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Mogavero MP, Salemi M, Lanza G, Rinaldi A, Marchese G, Ravo M, Salluzzo MG, Antoci A, DelRosso LM, Bruni O, Ferini-Strambi L, Ferri R. Unveiling the pathophysiology of restless legs syndrome through transcriptome analysis. iScience 2024; 27:109568. [PMID: 38617564 PMCID: PMC11015462 DOI: 10.1016/j.isci.2024.109568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 01/22/2024] [Accepted: 03/22/2024] [Indexed: 04/16/2024] Open
Abstract
The aim of this study was to analyze signaling pathways associated with differentially expressed messenger RNAs in people with restless legs syndrome (RLS). Seventeen RLS patients and 18 controls were enrolled. Coding RNA expression profiling of 12,857 gene transcripts by next-generation sequencing was performed. Enrichment analysis by pathfindR tool was carried-out, with p-adjusted ≤0.001 and fold-change ≥2.5. Nine main different network groups were significantly dysregulated in RLS: infections, inflammation, immunology, neurodegeneration, cancer, neurotransmission and biological, blood and metabolic mechanisms. Genetic predisposition plays a key role in RLS and evidence indicates its inflammatory nature; the high involvement of mainly neurotropic viruses and the TORCH complex might trigger inflammatory/immune reactions in genetically predisposed subjects and activate a series of biological pathways-especially IL-17, receptor potential channels, nuclear factor kappa-light-chain-enhancer of activated B cells, NOD-like receptor, mitogen-activated protein kinase, p53, mitophagy, and ferroptosis-involved in neurotransmitter mechanisms, synaptic plasticity, axon guidance, neurodegeneration, carcinogenesis, and metabolism.
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Affiliation(s)
- Maria P. Mogavero
- Vita-Salute San Raffaele University, 20132 Milan, Italy
- San Raffaele Scientific Institute, Division of Neuroscience, Sleep Disorders Center, 20127 Milan, Italy
| | | | - Giuseppe Lanza
- Oasi Research Institute-IRCCS, 94018 Troina, Italy
- University of Catania, Department of Surgery and Medical-Surgical Specialties, 95123 Catania, Italy
| | - Antonio Rinaldi
- Genomix4Life Srl, 84081 Baronissi, Italy
- Genome Research Center for Health-CRGS, 84081 Baronissi, Italy
| | - Giovanna Marchese
- Genomix4Life Srl, 84081 Baronissi, Italy
- Genome Research Center for Health-CRGS, 84081 Baronissi, Italy
| | - Maria Ravo
- Genomix4Life Srl, 84081 Baronissi, Italy
- Genome Research Center for Health-CRGS, 84081 Baronissi, Italy
| | | | | | | | - Oliviero Bruni
- Sapienza University of Rome, Developmental and Social Psychology, 00185 Rome, Italy
| | - Luigi Ferini-Strambi
- Vita-Salute San Raffaele University, 20132 Milan, Italy
- San Raffaele Scientific Institute, Division of Neuroscience, Sleep Disorders Center, 20127 Milan, Italy
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Cederberg KLJ, Peris Sempere V, Lin L, Zhang J, Leary EB, Moore H, Morse AM, Blackman A, Schweitzer PK, Kotagal S, Bogan R, Kushida CA, Mignot E. Proteomic insights into the pathophysiology of periodic limb movements and restless legs syndrome. Sleep Health 2024; 10:S161-S169. [PMID: 37563071 PMCID: PMC10850434 DOI: 10.1016/j.sleh.2023.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/11/2023] [Accepted: 06/27/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVES We used a high-throughput assay of 5000 plasma proteins to identify biomarkers associated with periodic limb movements (PLM) and restless legs syndrome (RLS) in adults. METHODS Participants (n = 1410) of the Stanford Technology Analytics and Genomics in Sleep (STAGES) study had blood collected, completed a sleep questionnaire, and underwent overnight polysomnography with the scoring of PLMs. An aptamer-based array (SomaScan) was used to quantify 5000 proteins in plasma. A second cohort (n = 697) that had serum assayed using a previous iteration of SomaScan (1300 proteins) was used for replication and in a combined analysis (n = 2107). A 5% false discovery rate was used to assess significance. RESULTS Multivariate analyses in STAGES identified 68 proteins associated with the PLM index after correction for multiple testing (ie, base model). Most significantly decreased proteins were iron-related and included Hepcidin (LEAP-1), Ferritin, and Ferritin light chain. Most significantly increased proteins included RANTES, Cathepsin A, and SULT 1A3. Of 68 proteins significant in the base model, 17 were present in the 1300 panel, and 15 of 17 were replicated. The most significant proteins in the combined model were Hepcidin (LEAP-1), Cathepsin A, Ferritin, and RANTES. Exploration of proteins in RLS versus non-RLS identified Cathepsin Z, Heme oxygenase 2 (HO-2), Interleukin-17A (upregulated in the combined cohort), and Megalin (upregulated in STAGES only) although results were less significant than for proteins associated with PLM index. CONCLUSIONS These results confirm the association of PLM with low iron status and suggest the involvement of catabolic enzymes in PLM/RLS.
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Affiliation(s)
- Katie L J Cederberg
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
| | - Vicente Peris Sempere
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
| | - Ling Lin
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
| | - Jing Zhang
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
| | - Eileen B Leary
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA; Axsome Therapeutics, New York, NY, USA
| | - Hyatt Moore
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
| | - Anne M Morse
- Division of Pediatric Sleep Medicine, Geisinger, Danville, PA, USA; Geisinger Commonwealth School of Medicine, Scranton, PA, USA
| | - Adam Blackman
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Paula K Schweitzer
- Sleep Medicine & Research Center, St. Luke's Hospital, Chesterfield, MO, USA
| | - Suresh Kotagal
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Richard Bogan
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Clete A Kushida
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
| | - Emmanuel Mignot
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA.
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Alaçam Köksal S, Boncuk Ulaş S, Acar BA, Acar T, Güzey Aras Y, Köroğlu M. Evaluation of the relationship between idiopathic restless legs syndrome and serum hepcidin levels. Brain Behav 2023; 13:e3259. [PMID: 37726920 PMCID: PMC10636386 DOI: 10.1002/brb3.3259] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/04/2023] [Accepted: 09/08/2023] [Indexed: 09/21/2023] Open
Abstract
INTRODUCTION The relationship between restless legs syndrome (RLS) and iron deficiency is a well-known topic. However, the etiology of the disease has not been determined. As the central iron deficiency is the most critical biological abnormality for RLS, we planned a study examining the relationship between RLS and hepcidin, which is the only regulatory hormone of iron metabolism known so far. METHODS International Restless Legs Syndrome Study Group diagnostic criteria (2014) were taken as a basis. A total of 40 RLS patients and 40 healthy controls were included in the study. To avoid the potential variables that might cause secondary RLS, all the participants were asked to provide hemogram, ferritin, iron, thyroid function tests, and sedimentation analysis. The hepcidin levels were measured with a Human Hepcidin (Hepc 25) ELISA kit (MyBioSource). RESULTS The statistically significant results of our analysis show that the red blood cell count, the neutrophil count, the percentage of lymphocytes and neutrophils, and, more distinctively, hepcidin levels were higher in RLS patients in comparison with the control group. CONCLUSION In this study, no differences were found in iron and ferritin values. High levels of hepcidin, the main regulator of iron metabolism, in those with primary RLS support the possibility that hepcidin may play a role in the pathogenesis of RLS. We think that larger studies on this subject can give clearer ideas.
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Affiliation(s)
| | | | | | - Türkan Acar
- Department of Neurology, Faculty of MedicineSakarya UniversitySerdivanSakaryaTurkey
| | - Yeşim Güzey Aras
- Department of Neurology, Faculty of MedicineSakarya UniversitySerdivanSakaryaTurkey
| | - Mehmet Köroğlu
- Department of Microbiology, Faculty of MedicineSakarya UniversitySerdivanSakaryaTurkey
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Jiménez-Jiménez FJ, Alonso-Navarro H, García-Martín E, Agúndez JAG. Inflammatory factors and restless legs syndrome: A systematic review and meta-analysis. Sleep Med Rev 2022; 68:101744. [PMID: 36634410 DOI: 10.1016/j.smrv.2022.101744] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/15/2022] [Accepted: 12/25/2022] [Indexed: 01/01/2023]
Abstract
The possible role of inflammatory factors in the pathogenesis of restless legs syndrome (RLS) is not well understood. Because several inflammatory diseases have shown an association with the risk for RLS, the measurement of serum/plasma levels of inflammatory factors has been a matter of a scarce number of studies. We performed a systematic review and a meta-analysis to assess the possible association of serum/plasma levels of inflammatory markers with the risk for RLS. Our results showed a significant trend towards higher serum/plasma C reactive protein (CRP) levels and higher neutrophil-to-lymphocyte (NLR) ratio in patients diagnosed with RLS than in controls, although statistical significance disappeared after applying the random-effects model. Further studies are needed to confirm the suggested possible role of inflammatory factors in the pathogenesis of RLS.
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Affiliation(s)
| | | | - Elena García-Martín
- Universidad de Extremadura, University Institute of Molecular Pathology Biomarkers. ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
| | - José A G Agúndez
- Universidad de Extremadura, University Institute of Molecular Pathology Biomarkers. ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
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Jiménez-Jiménez FJ, Gómez-Tabales J, Alonso-Navarro H, Rodríguez C, Turpín-Fenoll L, Millán-Pascual J, Álvarez I, Pastor P, Calleja M, García-Ruiz R, Navarro-Muñoz S, Recio-Bermejo M, Plaza-Nieto JF, García-Albea E, García-Martín E, Agúndez JAG. LAG3/CD4 Genes Variants and the Risk for Restless Legs Syndrome. Int J Mol Sci 2022; 23:ijms232314795. [PMID: 36499121 PMCID: PMC9739762 DOI: 10.3390/ijms232314795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/08/2022] [Accepted: 11/23/2022] [Indexed: 12/02/2022] Open
Abstract
According to several studies, inflammatory factors could be related to the pathogenesis of idiopathic restless legs syndrome (RLS). In addition, RLS and Parkinson's disease (PD) have shown a possible relationship, and recent studies have shown an association between CD4 rs1922452 and CD4 rs951818 single nucleotide variants (SNVs) and the risk for PD. For these reasons, we investigated the possible association between common variants in the LAG3/CD4 genes (which encoded proteins involved in inflammatory and autoimmune responses) and the risk for RLS in a Caucasian Spanish population. We assessed the frequencies of CD4 rs1922452, CD4 rs951818, and LAG3 rs870849 genotypes and allelic variants in 285 patients with idiopathic RLS and 350 healthy controls using a specific TaqMan-based qPCR assay. We also analyzed the possible influence of the genotypes' frequencies on several variables, including age at onset of RLS, gender, family history of RLS, and response to drugs commonly used in the treatment of RLS. We found a lack of association between the frequencies of genotypes and allelic variants of the 3 SNVs studied and the risk of RLS, and a weak though significant association between the CD4 rs1922452 GG genotype and an older age at onset of RLS. With the exception of this association, our findings suggest that common SNVs in the CD4/LAG3 genes are not associated with the risk of developing idiopathic RLS in Caucasian Spanish people.
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Affiliation(s)
- Félix Javier Jiménez-Jiménez
- Section of Neurology, Hospital Universitario del Sureste, E28500 Arganda del Rey, Spain
- Correspondence: or ; Tel.: +34-636-968-395
| | - Javier Gómez-Tabales
- ARADyAL Instituto de Salud Carlos III, University Institute of Molecular Pathology Biomarkers, Universidad de Extremadura, E10003 Cáceres, Spain
| | | | - Christopher Rodríguez
- ARADyAL Instituto de Salud Carlos III, University Institute of Molecular Pathology Biomarkers, Universidad de Extremadura, E10003 Cáceres, Spain
| | - Laura Turpín-Fenoll
- Section of Neurology, Hospital La Mancha-Centro, E13600 Alcázar de San Juan, Spain
| | - Jorge Millán-Pascual
- Section of Neurology, Hospital La Mancha-Centro, E13600 Alcázar de San Juan, Spain
| | - Ignacio Álvarez
- Fundació per la Recerca Biomèdica i Social Mútua de Terrassa, E08221 Terrassa, Spain
- Movement Disorders Unit, Department of Neurology, Hospital Universitari Mutua de Terrassa, E08221 Terrassa, Spain
| | - Pau Pastor
- Fundació per la Recerca Biomèdica i Social Mútua de Terrassa, E08221 Terrassa, Spain
- Movement Disorders Unit, Department of Neurology, Hospital Universitari Mutua de Terrassa, E08221 Terrassa, Spain
- Unit of Neurodegenerative Diseases, Department of Neurology, The Germans Trias i Pujol Research Institute (IGTP), University Hospital Germans Trias i Pujol, E08916 Badalona, Spain
| | - Marisol Calleja
- Section of Neurology, Hospital Universitario del Sureste, E28500 Arganda del Rey, Spain
| | - Rafael García-Ruiz
- Section of Neurology, Hospital La Mancha-Centro, E13600 Alcázar de San Juan, Spain
| | | | - Marta Recio-Bermejo
- Section of Neurology, Hospital La Mancha-Centro, E13600 Alcázar de San Juan, Spain
| | | | - Esteban García-Albea
- Department of Medicine-Neurology, Universidad de Alcalá, E28801 Alcalá de Henares, Spain
| | - Elena García-Martín
- ARADyAL Instituto de Salud Carlos III, University Institute of Molecular Pathology Biomarkers, Universidad de Extremadura, E10003 Cáceres, Spain
| | - José A. G. Agúndez
- ARADyAL Instituto de Salud Carlos III, University Institute of Molecular Pathology Biomarkers, Universidad de Extremadura, E10003 Cáceres, Spain
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Yang B, Yin H, Wang J, Gan J, Li J, Han R, Pei M, Song L, Yang H. A metabolic biomarker panel of restless legs syndrome in peritoneal dialysis patients. Metabolomics 2022; 18:79. [PMID: 36260187 DOI: 10.1007/s11306-022-01938-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 09/27/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Restless legs syndrome (RLS) is a neuromotor disorder, and dialysis patients are more likely to develop RLS. RLS often causes sleep disorders, anxiety and depression in patients. It will increase the risk of death and severely affect the life of patients. At present, RLS has not received enough recognition and attention, and the misdiagnosis rate can reach more than 10%. METHODS The discovery set selected 30 peritoneal dialysis (PD) patients and 27 peritoneal dialysis patients with RLS (PD-RLS). A metabolomics method based on ultra performance liquid chromatography tandem quadrupole time-of-flight mass spectrometric method (UPLC-Q-TOF/MS) was used to analyze the differential metabolites of the two groups. 51 PD patients and 51 PD-RLS patients were included in the validation set. The receiver operating characteristic (ROC) analysis was used to evaluate the early diagnostic biomarkers, and the correlation between the differential metabolites and laboratory test indexes was analyzed to explore the biological function of the differential metabolites. RESULTS Through the integrated analysis, four metabolites can be used as markers for the diagnosis of PD-RLS, including Hippuric acid, Phenylacetylglutamine, N,N,N-Trimethyl-L-alanyl-L-proline betaine and Threonic acid. Through ROC analysis, it is found that they can be used as a metabolic biomarker panel, and the area under the curve of this combination is more than 0.9, indicating that the panel has good diagnostic and predictive ability. CONCLUSION Metabolomics based on UPLC-Q-TOF/MS technology can effectively identify the potential biomarkers, and provide a theoretical basis for the early diagnosis, prevention and treatment on PD-RLS.
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Affiliation(s)
- Bo Yang
- Department of Nephrology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Hongqing Yin
- School of Traditional Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Jianwei Wang
- Department of Nephrology, Qian'an Traditional Chinese Medicine Hospital, Tianjin, 301617, He Bei, China
| | - Jiali Gan
- Department of Pathology, School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Jingfang Li
- School of Traditional Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Rui Han
- School of Traditional Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Ming Pei
- Department of Nephrology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Lili Song
- School of Traditional Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China.
| | - Hongtao Yang
- Department of Nephrology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China.
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Abstract
This review summarizes the available data about genetic factors which can link ischemic stroke and sleep. Sleep patterns (subjective and objective measures) are characterized by heritability and comprise up to 38-46%. According to Mendelian randomization analysis, genetic liability for short sleep duration and frequent insomnia symptoms is associated with ischemic stroke (predominantly of large artery subtype). The potential genetic links include variants of circadian genes, genes encoding components of neurotransmitter systems, common cardiovascular risk factors, as well as specific genetic factors related to certain sleep disorders.
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Affiliation(s)
- Lyudmila Korostovtseva
- Sleep Laboratory, Research Department for Hypertension, Department for Cardiology, Almazov National Medical Research Centre, 2 Akkuratov Str., Saint Petersburg, 197341, Russia.
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Cerit C, Sarıhan M, Nart Ö, Kasap M, Yaşar H, Akpınar G. Are Mannan-binding Lectine Serin Protease-2 and Alpha-1-microglobulin and Bukinin Precursor the Potential Biomarkers of Manic Episode? A Study via Urinary Proetomic Analysis. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2021; 19:269-281. [PMID: 33888656 PMCID: PMC8077062 DOI: 10.9758/cpn.2021.19.2.269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/15/2020] [Accepted: 08/28/2020] [Indexed: 12/13/2022]
Abstract
Objective Investigating the molecular basis of bipolar disorder (BD) is crucial in terms of developing effective treatment strategies as well as objective laboratory-based diagnostic tools for the disease. Methods We examined the urine samples of BD patients both in manic episode and after remission and compared their urinary protein profiles with the controls. Twelve patients and twelve controls (C group) included to the study. Urinary samples of patients were first collected during manic episode (M group) and then after remission (R group). Two-dimensional gel electrophoresis (2-DE) coupled to MALDI-TOF/TOF massspectrometry approach and Western blot analysis were used. Results Alphα-1-microglobulin and bukinin precursor (AMBP), Mannan-binding lectine serin protease-2 (MASP-2), and Ig gamma-1-chain displayed significant increases in their abundance in the urine protein pool of M group in comparison to the C and R groups. Alpha-1B glycoprotein and prostaglandin-H2 D-isomerase (PGD2) levels were significantly higher in the urine protein pool of the M and R groups in comparison to the C group. Annexin A1 was downregulated significantly in the urine protein pool of the M group in comparison to the C group. Conclusion Intensities of MASP-2 and AMBP proteins discriminated manic episode from remission period and healthy controls indicating that these proteins may be candidate biomarkers for manic episode. The decrease in Annexin A1 and increase in Ig gamma-1 chain levels appeared to be associated with “Manic Episode” while the increase in PGD2 and alpha-1B glycoprotein levels appeared to be associated with “Bipolar Disorder”.
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Affiliation(s)
- Cem Cerit
- Department of Psychiatry, School of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Mehmet Sarıhan
- Department of Medical Biology, School of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Ömer Nart
- Clinic of Psychiatry, Bursa State Hospital, Bursa, Turkey
| | - Murat Kasap
- Department of Medical Biology, School of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Hilmi Yaşar
- Department of Psychiatry, School of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Gürler Akpınar
- Department of Medical Biology, School of Medicine, Kocaeli University, Kocaeli, Turkey
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Mondello S, Kobeissy FH, Mechref Y, Zhao J, El Hayek S, Zibara K, Moresco M, Plazzi G, Cosentino FII, Ferri R. Searching for Novel Candidate Biomarkers of RLS in Blood by Proteomic Analysis. Nat Sci Sleep 2021; 13:873-883. [PMID: 34234594 PMCID: PMC8243594 DOI: 10.2147/nss.s311801] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/28/2021] [Indexed: 01/03/2023] Open
Abstract
PURPOSE We performed comparative proteomic analyses of blood of patients with RLS and healthy individuals aiming to identify potential biomarker and therapeutic target candidate for RLS. PATIENTS AND METHODS Blood serum samples from 12 patients with a clinical diagnosis of RLS (8 females and 4 males, with a mean age of 68.52 years) and 10 healthy controls (5 females and 5 males, with a mean age of 67.61 years) underwent proteomic profiling by liquid chromatography coupled with tandem mass spectrometry. Pathway analysis incorporating protein-protein interaction networks was carried out to identify pathological processes linked to the differentially expressed proteins. RESULTS We quantified 272 proteins in patients with RLS and healthy controls, of which 243 were shared. Five proteins - apolipoprotein C-II, leucine-rich alpha-2-glycoprotein 1, FLJ92374, extracellular matrix protein 1, and FLJ93143 - were substantially increased in RLS patients, whereas nine proteins - vitamin D-binding protein, FLJ78071, alpha-1-antitrypsin, CD5 antigen-like, haptoglobin, fibrinogen alpha chain, complement factor H-related protein 1, platelet factor 4, and plasma protease C1 inhibitor - were decreased. Bioinformatics analyses revealed that these proteins were linked to 1) inflammatory and immune response, and complement activation, 2) brain-related development, cell aging, and memory disorders, 3) pregnancy and associated complications, 4) myocardial infarction, and 5) reactive oxygen species generation and subsequent diabetes mellitus. CONCLUSION Our findings shed light on the multifactorial nature of RLS and identified a set of circulating proteins that may have clinical importance as biomarkers and therapeutic targets.
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Affiliation(s)
- Stefania Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Firas H Kobeissy
- Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Yehia Mechref
- Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Jingfu Zhao
- Department of Chemistry and Biochemistry, Texas Tech University, Lubbock, TX, 79409, USA
| | - Samer El Hayek
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
| | - Kazem Zibara
- Department of Biology, Faculty of Sciences-I, PRASE, DSST, Lebanese University, Beirut, Lebanon
| | - Monica Moresco
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Giuseppe Plazzi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | | | - Raffaele Ferri
- Sleep Research Centre, Oasi Research Institute - IRCCS, Troina, Italy
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Shin JW, Lee JH, Kim H, Lee DH, Baek KH, Sunwoo JS, Byun JI, Kim TJ, Jun JS, Han D, Jung KY. Bioinformatic analysis of proteomic data for iron, inflammation, and hypoxic pathways in restless legs syndrome. Sleep Med 2020; 75:448-455. [PMID: 32992101 DOI: 10.1016/j.sleep.2020.09.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 07/13/2020] [Accepted: 09/03/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE/BACKGROUND We performed bioinformatic analysis of proteomic data to identify the biomarkers of restless legs syndrome (RLS) and provide insights into the putative pathomechanisms, including iron deficiency, inflammation, and hypoxic pathways. PATIENTS/METHODS Patients with drug-naïve idiopathic RLS were recruited at a university hospital from June 2017 to February 2018. Serum samples from patients with RLS (n = 7) and healthy sex- and age-matched controls (n = 6) were evaluated by proteomic analysis. For differentially expressed proteins (DEPs) in patients with RLS, compared to those in controls, the expression profiles and protein-protein interaction (PPI) network were characterized between dysregulated proteins and extracted proteins involved in iron deficiency, hypoxia, and inflammation responses using the String database (http://string-DB.org). The PPI network was visualized by Cytoscape ver. 3. 7. 1. Statistical analyses of the validation Western blot assays were performed using a Student's t-test. RESULTS Interactome network analysis revealed a relationship among the eight proteins, their associated genes, and 150, 47, and 11 proteins related to iron deficiency, inflammation, and hypoxic pathways, respectively. All DEPs were well associated with inflammation, and complement 3, complement C4A, alpha-2 HS glycoprotein, and alpha-2 macroglobulin precursor were found to be in hub positions of networks involved in PPIs including iron deficiency, hypoxia pathway, and inflammation. C3 and C4A were verified using western blotting. CONCLUSIONS We identified key molecules that represent the selected cellular pathways as protein biomarkers by PPI network analysis. Changes in inflammation can mediate or affect the pathomechanism of RLS and can thus act as systemic biomarkers.
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Affiliation(s)
- Jung-Won Shin
- Department of Neurology, CHA University, Bundang CHA Medical Center, Republic of Korea
| | - Jung-Hun Lee
- Proteomics Core Facility, Biomedical Research Institute, Seoul National University Hospital, Republic of Korea
| | - Hyeyoon Kim
- Proteomics Core Facility, Biomedical Research Institute, Seoul National University Hospital, Republic of Korea
| | - Da-Hye Lee
- Department of Biomedical Science, CHA University, Republic of Korea
| | - Kwang-Hyun Baek
- Department of Biomedical Science, CHA University, Republic of Korea
| | - Jun-Sang Sunwoo
- Department of Neurosurgery, Seoul National University Hospital, Republic of Korea
| | - Jung-Ick Byun
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Republic of Korea
| | - Tae-Joon Kim
- Department of Neurology, Ajou University School of Medicine, Republic of Korea
| | - Jin-Sun Jun
- Department of Neurology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Republic of Korea
| | - Dohyun Han
- Proteomics Core Facility, Biomedical Research Institute, Seoul National University Hospital, Republic of Korea.
| | - Ki-Young Jung
- Seoul National University College of Medicine, Department of Neurology, Seoul National University Hospital, Republic of Korea.
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Balseanu AT, Grigore M, Pinosanu LR, Slevin M, Hermann DM, Glavan D, Popa-Wagner A. Electric Stimulation of Neurogenesis Improves Behavioral Recovery After Focal Ischemia in Aged Rats. Front Neurosci 2020; 14:732. [PMID: 32742258 PMCID: PMC7365235 DOI: 10.3389/fnins.2020.00732] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 06/19/2020] [Indexed: 12/31/2022] Open
Abstract
The major aim of stroke therapies is to stimulate brain repair and to improve behavioral recuperation after cerebral ischemia. Despite remarkable advances in cell therapy for stroke, stem cell-based tissue replacement has not been achieved yet stimulating the search for alternative strategies for brain self-repair using the neurogenic zones of the brain, the dentate gyrus and the subventricular zone (SVZ). However, during aging, the potential of the hippocampus and the SVZ to generate new neuronal precursors, declines. We hypothesized that electrically stimulation of endogenous neurogenesis in aged rats could increase the odds of brain self-repair and improve behavioral recuperation after focal ischemia. Following stroke in aged animals, the rats were subjected to two sessions of electrical non-convulsive stimulation using ear-clip electrodes, at 7- and 24 days after MCAO. Animal were sacrificed after 48 days. We report that electrical stimulation (ES) stimulation of post-stroke aged rats led to an improved functional recovery of spatial long-term memory (T-maze) but not on the rotating pole or the inclined plane, both tests requiring complex sensorimotor skills. Surprisingly, ES had a detrimental effect on the asymmetric sensorimotor deficit. Histologically, there was a robust increase in the number of doublecortin-positive cells in the dentate gyrus and SVZ of the infarcted hemisphere and the presence of a considerable number of neurons expressing tubulin beta III in the infarcted area. Among the gene that were unique to ES, we noted increases in the expression of seizure related 6 homolog like which is one of the physiological substrate of the β-secretase BACE1 involved in the pathophysiology of the Alzheimer’s disease and Igfbp3 and BDNF receptor mRNAs which has been shown to have a neuroprotective effect after cerebral ischemia. However, ES was associated with a long-term down regulation of cortical gene expression after stroke in aged rats suggesting that gene expression in the peri-infarcted cortical area may not be related to electrical stimulation induced-neurogenesis in the subventricular zone and hippocampus.
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Affiliation(s)
- Adrian Tudor Balseanu
- Center of Clinical and Experimental Medicine, Department of Psychiatry, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Monica Grigore
- Center of Clinical and Experimental Medicine, Doctoral School, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Leonard-Radu Pinosanu
- Center of Clinical and Experimental Medicine, Doctoral School, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Mark Slevin
- Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
| | - Dirk M Hermann
- Department of Neurology the Chair of Vascular Neurology and Dementia, Essen University Hospital, Essen, Germany
| | - Daniela Glavan
- Center of Clinical and Experimental Medicine, Department of Psychiatry, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Aurel Popa-Wagner
- Center of Clinical and Experimental Medicine, Department of Psychiatry, University of Medicine and Pharmacy of Craiova, Craiova, Romania.,Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
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Dong X, Mondello S, Kobeissy F, Ferri R, Mechref Y. Serum Glycomics Profiling of Patients with Primary Restless Legs Syndrome Using LC–MS/MS. J Proteome Res 2020; 19:2933-2941. [DOI: 10.1021/acs.jproteome.9b00549] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Xue Dong
- Department of Chemistry and Biochemistry, Texas Tech University, Lubbock, Texas 79409-1061, United States
| | - Stefania Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina 98122, Italy
- Sleep Research Centre, Department of Neurology IC, Oasi Research Institute—IRCCS, Troina 94018, Italy
| | - Firas Kobeissy
- Department of Biochemistry & Molecular Genetics, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Raffaele Ferri
- Sleep Research Centre, Department of Neurology IC, Oasi Research Institute—IRCCS, Troina 94018, Italy
| | - Yehia Mechref
- Department of Chemistry and Biochemistry, Texas Tech University, Lubbock, Texas 79409-1061, United States
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Weinstock LB, Walters AS, Brook JB, Kaleem Z, Afrin LB, Molderings GJ. Restless legs syndrome is associated with mast cell activation syndrome. J Clin Sleep Med 2020; 16:401-408. [PMID: 31994488 DOI: 10.5664/jcsm.8216] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
STUDY OBJECTIVES Mast cell activation syndrome (MCAS) is an inflammatory and allergic disorder. We determined the prevalence of restless legs syndrome (RLS) in MCAS because each common syndrome may be inflammatory in nature and associated with dysautonomia. METHODS Individuals with MCAS were evaluated for RLS by two standard questionnaires. Prevalence comparisons included spouse control patients and two prevalence publications. MCAS diagnosis required mast cell (MC) symptoms in ≥ 2 organs plus ≥ 1 elevated MC mediators, improvement with MC therapy, and/or increased intestinal MC density. Clinical variables were studied. RESULTS There were 174 patients with MCAS (146 female, 28 male, mean age 44.8 years) and 85 spouse control patients (12 female, 73 male, mean age 50.9 years). Patients with MCAS as a whole had a higher prevalence of RLS (40.8%) than spouse control (12.9%) (P < .0001) Male patients with MCAS had a higher prevalence of RLS (32.1%) than male controls (12.3%, odds ratio [OR] 3.4, confidence interval [CI] 1.2-9.7, P = .025), American men (8.4%, OR 5.2, CI 2.2-12.0, P < .001), and French men (5.8%, OR 7.7, CI 3.4-17.1, P < .001). Female patients with MCAS also had a higher prevalence of RLS (42.5%) than female controls (16.7%) but this did not reach statistical significance perhaps because of the sample size of the female controls. However, female patients with MCAS had a statistically higher prevalence of RLS than American women (10.0%, OR 6.7, CI 4.5-9.7, P < .0001) and French women (10.8%, OR 6.1, CI 4.4-8.6, P < .0001). CONCLUSIONS RLS appears to be associated with MCAS. Effects of mast cell mediators, inflammation, immune mechanisms, dysautonomia, or hypoxia may theoretically activate RLS in MCAS.
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Affiliation(s)
- Leonard B Weinstock
- Washington University School of Medicine, Specialists in Gastroenterology, LLC, St. Louis, Missouri
| | - Arthur S Walters
- Division of Sleep Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
| | | | - Zahid Kaleem
- Specialists in Gastroenterology, LLC, St. Louis, Missouri
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14
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Evaluation of potential cardiovascular risk protein biomarkers in high severity restless legs syndrome. J Neural Transm (Vienna) 2019; 126:1313-1320. [DOI: 10.1007/s00702-019-02051-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 07/19/2019] [Indexed: 12/22/2022]
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Bellei E, Monari E, Ozben S, Koseoglu Bitnel M, Topaloglu Tuac S, Tomasi A, Bergamini S. Discovery of restless legs syndrome plasmatic biomarkers by proteomic analysis. Brain Behav 2018; 8:e01062. [PMID: 30244532 PMCID: PMC6192389 DOI: 10.1002/brb3.1062] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 06/12/2018] [Accepted: 06/13/2018] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Restless legs syndrome (RLS) can lead to severe clinical consequences, thus negatively impacts on patients' overall health and quality of life. Nevertheless, the pathophysiology of RLS is still unclear, resulting in underestimate, incorrect, or ignored diagnosis and in limited management and treatment. The aim of this study was to compare the plasma proteome of RLS patients and healthy controls, in the search of diagnostic biomarkers related to the disease severity. MATERIALS AND METHODS Two-dimensional gel electrophoresis coupled with liquid chromatography-mass spectrometry was employed to analyze plasma samples of 34 patients with primary RLS, divided into two subgroups according to the disease severity: MMS group (mild-moderate symptoms) and HS group (severe and very severe symptoms), and 17 age- and sex-matched control subjects. Sleep quality, daytime sleepiness, and the level of depression were also evaluated. RESULTS We identified eight upregulated spots, corresponding to five unique proteins, in both RLS group vs. controls (alpha-1B-glycoprotein, alpha-1-acid glycoprotein 1, haptoglobin, complement C4-A, and immunoglobulin kappa constant); five increased spots, consistent with three unique proteins, only in HS-RLS (kininogen-1, immunoglobulin heavy constant alpha 1, and immunoglobulin lambda constant 2); one downregulated spot in both patient's groups (complement C3) and another one only in HS-RLS (alpha-1-antitrypsin). CONCLUSIONS The significantly different plasma proteins detected in RLS were mainly associated with inflammation, immune response, and cardiovascular disorders. Particularly, the gradual increasing in immunoglobulins could be indicative of the disease severity and evolution. Accordingly, these proteins may represent a valid set of useful biomarkers for RLS diagnosis, progression and treatment.
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Affiliation(s)
- Elisa Bellei
- Department of Diagnostic and Clinical Medicine and Public Health, Proteomic Lab, University of Modena and Reggio Emilia, Modena, Italy
| | - Emanuela Monari
- Department of Diagnostic and Clinical Medicine and Public Health, Proteomic Lab, University of Modena and Reggio Emilia, Modena, Italy
| | - Serkan Ozben
- Department of Neurology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Mesrure Koseoglu Bitnel
- Department of Neurology, Bakirkoy Psychiatry and Neurology Research and Training Hospital, Istanbul, Turkey
| | - Selma Topaloglu Tuac
- Department of Neurology, Bakirkoy Psychiatry and Neurology Research and Training Hospital, Istanbul, Turkey
| | - Aldo Tomasi
- Department of Diagnostic and Clinical Medicine and Public Health, Proteomic Lab, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefania Bergamini
- Department of Diagnostic and Clinical Medicine and Public Health, Proteomic Lab, University of Modena and Reggio Emilia, Modena, Italy
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