Clinical Chemistry 51: 1547-1549, 2005;
10.1373/clinchem.2005.051656
(Clinical Chemistry. 2005;51:1547-1549.)
© 2005 American Association for Clinical Chemistry, Inc.
Genotyping of the Angiotensin I-Converting Enzyme Gene Insertion/Deletion Polymorphism by the TaqMan Method
Werner Kocha,
Wolfgang Latz,
Marianne Eichinger,
Claudia Ganser,
Albert Schömig and
Adnan Kastrati
Deutsches Herzzentrum München and 1. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany;
aaddress correspondence to this author at: Deutsches Herzzentrum München, Lazarettstrasse 36, D-80636 Munich, Germany; fax 49-89-1218-3053, e-mail wkoch{at}dhm.mhn.de
Intron 16 of the angiotensin I-converting enzyme gene (ACE) contains an insertion/deletion (I/D) polymorphism that is characterized by the presence (I allele) or absence (D allele) of a 289-bp incomplete alu type repeat sequence (1)(2). The D allele has been related to higher concentrations of ACE mRNA in cells and increased ACE concentration and activity in plasma and serum (1)(3)(4)(5)(6). There is great continuing interest in the link between the ACE I/D polymorphism and interindividual variations in physiologic properties and disease susceptibility. Reported associations include physical activity and endurance, drug response, and neuropathologic, cardiac, and cardiovascular diseases (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). However, a considerable number of findings are in disagreement with the existence of such relationships (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31), and more work is required before the role of the ACE I/D polymorphism in health and disease can be firmly established.
Conventional genotyping of the ACE I/D polymorphism involves PCR, using primers that flank the insertion sequence, and exploits the different migration velocities of I- and D-allelespecific PCR products during electrophoresis in gel matrices (32). Here we describe an assay for genotyping of the ACE I/D polymorphism that is based on the TaqMan technique (33). The TaqMan method involves 2 allele-specific fluorogenic oligonucleotide probes and combines DNA amplification and genotype detection in a single assay. Usually, TaqMan genotyping assays are designed and used for the analysis of single-nucleotide polymorphisms or small insertions/deletions (34)(35)(36). The new TaqMan assay for the ACE I/D polymorphism extends the scope of the TaqMan genotyping technique to the analysis of a polymorphism that is distinguished by the presence or absence of a relatively large sequence block. Special to this assay is the requirement of 3 different PCR primers to obtain the 2 types of allele-specific PCR products, instead of the 2 primers used in conventional TaqMan assays. The binding sites of primers and probes on the I- and D-allelespecific DNA templates are shown in Fig. 1A
. Primer pair AC111/ACE112 gave rise to a D-allelespecific PCR product of 78 bp, and primer pair AC112/ACE113 gave rise to an I-allelespecific PCR product of 71 bp. The 367-bplong I-allelespecific amplicon produced by primer pair AC111/ACE112 was not detectably multiplied in TaqMan reactions that included DNA of genotype II or ID, as indicated by sample analysis using electrophoresis in a polyacrylamide gel and subsequent treatment of the gel with ethidium bromide solution. Allele-specific signaling of the probes was accomplished by the reporter dyes VIC (proprietary dye of Applied Biosystems) and 6-carboxyfluorescein (FAM), which were attached to the 5' ends of the I- and D-allelespecific oligonucleotides, respectively. Minor groove binder (MGB) groups were conjugated with the 3' ends of the oligonucleotides to facilitate formation of stable duplexes between the probes and their single-stranded DNA targets (37). Primers and probes were synthesized by Applied Biosystems and had the following structures:
- Primer ACE111: 5'-CCCATCCTTTCTCCCATTTCTC-3'
- Primer ACE112: 5'-AGCTGGAATAAAATTGGCGAAAC-3'
- Primer ACE113: 5'-CCTCCCAAAGTGCTGGGATTA-3'
- I-Allelespecific probe (VIC-ACE100): VIC-5'-AGGCGTGATACAGTCA-3'-MGB
- D-Allelespecific probe (FAM-ACE100): FAM-5'-TGCTGCCTATACAGTCA-3'-MGB

View larger version (15K):
[in this window]
[in a new window]
|
Figure 1. Genotyping of the ACE I/D polymorphism with the TaqMan method.
(A), schematic presentation of the binding sites of primers ACE111, ACE112, and ACE113 and probes VIC-AC100 (VIC) and FAM-AC100 (FAM) in the I allele (I) and D allele (D) of ACE. The insertions were found to be 288 bp long (GenBank and EMBL accession nos. A28005 and X62855) or 289 bp long (AF118569 and our own sequence analysis). The D-allelerelated sequence has been deposited under the accession number AY436326. (B), screen shot showing a typical genotyping result, as obtained on the ABI Prism 7000 Sequence Detection System after completion of the cycling reactions. The graphic represents a read-out of a 96-well microtiter plate, which included, at the outset of the experiment, 90 reactions with DNA samples of unknown genotype and, as controls, reactions containing no DNA (2 wells), DNA of the II genotype (2 wells), and DNA of the DD genotype (2 wells).
|
|
Genomic DNA was extracted from peripheral blood leukocytes by use of the NucleoSpin Blood Quick Pure reagents (Macherey-Nagel). Reactions were carried out on 96-well microtiter plates. The assay volume was 22 µL, which contained 11 µL of the Absolute QPCR ROX Mix (ABgene); 150 nM each of the primers ACE111, ACE112, and ACE113; 150 nM I-allelespecific probe VIC-ACE100, 75 nM D-allelespecific probe FAM-ACE100, and 1050 ng of DNA. The 2-step thermocycling procedure consisted of 35 cycles of denaturation at 92 °C for 15 s and primer annealing and extension at 57 °C for 1 min. After cycling on a GeneAmp PCR System 9600 or 9700 (Applied Biosystems), genotype calling was carried out on the ABI Prism 7000 Sequence Detection System (Applied Biosystems). A typical result is shown in Fig. 1B
, which demonstrates the capability of the new TaqMan assay to differentiate between the ACE I/D genotypes. We verified the ability of the TaqMan system to provide correct genotype data by separate analysis of a limited number of samples (n = 150), using DNA sequencing or an established PCR genotyping system for the ACE I/D polymorphism, as described previously (30)(38).
Using the new method, we determined the ACE I/D genotype in 1500 individuals of Caucasian origin who were included in a study designed to examine a possible association of the ACE I/D polymorphism with adverse events commonly occurring after interventions in coronary arteries. Written informed consent was obtained from all participating patients. The study protocol was approved by the institutional ethics committee, and the investigations were in accordance with the principles of the current version of the Declaration of Helsinki (39). In this series of patients, 299 (19.9%) were homozygous II, 737 (49.1%) were heterozygous ID, and 464 (30.9%) were homozygous DD. The observed ACE I/D genotype distribution was in HardyWeinberg equilibrium (P = 0.84) and in accordance with results obtained in other Caucasian populations (4)(5)(9)(15)(19)(20)(24)(26)(28)(31).
The widely used conventional technique for ACE I/D genotyping, a combination of PCR and gel electrophoresis, is prone to misclassification of ID heterozygotes as DD homozygotes because of preferential amplification of the smaller D-allelerelated sequence (28)(40)(41). To take into consideration the possibility of mistyping, it has been recommended samples typed as DD be subjected to a second, independent PCR including a primer pair that permits amplification only in the presence of the I allele but not the D allele (28)(40)(41). With the conventional method, accurate genotyping requires several time-consuming reaction steps, repeated transfer of material, and manual data acquisition.
The new TaqMan genotyping system for the ACE I/D polymorphism is relatively simple to use and requires little hands-on time because it is a single-tube assay and allows for automated reaction setup, genotype determination, and data processing. Because post-PCR sample handling is not involved, the chance of sample mix-up or the possibility of carryover contamination is greatly reduced. The microtiter plate format and the option to process multiple plates in parallel make this method particularly suitable for approaches demanding high-throughput genotyping, such as clinical association studies involving large numbers of individuals. In addition, the TaqMan system for the ACE I/D polymorphism may serve as a prototype for genotyping assays to be designed for other polymorphisms that are characterized by large insertions/deletions.
References
- Rigat B, Hubert C, Alhenc-Gelas F, Cambien F, Corvol P, Soubrier F. An insertion/deletion polymorphism in the angiotensin I-converting enzyme gene accounting for half the variance of serum enzyme levels. J Clin Invest 1990;86:1343-1346.
- Rieder MJ, Taylor SL, Clark AG, Nickerson DA. Sequence variation in the human angiotensin converting enzyme. Nat Genet 1999;22:59-62.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Suehiro S, Morita T, Inoue M, Kumon Y, Ikeda Y, Hashimoto K. Increased amount of the angiotensin-converting enzyme (ACE) mRNA originating from the ACE allele with deletion. Hum Genet 2004;115:91-96.[Web of Science][Medline]
[Order article via Infotrieve]
- Tiret L, Rigat B, Visvikis S, Breda C, Corvol P, Cambien F, et al. Evidence, from combined segregation and linkage analysis, that a variant of the angiotensin I-converting enzyme (ACE) gene controls plasma ACE levels. Am J Hum Genet 1992;51:197-205.[Web of Science][Medline]
[Order article via Infotrieve]
- Cambien F, Costerousse O, Tiret L, Poirier O, Lecerf L, Gonzales MF, et al. Plasma level and gene polymorphism of angiotensin-converting enzyme in relation to myocardial infarction. Circulation 1994;90:669-676.[Abstract/Free Full Text]
- Agerholm-Larsen B, Tybjærg-Hansen A, Schnohr P, Nordestgaard BG. ACE gene polymorphism explains 3040% of variability in serum ACE activity in both women and men in the population at large: the Copenhagen City Heart Study. Atherosclerosis 1999;147:425-427.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Winnicki M, Accurso V, Hoffmann M, Pawlowski R, Dorigatti F, Santonastaso M, et al. Physical activity and angiotensin-converting enzyme gene polymorphism in mild hypertensives. Am J Med Genet A 2004;125:38-44.[Medline]
[Order article via Infotrieve]
- Collins M, Xenophontos SL, Cariolou MA, Mokone GG, Hudson DE, Anastasiades L, et al. The ACE gene and endurance performance during the South African Ironman triathlons. Med Sci Sports Exerc 2004;36:1314-1320.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- McNamara DM, Holubkov R, Postava L, Janosko K, MacGowan GA, Mathier M, et al. Pharmacogenetic interactions between angiotensin-converting enzyme inhibitor therapy and the angiotensin-converting enzyme deletion polymorphism in patients with congestive heart failure. J Am Coll Cardiol 2004;44:2019-2026.[Abstract/Free Full Text]
- Siest G, Jeannesson E, Berrahmoune H, Maumus S, Marteau J-B, Mohr S, et al. Pharmacogenomics and drug response in cardiovascular disorders. Pharmacogenomics 2004;5:779-802.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Kehoe PG, Russ C, McIlroy S, Williams H, Holmans P, Holmes C, et al. Variation in DCP1, encoding ACE, is associated with susceptibility to Alzheimer disease. Nat Genet 1999;21:71-72.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Elkins JS, Douglas VC, Johnston SC. Alzheimer disease risk and genetic variation in ACE: a meta-analysis. Neurology 2004;62:363-368.[Abstract/Free Full Text]
- Marian AJ, Yu QT, Workman R, Greve G, Roberts R. Angiotensin-converting enzyme polymorphism in hypertrophic cardiomyopathy and sudden cardiac death. Lancet 1993;342:1085-1086.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Raynolds MV, Bristow MR, Bush EW, Abraham WT, Lowes BD, Zisman LS, et al. Angiotensin-converting enzyme DD genotype in patients with ischaemic or idiopathic dilated cardiomyopathy. Lancet 1993;342:1073-1075.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Schunkert H, Hense H-W, Holmer SR, Stender M, Perz S, Keil U, et al. Association between a deletion polymorphism of the angiotensin-converting-enzyme gene and left ventricular hypertrophy. N Engl J Med 1994;330:1634-1638.[Abstract/Free Full Text]
- Higaki J, Shunroku B, Katsuya T, Sato N, Ishikawa K, Mannami T, et al. Deletion allele of angiotensin-converting enzyme gene increases risk of essential hypertension in Japanese men: the Suita Study. Circulation 2000;101:2060-2065.[Abstract/Free Full Text]
- Schut AFC, Bleumink GS, Stricker BHCh, Hofmann A, Witteman JCM, Pols HAP, et al. Angiotensin converting enzyme insertion/deletion polymorphism and the risk of heart failure in hypertensive subjects. Eur Heart J 2004;25:2143-2148.[Abstract/Free Full Text]
- Oike Y, Hata A, Ogata Y, Numata Y, Shido K, Kondo K. Angiotensin converting enzyme as a genetic risk factor for coronary artery spasm: implication in the pathogenesis of myocardial infarction. J Clin Invest 1995;96:2975-2979.
- Cambien F, Poirier O, Lecerf L, Evans A, Cambou J-P, Arveiler D, et al. Deletion polymorphism in the gene for angiotensin-converting enzyme is a potent risk factor for myocardial infarction. Nature 1992;359:641-644.[CrossRef][Medline]
[Order article via Infotrieve]
- Palmer BR, Pilbrow AP, Yandle TG, Frampton CM, Richards AM, Nicolls MG, et al. Angiotensin-converting enzyme gene polymorphism interacts with left ventricular ejection fraction and brain natriuretic peptide levels to predict mortality after myocardial infarction. J Am Coll Cardiol 2003;41:729-736.[Abstract/Free Full Text]
- Schelleman H, Stricker BH, De Boer A, Kroon AA, Verschuren MW, Van Duijn CM, et al. Drug-gene interactions between genetic polymorphisms and antihypertensive therapy. Drugs 2004;64:1801-1816.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Dudley C, Keavney B, Casadei B, Convay J, Bird R, Ratcliffe P. Prediction of patient responses to antihypertensive drugs using genetic polymorphisms: investigation of renin-angiotensin system genes. J Hypertens 1996;14:259-262.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Yamada Y, Ichihara S, Fujimura T, Yokota M. Lack of association of polymorphisms of the angiotensin converting enzyme and angiotensinogen genes with nonfamilial hypertrophic or dilated cardiomyopathy. Am J Hypertens 1997;10:921-928.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Tiret L, Mallet C, Poirier O, Nicaud V, Millaire A, Bouhour J-B, et al. Lack of association between polymorphisms of eight candidate genes and idiopathic dilated cardiomyopathy: the CARDIGEN study. J Am Coll Cardiol 2000;35:29-35.[Abstract/Free Full Text]
- Lindpaintner K, Lee M, Larson MG, Rao VS, Pfeffer MA, Ordovas JM, et al. Absence of association or genetic linkage between the angiotensin-converting-enzyme gene and left ventricular mass. N Engl J Med 1996;334:1023-1028.[Abstract/Free Full Text]
- Agerholm-Larsen B, Nordestgaard BG, Steffensen R, Sørensen TIA, Jensen G, Tybjærg-Hansen A. ACE gene polymorphism: ischemic heart disease and longevity in 10150 individuals: a case-referent and retrospective cohort study based on the Copenhagen City Heart Study. Circulation 1997;95:2358-2367.[Abstract/Free Full Text]
- Keavney B, McKenzie C, Parish S, Palmer A, Clark S, Youngman L, et al. Large-scale test of hypothesised associations between the angiotensin-converting-enzyme insertion/deletion polymorphism and myocardial infarction in about 5000 cases and 6000 controls. Lancet 2000;355:434-442.[Web of Science][Medline]
[Order article via Infotrieve]
- Lindpaintner K, Pfeffer MA, Kreutz R, Stampfer MJ, Grodstein F, LaMotte F, et al. A prospective evaluation of an angiotensin-converting-enzyme gene polymorphism and the risk of ischemic heart disease. N Engl J Med 1995;332:706-711.[Abstract/Free Full Text]
- Harrap SB, Davidson HR, Connor JM, Soubrier F, Corvol P, Fraser R, et al. The angiotensin I converting enzyme gene and predisposition to high blood pressure. Hypertension 1993;21:455-460.[Abstract/Free Full Text]
- Koch W, Kastrati A, Mehilli J, Böttiger C, von Beckerath N, Schömig A. Insertion/deletion polymorphism of the angiotensin I-converting enzyme gene is not associated with restenosis after coronary stent placement. Circulation 2000;102:197-202.[Abstract/Free Full Text]
- Jørgensen E, Kelbæk H, Helqvist S, Jensen GVH, Saunamäki K, Kastrup J, et al. Predictors of coronary in-stent restenosis: importance of angiotensin-converting enzyme gene polymorphism and treatment with angiotensin-converting enzyme inhibitors. J Am Coll Cardiol 2001;38:1434-1439.[Abstract/Free Full Text]
- Rigat B, Hubert C, Corvol P, Soubrier F. PCR detection of the insertion/deletion polymorphism of the human angiotensin converting enzyme gene (DCP1) (dipeptidyl carboxypeptidase 1). Nucleic Acids Res 1992;20:1433.[Free Full Text]
- Livak KJ. Allelic discrimination using fluorogenic probes and the 5' nuclease assay. Genet Anal 1999;14:143-149.[Medline]
[Order article via Infotrieve]
- Koch W, Ehrenhaft A, Griesser K, Pfeufer A, Müller J, Schömig A, et al. TaqMan systems for genotyping of disease-related polymorphisms present in the gene encoding apolipoprotein E. Clin Chem Lab Med 2002;40:1123-1131.[CrossRef][Medline]
[Order article via Infotrieve]
- Koch W, Hoppmann P, Michou E, Jung V, Pfeufer A, Müller J, et al. TaqMan assays for genotyping of single nucleotide polymorphisms present at a disease susceptibility locus on chromosome 6. Clin Chem Lab Med 2005;43:167-172.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Hoppmann P, Koch W, Schömig A, Kastrati A. The 5A/6A polymorphism of the stromelysin-1 gene and restenosis after percutaneous coronary interventions. Eur Heart J 2004;25:335-341.[Abstract/Free Full Text]
- Kutyavin IV, Afonina IA, Mills A, Gorn VV, Lukhtanov EA, Belousov ES, et al. 3'-Minor groove binder-DNA probes increase sequence specificity at PCR extension temperatures. Nucleic Acids Res 2000;28:655-661.[Abstract/Free Full Text]
- Koch W, Mehilli J, von Beckerath N, Böttiger C, Schömig A, Kastrati A. Angiotensin I-converting enzyme (ACE) inhibitors and restenosis after coronary artery stenting in patients with the DD genotype of the ACE gene. J Am Coll Cardiol 2003;41:1957-1961.[Abstract/Free Full Text]
- World Medical Association Declaration of Helsinki: recommendations guiding physicians in biomedical research involving human subjects. JAMA 1997;277:925-926.[Abstract/Free Full Text]
- Shanmugam V, Sell KW, Saha BK. Mistyping ACE heterozygotes. PCR Methods Appl 1993;3:120-121.[Web of Science][Medline]
[Order article via Infotrieve]
- Odawara M, Matsunuma A, Yamashita K. Mistyping frequency of the angiotensin-converting enzyme gene polymorphism and an improved method for its avoidance. Hum Genet 1997;100:163-166.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]