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Adhesion G Protein-Coupled Receptor F1

Adhesion G protein-coupled receptor F1 (ADGRF1), also known by its alias GPR110, is a member of the adhesion G protein-coupled receptor (aGPCR) family, which represents a distinct and evolutionarily conserved class of G protein-coupled receptors. These receptors are characterized by a large N-terminal extracellular domain (ECD) that is often involved in cell adhesion and sensing the extracellular environment, fused to a canonical seven-transmembrane domain that mediates intracellular signaling. ADGRF1 plays a fundamental role in mediating cell-cell and cell-matrix interactions, thereby influencing a wide array of physiological processes.

ADGRF1 functions as a mechanosensory receptor or a receptor for specific extracellular ligands. Its elaborate extracellular domain enables interactions with various binding partners, including the complement regulatory protein decay-accelerating factor (DAF/CD55). These interactions, or mechanical forces, are thought to induce conformational changes or proteolytic processing within the receptor, leading to the activation of its intracellular signaling domain. This activation subsequently triggers downstream signaling cascades through the coupling of heterotrimeric G proteins, which in turn regulate crucial cellular functions such as cell migration, proliferation, and survival. ADGRF1 is widely expressed across different cell types, including those of the immune system and endothelial cells, highlighting its diverse biological functions.

The functional significance of ADGRF1 extends to its involvement in various human diseases. In the context of the immune system, ADGRF1 contributes to the modulation of inflammatory responses and the regulation of immune cell trafficking and activation. Disruptions in its expression or activity can affect immune surveillance and contribute to autoimmune or inflammatory conditions. Furthermore, ADGRF1has emerged as a significant player in the pathology of cancer. Research indicates its involvement in key processes of tumor progression, including cancer cell adhesion, motility, invasion, and angiogenesis. This makesADGRF1a potential therapeutic target for mitigating metastasis and improving treatment outcomes in several malignancies, such as colorectal cancer, gastric cancer, and glioblastoma.

Understanding the intricate roles of ADGRF1 and other aGPCRs carries substantial social importance by deepening our knowledge of fundamental biological mechanisms governing cell behavior and tissue homeostasis. Insights derived from ADGRF1 research can facilitate the development of innovative diagnostic tools and targeted therapeutic strategies for a range of diseases, particularly in oncology and immunology. By elucidating the molecular pathways influenced by ADGRF1, scientists and clinicians aim to develop more effective interventions, ultimately enhancing the health and well-being of individuals affected by complex diseases.

Methodological and Statistical Considerations

Section titled “Methodological and Statistical Considerations”

The initial genome-wide association study, while robust, was conducted on a specific cohort of 6,578 women, which, for complex traits, might limit the statistical power to detect genetic variants with very small effect sizes. [1] Such studies often face challenges in achieving genome-wide significance for all associations, particularly when stringent multiple testing corrections, like Bonferroni, are applied. [2] This can lead to an underestimation of the full genetic architecture contributing to soluble intercellular adhesion molecule-1 (sICAM-1) levels and potentially miss true associations of modest effect.

Although largely successful, the replication phase for some identified single nucleotide polymorphisms (SNPs) did not consistently validate all initial associations in the replication cohort.[1] While these non-replicated SNPs often achieved stronger significance when both discovery and replication samples were combined, the initial discrepancies highlight the inherent challenges of consistent signal detection across different sample subsets. This phenomenon can also be indicative of the “winner’s curse,” where initial effect sizes may be overestimated in the discovery phase [3] necessitating further validation in independent cohorts to confirm true genetic associations and refine effect estimates.

Population Specificity and Phenotypic Measurement Nuances

Section titled “Population Specificity and Phenotypic Measurement Nuances”

A significant limitation of the study is its focus exclusively on self-identified Caucasians, which restricts the direct generalizability of these findings to other diverse populations. [1] Genetic associations, allele frequencies, and linkage disequilibrium patterns can vary substantially across different ancestries, meaning that the identified variants might not have the same effects or predictive power in non-European populations. Furthermore, the cohort consisted solely of women, which may obscure potential sex-specific genetic effects or gene-environment interactions that could influence sICAM-1 levels differently between sexes.

The phenotype under investigation, sICAM-1, represents a circulating biomarker rather than a direct measure of cellular adhesion in tissues. While sICAM-1 is an important indicator, its levels may not perfectly correlate with the complex in vivo processes of cell-cell adhesion or disease pathogenesis. Therefore, the identified genetic associations primarily reflect factors influencing the soluble form ofICAM1 [1] and further research is required to fully elucidate the intricate relationship between circulating sICAM-1 levels and actual cellular adhesion mechanisms or clinical outcomes.

Uncharacterized Genetic Landscape and Broader Context

Section titled “Uncharacterized Genetic Landscape and Broader Context”

Despite identifying significant associations at the ICAM1 and ABO loci, the study also pointed to a broader genetic landscape where the functional implications of some associated variants remain poorly understood. For example, a SNP with a notable p-value was found within CCDC46, a gene whose function is not well characterized [1] indicating existing gaps in our understanding of the biological mechanisms linking these genetic variants to sICAM-1 levels. Such findings underscore the need for extensive functional studies to translate genetic associations into biological insights.

The study, like many genome-wide association studies, likely explains only a fraction of the total heritability of sICAM-1 levels, implying that a substantial portion of genetic influence remains unaccounted for. This “missing heritability” suggests that numerous other genetic factors, including rare variants, structural variations, or complex gene-gene and gene-environment interactions, contribute to the trait but were not detectable with the current study design and array platforms. [4] Future research with larger cohorts, denser genotyping, and advanced analytical approaches will be crucial to comprehensively map these additional genetic and environmental determinants.

VTN(Vitronectin) is a significant glycoprotein found in blood plasma and the extracellular matrix, playing a crucial role in cell adhesion, spreading, and migration, as well as being involved in the coagulation and complement cascades. Variants inVTN can influence its expression levels, binding affinities, or structural integrity, thereby impacting its diverse functions in tissue remodeling, angiogenesis, and immune responses. These functions are highly relevant to the role of ADGRF1 (Adhesion G Protein-Coupled Receptor F1), an adhesion G protein-coupled receptor that mediates cell-cell and cell-matrix interactions and signal transduction, essential for maintaining tissue architecture. The interplay between VTN and ADGRF1is vital for cellular communication and maintaining tissue integrity, with genetic studies frequently examining single nucleotide polymorphisms (SNPs) within or near candidate genes for associations with various phenotypes.[5] Understanding how VTN variants affect the extracellular environment helps clarify the signaling landscape for adhesion GPCRs like ADGRF1.

SARM1(Sterile Alpha and Toll/Interleukin-1 Receptor Motif-Containing 1) is a critical enzyme that acts as an NADase, initiating a programmed form of axonal degeneration in response to injury or stress, a process central to neurological health and disease. The variantrs704 within the SARM1 gene may modulate this enzymatic activity, influencing the rate and extent of axonal loss and potentially impacting susceptibility to neurodegenerative conditions. ADGRF1 is also expressed in the nervous system and is involved in neuronal development, synapse formation, and maintaining the structural integrity of neural circuits. Therefore, variations in SARM1, such as rs704 , could indirectly affect the cellular environment and signaling pathways in which ADGRF1 operates, influencing overall neuronal resilience and function. Genome-wide association studies (GWAS) are commonly used to identify such genetic associations across various phenotypes. [6]

APOE(Apolipoprotein E) is a key lipid-binding protein that plays a central role in the metabolism and transport of lipids, particularly cholesterol, throughout the body and within the brain. The single nucleotide polymorphismrs429358 , along with another variant, defines the three major APOEisoforms (E2, E3, E4), which have differential effects on lipid binding and receptor interactions. For instance, the E4 allele, characterized by specific nucleotide changes includingrs429358 , is a significant genetic risk factor for Alzheimer’s disease and is associated with altered lipid profiles, including higher LDL cholesterol levels.[7] These changes in lipid metabolism can influence cellular membrane composition and signaling pathways, which are relevant to ADGRF1, an adhesion G protein-coupled receptor whose function can be modulated by its lipid microenvironment. The broader landscape of lipid-related genes is often investigated in large-scale genetic studies to understand their contribution to complex traits. [8]

RS IDGeneRelated Traits
rs704 VTN, SARM1blood protein amount
heel bone mineral density
tumor necrosis factor receptor superfamily member 11B amount
low density lipoprotein cholesterol measurement
protein measurement
rs429358 APOEcerebral amyloid deposition measurement
Lewy body dementia, Lewy body dementia measurement
high density lipoprotein cholesterol measurement
platelet count
neuroimaging measurement

Cellular adhesion is a fundamental biological process crucial for maintaining tissue integrity, facilitating cell migration, and orchestrating immune responses. A key biomolecule involved in these processes is Intercellular Adhesion Molecule-1 (ICAM-1), a cell surface glycoprotein that mediates cell-to-cell binding.ICAM-1 plays a critical role in inflammatory responses by enabling the extravasation of leukocytes from the bloodstream into tissues, a process essential for generating effector cells that mediate inflammation. [1] Its expression is tightly regulated, notably by inflammatory cytokines in human endothelial cells, where the ICAM-1 gene’s transcription relies on essential roles played by a variant NF-kappa B site and p65 homodimers. [9] The presence of a soluble form, s_ICAM-1_, in circulation reflects the shedding of the membrane-bound molecule, and its levels can serve as a biomarker for various physiological and pathophysiological states.

Genetic Influences on Adhesion Molecule Expression

Section titled “Genetic Influences on Adhesion Molecule Expression”

The levels of circulating s_ICAM-1_ are significantly influenced by genetic factors, with strong linkage identified to the ICAM gene cluster region located on chromosome 19p13.2 [10]. [11] This genetic predisposition means that variations within this region can dictate an individual’s baseline s_ICAM-1_ concentrations. Specific genetic polymorphisms, such as the Gly241Arg ICAM-1 gene polymorphism, have been directly associated with serum s_ICAM-1_ levels. [12] Furthermore, genome-wide association studies have pinpointed specific loci, including rs1799969 , rs5498 , and rs281437 within the 19p13.2 (ICAM1) locus, that collectively account for a substantial portion of the variance in s_ICAM-1_ concentrations. [1] These genetic variations can affect the efficiency of gene transcription, protein stability, or shedding mechanisms, thereby modulating the overall availability of s_ICAM-1_.

The Interplay of Blood Group Antigens and Adhesion

Section titled “The Interplay of Blood Group Antigens and Adhesion”

A novel and significant association has been discovered between the ABO histo-blood group antigen and soluble ICAM-1 levels. [1] The ABO gene, located on chromosome 9q34.2, encodes glycosyltransferase enzymes responsible for adding specific sugar residues to the precursor H antigen, thereby forming the A, B, or O blood group antigens. [1] The A allele, for instance, codes for alpha1R3 N-acetylgalactosamyl-transferase, which creates the A antigen, while the B allele produces alpha1R3 galactosyltransferase for the B antigen, and the O allele results in an inactive enzyme. [1] This enzymatic activity is not uniform, as the A2 allele, a subtype of A, exhibits significantly lower A transferase activity compared to A1 [13]. [1] The presence of ABO(H) blood group antigens is not limited to red blood cells; they are also covalently linked to other plasma proteins, such as alpha 2-macroglobulin and von Willebrand factor [14]suggesting a broader biological role for these carbohydrate structures in protein function and interaction.

The physiological relevance of adhesion molecules like ICAM-1 extends to their involvement in various pathophysiological processes. Elevated circulating levels of s_ICAM-1_, along with soluble VCAM-1, are associated with an increased risk for the development of symptomatic peripheral arterial disease.[15] Similarly, high circulating levels of endothelial adhesion molecules, including s_ICAM-1_, are indicative of an elevated risk of diabetes. [16]Beyond cardiovascular and metabolic disorders, theICAM-1 gene has also been linked to type 1 diabetes, highlighting its role in autoimmune processes. [17] Furthermore, the ABOblood group system, through its genetic influence on s_ICAM-1_ and other pathways, has been implicated in the susceptibility to vascular disease and cardiac infarction, demonstrating systemic consequences that affect organ-level biology and overall homeostatic balance[18], [19]. [20]

Receptor-Mediated Adhesion and Inflammatory Signaling

Section titled “Receptor-Mediated Adhesion and Inflammatory Signaling”

Adhesion molecules like intercellular adhesion molecule-1 (ICAM1) play a critical role in cellular interactions, particularly in inflammatory responses. The ICAM1 gene locus on chromosome 19p13.2 is strongly associated with plasma concentrations of soluble ICAM1 (sICAM-1). [1] This molecule’s transcription is regulated by inflammatory cytokines, involving essential roles for a variant NF-kappa B site and p65 homodimers. [9] Such regulation highlights a key mechanism where external inflammatory signals directly modulate the expression of adhesion proteins, influencing their availability and function.

Beyond direct ICAM1 regulation, other factors integrate into adhesion processes. The ABO histo-blood group antigen, for instance, exhibits a novel association with sICAM-1 concentrations, suggesting an uncharacterized regulatory role for these antigens in inflammatory adhesion. [1]Furthermore, monocyte chemoattractant protein-1 (CCL2), a chemokine, is involved in inflammatory processes and its synthesis and secretion can be stimulated by receptor activation, such as the high-affinity IgE receptor on mast cells. [21] These interconnected signaling pathways underscore the complexity of cellular adhesion and inflammatory responses, where multiple receptors and regulatory elements converge to control cellular trafficking and tissue infiltration.

Metabolic pathways are intimately linked with cellular composition and function, including membrane properties crucial for adhesion. The FADS1 gene, encoding delta-5 desaturase, is central to the biosynthesis of long-chain polyunsaturated fatty acids from essential fatty acids like linoleic acid. [22] This enzyme catalyzes the conversion of eicosatrienoyl-CoA (C20:3) to arachidonyl-CoA (C20:4), which are then incorporated into glycerophospholipids such as phosphatidylcholines (e.g., PC aa C36:3 to PC aa C36:4). [22] Genetic variations in FADS1 significantly impact the efficiency of these desaturation reactions, profoundly affecting the fatty acid composition of phospholipids and, consequently, membrane fluidity and signaling platforms. [22]

Beyond lipid metabolism, other metabolic pathways contribute to systemic homeostasis. The SLC2A9gene encodes a urate transporter that significantly influences serum uric acid concentrations and urate excretion, with implications for conditions like gout.[23] Additionally, a common variant in the GCKRgene is associated with elevated fasting serum triacylglycerol levels, reduced fasting and oral glucose tolerance test-related insulinemia, and a decreased risk of type 2 diabetes.[24] The GCKRprotein also plays a role in regulating glucokinase activity, a key enzyme in glucose metabolism.[25] These examples illustrate how specific genetic variants modulate fundamental metabolic processes, impacting not only energy balance but also the availability of crucial signaling molecules and the overall cellular environment.

Gene Regulation and Post-Translational Modifiers

Section titled “Gene Regulation and Post-Translational Modifiers”

Cellular functions are tightly controlled by layered regulatory mechanisms, starting with gene expression. The transcription of adhesion molecules, such as ICAM1, is precisely regulated at the promoter level by transcription factors like NF-kappa B in response to inflammatory cytokines. [9]Similarly, the human C-reactive protein promoter is synergistically trans-activated by transcription factorHNF1A binding at distinct sites, demonstrating hierarchical regulation of acute phase response genes. [26] These examples highlight how specific genetic elements and their interacting transcription factors orchestrate the cellular response by controlling the synthesis of key proteins.

Post-translational modifications further refine protein function and localization. The generation of soluble forms of adhesion molecules, such as sICAM-1, from their membrane-bound counterparts represents a crucial post-translational regulatory mechanism, potentially through proteolytic cleavage. [1] Protein modifications like glycosylphosphatidylinositol-specific phospholipase D activity are known to influence membrane-associated proteins. [27] Allosteric control, while not explicitly detailed for specific adhesion receptors in the context, is a fundamental regulatory principle in metabolism, exemplified by the impact of genetic variants on enzyme efficiencies, such as those in FADS1, SCAD, and MCAD genes, which alter metabolic flux. [22]

The integration of diverse signaling and metabolic pathways is critical for maintaining cellular and systemic health, and their dysregulation underlies various diseases. For instance, circulating levels of endothelial adhesion molecules like sICAM-1 and soluble VCAM-1 are associated with the development of symptomatic peripheral arterial disease[15] and also with the risk of diabetes. [16] The association of ICAM1gene polymorphisms with type 1 diabetes further exemplifies how genetic variations in adhesion pathways contribute to complex disease susceptibility.[17]These connections reveal a systems-level integration where inflammatory and adhesion processes are central to the pathogenesis of cardiovascular and metabolic disorders.

Metabolic dysregulation often intertwines with inflammatory and adhesion pathways. Variants in genes influencing lipid metabolism, such as FADS1 affecting fatty acid profiles, or GCKRimpacting glucose and triglyceride levels, contribute to the risk of metabolic syndrome and type 2 diabetes.[22] Similarly, CCL2polymorphisms are associated with serum monocyte chemoattractant protein-1 levels and myocardial infarction, highlighting the role of chemokine signaling in cardiovascular disease.[28] Understanding these intricate pathway crosstalks, where genetic predispositions affect both metabolic and inflammatory axes, offers potential avenues for identifying therapeutic targets and developing personalized medicine strategies.

Clinical Relevance of Adhesion G Protein-Coupled Receptor F1 (ICAM-1)

Section titled “Clinical Relevance of Adhesion G Protein-Coupled Receptor F1 (ICAM-1)”

Prognostic and Risk Stratification in Vascular and Metabolic Health

Section titled “Prognostic and Risk Stratification in Vascular and Metabolic Health”

Circulating levels of soluble intercellular adhesion molecule-1 (sICAM-1) are valuable for predicting outcomes in various cardiovascular and metabolic diseases. ElevatedsICAM-1is associated with an increased risk for developing symptomatic peripheral arterial disease (PAD) in men.[15]These levels also serve as predictors for the progression of peripheral atherosclerosis and are recognized as potential risk factors for acute coronary syndromes.[29] Furthermore, in women, higher circulating levels of endothelial adhesion molecules, including sICAM-1, are linked to an elevated risk of developing diabetes, highlighting its broad relevance in metabolic health. [16]

These associations underscore the utility of sICAM-1 as a biomarker for identifying individuals at high risk and guiding preventative strategies. The differential impact of sICAM-1on atherosclerosis progression suggests its potential role in personalized risk assessment.[30] Early detection of elevated sICAM-1could prompt interventions to mitigate disease development, making it a crucial component in risk stratification models for these prevalent conditions.

Genetic variations within the ICAM1 gene cluster on chromosome 19 significantly influence circulating sICAM-1 levels, with specific quantitative trait loci identified through genome-wide association studies. [10] For instance, the minor allele of the non-synonymous coding SNP rs1799969 (G241R) in ICAM1 is correlated with lower sICAM-1 concentrations and has been associated with a reduced risk of type 1 diabetes. [1] This genetic insight provides a foundation for identifying individuals with a predisposed risk or resilience to sICAM-1-related pathologies.

Beyond the ICAM1 locus, the ABO histo-blood group antigen, encoded by the ABO gene on chromosome 9q34.2, also shows a novel association with sICAM-1 levels. [1] Individuals with blood group O typically exhibit lower sICAM-1 levels compared to non-O individuals. [1] Given that ABOblood group influences plasma von Willebrand factor levels, which are themselves linked to vascular disease, this genetic association suggests a complex interplay that could inform more comprehensive risk stratification and personalized medicine approaches.[20]

Diagnostic Utility and Monitoring of Inflammatory Conditions

Section titled “Diagnostic Utility and Monitoring of Inflammatory Conditions”

The established associations of sICAM-1 with various inflammatory and vascular conditions position it as a valuable diagnostic and monitoring tool. Its utility extends to conditions such as type 1 diabetes, where the ICAM1gene itself has been linked to disease susceptibility.[17] Monitoring sICAM-1levels could aid in tracking disease activity or the effectiveness of therapeutic interventions, particularly in chronic inflammatory states, by providing insights into the underlying endothelial activation and inflammation.

While current research largely focuses on prognostic value, the ability to genetically determine baseline sICAM-1 levels through variants like rs1799969 and ABO blood group status offers avenues for enhanced diagnostic precision. [1] Integrating these genetic markers with circulating sICAM-1measurements could provide a more holistic view of a patient’s inflammatory burden and vascular health, guiding treatment selection and disease management strategies.

[1] Pare G, et al. “Novel association of ABO histo-blood group antigen with soluble ICAM-1: results of a genome-wide association study of 6,578 women.” PLoS Genet, vol. 4, no. 7, 2008, p. e1000118.

[2] Benjamin EJ, et al. “Genome-wide association with select biomarker traits in the Framingham Heart Study.” BMC Med Genet, vol. 8, suppl. 1, 2007, p. S10.

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[9] Ledebur, H. C., and T. P. Parks. “Transcriptional regulation of the intercellular adhesion molecule-1 gene by inflammatory cytokines in human endothelial cells. Essential roles of a variant NF-kappa B site and p65 homodimers.” J Biol Chem, vol. 270, 1995, pp. 933–943.

[10] Bielinski, S. J., et al. “Circulating soluble ICAM-1 levels shows linkage to ICAM gene cluster region on chromosome 19: The NHLBI Family Heart Study follow-up examination.” Atherosclerosis, 2007.

[11] Kent, J. W. Jr., et al. “Quantitative trait locus on Chromosome 19 for circulating levels of intercellular adhesion molecule-1 in Mexican Americans.” Atherosclerosis, vol. 195, 2007, pp. 367–373.

[12] Ponthieux, A., et al. “Association between Gly241Arg ICAM-1 gene polymorphism and serum sICAM-1 concentration in the Stanislas cohort.” Eur J Hum Genet, vol. 11, 2003, pp. 679–686.

[13] Yamamoto, F., et al. “Human histo-blood group A2 transferase coded by A2 allele, one of the A subtypes, is characterized by a single base deletion in the coding sequence, which results in an additional domain at the carboxyl terminal.” Biochem Biophys Res Commun, vol. 187, 1992, pp. 366–374.

[14] Matsui, T., et al. “Human plasma alpha 2-macroglobulin and von Willebrand factor possess covalently linked ABO(H) blood group antigens in subjects with corresponding ABO phenotype.”Blood, vol. 82, 1993.

[15] Pradhan, A. D., et al. “Soluble intercellular adhesion molecule-1, soluble vascular adhesion molecule-1, and the development of symptomatic peripheral arterial disease in men.”Circulation, vol. 106, 2002, pp. 820–825.

[16] Song, Y., et al. “Circulating levels of endothelial adhesion molecules and risk of diabetes in an ethnically diverse cohort of women.” Diabetes, vol. 56, 2007, pp. 1898–1904.

[17] Nejentsev, S., et al. “Association of intercellular adhesion molecule-1 gene with type 1 diabetes.” Lancet, vol. 362, 2003, pp. 1723–1724.

[18] Medalie, J. H., et al. “Blood groups, myocardial infarction and angina pectoris among 10,000 adult males.”N Engl J Med, vol. 285, 1971, pp. 1348–1353.

[19] Platt, D., et al. “ABO blood group system, age, sex, risk factors and cardiac infarction.” Arch Gerontol Geriatr, vol. 4, 1985.

[20] Wu, O., et al. “ABO(H) blood groups and vascular disease: a systematic review and meta-analysis.”Blood, vol. 110, 2008, pp. 2250–2258.

[21] Eglite, S., J.M. Morin, and H. Metzger. “Synthesis and secretion of monocyte chemotactic protein-1 stimulated by the high affinity receptor for IgE.”Journal of Immunology, vol. 170, 2003, pp. 2680–2687.

[22] Gieger, Christian, et al. “Genetics meets metabolomics: a genome-wide association study of metabolite profiles in human serum.”PLoS Genetics, vol. 4, no. 11, 2008, e1000282.

[23] Vitart, Veronique, et al. “SLC2A9 is a newly identified urate transporter influencing serum urate concentration, urate excretion and gout.”Nature Genetics, vol. 39, no. 3, 2007, pp. 325–330.

[24] Ridker, Paul M., et al. “Loci related to metabolic-syndrome pathways including LEPR, HNF1A, IL6R, and GCKR associate with plasma C-reactive protein: the Women’s Genome Health Study.”American Journal of Human Genetics, vol. 82, no. 5, 2008, pp. 1185–1192.

[25] Garcia-Herrero, C. M., et al. “Functional analysis of human glucokinase gene mutations causing MODY2: exploring the regulatory mechanisms of glucokinase activity.”Diabetologia, vol. 50, 2007, pp. 325–333.

[26] Toniatti, C., et al. “Synergistic trans-activation of the human C-reactive protein promoter by transcription factor HNF-1 binding at two distinct sites.”EMBO Journal, vol. 9, no. 13, 1990, pp. 4467–4475.

[27] Chalasani, Naga, et al. “Glycosylphosphatidylinositol-specific phospholipase d in nonalcoholic Fatty liver disease: A preliminary study.”Journal of Clinical Endocrinology & Metabolism, vol. 91, no. 6, 2006, pp. 2279–2285.

[28] McDermott, D.H., et al. “CCL2 polymorphisms are associated with serum monocyte chemoattractant protein-1 levels and myocardial infarction in the Framingham Heart Study.”Circulation, vol. 112, no. 8, 2005, pp. 1113–1120.

[29] Tzoulaki, Ioanna, et al. “C-Reactive Protein, Interleukin-6, and Soluble Adhesion Molecules as Predictors of Progressive Peripheral Atherosclerosis in the General Population: Edinburgh Artery Study.”Circulation, vol. 112, no. 7, 2005, pp. 976–983.

[30] Albert, Nancy A., et al. “Differential Effect of Soluble Intercellular Adhesion Molecule-1 on the Progression of Atherosclerosis as.”Circulation, vol. 116, no. 17, 2007, pp. 1827–1834.