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Hsieh L, Tu LN, Paquette A, Sheng Q, Zhao S, Bittel D, O’Brien J, Vickers K, Pastuszko P, Nigam V. microRNA Expression Levels Change in Neonatal Patients During and After Exposure to Cardiopulmonary Bypass. J Am Heart Assoc 2022; 11:e025864. [PMID: 36000433 PMCID: PMC9496435 DOI: 10.1161/jaha.122.025864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/27/2022] [Indexed: 02/02/2023]
Abstract
Background The systemic inflammation that occurs after exposure to cardiopulmonary bypass (CPB), which is especially severe in neonatal patients, is associated with poorer outcomes and is not well understood. In order to gain deeper insight into how exposure to bypass activates inflammatory responses in circulating leukocytes, we studied changes in microRNA (miRNA) expression during and after exposure to bypass. miRNAs are small noncoding RNAs that have important roles in modulating protein levels and function of cells. Methods and Results We performed miRNA-sequencing on leukocytes isolated from neonatal patients with CPB (n=5) at 7 time points during the process of CPB, including before the initiation of bypass, during bypass, and at 3 time points during the first 24 hours after weaning from bypass. We identified significant differentially expressed miRNAs using generalized linear regression models, and miRNAs were defined as statistically significant using a false discovery rate-adjusted P<0.05. We identified gene targets of these miRNAs using the TargetScan database and identified significantly enriched biological pathways for these gene targets. We identified 54 miRNAs with differential expression during and after CPB. These miRNAs clustered into 3 groups, including miRNAs that were increased during and after CPB (3 miRNAs), miRNAs that decreased during and after CPB (10 miRNAs), and miRNAs that decreased during CPB but then increased 8 to 24 hours after CPB. A total of 38.9% of the target genes of these miRNAs were significantly differentially expressed in our previous study. miRNAs with altered expression levels are predicted to significantly modulate pathways related to inflammation and signal transduction. Conclusions The unbiased profiling of the miRNA changes that occur in the circulating leukocytes of patients with bypass provides deeper insight into the mechanisms that underpin the systemic inflammatory response that occurs in patients after exposure to CPB. These data will help the development of novel treatments and biomarkers for bypass-associated inflammation.
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Affiliation(s)
- Lance Hsieh
- Department of Pediatrics (Cardiology)University of WashingtonSeattleWA
- Center for Developmental Biology and Regenerative MedicineSeattle Children’s Research InstituteSeattleWA
| | - Lan N. Tu
- Department of Pediatrics (Cardiology)University of WashingtonSeattleWA
- Center for Developmental Biology and Regenerative MedicineSeattle Children’s Research InstituteSeattleWA
| | - Alison Paquette
- Center for Developmental Biology and Regenerative MedicineSeattle Children’s Research InstituteSeattleWA
| | - Quanhu Sheng
- Department of BiostatisticsVanderbilt University Medical CenterNashvilleTN
| | - Shilin Zhao
- Department of BiostatisticsVanderbilt University Medical CenterNashvilleTN
| | - Douglas Bittel
- Ward Family Heart CenterChildren’s Mercy HospitalKansas CityMO
- College of BiosciencesKansas City University of Medicine and BiosciencesKansas CityMO
| | - James O’Brien
- Ward Family Heart CenterChildren’s Mercy HospitalKansas CityMO
| | - Kasey Vickers
- Department of MedicineVanderbilt University Medical CenterNashvilleTN
| | - Peter Pastuszko
- Department of Cardiovascular SurgeryIcahn School of Medicine at Mount SinaiNew YorkNY
| | - Vishal Nigam
- Department of Pediatrics (Cardiology)University of WashingtonSeattleWA
- Center for Developmental Biology and Regenerative MedicineSeattle Children’s Research InstituteSeattleWA
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The TBX1/miR-193a-3p/TGF- β2 Axis Mediates CHD by Promoting Ferroptosis. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:5130546. [PMID: 35035663 PMCID: PMC8759832 DOI: 10.1155/2022/5130546] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/24/2021] [Accepted: 12/06/2021] [Indexed: 11/18/2022]
Abstract
Congenital heart disease (CHD) is the most common noninfectious cause of death during the neonatal stage. T-box transcription factor 1 (TBX1) is the main genetic determinant of 22q11.2 deletion syndrome (22q11.2DS), which is a common cause of CHD. Moreover, ferroptosis is a newly discovered kind of programmed cell death. In this study, the interaction among TBX1, miR-193a-3p, and TGF-β2 was tested using quantitative reverse transcription polymerase chain reaction (qRT-PCR), Western blotting, and dual-luciferase reporter assays. TBX1 silencing was found to promote TGF-β2 messenger ribonucleic acid (mRNA) and protein expression by downregulating the miR-193a-3p levels in H9c2 cells. In addition, the TBX1/miR-193a-3p/TGF-β2 axis was found to promote ferroptosis based on assessments of lipid reactive oxygen species (ROS) levels, Fe2+ concentrations, mitochondrial ROS levels, and malondialdehyde (MDA) contents; Cell Counting Kit-8 (CCK-8) assays and transmission electron microscopy; and Western blotting analysis of glutathione peroxidase 4 (GPX4), nuclear factor erythroid 2-related factor 2 (NRF2), heme oxygenase-1 (HO-1), NADPH oxidase 4 (NOX4), and acyl-CoA synthase long-chain family member 4 (ACSL4) protein expression. The protein expression of NRF2, GPX4, HO-1, NOX4, and ACSL4 and the level of MDA in human CHD specimens were also detected. In addition, TBX1 and miR-193a-3p expression was significantly downregulated and TGF-β2 levels were high in human embryonic CHD tissues, as indicated by the H9c2 cell experiments. In summary, the TBX1/miR-193a-3p/TGF-β2 axis mediates CHD by inducing ferroptosis in cardiomyocytes. TGF-β2 may be a target gene for CHD diagnosis and treatment in children.
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Manuel V, Miana LA, Jatene MB. Neutrophil-Lymphocyte Ratio in Congenital Heart Surgery: What Is Known and What Is New? World J Pediatr Congenit Heart Surg 2022; 13:208-216. [PMID: 35238705 DOI: 10.1177/21501351211064143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Operative mortality after repair of congenital heart disease has improved dramatically over the past few decades. Nevertheless, there is always room for the additional mitigation of complications and mortality. Being able to anticipate adverse outcomes is clearly important, especially when using low-cost and easily accessible resources. The neutrophil-lymphocyte ratio (NLR) is defined as the ratio of the absolute neutrophil to lymphocyte count, which can be easily measured using a regular white blood cell count. Recently, preoperative NLR has been shown to be a predictor of outcomes in patients undergoing congenital heart surgery. Although it presented promising results, there are still many gaps to be filled like the normal value for children, the ideal cutoff value to predict adverse outcomes, the wide variation and its correlation with other biomarkers, and if it is a modifiable risk factor. The aim of this review is to understand the prognostic value of preoperative NLR as a biomarker predictor of outcomes in patients undergoing congenital heart surgery based on previous clinical studies and to propose future directions in order to solve the above-mentioned questions.
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Affiliation(s)
- Valdano Manuel
- 42523Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Clínica Girassol, Luanda, Angola
| | - Leonardo A Miana
- 42523Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Marcelo B Jatene
- 42523Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Manuel V, Miana LA, Guerreiro GP, Turquetto A, Santos RM, Fernandes N, Tenório DF, Caneo LF, Jatene FB, Jatene MB. Preoperative Neutrophil-Lymphocyte Ratio Can Predict Outcomes for Patients Undergoing Tetralogy of Fallot Repair. Braz J Cardiovasc Surg 2021; 36:607-613. [PMID: 34236799 PMCID: PMC8597611 DOI: 10.21470/1678-9741-2020-0408] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 12/18/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Elevated neutrophil-lymphocyte ratio (NLR) has been associated with poorer outcomes in cyanotic patients undergoing single ventricle palliation. Little is known about this biomarker on patients with tetralogy of Fallot (TOF), the most common cyanotic congenital heart disease. Our objective is to study the impact of preoperative NLR on outcomes of TOF patients undergoing total repair. METHODS This retrospective study included 116 consecutive patients between January 2014 and December 2018. Preoperative NLR was measured from the last complete blood count test before the surgery. Using the cutoff value of 0.80, according to the receiver-operating characteristic (ROC) curve, the sample was divided into two groups (NLR < 0.80 and ≥ 0.80). The primary endpoint was hospital length of stay (LOS). RESULTS ROC curves showed that higher preoperative NLR was associated with longer hospital LOS, with an area under the curve of 0.801±0.040 (95% confidence interval 0.722 - 0.879; P<0.001). High preoperative NLR was also associated with long intensive care unit (ICU) LOS (P=0.035). Preoperative NLR predicted longer hospital LOS with a sensitivity of 63% and a specificity of 81.4%. CONCLUSION Higher preoperative NLR was associated with long ICU and hospital LOS in patients undergoing TOF repair.
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Affiliation(s)
- Valdano Manuel
- Division of Cardiovascular Surgery, Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
- Cardio-Thoracic Center, Clínica Girassol, Luanda, Angola
| | - Leonardo A. Miana
- Division of Cardiovascular Surgery, Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Gustavo Pampolha Guerreiro
- Division of Cardiovascular Surgery, Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Aida Turquetto
- Division of Cardiovascular Surgery, Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Rômullo Medeiros Santos
- Division of Cardiovascular Surgery, Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Natália Fernandes
- Division of Cardiovascular Surgery, Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Davi Freitas Tenório
- Division of Cardiovascular Surgery, Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Luiz Fernando Caneo
- Division of Cardiovascular Surgery, Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Fabio B. Jatene
- Division of Cardiovascular Surgery, Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Marcelo Biscegli Jatene
- Division of Cardiovascular Surgery, Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
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Bone microRNA-21 as surgical stress parameter is associated with third molar postoperative discomfort. Clin Oral Investig 2020; 25:319-328. [PMID: 32495225 DOI: 10.1007/s00784-020-03366-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 05/20/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To evaluate an association between bone levels of inflammation/oxidative stress mediators and postoperative discomfort after third molar conventional or piezosurgery. MATERIAL AND METHODS Twenty-six subjects with bilaterally impacted mandibular third molars, who underwent either piezo or conventional surgery, were included in a split-mouth design study. MicroRNA-21 (miR-21) expression, interleukin-1 beta (IL-1β), and vascular endothelial growth factor (VEGF) proteins, as well as superoxide dismutase (SOD) activity in alveolar bone, were evaluated. Pain intensity, the first pain appearance, analgesic first use and total dose taken, trismus, and swelling were clinically recorded. RESULTS MiR-21 expression was higher while VEGF protein was lower in piezosurgery vs. conventional groups. The differences in IL-1β protein and SOD activity were not significant between groups. The pain intensity on the first day was significantly decreased in piezosurgery group. The first pain appearance and the first analgesic taken were reported sooner in conventional vs. piezosurgical group. Significantly pronounced trismus on the third day following conventional surgery was found. In conventional group, significantly increased trismus was observed on the third compared to the first postoperative day. MiR-21 showed significant correlation with the first pain appearance. CONCLUSION Delayed onset of less pronounced postoperative pain after piezosurgical vs. conventional extraction of impacted lower third molar was significantly associated with expression of bone miR-21. CLINICAL RELEVANCE Alveolar bone miR-21 may reflect surgical stress and is associated with third molar postoperative pain onset.
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Su M, Niu Y, Dang Q, Qu J, Zhu D, Tang Z, Gou D. Circulating microRNA profiles based on direct S-Poly(T)Plus assay for detection of coronary heart disease. J Cell Mol Med 2020; 24:5984-5997. [PMID: 32343493 PMCID: PMC7294166 DOI: 10.1111/jcmm.15001] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 12/07/2019] [Accepted: 12/27/2019] [Indexed: 02/06/2023] Open
Abstract
Coronary heart disease (CHD) is one of the leading causes of heart-associated deaths worldwide. Conventional diagnostic techniques are ineffective and insufficient to diagnose CHD with higher accuracy. To use the circulating microRNAs (miRNAs) as non-invasive, specific and sensitive biomarkers for diagnosing of CHD, 203 patients with CHD and 144 age-matched controls (126 high-risk controls and 18 healthy volunteers) were enrolled in this study. The direct S-Poly(T)Plus method was used to identify novel miRNAs expression profile of CHD patients and to evaluate their clinical diagnostic value. This method is an RNA extraction-free and robust quantification method, which simplifies procedures, reduces variations, in particular increases the accuracy. Twelve differentially expressed miRNAs between CHD patients and high-risk controls were selected, and their performances were evaluated in validation set-1 with 96 plasma samples. Finally, six (miR-15b-5p, miR-29c-3p, miR-199a-3p, miR-320e, miR-361-5p and miR-378b) of these 12 miRNAs were verified in validation set-2 with a sensitivity of 92.8% and a specificity of 89.5%, and the AUC was 0.971 (95% confidence interval, 0.948-0.993, P < .001) in a large cohort for CHD patients diagnosis. Plasma fractionation indicated that only a small amount of miRNAs were assembled into EVs. Direct S-Poly(T)Plus method could be used for disease diagnosis and 12 unique miRNAs could be used for diagnosis of CHD.
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Affiliation(s)
- Mingyang Su
- Shenzhen Key Laboratory of Microbial Genetic EngineeringVascular Disease Research CenterCollege of Life Sciences and OceanographyGuangdong Provincial Key Laboratory of Regional Immunity and DiseasesCarson International Cancer CenterShenzhen UniversityShenzhenGuangdongChina
- Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education and Guangdong ProvinceCollege of Optoelectronic EngineeringShenzhen UniversityShenzhenGuangdongChina
| | - Yanqin Niu
- Shenzhen Key Laboratory of Microbial Genetic EngineeringVascular Disease Research CenterCollege of Life Sciences and OceanographyGuangdong Provincial Key Laboratory of Regional Immunity and DiseasesCarson International Cancer CenterShenzhen UniversityShenzhenGuangdongChina
| | - Quanjin Dang
- Shenzhen Key Laboratory of Microbial Genetic EngineeringVascular Disease Research CenterCollege of Life Sciences and OceanographyGuangdong Provincial Key Laboratory of Regional Immunity and DiseasesCarson International Cancer CenterShenzhen UniversityShenzhenGuangdongChina
| | - Junle Qu
- Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education and Guangdong ProvinceCollege of Optoelectronic EngineeringShenzhen UniversityShenzhenGuangdongChina
| | - Daling Zhu
- Department of Biopharmaceutical SciencesCollege of PharmacyHarbin Medical UniversityHarbinHeilongjiangChina
| | - Zhongren Tang
- Third Cardiovascular DepartmentMudanjiang City Second People's HospitalMudanjiangHeilongjiangChina
| | - Deming Gou
- Shenzhen Key Laboratory of Microbial Genetic EngineeringVascular Disease Research CenterCollege of Life Sciences and OceanographyGuangdong Provincial Key Laboratory of Regional Immunity and DiseasesCarson International Cancer CenterShenzhen UniversityShenzhenGuangdongChina
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Zloto K, Tirosh-Wagner T, Bolkier Y, Bar-Yosef O, Vardi A, Mishali D, Paret G, Nevo-Caspi Y. Preoperative miRNA-208a as a Predictor of Postoperative Complications in Children with Congenital Heart Disease Undergoing Heart Surgery. J Cardiovasc Transl Res 2019; 13:245-252. [PMID: 31732917 PMCID: PMC7224117 DOI: 10.1007/s12265-019-09921-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 10/01/2019] [Indexed: 03/12/2023]
Abstract
Major perioperative cardiovascular events are important causes of morbidity in pediatric patients with congenital heart disease who undergo reparative surgery. Current preoperative clinical risk assessment strategies have poor accuracy for identifying patients who will sustain adverse events following heart surgery. There is an ongoing need to integrate clinical variables with novel technology and biomarkers to accurately predict outcome following pediatric heart surgery. We tested whether preoperative levels of miRNAs-208a can serve as such a biomarker. Serum samples were obtained from pediatric patients immediately before heart surgery. MiRNA-208a was quantified by RQ-PCR. Correlations between the patient's clinical variables and miRNA levels were tested. Lower levels of preoperative miRNA-208a correlated with and could predict the appearance of postoperative cardiac and inflammatory complications. MiRNA-208a may serve as a biomarker for the prediction of patients who are at risk to develop complications following surgery for the repair of congenital heart defects.
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Affiliation(s)
- Keren Zloto
- Department of Pediatric Critical Care Medicine, Safra Children's Hospital, Sheba Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Tal Tirosh-Wagner
- Department of Pediatric Cardiology, Safra Children's Hospital, Sheba Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Yoav Bolkier
- Department of Pediatric Cardiology, Safra Children's Hospital, Sheba Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Omer Bar-Yosef
- Department of Pediatric Critical Care Medicine, Safra Children's Hospital, Sheba Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Amir Vardi
- Department of Pediatric Cardiac Intensive Care, Safra Children's Hospital, Sheba Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - David Mishali
- Department of Pediatric Cardiac Surgery, Safra Children's Hospital, Sheba Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Gidi Paret
- Department of Pediatric Critical Care Medicine, Safra Children's Hospital, Sheba Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Yael Nevo-Caspi
- Department of Pediatric Critical Care Medicine, Safra Children's Hospital, Sheba Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
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