Sadia Rehman, Nafees Ahmad, Naveed Akhtar, Sooda Usman, Saeeda Munir, Nusrat Saba, Waqar Ahmed, Asif Mir, Abdul Hameed, Aisha Mohyuddin and Azra Khanum
Background: Rheumatic heart disease (RHD) is an inflammatory autoimmune cardiovascular disorder. The disease is highly prevalent in both urban (22 per 1000 individuals) and rural (5.7 per 1000 individuals) areas of Pakistan. The main purpose of this research work was to examine the role of two most widely studied genes, MEFV and TNF in the susceptibility of RHD in Pakistani patients.
Methods and Materials: In total 360 samples, including 156 clinically diagnosed RHD patients and 204 healthy controls were included in the study. Single strand conformational polymorphism (SSCP) and direct DNA sequencing approach were used to identify the genetic changes in TNF exons and hot spots of MEFV gene.
Results: No genetic variation in the two genes was detected in this study except a novel mutation (g.G2,096A) in exon 2 of MEFV gene. Computational analysis revealed that this mutation (p.S179N) severely affect the threedimensional structure of the protein and thus probably has a pathogenic role. However, this mutation was identified in two patients only.
Conclusion: Hence, contribution of this mutation is expected to be very small in Pakistani patients. Our results showed a novel mutation with pathogenic effect in a very small proportion of the RHD patients in Pakistan. However, majority of the patients may have mutation outside the hot spot region of MEFV gene or there are other susceptibility factors that are contributing toward high prevalence of RHD in Pakistan. Therefore, it is important to screen the complete MEFV gene and other genetic susceptibility factors to understand etiology of RHD and thus manage its increasing incidence.