This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The success of the human genome project provides the promise of a new era in understanding and modifying human disease. It seems both likely and feasible that, during the next generation, we will identify the major host genes and their genetic variations, which modulate susceptibility to and severity of disease and responsiveness to medical therapies. To translate this promise into reality will require careful clinical characterizations of different patient phenotypes, coupled with determination of genotypes (genetic variations), gene expression information (mRNA's by microarrays, etc.), and information about translation of mRNA's into proteins (proteomics). A few studies have already identified genotypes that predict with greatly improved accuracy susceptibility to chronic vascular or neoplastic diseases and/or severity and outcome of these diseases. This project will take full advantage of the samples and clinical data obtained through the landmark HALT-C Trial, in order to develop a similar body of knowledge for chronic hepatitis C (CHC). The long-term goal of this program is to ascertain the major genetic variations that predispose patients to develop advanced CHC and/or lack of responsiveness to (Interferon) IFN-based treatment. We will concentrate our efforts on variations in selected genes, which in previous smaller studies, have been shown to predict severity of CHC and/or responsiveness to IFN treatment. Specifically, we will delineate the role of iron, HFE gene mutations, and/or polymorphisms in other selected genes or gene promoters on the production and progression of CHC. Our major hypotheses are that hepatic iron, mutations of the HFE gene associated with HLA-linked hereditary hemochromatosis (HHC), and/or selected polymorphisms in other genes, are important host factors that influence the progression of chronic hepatitis C to cirrhosis, decompensation, and hepatocellular carcinoma and/or the response of CHC to IFN-based therapies.
The specific aims of this project are: To determine whether there is a direct correlation between progression of chronic hepatitis C (i.e., the major endpoints of the HALT-C Trial) and hepatic or total body iron content and/or the presence of the HFE gene mutations (C282Y, H63D, S65C) associated with HHC; To determine whether there are correlations between progression of chronic hepatitis C and polymorphisms of the angiotensinogen promoter (Ang-P), apolipoprotein E (apo-E) genotype, the interleukin-I0 promoter (IL-10-P), microsomal epoxide hydrolase (mEH), transforming growth factor-beta (TGF), or the tumor necrosis factor-alpha promoter (TNF-P); To explore whether there are significant interactions among mutations of HFE, polymorphisms of other genes, and patients' responses to therapy or long-term outcomes; and To determine whether the frequencies of these genetic variations differ significantly among subjects in the HALT-C Trial vs other subjects with less advanced CHC, or control subjects without CHC, matched for age, sex, and ethnicity.
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