1.Genetic and risk factors of age-related macular degeneration
Ariunzaya A ; Chimedlkhamsuren G ; Bayarlakh B ; Suvd T ; Baasankhuu J ; Sarantuya J ; Uranchimeg D
Mongolian Medical Sciences 2024;210(4):18-25
		                        		
		                        			Background:
		                        			Worldwide, the leading cause of blindness in people over the age of 50 is age-related macular 
degeneration (AMD), which is a complication of the exudative “wet” and dry type. AMD is a 
multifactorial neurodegenerative disease relating with a combination of environmental and 
genetic factors, and a contribution of age effect and smoking also, obesity was investigated 
to be associated with the disease. Number of previous studies have shown that the 
polymorphisms in the ARMS2, CFH and VEGF-A genes are associated with AMD. Therefore, 
we investigated the associations between the five common vascular endothelial growth factor 
(VEGF) polymorphisms and AMD with its therapeutic results.
		                        		
		                        			Materials and Methods:
		                        			Totally 161 AMD patients and 223 controls were enrolled in this case-control study. A 
prospective analysis of 66 eyes of 34 patients with neovascular AMD evaluated intravitreal 
bevacizumab injections. The polymorphisms in CFH, ARMS2 and VEGF-А were detected 
by using the methods of allele-specific polymerase chain reaction (ASPCR) and PCR based 
restriction fragment length polymorphism (RFLP). Statistical analyses were performed by 
SNPalyze software.
		                        		
		                        			Results:
		                        			Results of the study showed that rs1061170, rs1065489, and rs800292 polymorphisms are 
associated with arterial hypertension. Anti-coagulant intake rs1061170 polymorphism T/C, 
C/C/C/C risk genotype (OR=5.04, 95% CI, 1.81-14.09, p=0.002, RERI=2.568, AP=0.509, 
S=2.7302) , combined effect of G/C/C/C/ /G, G/A risk genotype (OR=6.52, 95% CI, 2.88
14.79, p<0.001, RERI=4.187, AP=0.642, S=4.136) are associated with increased risk of AMD. In the study, in 66 eyes of a total of 34 people who received intravitreous injection 
treatment, the central retinal thickness before and after treatment was 294.59±83.52 before 
treatment, 262.74±87.02 on the first day after treatment, 259.5±111.83 after one month, 
248.98±84.96 after 3 months, and 262.69 after 6 months. ±110.59, after 1 year it decreased 
to 259.19±112.29 (95% CI, 226.74-291.65), which is a statistically significant difference. A 
comparative study of polymorphisms in therapeutic and non-therapeutic groups revealed 
statistically significant differences in the G/G groups of rs2010963 polymorphisms. Also, 
people with G/G genotype of rs2010963 polymorphism are more effective in treatment than 
people with other genotypes.
		                        		
		                        			Conclusion
		                        			Individual factors such as not wearing sunglasses and arterial hypertension and using anti
coagulant medication have been identified as risk factors for AMD. The result showed that 
polymorphisms of ARMS2, CFH, VEGF genes can be a genetic risk factor for AMD. The 
decreased in central retinal thickness and improving VA after anti-VEGF treatment confirm the 
effectiveness of the treatment.  Also, people with G/G genotype of rs2010963 polymorphism 
are more effective in treatment than people with other genotypes. Identification of genetic 
markers that affect clinical response may result in optimization of anti-VEGF therapy.
		                        		
		                        		
		                        		
		                        	
2.Clinical features of ophthalmology in thyroid disease
Oyungerel B ; Erdenezul G ; Misheel B ; Uranchimeg D ; Chimedlkhamsuren G ; Nomin-Erdene M ; Sarantuya J
Innovation 2021;14(2-Ophthalmology):6-10
		                        		
		                        			Background:
		                        			TED (thyroid eye disease) is an inflammatory disease of the orbit caused by 
autoimmune diseases of the thyroid, which adversely affect the vision, appearance, and quality 
of life. Exophthalmos and eyelid retraction are the main features of TED, which can lead to ocular 
motility, diplopia, optic neuropathy, and permanent vision loss. The study aims to determine the 
most common clinical signs of TED in Mongolians and define whether there is a correlation with 
the levels of thyroid autoantibodies.
		                        		
		                        			Methods:
		                        			The study involved 102 patients with TED and 81 patients with Graves’ ophthalmopathy. 
The clinical features of TED were identified and evaluated by activity score (CAS) and severity of 
GO using the European Group of Graves’ Orbitopathy (EUGOGO).
		                        		
		                        			Results:
		                        			The mean age of TED patients was 42.6±11.2, which was younger than GD patients 
(P=0.012). The current smoker was 24 patients (23.5%) with TED, which is relatively higher than GD 
(P=0.0001). The most common ocular signs were eyelid retraction 80 (78.4%), proptosis 77 (75.5%), 
diplopia 14 (13.7%) and 4% vision loss. There were no differences in proptosis between the right (18 
mm, median) and left eye (17.8 mm, median) (P>0.05). The mean CAS score was 3.09±1.72 and 
varied depending on gender and smoking. According to EUGOGO, 62.7% of the patients were 
moderately severe. Only 7 % of the patients were in the sight-threatening stage, presenting optic 
neuropathy and corneal breakdown. The mean TSI level in patients with TED was 37.95 ± 35.41 IU 
/ ml, which was 2.7 times higher than the mean in patients with GD.
		                        		
		                        			Conclusions
		                        			Eyelid retraction and exophthalmos are the most common clinical signs of TED. 
Early diagnosis of these features can prevent complications of the disease. Determining serum TSI 
levels will help in the treatment and monitoring of TED.
		                        		
		                        		
		                        		
		                        	
3.Influence of rs16924159 polymorphism of IL-33 gene on asthma susceptibility
Chimedlkhamsuren G ; Uyangakhorol N ; Batbold O ; Ichinnorov D ; Sarantuya J
Innovation 2020;14(2):67-71
		                        		
		                        			Background:
		                        			Interleukin-33 (IL-33) cytokine plays a crucial role in asthma pathogenesis. Recent 
studies have established that IL-33 activity was increased in serum, airway smooth muscle and 
epithelial cells from patients with asthma and this increase positively correlates with asthma 
severity. We hypothesized that several genetic variations that contributing IL-33 expression 
and activity, which may risk factor for susceptibility to asthma. In this study, we examined the 
association between rs16924159 single nucleotide polymorphism (SNP) of IL-33 gene and asthma 
susceptibility.
		                        		
		                        			Methods:
		                        			51 asthma patients and 54 healthy volunteers were involved in this case-control 
study. Blood sample was collected for genomic DNA extraction. rs16924159 SNP genotyping was 
performed by the allele specific-polymerase chain reaction (AS-PCR) method. Statistical analysis 
was performed using STATA 13.0 software.
		                        		
		                        			Results:
		                        			The groups were matched for age, gender and body mass index (p>0.05). The distribution 
of rs16924159 allele and genotypes among patients and controls was found in accordance with 
those expected by the Hardy-Weinberg equilibrium (p=0.088). Adenine (A) allele frequency of 
rs16924159 was significantly different between case and control groups (OR = 1.91, 95% CI = 1.04-
3.51, p = 0.037). Also, homozygote A/A (OR=6.53, 95% CI 0.68-62.38, p=0.104) and heterozygote 
(OR=2.08, 95% CI 0.93-4.62, p=0.073) genotypes were more frequent among asthma patients than 
in controls.
		                        		
		                        			Conclusions
		                        			From these findings, we conclude the A allele of rs16924159 SNP in IL-33 gene 
may be contributing to asthma susceptibility, increasing the carrier`s risk to the development of 
asthma.
		                        		
		                        		
		                        		
		                        	
4.VEGF-A and ARMS2 gene polymorphism on AMD susceptibility
Ariunzaya A ; Chimedlkhamsuren G ; Suvd T ; Sarantuya J ; Uranchimeg D ; Baasankhuu J
Innovation 2019;13(1-Ophthalmology):10-13
		                        		
		                        			Background:
		                        			Age-related macular degeneration (AMD) is an eye condition, that occurs 
people aged above 50, leads to gradual loss of the vision because of a damage in the macula, 
which is located in the center of the retina. Several polymorphisms in different genes have been 
proposed as factors that increase the disease susceptibility. Therefore, we investigated the 
association between rs833061 polymorphism of VEGF-A gene and rs10490924 polymorphism of 
ARMS2 gene and AMD in order to analyze with other similar studies by meta analysis.
		                        		
		                        			Purpose:
		                        			To investigate the polymorphisms of VEGF-A gene and ARMS2 gene on AMD susceptibility
		                        		
		                        			Methods:
		                        			is case-control study was conducted on 74 AMD patients and 32 unaffected age-and gender-matched control individuals. Genomic DNA was extracted from the peripheral 
venous blood. The single nucleotide polymorphisms were identified by restriction fragment length 
polymorphism (RFLP) method and results confirmed by gel electrophoresis. The REVIEW MANAGER 
5.2 software and MetaXL was used for meta-analysis
		                        		
		                        			Results:
		                        			We did not find statistically significant differences in С allele and СС genotype frequency 
of rs833061 polymorphism of VEGF-A gene between patients and controls. However, analysis of 
rs10490924 polymorphism of ARMS2 gene shows that T allele (OR=2.72, 95% CI, 1.47 – 5.02, p=0.001), 
TT genotype (OR=4.54, 95% CI, 1.49 – 13.87,p=0.019) were significantly associated with AMD risk. 
Haplotype analysis of these SNPs showed that C+T haplotype was statistically significantly different 
(OR=5.23, 95% CI, 1.76-15.54, p=0.002) between patients and controls.
		                        		
		                        			Conclusion
		                        			As shown by results, rs10490924 polymorphism of ARMS2 gene show that T allele, 
TT genotype and C+T haplotype were significantly associated with AMD risk In meta-analysis, T 
allele of rs10490924 polymorphism of ARMS2 gene was significantly associated with AMD risk in all 
ethnicity that include Asian and Caucasian. However, T allele prevalence was higher in Asians. 
		                        		
		                        		
		                        		
		                        	
5.Impact of ADRB2 gene rs1042713 and rs1042714 polymorphisms on COPD
Chimedlkhamsuren G ; Jambaldorj J ; Odonchimeg P ; Ichinnorov D ; Sarantuya J
Mongolian Medical Sciences 2016;175(1):17-20
		                        		
		                        			
		                        			 IntroductionMany factors can contribute to the occurrence of COPD. Recent studies have pointed to the notion thatpolymorphism of candidate genes may also play a signifi cant role in COPD pathogenesis.GoalTo investigate the association of polymorphisms in ADRB2 and TNF-α genes with COPD.Materials and MethodsWe genotyped three SNPs included rs1042713 and rs1042714 in ADRB2, rs1800629 in TNF-α gene,using PCR-RFLP method.ResultsThere is no statistically signifi cant difference was observed for TNF-α rs1800629 between case andcontrol groups. Genotype frequency of the homozygote Gly16 (rs1042713) was more frequent in COPDpatients than controls (OR=3.25; 95%CI, 1.58–6.66, p=0.0037). Also, haplotype frequency of Gly/Gly16+Gln/Glu27 was signifi cant difference among cases and controls (OR=5.03; 95%CI, 1.8–14.2,p<0.01).Conclusion:Overall, ADRB2 rs1042713 and rs1042714 polymorphisms are associated with increased susceptibilityto the development of COPD. Further studies in large groups of patients with COPD are needed toaddress other genetic risk factors. 
		                        		
		                        		
		                        		
		                        	
            
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