Search results for “Polymorphism

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16 articles

Plasma TREM2 Levels, Alcohol Consumption, and Liver Enzymes in Patients with Alcohol use Disorder: A Sex-Dependent Relationship Involving MS4A6A Genetic Polymorphism

Feb 2025 DOI 10.14302/issn.2326-0793.jpgr-25-5405
Ho Ming-FenCorresponding author

Alcohol use disorder (AUD) is the most prevalent substance use disorder. Excessive alcohol consumption leads to a range of health issues. We set out to identify inflammatory markers linked to alcohol consumption, which might ultimately offer novel insight into genetic underpinnings and have implications for alcohol-associated disease. Alcohol consumption and blood-based multi-omics data were collected by The Mayo Clinic Center for Individualized Treatment of Alcohol Dependence study. Plasma samples from patients with AUD were used for proteomics analysis using the OLINK “Explore Inflammation” panel (n=410). Liver enzymes were also measured. A genome-wide association study (GWAS) was performed to explore the relationship between genetic variants and plasma TREM2 levels. Our findings show thatplasma triggering receptor expressed on myeloid cells 2 (TREM2), a key gene associated with neurodegenerative disease, was the most significant signal correlated with alcohol consumption, and has also been associated with liver enzyme levels in patients with AUD. We identified the rs7232 single nucleotide polymorphism (SNP) in MS4A6A as a key genetic variant associated with plasma TREM2 levels, with the minor allele (A) linked to higher TREM2 levels and increased alcohol consumption, particularly in men. Furthermore, MA4A6A is an ethanol-responsive gene in a SNP-dependent manner, and the variant genotype of the rs7232 SNP was associated with lower expression for MA4A6A due to proteasome-mediated protein degradation. In summary, this study provides insight into the relationship between plasma TREM2 levels, alcohol consumption, and liver function in AUD patients, shedding light on genetic factors underlying alcohol-related diseases.

DNA And RNA Research Open Access

Molecular Study of Hepcidin HAMP (-582A/G) Gene Polymorphisms and Measurement of Serum Hepcidin Level among Sudanese Patients with Anemia of Chronic Kidney Disease

May 2020 DOI 10.14302/issn.2575-7881.jdrr-20-3343
Hussen Abdelrhman AmgedCorresponding author Assis Professor, Department of Hematology and Immunohematology, Omdurman Islamic university / Sudan

Background Anemia of chronic disease is anemia found in certain chronic disease states, is typically marked by the disturbance of iron homeostasis or hypoferremia. Chronic renal failure is currently known as Chronic Kidney Disease (CKD) or Chronic Renal Insufficiency (CRI) implies long-standing, progressive and irreversible renal parenchyma disease resulting in diminished renal function up to 40 to 60%. Often, chronic kidney disease is diagnosed as a result of screening of people known to be at risk of kidney problems, such as those with high blood pressure or diabetes and those with a blood relative with chronic kidney disease. This disease may also be identified when it leads to one of its recognized complications such as cardiovascular disease, anemia, or pericarditis.                             Methods Sysmex kx21 used to CBC and the Cobase411 used to iron profile. Enzyme-Linked immunoassay (ELISA) was used to determine the level of serum hepcidin.  Sample preparation and PCR detection of HAMP DNA Polymorphisms: Restriction digestion of PCR products was done using Fast Digest. (Figure 1).                                                                                         Results Serum hepcidin levels higher in patients with anemia of chronic kidney disease compared with healthy controls mean. The polymorphisms of the hepcidin gene promoter in Sudanese patients with ACKD showed that the hepcidin HAMP AA genotype 70, AG 23, and GG 7 in 100 patients dialysis-dependent and AA 83, AG 17 and GG 0, and the allele A are more frequent in patients affected by ACKD. Significant statistical association observed between the hepcidin level and end-stage kidney disease. Conclusion This study evaluates for the first time the association between anemia of chronic kidney disease and hepcidin genes promoter polymorphisms and show that the hepcidin HAMP AA genotype and the allele A are more frequent in patients affected by ACKD, further investigation is needed, our data support the hypothesis and hepcidin HAMP are important in the pathophysiology of ACKD.

Association of BsmI and ApaI Polymorphisms of the Vitamin D Receptor Gene with Dyslipidemia in Patients with Coronary Artery Disease.

Mar 2020 DOI 10.14302/issn.2374-9431.jbd-20-3195
E.G SergeevaCorresponding author FIRST St. Petersburg state medical University named after academician I. P. Pavlov

Purpose The goals of the present study were to assess the genotypic and allelic distribution of Bsm-I (rs1544410) and Apa-I (rs7975232) polymorphisms of the vitamin D receptor (VDR) gene in coronary artery disease (CAD) patients in comparison to control patients of the same age without CAD and to determine whether these gene variants are associated with dyslipidemia. Materials and Methods Based on a case-control design, 302 hospitalized patients  with CAD and 194 people of comparable age without CAD were enrolled in the study. The BsmI and ApaI polymorphisms of VDR gene were studied using polymerase chain reaction followed by restriction analysis. The allele digested by the restriction enzyme was denoted by a lower letter, whereas that not digested was indicated by a capital letter. Determination of the level of vitamin D and immunoreactive insulin in the blood serum was carried out using the immuno-enzyme method. Results The bb genotype of Bsm-I VDR gene polymorphism was detected more often in patients with CAD than in the comparison group with an increased risk of CAD by 1.52 times (p=0.006, OR=1.52(1.05÷2.2). The level of HDL cholesterol was higher in CAD patients − carriers of BB genotype compared to its level in Bb genotype carriers and bb genotype carriers (1,13±0,05 mmol/l, 1,01±0,03 mmol/l, 1,02±0,03 mmol/l respectively, p<0,05). The level of vitamin D was higher in patients with BB genotype compared to its level in bb genotype carriers (45.12±3.73 nmol / l and 34.16±1.95 nmol/l respectively, p=0.008). The occurrence of a allele of Apa-I VDR gene polymorphism was higher in patients with CAD than in the control group (p=0.02, OR=1.21(0.93÷1.57). HDL cholesterol level was higher in CAD patients - AA genotype carriers compared with carriers of Aa and aa genotypes (1.18±0.08 mmol / l, 1,02±0.02 mmol / l and 1.01±0.03 mmol/l respectively, p<0,05). Immunoreactive insulin level was significantly higher in CAD patients – aa genotype carriers. No differences in LDL cholesterol and triglycerides were found. Vitamin D level was lower in CAD patients - Aa and aa genotype carriers (33,8±33,9 nmol/l ,p=0,02 and 24,7±4,9 nmol/l, p=0,05 respectively in comparison to vitamin D level = 43,3 ±4,2 nmol/l in AA genotype carriers). Conclusion The bb genotype of Bsm-I VDR gene polymorphism is associated with an increased risk of CAD. A carriage of b allele in CAD patients is associated with lower level of vitamin D and HDL cholesterol. A carriage of a allele of Apa-I VDR gene polymorphism in CAD patients is associated with lower level of vitamin D and HDL cholesterol.  

D Allele and DD Genotype of I /D Polymorphism in The ACE Gene in Patients with Hypertension, Stroke And Cancer Prostate In Libreville: A Concern Given The High Frequencies of these Signatures in Gabonese Population

Dec 2019 DOI 10.14302/issn.2326-0793.jpgr-19-3114
Ollomo BenjaminCorresponding author Unité Mixte de Recherches (UMR-BIOMED), Faculté de Médecine, B.P 8507 Libreville, Gabon

Background During the last two decades, the polymorphism of Angiotensin-Converting Enzyme (ACE) gene has been extensively studied among different human populations. In humans, several studies have shown the relationship between this polymorphism and the risk of many serious diseases with a heavy burden of health in developing countries. After analyzing the polymorphism in the population, the present study was also concerned with the investigation of an eventual association between hypertension, stroke, cancer prostate and I/D polymorphism of the ACE gene. Materials and Methods Our study population included 163 Baka (pygmy) and 158 Fang (Bantu) from Gabon to evaluate the polymorphism in the country. Concerning the diseases, we included 105 patients and 120 controls for hypertension, 37 patients stroke matched with 50 controls and 97 patients with prostate cancer were recruited. All participants in the study were genotyped for the ACE I/D polymorphism obtained by polymerase chain reaction amplification on genomic DNA. Results Our analysis showed that the ACE D allele DD genotype frequencies were highest of all the data so far in human populations. We obtained a frequency of 0.138 for I allele and 0.862 for D allele among pygmy and the frequencies of 0.313 and 0.687 respectively for the I and D alleles. This difference was significant (p<0.05). In patients, we revealed the predominance of D allele and DD genotype for hypertension (0.27 for I allele and 0.73 for D allele), for stroke (0.15 for I allele and 0.85 for D allele) and 83% of individuals with cancer prostate carry the D allele. D allele and DD genotype are associated with risk to hypertension whereas allele I seem protective at the occurrence of stroke (p<0.05 between healthy and controls). Conclusion We show that the D allele and DD genotype were higher in this population. Also theses two signatures may be associated at genetic risk of hypertension, stroke and prostate cancer in this country deprived of human resources for quality care of many patients.

L162v Polymorphism of Par-Α Gene, A603g Polymorphism of Tissue Factor Gene and Risk of Coronary Heart Disease in Russian Population

Jun 2019 DOI 10.14302/issn.2374-9431.jbd-19-2788
Sergeeva E.G.Corresponding author First Pavlov State Medical University of St. Petersburg

Purpose The goal of this study is to determine the association of L162V polymorphism of PPAR-alpha gene, A603G polymorphism of tissue factor gene and the risk of coronary heart disease development in Russian population.   Materials and Methods A clinical and genetic study of 414 patients with CHD and 220 people of comparable age without CHD which amounted to a control group was performed. L162L and L162V genotypes of L162V polymorphism of PPAR-α gene, A603A, A603G and G603G genotypes of A603G polymorphism of tissue factor gene were determined by polymerase chain reaction followed by restriction analysis. Results A carriage of L162V genotype and V allele of PPAR-α gene was associated with an increase risk of CHD in 2,13 times (L162V genotype) and in 2,21 times (V allele), with an increase in risk of CHD before the age of 45 years in 4,68 times (L162V genotype) and in 3,88 times (V allele). Significantly higher in patients with CHD compared with the general population and in patients with a carriage of G603G genotype and G allele of tissue factor gene was associated with the increase of CHD risk in 2,68 times (G603G genotype) and in 4,37 times (G allele), occurred more frequently in patients with debut of disease at age of 45 years and younger. The level of tissue factor was significantly higher in patients with CHD – carriers G603G genotype compared with carriers A603A genotype (217,9±15,2 pg/ml and 152,6±30,4 pg/ml, respectively, p=0,04). A carriage of the combination of L162V and G603G genotypes was associated with an increased risk of CHD in 3,04 times. Conclusion A carriage of V allele of L162V polymorphism of PPAR-α gene and G allele of A603G polymorphism of tissue factor gene, as well as their pair combination are associated with an increased CHD risk, especially at age 45 years or less.

Genetic Polymorphisms in Patients with Epilepsy: A Mini Review.

Sep 2018
Santiago Freitas e Silva KleberCorresponding author Biological Sciences Institute, Federal University of Goiás, Brazil.

Epilepsy comprises a series of chronic neurological disorders characterized by recurrent seizures. Over 50 million people are affected by epilepsy worldwide. In addition, genetic components capable of predicting epilepsy predisposition and antiepileptic drugs response would lead to the development of promising treatment and a better prognosis of the disease. Several genes and their variants have been investigated whether they could affect the onset of epilepsy. The brain-derived neurotrophic factor gene, the ATP-binding cassette subfamily B member and the cytochrome P450 are the most common polymorphic genes related to epilepsy. Early identification of risk factors for epilepsy should optimize treatment and prognosis. The characterization of genetic polymorphism contribute to the selection of the most promising antiepileptic therapy and avoidance of drug resistance. The development of biomarkers to estimate the risk of epilepsy and drug resistance would have a clinical impact on the treatment of the disease and on anti-epileptic drug therapy.

Organ Transplantation Open Access

Single Nucleotide Polymorphism Profiles of Patients with Acute Renal Rejection to Personalize Immunosuppressive Therapy: Preliminary Results from An On-Going, Italian Study

Jun 2017 DOI 10.14302/issn.2576-9359.jot-17-1603
Caprara CarlottaCorresponding author  Department of Nephrology, Dialysis and Transplantation; International Renal Research Institute Vicenza (IRRIV); San Bortolo Hospital; Vicenza.

Single-nucleotide polymorphisms (SNPs) in genes involved in immune responses and in the pharmacokinetics/pharmacodynamics of immunosuppressive drugs influence transplant outcomes of patients receiving the same immunosuppressive therapy. The aim of our preliminary study was to determine the SNPs profiles of ABCB1/MDR-1, UGT1A9, IMPDH2, IL-10 and TNF-α genes associated with acute rejection (AR) events in renal allograft recipients. DNA was extracted from whole blood samples of 220 individuals in 3 experimental groups; Case: 41 kidney transplant patients with AR event(s), Control I: 109 kidney transplant patients without AR event, Control II: 70 healthy blood donors. Acute rejection defined as rapid, unexplained rise in serum creatinine was biopsy-proven. 19 SNPs were analyzed by Sanger Sequencing. Analysis of allele and genotype frequencies and gene-disease association tests were performed. Allele frequencies of healthy persons are in line with ones reported from Europe indicating that the studied population is representative. Statistically significant differences only by the comparison of kidney transplant patients with AR event(s) and healthy individuals are found for rs2032582 and rs1045642 SNPs of ABCB1/MDR1, the latter is also not in Hardy-Weinberg equilibrium in our population. Patients with specific alleles for these SPNs are more prone to have acute rejection events. Certain allele variants of ABCB1/MDR1 by modifying the effectiveness of the drugs may compromise the success of the immunosuppressive therapy and put patients at higher risk to reject the new organ. Therefore screening for these polymorphisms before transplantation would help clinicians to more accurately personalize medications.

DNA And RNA Research Open Access

Fast Screening Method for Polymorphisms in Exon 9 of the Catalase Gene.

Jan 2017 DOI 10.14302/issn.2575-7881.jdrr-16-1375
Góth LászlóCorresponding author Department of Medical Laboratory and Diagnostic Imaging, University of Debrecen, Debrecen POBox 55, Hungary H-4012

We checked our simple screening technique for detection of the known polymorphism of rs769217, and the two acatalasemic mutations in exon 9 of the catalase gene. This fast and inexpensive method yielded better resolution than those of the standard SSCP. We suppose that the method detects the spontaneously formed single stranded DNAs.

A study on the association of ACE i/D gene polymorphism, Obesity, Blood pressure and susceptibility of type 2 diabetes mellitus among the Kurmis of West Bengal, India.

Jun 2016
Ratan Bandyopadhyay ArupCorresponding author Department of Anthropology, University College of Science, Technology & Agriculture, University of Calcutta, India

Earlier studies reported significant association of obesity, hypertension and Type2 Diabetes Mellitus (T2DM). Genetic and many disease-associated alleles have been identified through GWAS and applied to T2DM and indicated roles of renin-angiotensin system (RAS) in insulin signaling pathway and insulin resistance has been well documented. Angiotensin converting enzyme (ACE) gene catalyzes the conversion of angiotensin I to angiotensin II and also inactive the vasodilatation and hence renin-angiotensin system (RAS) in insulin signaling pathway and insulin resistance has been reported. To best of the knowledge we are reporting for the first time regarding association of ACE gene polymorphism with body composition, physiological and metabolic variables among any endogamous ethnic group (Kurmis) from of West Bengal, Eastern India. To achieve the purpose, total 197 (male 99 and female 98) randomly selected apparently healthy unrelated adult individuals of Kurmi population of Purulia District, West Bengal, India were incorporated in the present study. Anthropometric variables, physiological variables (blood pressure) and metabolic variables (PP blood sugar) have been collected using standard techniques. Extracted genomic DNA was PCR amplified and genotyped to understand ACE gene I/D polymorphism. The result demonstrated significant (p<0.05) sexual dimorphism in PBF. MAP and PP blood sugar found to be in normal range among the Kurmis. ACE gene polymorphism showed no deletion of the Kurmis and hence, only the prevalence of ACE II (insertion-Insertion) genotype has been noticed. The present study vindicated on the basis of body composition in terms of fat patterning, physiological and metabolic variables and ACE gene polymorphism that there is very low or no risk of T2DM among the Kurmis of West Bengal, India.

Single Nucleotide Polymorphisms associated with alimentary fatty liver disease are not genetic risk factors for treatment-associated hepatic steatosis in HIV patients on HAART

May 2013 DOI 10.14302/issn.2324-7339.jcrhap-12-140
Dold LeonaCorresponding author Department of Internal Medicine, University of Bonn, Sigmund-Freud-Strasse 25, Bonn, Germany

Analyzing SNPs linked to fatty liver disease, this study finds no association with HAART‑related hepatic steatosis in HIV patients. The work underscores the multifactorial nature of antiretroviral toxicity and points to metabolic and pharmacologic contributors beyond common variants.

Radio-Induced Maxillary Angiosarcoma: About a Case

May 2025 DOI 10.14302/issn.2379-8572.joa-25-5504
Hachemi MohamedCorresponding author

Introduction Angiosarcoma is a rare malignant tumour from fast-evolving and aggressive vascular endothelial cells that accounts for 1% of all sarcomas. The sinus location of angiosarcoma is exceptional. The clinical polymorphism of this tumour may cause a delay in diagnosis. Risk factors are not always understood. However, a history of radiation therapy for locoregional cancer and/or lymphedema is most commonly found. The prognosis remains bleak with an overall five-year survival of 35 to 40%. Objectives The authors discuss the diagnostic, therapeutic and prognostic modalities and difficulties of this tumour. Observation: The authors report a case of maxillary sinus angiosarcoma confirmed by radio-induced secondary CD34 immunohistological staining in a 40-year-old man having a history of hemangioendothelioma treated with conservative endoscopic surgery and adjuvant radiotherapy 15 months earlier. Discussion This lesion is rare in the ENT sphere and may be confused with a benign tumor in its early stages. Only histological examination with immunohistochemistry can confirm the diagnosis (factor VIII, CD34 and CD31 antigens). Treatment consists of a wide resection followed by radiotherapy, hence the need for early diagnosis in the metastatic phase, first-line treatments include doxorubicin or paclitaxel weekly. Conclusion Radio-induced angiosarcoma is a rare malignant tumour, it occurs in patients who have received conservative treatment and radiation therapy for nasosinusitis cancers. Angiosarcomas of the nasal passages remain a diagnostic and therapeutic challenge due to their local and general aggressiveness.

The Intersection of Cultural Characteristics and Genetics on the Prevalence of Delayed Sleep Phase Syndrome in Brazilian and Japanese Adults

Apr 2020 DOI 10.14302/issn.2574-4518.jsdr-20-3161
Sedky KarimCorresponding author Psychiatry Residency Director and Medical Student Education Director, Cooper Medical School of Rowan University

Delayed sleep phase syndrome (DSPS) is a circadian rhythm disorder where individuals experience difficulty modifying the time they go to sleep and wake up in response to environmental changes. The circadian rhythm itself is regulated by a variety of clock genes, and various other genes (e.g., AA-NAT gene, CKIϵ gene) code for proteins that regulate clock genes. Various polymorphisms of the clock gene influencers have been shown to increase susceptibility to DSPS. This paper seeks to examine how certain cultural characteristics (e.g., napping, timing of meals, exposure to artificial light) and the presence of the AA-NAT gene (G619A polymorphism) and the CKIϵ gene (S408N polymorphism) influence the prevalence of DSPS amongst Japanese and Brazilian populations.

An Unexpected Etiology of Myocardial Ischemia in Young

Apr 2019 DOI 10.14302/issn.2329-9487.jhc-19-2719
Bouomrani SalemCorresponding author Department of Internal medicine. Military Hospital of Gabes. Gabes 6000. Tunisia

Introduction The cardiac localization of hydatid cyst (HC) is rare and little known. It is exceptionally primary and isolated. Myocardial ischemia remains an exceptional and unusual manifestation of this localization. We report the original observation of cardiac HC revealed by acute myocardial ischemia in a young subject. Observation A 35-year-old patient with no notable pathological history was admitted to our department via the emergency room for acute anterior chest pain. The somatic examination was without abnormalities as well as the baseline biological tests. The electrocardiogram demonstrated epicardial ischemia in the infero-lateral territory without other abnormalities. The cardiac troponin I was slightly elevated (32ng/l, N<19ng/l). Subsequent controls after 30min, 60min and 180min did not show significant variations. Subsequent investigations (CT, coro-CT, coronary angiography) led to the diagnosis of intramyocardial HC of the left ventricle, with no abnormalities of the coronary arteries. After surgical excision, the evolution was favorable with normalization of the electrocardiogram and the troponin Ic. Conclusion Cardiac localization of this parasitosis is exceptional and characterized by an important clinical polymorphism making its diagnosis a real challenge. It seems useful to discuss the diagnosis of cardiac HC in front of any unexplained electrocardiogram abnormality occurring in endemic zone.

Ophthalmic Science Open Access

Recurrent branch retinal arterial occlusions associated with plasminogen activator inhibitor-1 mutation

Aug 2017 DOI 10.14302/issn.2470-0436.jos-17-1721
C. Rodger DamienCorresponding author USC Roski Eye Institute, Los Angeles, California

A 57-year-old Hispanic female presented with 3 days of blurry vision in the left eye. Eight years prior, she had a branch retinal artery occlusion in the right eye and a hematologic work-up revealed a 4G/4G polymorphism in plasminogen activator inhibitor-1. With the current episode, she was found to have bilateral branch retinal artery occlusions and mild vitritis in the left eye, simulating a toxoplasma infection. An infectious and inflammatory work up, however, was negative and the vitritis resolved after a short course of steroids. Plasminogen activator inhibitor-1 mutations may be associated with an increased risk of retinal vascular occlusions.

Computational STAT4 rSNP Analysis, Transcriptional Factor Binding Sites and Disease

Feb 2016 DOI 10.14302/issn.2374-9431.jbd-15-890
E. Buroker NormanCorresponding author Department of Pediatrics, University of Washington, Seattle, WA 98195, USA

Purpose Signal Transducer and Activator of Transcription 4 (STAT4) is important for signaling by interleukins (IL-12 and IL-23) and type 1 interferons and has been found to have several simple nucleotide polymorphisms (SNPs) associated with human disease. STAT4 SNPs were computationally examined with respect to changes in potential transcriptional factor binding sites (TFBS) and these changes were discussed in relation to human disease. Methods The JASPAR CORE and ConSite databases were instrumental in identifying the TFBS. The Vector NTI Advance 11.5 computer program was employed in locating all theTFBS in theSTAT4 gene from 4 kb upstream of the transcriptional start site to 8.3 kb past the 3’UTR. The JASPAR CORE database was also involved in computing each nucleotide occurrence (%) within the TFBS. Results The STAT4 SNPs in the 70 kb intron between exon 2 and 3 are in linkage disequilibrium and have previously been found to be significantly associated with several vasculitis diseases as well as diabetes. The SNP alleles were found to alter the DNA landscape for potential transcriptional factors (TFs) to attach resulting in changes in TFBS and thereby, alter which transcriptional factors potentially regulate the STAT4 gene. These STAT4 SNPs should be considered as regulatory (r) SNPs. Conclusion The alleles of each rSNP were found to generate unique TFBS resulting in potential changes in TF STAT4 regulation. These regulatory changes were discussed with respect to changes in human health that result in disease.

Computational EPAS1 rSNP Analysis, Transcriptional Factor Binding Sites and High Altitude Sickness or Adaptation

Feb 2016 DOI 10.14302/issn.2326-0793.jpgr-15-889
E. Buroker NormanCorresponding author Department of Pediatrics, University of Washington, Seattle, WA 98195, USA

Purpose The endothetal Per-Arnt-Sim (PAS) domain protein 1 (EPAS1) gene which encodes hypoxia-inducible-factor-2 alpha (HIF2a) is a transcription factor that is involved in the response to hypoxia. EPAS1 has been found to have four (rs56721780, rs6756667, rs7589621, rs1868092) simple nucleotide polymorphisms (SNPs) associated with human disease.These SNPs were computationally examined with respect to changes in potential transcriptional factor binding sites (TFBS) and these changes were discussed in relation to disease and alterations in high altitude adaptation in humans. Methods The JASPAR CORE and ConSite databases were instrumental in identifying the TFBS. The Vector NTI Advance 11.5 computer program was employed in locating all theTFBS in theEPAS1 gene from 1.6 kb upstream of the transcriptional start site to 539 bps past the 3’UTR. The JASPAR CORE database was also involved in computing each nucleotide occurrence (%) within the TFBS. Results The EPAS1 SNPs in the promoter, intron two and the 3’UTR regions have previously been found to be significantly associated with disease and different levels of high-altitude hypoxia among native Tibetans. The SNP alleles were found to alter the DNA landscape for potential transcriptional factors (TFs) to attach resulting in changes in TFBS and thereby, alter which transcriptional factors potentially regulate the EPAS1 genesuch as for the glucocorticoid and mineralocorticoid nuclear receptor binding sites created by the rs7589621 rSNP EPAS1-G allele. These receptors regulate carbohydrate, protein and fat metabolism. Also the minor rs7589621 rSNP EPAS1-A creates a punitive TFBS for the FOXC TF which is an important regulator of cell viability and resistance to oxidative stress. These EPAS1 SNPs should be considered as regulatory (r) SNPs. Conclusion The alleles of each rSNP were found to generate unique TFBS resulting in potential changes in TF EPAS1 regulation. The punitive changes in TFBS created by the four rSNPs could very well influence the significant cline in allele frequencies seen in Tibetans with increasing altitude or the haplotype association with high altitude polycythemia in male Han Chinese. These regulatory changes were discussed with respect to changes in human health that result in disease and sickness.

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