Genetic Variants in PGE2 Receptors Modulate the Risk of Nephrosclerosis and Clinical Outcomes in These Patients.

Prostaglandin E2 (PGE2) is a major actor mediating renal injury. We aimed to determine genetic variability in the genes coding for its receptors () and study associations with nephrosclerosis risk and clinical outcomes. We identified 96 tag-SNPs capturing global variability in and screened 1209 nephrosclerosis patients and controls. The effect of these variants was evaluated by multivariate regression analyses. Two SNPs, rs11209730 and rs10399704, remained significant in a backward elimination regression model with other non-genetic variables (OR = 1.45 (1.07-1.95), = 0.016 and OR = 0.71 (0.51-0.99), = 0.041, respectively). In the nephrosclerosis patients, a proximal region of was tagged as relevant for eGFR ( values for identified SNPs ranged from 0.0003 to 0.038). Two consecutive SNPs, rs2284362 and rs2284363, significantly decreased systolic ( = 0.005 and = 0.0005), diastolic ( = 0.039 and = 0.005), and pulse pressure values ( = 0.038 and 0.014). Patients were followed for a median of 47 months (7-54) to evaluate cardiovascular (CV) risk. Cox regression analysis showed that carriers of the rs2241360 T variant had better CV event-free survival than wild-type individuals ( = 0.029). In addition, rs7533733 GG carriers had lower event-free survival than AA/AG patients ( = 0.011). Our results indicate that genetic variability in PGE2 receptors, particularly EP3, may be clinically relevant for nephrosclerosis and its associated CV risk.