Oxidative stress alters cellular homeostasis and elicits a cellular response that depends on the severity and type of damage: some cells activate defense mechanisms designed to ensure survival; the other, provided that the defense mechanisms are inhibited, triggers alternative signaling pathways that lead to apoptosis, necrosis, pyroptosis, autophagy, and so on. However, the exact cause of such damage and induction of oxidative stress, including the associated oxidative effects around pigment epithelial cells in the context of the onset and progression of age-related macular degeneration – one of the world’s most common eye diseases with blindness, remains unclear. Therefore, in the course of the study we turned to key biogenetic points of regulation of inflammation and apoptosis, in particular TNF. The aim of the work is to shed light on the role of TNF as a genetic determinant that can initiate and influence the course of age-related macular degeneration. For this purpose, the main pathognomonic markers of the morphological structure of the macula were determined in 291 persons with age-related macular degeneration and in 105 persons without ophthalmic pathology, using optical coherence tomography to confirm or exclude the diagnosis of the disease. To detect polymorphism of the TNF gene, we used the method of real-time PCR diagnostics on the BioRad CFX 96 amplifier using LiTech reagents. Statistical processing of the results was performed using Hardy-Weinberg equilibrium, Kruskal-Wallis method, logistic regression analysis and construction of the ROC curve to determine the AUC range and sensitivity and specificity values. The study revealed a significant difference in the distribution of mutant genotypes between patients with both forms of AMD and the control group. There was also a statistically significant effect of mutant allele A on the development of both "dry" (OR = 3.40; 95.0 %; CI = 1.90-6.07, p<0.001) and "wet" form of AMD (OR = 4.78; 95.0 % CI 2.65-8.64, p<0.001), and in the analysis of mutant genotypes it was found that the GA genotype increases the chances of "dry" and "wet" forms of the disease by 3.13 and 4.74 times, respectively, while AA – 5 times, regardless of the form of the disease. confirms the influence of TNF gene polymorphism on the occurrence and progression of age-related macular degeneration. In the analysis of ROC-curves and AUC regions, it was found that all mutant genotypes have a significant effect on the occurrence of age-related macular degeneration (p<0.05). However, the obtained values of sensitivity and specificity, especially in the AA genotype in both "dry" (17.9 % and 95.8 %, respectively) and "wet" (18.2 % and 95.8 %, respectively) forms of age-related macular degeneration indicate a low chance of error-free confirmation of the diagnosis. a disease that may be associated with multifactorial disease and requires further research.
Annotation. Age-related macular degeneration is a multifactorial nosology caused by the interaction of various risk factors, but the pathogenesis remains unclear. An alternative point of application in the pathogenesis of the disease was the product of the HTRA1 gene, which is actively expressed in retinal epithelial cells and modulates their response to stimuli. That is why the aim of our study was to elucidate the effect of the rs11200638 polymorphism of the HTRA1 gene on the occurrence and development of age-related macular degeneration and to determine the intensity of this pathological effect. The study group consisted of 291 individuals, while the comparison group consisted of 105 individuals of the appropriate age. Optical coherence tomography of the macular area of the retina using the ILM-RPE parameter was used to establish the diagnosis. Real-time polymerase chain reaction was used to detect polymorphism on the BioRad CFX 96 thermocycler-amplifier. Statistical processing of the results was performed by determining Hardy-Weinberg equilibrium, Kruskal-Wallace methods, logistic regression using OR and 95% CI curves and indicators of sensitivity and specificity. The study found a predominance of wild type among the comparison group, while heterozygous and mutant genotypes were almost equally distributed among patients with “dry” and “wet” forms of age-related macular degeneration (AMD). A statistically significant associative association was found between the mutant allele A and the occurrence of both atrophic (OR=7.75; 95% CI 3.87-15.49) and neovascular (OR=3.3; 95% CI 1, 89-5.91) forms of AMD (p<0.001). Subsequent analysis revealed a significant statistical relationship between variant AA and “wet” AMD (OR=21.3; 95% CI 2.57-176.8; p<0.001), as well as between heterozygous variant and “dry” (OR=7.7; 95% CI 3.8-15.46) and “wet” (OR=2.45; 95% CI 1.36-4.43) forms of the disease (p <0.01). In addition, the use of single nucleotide polymorphism (SNP) rs11200638 allows with a specificity of 59.2-98.4% and a sensitivity of 12.5-83.9% to diagnose AMD, depending on its form and the available genotype of the patient. Thus, our results indicate the high significance of the prognostic effect of the rs11200638 polymorphism of the HTRA1 gene on the development and progression of AMD, and the sensitivity and specificity indicators allow the use of the definition of this SNP to diagnose the disease.
Age-related macular degeneration mainly affects the elderly and is one of the most common causes of rapidly progressive vision loss. Over more than 150 years of research, the scientific community has gone from understanding the macroscopic picture of the lesion, presumable identification of drusen as the main morphological manifestation of nosology, to detailed classifications and determine the role of genetic determinants in the etiopathogenesis of the disease — high specificity, the possibility of preventive analysis, and much unclear in the field of genetic diagnosis of eye diseases determine the accurate attention of specialized research groups to the early diagnosis using genetic analysis. The review article was aimed to systematize the information about possible links in the pathogenesis of age-related macular degeneration and identify potential polymorphisms that can initiate and modulate the activity of these links. During the study, we could find out five main mechanisms of damage to the vascular membrane of the eye itself, which are affected by single nucleotide polymorphisms. The highest affinity was shown by genetic variants of separate sites of CFH (rs1061170), HTRA1 (rs11200638), TNF (rs1800629), VEGFA (rs2010963). Literature data obtained from foreign and national sources indexed by Scopus, Web of Science databases, in particular for the last 5 years, pay special attention to these areas as potential predictors or modifiers of pathological processes involved in the process of macular degeneration. Despite the large number of studies examining the predisposition, pathogenesis, diagnosis, and treatment of age-related macular degeneration to stop the spread of vision loss, only a few issues are understood thoroughly. Considering the successful cases of application of biological and gene therapy for the management of such patients, we see new horizons in the detailed study of molecular interactions that underlie the pathology. The review confirms the active role of polymorphisms in one of the most relevant pathological processes of the human eye.
Annotation. AMD (age-related macular degeneration) is one of the leading causes of blindness in the world, associated with the formation of extracellular deposits called drusen in the macula, i.e. in the central part of the retina. These drusen contain cellular debris and proteins, including components of the complement system, such as the regulator CFH (complement factor H). Complement dysregulation is believed to play a major role in the development of AMD. CFH acts through its ability to recognize polyanionic structures (eg, sulfated GAGs (glycosaminoglycans)) found in host tissues, and thus CFH inactivates any complement system (C3b) that is deposited. Importantly, the common CFH (Y402H) polymorphism was strongly associated with an increased risk of AMD. Recent studies have shown that the disease-associated allotype 402H interacts more poorly (compared to 402Y) with binding sites in the macula (eg, Bruch's membrane), where GAGs (glycosaminoglycans), heparan sulfate, and dermatan sulfate play a major role in mediating the interaction with CFH. Decreased binding of the 402H allotype may lead to complement dysregulation, leading to chronic local inflammation that may contribute to drusen accumulation and thus the initiation, development, and progression of AMD. That is why the goal of our study was to highlight the effect of the rs1061170 polymorphism of the CFH gene on the occurrence and development of age-related macular degeneration and to clarify the intensity of this pathological effect. The study group consisted of 291 people suffering from AMD (89 – with the “dry” form, 97 – with the “wet” form), the comparison group – 105 people without a history of ophthalmic pathology of the corresponding age. Optical coherence tomography (SOCT Copernicus “Optopol”) of the macular area of the retina was used in the study. We used the parameter ILM-RPE (internal limiting membrane-retinal pigmented epithelium). DNA was isolated from the biological material obtained by the buccal scraping method using the Bio-Rad Chelex ® 100 kit. Polymerase chain reaction was used to detect the rs1061170 polymorphism of the CFH gene. Statistical processing of the obtained results was carried out using Statistica 10 (StatSoft, Inc., USA) and SPSS 23.0 programs. The following were used: Hardy-Weinberg equilibrium (Hardy–Weinberg); Kruskal-Wallis test ANOVA by Ranks and Friedman ANOVA and Kendall Coeff. of Concordance; H-criterion; indicators of the odds ratio (OR; Odds Ratio – OR) and 95% probable interval (±95% CI; Confidence limit for means Interval – CI); used the method of analysis of operating characteristic curves (ROC – Receiver Operating Characteristic curve analysis); used special formulas using 2x2 tables. Our results confirm the high prognostic significance of the rs1061170 polymorphism of the CFH gene on the development and progression of AMD in the Ukrainian population. Indicators of specificity and sensitivity of SNP genotypes are ambiguous.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.