Received: 30 May 2018; Published on-line: 30 August 2018
Predicting the development and progression of primary open-angle glaucoma based on the determination of GST gene polymorphisms
S.O. Rykov1, Dr Sc (Med), Prof., A.V. Burdei1, Postgraduate, S.V. Ziablitsev2, Dr Sc (Med), Prof., S.Yu. Mogilevskyy1, Dr Sc (Med), Prof.
1 Shupik National Medical Academy of Postgraduate Education; Kyiv (Ukraine)
2 Bohomolets National Medical University; Kyiv (Ukraine)
Background: Epidemiological studies have demonstrated that primary open-angle glaucoma (POAG) is a complex multifactorial disease resulting from interaction of risk factors and gene polymorphisms. Previously, we have demonstrated the role of deletion polymorphisms of glutathione-S-transferase (GST) genes in the development and progression of POAG.
Purpose: To predict the speed of POAG development and the speed of POAG progression as early as at patient presentation based on determination of GST gene (GSTТ1, GSTР1 and GSTM1) polymorphisms.
Materials and Methods: Data of 172 patients (344 eyes) diagnosed with stage 1, 2, 3 or 4 POAG, and of 98 control group volunteers (196 eyes) diagnosed with no POAG, were included in the analysis. Two indices, SDPOAG (speed of POAG development, expressed as stage/life year), and SPPOAG (speed of POAG progression, expressed as stage/disease year), were used as measures for assessing speed of the pathological process. Polymorphisms of GSTP1, GSTM1 та GSTT1 were investigated by real-time polymerase chain reaction (PCR) using TaqMan Mutation Detection Assays (Life Technologies, Carlsbad, CA) and Gene Amp® 7500 PCR System (Applied Biosystems, Foster City, CA).
Results and Discussion: We built an algorithm (computer program) for predicting the speed of the development and progression of POAG, with the potential to calculate these indices as early as at presentation. The GSTP1 Ile105Val polymorphism (with the presence of the mutant Val allele) and GSTM1 and GSTT1 deletion polymorphisms contributed more to prediction of dependent variables, SDPOAG and SPPOAG, than others. We found a significant effect of the combination of independent variables in the regression equation on the dependent variable SDPOAG, with a multiple correlation coefficient R of 0.801, a coefficient of determination R2 of 0.622, and an F value of 77.338 at p<0.0001. In addition, the regression equation for prediction for the speed of the progression of POAG had a multiple correlation coefficient R of 0.857, a coefficient of determination R2 of 0.734, and an F value of 73.450 at p<0.0001.
Conclusion: The objectives of the study (i.e., to predict the age of onset of clinical manifestations of POAG and the speed of the development of POAG, with the potential to calculate them as early as at presentation) have been met.
Keywords: primary open-angle glaucoma, GSTP1, GSTM1 and GSTT1 polymorphisms, speed of the development and progression
- World Health Organization. Blindness and visual impairment (accessed Oct 2017). http://www.who.int/news-room/fact-sheets/detail/blindness-and-visual-imp...
- Weinreb RN, Aung T, Medeiros FA. The pathophysiology and treatment of glaucoma: a review. JAMA. 2014; 311:1901-11.
- Nesterov AP. [Glaucoma]. Moscow: Meditsinskoye Informatsionnoye Agenstvo; 2008. Russian
- The Advanced Glaucoma Intervention Study (AGIS): 7. The relationship between control of intraocular pressure and visual field deterioration.The AGIS Investigators. Am J Ophthalmol. 2000 Oct;130(4):429-40
- Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol. 2006; 90:262-7.
- Ojha P, Wiggs JL, Pasquale LR. The genetics of intraocular pressure. Semin Ophthalmol. 2013 Sep-Nov;28(5-6):301-5.
- Huang W, Wang W, Zhou M, et al. Association of glutathione S-transferase polymorphisms (GSTM1 and GSTT1) with primary open-angle glaucoma: an evidence-based meta-analysis. Gene. 2013 Sep 10;526(2):80-6
- Surkova VK, Safina AZ, Orenburkina OI. [On the role of genetic predisposition to the development of primary open-angle glaucoma]. Glaukoma. 2007;4:21-2. Russian
- Liu Y, Allingham RR. Molecular genetics in glaucoma. Exp Eye Res. 2011 Oct;93(4):331-9
- Rykov SO, Burdei AV. [Association of GST deletion polymorphisms with primary open-angle glaucoma]. Archive of Ophthalmology of Ukraine. 2017;5(3);9:61-7. Ukrainian