Endothelial Nitric Oxide Synthase G894T Polymorphism Associates with Disease Severity in Puumala Hantavirus Infection

• Published in: PloS one Vol. 10; no. 11; p. e0142872
• Main Authors: Koskela, Sirpa, Laine, Outi, Mäkelä, Satu, Pessi, Tanja, Tuomisto, Sari, Huhtala, Heini, Karhunen, Pekka J, Pörsti, Ilkka, Mustonen, Jukka
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 11-11-2015; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Aged; Alleles; Blood platelets; Blood pressure; Cardiovascular disease; Carriers; Consent; Coronary vessels; Creatinine; Cytokines; Development and progression; Endothelial cells; Endothelium, Vascular - pathology; Female; Gene expression; Gene polymorphism; Genetic aspects; Genetic polymorphisms; Genotype; Genotypes; Hantavirus; Hantavirus infections; Hantavirus Infections - genetics; Hantavirus Infections - physiopathology; Health aspects; Heart attacks; Heterozygote; Heterozygotes; Homozygote; Homozygotes; Hospitalization; Hospitals; Humans; Hypertension; Identification and classification; Infections; Inflammatory bowel disease; Internal medicine; Kidney Diseases - genetics; Laboratories; Male; Medicine; Middle Aged; Nitric oxide; Nitric Oxide Synthase Type II - genetics; Nitric Oxide Synthase Type III - genetics; Nitric-oxide synthase; Oxidoreductases; Pathogenesis; Patients; Polymorphism; Polymorphism, Genetic; Polymorphism, Single Nucleotide; Properties; Prospective Studies; Puumala virus; Tumor necrosis factor-TNF; Young Adult; Europe; Finland
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0142872

Hantavirus infections are characterized by both activation and dysfunction of the endothelial cells. The underlying mechanisms of the disease pathogenesis are not fully understood. Here we tested the hypothesis whether the polymorphisms of endothelial nitric oxide synthase, eNOS G894T, and inducible nitric oxide synthase, iNOS G2087A, are associated with the severity of acute Puumala hantavirus (PUUV) infection.
Hospitalized patients (n = 172) with serologically verified PUUV infection were examined. Clinical and laboratory variables reflecting disease severity were determined. The polymorphisms of eNOS G894T (Glu298Asp, rs1799983) and iNOS G2087A (Ser608Leu, rs2297518) were genotyped.
The rare eNOS G894T genotype was associated with the severity of acute kidney injury (AKI). The non-carriers of G-allele (TT-homozygotes) had higher maximum level of serum creatinine than the carriers of G-allele (GT-heterozygotes and GG-homozygotes; median 326, range 102-1041 vs. median 175, range 51-1499 μmol/l; p = 0.018, respectively). The length of hospital stay was longer in the non-carriers of G-allele than in G-allele carriers (median 8, range 3-14 vs. median 6, range 2-15 days; p = 0.032). The rare A-allele carriers (i.e. AA-homozygotes and GA-heterozygotes) of iNOS G2087A had lower minimum systolic and diastolic blood pressure than the non-carriers of A-allele (median 110, range 74-170 vs.116, range 86-162 mmHg, p = 0.019, and median 68, range 40-90 vs. 72, range 48-100 mmHg; p = 0.003, respectively).
Patients with the TT-homozygous genotype of eNOS G894T had more severe PUUV-induced AKI than the other genotypes. The eNOS G894T polymorphism may play role in the endothelial dysfunction observed during acute PUUV infection.