Prothrombotic polymorphisms, mutations, and their association with pediatric non-cardioembolic stroke in Asian-Indian patients.
Genes involved in the hemostatic mechanism are logical candidate genes for association studies in prothrombotic conditions such as stroke. Since the underlying etiology in pediatric strokes is different than adults, looking for genetic causes would be the logical thing to do in the pediatric stroke population. Fifty-eight Asian-Indian stroke patients below 15 years of age and equal number of age- and sex-matched healthy controls were the subjects for the study. The subjects were screened for 13 polymorphisms and three mutations spread across seven different candidate genes involved in the hemostatic system. Of the 13 polymorphisms and three mutations studied, four polymorphisms, HPA-I, TAFI 147Ala>Thr, methylene tetrahydrofolate reductase (MTHFR) 677 C>T, and MTHFR 1298 A>C, showed significant association with the disease phenotype. MTHFR 677 C>T showed the strongest association and therefore may have a strong predisposing role for pediatric strokes. Gene-gene interaction studies showed a strong interaction between HPA-I and MTHFR 677 C>T polymorphism. The wild type of both these polymorphisms synergistically showed a strong protective effect [p < 0.0001, O.R: 10.06(4.26-23.71)]. Polymorphisms in HPA-I and MTHFR may have important predisposing roles in the development of pediatric stroke.
Department of Hematoloy, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
Arijit
A
Biswas
Arun Kumar
AK
Tiwari
Ravi
R
Ranjan
Arvind
A
Meena
Mohammad Suhail
MS
Akhter
Birendra Kumar
BK
Yadav
Madhuri
M
Behari
Renu
R
Saxena
D000293:Adolescent; D044466:Asian People / Q000235:genetics; D025901:Carboxypeptidase B2 / Q000235:genetics; D016022:Case-Control Studies; D004252:DNA Mutational Analysis; D020022:Genetic Predisposition to Disease; D006801:Humans; D007194:India / Q000453:epidemiology; D039661:Integrin beta3 / Q000235:genetics; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics; D009154:Mutation; D011110:Polymorphism, Genetic; D020521:Stroke / Q000235:genetics*
D039661:Integrin beta3; D042965:Methylenetetrahydrofolate Reductase (NADPH2); D025901:Carboxypeptidase B2