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The Association Between an Endothelial Nitric Oxide Synthase Gene Polymorphism and Coronary Heart Disease in Young People and the Underlying Mechanism

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The Association Between an Endothelial Nitric Oxide Synthase Gene Polymorphism and Coronary Heart Disease in Young People and the Underlying Mechanism 3928 MOLECULAR MEDICINE REPORTS 17: 3928-3934, 2018 The association between an endothelial nitric oxide synthase gene polymorphism and coronary heart disease in young people and the underlying mechanism XIAO-JIE CHEN1, CHUN-GUANG QIU1, XIANG-DONG KONG2, SHU-MIN REN2, JIAN-ZENG DONG1, HE-PING GU1, YING-WEI CHEN1, HAI-LONG TAO1 and JHA SARBESH1 Departments of 1Cardiology and 2Genetics and Prenatal Diagnosis, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, P.R. China Received May 12, 2017; Accepted November 2, 2017 DOI: 10.3892/mmr.2017.8314 Abstract. With the development of molecular biological tech- the active site of eNOS, and partial structures of the protein nology, the association between genes and diseases has drawn were converted from random coil to α-helix. In conclusion, increasing attention of researchers; the endothelial nitric oxide the eNOS G894T gene polymorphism was associated with synthase (eNOS) gene has been reported to be a candidate the occurrence and development of CHD in young people. gene for cardiovascular disease (CHD). The present study The potential mechanism is that the G894T polymorphism aimed to investigate the association between a polymorphism leads to altered protein structure, which affects the func- of eNOS and the risk of CHD in young people (≤40 years old), tion of eNOS in generating nitric oxide and cardiovascular in addition to the underlying mechanism. A total of 234 cases diastole. The results of the present study suggested a potential of CHD in young individuals were collected as the CHD target gene for the prevention and treatment of CHD in young group and 228 cases of healthy individuals as the control people (≤40 years old). group. Peripheral blood was collected and the genotype of the eNOS G894T polymorphism was identified by polymerase Introduction chain reaction-restriction fragment length polymorphism, the gene frequency was calculated and the distributions of Coronary heart disease (CHD) is a type of cardiovascular genotype and allele frequency between the two groups were disease causing by coronary artery atherosclerosis and plaque compared. Bioinformatics tools were employed to analyze the rupture, leading to the arterial stenosis or occlusion, then differences in the local protein structures of the eNOS G894T resulting in myocardial ischemia or necrosis, which is among polymorphism and the biological mechanism was preliminary the top ten causes of human mortality. At present, the treatment discussed. The results demonstrated that there were signifi- methods of CHD include: Surgical treatment, interventional cant differences in the distribution of genotype frequency therapy (stent implantation) and medication (nitric acid ester, and allele frequency of the eNOS G894T gene polymorphism β-blocker, antithrombotic and statins); however, medica- between the CHD group and control group (P<0.05). The risk tion is the basis of all treatment (1). With the improvement of CHD in GT and TT genotypes were higher compared with of the living standards, the incidence and mortality rates of the GG genotype (P<0.05). The G894T polymorphism led CHD has increased rapidly, particularly within young people to Glu298Asp mutation of encoded protein, which is within (≤40 years old) in China (2,3). The earlier incidence of CHD is not only threat to human health, but may burden a patient's families and society; CHD has gained increasing attention of researchers (4). It is well-known that smoking, drinking, obesity, hypertension and metabolic syndrome are risk factors Correspondence to: Professor Chun-Guang Qiu, Department of for CHD. For smokers, nicotine in tobacco may damage the Cardiology, The First Affiliated Hospital of Zhengzhou University, vascular endothelium, resulting in the vasospasm and plaques 1 East Jianshe Road, Zhengzhou, Henan 450000, P.R. China rupture, accelerating the onset of coronary atherosclerosis (5). E-mail: [email protected] In addition, previous studies have demonstrated that the Abbreviations: CHD, coronary heart disease; eNOS, endothelial functional disturbance of endothelial cells and early-stage nitric oxide synthase; NO, nitric oxide atherosclerosis may be caused by reduced levels of nitric oxide (NO), nitric oxide has an important role in the pathogenesis of Key words: endothelial nitric oxide synthase, gene polymorphism, CHD (6-8). Endothelial NO synthase (eNOS) is the enzyme coronary heart disease of young people, G894T, bioinformatics responsible for the generation of NO in endothelial cell (9-11). analysis Various studies have investigated the association between the eNOS G894T polymorphism and the risks of CHD (12-15). However, to the best of our knowledge, the association CHEN et al: ASSOCIATION AND MECHANISM BETWEEN AN eNOS POLYMORPHISM AND CHD 3929 between eNOS and the risk of CHD in young people is yet to be established. Therefore, in the present study, the association between the eNOS G894T polymorphism and CHD in young individuals, and the influence of the polymorphism on the protein structure and function, were analyzed and the potential biological mechanisms were preliminarily investigated by a series of bioinformatics analyses. Materials and methods Study subjects. A total of 234 cases of young patients with CHD, who received treatment between August 2013 Figure 1. The image of agarose gel electrophoresis for enzyme digestion and May 2016 at the Department of Cardiology, The First products. 0: DNA marker, 1-8: the enzyme digestion products in different individuals. Affiliated Hospital of Zhengzhou University (Zhengzhou, China) were included in the CHD group, which comprised 198 males and 36 females between the ages of 18 and 40 years old with a mean age of 34.2±3.7 years old. All cases restriction endonuclease Eco24I (Ban II) (Takara, Japan) at were diagnosed with CHD through a coronary angiogram 37˚C for 10 h. The results of enzyme digestion was performed and complied with the following CHD diagnostic criteria by agarose gel electrophoresis (Fig. 1) and the results demon- specified by the World Health Organization (16): Exhibited strated that wild-type homozygote GG contained 169 and 94 symptoms typical of angina; an electrocardiogram identi- bp fragments, variant homozygote TT contained a single 263 fied the previous occurrence of a myocardial infarction; and bp fragment and heterozygote GT contained 263 and 169 and confirmation by angiography, which is considered the ‘gold 94 bp fragments. The G8494T polymorphism from individuals standard’ for the assessment of coronary artery disease. A of the present study had been sequence by PCR-RFLP; in the comprehensive individualized treatment program should be GG genotype, the G849T locus was at a guanine nucleotide, applied to suit the circumstances of each patient. A total of which could be digested by Eco24I. Within the TT genotype, 228 healthy individuals between the ages of 18 and 40 years the G849T locus was at a thymine nucleotide; however, within old who visited the hospital for physical examination and the GT type, the G849T locus was a guanine or thymine voluntarily agreed to participate in the study during the same nucleotide. period were randomly collected as the control group, which comprised 195 males and 33 females with a mean age of Bioinformatics analysis on the polymorphism site. Alterations 35.7±2.6 years old. All of the participants lived in the Henan in the amino acid sequences of the eNOS G894T gene polymor- province of China and had no blood relationship with each phism were analyzed by the Single Nucleotide Polymorphisms other. The present study was reviewed and approved by the and open reading frame databases (National Center for Ethical Inspection Committee of Zhengzhou University and Biotechnology Information (NCBI); https://www.ncbi. participants in the CHD and control groups volunteered and nlm.nih.gov/snp/; https://www.ncbi.nlm.nih.gov/orffinder/, signed the informed content. respectively), and alterations in the protein structure prior to and following the amino acid sequence mutation were Identifying genotypes by polymerase chain reaction‑restriction analyzed using the protein modeling tool, QUARK (17). fragment length polymorphism (PCR‑RFLP). Peripheral blood Amino acid sequences consisting of 20 amino acids around (4 ml) was collected from each participant, 0.6 mg EDTA-Na2 the G894T polymorphism site were entered into the QUARK was used as an anticoagulant (final concentration was 1.5 g/l) tool to perform local structural modeling of the protein, and and the genomic DNA was extracted using a Genelute™ blood structural characteristics prior to and following the mutation genomic DNA kit (Sigma-Aldrich; Merck KGaA, Darmstadt, were analyzed and compared by Cn3D 4.3.1 viewer software Germany) according to the manufacturer's protocols. The diag- (NCBI; http://www.ncbi.nlm.nih.gov). Characteristics of the nostic primer for the genotype of the G894T polymorphism eNOS structural domain were analyzed by SMART v7 (18) was synthesized by Sangon Biotech Company (Shanghai, and the NCBI Conserved Domain Database (CDD) (19), and China): Sense, 5'-GAG ATG AAG GCA GGA GAC AGT-3'; and the potential biological functions of the region where the poly- anti-sense, 5'-TCC ATC CCA CCC AGT CAA T-3'. The PCR morphism sites were located was discussed. In addition, the reaction system (25 µl) constituted: Genomic DNA 1.0 µl, 10x potential eNOS signaling pathway and the effects of structural buffer 2.5 µl, dNTP Mix 2.0 µl, sense primer 0.2 µl, anti-sense changes on the pathway activity were analyzed by using the primer 0.2 µl, Taq DNA polymerase 0.1 µl and deionized water Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway 19 µl. The amplification procedure: pre‑denaturation at 95˚C or database (20) (http://www.genome.jp/kegg/pathway.html). 2 min; 35 cycles of denaturation at 95˚C for 30 sec, annealing at 58˚C for 30 sec and extension for 30 sec at 72˚C and final Statistical analysis. All data were analyzed by SPSS 19.0 extension at 72˚C for 5 min.
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