Effect of angiotensin-converting enzyme gene insertion/deletion polymorphism on steroid resistance in Egyptian children with idiopathic nephrotic syndrome

Abstract

Introduction. The presence of the deletion (D) allele in the angiotensin-converting enzyme (ACE) gene has been reported as a probable genetic risk factor for idiopathic nephrotic syndrome (INS), but its role in determining resistance to steroid therapy remains to be evaluated. Methods. Fifty-one patients were enrolled in the study and received oral steroids. The pattern of response to steroid therapy was determined. A group of 50 healthy adults served as a control group. The genotypes for ACE insertion (I)/D polymorphism were analysed using a PCR-based method. Results. Twenty patients were steroid sensitive (SS) and 31 were non-SS. The presence of hypertension at presentation was significantly related to steroid unresponsiveness. Among the SS group, the frequencies of the II, ID, and DD genotypes of the ACE gene were 20% (n=4), 65% (n=13), and 15% (n=3), respectively, while the frequencies among the non-SS group were 19.4% (n=6), 74.2% (n=23), and 6.5% (n=2), respectively. The differences between the two groups were not statistically significant (Chi square=0.59). Conclusion. The current study on Egyptian children with INS reveals no association between the ACE gene I/D polymorphism and clinical parameters, histological findings, and steroid resistance.

Association of angiotensin converting enzyme insertion/deletion gene polymorphism with idiopathic nephrotic syndrome susceptibility in children: a meta-analysis

“…This was another source of heterogeneity and we conducted a sensitivity analysis according to whether the included study strictly stated their INS definition for participant recruitment. In those nine reports, three 21,26,27 presented the diagnostic cri teria for INS in their studies, which was consistent with the definition of INS in our study. Another six reports only mentioned that the patients recruited into their studies were suffering from INS but did not show the definition of INS in their reports, and were excluded from this sensitivity analysis.…”

“…However, SaberAyad et al 26 (1.31fold). The increased D allele fre quency in African children was more notable when com pared with that in Asians or Caucasians.…”

“…In those nine reports, three 21 presented the diagnostic criteria for INS in their studies, which was consistent with the definition of INS in our study, and other six reports only mentioned that the patients recruited into their studies were suffering from INS but did not show the definition of INS in their reports. Six studies 13,[21][22][23][24]27 were conducted in Asians, one investigation 25 was performed in Caucasian children and two studies 12,26 were conducted in Africans. Eight studies were published in English and one investigation 21 was published in Chinese.…”

A meta-analysis of the association between angiotensin-converting enzyme insertion/deletion gene polymorphism and steroid-sensitive nephrotic syndrome in children

“…ACE I/D gene polymorphism might be not associated with the onset of SSNS in Caucasian children. In Africans, Saber-Ayad et al 12 performed an investigation in Egyptian children and observed that the differences of ACE I/D gene polymorphism between controls and SSNS group were not statistically significant. Fahmy et al 13 performed a study to investigate the distributions of ACE I/D gene polymorphism in Egyptian children with INS and found that there was no significant difference for DD genotype between the SSNS versus the normal control group and there was a significant difference for D allele between the normal control group versus SSNS group.…”

Angiotensin-Converting Enzyme Genotype Is Not a Significant Genetic Risk Factor for Idiopathic Nephrotic Syndrome in Croatian Children

“…The increased Ang II plays deleterious effects on renal hemodynamics and increases the expression of some growth factors that can take part in the onset and progression of various renal diseases [3,4,5,6,7,8]. The relationship between ACE gene I/D polymorphism and INS in children has been investigated with conflicting results [9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27]. The majority of investigations have been performed in Asian populations, with only scarce information from Europe and other parts of the world.…”