Mutations in NLRP7 are associated with diploid biparental hydatidiform moles, but not androgenetic complete moles.

BACKGROUND: NLRP7 (NALP7) has been identified as the major gene involved in the inherited predisposition to recurrent molar pregnancies, a rare recessive condition in which affected individuals have complete hydatidiform moles of diploid biparental origin (BiCHM). The role of NLRP7 in other types of molar pregnancy and reproductive wastage has not been conclusively demonstrated. The purpose of this study was to clarify this by identifying NLRP7 variation in two clinically well-defined groups of patients: women with recurrent BiCHM, and women with three or more recurrent complete hydatidiform moles of proven androgenetic origin (AnCHM). METHODS: Fluorescent microsatellite genotyping of molar tissue was used to establish a diagnosis of recurrent BiCHM (four novel cases) or recurrent AnCHM (nine women with multiple CHM). These two groups were subsequently screened for mutations in NLRP7 using DNA sequencing. Additional screening for non-pathological variants was performed in 21 previously published cases of recurrent BiCHM. Taqman genotyping was used to determine the frequency of novel NLRP7 variants in two control cohorts of Caucasian and Asian women with no adverse reproductive outcomes. RESULTS: Of the four novel cases with recurrent BiCHM, two were homozygous for mutations in NLRP7 while one was a compound heterozygote for a nonsense mutation and a pathological variant. No NLRP7 mutations or pathological variants were identified in the fourth case. None of the women with AnCHM carried any mutations or pathological variants of NLRP7. A single case of AnCHM was found to be heterozygous for a novel variant (R413Q). CONCLUSION: NLRP7 mutations do not represent a major cause of AnCHM.

Angiotensin II type 1 and 2 receptors gene polymorphisms in pre-eclampsia and normal pregnancy in three different populations.

OBJECTIVES: To investigate a possible association between pre-eclampsia (PE) and the genotype for the angiotensin II type-1 receptor (AT1R) and the angiotensin type-2 receptor (AT2R) in various population groups. DESIGN: The study was retrospective in a case-controlled design. SAMPLES: Two hundred thirty-six pregnant women with PE/eclampsia (E) and 426 non-hypertensive pregnant women were included. METHOD: Polymorphic sites of AT1R (A1166C) and AT2R (A1675G) were amplified by polymerase chain reaction, digested with a restriction enzyme that differentiated between the alternative alleles, and analyzed. MAIN OUTCOME MEASURES: Maternal genotypes and their correlation with clinical parameters. RESULTS: The frequency of the AT2R-GG genotype (A1675G) in the PE group was significantly greater than in controls for Afro-Caribbean women (49.3% vs 26.9%, p=0.004), but the frequency difference in Asian or Caucasian women was not significant (23.0% vs 25.4%, p=0.63; 27.7% vs 14.8%, p=0.17, respectively). The highly significant difference in Afro-Caribbean women was maintained after controlling for the effects of age, BMI and parity (p=0.005). There was no significant association of the molecular variant of AT1R (A1166C) with PE in Afro-Caribbean, Caucasian or Asian women. However, in the whole PE group compared to the controls there was a higher proportion of the AT2R-GG genotype with AT1R-AC (56% vs 44%, OR 2.37; 95% CI: 1.06-5.32). In Afro-Caribbean women, the combination of AT1R-AC with AT2R-AG genotypes was significantly higher in controls compared to PE group (93.8% vs 6.3%, OR 0.11; 95% CI: 0.01-0.81). CONCLUSION: There is an association between PE/E and the GG-genotype of AT2R in Afro-Caribbean women.