1. Genetic variation implicates plasma angiopoietin-2 in the development of acute kidney injury sub-phenotypes
- Author
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David C. Christiani, Max Cohen, Sina A. Gharib, Mark M. Wurfel, Eric D. Morrell, Jonathan Himmelfarb, Kathleen D. Liu, Xin-Ya Chai, W. Conrad Liles, Joseph A.C. Delaney, Pavan K. Bhatraju, Robin M. Nance, Jason D. Christie, Susanna Kosamo, Carmen Mikacenic, Ryan J. Nagao, Victoria Dmyterko, and Ying Zheng
- Subjects
0301 basic medicine ,Oncology ,Nephrology ,Male ,Kidney Disease ,Type I ,lcsh:RC870-923 ,urologic and male genital diseases ,0302 clinical medicine ,Receptors ,2.1 Biological and endogenous factors ,Endothelial dysfunction ,Aetiology ,Acute kidney injury ,Single Nucleotide ,Acute Kidney Injury ,Middle Aged ,Urology & Nephrology ,medicine.anatomical_structure ,Receptors, Tumor Necrosis Factor, Type I ,Tumor necrosis factor alpha ,Female ,Research Article ,Adult ,medicine.medical_specialty ,Endothelium ,Critical Illness ,Clinical Sciences ,Renal and urogenital ,In Vitro Techniques ,Polymorphism, Single Nucleotide ,White People ,Angiopoietin-2 ,03 medical and health sciences ,Internal medicine ,medicine ,Angiopoietin-1 ,Genetics ,Humans ,Genetic Predisposition to Disease ,Allele ,Polymorphism ,Aged ,business.industry ,Human Genome ,Endothelial Cells ,030208 emergency & critical care medicine ,Odds ratio ,medicine.disease ,lcsh:Diseases of the genitourinary system. Urology ,Minor allele frequency ,030104 developmental biology ,Microvessels ,business ,Tumor Necrosis Factor - Abstract
Background We previously identified two acute kidney injury (AKI) sub-phenotypes (AKI-SP1 and AKI-SP2) with different risk of poor clinical outcomes and response to vasopressor therapy. Plasma biomarkers of endothelial dysfunction (tumor necrosis factor receptor-1, angiopoietin-1 and 2) differentiated the AKI sub-phenotypes. However, it is unknown whether these biomarkers are simply markers or causal mediators in the development of AKI sub-phenotypes. Methods We tested for associations between single-nucleotide polymorphisms within the Angiopoietin-1, Angiopoietin-2, and Tumor Necrosis Factor Receptor 1A genes and AKI- SP2 in 421 critically ill subjects of European ancestry. Top performing single-nucleotide polymorphisms (FDR Results A genetic variant, rs2920656C > T, near ANGPT2 was associated with reduced risk of AKI-SP2 (odds ratio, 0.45; 95% CI, 0.31–0.66; adjusted FDR = 0.003) and decreased plasma angiopoietin-2 (p = 0.002). Causal inference analysis showed that for each minor allele (T) the risk of developing AKI-SP2 decreases by 16%. Plasma angiopoietin-2 mediated 41.5% of the rs2920656 related risk for AKI-SP2. Human kidney microvascular endothelial cells carrying the T allele of rs2920656 produced numerically lower levels of angiopoietin-2 although this was not statistically significant (p = 0.07). Finally, analyses demonstrated that angiopoietin-2 is minimally renally cleared in critically ill subjects. Conclusion Genetic mediation analysis provides supportive evidence that angiopoietin-2 plays a causal role in risk for AKI-SP2.
- Published
- 2020