J Korean Med Sci.  2003 Feb;18(1):58-64. 10.3346/jkms.2003.18.1.58.

Tissue Plasminogen Activator and Plasminogen Activator Inhibitor Type 1 Gene Polymorphism in Patients with Gastric Ulcer Complicated with Bleeding

Affiliations
  • 1Department of Internal Medicine, Soonchunhyang University Chunan Hospital, Soonchunhyang University, Chonan, Korea. syhong@schch.co.kr
  • 2Department of Preventive Medicine, Soonchunhyang University Chunan Hospital, Soonchunhyang University, Chonan, Korea.

Abstract

Tissue plasminogen activator (t-PA) and plasminogen activator inhibitor type 1 (PAI-1) may be involved in the pathogenesis of peptic ulcers through suppression of fibrinolysis. This study was designed to investigate associations of t-PA and PAI-1 genes with clinical features of the patients with bleeding gastric ulcers. Eighty-four patients with peptic ulcers and 100 controls were studied between January 1998 and April 2000. We used polymerase chain reaction and endonuclease digestion to genotype for 4G/5G polymorphism in the promoter region of the PAI-1 gene and the Alurepeat insertion/deletion (I/D) polymorphism in intron h of the t-PA gene. Various clinical features, including lesion site, bleeding event, recurrence of ulcer, and rebleeding, were assessed using a multiple logistic regression model. The genotype distributions of both the t-PA and PAI-1 genes did not differ between the patient and control groups. The occurrence of the I/D or D/D genotype of t-PA was significantly higher in cases of duodenal ulcer (adjusted OR=4.39, 95% CI=1.12-17.21). When a dominant effect (i.e., 4G/4G or 4G/5G versus 5G/5G) of the 4G allele was assumed, the PAI-1 4G/4G genotype was independently associated with rebleeding after hemostasis (adjusted OR=5.07, 95% CI=1.03-24.87). Our data suggest that t-PA gene polymorphism is associated with duodenal ulcers, and that the PAI-1 gene may be a risk factor leading to recurrent bleeding after initial hemostasis.

Keyword

Tissue Plasminogen Activator; Plasminogen Activator Inhibitor 1; Peptic Ulcer; Fibrinolysis; Hemostasis

MeSH Terms

Adult
Aged
Alu Elements/genetics
DNA Mutational Analysis
Duodenal Ulcer/complications
Duodenal Ulcer/genetics*
Female
Gene Frequency
Genetic Predisposition to Disease
Genotype
Human
Male
Middle Aged
Mutagenesis, Insertional
Peptic Ulcer Hemorrhage/etiology
Peptic Ulcer Hemorrhage/genetics*
Plasminogen Activator Inhibitor 1/genetics*
Polymorphism (Genetics)*
Promoter Regions (Genetics)/genetics
Recurrence
Sequence Deletion
Stomach Ulcer/complications
Stomach Ulcer/genetics*
Tissue Plasminogen Activator/genetics*
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