Cardiovascular Diseases Clinical Trial
To map the major gene influencing low-density lipoprotein subclass phenotypes, denoted atherogenic lipoprotein (ALP) phenotypes, with a long term goal of cloning the ALP gene and understanding its role in genetic susceptibility to atherosclerosis.
BACKGROUND:
ALP phenotype B (ALP-B), characterized by a predominance of small, dense LDL particles as
determined by gradient gel electrophoresis, has been associated with increased risk of
myocardial infarction and a constellation of atherogenic lipid and apolipoprotein (apo)
changes. Based on complex segregation analysis, ALP-B appeared to be influenced by a single
major genetic locus with a dominant mode of inheritance and a common allele frequency. This
project was designed to identify a new gene involved in susceptibility to coronary heart
disease.
DESIGN NARRATIVE:
The investigators identified, collected and constructed a repository of immortalized cell
lines and lipid and apo measurements from members of families informative for ALP. They
tested genes implicated in lipoprotein metabolism as possible candidate ALP genes and used
highly informative DNA probes to search the genome for linkage to the ALP gene. They also
refined the model for the inheritance of ALP phenotypes and tested for genetic-environmental
interactions. Forty informative families were recruited for the repository. The families
were identified through two sources of probands: former participants in a
cholesterol-lowering diet study and patients seen at the lipid clinics at the University of
Washington. Each participating family member completed a medical history questionnaire and
provided a blood sample for ALP phenotype determination, for DNA studies, and for lipid and
apo measurements. Linkage studies and LOD score analyses began with a candidate gene
approach, and continued by using DNA probes that revealed restriction fragment length
polymorphisms (RFLPs) to search the genome for linkage to the ALP gene. When a linkage was
found, ALP genotype information was used to refine the statistical model describing the
inheritance of ALP phenotypes, and to evaluate genetic-environmental interactions involving
lipid and apo levels and environmental and behavioral factors.
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