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The -323P0/P10 factor VII gene polymorphism and the risk of recurrent miscarriage

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(2)   . P R A C E O R Y G I N A L N E poł ożn i ct wo. The -323P0/P10 factor VII gene polymorphism and the risk of recurrent miscarriage Polimorfizm -323P0/P10 genu czynnika VII krzepnięcia a ryzyko poronień nawracających   

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(11) 4,5  " 4,5 # $ % 1,2 1 2 3 4 5. Department of Perinatology and Women’s Diseases, University of Medical Sciences, Poznan, Poland Laboratory of Molecular Biology in Division of Perinatology and Women’s Diseases, Poznan University of Medical Sciences, Poland Division of Gynecology and Obstetrics, Podhale Multidisciplinary Hospital, Nowy Targ, Poland Laboratory of Experimental Pharmacogenetics, Department of Clinical Pharmacy and Biopharmacy, University of Medical Sciences, Poznan, Poland Department of Quality Control of Medicinal Products and Dietary Supplements, Institute of Natural Fibres and Medicinal Plants, Poznan, Poland. Abstract Objectives: Genetically determined disturbances in the activity of coagulation factor VII may lead to obstetric complications. The aim of the study was to evaluate the correlation between -323P0/P10 factor VII gene polymorphism and the risk of recurrent miscarriage. Material and methods: The study group consisted of 152 women with a history of ≥2 miscarriages. The control group comprised 180 women with no history of miscarriage and ≥1 pregnancy who gave birth to a healthy newborn at term. The study group was further subdivided twice into two subgroups: 114 patients with a history of 2 miscarriages and 38 subjects with a history of ≥3 miscarriages, and 123 patients with miscarriages <13 gw. and 29 with miscarriages <21 gw. Genetic analysis was performed with the use of PCR/RFLP. Results: Overrepresentation of P0/P0 genotype and lower frequency of P0/P10 genotype was noted in the study group as compared to controls (P0/P0: 80,26 vs. 76,67%, p=0,25; P0/P10: 18,42 vs. 22,78%, p=0,20). A higher presentation of P0/P0 genotype and P0 allele, lower frequency of P0/P10 genotype and P10 allele was observed in the subgroup of women with ≥3 miscarriages as compared to controls (P0/P0: 86,84 vs. 76,67%, p=0,12; P0: 93,42 vs. 88,06%, p=0,12; P0/P10:13,16 vs. 22,78%, p=0,13; P10: 11,94 vs. 6,58%, p=0,12). Conclusions: The obtained results suggest a probable protective role of -323P10 allele against the risk of miscarriage in women with ≥3 recurrent pregnancy losses.. Key words:  

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(16) /    /. Corresponding author: Magdalena Barlik Department of Perinatology and Women’s Diseases University of Medical Sciences, Poznan, Poland ul. Polna 33, 60-535 Poznań, Poland tel. 0048 61 8419 613 e-mail: magda.barlik@op.pl. 594. Otrzymano: 12.12.2013 Zaakceptowano do druku: 02.03.2014. © Polskie Towarzystwo Ginekologiczne. Nr 8/2014.

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(18)   . P R A C E. O R Y G I N A L N E po ł o ż n i c t wo. Magdalena Barlik et al. The -323P0/P10 factor VII gene polymorphism and the risk of recurrent miscarriage.. Streszczenie Cel pracy: Genetycznie uwarunkowane zaburzenia aktywności VII czynnika krzepnięcia mogą prowadzić do powikłań położniczych. Celem pracy była ocena związku polimorfizmu -323P0/P10 genu czynnika VII krzepnięcia z występowaniem poronień nawracających. Materiał i metody: Do grupy badanej włączono 152 kobiety z wywiadem obciążonym wystąpieniem ≥2 poronień. Grupę kontrolną stanowiło 180 kobiet (≥1 ciąża zakończona urodzeniem zdrowego, donoszonego noworodka, brak poronień w wywiadzie). Grupę badaną dwukrotnie podzielono na dwie podgrupy (114 pacjentek z 2 poronieniami oraz 38 z ≥3 poronieniami, 123 pacjentki z poronieniami <13 tc. oraz 29 z poronieniami <21 tc.). Analizę genetyczną przeprowadzono przy użyciu metody PCR/RFLP. Wyniki: Odnotowano wyższą częstość genotypu P0/P0 oraz niższą P0/P10 w grupie badanej w porównaniu do kontroli (P0/P0: 80,26 vs. 76,67%, p=0,25; P0/P10: 18,42 vs. 22,78%, p=0,20). W podgrupie z ≥3 poronieniami zaobserwowano znacznie wyższą frekwencję genotypu P0/P0 i allela P0 oraz niższą częstość genotypu P0/P10 i allela P10 w porównaniu do kontroli (P0/P0: 86,84 vs. 76,67%, p=0,12; P0: 93,42 vs. 88,06%, p=0,12; P0/ P10:13,16 vs. 22,78%, p=0,13; P10: 11,94 vs. 6,58%, p=0,12). Wnioski: Analiza częstości występowania genotypów i alleli polimorfizmu insercyjno-delecyjnego -323P0/P10 genu czynnika VII krzepnięcia pozwala na założenie, że zmutowany insercyjny allel -323P10 odgrywa protekcyjną rolę w stosunku do występowania poronień u kobiet z 3 i więcej utratami ciąży.. Słowa kluczowe: 

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(434)   . P R A C E. O R Y G I N A L N E po ł o ż n i c t wo. Magdalena Barlik et al. The -323P0/P10 factor VII gene polymorphism and the risk of recurrent miscarriage.. Tab le I I . The frequency of genotypes and alleles of -323P0/P10 factor VII gene polymorphism in the study group and in the control group. Study group (n=152). -323P0/10. Genotypes. observed value n (%). Control group (n=180). expected value (%). observed value n (%). OR. 95%CI. p. 1,24. 0,73-2,10. 0,25. expected value (%). P0/P0. 122 (80,26). 80,05. 138 (76,67 ). 77,54. P0/P10. 28 (18,42). 18,84. 41 (22,78). 21,03. 0,77. 0,45-1,31. 0,20. P10/P10. 2 (1,32). 1,11. 1 (0,55). 1,43. 2,39. 0,21-26,58. 0,44. 152 (100,00). 100. 180 (100,00). 100. 272 (89,47). '. 317 (88,06). '. 1,15. 0,71-1,87. 0,33. 0,87. 0,53-1,41. 0,33. Suma Alleles P0 P10. 32 (10,53). '. 43 (11,94). '. Total. 304 (100,0). '. 360 (100,0). '. Tab le I I I . The frequency of genotypes and alleles of -323P0/P10 factor VII gene polymorphism in the subgroup of women with the history of 2 miscarriages and in the subgroup of women with a history of 3 or more miscarriages. Study group (n=152) -323P0/10. Genotypes. 2 miscarriages (n=114) observed value n (%). expected value (%). Control group (n=180). 3 or more miscarriages (n=38) OR. p. observed value n (%). expected value (%). OR. p. observed value n (%). expected value (%). P0/P0. 89 (78,07). 77,72. 1,08. 0,45. 33 (86,84). 87,27. 2,01. 0,12. 138 (76,67). 77,54. P0/P10. 23 (20,18). 20,88. 0,86. 0,35. 5 (13,16). 12,29. 0,51. 0,13. 41 (22,78). 21,03. P10/P10. 2 (1,75). 1,40. 3,20. 0,33. 0 (0,00). 0,43. '. 0,83. 1 (0,55). 1,43. 114 (100,0). 100,0. 38 (100,0). 100,0. 180 (100,00). 100. Total Alleles P0. 201 (88,16). '. 1,01. 0,54. 71 (93,42). '. 1,93. 0,12. 317 (88,06). '. P10. 27 (11,84). '. 0,99. 0,54. 5 (6,58). '. 0,52. 0,12. 43 (11,94). '. Total. 228 (100,0). '. 76 (100,0). '. 360 (100,0). '. *analyzed subgroups were compared to the control group. Tab le I V. The frequency of genotypes and alleles of -323P0/P10 factor VII gene polymorphism in the subgroup of women with the history of pregnancy losses only in the first trimester and in the subgroup of women with the history of pregnancy losses in the first and second trimester. Study group (n=152) -323P0/10. I trimester (n=123). Control group (n=180). I and II trimester (n=29). Genotypes. observed value n (%). expected value (%). OR. P. observed value n (%). expected value (%). OR. p. observed value n (%). expected value (%). P0/P0. 100 (81,30). 80,71. 1,32. 0,21. 22 (75,86). 77,32. 0,96. 0,54. 138 (76,67). 77,54. P0/P10. 21 (17,07). 18,26. 0,70. 0,14. 7 (24,14). 21,22. 1,08. 0,52. 41 (22,78). 21,03. P10/P10. 2 (1,63). 1,03. 2,96. 0,36. 0 (0,00). 1,46. '. 0,86. 1 (0,55). 1,43. 123 (100,0). 100. 29 (100,0). 100. 180 (100,00). 100. 221 (89,84). '. 1,20. 0,29. 51 (87,93). '. 0,99. 0,56. 317 (88,06). '. P10. 25 (10,16). '. 0,83. 0,29. 7 (12,07). '. 1,01. 0,56. 43 (11,94). '. Total. 246 (100,0). '. 58 (100,0). '. 360 (100,0). '. Total Alleles P0. *analyzed subgroups were compared to the control group. Nr 8/2014. © Polskie Towarzystwo Ginekologiczne. 597.

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(539)  

(540)   

(541)  )   

(542) * *

(543)   $   

(544) 

(545)  -.. ./ .70! ;* *  $ 

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(548) 

(549) 

(550)   * 

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(552) 

(553) 

(554)  

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(556) 

(557)  *  )

(558)  *  *  $   *

(559)  *  * =    *  

(560)   -323P0/P10 $ '66  ) )*

(561)     

(562) 

(563) ! (

(564)   !

(565) +

(566)  * $ > $ -323P0/P10  Arg353Gln ) )*

(567) 

(568)  /D< **   /.8 ** $ $  * "*

(569)  ))

(570) ! ;*

(571) 

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(573) +!  +  * 

(574)     = 

(575)  $    

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(578) 

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(589)    9) 

(590) 

(591)    9

(592) + * $ * Arg353Gln 

(593)  +

(594) !  -323P10    

(595) *   

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(598)    $ '66   + -.80! H  *  *

(599) * $ > $ *

(600)  P0/P0 )   $ > $ * 

(601)  P0/ P10 )

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(604) 

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(608)    + $ 

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(610) 

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(612)   )  * 

(613)  $ *  $ 

(614) 

(615) ! ;* 

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(618) 

(619) 

(620)  *  ) $  

(621) * 7    )  ! 

(622)  *

(623)   ) $    $ > $ *  -323P10    + @7/7P0/P10: .7.B vs. //EFU

(624)    HQVD?.  .DR B?F vs. ..<8U

(625)    HQVD?/ A!   * -323P0/P10 $ '66  ) )*

(626)  

(627) C * 

(628)  *  >  

(629)  $ $   

(630) 

(631) ! ;*

(632)  *)*

(633)     * 

(634)   * -323P0/P10 

(635)  +

(636)  

(637)   

(638)  

(639) * * +) $  

(640) + 

(641)  

(642) 

(643)   * 

(644)  *! *

(645)    

(646)  $ *  *   C

(647) 

(648) !  $ * 

(649)  =  * 9

(650)  $   

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(652)  

(653)  $ * 

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(660)  -< .? .B .E0!   ! ) $   

(661)  $ * 

(662) *

(663) )  $ '66  ) )*

(664)   *  -323P0/ P10 

(665)  +

(666)   *

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(668) 

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(670)  ))

(671) ! ;* 

(672) 

(673) ++ 7< 

(674)   $ *

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(676) ! ;*  

(677) 

(678) $ 

(679) 

(680)   

(681) 

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(683)   8/8D  ! &

(684)  * 

(685)  =  

(686) )   $ *  -323P10 

(687)  * 

(688)  $  

(689)  + 

(690)  -<0! ;*  $ :

(691) #*

(692) $  !  ) + * 

(693) *

(694) )  * -323P0/P10 $ '66  ) )*

(695)   *

(696)  $ * 

(697)  *! ;*   ) 

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(699)  

(700) *   

(701) + 

(702)  *  7./ ** :    

(703)  *    )! ;* $ '66    

(704)  +  

(705) 

(706)  

(707) 

(708) = *

(709) *

(710)  *   )!  +  *

(711)   

(712)   )

(713) 

(714) +   

(715) * * +

(716)  $ * 

(717) ! ;* 

(718)  

(719)  + * 

(720)   $ -323P10   

(721)  *  ) $

(722)  

(723)  $   

(724) + 

(725)   *

(726)  

(727)  +

(728)  

(729)   * * $ '66    

(730)  + -.?0! ;* 

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(732)   !   + *  

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(734)  

(735) * *

(736)  $  

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(739) 

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(741)   8?   $ 

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(745)  /BB )

(746)   8?   $  

(747) *  )

(748) 

(749) + *

(750)   $  

(751) 

(752) $ 

(753) ! ;*    ) 

(754)  $ .7E ** : X 8?   $ !   

(755)  $  

(756) 

(757) $ 

(758)   

(759)  * 

(760)   $ *  -323P10 ! ;*

(761)  = . © Polskie Towarzystwo Ginekologiczne. Nr 8/2014.

(762)  

(763)   . P R A C E. O R Y G I N A L N E po ł o ż n i c t wo. Magdalena Barlik et al. The -323P0/P10 factor VII gene polymorphism and the risk of recurrent miscarriage..   

(764)   * -323P0/P10 

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(767) 

(768) 

(769)   * 

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(771)    

(772) *  +

(773)  $ *  * !  

(774)   ! * * * )  $  323P10 

(775)   *

(776)  $ * 

(777)  *! ;*    ) 

(778) +  $ -323P10  

(779)  *

(780)  $  

(781) 

(782) $ 

(783)  -.B0! 

(784) 

(785)   +

(786)        ! ;*

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(788)    ) $ .D/D )

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(792)  )*

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(794) 

(795) ! ;*    ) 

(796)  $ .../ ** + ! M

(797)  

(798) 

(799) +

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(801) ! ;* 

(802)   =  * ) 

(803) +  $ -323P10 

(804)  * 

(805)  $       

(806)  -.E0!. Conclusions ;* 

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(808)  +  )  ) 

(809) +  $  -323P10  

(810)  *

(811)  $   

(812) 

(813) 

(814)   

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(816) +  *

(817)     ) 

(818) 

(819)    =  *  +  

(820) !  + 

(821) C $ * 

(822)   +

(823)  $  *    

(824)  

(825)  

(826) !. References 1. Soldo V, Cutura N, Zamurovic M. Defect of methylenetetrahydrofolate reductase in a patient with ten habitual miscarriages: a case report. Clin Exp Obstet Gynecol. 2012, 39, 556-558. 2. Mierla D, Szmal C, Neagos D, [et al.]. D. Association of Prothrombin (A20210G) and Factor V Leiden (A506G) with Recurrent Pregnancy Loss. Maedica (Buchar). 2012, 7, 222-226. 3. Seremak-Mrozikiewicz A, Drews K, Kurzawińska G, [et al.]. Związek polimorfizmu Arg353Gln czynnika VII krzepnięcia z poronieniami nawracającymi. Ginekol Pol. 2009, 80, 8-13. 4. Barlik M, Seremak-Mrozikiewicz A, Kraśnik W, Drews K. Polimorfizmy 20210G>A i 19911A>G genu protrombiny a występowanie poronień nawracających. Ginekol Pol. 2013, 84, 830-834. 5. Mrozikiewicz PM, Cascorbi I, Ziemer S, [et al.]. Reduced procedural risk for coronary catheter interventions in carriers of the coagulation factor VII-Gln353 gene. J Am Coll Cardiol. 2000, 36, 1520-1525. 6. Nour M, Slama FB, Maaroufi RM, [et al.]. Factor VII polymorphisms associated with plasma factor VII coagulant activity levels in healthy Tunisians. East Mediterr Health J. 2005, 11, 102108. 7. Sacchi E, Tagliabue L, Scoglio R, [et al.]. Plasma factor VII levels are influenced by a polymorphism in the promoter region of the FVII gene. Blood Coagul Fibrinolysis. 1996, 7, 1147. 8. Humphries S, Temple A, Lane A, [et al.]. Low plasma levels of factor VIIc and antigen are more strongly associated with the 10 base pair promoter (-323) insertion than the glutamine 353 variant. Thromb Haemost. 1996, 75, 567-572. 9. Mo X, Hao Y, Yang X, [et al.]. Association between polymorphisms in the coagulation factor VII gene and coronary heart disease risk in different ethnicities: a metaanalysis. BMC Med Genet. 2011, 12, 107. 10. van ‚t Hooft FM, Silveira A, Tornvall P, [et al.]. Two common functional polymorphisms in the promoter region of the coagulation factor VII gene determining plasma factor VII activity and mass concentration. Blood. 1999, 93, 3432-3441. 11. Varga E. Inherited thrombophilia: key points for genetic counseling. J Genet Couns. 2007, 16, 261-277. 12. de Jong PG, Goddijn M, Middeldorp S. Testing for inherited thrombophilia in recurrent miscarriage. Semin Reprod Med. 2011, 29, 540-547. doi: 10.1055/s-0031-1293207 13. Bradley LA, Palomaki GE, Bienstock J, [et al.]. Can Factor V Leiden and prothrombin G20210A testing in women with recurrent pregnancy loss result in improved pregnancy outcomes?: Results from a targeted evidence-based review. Genet Med. 2012, 14, 39-50. doi: 10.1038/ gim.0b013e31822e575b 14. Liu Y, Heng CK, Saha N, [et al.]. Genotype associations of factor VII gene with plasma factor VII coagulant activity and antigen levels in healthy Chinese. Blood Coagul Fibrinolysis. 2002, 13, 217-224. 15. Ben-Hadj-Khalifa S, Lakhal B, Nsiri B, [et al.]. Factor VII levels, R353Q and -323P0/10 Factor VII variants, and the risk of acute coronary syndrome among Arab-African Tunisians. Mol Biol Rep. 2013, 40, 3793-3798.. Oświadczenie autorów: 1. Magdalena Barlik – autor koncepcji i założeń pracy, przygotowanie manuskryptu i piśmiennictwa, autor analizy i interpretacji wyników – autor zgłaszający i odpowiedzialny za manuskrypt. 2. Agnieszka Seremak-Mrozikiewicz – zebranie materiału, analiza statystyczna wyników, interpretacja wyników, przygotowanie manuskryptu. 3. Hubert Wolski – korekta i aktualizacja literatury. 4. Anna Bogacz – autor analizy i interpretacji wyników. 5. Przemysław M. Mrozikiewicz – opracowanie koncepcji i założeń badania, opracowanie wyników badań. 6. Bogusław Czerny – opracowanie wyników badań. 7. Krzysztof Drews – ostateczna weryfikacja I akceptacja manuskryptu.. 16. Sakowicz A, Fendler W, Lelonek M, [et al.]. Two polymorphisms of the FVII gene and their impact on the risk of myocardial infarction in poles under 45 years of age. Mol Biol (Mosk). 2010, 44, 229-234. 17. Huang H, Jia S, Chen S, [et al.]. The coagulation factor VII gene polymorphisms in patients with myocardial infarction in Ningxia Hui and Han population. Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2009, 26, 653-658.. Źródło finansowania: Badania statutowe Kliniki Perinatologii i Chorób Kobiecych UM w Poznaniu. Konflikt interesów: Autorzy nie zgłaszają konfliktu interesów oraz nie otrzymali żadnego wynagrodzenia związanego z powstawaniem pracy.. Nr 8/2014. © Polskie Towarzystwo Ginekologiczne. 599.

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