Potassium Channels, Inwardly Rectifying

钾通道,内部整流
  • 文章类型: Journal Article
    背景:KCNJ16基因与一种新的肾小管病表型相关,viz.酸碱稳态受干扰,低钾血症和肾盐转运改变。KCNJ16编码Kir5.1,与Kir4.1一起构成位于肾小管细胞基底外侧膜的钾通道。临床前研究提供了Kir5.1和肾小管病之间的机制联系,然而,该疾病的病理学仍然知之甚少。这里,我们的目的是产生和表征一种新的先进的体外人类肾脏模型,该模型概括了疾病表型,以进一步研究肾小管病的病理生理机制和潜在的治疗干预措施。
    方法:我们使用CRISPR/Cas9从健康人诱导多能干细胞(iPSC)KCNJ16对照(KCNJ16WT)产生KCNJ16突变体(KCNJ16+/-和KCNJ16-/-)细胞系。iPSC按照优化方案在气-液界面中分化为肾脏类器官。
    结果:KCNJ16耗尽的肾脏类器官显示关键电压依赖性电解质和水平衡转运蛋白的转录组和潜在功能损害。我们观察到囊肿形成,Kir5.1功能丧失后的脂滴积累和纤维化。此外,大规模,谷氨酰胺示踪通量代谢组学分析表明,KCNJ16-/-类器官表现出TCA循环和脂质代谢障碍。药物筛选显示他汀类药物治疗,特别是辛伐他汀和C75的联合使用可防止KCNJ16-/-肾类器官中的脂滴积累和胶原蛋白I沉积。
    结论:成熟的肾脏类器官代表了研究Kir5.1功能的相关体外模型。我们发现了这种遗传性肾小管病的新分子靶标,并将他汀类药物确定为肾脏KCNJ16缺陷的潜在治疗策略。
    BACKGROUND: The KCNJ16 gene has been associated with a novel kidney tubulopathy phenotype, viz. disturbed acid-base homeostasis, hypokalemia and altered renal salt transport. KCNJ16 encodes for Kir5.1, which together with Kir4.1 constitutes a potassium channel located at kidney tubular cell basolateral membranes. Preclinical studies provided mechanistic links between Kir5.1 and tubulopathy, however, the disease pathology remains poorly understood. Here, we aimed at generating and characterizing a novel advanced in vitro human kidney model that recapitulates the disease phenotype to investigate further the pathophysiological mechanisms underlying the tubulopathy and potential therapeutic interventions.
    METHODS: We used CRISPR/Cas9 to generate KCNJ16 mutant (KCNJ16+/- and KCNJ16-/-) cell lines from healthy human induced pluripotent stem cells (iPSC) KCNJ16 control (KCNJ16WT). The iPSCs were differentiated following an optimized protocol into kidney organoids in an air-liquid interface.
    RESULTS: KCNJ16-depleted kidney organoids showed transcriptomic and potential functional impairment of key voltage-dependent electrolyte and water-balance transporters. We observed cysts formation, lipid droplet accumulation and fibrosis upon Kir5.1 function loss. Furthermore, a large scale, glutamine tracer flux metabolomics analysis demonstrated that KCNJ16-/- organoids display TCA cycle and lipid metabolism impairments. Drug screening revealed that treatment with statins, particularly the combination of simvastatin and C75, prevented lipid droplet accumulation and collagen-I deposition in KCNJ16-/- kidney organoids.
    CONCLUSIONS: Mature kidney organoids represent a relevant in vitro model for investigating the function of Kir5.1. We discovered novel molecular targets for this genetic tubulopathy and identified statins as a potential therapeutic strategy for KCNJ16 defects in the kidney.
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  • 文章类型: Journal Article
    年轻人的成熟型糖尿病(MODY)是单基因糖尿病(MD)异质性组的一部分,其特征是胰腺β细胞的非免疫功能障碍。MODY的诊断仍然是临床医生的挑战,许多病例被误诊为1型或2型糖尿病(T1DM/T2DM),超过80%的病例仍未确诊。随着现代技术的引入,在破译MD的分子机制和异质性病因方面取得了重要进展,包括MODY。我们研究的目的是在一组临床怀疑MD的早发性糖尿病/前驱糖尿病患者中鉴定与MODY相关的遗传变异。基因检测,基于下一代测序(NGS)技术,要么是有针对性地进行的,使用单基因糖尿病的基因面板,或通过分析整个外显子组(全外显子组测序)。GKC-MODY2是最常见的变异体,但是KCNJ11-MODY13的罕见形式,特别是,还鉴定了HNF4A-MODY1。我们强调了基因检测对早期诊断的重要性,MODY亚型分化,和遗传咨询。我们提出了基因型-表型相关性,特别是与临床进化和个性化治疗有关,还强调了每个患者在家庭环境中的特殊性。
    Maturity-onset diabetes of the young (MODY) is part of the heterogeneous group of monogenic diabetes (MD) characterized by the non-immune dysfunction of pancreatic β-cells. The diagnosis of MODY still remains a challenge for clinicians, with many cases being misdiagnosed as type 1 or type 2 diabetes mellitus (T1DM/T2DM), and over 80% of cases remaining undiagnosed. With the introduction of modern technologies, important progress has been made in deciphering the molecular mechanisms and heterogeneous etiology of MD, including MODY. The aim of our study was to identify genetic variants associated with MODY in a group of patients with early-onset diabetes/prediabetes in whom a form of MD was clinically suspected. Genetic testing, based on next-generation sequencing (NGS) technology, was carried out either in a targeted manner, using gene panels for monogenic diabetes, or by analyzing the entire exome (whole-exome sequencing). GKC-MODY 2 was the most frequently detected variant, but rare forms of KCNJ11-MODY 13, specifically, HNF4A-MODY 1, were also identified. We have emphasized the importance of genetic testing for early diagnosis, MODY subtype differentiation, and genetic counseling. We presented the genotype-phenotype correlations, especially related to the clinical evolution and personalized therapy, also emphasizing the particularities of each patient in the family context.
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  • 文章类型: Journal Article
    当前的麻醉理论主要基于神经元和/或神经元回路。星形胶质细胞的作用也被证明在促进挥发性麻醉的恢复中,而星形胶质细胞的确切调节机制和/或分子靶标仍然未知。在这项研究中,通过雄性小鼠的动物模型和体内和体外的电生理记录,我们发现激活室丘脑旁星形胶质细胞(PVT)和/或击倒PVT星形胶质细胞Kir4.1促进七氟醚麻醉后的意识恢复。PVT的单细胞RNA测序揭示了谷氨酸能神经元的两种不同的细胞亚型:PVTGRM和PVTChAT神经元。膜片钳记录结果证明星形细胞Kir4.1介导的七氟醚对PVT的调节主要作用于PVTChAT神经元,这主要是对mPFC的预测。总之,我们的研究结果支持了一个新的概念,即七氟醚麻醉的意识恢复涉及一个特定的PVT-前额叶皮质投射,七氟醚对PVT星形细胞Kir4.1电导的抑制作用。重要性声明挥发性麻醉剂的工作原理尚未完全了解。这里,我们证明,常用的挥发性麻醉剂七氟醚可以抑制PVT中星形细胞的Kir4.1电导,增强PVT神经元的神经元放电。此外,通过单细胞测序,PVT中的胆碱能神经元(PVTChAT)是挥发性麻醉中星形细胞调节的神经元基质,直接投射到前额叶皮层。行为上,星形胶质细胞对PVTChAT的调节促进了前额叶皮层的脑电图(EEG)过渡;然后加速了七氟醚麻醉的出现。总之,这项研究是首次确定觉醒核中星形细胞Kir4.1参与挥发性麻醉药的意识恢复,以及亚细胞机制。
    Current anesthetic theory is mostly based on neurons and/or neuronal circuits. A role for astrocytes also has been shown in promoting recovery from volatile anesthesia, while the exact modulatory mechanism and/or the molecular target in astrocytes is still unknown. In this study by animal models in male mice and electrophysiological recordings in vivo and in vitro, we found that activating astrocytes of the paraventricular thalamus (PVT) and/or knocking down PVT astrocytic Kir4.1 promoted the consciousness recovery from sevoflurane anesthesia. Single-cell RNA sequencing of the PVT reveals two distinct cellular subtypes of glutamatergic neurons: PVT GRM and PVT ChAT neurons. Patch-clamp recording results proved astrocytic Kir4.1-mediated modulation of sevoflurane on the PVT mainly worked on PVT ChAT neurons, which projected mainly to the mPFC. In summary, our findings support the novel conception that there is a specific PVT→prefrontal cortex projection involved in consciousness recovery from sevoflurane anesthesia, which is mediated by the inhibition of sevoflurane on PVT astrocytic Kir4.1 conductance.
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  • 文章类型: Journal Article
    比较有和没有贝伐单抗(BEV)和曲安奈德(TA)的猪的视网膜分支静脉阻塞(BRVO)后的基因表达变化。
    在四组九只猪(2、6、10和20天)的双眼中产生光血栓BRVO。在每一组中,六只猪一只眼睛接受了BEV的玻璃体内注射,另一只眼睛接受了TA注射,三只猪作为未经治疗的BRVO对照。三只未处理的猪作为健康对照。血管内皮生长因子(VEGF)mRNA的表达胶质纤维酸性蛋白(GFAP),肌营养不良蛋白(DMD),钾向内整流通道亚家族J成员10蛋白(Kir4.1,KCNJ10),水通道蛋白-4(AQP4),基质细胞衍生因子-1α(CXCL12),白细胞介素-6(IL6),白细胞介素-8(IL8),单核细胞趋化蛋白-1(CCL2),细胞间粘附分子1(ICAM1),通过定量逆转录聚合酶链反应分析热休克因子1(HSF1)。通过免疫组织化学表征视网膜VEGF蛋白水平。
    在未经治疗的眼睛中,BRVO显著增加GFAP的表达,IL8、CCL2、ICAM1、HSF1和AQP4。VEGF的表达,KCNJ10和CXCL12在BRVO后6天显着减少,表达在第20天恢复至健康对照水平。用BEV或TA治疗显著增加VEGF,DMD,与未经治疗的BRVO眼相比,IL6表达和抑制BRVO诱导的CCL2和AQP4上调,以及KCNJ10表达的恢复,在BRVO后10到20天。
    炎症和细胞渗透稳态而不是VEGF抑制似乎在BRVO诱导的视网膜神经变性中起重要作用,在BEV和TA处理的视网膜中增强。
    在这种BRVO急性模型中看到的内部视网膜神经变性似乎是由炎症和渗透稳态的改变而不是VEGF抑制介导的,这可能对BRVO急性期更具体的治疗方式有影响。
    UNASSIGNED: To compare gene expression changes following branch retinal vein occlusion (BRVO) in the pig with and without bevacizumab (BEV) and triamcinolone acetonide (TA).
    UNASSIGNED: Photothrombotic BRVOs were created in both eyes of four groups of nine pigs (2, 6, 10, and 20 days). In each group, six pigs received intravitreal injections of BEV in one eye and TA in the fellow eye, with three pigs serving as untreated BRVO controls. Three untreated pigs served as healthy controls. Expression of mRNA of vascular endothelial growth factor (VEGF), glial fibrillary acidic protein (GFAP), dystrophin (DMD), potassium inwardly rectifying channel subfamily J member 10 protein (Kir4.1, KCNJ10), aquaporin-4 (AQP4), stromal cell-derived factor-1α (CXCL12), interleukin-6 (IL6), interleukin-8 (IL8), monocyte chemoattractant protein-1 (CCL2), intercellular adhesion molecule 1 (ICAM1), and heat shock factor 1 (HSF1) were analyzed by quantitative reverse-transcription polymerase chain reaction. Retinal VEGF protein levels were characterized by immunohistochemistry.
    UNASSIGNED: In untreated eyes, BRVO significantly increased expression of GFAP, IL8, CCL2, ICAM1, HSF1, and AQP4. Expression of VEGF, KCNJ10, and CXCL12 was significantly reduced by 6 days post-BRVO, with expression recovering to healthy control levels by day 20. Treatment with BEV or TA significantly increased VEGF, DMD, and IL6 expression compared with untreated BRVO eyes and suppressed BRVO-induced CCL2 and AQP4 upregulation, as well as recovery of KCNJ10 expression, at 10 to 20 days post-BRVO.
    UNASSIGNED: Inflammation and cellular osmohomeostasis rather than VEGF suppression appear to play important roles in BRVO-induced retinal neurodegeneration, enhanced in both BEV- and TA-treated retinas.
    UNASSIGNED: Inner retinal neurodegeneration seen in this acute model of BRVO appears to be mediated by inflammation and alterations in osmohomeostasis rather than VEGF inhibition, which may have implications for more specific treatment modalities in the acute phase of BRVO.
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  • 文章类型: Journal Article
    肾上皮对血钾(K)的变化敏感。我们确定了基底外侧K+通道,Kir4.2,作为近端小管对K缺乏反应的介质。缺乏Kir4.2的小鼠具有补偿的基线表型,由此它们增加其远端转运负担以维持体内平衡。在膳食K+耗尽后,敲除动物代偿失调,如尿K排泄增加和近端肾小管酸中毒的发展所证明。钾消耗不是近端起源,而是由较高的ENaC活性引起的,并且取决于远端钠递送的增加。三维成像显示Kir4.2敲除未能进行近端小管扩张,而远曲小管反应被夸大了。AKT信号介导膳食K+反应,在Kir4.2淘汰赛中被钝化。最后,我们在分离的小管中证明,响应于低K的AKT磷酸化取决于通过Cl-转运的次级变化而激活的mTORC2。数据支持细胞Cl-的近端作用,就像它沿着远端肾单位一样,响应K+变化以激活激酶信号传导。
    The renal epithelium is sensitive to changes in blood potassium (K+). We identify the basolateral K+ channel, Kir4.2, as a mediator of the proximal tubule response to K+ deficiency. Mice lacking Kir4.2 have a compensated baseline phenotype whereby they increase their distal transport burden to maintain homeostasis. Upon dietary K+ depletion, knockout animals decompensate as evidenced by increased urinary K+ excretion and development of a proximal renal tubular acidosis. Potassium wasting is not proximal in origin but is caused by higher ENaC activity and depends upon increased distal sodium delivery. Three-dimensional imaging reveals Kir4.2 knockouts fail to undergo proximal tubule expansion, while the distal convoluted tubule response is exaggerated. AKT signaling mediates the dietary K+ response, which is blunted in Kir4.2 knockouts. Lastly, we demonstrate in isolated tubules that AKT phosphorylation in response to low K+ depends upon mTORC2 activation by secondary changes in Cl- transport. Data support a proximal role for cell Cl- which, as it does along the distal nephron, responds to K+ changes to activate kinase signaling.
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  • 文章类型: Journal Article
    树突在多种临床病症中受伤,例如创伤性脑和脊髓损伤以及中风。神经元如何直接检测其树突的损伤以启动促再生反应尚未得到彻底研究。钙在轴突损伤检测的早期阶段中起着至关重要的作用,并且对于切断的轴突的再生也是必不可少的。这里,我们报道了激光损伤诱导的细胞内钙水平升高的细胞和神经突类型特异性差异。使用人类KCNJ2转基因,我们证明,只有在损伤时,超极化神经元才会抑制树突再生,表明抑制损伤诱导的膜去极化(以及早期钙流入)在检测和响应树突损伤中起作用。在探索潜在的下游钙调节效应物中,我们确定了L型电压门控钙通道,肌醇三磷酸信号,和蛋白激酶D活性是枝晶再生的驱动因素。总之,我们证明,树突损伤引起的钙升高在树突的再生反应中起关键作用,并开始描述控制树突修复的分子机制。
    Dendrites are injured in a variety of clinical conditions such as traumatic brain and spinal cord injuries and stroke. How neurons detect injury directly to their dendrites to initiate a pro-regenerative response has not yet been thoroughly investigated. Calcium plays a critical role in the early stages of axonal injury detection and is also indispensable for regeneration of the severed axon. Here, we report cell and neurite type-specific differences in laser injury-induced elevations of intracellular calcium levels. Using a human KCNJ2 transgene, we demonstrate that hyperpolarizing neurons only at the time of injury dampens dendrite regeneration, suggesting that inhibition of injury-induced membrane depolarization (and thus early calcium influx) plays a role in detecting and responding to dendrite injury. In exploring potential downstream calcium-regulated effectors, we identify L-type voltage-gated calcium channels, inositol triphosphate signaling, and protein kinase D activity as drivers of dendrite regeneration. In conclusion, we demonstrate that dendrite injury-induced calcium elevations play a key role in the regenerative response of dendrites and begin to delineate the molecular mechanisms governing dendrite repair.
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  • 文章类型: Journal Article
    气孔控制着叶片和外部大气之间的气体交换,它们的功能对于光合作用和全球碳氧循环至关重要。日常黑暗/光照周期中的有节奏的气孔运动可防止夜间水分流失,并允许白天吸收CO2。所涉及的参与者是如何被转录调节的,以及这可能如何导致节律性,在很大程度上是未知的。这里,我们显示早晨气孔的开放取决于前一天晚上。转录因子植物铬相互作用因子(PIFs)在夜晚结束时积累并直接诱导保卫细胞特异性K+通道KAT1。值得注意的是,蓝光诱导的气孔开放需要PIF和KAT1。一起,我们的数据为水分充足的条件下的每日节律性气孔运动建立了分子框架,因此,在夜间积累KAT1需要PIF,在早晨被蓝光激活后,会导致K+摄入量驱动气孔打开。
    Stomata govern the gaseous exchange between the leaf and the external atmosphere, and their function is essential for photosynthesis and the global carbon and oxygen cycles. Rhythmic stomata movements in daily dark/light cycles prevent water loss at night and allow CO2 uptake during the day. How the actors involved are transcriptionally regulated and how this might contribute to rhythmicity is largely unknown. Here, we show that morning stomata opening depends on the previous night period. The transcription factors PHYTOCHROME-INTERACTING FACTORS (PIFs) accumulate at the end of the night and directly induce the guard cell-specific K+ channel KAT1. Remarkably, PIFs and KAT1 are required for blue light-induced stomata opening. Together, our data establish a molecular framework for daily rhythmic stomatal movements under well-watered conditions, whereby PIFs are required for accumulation of KAT1 at night, which upon activation by blue light in the morning leads to the K+ intake driving stomata opening.
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  • 文章类型: Case Reports
    先天性高胰岛素血症(CHI)是一种罕见的葡萄糖代谢障碍,是严重和持续低血糖的最常见原因(高胰岛素血症性低血糖,HH)在新生儿期和儿童期。大多数病例是由编码ATP敏感性钾通道(KATP)的ABCC8和KCNJ11基因突变引起的。我们介绍了ABCC8基因突变引起的早发性HH患者的遗传异质性与可变表型之间的相关性。在第一个病人中,从生命的第一天起就出现了持续的严重低血糖,分子遗传学测试表明ABCC8基因中存在纯合突变[ABCC8基因c.(23901_2391-1)_(33291_3330-1)del中的缺失],这与弥漫性高胰岛素血症(父母是健康的杂合携带者)有关。第二个病人,发病在生命的第三天,伴有严重的低血糖,和遗传测试确定了ABCC8基因c.1792C>T中的杂合突变(p。Arg598*)继承了父系,这导致了高胰岛素血症的局灶性形式的诊断。为了定位局灶性病变,(18)建议使用F-DOPA(3,4-二羟基-6-[18F]氟-L-苯丙氨酸)正电子发射断层扫描/计算机断层扫描(PET/CT)(该国无法进行的调查),但是父母拒绝在国外进行调查。在这种情况下,早期手术治疗可以治愈。此外,第二个孩子也出现继发性肾上腺功能不全,需要替代治疗.同时,她出现了早期复发性癫痫发作,需要抗癫痫治疗。我们强调分子基因检测对诊断的重要性,HH患者的管理和遗传咨询。
    Congenital hyperinsulinism (CHI) is a rare disorder of glucose metabolism and is the most common cause of severe and persistent hypoglycemia (hyperinsulinemic hypoglycemia, HH) in the neonatal period and childhood. Most cases are caused by mutations in the ABCC8 and KCNJ11 genes that encode the ATP-sensitive potassium channel (KATP). We present the correlation between genetic heterogeneity and the variable phenotype in patients with early-onset HH caused by ABCC8 gene mutations. In the first patient, who presented persistent severe hypoglycemia since the first day of life, molecular genetic testing revealed the presence of a homozygous mutation in the ABCC8 gene [deletion in the ABCC8 gene c.(2390+1_2391-1)_(3329+1_3330-1)del] that correlated with a diffuse form of hyperinsulinism (the parents being healthy heterozygous carriers). In the second patient, the onset was on the third day of life with severe hypoglycemia, and genetic testing identified a heterozygous mutation in the ABCC8 gene c.1792C>T (p.Arg598*) inherited on the paternal line, which led to the diagnosis of the focal form of hyperinsulinism. To locate the focal lesions, (18)F-DOPA (3,4-dihydroxy-6-[18F]fluoro-L-phenylalanine) positron emission tomography/computed tomography (PET/CT) was recommended (an investigation that cannot be carried out in the country), but the parents refused to carry out the investigation abroad. In this case, early surgical treatment could have been curative. In addition, the second child also presented secondary adrenal insufficiency requiring replacement therapy. At the same time, she developed early recurrent seizures that required antiepileptic treatment. We emphasize the importance of molecular genetic testing for diagnosis, management and genetic counseling in patients with HH.
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  • 文章类型: Journal Article
    在糖尿病进展期间,由于对ATP敏感的钾通道丢失,β细胞功能障碍,称为KATP通道,发生有助于高血糖。这项研究的目的是研究在高脂肪(HFD)喂养的饮食诱导的肥胖小鼠模型中,神经系统中KATP通道的表达或活性是否发生了变化。两个KATP通道亚基的表达,Kcnj11(Kir6.2)和Abcc8(SUR1),在HFD小鼠的外周和中枢神经系统中减少,这与机械缩爪阈值显着相关。与对照饮食(CON)小鼠相比,HFD小鼠对全身性吗啡的抗伤害感受降低,这是预期的,因为KATP通道是阿片受体的下游靶标。用格列本脲或那格列奈全身治疗后,HFD小鼠的机械性超敏反应加剧,临床上用于控制血糖水平的KATP通道拮抗剂。通过鞘内递送的腺病毒上调SUR1和Kir6.2,HFD小鼠吗啡抗伤害感受增加,.这些数据显示了KATP通道功能与糖尿病早期神经病变之间的潜在联系。需要增加糖尿病如何影响神经系统结构和分子变化的知识,包括离子通道,导致慢性疼痛和感觉问题的进展。
    During diabetes progression, β-cell dysfunction due to loss of potassium channels sensitive to ATP, known as KATP channels, occurs, contributing to hyperglycemia. The aim of this study was to investigate if KATP channel expression or activity in the nervous system was altered in a high-fat diet (HFD)-fed mouse model of diet-induced obesity. Expression of two KATP channel subunits, Kcnj11 (Kir6.2) and Abcc8 (SUR1), were decreased in the peripheral and central nervous system of mice fed HFD, which was significantly correlated with mechanical paw-withdrawal thresholds. HFD mice had decreased antinociception to systemic morphine compared with control diet (CON) mice, which was expected because KATP channels are downstream targets of opioid receptors. Mechanical hypersensitivity in HFD mice was exacerbated after systemic treatment with glyburide or nateglinide, KATP channel antagonists clinically used to control blood glucose levels. Upregulation of SUR1 and Kir6.2, through an adenovirus delivered intrathecally, increased morphine antinociception in HFD mice. These data present a potential link between KATP channel function and neuropathy during early stages of diabetes. There is a need for increased knowledge of how diabetes affects structural and molecular changes in the nervous system, including ion channels, to lead to the progression of chronic pain and sensory issues.
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  • 文章类型: Journal Article
    背景:先前的研究强调了抗糖尿病药物在抑制慢性阻塞性肺疾病(COPD)恶化方面的潜在益处,然而,抗糖尿病药物对COPD风险的作用仍不确定.
    方法:本研究采用孟德尔随机化(MR)方法来评估与六类抗糖尿病药物靶标相关的遗传变异与COPD的因果关系。COPD的主要结局来自全球生物库Meta分析倡议(GBMI)联盟,包括对12个队列的荟萃分析,包括81,568例病例和1,310,798例对照。HbA1c的汇总数据来自英国生物银行,涉及344182人。对2型糖尿病(T2DM)进行阳性对照分析,以验证工具变量的选择。该研究应用基于摘要数据的MR(SMR)和双样本MR进行效果评估,并进一步采用共定位分析来验证遗传变异的证据。
    结果:SMR分析显示,血液中KCNJ11基因表达水平升高与COPD风险降低相关(OR=0.87,95%CI=0.79-0.95;p=0.002),而DPP4表达增加与COPD发病率增加相对应(OR=1.18,95%CI=1.03-1.35;p=0.022).此外,MR分析中的主要方法表明PPARG介导的HbA1c与FEV1(OR=1.07,95%CI=1.02-1.13;P=0.013)和FEV1/FVC(OR=1.08,95%CI=1.01-1.14;P=0.007)之间呈正相关,SLC5A2介导的HbA1c与FEV1/FVC呈负相关(OR=0.86,95%CI=0.74-1.00;P=0.045)。未检测到与结果表型的共定位证据(所有PP。H4<0.7)。
    结论:本研究为抗糖尿病药物在改善COPD和肺功能方面的作用提供了提示性证据。将来有必要进行进一步更新的MR分析,在获得更广泛和全面的数据之后,来验证我们的结果。
    BACKGROUND: Previous research has emphasized the potential benefits of anti-diabetic medications in inhibiting the exacerbation of Chronic Obstructive Pulmonary Disease (COPD), yet the role of anti-diabetic drugs on COPD risk remains uncertain.
    METHODS: This study employed a Mendelian randomization (MR) approach to evaluate the causal association of genetic variations related to six classes of anti-diabetic drug targets with COPD. The primary outcome for COPD was obtained from the Global Biobank Meta-analysis Initiative (GBMI) consortium, encompassing a meta-analysis of 12 cohorts with 81,568 cases and 1,310,798 controls. Summary-level data for HbA1c was derived from the UK Biobank, involving 344,182 individuals. Positive control analysis was conducted for Type 2 Diabetes Mellitus (T2DM) to validate the choice of instrumental variables. The study applied Summary-data-based MR (SMR) and two-sample MR for effect estimation and further adopted colocalization analysis to verify evidence of genetic variations.
    RESULTS: SMR analysis revealed that elevated KCNJ11 gene expression levels in blood correlated with reduced COPD risk (OR = 0.87, 95% CI = 0.79-0.95; p = 0.002), whereas an increase in DPP4 expression corresponded with an increased COPD incidence (OR = 1.18, 95% CI = 1.03-1.35; p = 0.022). Additionally, the primary method within MR analysis demonstrated a positive correlation between PPARG-mediated HbA1c and both FEV1 (OR = 1.07, 95% CI = 1.02-1.13; P = 0.013) and FEV1/FVC (OR = 1.08, 95% CI = 1.01-1.14; P = 0.007), and a negative association between SLC5A2-mediated HbA1c and FEV1/FVC (OR = 0.86, 95% CI = 0.74-1.00; P = 0.045). No colocalization evidence with outcome phenotypes was detected (all PP.H4 < 0.7).
    CONCLUSIONS: This study provides suggestive evidence for anti-diabetic medications\' role in improving COPD and lung function. Further updated MR analyses are warranted in the future, following the acquisition of more extensive and comprehensive data, to validate our results.
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