EDTA chelation therapy for cardiovascular disease: a systematic review

Background

Experimental studies support an important role for endothelial nitric oxide synthase (eNOS) in the regulation of angiogenesis. In humans, a common polymorphism exists in the eNOS gene that results in the conversion of glutamate to aspartate for codon 298. In vitro and in vivo studies have suggested a decreased NOS activity in patients with the Asp²⁹⁸ variant. We hypothesized that a genetic-mediated decreased eNOS activity may limit collateral development in patients with chronic coronary occlusions.

Methods

We selected 291 consecutive patients who underwent coronary angiography and who had at least one chronic (>15 days) total coronary occlusion. Collateral development was graded angiographically using two different methods: the collateral flow grade and the recipient filling grade. Genomic DNA was extracted from white blood cells and genotyping was performed using previously published techniques.

Results

Collateral development was lower in patients carrying the Asp²⁹⁸ variant than in Glu-Glu homozygotes (collateral flow grade: 2.64 ± 0.08 and 2.89 ± 0.08, respectively, p = 0.04; recipient filling grade: 3.00 ± 0.08 and 3.24 ± 0.07, respectively, p = 0.04). By multivariable analysis, three variables were independently associated with the collateral flow grade: female gender, smoking, and the Asp²⁹⁸ variant (p = 0.03) while the Asp²⁹⁸ variant was the sole variable independently associated with the recipient filling grade (p = 0.03).

Conclusion

Collateral development is lower in patients with the Asp²⁹⁸ variant. This may be explained by the decreased NOS activity in patients with the Asp²⁹⁸ variant. Further studies will have to determine whether increasing eNOS activity in humans is associated with coronary collateral development.     

Genetic sperm defects

Genetic sperm defects are specific sperm defects, which have been shown to have a genetic mode of transmission. Such genetic linkage, either direct or indirect, has been associated with a number of sperm defects in different species, with this number increasing with improved diagnostic capabilities. A number of sperm defects, which have proven or suspected genetic modes of transmission are discussed herein, with particular emphasis on cattle. These include: 1. Acrosome defects (knobbed, ruffled and incomplete); 2. Head defects (abnormal condensation, decapitated, round head, rolled head, nuclear crest); 3. Midpiece abnormalities ("Dag" defect, "corkscrew" defect, "pseudo-droplet" defect); 4. Tail defects ("tail stump" defect, primary ciliary dyskinesia).     

Functional Gene Hybridization Patterns of Terrestrial Ammonia-Oxidizing Bacteria

Abstract The biochemical pathway and genetics of autotrophic ammonia oxidation have been studied almost exclusively in Nitrosomonas europaea. Terrestrial autotrophic ammonia-oxidizing bacteria (AAOs), however, comprise two distinct phylogenetic groups in the beta-Proteobacteria, the Nitrosomonas and Nitrosospira groups. Hybridization patterns were used to assess the potential of functional probes in non-PCR-based molecular analysis of natural AAO populations and their activity. The objective of this study was to obtain an overview of functional gene homologies by hybridizing probes derived from N. europaea gene sequences ranging in size from 0.45 to 4.5 kb, and labeled with 32P to Southern blots containing genomic DNA from four Nitrosospira representatives. Probes were specific for genes encoding ammonia monooxygenase (amoA and amoB), hydroxylamine oxidoreductase (hao), and cytochrome c-554 (hcy). These probes produced hybridization signals, at low stringency (30 degreesC), with DNA from each of the four representatives; signals at higher stringency (42 degreesC) were greatly reduced or absent. The hybridization signals at low stringency ranged from 20 to 76% of the total signal obtained with N. europaea DNA. These results indicate that all four functional genes in the ammonia oxidation pathway have diverged between the Nitrosomonas and Nitrosospira groups. The hao probe produced the most consistent hybridization intensities among the Nitrosospira representatives, suggesting that hao sequences would provide the best probes for non-PCR-based molecular analysis of terrestrial AAOs. Since N. europaea can also denitrify, an additional objective was to hybridize genomic DNA from AAOs with probes for Pseudomonas genes involved in denitrification. These probes were specific for genes encoding heme-type dissimilatory nitrite reductase (dNir), Cu-type dNir, and nitrous oxide reductase (nosz). No hybridization signals were observed from probes for the heme-type dNir or nosz, but Nitrosospira sp. NpAV and Nitrosolobus sp. 24-C hybridized, under low-stringency conditions, with the Cu-type dNir probe. These results indicate that AAOs may also differ in their mechanisms and capacities for denitrification.     

Independent regulation of human neutrophil chemotactic receptors after activation

The fluoresceinated chemotactic factors, C5a, formyl-methionyl-leucyl-phenylalanyl-lysine (FMLPL), and casein were used in conjunction with flow cytometry to examine chemotactic factor receptor expression on polymorphonuclear leukocytes (PMN) activated with phorbol myristate acetate (PMA), C5a, or formyl-methionyl-leucyl-phenylalanine. Activation with PMA resulted in a dose-dependent increase in binding of fluorescein-labeled (FL)-casein and (FL-FMLPL) over the range of PMA concentrations from 0.5 to 50 ng/ml. In contrast, activation of PMN with PMA resulted in a dose-dependent decrease in FL-C5a binding, and activation with concentrations above 5 ng/ml resulted in a complete loss of binding. This loss of binding was not caused by inactivation of the ligand or prevented by the addition of superoxide dismutase and catalase or protease inhibitors. Furthermore, incubation of PMN with supernatants from PMN stimulated to degranulate did not reduce the availability of C5a receptors. This pattern of increased FMLPL and casein binding with decreased C5a binding was also observed with cytochalasin B-pretreated PMN that were stimulated with chemotactic factors. Parallel studies of superoxide anion generation demonstrated that PMA-treated PMN were still responsive to formyl-methionyl-leucyl-phenylalanine, but not to C5a. These data demonstrate that the activation of PMN up-regulates formyl peptide and casein receptors whereas C5a receptors are down-regulated under similar conditions.     

Regulation of C5a and formyl peptide receptor expression on human polymorphonuclear leukocytes

Fluorescein conjugates of C5a (FL-C5a) and formyl methionine-leucine-phenylalanine-lysine (FL-FMLPL) have been used to determine how the expression of receptors for these peptides is regulated on human polymorphonuclear leukocytes (PMN). Video intensification microscopy showed that receptors for FL-C5a were homogeneously distributed on the surface of the PMN, but within minutes were mobilized into patches and internalized by the PMN. Internalization of C5a receptors was confirmed in studies in which external FL-C5a fluorescence was quenched by reducing the pH. A similar rapid internalization was observed with FL-FMLPL. This process was inhibited for both fluorescent ligands by monensin. Reexpression of C5a and formyl peptide receptors after internalization occurred with both receptors. By comparison, the rate of reexpression of formyl peptide receptors was much faster than that observed with C5a receptors with the half maximal reexpression time for each being 5 to 10 min and 18 to 60 min, respectively. C5a receptor reexpression was completely blocked by monensin suggesting receptor recycling, whereas monensin had little effect on FMLPL receptor reexpression. The reexpression of both receptors occurred in the presence of cycloheximide indicating that this process occurred independent of protein synthesis. Additional studies on formyl peptide receptor showed that when PMN were treated with ionomycin to fully mobilize the intracellular pool of FMLPL receptors, receptor reexpression failed to occur. These studies show that both C5a and formyl peptide receptors are internalized after binding ligand, but that their reexpression occurs through different mechanisms. C5a receptors appear to be recycled to the cell surface whereas formyl peptide receptors are reexpressed predominantly by translocation from an intracellular pool.     

Modulation of monocyte chemotactic function in inflammatory lesions. Role of inflammatory mediators

Monocyte recruitment and accumulation in the synovial tissue is pivotal in the evolution of rheumatoid arthritis (RA). In the present study we examined the chemotactic potential of monocytes obtained from synovial fluid (SF) of patients with RA. Functionally, SF monocytes exhibited greatly diminished chemotactic activity to C5a compared with monocytes from the peripheral blood. In contrast, their chemotactic responsiveness to the synthetic peptide, FMLP, was nearly normal. To define a mechanism for this differential chemotactic dysfunction, cell-surface receptors for C5a (C5aR) and FMLP (FMLP-R) were evaluated. Whereas FMLP-R expression was similar on both blood and inflammatory monocytes, C5aR expression was markedly reduced on SF cells. Because decreased C5a binding in certain RA SF samples could not be attributed to free C5a, known or suspected components of inflammatory SF were evaluated for their ability to modulate chemotactic ligand receptors. Bacterial products including LPS and streptococcal cell walls, which are potent monocyte activators, down-regulated C5aR without affecting FMLP-R. Moreover, the cytokines IFN-gamma and granulocyte-macrophage-CSF selectively decreased C5aR in parallel with decreased in vitro chemotactic activity to C5a. Thus, these data indicate that 1) synovial effusions may contain C5a and/or inflammatory mediators that modulate phenotypic and functional changes in monocytes, 2) chemotactic ligand receptors are independently regulated in inflammatory lesions, and 3) decreased C5aR expression and chemotactic potential likely provide a mechanism whereby monocyte-macrophages persist within the inflamed synovium.     

Pleiotropic Mutations Are Subject to Strong Stabilizing Selection

The assumption that pleiotropic mutations are more deleterious than mutations with more restricted phenotypic effects is an important premise in models of evolution. However, empirical evidence supporting this assumption is limited. Here, we estimated the strength of stabilizing selection on mutations affecting gene expression in male Drosophila serrata. We estimated the mutational variance (V_M) and the standing genetic variance (V_G) from two well-matched panels of inbred lines: a panel of mutation accumulation (MA) lines derived from a single inbred ancestral line and a panel of inbred lines derived from an outbred population. For 855 gene-expression traits, we estimated the strength of stabilizing selection as s = V_M/V_G. Selection was observed to be relatively strong, with 17% of traits having s > 0.02, a magnitude typically associated with life-history traits. Randomly assigning expression traits to five-trait sets, we used factor analytic mixed modeling in the MA data set to identify covarying traits that shared pleiotropic mutations. By assigning traits to the same trait sets in the outbred line data set, we then estimated s for the combination of traits affected by pleiotropic mutation. For these pleiotropic combinations, the median s was three times greater than s acting on the individual component traits, and 46% of the pleiotropic trait combinations had s > 0.02. Although our analytical approach was biased toward detecting mutations with relatively large effects, likely overestimating the average strength of selection, our results provide widespread support for the prediction that stronger selection can act against mutations with pleiotropic effects.THE extent to which new mutations have pleiotropic effects on multiple traits, and ultimately on fitness is central to our understanding of the maintenance of genetic variation and the process of adaptation (Kondrashov and Turelli 1992; Otto 2004; Johnson and Barton 2005; Zhang and Hill 2005). Analyses of Fisher’s (1930) geometric model of adaptation have shown that a mutation with effects on many traits will have a reduced probability of contributing to adaptive evolution (Orr 2000; Welch and Waxman 2003; see also Haygood 2006). For a population close to its optimum under mutation–selection balance, a direct corollary of this is that selection must act more strongly against mutations with wider pleiotropic effects (Zhang 2012).Evidence for the strength of selection increasing with the number of traits that are pleiotropically affected by a mutation is limited. At a phenotypic level, nonlinear (stabilizing) selection is much stronger on combinations of metric traits than on each individual trait contributing to the combination (Blows and Brooks 2003; Walsh and Blows 2009). Given that genetic correlations among such traits are expected to be a consequence of pleiotropic alleles (Lande 1980), stronger selection on trait combinations is consistent with stronger selection on pleiotropic mutations that are likely to underlie the genetic covariance among such traits. There is some evidence that per-trait allelic effects might be greater for alleles with more widespread pleiotropic effects (Wagner et al. 2008; Wang et al. 2010); as mutations with larger phenotypic effects might be more effectively targeted by selection, this also suggests stronger selection against more pleiotropic mutation.Mutation accumulation (MA) breeding designs, in which the opportunity for selection is reduced, allowing new mutations to drift to fixation, provide an opportunity to characterize the strength of selection acting directly against new mutations. Rice and Townsend (2012) proposed an approach for determining the strength of selection acting against mutations at individual loci, combining information from QTL mapping and MA studies. This approach could conceivably be extended to associate the strength of selection with the number of traits a QTL affects. More typically, estimates of selection from MA designs are focused on traits, rather than alleles. Under the assumption that most mutations are deleterious, an assumption supported by MA studies (Halligan and Keightley 2009), the strength of selection acting on mutations affecting quantitative traits can be measured as the ratio of the mutational to the standing genetic variance, s = V_M/V_G, where s is the selection coefficient of the mutation in heterozygous form (Barton 1990; Houle et al. 1996). While estimating s in this way provides a framework for estimating selection on pleiotropic combinations of traits, we are not aware of any studies adopting this approach to directly estimate the strength of selection acting on mutations affecting multiple traits.Within an MA framework, Estes and Phillips (2006) manipulated the opportunity for selection, providing rare direct evidence of stronger selection against mutations with pleiotropic effects. In a DNA repair-deficient strain of Caenorhabditis elegans, Estes and Phillips (2006) observed lower mutational covariance among life-history components when selection was allowed (larger populations) than when the opportunity for selection was limited (small populations). Similarly, McGuigan et al. (2011) compared Drosophila serrata MA lines accumulating mutations in the presence or absence of sexual selection on males, reporting reduced covariance between two fitness components in the selection treatment. These studies reveal that selection can eliminate nonlethal alleles with pleiotropic effects, but whether traits other than life-history components exhibit similar evidence of selection against pleiotropic alleles remains unknown.In parallel to the quantitative genetic predictions that pleiotropic alleles will be under stronger selection, molecular genetic theory predicts that the rate of gene evolution will be negatively correlated with pleiotropy (Pal et al. 2006; Salathe et al. 2006). More highly pleiotropic genes, as identified through the extent of connectivity (the number of interactions) in protein–protein interaction networks (Jeong et al. 2001), or the number of gene ontology (GO) terms (Jovelin and Phillips 2009) are more likely to be essential (i.e., knockout mutations result in lethality), suggesting that selection is stronger against large-effect (knockout) mutations in more highly pleiotropic genes. However, the selection acting against small-effect, nonlethal mutations in pleiotropic genes is less clear (Pal et al. 2006). Several studies have found an association between gene pleiotropy indices, such GO annotation of the number of biological processes or tissue specificity of expression, and the rate of sequence evolution (e.g., Pal et al. 2001; Salathe et al. 2006; Jovelin and Phillips 2009; Su et al. 2010). These pleiotropy indices typically explain little of the variation in sequence evolutionary rates, and it remains unclear whether more highly pleiotropic mutations are typically under stronger selection (Pal et al. 2006; Salathe et al. 2006).Here, we estimate the selection coefficients acting against naturally occurring mutations affecting gene-expression traits in male D. serrata to quantitatively test if selection is stronger on mutations that affect multiple traits. Gene-expression phenotypes are uniquely positioned to enable detailed investigations of pleiotropy: there are many of them, they represent a broad coverage of biological function, they can be analyzed to quantify developmental pleiotropy in the same way as traits traditionally considered in quantitative genetics, and GO information can be used to index molecular genetic pleiotropy. We use multivariate mixed-model analyses of expression traits in a set of inbred lines from a mutation accumulation experiment to estimate the mutational variance in individual expression traits, and the pleiotropic mutational covariance among random sets of five expression traits. Using a second panel of inbred lines, derived from a natural, outbred, population, we estimate the standing genetic variance in the same individual traits and five-trait combinations. From these estimates of mutational and standing genetic variance, we calculate s for each of the individual traits and trait combinations to determine whether selection has typically been stronger on mutations with pleiotropic effects than on other mutations affecting each trait. We complement this quantitative genetic analysis of developmental pleiotropy with an analysis of molecular genetic pleiotropy (Paaby and Rockman 2013), determining whether the strength of selection acting on individual expression traits can be predicted from the number of biological functions that the gene annotates to in the GO database or to the range of tissues in which the gene is expressed.     

The B-matrix harbors significant and sex-specific constraints on the evolution of multicharacter sexual dimorphism

The extent to which sexual dimorphism can evolve within a population depends on an interaction between sexually divergent selection and constraints imposed by a genetic architecture that is shared between males and females. The degree of constraint within a population is normally inferred from the intersexual genetic correlation, r(mf) . However, such bivariate correlations ignore the potential constraining effect of genetic covariances between other sexually coexpressed traits. Using the fruit fly Drosophila serrata, a species that exhibits mutual mate preference for blends of homologous contact pheromones, we tested the impact of between-sex between-trait genetic covariances using an extended version of the genetic variance-covariance matrix, G, that includes Lande's (1980) between-sex covariance matrix, B. We find that including B greatly reduces the degree to which male and female traits are predicted to diverge in the face of divergent phenotypic selection. However, the degree to which B alters the response to selection differs between the sexes. The overall rate of male trait evolution is predicted to decline, but its direction remains relatively unchanged, whereas the opposite is found for females. We emphasize the importance of considering the B-matrix in microevolutionary studies of constraint on the evolution of sexual dimorphism.