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Biomedical subjects

K Schueler

Publications and source records attributed to K Schueler.

3 recordsLinked to original sources

Identification of a novel Arg-->Cys mutation in the LDL receptor that contributes to spontaneous hypercholesterolemia in pigs.

We previously carried out genetic and metabolic studies in a partially inbred herd of pigs carrying cholesterol-elevating mutations. Quantitative pedigree analysis indicated that apolipoprotein (apo)B and a second major gene were responsible for the hypercholesterolemia in these animals. In this study, we assessed LDL receptor function by three different methods: ligand blots of liver membranes using beta-very low density lipoprotein (VLDL) as a ligand; low density lipoprotein (LDL)-dependent proliferation of T-lymphocytes; and direct binding of 125I-labeled LDL to cultured skin fibroblasts. All three methods demonstrated that LDL receptor ligands bound with decreased affinity to the LDL receptor in these animals. In skin fibroblasts from the hypercholesterolemic pigs, the Kd of binding was about 4-fold higher than in cells from normal pigs. The cDNA of the pig LDL receptor from normal and hypercholesterolemic pigs was isolated and sequenced. We identified a missense mutation that results in an Arg'Cys substitution at the position corresponding to Arg94 of the human LDL receptor. The mutation is in the third repeat of the ligand binding domain of the receptor. By single-stranded conformational polymorphism (SSCP) analysis, we studied the relationship between LDL receptor genotype and plasma cholesterol phenotype. In contrast to humans, the hypercholesterolemia associated with the LDL receptor mutation in pigs was expressed as a recessive trait. The LDL receptor mutation made a far more significant contribution to hypercholesterolemia than did the apoB mutation, consistent with observations made in human subjects with apoB mutations. Within each genotypic group (mutated apoB or mutated receptor), there was a wide range in plasma cholesterol. As the animals were on a well-controlled low-fat diet, this suggests that there are additional genetic factors that influence the penetrance of cholesterol-elevating mutations.

Amino Acid Sequence↗

Cost-effectiveness issues in hypertension control.

In recent years, significant attention has been directed to the economics of health care. Pressures continue to mount to evaluate the cost-effectiveness of treating specific conditions and of utilizing specific treatment regimens. It has been demonstrated that the treatment of hypertension is very cost-effective. In fact, the total cost of hypertensive medication is more than offset by the savings from stroke alone. There is significant underidentification of hypertensive patients and therefore underprescribing of antihypertensive medications. Better identification would involve increased medication costs, but these should be more than offset by reduced hospital costs, improved productivity and enhanced quality of life. In selecting antihypertensive agents, particular attention should be given to the use of regimens that facilitate patient compliance. Once- or twice-a-day formulations, even when they are more expensive than formulations given three or four times daily, can result in lower overall treatment costs due to greater rates of compliance, better hypertension control and less use of physician, hospital and laboratory services.

Antihypertensive Agents↗