Summary:
Paraoxonase 1 (PON1) is an HDL-associated enzyme which protects HDL and LDL particles
from lipid peroxidation. Its enzymatic serum activity varies 10-40-fold between individuals,
and its biallelic gene polymorphism at codon 192 (glutamine → arginine, Gln/Arg) has
been associated with coronary artery disease in diabetic patients. To evaluate the
role of this PON1 gene polymorphism in cerebrovascular disease, we determined the
PON1 192 genotype in 149 patients with hemodynamically relevant extracranial artery
stenosis and in 241 controls. The PON1 192 Gln/Arg genotype was determined using polymerase
chain reaction followed by Alw I digestion and polyacrylamide gel electrophoresis.
Among all subjects, there was no association between the PON1 192 Gln/Arg genotype
and cerebrovascular disease (Odds ratio for Arg/Arg and Gln/Arg vs Gln/Gln 0.99, 95%-CI
0.70-1.39). In contrast, in the subgroup of type 2 diabetic patients the PON1 192
Arg allele conferred about twice the risk of cerebrovascular stenosis compared to
those homozygous for the Gln allele (Odds ratio 2.00, 95%-CI 0.92-4.38). Our data
indicate that in the general population the PON1 192 Gln/Arg gene polymorphism cannot
be regarded as a major risk marker for cerebrovascular disease. The observed interaction
with type 2 diabetes, however, is supporting the hypothesis that the effect of the
PON1 192 Arg allele on atherosclerosis is modulated by other risk factors like diabetes.
Key words:
Paraoxonase 1 - genetics - atherosclerosis - carotid artery stenosis - stroke
References
- 1
Adkins S, Gan K N, Mody M, La Du B N.
Molecular basis for the polymorphic forms of human serum paraoxonase/arylesterase:
glutamine or arginine at position 191, for the respective A or B allozymes.
Am. J. Hum. Genet..
52
598-608
1993;
- 2
Antikainen M, Murtomaki S, Syvanne M, Pahlman R, Tahvanainen E, Jauhiainen M, Frick M H,
Ehnholm C.
The Gln-Arg191 polymorphism of the human paraoxonase gene (HUMPONA) is not associated
with the risk of coronary artery disease in Finns.
J. Clin. Invest..
98
883-885
1996;
- 3
Cao H, Girard-Globa A, Serusclat A, Bernard S, Bondon P, Picard S, Berthezene F, Moulin P.
Lack of association between carotid intima-media thickness and paraoxonase gene polymorphism
in non-insulin dependent diabetes mellitus.
Atherosclerosis.
138
361-366
1998;
- 4
Dessi M, Gnasso A, Motti C, Pujia A, Irace C, Casciani S, Staffa F, Federici G, Cortese C.
Influence of the human paraoxonase polymorphism (PON1 192) on the carotid-wall thickening
in a healthy population.
Coron Artery Dis.
10
595-599
1999;
- 5
Friedewald W T, Levy R I, Fredrickson D S.
Estimation of the concentration of low density lipoprotein cholesterol in plasma without
use of the preparative ultracentrifuge.
Clin. Chem..
18
499-502
1972;
- 6
Hassett C R, Richter J, Humbert R, Chapline C, Crabb J W, Omiecinski C J, Furlong C E.
Characterization of cDNA clones encoding rabbit and human serum paraoxonase: the mature
protein retains its signal sequence.
Biochemistry.
30
10141-10149
1991;
- 7
Humbert R, Adler D A, Disteche C M, Hassett C, Omiecinski C J, Furlong C E.
The molecular basis of the human serum paraoxonase activity polymorphism.
Nat. Genet..
3
73-76
1993;
- 8
Hegele R A.
Paraoxonase genes and disease.
Ann Med.
31
217-224
1999;
- 9
Imai Y, Morita H, Kurihara H, Sugiyama T, Kato N, Ebihara A, Hamada C, Kurihara Y,
Shindo T, Oh-hashi Y, Vazaki Y.
Evidence for association between paraoxonase gene polymorphisms and atherosclerotic
diseases.
Atherosclerosis.
149
435-442
2000;
- 10
James R W, Leviev I, Righetti A.
Smoking is associated with reduced serum paraoxonase activity and concentration in
patients with coronary artery disease.
Circulation.
101
2252-2257
2000;
- 11
Kiely D K, Wolf P A, Cupples L A, Beiser A S, Myers R H.
Familial aggregation of stroke: the Framingham Study.
Stroke.
24
1366-1371
1993;
- 12
Mackness B, Mackness M I, Arrol S, Turkie W, Julier K, Abuasha B, Miller J E, Boulton A J,
Durrington P N.
Serum paraoxonase (PON1) 55 and 192 polymorphism and paraoxonase activity and concentration
in non-insulin dependent diabetes mellitus.
Atherosclerosis.
139
341-349
1998;
- 13
Mackness M I, Arrol S, Durrington P N.
Paraoxonase prevents accumulation of lipoperoxides in low-density lipoprotein.
FEBS Lett..
286
152-154
1991;
- 14
Mackness M I, Arrol S, Abbott C A, Durrington P N.
Protection of low-density lipoprotein against oxidative modification by high-density
lipoprotein associated paraoxonase.
Atherosclerosis.
104
129-135
1993;
- 15
Mackness M I, Arrol S, Mackness B, Durrington P N.
Alloenzymes of paraoxonase and effectiveness of high-density lipoproteins in protecting
low-density lipoprotein against lipid peroxidation.
Lancet.
349
851-852
1997;
- 16
Mackness M I, Durrington P N.
HDL, its enzymes and its potential to influence lipid peroxidation.
Atherosclerosis.
115
243-253
1995;
- 17
Mackness M I, Mackness B, Durrington P N, Connelly P W, Hegele R A.
Paraoxonase: biochemistry, genetics and relationship to plasma lipoproteins.
Curr. Opin. Lipidol..
7
69-76
1996;
- 18
Pfohl M, Koch M, Enderle M D, Kuhn R, Füllhase J, Karsch K R, Häring H U.
Paraoxonase 192 Gln/Arg gene polymorphism, coronary artery disease, and myocardial
infarction in type 2 diabetes.
Diabetes.
48
623-627
1999;
- 19
Pfohl M, Fetter M, Koch M, Barth C M, Weiss R, Häring H U.
Association between angiotensin I-converting enzyme genotypes, extracranial artery
stenosis, and stroke.
Atherosclerosis.
140
161-166
1998;
- 20
Ruiz J, Blanche H, James R W, Garin M C, Vaisse C, Charpentier G, Cohen N, Morabia A,
Passa P, Froguel P.
Gln-Arg192 polymorphism of paraoxonase and coronary heart disease in type 2 diabetes.
Lancet.
346
869-872
1995;
- 21
Sanghera D K, Saha N, Aston C E, Kamboh M I.
Genetic polymorphism of paraoxonase and the risk of coronary heart disease.
Arterioscler. Thromb. Vasc. Biol..
17
1067-1073
1997;
- 22
Serrato M, Marian A J.
A variant of human paraoxonase/arylesterase (HUMPONA) gene is a risk factor for coronary
artery disease.
J. Clin. Invest..
96
3005-3008
1995;
- 23
Suehiro T, Nakauchi Y, Yamamoto M, Arii K, Itoh H, Hamashige N, Hashimoto K.
Paraoxonase gene polymorphism in Japanese subjects with coronary heart disease.
Int. J. Cardiol..
57
69-73
1996;
PD Dr. Martin Pfohl
BG-Kliniken Bergmannsheil
Medizinische Universitätsklinik
Bürkle-de-la-Camp-Platz 1
D-44789 Bochum
Germany
Phone: + 49-234/302-6329
Fax: + 49-234/302-6403
Email: martin.pfohl@t-online.de