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Home > Assessment of Genetic Risk Factors for Cardiovascular Diseases in Pakistani Population

Assessment of Genetic Risk Factors for Cardiovascular Diseases in Pakistani Population

Thesis Info

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Author

Shakeel, Muhammad

Program

PhD

Institute

University of Karachi

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2018

Thesis Completion Status

Completed

Subject

Molecular Medicine

Language

English

Link

http://prr.hec.gov.pk/jspui/bitstream/123456789/10511/1/Muhammad%20Shakeel_Molecular%20Med_2018_UoK_PRR.pdf

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676725541718

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Cardiovascular diseases (CVDs) are the prime cause of death accounting for 17.7 million deaths every year globally. In Pakistan, prevalence of CVDs is also considerably high. CVDs are multifactorial with many risk factors involved in the pathophysiology of the disease including the genetic predisposition. Genetically, CVDs may be monogenic or polygenic. Also, there is heterogeneity among genetic predisposition of cardiac disorders in different populations of the world. This study aims to investigate the genetic risk factors related to CVDs in Pakistani population. In this study, the whole genome sequencing data of Pakistani individuals (PJL) from 1000 Genomes Project (n=96), whole exome sequencing data from Exome Aggregation Consortium (predominantly containing individuals from Pakistan) (n=8256), and whole exome sequencing data of British Pakistanis (n=3222) were analyzed using different bioinformatics tools against a manually curated list of 1187 genes associated with major CVDs. The analysis of genetic variants with ANNOVAR and CADD tools highlighted 561 deleterious variants from 1000 Genomes PJL, 7374 deleterious variants from ExAC (SAS), and 6028 deleterious variants from British Pakistanis datasets in protein coding regions. The analysis with VEP showed 03 Loss of Function variants from 1000 Genomes PJL, 30 Loss of Function variants from ExAC (SAS), and 29 Loss of Function variants from British Pakistanis datasets. Further, the filtration from ClinVar database revealed 03 pathogenic and 02 likely pathogenic variants from 1000 Genomes Project PJL, 112 pathogenic, and 42 likely pathogenic variants from ExAC (SAS), and 42 pathogenic and 16 likely pathogenic variants from British Pakistanis datasets. The comparative analysis of prioritized deleterious variants showed many variants having two fold or higher allele frequency in Pakistani population than in other populations of the world. Likewise, the population differentiation analysis highlighted 10 deleterious SNVs greatly differentiated from world populations and 02 deleterious SNVs moderately differentiated from other South Asian populations. The principal components analysis showed the grouping of Pakistani and other South Asian populations with Europeans and Americans for deleterious mutations of CVDs. XIV To further analyze the filtered data for CVDs, whole genome sequencing of an individual with hyperlipidemia, obesity, and coronary artery disease was carried out using SOLiD 5500xl NGS system, and whole exome sequencing of 05 patients with dilated cardiomyopathy was carried out using Illumina NGS system. After variants calling and applying the same analysis pipeline, 27 deleterious SNVs were observed in 25 genes associated with hyperlipidemia and risk of coronary artery disease. Two genes, MTRR (methionine synthase reductase), and PLB1 (Phospholipase B1) contained two deleterious variants each, and are associated with low levels of low density lipoprotein-cholesterol (LDL-C) and risk of coronary artery disease. Furthermore, 11 deleterious variants, also filtered from the healthy dataset, were observed having significantly higher allele frequency in SAS Populations than in other populations of the world. In addition, two genes, KCNJ12 (potassium voltage-gated channel subfamily J member 12) and CDC27 (cell division cycle 27 protein), were identified having highest number of deleterious nonsynonymous and non-coding variants. From whole exome analysis of 05 dilated cardiomyopathy patients, 54 variants were identified in genes associated with dilated cardiomyopathy, which were prioritized in mutational load analysis as well. Here, the highest number of deleterious variants was observed in TTN (titin) and MUC19 (Mucin 19) genes. Also, there were 19 deleterious SNVs in homozygous state with global minor allele frequency < 1.0%. Overall, 278 deleterious SNVs were having higher allele frequency in SAS than in other populations of the world. Further, three rare allele frequency (AF < 1%) loss of function SNVs in C2orf40, MYOM3, and TMED4 genes, a homozygous frameshift insertion in RTKN2., and a splice site homozygous deletion in SLC6A6 were found in at least one of the patients. To conclude, this study comprehensively presents a picture of deleterious mutations for cardiac disorders in Pakistani population. The mutational load for major CVDs in a descending order was for hypertension, atherosclerosis, coronary aneurysm, heart failure, coronary artery disease, cardiomyopathies, cardiac arrhythmias, and congenital heart defects. The effect of this genetic predisposition (which is a non- modifiable risk factor) can be suppressed by minimizing the modifiable risk factors such as healthy lifestyle.
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۳۲۔ ہم ہر لمحہ فسوں میں ہیں

ہم ہر لمحہ فسوں میں ہیں

ہم نجانے کس فسوں میں ہیں

خود سے بے خبر ،منتشر منتشر

شب و روز کے فریب میں

 سایۂ آسیب میں

ہم اس فریب کے فسوں میں ہیں

جس میں زندگی کی حلاوتیں ،کرواہٹوں میں بدل گئیں

مسکراہٹیں ،قہقہے،محفلیں،سب آہٹوں میں بدل گئیں

کیا ان دروازوں کو گرا نہ دیں؟

اب کوئی دستک نہیں دیتا

کیا ان مکانوں کو ڈھا نہ دیں؟

...

بلاغة القرآن الكريم وتحدت ترجمة المعاني القرآنية الثانية إلى اللغة الأردية

His research paper is meant to explain the difficulties of translation of rhetorical and implicit meanings of Qur᾽ān into Urdu language as the translation of such meanings of Qur᾽ān is seriously a difficult job for reasons including the tacit relationship of meanings with the words’ structure and because these meanings take effect of social and mental characteristics of a particular group of people speaking a common language and also for the reason that the meanings change their position with the incessantly changing condition of mind and culture. Given the above facts the writer put forth analysis of four Urdu translations of Sūrah Al-Ḍuḥā after having studied their rhetorical aspects and implicit meanings in interpretations of different interpreters. The translations are as under. 1. Translation of Shaykh Abdul Qādir (d. 1233 A. H) named as “Maudihul Qur᾽ān”. 2. Translation of Aḥmad Raḍa Khan Braylvi (d. 1340 A. H) named as “Kanz ul ᾽Īmān fi Tarjama Al-Qur᾽ān” 3. Translation of Ashraf ‘Alī Thānvi (d. 1362 AH) with the name “Bayān Al-Qur᾽ān”. 4. Translation of Abdul Mājid Daryā Abādī (d. 1977 A. D) which is in literary style with attractive language. The writer has highlighted the lapses and shortcomings of these translations in rhetorical perspectives of Qur᾽ān and its implicit meanings and has also underlined the difficulties faced by these translators in a descriptive table. Findings and suggestions are given at the end.

Effects of 1-Trifluoromethoxyphenyl-3- 1-Propionylpiperidin-4-Yl Urea on Cardiovascular and Metabolic Dysfunctions in Obese and Diabetic Rodent Models

Obesity and diabetes are increasingly important public health problems across the world.Obesity is associated with higher risk for chronic diseases including cardiovascular disease and type 2 diabetes. The increasing trend of diabetes and obesity is imposing a huge burden on health-care systems. Despite therapeutic management with conventional agents obesity and related cardiovascular and metabolic complications remain the major health concerns around the globe. The currently available drugs for obesity and diabetes are associated with multiple adverse effects. Therefore there is an urgent need to develop newer drugs, which are safe and effective. Soluble epoxide hydrolase (sEH) inhibitors offer a novel promising therapeutic target to manage diabetes, obesity and associated complications. Inhibition of soluble epoxide hydrolase increases epoxyeicosatrienoic acids (EETs) levels. EETs are epoxide derivatives formed from arachidonic acid by the action of cytochrome P450 (CYP) epoxygenases specially theCYP2C and CYP2J subfamilies thatmetabolize arachidconic acid to various EETs, such as 5,6-, 8,9-, 11,12-, and 14,15-EETs. EETs are important regulators of the cardiovascular system and have been shown to exert potent vasodilators, anti-inflammatory, antithrombotic, cardio protective and antioxidant effects. Growing number of evidences suggest the over activity of sEH in obesity and diabetes which leads to functional deficit of EETs in the body. Decreased level of EETs is implicated in pathophysiological mechanisms of obesity and diabetes associated complications. Stabilization of EETs through pharmacological inhibition of sEH or sEH deletion has been shown to have beneficial effects in various conditions including pain, inflammation, hypertension and ischemia. Based on diverse physiological role of EETs, the current project was aimed at evaluation of 1-trifluoromethoxyphenyl-3-(1-propionylpiperidine-4-yl) urea (TPPU), a novel soluble epoxide hydrolase inhibitor (sEHI) against fructose induced diabetes and high fat diet–induced obesity in related cardiovascular and metabolic complicationsin rats. TPPUis the most potent soluble epoxide hydrolase inhibitor, metabolically stable and having good pharmacokinetic profile. Although the potential of soluble epoxide hydrolase inhibitor for the treatment of obesity related cardiovascular diseases and metabolic dysfunctions appear promising, it has not been fully established. The current study revealed that rats administered with fructose solution for 12 weeks developed classic symptoms of metabolic syndrome. Controlled rats fed on fructose showed tremendous increase in blood pressure, blood glucose and insulin levels as well as levels of TGs, cholesterol, LDLs were increased (P<0.001). There was significant increase of ALT, ALP, urea and uric acid levels in rats fed on fructose. Endothelium dysfunction was observed in fructose fed animal with attenuated response to acetylcholine.Animals that were fed on fructose and treated with TPPU (2 mg/kg p.o) for 12 weeks improved insulin resistance , decreased blood pressure, blood glucose levels and lowered serum cholesterol, TGs and LDL while HDL levels was elevated, compared to untreated control animals. The fructose induced endothelium dysfunction was also improved with TPPU treatement. The histopathology and immunohistochemistry results of the TPPU treated animals exhibited regenerative effect on ?-cells of the pancreas in diabetic rats. There was increase in the number of islet of langerhans in the pancreas of diabetic rats treated with TPPU compared with untreated rate. The Immunohistochemical staining with anti-insulin antibody confirmed a marked reduction in insulin secreting cells in diabetic untreated rats while TPPU treated group showed normal mass of secreting cells. The results of the present study revealed regeneration in the pancreatic ?-cells in diabetic rats treated with the TPPU (2 mg/kg p.o) for 12 weeks.The present work showed a significant increase in levels of serum liver enzymes (ALP, ALT) in the fructose-fed untreated animals which were significantly decreased in TPPU treated animals. The microscopic examination of the liver sections of diabetic untreated group exhibited great improvement of cellular architecture in the TPPU treated animals. In the present study, obesity was induced rats by feeding them on HFD (Cholesterol 40%, carbohydartes 40% and proteins 20%) for two months. Rats fed on HFD had considerable increase in their body weights compared to age-matched control animals fed on regular diet (Normal control). The increase in body weights of rats fed on HFD and simultaneously administered with TPPU (2 mg/kg p.o) for the two months was significantly decreased (P<0.01). There was also significant (P<0.01) increase in the systolic blood pressure of animals and vascular dysfunction with decreased relaxant response of vessels to acetylcholine and sodium nitroprussidein animals fed on HFD compared to control rats fed on regular diet. This increase in systolic blood pressure and vascular dysfunction was attenuated by TPPU treatment in animals fed on HFD. , In the present study, HDF caused significant increase in plasma creatinine levels (P<0.001) in animals compared to those fed on normal diet. The increased in plasma creatinine levels were inhibited in animals fed on HFD and treated with TPPU for two months. HFD-induced obesity is most commonly associated with systemic inflammation. The present study also investigated systemic inflammation by measurement of circulating obesity markers. The adiponectin plasma levels were highly decreased (P<0.001) in rats fed on HFD for two months compared to control rate fed on normal diet (p < 0.001).Adiponectin levels were increased in rats fed on HFD and treated with TPPU. Leptin resistance was also increased in obese animals associated with higher leptin levels inanimals fed on HFD compared to those fed on normal diet. The increase in leptin levels was significantly decreased in animals fed on HFD and treated with TPPU for two months.In the present investigation obese animals had increased levels of plasma insulin compared to the control animals fed on regular diet (normal control). This increase in insulin levels was significantly suppressed (P< 0.001) by TPPU treatment in rats fed on HFD. The other metabolic parameters such as plasma cholesterol, TGs, LDLs were increased and HDL decreased in obese animals fed on HFD compared to those fed a regular diet.HFD also caused tremendous increase in serum ALT and ALP. The increase in lipid levels was inhibited and HDL levels enhanced in animals fed on HFD and treated with TPPU. TPPU treatment also reversed HFD induced ALT and ALP abnormalities in rats caused by HFD treatment. The decrease in liver enzymes was also reflected in the finding from microscopic examination of the liver sections showing marked improvement in the liver architecture in animals fed on HFD and treated with TPPU compared to those treated with vehicle and fed on HFD. These findings indicate that TPPU could be potential new drug to manage obesity induced cardiovascular and metabolic complications. These findings indicate that therapeutic and/or preventive potentials of TPPU against fructose induced diabetes and HFD-induced obesity and the related cardiovascular and metabolic complications in rats.