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CORRESPONDENCE
Year : 2018  |  Volume : 1  |  Issue : 2  |  Page : 99

Comment on “Polymorphisms in genes regulating vitamin A metabolism and kidney size in Indian newborns”


1 Sanitation 1 Medical Academic Center, Bangkok, Thailand
2 Department of Community Medicine, Dr. DY Patil University, Pune, Maharashtra, India

Date of Web Publication27-Dec-2018

Correspondence Address:
Dr. Beuy Joob
Sanitation 1 Medical Academic Center, Bangkok
Thailand
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/AJPN.AJPN_29_18

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How to cite this article:
Joob B, Wiwanitkit V. Comment on “Polymorphisms in genes regulating vitamin A metabolism and kidney size in Indian newborns”. Asian J Pediatr Nephrol 2018;1:99

How to cite this URL:
Joob B, Wiwanitkit V. Comment on “Polymorphisms in genes regulating vitamin A metabolism and kidney size in Indian newborns”. Asian J Pediatr Nephrol [serial online] 2018 [cited 2019 Jan 22];1:99. Available from: http://www.ajpn-online.org/text.asp?2018/1/2/99/248642

Sir,

We read the publication on “Association between polymorphisms in genes regulating vitamin A metabolism and kidney size in Indian newborns” with interest.[1] Narikot et al. concluded that “polymorphisms in genes involved in vitamin A metabolism are not associated with kidney size in Indian newborns.[1]” In fact, the effect of gene on anatomical structure is an interesting issue. However, epigenetic effects and environmental factors (such as nutrition[2]) have to be considered. In the present study, Narikot et al. selected to study certain specific polymorphisms and not the entire coding sequences of the genes studied, Also, polymorphisms in other genes such as angiotensin-converting enzyme are known to affect kidney size in newborn.[3] Further, the population in the present study is not controlled for other epigenetic and environmental effects, because of which the results might not be conclusive.

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Authors' Reply

Sir,

We appreciate the comments by Joob et al. on our article titled “Polymorphisms in genes regulating vitamin A metabolism and kidney size in Indian newborns.” Multiple factors have an effect on kidney size at birth in humans. During nephrogenesis, developmental programming in the kidney is determined by interactions between genetic and environmental factors, ultimately resulting in what has been called “nephron endowment.” Studies have shown that fetal nutrition, including low protein intake, maternal vitamin A or iron deficiency, maternal diabetes/hyperglycemia, decreased placenta perfusion, and administration of steroids in late pregnancy, may be associated with smaller kidneys.1, 2, 3 In our study, we have included only healthy mothers.4 Pregnant women with iron deficiency anemia, maternal diabetes or low body mass index and those with hypertension were excluded to remove the confounding effect of these factors on nephron endowment. While authors raise a relevant point about epigenetic factors being involved in nephrogenesis, our study focused only on the common genetic polymorphisms in genes involved in vitamin A metabolism. In renal development, context-dependent variations in epigenetic modifications occur which can only be determined by examining renal tissue during development.5 This was not feasible with our study design and methodology.

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Nil.

Conflicts of interest

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  References Top




1 Luyckx VA, Brenner BM. The clinical importance of nephron mass. J Am Soc Nephrol 2010;21:898-910.

2 Langley-Evans SC, Welham SJ, Jackson AA. Fetal exposure to a maternal low protein diet impairs nephrogenesis and promotes hypertension in the rat. Life Sci 1999;64:965-74.

3 Celsi G, Kistner A, Aizman R, Eklöf AC, Ceccatelli S, de Santiago A, et al. Prenatal dexamethasone causes oligonephronia, sodium retention, and higher blood pressure in the offspring. Pediatr Res 1998;44:317-22.

4 Narikot A, Pardeshi VC, Siji A, George A, Vasudevan A. Association between polymorphisms in genes regulating vitamin A metabolism and kidney size in Indian newborns. Asian J Pediatr Nephrol 2018;1:12-6.

5 Dressler GR, Patel SR. Epigenetics in kidney development and renal disease. Transl Res 2015;165:166-76.

 
  References Top

1.
Narikot A, Pardeshi VC, Siji A, George A, Vasudevan A. Association between polymorphisms in genes regulating vitamin A metabolism and kidney size in Indian newborns. Asian J Pediatr Nephrol 2018;1:12-6.  Back to cited text no. 1
  [Full text]  
2.
Galu SC, Hascoet JM, Vieux R. Impact of neonatal factors and nutrition on kidney size in 5-year-old preterm-born children. Am J Perinatol 2015;32:219-24.  Back to cited text no. 2
    
3.
Kaczmarczyk M, Łoniewska B, Kuprjanowicz A, Józwa A, Bińczak-Kuleta A, Gorący I, et al. An insertion/deletion ACE polymorphism and kidney size in Polish full-term newborns. J Renin Angiotensin Aldosterone Syst 2013;14:369-74.  Back to cited text no. 3
    




 

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