Associations of the VDR gene with clinical manifestations and complications of cystic fibrosis
https://doi.org/10.18093/0869-0189-2023-33-4-443-453
Abstract
Cystic fibrosis (CF) is the most common severe autosomal recessive disease in the Caucasoid population caused by mutations in the CF transmembrane regulator (CFTR) gene. However, the course of the disease may be modulated by genetic factors other than the CFTR gene and may be pleiotropically influenced by VDR (Vitamin D Receptor) gene. The aim of the study was to search for associations between genetic variants (c.1206T>C(A>G), c.152T>C, c.1174+283G>A) of VDR gene and clinically significant manifestations of CF, complications, and responses to therapy. Methods. Patients with CF (n = 283) and healthy children (n = 333), who formed the control group, were examined. Calcidiol levels were tested in all subjects. Polymorphic variants of VDR gene (c.1206T>C(A>G), c.152T>C, c.1174+283G>A) were tested by polymerase chain reaction and restriction fragment length polymorphism analysis. Results. It was found that carriers of the TT genotype of the c.152T>C FokI variant of VDR gene are 6.3 times more likely to develop meconium ileus (odds ratio – OR – 6.375; p = 0.011), 3.2 times more likely – respiratory failure (OR – 3.253; p = 0.079), 3.4 times more likely – chronic lung infection (CIL) caused by Pseudomonas aeruginosa (OR – 3.432; p = 0.026), and 4 times more likely – CIL caused by non-fermenting gram-negative bacteria (OR – 4.056; p = 0.009). Carriers of the CC genotype of the c.1206T>C(A>G) TaqI genetic variant use systemic corticosteroids more frequently (66% vs 7%) (OR – 0.034; p = 0.001). It was shown that the AA genotype of the BsmlI polymorphism (c.1174 + 283G>A) is 4 times more likely to be detected in children with CF-associated liver diseases (OR – 4.300; p = 0.051). Conclusion. The contribution of all studied genetic variants c.1206T>C(A>G) TaqI, c.152T>C FokI, BsmlI (c.1174+283G>A) of the VDR gene to the clinical manifestations, complications and response to therapy in CF is described.
About the Authors
E. V. LoshkovaRussian Federation
Elena V. Loshkova - Candidate of Medicine, Senior Researcher, Department of Hereditary and Metabolic Diseases, Moscow Region State Budgetary Healthcare Institution “Research Clinical Institute of Childhood, Ministry of Health of the Moscow Region”; Associate Professor, Department of Hospital Pediatrics, Department of Faculty Pediatrics with a Course in Children’s Diseases of the Faculty of Medicine, Federal State Budgetary Educational Institution of Higher Education “Siberian State Medical University”, Ministry of Healthcare of the Russian Federation.
Bolshaya Serpukhovskaya ul. 62, Moscow, 115093; Moskovskiy trakt 2, Tomsk, 634050
tel.: (3822) 90-11-01 (add. 1954)
Competing Interests:
None
E. I. Kondratyeva
Russian Federation
Elena I. Kondratyeva - Doctor of Medicine, Professor, Head of the Scientific and Clinical Department of cystic fibrosis, Federal State Budgetary Scientific Institution “Research Centre for Medical Genetics”, Ministry of Science and Higher Education of the Russian Federation; Deputy Director for Science, Moscow Region State Budgetary Healthcare Institution “Research Clinical Institute of Childhood, Ministry of Health of the Moscow Region”.
Bolshaya Serpukhovskaya ul. 62, Moscow, 115093; Moskvorechye ul.1, Moscow, 115522
tel.: (495) 111-03-03
Competing Interests:
None
E. K. Zhekaite
Russian Federation
Elena K. Zhekaite - Candidate of Medicine, Researcher, Department of Cystic Fibrosis, Federal State Budgetary Scientific Institution “Research Centre for Medical Genetics”, Ministry of Science and Higher Education of the Russian Federation; Senior Researcher, Pediatrician, Department of Cystic Fibrosis, Moscow Region State Budgetary Healthcare Institution “Research Clinical Institute of Childhood, Ministry of Health of the Moscow Region”.
Bolshaya Serpukhovskaya ul. 62, Moscow, 115093; Moskvorechye ul.1, Moscow, 115522
tel.: (495) 111-03-03
Competing Interests:
None
L. Ya. Klimov
Russian Federation
Leonid Ya. Klimov - Doctor of Medicine, Professor, Head of the Department of Faculty Pediatrics, Federal State Budgetary Educational Institution of Higher Education “Stavropol’ State Medical University”, Ministry of Healthcare of the Russian Federation.
Mira ul. 310, Stavropol’, 355017
tel.: (8652) 35-23-39
Competing Interests:
None
N. A. Ilyenkova
Russian Federation
Natalia A. Ilenkova - Doctor of Medicine, Professor, Leading Researcher, Department of Hereditary and Metabolic Diseases, Moscow Region State Budgetary Healthcare Institution “Research Clinical Institute of Childhood, Ministry of Health of the Moscow Region”; Head of the Department of Children’s Diseases with a Postgraduate Education Course, Federal State Budgetary Educational Institution of Higher Education “Krasnoyarsk State Medical University named after Professor V.F. Voyno-Yasenetsky” of the Ministry of Health of the Russian Federation.
Bolshaya Serpukhovskaya ul. 62, Moscow, 115093; Partizana Zheleznyaka ul. 1, Krasnoyarsk, 660022
tel.: (391) 205-22-33
Competing Interests:
None
Yu. L. Melyanovskaya
Russian Federation
Yuliya L. Melyanovskaya - Researcher, Scientific and Clinical Department of Cystic Fibrosis, Federal State Budgetary Scientific Institution “Research Centre for Medical Genetics”, Ministry of Science and Higher Education of the Russian Federation; Researcher, Moscow Region State Budgetary Healthcare Institution “Research Clinical Institute of Childhood.
Bolshaya Serpukhovskaya ul. 62, Moscow, 115093; Moskvorechye ul.1, Moscow, 115522
tel.: (495) 324-20-24
Competing Interests:
None
A. Yu. Voronkova
Russian Federation
Anna Yu. Voronkova - Candidate of Medicine, Leading Researcher, Scientific and Clinical Department of Cystic Fibrosis, Federal State Budgetary Scientific Institution “Research Centre for Medical Genetics”, Ministry of Science and Higher Education of the Russian Federation; Leading Researcher, Department of Hereditary and Metabolic Diseases, Moscow Region State Budgetary Healthcare Institution “Research Clinical Institute of Childhood, Ministry of Health of the Moscow Region”.
Bolshaya Serpukhovskaya ul. 62, Moscow, 115093; Moskvorechye ul.1, Moscow, 115522
tel.: (495) 111-03-03
Competing Interests:
None
References
1. Clinical guidelines. [Cystic fibrosis (cystic fibrosis)]. 2021. Available at: https://mukoviscidoz.org/doc/%D0%9A%D0%A0372.pdf (in Russian).
2. Bell S.C., Mall M.A., Gutierrez H. et al. The future of cystic fibrosis care: a global perspective. Lancet Respir. Med. 2020; 8 (1): 65–124. DOI: 10.1016/S2213-2600(19)30337-6.
3. Rueda-Nieto S., Mondejar-Lopez P., Mira-Escolano M.P. et al. Analysis of the genotypic profile and its relationship with the clinical manifestations in people with cystic fibrosis: study from a rare disease registry. Orphanet J. Rare Dis. 2022; 17 (1): 222. DOI: 10.1186/s13023-022-02373-y.
4. Kashirskaya N.Yu., Kondratyeva E.I., Krasovskiy S.A. et al. (eds.). [Register of patients with cystic fibrosis in the Russian Federation. 2019]. Moscow: Medpraktika-M; 2021. Available at: https://mukoviscidoz.org/doc/registr/site_Registre_2019.pdf (in Russian).
5. Saluzzo F., Riberi L., Messore B. et al. CFTR modulator therapies: potential impact on airway infections in cystic fibrosis. Cells. 2022; 11 (7): 1243. DOI: 10.3390/cells11071243.
6. Ferrari V., Terlizzi V., Stagi S. Auxological and endocrinological features in children and adolescents with cystic fibrosis. J. Clin. Med. 2022; 11 (14): 4041. DOI: 10.3390/jcm11144041.
7. Bailey J., Krick S., Fontaine K.R. The changing landscape of nutrition in cystic fibrosis: the emergence of overweight and obesity. Nutrients. 2022; 14 (6): 1216. DOI: 10.3390/nu14061216.
8. Bass R.M., Zemel B.S., Stallings V.A. et al. Bone accrual and structural changes over one year in youth with cystic fibrosis. J. Clin. Transl. Endocrinol. 2022; 28: 100297. DOI: 10.1016/j.jcte.2022.100297.
9. Putman M.S., Greenblatt L.B., Bruce M. et al. The effects of ivacaftor on bone density and microarchitecture in children and adults with cystic fibrosis. J. Clin. Endocrinol. Metab. 2021; 106 (3): e1248–1261. DOI: 10.1210/clinem/dgaa890.
10. Ullal J., Kutney K., Williams K.M., Weber D.R. Treatment of cystic fibrosis related bone disease. J. Clin. Transl. Endocrinol. 2021; 27: 100291. DOI: 10.1016/j.jcte.2021.100291.
11. Boyle R.L., Psoter K.J., Merlo C.A. et al. Prevalence and risk factors for low bone mineral density in adults with cystic fibrosis. JBMR Plus. 2022; 6 (11): e10666. DOI: 10.1002/jbm4.10666.
12. Gong J., Gong H., Liu Y. et al. Calcipotriol attenuates liver fibrosis through the inhibition of vitamin D receptor-mediated NF-κB signaling pathway. Bioengineered. 2022; 13 (2): 2658–2672. DOI: 10.1080/21655979.2021.2024385.
13. Zhao X.Q., Chen K., Wan H.Y. et al. Receptor genetic variations may associate with the risk of developing late fracture-related infection in the Chinese Han population. J. Immunol. Res. 2022; 2022: 9025354. DOI: 10.1155/2022/9025354.
14. Awasthi N., Awasthi S., Pandey S. Role of VDR gene polymorphisms with community acquired pneumonia in North Indian children: a case-control study. Int. J. Mol. Epidemiol. Genet. 2021; 12 (1): 1–8. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8044708/
15. Albu-Mohammed W.H.M., Anvari E., Fateh A. Evaluating the role of BglI rs739837 and TaqI rs731236 polymorphisms in vitamin D receptor with SARS-CoV-2 variants mortality rate. Genes (Basel). 2022; 13 (12): 2346. DOI: 10.3390/genes13122346.
16. Jafarpoor A., Jazayeri S.M., Bokharaei-Salim F. et al. VDR gene polymorphisms are associated with the increased susceptibility to COVID-19 among Iranian population: a case-control study. Int. J. Immunogenet. 2022; 49 (4): 243–253. DOI: 10.1111/iji.12585.
17. Hashemi S.M.A., Thijssen M., Hosseini S.Y. et al. Human gene polymorphisms and their possible impact on the clinical outcome of SARS-CoV-2 infection. Arch. Virol. 2021; 166 (8): 2089–2108. DOI: 10.1007/s00705-021-05070-6.
18. Laplana M., Royo J.L., Fibla J. Vitamin D receptor polymorphisms and risk of enveloped virus infection: a meta-analysis. Gene. 2018; 678: 384–394. DOI: 10.1016/j.gene.2018.08.017.
19. Castellani C., Malerba G., Sangalli A. et al. The genetic background of osteoporosis in cystic fibrosis: association analysis with polymorphic markers in four candidate genes. J. Cyst. Fibros. 2006; 5 (4): 229–235. DOI: 10.1016/j.jcf.2006.03.008.
20. Gong J., Gong H., Liu Y. et al. Calcipotriol attenuates liver fibrosis through the inhibition of vitamin D receptor-mediated NF-κB signaling pathway. Bioengineered. 2022; 13 (2): 2658–2672. DOI: 10.1080/21655979.2021.2024385.
Supplementary files
Review
For citations:
Loshkova E.V., Kondratyeva E.I., Zhekaite E.K., Klimov L.Ya., Ilyenkova N.A., Melyanovskaya Yu.L., Voronkova A.Yu. Associations of the VDR gene with clinical manifestations and complications of cystic fibrosis. PULMONOLOGIYA. 2023;33(4):443-453. (In Russ.) https://doi.org/10.18093/0869-0189-2023-33-4-443-453