ADRB2 polymorphism Arg16Gly modifies the natural outcome of heart failure and dictates therapeutic response to β-blockers in patients with heart failure

作者：Huang, Jin; Li, Chenze; Song, Ying; Fan, Xiaohan; You, Ling; Tan, Lun; Xiao, Lei; Li, Qing; Ruan, Guoran; Hu, Senlin; Cui, Wei; Li, Zongzhe; Ni, Li; Chen, Chen; Woo, Anthony Yiu-Ho; Xiao, Rui-Ping^*; Wang, Dao Wen^*

来源：Cell Discovery, 2018, 4(1): 57.

DOI：10.1038/s41421-018-0058-6

• G-PROTEIN
• RECEPTOR SUBTYPES
• CARDIAC MYOCYTES
• CELL-DEATH
• SURVIVAL
• BETA(2)-ADRENOCEPTOR
• STIMULATION
• ASSOCIATION
• MYOCARDIUM
• CARVEDILOL

We sought to investigate the association of single nucleotide polymorphisms (SNPs) of the genes involved in beta AR signaling with the response of patients to beta AR blockers. A total of 2403 hospitalized patients with chronic heart failure (HF) were enrolled in a multicenter observational study as the first cohort and followed up for a mean period of 20 months. Genes for beta 1AR, beta 2AR, and the major cardiac G-protein-coupled receptor kinases (GRKs) GRK2 and GRK5 were analyzed to identify SNPs, and patients were stratified according to genotypes. A second independent cohort enrolling 919 patients with chronic HF was applied to validate the observed associations. The signaling properties of the key identified SNPs were assessed in vitro. Our data showed that HF patients harboring the Gly16 allele in the gene for beta 2AR (ADRB2) had an increased risk of the composite end point relative to patients who were homozygous for Arg16. Notably, these patients showed a beneficial response to beta AR-blocker treatment in a G allele-dose-dependent manner, whereas Arg16 homozygotes had no response to beta AR-blocker therapy. This Arg16Gly genotype-dependent heterogeneity in clinical outcomes of HF was successfully validated in the second independent population. Besides, the in vitro experiments revealed that G allele carriers were defective in beta 2AR-coupled inhibitory adenylate cyclase g (G) protein signaling.

• 出版日期2018-10-23
• 单位华中科技大学; 中国医学科学院北京协和医院; 北京大学; 中国医学科学院阜外医院; 沈阳药科大学; 河北医科大学