Padua, Italy; 3Division of Nephrology, Dialysis and Hypertension, University Vita Salute San Raffaele, Milan, Italy and 4Centre for Epidemiological Studies and Clinical Trials, Ruijin Hospital, Shanghai Institute of Hypertension, Shanghai, China Genetic variability in the ADD1 (Gly460Trp) and ADD2 P ¼ 0.93). In men, iK, iMg and iNa did not differ according (C1797T) subunits of the cytoskeleton protein adducin to ADD1 genotypes. In men, iK (R 2 ¼ 0.128) increased plays a role in the pathogenesis of hypertension, with age and serum Na þ , but decreased with serum total possibly via changes in intracellular cation concentra- calcium and the daily intake of alcohol. iMg (R2 ¼ 0.087) tions. ADD2 1797CC homozygous men have decreased decreased with age, but increased with serum total erythrocyte count and hematocrit. We investigated calcium. After adjustment for these covariates (Pp0.04 possible association between intra-erythrocyte cations for all), findings in men for iK (CC versus T: 85.8 versus and the adducin polymorphisms. In 259 subjects (mean 87.3 mmol/l; P ¼ 0.14) and iMg (1.91 versus 1.82 mmol/l; age 47.7 years), we measured intra-erythrocyte Na þ P ¼ 0.03) remained consistent. In 136 women, none of [iNa], K þ [iK] and Mg2 þ [iMg], serum cations and the phenotype–genotype relations reached significance. adducin genotypes. Genotype frequencies (ADD1: GlyGly Changes in intra-erythrocyte cations in ADD2 1797CC 61.5%, Trp 38.5%; ADD2: CC 80.4%, T 19.6%) complied homozygous men might lead to osmotic fragility of with Hardy–Weinberg proportions. In men, ADD2 CC erythrocytes, but to what extent they reflect systemic homozygotes (n ¼ 100) compared to T-carriers (n ¼ 23) changes or are possibly involved in blood pressure had slightly lower iK (85.8 versus 87.5 mmol/l cells; P ¼ regulation remains unknown. 0.107), higher iMg (1.92 versus 1.80 mmol/l cells; P ¼ Journal of Human Hypertension (2007) 21, 387–392. 0.012), but similar iNa (6.86 versus 6.88 mmol/l cells; doi:10.1038/sj.jhh.1002154; published online 15 February 2007 Keywords: adducin; erythrocytes; polymorphism; genetics; osmotic Introduction knockout mice show a phenotype characterised by mild anemia and compensated hemolysis.1,2 In The membrane-skeleton protein adducin stimulates humans, a common polymorphism (C1797T) occurs the assembly of the spectrin–actin network, which in exon 15 of the b-adducin gene. We have demon- determines the structural integrity of the cell strated previously in cross-sectional and prospec- membrane. Adducin is composed of either a- and tive studies that genetic variability in the subunits of b-ora- and g-subunits, which are encoded by the cytoskeleton protein adducin plays a role in the different genes. In erythrocytes, a- and b-adducin are pathogenesis of hypertension, possibly via altera- abundantly present, whereas most other tissues tion of the intracellular cation concentrations.3,4 predominantly express a-g-heterodimers. b-Adducin In addition, we have recently noticed that in men consuming alcohol, b-adducin CC homozygosity was associated with lower erythrocyte count, 5 Correspondence: Dr JA Staessen, Studies Coordinating Centre, haemoglobin level and haematocrit. The osmotic Laboratory of Hypertension, Hypertension and Cardiovascular stability of erythrocytes decreases with lower intra- Rehabilitation Unit, Department of Cardiovascular Diseases, cellular potassium concentration.6 We therefore Campus Gasthuisberg, Herestraat 49, box 702, Leuven, B-3000 measured the intra-erythrocyte concentration of Belgium. cations in a sub-sample of our previous study E-mail: [email protected] 5 Received 21 August 2006; revised 27 November 2006; accepted 10 population to test possible association with the December 2006; published online 15 February 2007 a- and b-adducin polymorphisms. Intra-erythrocyte cations and adducin T Richart et al 388 Methods iNa þ and 2.1270.12% for iK þ . The inter-assay variation determined in five blood samples was Study population 2.3771.03% for iNa þ and 3.2271.18% for iK þ . The Ethics Committee of the University of Leuven approved the protocol of the Flemish study on Environment, Genes and Health Outcomes Determination of genotypes (FLEMENGHO). All subjects gave informed consent. Genomic DNA was extracted from peripheral blood. From August 1985 to November 1990, we recruited a Allelic discrimination of the ADD1 460 glycine random sample of the households living in a (Gly)/460 tryptophan (Trp) and the ADD2 C1797 T geographically defined area of Northern Belgium.7 polymorphism was carried out using the 50-nuclease We stratified the sample by sex and age (20–39, assay9 on an ABI Prism 7700 apparatus (Perkin 40–59 and X60 years) to recruit equal numbers of Elmer, Foster City, CA, USA). The forward and participants in each of the six strata. From June 1996 reverse primers and the 460Gly and 460Trp probes to December 2000, we enrolled nuclear families, employed in the TAQMan2 assay were 50-CGTCCAC using the former participants (1985–1990) as index ACCTTAGTCTTCGACTT-30 50-GGAGAAGACAAGA persons. The participation rate among the 2310 TGGCTGAACTC-30,50-FAM-TTCCATTCTGCCCTTC subjects contacted was 66.1%. Our previous study5 CTCGGATAMRA-30 and 50-TET-TTCCATTCTGCCA included 1870 subjects with haematological pheno- TTCCTCGGAA-TAMRA-3,0 respectively (where FAM, types and the C1797T b-adducin genotype. Of these, TAMRA and TET are dyes used with the TAQMan 277 subjects were randomly selected and underwent system). For the ADD2 C1797T polymorphism, the additional measurements of their intra-erythrocyte forward and reverse primers and the 1797C and 1797T cation concentrations and the concentration of probes employed in the TAQMan2 assay were 50-AGG serum ionised calcium. We excluded 18 subjects, AACGAGAGCCAGGCTCT-30 50-TTCATCAAAACAC because of missing values. ACACCTACCAAT-30,50-VIC2-TTCTTCAGCGTTGC Trained nurses measured each participant’s blood CCTCCACATTAMRA2-30 and 50-FAM2-TCTTCAGT pressure (BP) five times consecutively by conven- GTTGCCCTCCACATCTG-TAMRA2-30 (where VIC2, tional sphygmomanometry after the subjects had TAMRA2 and FAM2 are dyes used with the rested for at least 5 min in the sitting position. These TAQMan system). Per 25 ml, the polymerase chain five readings were averaged for analysis. Hyper- reaction (PCR) fluid contained 50 ng of DNA, tension was defined as a BP of at least 140 mm Hg 200 nmol of primers, 50 nmol of FAM probe and systolic or 90 mm Hg diastolic, or as use of anti- 100 nmol of VIC probe. The amplification condi- hypertensive drugs. Body mass index (BMI) was tions were 501C for 2 min and 951C for 10 min, body weight in kilograms divided by height in followed by 40 cycles at 951C for 15 s and 621C for metres squared. We used a standardized and 1 min. The genotyping procedure was established validated8 questionnaire to collect information after we had confirmed the polymorphism (C1797T, on medical history, smoking habits, intake of starting from ATG; dbSNP number rs4984; URL: alcohol, use of medications and the menstrual cycle http://www.ncbi.nlm.nih.gov/SNP) by sequencing of women. From the type and number of alcoholic 17 individuals using the ABI Prism Big Dye beverages used each day, we calculated alcohol Terminator cycle sequencing ready reaction kit consumption in grams per day. (Applied Biosystems, Foster City, CA, USA). We tested the frequency of the polymorphism in a random population of 250 blood donors from North Italy, and found that the minor allele had a Measurement of phenotypes frequency of 15%. For quality control, 10% of the Venous blood samples were collected into ethylene- DNA samples in our study were genotyped in diamine-tetraacetic acid-containing tubes. Erythro- duplicate in a blinded fashion. Duplicate genotypes cyte count, haemoglobin, and haematocrit were were confirmatory in all samples. measured in whole-blood specimens with a SYS- MEX HST 403XE model automated cell counter (Systmex Corporation, Chuku, Kobe, Japan). Serum Statistical analysis ionised calcium and pH were determined using For database management and statistical analysis, an ICA2 ionised calcium analyser (Radiometer, we used SAS software, version 9.1.3 and JMP, Copenhagen, Denmark). version 6 (SAS Institute, Cary, NC, USA). Measure- Erythrocytes (1.5 ml) were washed three times ments with a skewed distribution were norma- with ice-cold 140 mM choline chloride. After centri- lised by logarithmic transformation. Comparisons fugation at 5500 r.p.m. at 41C for 3 min, the super- of means and proportions were performed using natant and the top layer of the cells were discarded Student’s t-test and Fisher’s exact test, respectively. by aspiration. The cells were lysed with double- We computed Pearson’s correlation coefficients distilled water and the Na þ ,Kþ and Mg2 þ concen- between the cation concentrations in erythrocytes trations were measured by atomic absorption and serum and compared