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Chybowska AD, Gadd DA, Cheng Y, Bernabeu E, Campbell A, Walker RM, McIntosh AM, Wrobel N, Murphy L, Welsh P, Sattar N, Price JF, McCartney DL, Evans KL, Marioni RE. Epigenetic Contributions to Clinical Risk Prediction of Cardiovascular Disease. CIRCULATION. GENOMIC AND PRECISION MEDICINE 2024; 17:e004265. [PMID: 38288591 PMCID: PMC10876178 DOI: 10.1161/circgen.123.004265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 11/30/2023] [Indexed: 02/21/2024]
Abstract
BACKGROUND Cardiovascular disease (CVD) is among the leading causes of death worldwide. The discovery of new omics biomarkers could help to improve risk stratification algorithms and expand our understanding of molecular pathways contributing to the disease. Here, ASSIGN-a cardiovascular risk prediction tool recommended for use in Scotland-was examined in tandem with epigenetic and proteomic features in risk prediction models in ≥12 657 participants from the Generation Scotland cohort. METHODS Previously generated DNA methylation-derived epigenetic scores (EpiScores) for 109 protein levels were considered, in addition to both measured levels and an EpiScore for cTnI (cardiac troponin I). The associations between individual protein EpiScores and the CVD risk were examined using Cox regression (ncases≥1274; ncontrols≥11 383) and visualized in a tailored R application. Splitting the cohort into independent training (n=6880) and test (n=3659) subsets, a composite CVD EpiScore was then developed. RESULTS Sixty-five protein EpiScores were associated with incident CVD independently of ASSIGN and the measured concentration of cTnI (P<0.05), over a follow-up of up to 16 years of electronic health record linkage. The most significant EpiScores were for proteins involved in metabolic, immune response, and tissue development/regeneration pathways. A composite CVD EpiScore (based on 45 protein EpiScores) was a significant predictor of CVD risk independent of ASSIGN and the concentration of cTnI (hazard ratio, 1.32; P=3.7×10-3; 0.3% increase in C-statistic). CONCLUSIONS EpiScores for circulating protein levels are associated with CVD risk independent of traditional risk factors and may increase our understanding of the etiology of the disease.
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Affiliation(s)
- Aleksandra D Chybowska
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (A.D.C., D.A.G., Y.C., E.B., A.C., D.L.M., K.L.E., R.E.M.), The University of Edinburgh, United Kingdom
| | - Danni A Gadd
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (A.D.C., D.A.G., Y.C., E.B., A.C., D.L.M., K.L.E., R.E.M.), The University of Edinburgh, United Kingdom
| | - Yipeng Cheng
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (A.D.C., D.A.G., Y.C., E.B., A.C., D.L.M., K.L.E., R.E.M.), The University of Edinburgh, United Kingdom
| | - Elena Bernabeu
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (A.D.C., D.A.G., Y.C., E.B., A.C., D.L.M., K.L.E., R.E.M.), The University of Edinburgh, United Kingdom
| | - Archie Campbell
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (A.D.C., D.A.G., Y.C., E.B., A.C., D.L.M., K.L.E., R.E.M.), The University of Edinburgh, United Kingdom
| | - Rosie M Walker
- School of Psychology, University of Exeter, United Kingdom (R.M.W.)
| | - Andrew M McIntosh
- Division of Psychiatry, Royal Edinburgh Hospital (A.M.M.), The University of Edinburgh, United Kingdom
| | - Nicola Wrobel
- Edinburgh Clinical Research Facility, Western General Hospital (N.W., L.M.), The University of Edinburgh, United Kingdom
| | - Lee Murphy
- Edinburgh Clinical Research Facility, Western General Hospital (N.W., L.M.), The University of Edinburgh, United Kingdom
| | - Paul Welsh
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, United Kingdom (P.W., N.S.)
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, United Kingdom (P.W., N.S.)
| | - Jackie F Price
- Usher Institute, Old Medical School (J.F.P.), The University of Edinburgh, United Kingdom
| | - Daniel L McCartney
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (A.D.C., D.A.G., Y.C., E.B., A.C., D.L.M., K.L.E., R.E.M.), The University of Edinburgh, United Kingdom
| | - Kathryn L Evans
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (A.D.C., D.A.G., Y.C., E.B., A.C., D.L.M., K.L.E., R.E.M.), The University of Edinburgh, United Kingdom
| | - Riccardo E Marioni
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (A.D.C., D.A.G., Y.C., E.B., A.C., D.L.M., K.L.E., R.E.M.), The University of Edinburgh, United Kingdom
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Dos Santos F, Li JB, Juocys N, Mazor R, Beretta L, Coufal NG, Lam MTY, Odish MF, Irigoyen MC, O’Donoghue AJ, Aletti F, Kistler EB. Plasma enzymatic activity, proteomics and peptidomics in COVID-19-induced sepsis: A novel approach for the analysis of hemostasis. Front Mol Biosci 2023; 9:1051471. [PMID: 36710882 PMCID: PMC9874325 DOI: 10.3389/fmolb.2022.1051471] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/20/2022] [Indexed: 01/13/2023] Open
Abstract
Introduction: Infection by SARS-CoV-2 and subsequent COVID-19 can cause viral sepsis. We investigated plasma protease activity patterns in COVID-19-induced sepsis with bacterial superinfection, as well as plasma proteomics and peptidomics in order to assess the possible implications of enhanced proteolysis on major protein systems (e.g., coagulation). Methods: Patients (=4) admitted to the intensive care units (ICUs) at the University of California, San Diego (UCSD) Medical Center with confirmed positive test for COVID-19 by real-time reverse transcription polymerase chain reaction (RT-PCR) were enrolled in a study approved by the UCSD Institutional Review Board (IRB# 190699, Protocol #20-0006). Informed consent was obtained for the collection of blood samples and de-identified use of the data. Blood samples were collected at multiple time points and analyzed to quantify a) the circulating proteome and peptidome by mass spectrometry; b) the aminopeptidase activity in plasma; and c) the endopeptidase activity in plasma using fluorogenic substrates that are cleaved by trypsin-like endopeptidases, specific clotting factors and plasmin. The one patient who died was diagnosed with bacterial superinfection on day 7 after beginning of the study. Results: Spikes in protease activity (factor VII, trypsin-like activity), and corresponding increases in the intensity of peptides derived by hydrolysis of plasma proteins, especially of fibrinogen degradation products and downregulation of endogenous protease inhibitors were detected on day 7 for the patient who died. The activity of the analyzed proteases was stable in survivors. Discussion: The combination of multiomics and enzymatic activity quantification enabled to i) hypothesize that elevated proteolysis occurs in COVID-19-induced septic shock with bacterial superinfection, and ii) provide additional insight into malfunctioning protease-mediated systems, such as hemostasis.
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Affiliation(s)
- Fernando Dos Santos
- Department of Anesthesiology, School of Medicine, University of California, San Diego, CA, United States
| | - Joyce B. Li
- Department of Bioengineering, University of California, San Diego, CA, United States
| | - Nathalia Juocys
- Department of Anesthesiology, School of Medicine, University of California, San Diego, CA, United States
- Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (InCor-FMUSP), São Paulo, Brazil
| | - Rafi Mazor
- Department of Anesthesiology, School of Medicine, University of California, San Diego, CA, United States
| | - Laura Beretta
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, CA, United States
| | - Nicole G. Coufal
- Department of Pediatrics, School of Medicine, University of California, San Diego, CA, United States
| | - Michael T. Y. Lam
- Department of Medicine, School of Medicine, University of California, San Diego, CA, United States
| | - Mazen F. Odish
- Department of Medicine, School of Medicine, University of California, San Diego, CA, United States
| | - Maria Claudia Irigoyen
- Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (InCor-FMUSP), São Paulo, Brazil
| | - Anthony J. O’Donoghue
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, CA, United States
| | - Federico Aletti
- Instituto de Ciência e Tecnologia, Universidade Federal de São Paulo, São Josê dos Campos, Brazil
| | - Erik B. Kistler
- Department of Anesthesiology, School of Medicine, University of California, San Diego, CA, United States
- Department of Anesthesiology and Critical Care, VA San Diego Healthcare System, San Diego, CA, United States
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Luskin K, Mortazavi D, Bai-Tong S, Bertrand K, Chambers C, Schulkers-Escalante K, Ahmad A, Luedtke S, O'Donoghue AJ, Ghassemian M, Geng B, Leibel SL, Leibel SA. Allergen Content and Protease Activity in Milk Feeds from Mothers of Preterm Infants. Breastfeed Med 2022; 17:947-957. [PMID: 36251466 PMCID: PMC10081709 DOI: 10.1089/bfm.2022.0115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Rationale: There is little information regarding the allergen content of milk feeds in the preterm population. Previous studies have not performed a broad analysis of the allergenic peptide content and protease activity of milk feeds in this population. Methods: To evaluate feasibility, we initially performed mass spectrometry on 4 human milk (HM) samples (2 term and 2 preterm) from the Mommy's Milk Human Milk Biorepository (HMB) and analyzed the results against the University of Nebraska FASTA database and UniProt for a total of 2,211 protein sequences. We then further analyzed five samples from the Microbiome, Atopy, and Prematurity (MAP) study including peptidomic and protease activity analysis. Results: Each HMB sample had between 806 and 1,007 proteins, with 37-44 nonhuman proteins/sample encompassing 26 plant and animal species. In the preterm MAP samples, 784 digested nonhuman proteins were identified, 30 were nonbovine in origin. Proteins from 23 different species including aeroallergens, food, and contact allergens were identified. Protease activity was highest in HM samples without human milk fortifier and lowest in preterm formula. Conclusions: These findings represent the first preterm milk feed mass spectrometry and protease analysis with identification of known allergenic proteins to food, contact, and aeroallergens. These results raise questions of whether the composition of milk feeds in the neonatal intensive care unit impact the development of atopic disease in the preterm population and whether the complex interaction between allergens, proteases, and other HM components can serve to induce sensitization or tolerance to allergens in infants. Clinical Trial Registration Number: NCT04835935.
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Affiliation(s)
| | - Diba Mortazavi
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
| | - Sherry Bai-Tong
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
| | - Kerri Bertrand
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
| | - Christina Chambers
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
| | | | - Alla Ahmad
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
| | - Stephanie Luedtke
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
| | - Anthony J. O'Donoghue
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
| | - Majid Ghassemian
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
| | - Bob Geng
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
| | - Sandra L. Leibel
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
| | - Sydney A. Leibel
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
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