Association of eNOS and ACE Gene Variants with Increased Susceptibility to Congenital Heart Defects

Authors

  • Nandini Krishnamurthy
  • Jebaraj Rathinasamy, Ashok Kumar
  • Shuba S
  • Devi Krishna RB
  • Sanjana Murali
  • Andrea Mary Francis

DOI:

https://doi.org/10.63682/jns.v14i32S.8180

Keywords:

Congenital heart defects, eNOS polymorphism, ACE gene variant, PCR-RFLP, Genetic susceptibility, Case-control study

Abstract

Background: Genetic polymorphisms in the endothelial nitric oxide synthase (eNOS) and angiotensin-converting enzyme (ACE) genes have been linked to the pathogenesis of congenital heart defects (CHDs). However, their precise role in CHD susceptibility remains to be fully elucidated. Aim: This study aimed to evaluate the association of eNOS (rs1799983) and ACE (rs4646994) gene polymorphisms with the risk of CHDs in an Indian population. Methods:
A case-control study was conducted involving 112 children with CHDs and 112 age-matched healthy controls. Genomic DNA was extracted from peripheral blood, and genotyping was performed using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analysis. Results were confirmed by Sanger sequencing.

Results: For eNOS (rs1799983), both the GT genotype P < 0.0001; OR = 4.7435 (2.5849 to 8.7050) and GG genotype P = 0.0051; OR = 3.3281 (1.4350 to 7.7189) were significantly associated with increased CHD risk. The dominant model (GT + GG) also showed a strong association P < 0.0001; OR = 4.3293 (2.4679 to 7.5945) For ACE (rs4646994), the ID genotype resulted in P= 0.0307; OR= 2.3824 (1.0841 to 5.2352) DD genotype was significantly more frequent among CHD cases P < 0.0001; OR = 5.2941(2.8342 to 9.8892) while the dominant model (ID/DD) demonstrated a strong association with CHD risk P < 0.0001; OR = 4.1294 (2.3629 to 7.2166). Allele frequency analysis revealed a significantly higher frequency of the G allele in  eNOS (rs1799983) and D allele ACE (rs4646994) among cases compared to controls (both P < 0.0001), suggesting their roles as potential genetic risk factors for CHD.

Conclusion: Polymorphisms in eNOS (rs1799983) and ACE (rs4646994) genes are significantly associated with increased susceptibility to congenital heart defects in the studied Indian cohort. These findings provide valuable insight into the genetic basis of CHDs and support the potential for using these markers in genetic screening and risk assessment.

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References

Xu, X., Jin, K., Bais, A. S., Zhu, W., Yagi, H., Feinstein, T. N., et al. (2022). Uncompensated mitochondrial oxidative stress underlies heart failure in an iPSC-derived model of congenital heart disease. Cell Stem Cell. 5 (5), 840–855. doi:10.1016/j.stem.2022.03.003

https://www.cdc.gov/heart-defects/data/index.html

https://www.indianpediatrics.net/dec2018/dec-1075-1082.htm

Yingjuan Liu, Sen Chen, Liesl Zühlke, Graeme C Black, Mun-kit Choy, Ningxiu Li, Bernard D Keavney, Global birth prevalence of congenital heart defects 1970–2017: updated systematic review and meta-analysis of 260 studies, International Journal of Epidemiology, Volume 48, Issue 2, April 2019, Pages 455–463, https://doi.org/10.1093/ije/dyz009

Khatami, M., Ratki, F. M., Tajfar, S., & Akrami, F. (2017). Relationship of the MTHFD1 (rs2236225), eNOS (rs1799983), CBS (rs2850144) and ACE (rs4343) gene polymorphisms in a population of Iranian pediatric patients with congenital heart defects. The Kaohsiung Journal of Medical Sciences, 33(9), 442–448. doi:10.1016/j.kjms.2017.05.016

Fang, C., Ren, X., Zhou, H., Gong, Z., Shen, L., Bai, J., Yin, J., Qu, J., Li, X., Zhou, H., & Liu, Z. (2014). Effects of eNOS rs1799983 and ACE rs4646994 polymorphisms on the therapeutic efficacy of salvianolate injection in Chinese patients with coronary heart disease. Clinical and Experimental Pharmacology and Physiology, 41(8), 558-564.

Hemeed, R.N., Al-Tu’ma, F.J., Al-Koofee, D.A. et al. Relationship of angiotensin converting enzyme (I/D) polymorphism (rs4646994) and coronary heart disease among a male Iraqi population with type 2 diabetes mellitus. J Diabetes Metab Disord 19, 1227–1232 (2020). https://doi.org/10.1007/s40200-020-00632-y

Alderton WK, Cooper CE, Knowles RG. Nitric oxide synthases: structure, function and inhibition. Biochem J2001;357:593e615.

Huang LT, Hsieh CS, Chang KA, Tain YL. Roles of nitric oxide and asymmetric dimethylarginine in pregnancy and fetal programming. Int J Mol Sci 2012;13:14606e22.

Nagy G, Koncz A, Telarico T, Fernandez D, Ersek B, Buzas E, et al. Central role of nitric oxide in the pathogenesis of rheumatoid arthritis and systemic lupus erythematosus. Arthritis Res Ther. 2010;12(3):210, http://dx.doi.org/ 10.1186/ar3045

Forstermann U, Sessa WC. Nitric oxide synthases: regulation and function. Eur Heart J. 2012;33(7):829-37, 837a-837d, http://dx.doi.org/ 10.1093/eurheartj/ehr304.

Thameem F, Puppala S, Arar NH, Stern MP, Blangero J, Duggirala R, et al. Endothelial nitric oxide synthase (eNOS) gene polymorphisms and their association with type 2 diabetes-related traits in Mexican Americans. Diab Vasc Dis Res. 2008;5(2):109-13, http://dx.doi.org/10. 3132/dvdr.2008.018

Fang C, Ren X, Zhou H, Gong ZC,Shen L, Bai J, et al. Effects of eNOS rs1799983 and ACE rs4646994 polymorphisms on the therapeutic efficacy of salvianolate injection in Chinese patients with coronary heart disease. Clin Exp Pharmacol Physiol 2014;41:558e64.

Jiang MH, Su YM, Tang JZ, Shen YB, Deng XT, Yuan DS, Wu J, Pan M, Huang ZW. Angiotensin-converting enzyme gene 2350 G/A polymorphism and susceptibility to atrial fibrillation in Han Chinese patients with essential hypertension. Clinics. 2013 Nov;68(11):1428-32.

Iwashima Y, Horio T, Kuroda S, Takishita S, Kawano Y. Influence of plasma aldosterone on left ventricular geometry and diastolic function in treated essential hypertension. Hypertension Research. 2002;25(1):49-56.

Saeed M, Saleheen D, Siddiqui S, Khan A, Butt ZA, Frossard PM. Retraction: Association of Angiotensin Converting Enzyme Gene Polymorphisms with Left Ventricular Hypertrophy. Hypertension research. 2005 Apr;28(4):345-9.

Pan M, Zhu JH, Liu ZH, Jiang WP, Cui ZC, Yu XH, Li HM, Yang XJ. Angiotensin-converting enzyme gene 2350 G/A polymorphism is associated with left ventricular hypertrophy but not essential hypertension. Hypertension Research. 2007 Jan;30(1):31-7.

Zhu X, Bouzekri N, Southam L, Cooper RS, Adeyemo A, McKenzie CA, Luke A, Chen G, Elston RC, Ward R. Linkage and association analysis of angiotensin I–converting enzyme (ACE)–gene polymorphisms with ACE concentration and blood pressure. The American Journal of Human Genetics. 2001 May 1;68(5):1139-48.

Ahamad S, Kukshal P, Kumar A, Chellappan S, Sathe Y, Murthy P. ACE Insertion/Deletion Polymorphism as a Potential Risk Factor for Congenital Heart Disease among North Indians: Insights from a Tertiary Pediatric Cardiac Care Centre Study.

Ahmad H, Khan H, Haque S, et al. Angiotensin-Converting enzyme and hypertension: A systemic analysis of various ACE inhibitors, their side effects, and bioactive peptides as a putative therapy for hypertension. J Renin Angiotensin Aldosterone Syst 2023;2023:7890188;

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Published

2025-07-10

How to Cite

1.
Krishnamurthy N, Ashok Kumar JR, S S, RB DK, Murali S, Francis AM. Association of eNOS and ACE Gene Variants with Increased Susceptibility to Congenital Heart Defects. J Neonatal Surg [Internet]. 2025Jul.10 [cited 2025Oct.13];14(32S):4670-8. Available from: https://www.jneonatalsurg.com/index.php/jns/article/view/8180