Possible synergic effect of angiotensin-I converting enzyme gene insertion/deletion polymorphism and angiotensin-II type-1 receptor 1166A/C gene polymorphism on ischemic heart disease in patients with Kawasaki disease.
ACE I/D and AT1R 1166A/C polymorphisms are considered to comprise individual risk factors for the development of coronary disease. We sought to demonstrate that the ACE I/D and AT1R 1166A/C polymorphisms affect coronary artery stenosis in patients with Kawasaki disease (KD). We examined 147 healthy controls and 281 Japanese children with KD. The patients were further divided into group N (n = 246, no ischemia) and group I (n = 35, severe coronary artery stenosis with myocardial ischemia), and we studied the genotype of ACE I/D and AT1R 1166A/C polymorphisms. We also examined ACE activity in patients with acute KD. We did not detect any prevalent genotypes of the ACE and AT1R polymorphisms between controls and KD patients. However, the prevalence of the D allele in the ACE polymorphism and of the C allele in the AT1R polymorphism tended to be higher in group I than in group N (odds ratios, 2.00 and 2.32, respectively). In addition, the presence of the D and/or C alleles significantly increased the relative risk of developing myocardial ischemia (odds ratio, 2.71; p = 0.038). During the convalescent phase of KD, ACE activity was increased despite significant attenuation during the acute phase. These results suggested that the renin-angiotensin system is associated with the formation of severe coronary artery stenosis and myocardial ischemia.
Department of Pediatrics, Nippon Medical School, 113-8603 Tokyo, Japan oraora@nms.ac.jp
Ryuji
R
Fukazawa
Tomoyoshi
T
Sonobe
Kunihiro
K
Hamamoto
Kenji
K
Hamaoka
Koichi
K
Sakata
Takeshi
T
Asano
Takehide
T
Imai
Mitsuhiro
M
Kamisago
Takashi
T
Ohkubo
Yohko
Y
Uchikoba
Ei
E
Ikegami
Miki
M
Watanabe
Shunichi
S
Ogawa
D000208:Acute Disease; D002675:Child, Preschool; D015331:Cohort Studies; D003289:Convalescence; D023921:Coronary Stenosis / Q000235:genetics; D005260:Female; D017353:Gene Deletion; D005838:Genotype; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000235:genetics*; D017202:Myocardial Ischemia / Q000235:genetics*; D007703:Peptidyl-Dipeptidase A / Q000097:blood / Q000235:genetics*; D011110:Polymorphism, Genetic; D044140:Receptor, Angiotensin, Type 1 / Q000235:genetics*
D044140:Receptor, Angiotensin, Type 1; D007703:Peptidyl-Dipeptidase A