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Biomedical subjects

P J Talmud

Publications and source records attributed to P J Talmud.

At least 73 records · Page 4Linked to original sources

Familial lipoprotein lipase (LPL) deficiency: a catalogue of LPL gene mutations identified in 20 patients from the UK, Sweden, and Italy.

The aim of this study was to identify mutations in the lipoprotein lipase (LPL) gene in 20 unrelated patients with familial lipoprotein deficiency (FLLD) and to investigate the genotype/phenotype relationship. The previously reported G188E mutation (Monsalve et al., J Clin Invest 86:728-734, 1990) was screened for and found to be present in seven individuals (12/40 alleles). In addition, three patients were heterozygous for the 2.0 kb insertion (Langlois et al., Proc Nalt Acad Sci US 86:948-952, 1989). Two approaches were taken for new mutation detection; single-strand conformation polymorphism and sequencing to identify micro-mutations in the proximal promoter and exons 1-9 of the LPL gene and Southern blotting to identify gross mutations. Ten different point mutations were found (W86G, A158T, H183Q, G188E, S193R, P207L, L252X, N291S, M301T, L303P). Additionally, a two nucleotide deletion in exon 6 (delta1006-1007), a six nucleotide deletion in exon 8 (delta1441-1447), and a silent substitution in the wobble position of codon E118 were identified. In vitro mutagenesis and expression in COS-B cells suggested that the A158T and S193R substitutions virtually abolished enzyme activity. In analysing the genotype/phenotype relationship, there was no strong association between age at diagnosis, severity of symptoms, lipid levels, and the nature/position of the mutation. Triglyceride levels, however, were higher in compound heterozygotes compared to true homozygotes, possibly reflecting increased instability of heterodimers. Overall, 29 of 40 (72.5%) mutant alleles were identified. Failure to identify the mutation in 11 alleles might reflect the inadequacy of the method or the possibility that mutations lie within regions of the gene not screened in the study because of lack of availability of sequence.

Adult↗

Common variation in the lipoprotein lipase gene: effects on plasma lipids and risk of atherosclerosis.

The importance of the enzyme lipoprotein lipase (LPL) in the development of dyslipidaemia and atherosclerosis is increasingly recognised. Variations in the LPL gene which are common in the general population have been shown to be associated with alterations in plasma lipids. D9N and N291S both occur at carrier frequencies of up to about 5% and have been associated with increased plasma triacylglycerol and decreased high density lipoprotein cholesterol concentrations, effects which seem to be magnified in more obese individuals. S447X carrier frequency is approximately 20%, but unlike carriers of N9 or S291, X447 carriers appear to have a more favourable lipid profile. A transition within the LPL promoter at position-93 may lead to increased LPL activity and have a beneficial effect on plasma lipids. Greater knowledge of the underlying mechanisms of these variations within the LPL gene may be of considerable importance in understanding genetic predisposition to atherosclerosis and heart disease.

Arteriosclerosis↗

Apolipoprotein C-III gene variation and dyslipidaemia.

Within the apolipoprotein A-I-C-III-A-IV gene cluster, the Ssti polymorphism in the 3' untranslated region of the apolipoprotein C-III gene is the variant site most consistently and strongly associated with raised plasma triglyceride levels and coronary artery disease. To date the molecular mechanisms that underlie this effect have not been fully identified and variation within the insulin-responsive element of the apolipoprotein C-III proximal promoter cannot entirely explain the Ssti effect.

Animals↗

A common mutation in the lipoprotein lipase gene promoter, -93T/G, is associated with lower plasma triglyceride levels and increased promoter activity in vitro.

Single-strand conformational polymorphism analysis of the lipoprotein lipase promoter identified a T-->G transition at position -93. The frequency in healthy white men was 3.4% (n = 1575). There was an 83% allelic association between -93T-->G and Asp9-->Asn (D9N); all N9 mutations occurred on a -93G allele, but not all -93G mutations occurred on an N9 allele. It was thus possible to assess the effect on plasma triglyceride (Tg) levels of the rare -93G mutation in the presence of the wild-type D9. Carriers of the -93G, with genotype TG/DD, had significantly lower Tg levels than TT/DD individuals (1.36 versus 1.78 mmol/L, P = .01); carriers of both mutations (TG/DN) had the highest Tg levels (1.93 mmol/L). When the group was stratified above and below the sample mean for body mass index (BMI), carriers of the -93G on a D9 allele (TG/DD) were "protected" against the Tg-raising effect of obesity, as assessed by BMI. In Afro-Caribbeans (n = 91), the carrier frequency of -93G was 18-fold higher (63%), with weaker (17%) allelic association between -93G and N9. In vitro, the -93G promoter had 24% higher activity than the -93T in a rat smooth muscle cell line and 18% higher activity in a human adrenal cell line. A protein identified by band-shift assays bound to the -93G but not to the -93T allele, which may explain the lower Tg levels in -93G carriers.

Adult↗

Determinants of postprandial lipemia in men with coronary artery disease and low levels of HDL cholesterol.

We studied the determinants of postprandial lipemia in 49 post-coronary-bypass men with low HDL cholesterol (< or = 1.1 mmol/l at screening). The subjects were given a mixed meal containing 63 g fat and 150,000 IU vitamin A. Serum was obtained before and 3, 4, 5, 6, and 8 h after the meal. S(f) > 400 and S(f) 12-400 lipoproteins, LDL, and HDL were separated by ultracentrifugation; and triglyceride (TG), retinyl ester (RE), and apolipoprotein (apo)E concentrations were measured. The associations of 15 potential predictor variables with measures of postprandial lipemia were evaluated in univariate and multivariate models. Fasting TG concentration was the most important determinant of postprandial lipid and apoE concentrations. In univariate analyses, neither apoE phenotype nor common genetic polymorphisms in the apoB gene (XbaI and apoB signal peptide length polymorphisms), lipoprotein lipase gene (Hind III polymorphism), or apoC-III gene (C[1100] to T sequence change) significantly predicted the magnitude of postprandial lipemia. In multivariate linear regression analyses, fasting TG concentration (P< 0.001) and postheparin plasma hepatic lipase activity (P = 0.023) were directly, and body mass index (P = 0.007) and the presence of apoE2 (P = 0.029) allele inversely related to the TG increment in S(f) >400 lipoproteins. Fasting TG was associated with a high (P < 0.001) and presence of the SP24 allele of the apoB signal peptide gene with a low (P = 0.014) S(f) 12-400 TG response. Fasting TG concentrations alone predicted 35%, 10%, and 34% of the variability in postprandial S(f) >400 responses of TG, RE, and apoE; multivariate models improved this predictive power to 40-50%. Even multivariate models were poor predictors of postprandial responses in S(f) 12-400 lipoproteins (0-26%). Much of the interindividual variation in the magnitude of postprandial lipemia remained unexplained in the present study.

Adult↗

The association between free fatty acid concentrations and triglyceride-rich lipoproteins in the post-prandial state is altered by a common deletion polymorphism of the apo B signal peptide.

To investigate whether there were associations between the free fatty acid (FFA) response during a fat tolerance test and changes in concentrations of triglyceride-rich lipoproteins 57 healthy Caucasian men between 57 and 70 years of age underwent a fat tolerance test lasting 8 h. FFA concentrations initially decreased from 0.75 +/- 0.03 to 0.64 +/- 0.03 mmol/l at 2 h and thereafter increased to 1.2 +/- 0.04 mmol/l at 8 h. Maximum FFA concentration was the only significant determinant of 8 h triglyceride-rich lipoprotein (TGRLP) concentrations (pooled chylomicron and VLDL fractions d < 1.006) (TGRLP-TG r = 0.33, P = 0.012; TGRLP apo B r = 0.37, P = 0.004; TGRLP cholesterol r = 0.38, P = 0.004). The strength of the association between FFA and TGRLP was affected by the apo B signal peptide genotype. Only in individuals who were homozygous for the 27 amino acid (SP27 or I) allele of the apo B signal peptide were there significant associations between maximum FFA concentration quartile and 8 h TGRLP concentration (P value for linear trend = 0.025). In this genotype group there were lower HDL cholesterol concentrations (1.16 mmol/l compared to 1.38 mmol/l in subjects either heterozygous or homozygous for the SP24 [D] allele; P = 0.005) and there was a trend toward increased 8 h TGRLP concentrations. We propose that the association between post-prandial FFA concentrations and post-prandial TGRLP concentrations in individuals who are homozygous for the SP27 allele may be linked to the increased prevalence of ischemic heart disease (IHD) in this genotypic group.

Aged↗

Association between the LPL-D9N mutation in the lipoprotein lipase gene and plasma lipid traits in myocardial infarction survivors from the ECTIM Study.

Using polymerase chain reaction (PCR) based techniques, we have identified individuals in the ECTIM study of myocardial infarction survivors (cases) and healthy matched controls who are carriers for a mutation of the gene for lipoprotein lipase (LPL) which alters amino acid 9 from aspartic acid to asparagine (LPL-D9N). The frequency of carriers in the cases from Belfast and France (3 separate centres) was 2.5 and 3.7%, respectively (mean 3.3%, 95% CI 1.9-4.7) and in the controls 2.0 and 2.9%, respectively (mean 2.7%, 95% CI 1.6-3.8%), but this difference was not statistically significant. In the cases, carriers of the allele for LPL-N9 had higher levels of several plasma lipid traits including total triglycerides (TG) (30%), very low density lipoprotein (VLDL) cholesterol (19%), apo E (24%), apo C-III (17%), lipoprotein particles (Lp) containing both apo E and apo B (LpE:B) (32%), and particles containing both apo C-III and apo B (LpCIII:B) (39%), and this effect was consistent in cases both from Belfast and from the French centres combined. By contrast, in the controls there were no differences in any lipid trait between carriers and non-carriers of the mutation that was consistent between the French centres and Belfast. There were no significant differences in the levels of any measured factor between cases and controls that could explain the different effect on plasma lipid traits associated with the mutation. However, compared to the non-carriers, in both cases and controls who carried the mutation, plasma TG concentrations were higher in those whose body mass index (BMI) was above the mean of the sample (26.0 kg/m2), with statistically significant interaction seen between BMI and genotype and levels of apo C-III, and lipoprotein particles containing both apo C-III and apo B (P < 0.02). The data suggest that carriers for the LPL-N9 mutation have a mild genetic predisposition to developing hyperlipidaemia and an atherogenic lipid profile, but that this requires the presence of other genetic or environmental factors for full expression, one of which appears to be increasing obesity.

Adult↗

Genetic factors affecting the consistency and magnitude of changes in plasma cholesterol in response to dietary challenge.

We examined the role of common genetic variation in determining the consistency and magnitude of change in plasma total cholesterol (TC) levels in response to two separate changes from a high-saturated (SFA) to a low-saturated/high-polyunsaturated-fat (PUFA) diet, in a group of free-living healthy men and women. Consistent responders were defined as those whose mean difference in the change in TC was within one SD of the mean for all participants, and the remainder were defined as variable responders. DNA was obtained from 55 individuals and genotype determined at the apolipoprotein (apo) B locus (signal peptide, SP), apoCIII (C1100-T) and lipoprotein lipase (LPL) gene loci (HindIII). In the 38 consistent responders, the apoBSP24 allele was significantly more common than in the 17 individuals with a variable response (0.29 vs. 0.12; p < 0.05). No other polymorphism showed a significant frequency difference between groups. In the group as a whole, the correlation between the change in TC level in response to the first and second dietary change was 0.28 (p = 0.05), but those with one or more apoB SP24 alleles and those with the apoCIII genotype CC had a significantly higher correlation than those with other genotypes (0.46 (p = 0.05) vs. 0.12 (NS) and 0.31 (p = 0.05) vs. 0.02 (NS), respectively). In the group as a whole, mean response left TC 10% higher on the SFA than on the PUFA diet, and neither apoB nor apoCIII genotypes affected the magnitude of this response. However, individuals with the LPL HindIII genotype H+ H+ had a significantly smaller change in mean TC in response to diet than those with one or more H- allele (9.3% vs. 14.4%; p = 0.03). Thus variation at the apoB and apoCIII loci affects the consistency of response to change in dietary fat content, while variation at the LPL gene locus affects magnitude of response.

Apolipoproteins B↗

Lack of association of angiotensin-converting enzyme (ACE). Gene insertion/deletion polymorphism with CAD in two Asian populations.

Association of the insertion/deletion polymorphism of the angiotensin-converting enzyme (ACE) gene with coronary artery disease with or without myocardial infarction (MI) was examined in a group of Chinese and Indian men in Singapore. The sample comprised an angiographically confirmed patient group of 276 Chinese and 102 Indians, of which 155 Chinese and 72 Indians had MI, and a matched healthy control group (147 Chinese and 166 Indians). The frequency of the D allele in the Chinese was 0.39 in those with CAD with MI, 0.43 in those with CAD but without MI, and 0.41 in the control group. The frequency of the D allele in Indians was 0.44 in CAD with or without MI, and 0.45 in the control group. There was no significant association of the ACE gene with CAD or MI in the Chinese or Indians, either in the entire sample or in different risk groups. The frequency of the D allele was significantly lower in the healthy Chinese and Indians than that reported in Caucasians. The association of the ACE gene with MI or CAD observed in other studies could not be confirmed in the present series of Chinese and Indians in Singapore.

Adult↗

DNA polymorphisms of the apoprotein B gene are associated with altered plasma lipoprotein concentrations but not with perceived risk of cardiovascular disease: European Atherosclerosis Research Study.

Three polymorphisms of the apoprotein B gene (XbaI, signal peptide insertion/deletion and the 3'-variable number of tandem repeats) selected on the basis of previously published reports as likely to be the most informative, were investigated in a cross-cultural study in Europe. Students from 14 universities, grouped for analyses into five regions, were recruited as cases (n = 682) if they had a paternal history of premature myocardial infarction. For comparison, twice the number of age- and sex-matched controls (n = 1312) were recruited from the same student populations. There were significant regional differences in allele frequencies of the XbaI and VNTR polymorphisms but not of the signal peptide. There were no significant differences in allele frequencies between cases and controls. Adjusted for age, gender and region, the lipoprotein concentrations differed significantly with genotype. The XbaI polymorphism was associated with differences in plasma cholesterol (P = 0.007), triglyceride (P = 0.050), apo B (P = 0.001) and LDL cholesterol (P = 0.01). An interaction between XbaI genotype and body mass index was observed on plasma triglyceride (P = 0.015) and apo B (P = 0.005) concentrations. The signal peptide deletion allele was associated with increased plasma cholesterol (P = 0.03), apo B (P = 0.04) and LDL cholesterol (P = 0.02). The VNTR was not significantly associated with any of these variables although there was a significant genotype/status interaction in relation to HDL cholesterol (P = 0.001) and apo AI (P = 0.001) concentrations. We conclude that, although they are associated with significant differences in lipoprotein concentrations within- and between-populations, the apo B DNA polymorphisms studied are of less value as indicators of cardiovascular risk-factor status in the offspring of individuals affected by the disease.

Adolescent↗

Common variation in the gene for apolipoprotein B modulates postprandial lipoprotein metabolism: a hypothesis generating study.

We have carried out a pilot study to examine the influence on postprandial lipid and lipoprotein metabolism of common genetic variation in the gene coding for apolipoprotein (apo) B, in a previously described group of 30 individuals who had survived a myocardial infarction (MI) before the age of 45 (normo (NTG)- and hypertriglyceridaemic (HTG) patients) and 11 age-matched healthy individuals. Postprandial lipid or lipoprotein levels were examined by genotypes in the three groups separately and after adjustment for fasting triglycerides (TG) in the whole group combined. For the signal peptide polymorphism in the apo B gene, individuals with one or more SP-24 alleles had a 38% smaller mean area under curve (AUC) (P = 0.06) for postprandial large chylomicron remnants and a 29% smaller mean AUC (P = 0.01) for large very low density lipoproteins (VLDLs) compared to individuals homozygous for the wild type SP-27 allele. Previously in this patient group, small chylomicron remnants (apo B-48 levels in the Sf 20-60 range) were found to relate significantly and positively to progression of coronary atherosclerosis suggesting that these lipoproteins are implicated in progression of atherosclerosis. For the apo B Val591-Ala polymorphism (Ag a1/d), individuals homozygous for the V591 allele had a 33% greater AUC for Sf 20-60 postprandial triglycerides (P = 0.006), with higher postprandial levels of both apo B-48- and apo B-100-containing lipoproteins in this fraction. This pilot study gives insight into the mechanisms of the previously reported associations between polymorphisms in the apo B gene and fasting plasma lipids and lipoproteins.

Alleles↗

Lack of association between the insertion/deletion polymorphism of the angiotensin-converting enzyme gene and idiopathic dilated cardiomyopathy.

OBJECTIVES: We sought to investigate the role of polymorphisms of the gene for angiotensin-converting enzyme in the development and progression of idiopathic dilated cardiomyopathy. BACKGROUND: Cardiovascular renin-angiotensin systems may be involved in cardiac remodeling and fibrosis. The absence (deletion [D]) of a 287-base pair marker in the angiotensin-converting enzyme gene (introm 16) is associated with increased serum angiotensin-converting enzyme levels. The DD genotype may be a risk factor for the development of end-stage heart failure due to cardiomyopathy. We therefore examined the relation of the angiotensin-converting enzyme genotype to idiopathic dilated cardiomyopathy and to markers of disease severity. METHODS: We studied 364 control subjects and 99 consecutive patients with idiopathic dilated cardiomyopathy. When the incidence of the DD genotype in our control group was assumed to be similar to that previously reported (27%), this study had a power of 0.9 to detect a different incidence in the patient group, if the true incidence in patients was 42%. Deoxyribonucleic acid (DNA) was isolated from blood samples, and angiotensin-converting enzyme genotype was determined by specific polymerase chain reaction and separation of amplified fragments by agarose gel electrophoresis. We also compared genotype distribution with that in previously reported European control subjects. Functional status, clinical course over a mean +/- SD of 28 +/- 33 months and outcome were documented. Cardiac morphology and function and evidence of rhythm disturbance were noninvasively determined. RESULTS: Angiotensin-converting enzyme genotype distribution and allele frequencies were similar in patients and control subjects to within 10% (with 95% confidence) and were also similar between patients and European control subjects. No markers of disease severity or progression other than duration of symptoms before diagnosis and the number of ventricular ectopic beats/h were significantly associated with the presence of the DD alleles. CONCLUSIONS: We find no evidence to support an association between angiotensin-converting enzyme genotype and either the diagnosis of idiopathic dilated cardiomyopathy itself or progression of the disease.

Adult↗

The genetic determinants of plasma cholesterol and response to diet.

In general, risk factors for multifactorial disorders such as atherosclerosis and hyperlipidaemia show a continuous distribution in the population, and this is the result of both interaction between genetic variation at genetic loci, and genetic and environmental interaction. Therefore, the investigation of the genetics of intermediate phenotypes such as levels of plasma lipid traits is likely to be particularly informative. Once the genes involved in determining the levels of these phenotypes have been identified, it should be possible to use the information to obtain a better understanding of the way these genetic variations determine the clinical end points. In the population it will be possible to identify a number of polygenes that are having a small effect on determining the trait, but for a particular individual, or the relatives of that individual, only a subset of all these polygenes will determine the level of the trait and therefore the risk of developing the disorder. In general, mutations with a large effect on the trait are rare in the population, By contrast, polymorphisms with a small effect on the trait may be common, such as is found with the effect of the apoE alleles and variation at the apoB gene locus on lipid levels. In the field of hyperlipidaemia and atherosclerosis research, molecular techniques have already given a great deal of information on how specific sequence variations in some of the candidate genes are involved in determining levels of plasma apoproteins, lipoproteins and lipids. As more mutations and sequence variations are identified, this will not only aid our understanding of the underlying pathology, but should be useful for identifying individuals who are at risk of developing atherosclerosis because of their particular genotype or combination of genotypes.

Cholesterol↗

Hyperlipidaemia associated with genetic variation in the apolipoprotein B gene.

Common variants at the apolipoprotein B gene locus are associated with hyperlipidaemia, but conflicting data have been presented in the literature concerning the size of the effects and which polymorphisms give the best signal in the different groups of individuals studied. In this review, we will present a critique on the use and interpretation of association studies, with respect to the recent apolipoprotein B DNA polymorphism studies. The impact of these common polymorphisms and rare mutations of apolipoprotein B, primarily the substitution of arginine by glutamine at residue 3500 (R3500Q) that causes familial defective apolipoprotein B100, will also be considered.

Amino Acid Sequence↗

Role of glycaemic control in development of microalbuminuria in patients with insulin dependent diabetes.

OBJECTIVE: To ascertain which factors determine the progression from very low rates of albumin excretion to persistent microalbuminuria in patients with insulin dependent diabetes mellitus. DESIGN: A 10 year prospective study of a cohort of diabetic patients. SETTING: Outpatient department of the Portsmouth District Hospitals. SUBJECTS: 97 patients with insulin dependent diabetes mellitus who were initially free of microalbuminuria and hypertension. MAIN OUTCOME MEASURE: Urinary albumin: creatinine ratio. RESULTS: Eight of the 97 patients had developed microalbuminuria (urinary albumin:creatinine ratio > 3 mg/mmol in three consecutive early morning samples) by the 10 year follow up. The group who developed microalbuminuria had higher baseline log10 plasma glucose concentrations (mean (SD), 1.210 (0.122) v 0.984 (0.196) mmol/l, P < 0.001) and glycated haemoglobin concentrations (1.112% (0.069%) v 0.997% (0.076%), P < 0.001) and a younger age at onset of diabetes (10.0 (5.5) v 15.6 (7.8) years, P < 0.05). There was no difference in baseline duration of diabetes, smoking, sex, insulin dose, body mass index, serum creatinine concentration, or systolic, diastolic, or mean arterial blood pressure between the two groups. Multiple linear regression analysis showed that urinary albumin:creatinine ratio at 10 years was influenced by initial albumin:creatinine ratio (P = 0.006), initial glycated haemoglobin concentration (P = 0.002), and duration of diabetes (P = 0.045). Genotype for angiotensin converting enzyme was not related to the development of microalbuminuria nor, in a larger group of patients, the presence of any degree of diabetic nephropathy. CONCLUSION: In patients with insulin dependent diabetes mellitus the progression of minimal albuminuria and the development of microalbuminuria is determined primarily by poor long term glycaemic control. There is a weaker relation with longer duration of disease and younger age at onset of diabetes, but blood pressure does not seem to be implicated. Gene polymorphism for angiotensin converting enzyme is not linked to the development of microalbuminuria or established diabetic nephropathy.

Adolescent↗

Human apolipoprotein B signal sequence variants confer a secretion-defective phenotype when expressed in yeast.

Hyperlipidemia arises from a disturbance in the balance between production and degradation of lipoprotein particles. Variation in the secretion of human apolipoprotein B (apoB), the major protein component of triglyceride-rich lipoproteins, directly affects this homeostasis. Naturally occurring apoB signal peptide variants (associated with hypertriglyceridemia, altered postprandial lipid metabolism, or atherosclerosis) were investigated for their ability to direct transit through the secretion pathway. Three apoB signal peptide isoforms were fused to the secretory protein, invertase, and expressed in yeast. A deletion or insertion in the hydrophobic core of the signal peptide mediated inefficient translocation into the endoplasmic reticulum and was secretion-defective, relative to the common 27-residue isoform. Additionally, the insertion apoB isoform was observed in yeast to confer a defect in export from the endoplasmic reticulum. Secretion of the apoB signal peptide-invertase fusions responded positively to an inhibitor of calpain type I proteases. These observations suggest that the apoB signal peptide plays a role in determining the levels of apoB degradation and secretion and, thus, hyperlipidemia.

Amino Acid Sequence↗