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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2001;21:1538.)
© 2001 American Heart Association, Inc.

Thrombosis

Characterization of Polymorphic Structure of Cathepsin G Gene

Role in Cardiovascular and Cerebrovascular Diseases

Stefan-Martin Herrmann; Heiko Funke-Kaiser^*; Klaus Schmidt-Petersen^*; Viviane Nicaud; Marion Gautier-Bertrand; Alun Evans; Frank Kee; Dominique Arveiler; Caroline Morrison; Hans-Dieter Orzechowski; Alexis Elbaz; Pierre Amarenco; François Cambien; Martin Paul

From the Institute of Clinical Pharmacology and Toxicology (S.-M.H., H.F.-K., K.S.-P., H.-D.O., M.P.), the Department of Clinical Pharmacology, Benjamin Franklin Medical Center, Freie Universität Berlin, Germany; the Institut National de la Santé et de la Recherche Médicale (INSERM) SC7/U525 (V.N., F.C.) and U360 (M.G.-B., A. Elbaz), Paris, France; Monitoring Trends and Determinants in Cardiovascular Disease (MONICA) Project (A. Evans, F.K.) Belfast, UK; MONICA Project (D.A.), Strasbourg, France; MONICA Project (C.M.), Glasgow, UK; and the Department of Neurology (P.A.), Saint-Antoine and Lariboisière Hospitals, and Pierre and Marie Curie University, Formation de Recherche en Neurologie Vasculaire, Paris, France.

Correspondence to Dr S.-M. Herrmann, Institute of Clinical Pharmacology and Toxicology, Department of Clinical Pharmacology, Benjamin Franklin Medical Center, Freie Universität Berlin, Hindenburgdamm 30, 12200 Berlin, Germany. E-mail herrmann{at}medizin.fu-berlin.de

Abstract—— Cathepsin G (CTSG), a serine protease released from activated neutrophils, may cause platelet activation, leading to intravascular thrombosis, thus contributing to cardiovascular and cerebrovascular disease. Applying the candidate gene approach, we screened the 5'-flanking region and the entire coding region of the CTSG gene for genetic variation by using polymerase chain reaction/single-strand conformation polymorphism analysis from 96 patients at high risk for myocardial infarction (MI). We identified 4 polymorphisms in the 5'-flanking region (G-618C, G-315A, C-179T, and C-160T) and 1 polymorphism in the coding region (Asn125Ser) of the gene and genotyped the participants in the Etude Cas-Temoins sur l’Infarctus du Myocarde (ECTIM Study), a case-control study for MI, and in the Étude du Profil Génétique de l’Infarctus Cérébral (GENIC Study), a case-control study for brain infarction (BI), for all identified genetic variants. The potential in vitro functionality of the 4 variants in the 5'-flanking region was investigated with transient transfection analyses in U937 cells with different allelic promoter constructs by using a luciferase assay. Our in vitro analyses did not reveal any differences for the investigated allelic constructs with respect to promoter activity, and none of the polymorphisms in the 5'-flanking region was associated with the available phenotypes in either study. Allele and genotype distributions of all identified polymorphisms did not globally differ between cases and controls in the ECTIM Study. However, in patients from the ECTIM Study, the Ser125 allele was significantly associated with elevated plasma fibrinogen levels (P=0.006), but this effect was not seen in controls (case-control heterogeneity, P=0.04). There was a significant interaction between CTSG Asn125Ser and the ß-fibrinogen gene polymorphism G-455A on plasma fibrinogen levels (P=0.04). In the GENIC Study, the odds ratio for BI associated with CTSG Ser125 carrying was 1.82 (95% CI 1.16 to 2.84, P=0.008) in patients without a history of cardiovascular or cerebrovascular diseases. Our results indicate that the CTSG Ser125 allele is associated with plasma fibrinogen levels in MI patients from the ECTIM Study and with BI in the GENIC Study. Further studies should be carried out to define the underlying mechanisms.

Key Words: cathepsin G • genetic polymorphism • myocardial infarction • brain infarction • fibrinogen

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