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Published in: European Journal of Epidemiology 2/2008

01-02-2008 | GENETIC EPIDEMIOLOGY

Synergistic effect of the genetic polymorphisms of the renin–angiotensin–aldosterone system on high-altitude pulmonary edema: a study from Qinghai-Tibet altitude

Authors: Yue Qi, Wenquan Niu, Tongchun Zhu, Wenyu Zhou, Changchun Qiu

Published in: European Journal of Epidemiology | Issue 2/2008

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Abstract

The pathogenesis of high-altitude pulmonary edema (HAPE) has been at least partially attributed to the local dysregulation of the renin–angiotensin–aldosterone system (RAAS) cascade. To address this issue, we conducted the largest nested case-control study to-date to explore the association between variations in RAAS genes and HAPE in Chinese population. We recruited 140 HAPE patients and 144 controls during the construction of Qinghai-Tibet railway and genotyped 10 gene polymorphisms evenly interspersed in 5 RAAS candidate genes. The data were analyzed by haplotype and multifactor dimensionality reduction (MDR). The single-locus analysis showed that CYP11B2 C-344T and K173R and ACE A-240T polymorphisms were significantly associated with HAPE after Bonferroni correction (< 0.005). The linkage analysis constructed a linkage block including C-344T and K173R polymorphisms in complete linkage disequilibrium with each other, while occurred with significantly different frequencies between HAPE and control groups. The gene-gene interaction analysis found the overall best model including ACE A-240T and A2350G and CYP11B2 C-344T polymorphisms with strong synergistic effect. This model had a maximum testing accuracy of 68.61% and a maximum cross validation consistency of 9 out of 10 (= 0.004). The homozygous genotype combination of −240AA, 2350GG and −344TT conferred high genetic susceptibility to HAPE, which was further strengthened by haplotype analysis. Our results add evidence for synergistic effect of RAAS gene polymorphisms on HAPE susceptibility. Moreover, we proposed a promising data-mining analytical approach (MDR) for detecting and characterizing gene-gene interactions.
Literature
1.
go back to reference Bartsch P, Mairbaurl H, Maggiorini M, Swenson ER. Physiological aspects of high-altitude pulmonary edema. J Appl Physiol 2005;98:1101–10.PubMedCrossRef Bartsch P, Mairbaurl H, Maggiorini M, Swenson ER. Physiological aspects of high-altitude pulmonary edema. J Appl Physiol 2005;98:1101–10.PubMedCrossRef
2.
go back to reference Maggiorini M, Leon-Velarde F. High-altitude pulmonary hypertension: a pathophysiological entity to different diseases. Eur Respir J 2003;22:1019–25.PubMed Maggiorini M, Leon-Velarde F. High-altitude pulmonary hypertension: a pathophysiological entity to different diseases. Eur Respir J 2003;22:1019–25.PubMed
3.
go back to reference Mortimer H, Patel S, Peacock AJ. The genetic basis of high-altitude pulmonary oedema. Pharmacol Ther 2004;101:183–92.PubMedCrossRef Mortimer H, Patel S, Peacock AJ. The genetic basis of high-altitude pulmonary oedema. Pharmacol Ther 2004;101:183–92.PubMedCrossRef
4.
go back to reference Moore JH. The ubiquitous nature of epistasis in determining susceptibility to common human diseases. Hum Hered 2003;56:73–82.PubMedCrossRef Moore JH. The ubiquitous nature of epistasis in determining susceptibility to common human diseases. Hum Hered 2003;56:73–82.PubMedCrossRef
5.
go back to reference Moore JH, Williams SM. Traversing the conceptual divide between biological and statistical epistasis: systems biology and a more modern synthesis. Bioessays 2005;27:637–46.PubMedCrossRef Moore JH, Williams SM. Traversing the conceptual divide between biological and statistical epistasis: systems biology and a more modern synthesis. Bioessays 2005;27:637–46.PubMedCrossRef
6.
go back to reference Hultgren HN, Grover RF, Hartley LH. Abnormal circulatory responses to high altitude in subjects with a previous history of high-altitude pulmonary edema. Circulation 1971;44:759–70.PubMed Hultgren HN, Grover RF, Hartley LH. Abnormal circulatory responses to high altitude in subjects with a previous history of high-altitude pulmonary edema. Circulation 1971;44:759–70.PubMed
7.
go back to reference Eldridge MW, Podolsky A, Richardson RS, Johnson DH, Knight DR, Johnson EC, Hopkins SR, Michimata H, Grassi B, Feiner J, Kurdak SS, Bickler PE, Wagner PD, Severinghaus JW. Pulmonary hemodynamic response to exercise in subjects with prior high-altitude pulmonary edema. J Appl Physiol 1996;81:911–21.PubMed Eldridge MW, Podolsky A, Richardson RS, Johnson DH, Knight DR, Johnson EC, Hopkins SR, Michimata H, Grassi B, Feiner J, Kurdak SS, Bickler PE, Wagner PD, Severinghaus JW. Pulmonary hemodynamic response to exercise in subjects with prior high-altitude pulmonary edema. J Appl Physiol 1996;81:911–21.PubMed
9.
go back to reference Hotta J, Hanaoka M, Droma Y, Droma Y, Katsuyama Y, Ota M, Kobayashi T. Polymorphisms of renin-angiotensin system genes with high-altitude pulmonary edema in Japanese subjects. Chest 2004;126:825–30.PubMedCrossRef Hotta J, Hanaoka M, Droma Y, Droma Y, Katsuyama Y, Ota M, Kobayashi T. Polymorphisms of renin-angiotensin system genes with high-altitude pulmonary edema in Japanese subjects. Chest 2004;126:825–30.PubMedCrossRef
10.
go back to reference Montgomery HE, Marshall R, Hemingway H, Myerson S, Clarkson P, Dollery C, Hayward M, Holliman DE, Jubb M, World M, Thomas EL, Brynes AE, Saeed N, Barnard M, Bell JD, Prasad K, Rayson M, Talmud PJ, Humphries SE. Human gene for physical performance. Nature 1998;393:221–2.PubMedCrossRef Montgomery HE, Marshall R, Hemingway H, Myerson S, Clarkson P, Dollery C, Hayward M, Holliman DE, Jubb M, World M, Thomas EL, Brynes AE, Saeed N, Barnard M, Bell JD, Prasad K, Rayson M, Talmud PJ, Humphries SE. Human gene for physical performance. Nature 1998;393:221–2.PubMedCrossRef
11.
go back to reference Woods DR, Montgomery HE. Angiotensin-converting enzyme and genetics at high altitude. High Alt Med Biol 2001;2:201–10.PubMedCrossRef Woods DR, Montgomery HE. Angiotensin-converting enzyme and genetics at high altitude. High Alt Med Biol 2001;2:201–10.PubMedCrossRef
12.
go back to reference Qadar Pasha MA, Khan AP, Kumar R, Grover SK, Ram RB, Norboo T, Srivastava KK, Selvamurthy W, Brahmachari SK. Angiotensin converting enzyme insertion allele in relation to high altitude adaptation. Ann Hum Genet 2001;65:531–6.PubMedCrossRef Qadar Pasha MA, Khan AP, Kumar R, Grover SK, Ram RB, Norboo T, Srivastava KK, Selvamurthy W, Brahmachari SK. Angiotensin converting enzyme insertion allele in relation to high altitude adaptation. Ann Hum Genet 2001;65:531–6.PubMedCrossRef
13.
go back to reference Woods DR, Pollard AJ, Collier DJ, Jamshidi Y, Vassiliou V, Hawe E, Humphries SE, Montgomery HE. Insertion/deletionpolymorphism of the angiotensin I-converting enzyme gene and artery oxygen saturation at high altitude. Am J Respir Crit Care Med 2002;166:362–6.PubMedCrossRef Woods DR, Pollard AJ, Collier DJ, Jamshidi Y, Vassiliou V, Hawe E, Humphries SE, Montgomery HE. Insertion/deletionpolymorphism of the angiotensin I-converting enzyme gene and artery oxygen saturation at high altitude. Am J Respir Crit Care Med 2002;166:362–6.PubMedCrossRef
14.
go back to reference Keynes RJ, Smith GW, Slater JD, Brown MM, Brown SE, Payne NN, Jowett TP, Monge CC. Renin and aldosterone at high altitude in man. J Endocrinol 1982;92:131–40.PubMed Keynes RJ, Smith GW, Slater JD, Brown MM, Brown SE, Payne NN, Jowett TP, Monge CC. Renin and aldosterone at high altitude in man. J Endocrinol 1982;92:131–40.PubMed
15.
go back to reference Morrell NW, Morris KG, Stenmark KR. Role of angiotensin-converting enzyme and angiotensin II in development of hypoxia pulmonary hypertension. Am J Physiol 1995;269:H1186–94.PubMed Morrell NW, Morris KG, Stenmark KR. Role of angiotensin-converting enzyme and angiotensin II in development of hypoxia pulmonary hypertension. Am J Physiol 1995;269:H1186–94.PubMed
16.
go back to reference Kumar R, Pasha Q, Khan AP, Gupta V. Renin angiotensin aldosterone system and ACE I/D gene polymorphism in high-altitude pulmonary edema. Aviat Space Environ Med 2004;75:981–3.PubMed Kumar R, Pasha Q, Khan AP, Gupta V. Renin angiotensin aldosterone system and ACE I/D gene polymorphism in high-altitude pulmonary edema. Aviat Space Environ Med 2004;75:981–3.PubMed
17.
go back to reference Moore JH, Williams SM. New strategies for identifying gene-gene interactions in hypertension. Ann Med 2002;34:88–95.PubMedCrossRef Moore JH, Williams SM. New strategies for identifying gene-gene interactions in hypertension. Ann Med 2002;34:88–95.PubMedCrossRef
18.
go back to reference Ritchie MD, Hahn LW, Roodi N, Bailey LR, Dupont WD, Parl FF, Moore JH. Multifactor-dimensionality reduction reveals high-order interactions among estrogen-metabolism genes in sporadic breast cancer. Am J Hum Genet 2001;69:138–47.PubMedCrossRef Ritchie MD, Hahn LW, Roodi N, Bailey LR, Dupont WD, Parl FF, Moore JH. Multifactor-dimensionality reduction reveals high-order interactions among estrogen-metabolism genes in sporadic breast cancer. Am J Hum Genet 2001;69:138–47.PubMedCrossRef
19.
go back to reference Ritchie MD, Hahn LW, Moore JH. Power of multifactor dimensionality reduction for detecting gene-gene interactions in the presence of genotyping error, missing data, phenocopy, and genetic heterogeneity. Genet Epidemiol 2003;24:150–7.PubMedCrossRef Ritchie MD, Hahn LW, Moore JH. Power of multifactor dimensionality reduction for detecting gene-gene interactions in the presence of genotyping error, missing data, phenocopy, and genetic heterogeneity. Genet Epidemiol 2003;24:150–7.PubMedCrossRef
20.
go back to reference Hahn LW, Moore JH. Ideal discrimination of discrete clinical endpoints using multilocus genotypes. In Silico Biol 2004;4:183–94.PubMed Hahn LW, Moore JH. Ideal discrimination of discrete clinical endpoints using multilocus genotypes. In Silico Biol 2004;4:183–94.PubMed
21.
go back to reference Moore JH. Computational analysis of gene-gene interactions using multifactor dimensionality reduction. Expert Rev Mol Diagn 2004;4:795–803.PubMedCrossRef Moore JH. Computational analysis of gene-gene interactions using multifactor dimensionality reduction. Expert Rev Mol Diagn 2004;4:795–803.PubMedCrossRef
22.
go back to reference Moore JH, Gilbert JC, Tsai CT, Chiang FT, Holden T, Barney N, White BC. A flexible computational framework for detecting, characterizing, and interpreting statistical patterns of epistasis in genetic studies of human disease susceptibility. J Theor Biol 2006;241:252–61.PubMedCrossRef Moore JH, Gilbert JC, Tsai CT, Chiang FT, Holden T, Barney N, White BC. A flexible computational framework for detecting, characterizing, and interpreting statistical patterns of epistasis in genetic studies of human disease susceptibility. J Theor Biol 2006;241:252–61.PubMedCrossRef
23.
go back to reference Martin ER, Ritchie MD, Hahn L, Kang S, Moore JH. A novel method to identify gene-gene effects in nuclear families: the MDR-PDT. Genet Epidemiol 2006;30:111–23.PubMedCrossRef Martin ER, Ritchie MD, Hahn L, Kang S, Moore JH. A novel method to identify gene-gene effects in nuclear families: the MDR-PDT. Genet Epidemiol 2006;30:111–23.PubMedCrossRef
24.
go back to reference Millstein J, Conti DV, Gilliland FD, Gauderman WJ. A testing framework for identifying susceptibility genes in the presence of epistasis. Am J Hum Genet 2006;78:15–27.PubMedCrossRef Millstein J, Conti DV, Gilliland FD, Gauderman WJ. A testing framework for identifying susceptibility genes in the presence of epistasis. Am J Hum Genet 2006;78:15–27.PubMedCrossRef
25.
go back to reference Andrew AS, Nelson HH, Kelsey KT, Moore JH, Meng AC, Casella DP, Tosteson TD, Schned AR, Karagas MR. Concordance of multiple analytical approaches demonstrates a complex relationship between DNA repair gene SNPs, smoking and bladder cancer susceptibility. Carcinogenesis 2006;27:1030–7.PubMedCrossRef Andrew AS, Nelson HH, Kelsey KT, Moore JH, Meng AC, Casella DP, Tosteson TD, Schned AR, Karagas MR. Concordance of multiple analytical approaches demonstrates a complex relationship between DNA repair gene SNPs, smoking and bladder cancer susceptibility. Carcinogenesis 2006;27:1030–7.PubMedCrossRef
26.
go back to reference Sanada H, Yatabe J, Midorikawa S, Hashimoto S, Watanabe T, Moore JH, Ritchie MD, Williams SM, Pezzullo JC, Sasaki M, Eisner GM, Jose PA, Felder RA. Single-nucleotide polymorphisms for diagnosis of salt-sensitive hypertension. Clin Chem 2006;52:352–60.PubMedCrossRef Sanada H, Yatabe J, Midorikawa S, Hashimoto S, Watanabe T, Moore JH, Ritchie MD, Williams SM, Pezzullo JC, Sasaki M, Eisner GM, Jose PA, Felder RA. Single-nucleotide polymorphisms for diagnosis of salt-sensitive hypertension. Clin Chem 2006;52:352–60.PubMedCrossRef
27.
go back to reference Brassat D, Motsinger AA, Caillier SJ, Erlich HA, Walker K, Steiner LL, Cree BA, Barcellos LF, Pericak-Vance MA, Schmidt S, Gregory S, Hauser SL, Haines JL, Oksenberg JR, Ritchie MD. Multifactor dimensionality reduction reveals gene-gene interactions associated with multiple sclerosis susceptibility in African Americans. Genes Immun 2006;7:310–5.PubMedCrossRef Brassat D, Motsinger AA, Caillier SJ, Erlich HA, Walker K, Steiner LL, Cree BA, Barcellos LF, Pericak-Vance MA, Schmidt S, Gregory S, Hauser SL, Haines JL, Oksenberg JR, Ritchie MD. Multifactor dimensionality reduction reveals gene-gene interactions associated with multiple sclerosis susceptibility in African Americans. Genes Immun 2006;7:310–5.PubMedCrossRef
28.
go back to reference Cho YM, Ritchie MD, Moore JH, Park JY, Lee KU, Shin HD, Lee HK, Park KS. Multifactor-dimensionality reduction shows a two-locus interaction associated with Type 2 diabetes mellitus. Diabetologia 2004;47:549–54.PubMedCrossRef Cho YM, Ritchie MD, Moore JH, Park JY, Lee KU, Shin HD, Lee HK, Park KS. Multifactor-dimensionality reduction shows a two-locus interaction associated with Type 2 diabetes mellitus. Diabetologia 2004;47:549–54.PubMedCrossRef
29.
go back to reference Zapata C, Carollo C, Rodriguez S. Sampling variance and distribution of the D’ measure of overall gametic disequilibrium between multiallelic loci. Ann Hum Genet 2001;65:395–406.PubMedCrossRef Zapata C, Carollo C, Rodriguez S. Sampling variance and distribution of the D’ measure of overall gametic disequilibrium between multiallelic loci. Ann Hum Genet 2001;65:395–406.PubMedCrossRef
30.
go back to reference Moore JH, White BC. Tuning ReliefF for genome-wide genetic analysis. Lect Notes Comput Sci 2007;4447:166–75.CrossRef Moore JH, White BC. Tuning ReliefF for genome-wide genetic analysis. Lect Notes Comput Sci 2007;4447:166–75.CrossRef
31.
go back to reference Hahn LW, Ritchie MD, Moore JH. Multifactor dimensionality reduction software for detecting gene-gene and gene-environment interactions. Bioinformatics 2003;19:376–82.PubMedCrossRef Hahn LW, Ritchie MD, Moore JH. Multifactor dimensionality reduction software for detecting gene-gene and gene-environment interactions. Bioinformatics 2003;19:376–82.PubMedCrossRef
32.
go back to reference The International HapMap Consortium. The International HapMap Project. Nature 2003;426:789–96.CrossRef The International HapMap Consortium. The International HapMap Project. Nature 2003;426:789–96.CrossRef
33.
go back to reference Moore JH, Ritchie MD. The challenges of whole-genome approaches to common diseases. JAMA 2004;291:1642–3.PubMedCrossRef Moore JH, Ritchie MD. The challenges of whole-genome approaches to common diseases. JAMA 2004;291:1642–3.PubMedCrossRef
34.
go back to reference Tsai CT, Lai LP, Lin JL, Chiang FT, Hwang JJ, Ritchie MD, Moore JH, Hsu KL, Tseng CD, Liau CS, Tseng YZ. Renin-angiotensin system gene polymorphisms and atrial fibrillation. Circulation 2004;109:1640–6.PubMedCrossRef Tsai CT, Lai LP, Lin JL, Chiang FT, Hwang JJ, Ritchie MD, Moore JH, Hsu KL, Tseng CD, Liau CS, Tseng YZ. Renin-angiotensin system gene polymorphisms and atrial fibrillation. Circulation 2004;109:1640–6.PubMedCrossRef
37.
go back to reference Cargill RI, Lipworth BJ. Lisinopril attenuates acute hypoxic pulmonary vasoconstriction in humans. Chest 1996;109:424–9.PubMedCrossRef Cargill RI, Lipworth BJ. Lisinopril attenuates acute hypoxic pulmonary vasoconstriction in humans. Chest 1996;109:424–9.PubMedCrossRef
38.
go back to reference Clyne CD, Zhang Y, Slutsker L, Mathis JM, White PC, Rainey WE. Angiotensin II and potassium regulate human CYP11B2 transcription through common cis-elements. Mol Endocrinol 1997;11:638–49.PubMedCrossRef Clyne CD, Zhang Y, Slutsker L, Mathis JM, White PC, Rainey WE. Angiotensin II and potassium regulate human CYP11B2 transcription through common cis-elements. Mol Endocrinol 1997;11:638–49.PubMedCrossRef
39.
go back to reference Hackett PH, Rennie D, Hofmeister SE, Grover RF, Grover EB, Reeves JT. Fluid retention and relative hypoventilation in acute mountain sickness. Respiration 1982;43:321–9.PubMedCrossRef Hackett PH, Rennie D, Hofmeister SE, Grover RF, Grover EB, Reeves JT. Fluid retention and relative hypoventilation in acute mountain sickness. Respiration 1982;43:321–9.PubMedCrossRef
40.
go back to reference Cox NJ, Bell GI. Disease associations. Chance, artifact, or susceptibility genes. Diabetes 1989;38:947–50.PubMedCrossRef Cox NJ, Bell GI. Disease associations. Chance, artifact, or susceptibility genes. Diabetes 1989;38:947–50.PubMedCrossRef
Metadata
Title
Synergistic effect of the genetic polymorphisms of the renin–angiotensin–aldosterone system on high-altitude pulmonary edema: a study from Qinghai-Tibet altitude
Authors
Yue Qi
Wenquan Niu
Tongchun Zhu
Wenyu Zhou
Changchun Qiu
Publication date
01-02-2008
Publisher
Springer Netherlands
Published in
European Journal of Epidemiology / Issue 2/2008
Print ISSN: 0393-2990
Electronic ISSN: 1573-7284
DOI
https://doi.org/10.1007/s10654-007-9208-0

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