Polymorphisms of renin--angiotensin system genes as a risk factor for high-altitude pulmonary oedema

J Renin Angiotensin Aldosterone Syst. 2011 Jun;12(2):93-101. doi: 10.1177/1470320310387177. Epub 2011 Mar 10.

Abstract

The genes of the renin--angiotensin system (RAS) play an important role in the regulation of pulmonary vascular tone. Although studies on individual genes polymorphisms have reported association with high-altitude pulmonary oedema (HAPE), studies on multiple genes or epistasis are lacking. We therefore investigated the association of the RAS polymorphisms with HAPE. In a case-control design, we screened 163 HAPE-resistant/controls (HAPE-r) and 160 HAPEpatients (HAPE-p) of Indian origin for eight polymorphisms of four RAS genes, ACE, AGT, AGTR1 and AGTR2. Significant difference in genotype and allele frequencies of the ACE I/D and AGT M235T polymorphisms was observed between HAPE-p and HAPE-r (p < 0.05). In three-locus haplotype analysis of AGT the haplotype GTM was significantly higher in HAPE-p (29%) and haplotype GTT in HAPE-r (27%) after Bonferroni correction (p < 0.006). The differences were insignificant for polymorphisms from AGTR1 and AGTR2. The MDR (multifactor dimensional reduction) approach for gene--gene interaction depicted individual polymorphism M235T as the best disease predicting model (cross validation consistency, CVC = 10/10). We found a significant association of D allele of ACE and M allele of AGT with HAPE. The findings are supported at the haplotypic level as well as through nested genetic interaction between the RAS gene polymorphisms using the MDR approach.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alleles
  • Altitude Sickness / genetics*
  • Altitude*
  • Case-Control Studies
  • Epistasis, Genetic
  • Genetic Loci / genetics
  • Genetic Predisposition to Disease*
  • Haplotypes / genetics
  • Humans
  • Hypertension, Pulmonary / genetics*
  • Male
  • Models, Genetic
  • Multifactor Dimensionality Reduction
  • Polymorphism, Genetic*
  • Renin-Angiotensin System / genetics*
  • Risk Factors

Supplementary concepts

  • Pulmonary edema of mountaineers