1
|
Unterhuber M, Kresoja KP, Lurz P, Thiele H. Artificial intelligence in proteomics: new frontiers from risk prediction to treatment? Eur Heart J 2022; 43:4525-4527. [PMID: 35869894 DOI: 10.1093/eurheartj/ehac391] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Matthias Unterhuber
- Department of Cardiology, Heart Center Leipzig at University of Leipzig, Strümpellstraße 39, Leipzig 04289, Germany
| | - Karl-Patrik Kresoja
- Department of Cardiology, Heart Center Leipzig at University of Leipzig, Strümpellstraße 39, Leipzig 04289, Germany
| | - Philipp Lurz
- Department of Cardiology, Heart Center Leipzig at University of Leipzig, Strümpellstraße 39, Leipzig 04289, Germany
| | - Holger Thiele
- Department of Cardiology, Heart Center Leipzig at University of Leipzig, Strümpellstraße 39, Leipzig 04289, Germany.,Leipzig Heart Institute at Heart Center Leipzig, Russenstraße 69A, Leipzig 04289, Germany
| |
Collapse
|
2
|
Emma R, Caruso M, Campagna D, Pulvirenti R, Li Volti G. The Impact of Tobacco Cigarettes, Vaping Products and Tobacco Heating Products on Oxidative Stress. Antioxidants (Basel) 2022; 11:1829. [PMID: 36139904 PMCID: PMC9495690 DOI: 10.3390/antiox11091829] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/06/2022] [Accepted: 09/08/2022] [Indexed: 12/02/2022] Open
Abstract
Cells constantly produce oxidizing species because of their metabolic activity, which is counteracted by the continuous production of antioxidant species to maintain the homeostasis of the redox balance. A deviation from the metabolic steady state leads to a condition of oxidative stress. The source of oxidative species can be endogenous or exogenous. A major exogenous source of these species is tobacco smoking. Oxidative damage can be induced in cells by chemical species contained in smoke through the generation of pro-inflammatory compounds and the modulation of intracellular pro-inflammatory pathways, resulting in a pathological condition. Cessation of smoking reduces the morbidity and mortality associated with cigarette use. Next-generation products (NGPs), as alternatives to combustible cigarettes, such as electronic cigarettes (e-cig) and tobacco heating products (THPs), have been proposed as a harm reduction strategy to reduce the deleterious impacts of cigarette smoking. In this review, we examine the impact of tobacco smoke and MRPs on oxidative stress in different pathologies, including respiratory and cardiovascular diseases and tumors. The impact of tobacco cigarette smoke on oxidative stress signaling in human health is well established, whereas the safety profile of MRPs seems to be higher than tobacco cigarettes, but further, well-conceived, studies are needed to better understand the oxidative effects of these products with long-term exposure.
Collapse
Affiliation(s)
- Rosalia Emma
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia, 97, 95123 Catania, Italy
| | - Massimo Caruso
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia, 97, 95123 Catania, Italy
- Center of Excellence for the Acceleration of Harm Reduction (CoEHAR), University of Catania, Via S. Sofia, 89, 95123 Catania, Italy
| | - Davide Campagna
- Center of Excellence for the Acceleration of Harm Reduction (CoEHAR), University of Catania, Via S. Sofia, 89, 95123 Catania, Italy
- Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia, 97, 95123 Catania, Italy
| | - Roberta Pulvirenti
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia, 97, 95123 Catania, Italy
| | - Giovanni Li Volti
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia, 97, 95123 Catania, Italy
- Center of Excellence for the Acceleration of Harm Reduction (CoEHAR), University of Catania, Via S. Sofia, 89, 95123 Catania, Italy
| |
Collapse
|
3
|
Lira-Junior R, Boström EA, Gustafsson A. Periodontitis is associated to increased systemic inflammation in postmyocardial infarction patients. Open Heart 2021; 8:openhrt-2021-001674. [PMID: 34385358 PMCID: PMC8362710 DOI: 10.1136/openhrt-2021-001674] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 07/13/2021] [Indexed: 12/02/2022] Open
Abstract
Objective Periodontitis has been independently associated to cardiovascular disease. However, the biological mechanisms underlying such association are still partially unknown. Thus, this study aimed to discover immunological clues accounting for the increased risk of myocardial infarction (MI) in patients having periodontitis. Methods We included 100 patients with a first MI, 50 with and 50 without severe periodontitis, and 100 age-matched, sex-matched and area-matched controls from the Periodontitis and Its Relation to Coronary Artery Disease Study. Participants underwent comprehensive clinical and laboratory examinations 6–10 weeks after the MI and plasma expression of 92 inflammation-related markers was assessed through proximity extension assay. Results Patients who had an MI displayed altered expression of CCL19, TNFRSF9 and LAP TGF-β1 in comparison with controls. TNFRSF9 correlated significantly with the amount of alveolar bone loss. MI patients with deep periodontal pockets showed increased white cell count and higher expression of FGF-21, HGF, OSM, CCL20 and IL-18R1 than patients without. White cell count correlated significantly with four of these proteins. Conclusions Collectively, our results indicate molecular markers that could be responsible for the increased systemic inflammatory activity in patients with MI with periodontitis.
Collapse
Affiliation(s)
| | | | - Anders Gustafsson
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | | |
Collapse
|
4
|
Czekala L, Wieczorek R, Simms L, Yu F, Budde J, Trelles Sticken E, Rudd K, Verron T, Brinster O, Stevenson M, Walele T. Multi-endpoint analysis of human 3D airway epithelium following repeated exposure to whole electronic vapor product aerosol or cigarette smoke. Curr Res Toxicol 2021; 2:99-115. [PMID: 34345855 PMCID: PMC8320624 DOI: 10.1016/j.crtox.2021.02.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 02/11/2021] [Accepted: 02/12/2021] [Indexed: 11/15/2022] Open
Abstract
Smoking is a cause of serious diseases in smokers including chronic respiratory diseases. This study aimed to evaluate the tobacco harm reduction (THR) potential of an electronic vapor product (EVP, myblu™) compared to a Kentucky Reference Cigarette (3R4F), and assessed endpoints related to chronic respiratory diseases. Endpoints included: cytotoxicity, barrier integrity (TEER), cilia function, immunohistochemistry, and pro-inflammatory markers. In order to more closely represent the user exposure scenario, we have employed the in vitro 3D organotypic model of human airway epithelium (MucilAir™, Epithelix) for respiratory assessment. The model was repeatedly exposed to either whole aerosol of the EVP, or whole 3R4F smoke, at the air liquid interface (ALI), for 4 weeks to either 30, 60 or 90 puffs on 3-exposure-per-week basis. 3R4F smoke generation used the ISO 20778:2018 regime and EVP aerosol used the ISO 20768:2018 vaping regime. Exposure to undiluted whole EVP aerosol did not trigger any significant changes in the level of pro-inflammatory mediators, cilia beating function, barrier integrity and cytotoxicity when compared with air controls. In contrast, exposure to diluted (1:17) whole cigarette smoke caused significant changes to all the endpoints mentioned above. To our knowledge, this is the first study evaluating the effects of repeated whole cigarette smoke and whole EVP aerosol exposure to a 3D lung model at the ALI. Our results add to the growing body of scientific literature supporting the THR potential of EVPs relative to combustible cigarettes and the applicability of the 3D lung models in human-relevant product risk assessments.
Collapse
Key Words
- 2D, Two Dimensional
- 3D, Three Dimensional
- 3R4F, Scientific Reference Tobacco Cigarette (University of Kentucky)
- ALI, Air-Liquid Interface
- ANOVA, Analysis of Variance
- AOP, Adverse Outcome Pathway
- CAA, Cilia Active Area
- CBF, Cilia Beat Frequency
- COPD, Chronic Obstructive Pulmonary Disease
- CYP450, Cytochrome P450
- Cigarette
- Cilia
- DPBS, Dulbecco's phosphate-buffered saline containing Ca2+ and Mg2+
- EGFR, Epidermal Growth Factor Receptor
- EVP, Electronic Vapor Product
- Electronic vapor product
- FOX-J1, Forkhead Box J1 protein
- H&E, Hematoxylin and Eosin
- IIVS, Institute for In Vitro Sciences
- IL-13, Interleukin 13
- IL-1β, Interleukin 1 Beta
- IL-6, Interleukin-6
- IL-8, Interleukin-8
- ISO, International Organization for Standardization
- Immunohistochemistry
- KERs, Key Event Relationships
- KEs, Key Events
- LDH, Lactate Dehydrogenase
- MIE, Molecular Initiating Event
- MMP-1, Matrix Metalloproteinase-1
- MMP-3, Matrix Metalloproteinase-3
- MMP-9, Matrix Metalloproteinase-9
- MUC5AC, Mucin 5AC Protein
- MWP, Multi-Well Plate
- NKT, Natural Killer T Cells
- Organotypic tissue model
- PBS, Phosphate Buffered Saline
- PMN, polymorphonuclear
- Pro-inflammatory markers
- SAEIVS, Smoke Aerosol Exposure In Vitro System
- TEER, Transepithelial Electrical Resistance
- THR, Tobacco Harm Reduction
- TNF-α, Tumor Necrosis Factor Alpha
- TPM, Total Particulate Matter
Collapse
Affiliation(s)
- Lukasz Czekala
- Imperial Brands PLC, 121 Winterstoke Road, Bristol BS3 2LL, United Kingdom
| | - Roman Wieczorek
- Reemtsma Cigarettenfabriken GmbH, An Imperial Brands PLC Company, Albert-EinsteinRing-7, D-22761 Hamburg, Germany
| | - Liam Simms
- Imperial Brands PLC, 121 Winterstoke Road, Bristol BS3 2LL, United Kingdom
| | - Fan Yu
- Imperial Brands PLC, 121 Winterstoke Road, Bristol BS3 2LL, United Kingdom
| | - Jessica Budde
- Reemtsma Cigarettenfabriken GmbH, An Imperial Brands PLC Company, Albert-EinsteinRing-7, D-22761 Hamburg, Germany
| | - Edgar Trelles Sticken
- Reemtsma Cigarettenfabriken GmbH, An Imperial Brands PLC Company, Albert-EinsteinRing-7, D-22761 Hamburg, Germany
| | - Kathryn Rudd
- Imperial Brands PLC, 121 Winterstoke Road, Bristol BS3 2LL, United Kingdom
| | - Thomas Verron
- Imperial Brands PLC, 121 Winterstoke Road, Bristol BS3 2LL, United Kingdom
| | - Oleg Brinster
- Reemtsma Cigarettenfabriken GmbH, An Imperial Brands PLC Company, Albert-EinsteinRing-7, D-22761 Hamburg, Germany
| | - Matthew Stevenson
- Imperial Brands PLC, 121 Winterstoke Road, Bristol BS3 2LL, United Kingdom
| | - Tanvir Walele
- Imperial Brands PLC, 121 Winterstoke Road, Bristol BS3 2LL, United Kingdom
| |
Collapse
|
5
|
Corlin L, Liu C, Lin H, Leone D, Yang Q, Ngo D, Levy D, Cupples LA, Gerszten RE, Larson MG, Vasan RS. Proteomic Signatures of Lifestyle Risk Factors for Cardiovascular Disease: A Cross-Sectional Analysis of the Plasma Proteome in the Framingham Heart Study. J Am Heart Assoc 2021; 10:e018020. [PMID: 33372532 PMCID: PMC7955453 DOI: 10.1161/jaha.120.018020] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 10/27/2020] [Indexed: 02/06/2023]
Abstract
Background Proteomic biomarkers related to cardiovascular disease risk factors may offer insights into the pathogenesis of cardiovascular disease. We investigated whether modifiable lifestyle risk factors for cardiovascular disease are associated with distinctive proteomic signatures. Methods and Results We analyzed 1305 circulating plasma proteomic biomarkers (assayed using the SomaLogic platform) in 897 FHS (Framingham Heart Study) Generation 3 participants (mean age 46±8 years; 56% women; discovery sample) and 1121 FOS (Framingham Offspring Study) participants (mean age 52 years; 54% women; validation sample). Participants were free of hypertension, diabetes mellitus, and clinical cardiovascular disease. We used linear mixed effects models (adjusting for age, sex, body mass index, and family structure) to relate levels of each inverse-log transformed protein to 3 lifestyle factors (ie, smoking, alcohol consumption, and physical activity). A Bonferroni-adjusted P value indicated statistical significance (based on number of proteins and traits tested, P<4.2×10-6 in the discovery sample; P<6.85×10-4 in the validation sample). We observed statistically significant associations of 60 proteins with smoking (37/40 top proteins validated in FOS), 30 proteins with alcohol consumption (23/30 proteins validated), and 5 proteins with physical activity (2/3 proteins associated with the physical activity index validated). We assessed the associations of protein concentrations with previously identified genetic variants (protein quantitative trait loci) linked to lifestyle-related disease traits in the genome-wide-association study catalogue. The protein quantitative trait loci were associated with coronary artery disease, inflammation, and age-related mortality. Conclusions Our cross-sectional study from a community-based sample elucidated distinctive sets of proteins associated with 3 key lifestyle factors.
Collapse
Affiliation(s)
- Laura Corlin
- Boston University Department of MedicineBostonMA
- Department of Public Health and Community MedicineTufts University School of MedicineBostonMA
- Department of Civil and Environmental EngineeringTufts University School of EngineeringMedfordMA
| | - Chunyu Liu
- Boston University School of Public HealthBostonMA
| | | | | | - Qiong Yang
- Boston University School of Public HealthBostonMA
| | - Debby Ngo
- Department of MedicineBeth Israel Deaconess Medical CenterBostonMA
- Harvard Medical SchoolBostonMA
| | - Daniel Levy
- Population Sciences BranchNational Heart, Lung, and Blood Institute, National Institutes of HealthBethesdaMD
- Framingham Heart StudyFraminghamMA
| | - L. Adrienne Cupples
- Boston University School of Public HealthBostonMA
- Framingham Heart StudyFraminghamMA
| | - Robert E. Gerszten
- Department of MedicineBeth Israel Deaconess Medical CenterBostonMA
- Harvard Medical SchoolBostonMA
| | - Martin G. Larson
- Boston University School of Public HealthBostonMA
- Framingham Heart StudyFraminghamMA
| | - Ramachandran S. Vasan
- Boston University Department of MedicineBostonMA
- Boston University School of Public HealthBostonMA
- Framingham Heart StudyFraminghamMA
- Boston University Center for Computing and Data SciencesBostonMA
| |
Collapse
|
6
|
Wada H, Suzuki M, Matsuda M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Morita Y, Nakamura T, Fujimoto K, Matsubara H, Kato T, Unoki T, Takagi D, Wada K, Wada M, Iguchi M, Masunaga N, Ishii M, Yamakage H, Kusakabe T, Yasoda A, Shimatsu A, Kotani K, Satoh-Asahara N, Abe M, Akao M, Hasegawa K. Impact of Smoking Status on Growth Differentiation Factor 15 and Mortality in Patients With Suspected or Known Coronary Artery Disease: The ANOX Study. J Am Heart Assoc 2020; 9:e018217. [PMID: 33170061 PMCID: PMC7763732 DOI: 10.1161/jaha.120.018217] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Whether circulating growth differentiation factor 15 (GDF‐15) levels differ according to smoking status and whether smoking modifies the relationship between GDF‐15 and mortality in patients with coronary artery disease are unclear. Methods and Results Using data from a multicenter, prospective cohort of 2418 patients with suspected or known coronary artery disease, we assessed the association between smoking status and GDF‐15 and the impact of smoking status on the association between GDF‐15 and all‐cause death. GDF‐15 was measured in 955 never smokers, 1035 former smokers, and 428 current smokers enrolled in the ANOX Study (Development of Novel Biomarkers Related to Angiogenesis or Oxidative Stress to Predict Cardiovascular Events). Patients were followed up during 3 years. The age of the patients ranged from 19 to 94 years; 67.2% were men. Never smokers exhibited significantly lower levels of GDF‐15 compared with former smokers and current smokers. Stepwise multiple linear regression analysis revealed that the log‐transformed GDF‐15 level was independently associated with both current smoking and former smoking. In the entire patient cohort, the GDF‐15 level was significantly associated with all‐cause death after adjusting for potential clinical confounders. This association was still significant in never smokers, former smokers, and current smokers. However, GDF‐15 provided incremental prognostic information to the model with potential clinical confounders and the established cardiovascular biomarkers in never smokers, but not in current smokers or in former smokers. Conclusions Not only current, but also former smoking was independently associated with higher levels of GDF‐15. The prognostic value of GDF‐15 on mortality was most pronounced in never smokers among patients with suspected or known coronary artery disease.
Collapse
Affiliation(s)
- Hiromichi Wada
- Division of Translational Research National Hospital Organization Kyoto Medical Center Kyoto Japan
| | - Masahiro Suzuki
- Department of Clinical Research National Hospital Organization Saitama Hospital Wako Japan
| | - Morihiro Matsuda
- Institute for Clinical Research National Hospital Organization Kure Medical Center and Chugoku Cancer Center Kure Japan
| | - Yoichi Ajiro
- Division of Clinical Research National Hospital Organization Yokohama Medical Center Yokohama Japan
| | - Tsuyoshi Shinozaki
- Department of Cardiology National Hospital Organization Sendai Medical Center Sendai Japan
| | - Satoru Sakagami
- Department of Cardiovascular Medicine National Hospital Organization Kanazawa Medical Center Kanazawa Japan
| | - Kazuya Yonezawa
- Division of Clinical Research National Hospital Organization Hakodate National Hospital Hakodate Japan
| | - Masatoshi Shimizu
- Department of Cardiology National Hospital Organization Kobe Medical Center Kobe Japan
| | - Junichi Funada
- Department of Cardiology National Hospital Organization Ehime Medical Center Toon Japan
| | - Takashi Takenaka
- Division of Cardiology National Hospital Organization Hokkaido Medical Center Sapporo Japan
| | - Yukiko Morita
- Department of Cardiology National Hospital Organization Sagamihara National Hospital Sagamihara Japan
| | - Toshihiro Nakamura
- Department of Cardiology National Hospital Organization Kyushu Medical Center Fukuoka Japan
| | - Kazuteru Fujimoto
- Department of Cardiology National Hospital Organization Kumamoto Medical Center Kumamoto Japan
| | - Hiromi Matsubara
- Department of Cardiology National Hospital Organization Okayama Medical Center Okayama Japan
| | - Toru Kato
- Department of Clinical Research National Hospital Organization Tochigi Medical Center Utsunomiya Japan
| | - Takashi Unoki
- Division of Translational Research National Hospital Organization Kyoto Medical Center Kyoto Japan.,Intensive Care Unit Saiseikai Kumamoto Hospital Kumamoto Japan
| | - Daisuke Takagi
- Division of Translational Research National Hospital Organization Kyoto Medical Center Kyoto Japan.,Department of Acute Care and General Medicine Saiseikai Kumamoto Hospital Kumamoto Japan
| | - Kyohma Wada
- Division of Translational Research National Hospital Organization Kyoto Medical Center Kyoto Japan
| | - Miyaka Wada
- Division of Translational Research National Hospital Organization Kyoto Medical Center Kyoto Japan
| | - Moritake Iguchi
- Division of Translational Research National Hospital Organization Kyoto Medical Center Kyoto Japan.,Department of Cardiology National Hospital Organization Kyoto Medical Center Kyoto Japan
| | - Nobutoyo Masunaga
- Division of Translational Research National Hospital Organization Kyoto Medical Center Kyoto Japan.,Department of Cardiology National Hospital Organization Kyoto Medical Center Kyoto Japan
| | - Mitsuru Ishii
- Division of Translational Research National Hospital Organization Kyoto Medical Center Kyoto Japan.,Department of Cardiology National Hospital Organization Kyoto Medical Center Kyoto Japan
| | - Hajime Yamakage
- Department of Endocrinology, Metabolism, and Hypertension Clinical Research Institute National Hospital Organization Kyoto Medical Center Kyoto Japan
| | - Toru Kusakabe
- Department of Endocrinology, Metabolism, and Hypertension Clinical Research Institute National Hospital Organization Kyoto Medical Center Kyoto Japan
| | - Akihiro Yasoda
- Clinical Research Institute National Hospital Organization Kyoto Medical Center Kyoto Japan
| | - Akira Shimatsu
- Clinical Research Institute National Hospital Organization Kyoto Medical Center Kyoto Japan
| | - Kazuhiko Kotani
- Division of Community and Family Medicine Jichi Medical University Shimotsuke Japan
| | - Noriko Satoh-Asahara
- Department of Endocrinology, Metabolism, and Hypertension Clinical Research Institute National Hospital Organization Kyoto Medical Center Kyoto Japan
| | - Mitsuru Abe
- Division of Translational Research National Hospital Organization Kyoto Medical Center Kyoto Japan.,Department of Cardiology National Hospital Organization Kyoto Medical Center Kyoto Japan
| | - Masaharu Akao
- Division of Translational Research National Hospital Organization Kyoto Medical Center Kyoto Japan.,Department of Cardiology National Hospital Organization Kyoto Medical Center Kyoto Japan
| | - Koji Hasegawa
- Division of Translational Research National Hospital Organization Kyoto Medical Center Kyoto Japan
| | | |
Collapse
|
7
|
Higgins-Chen AT, Boks MP, Vinkers CH, Kahn RS, Levine ME. Schizophrenia and Epigenetic Aging Biomarkers: Increased Mortality, Reduced Cancer Risk, and Unique Clozapine Effects. Biol Psychiatry 2020; 88:224-235. [PMID: 32199607 PMCID: PMC7368835 DOI: 10.1016/j.biopsych.2020.01.025] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/28/2020] [Accepted: 01/31/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Schizophrenia (SZ) is associated with increased all-cause mortality, smoking, and age-associated proteins, yet multiple previous studies found no association between SZ and biological age using Horvath's epigenetic clock, a well-established aging biomarker based on DNA methylation. However, numerous epigenetic clocks that may capture distinct aspects of aging have been developed. This study tested the hypothesis that altered aging in SZ manifests in these other clocks. METHODS We performed a comprehensive analysis of 14 epigenetic clocks categorized according to what they were trained to predict: chronological age, mortality, mitotic divisions, or telomere length. To understand the etiology of biological age differences, we also examined DNA methylation predictors of smoking, alcohol, body mass index, serum proteins, and cell proportions. We independently analyzed 3 publicly available multiethnic DNA methylation data sets from whole blood, a total of 567 SZ cases and 594 nonpsychiatric controls. RESULTS All data sets showed accelerations in SZ for the 3 mortality clocks up to 5 years, driven by smoking and elevated levels of 6 age-associated proteins. The 2 mitotic clocks were decelerated in SZ related to antitumor natural killer and CD8T cells, which may help explain conflicting reports about low cancer rates in epidemiological studies of SZ. One cohort with available medication data showed that clozapine is associated with male-specific decelerations up to 7 years in multiple chronological age clocks. CONCLUSIONS Our study demonstrates the utility of studying the various epigenetic clocks in tandem and highlights potential mechanisms by which mental illness influences long-term outcomes, including cancer and early mortality.
Collapse
Affiliation(s)
- Albert T Higgins-Chen
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
| | - Marco P Boks
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, The Netherlands
| | - Christiaan H Vinkers
- Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, The Netherlands; Department of Anatomy and Neurosciences, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - René S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, The Netherlands
| | - Morgan E Levine
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
| |
Collapse
|
8
|
Lind L, Figarska S, Sundström J, Fall T, Ärnlöv J, Ingelsson E. Changes in Proteomic Profiles are Related to Changes in BMI and Fat Distribution During 10 Years of Aging. Obesity (Silver Spring) 2020; 28:178-186. [PMID: 31804015 PMCID: PMC6986305 DOI: 10.1002/oby.22660] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 09/04/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This study investigated how changes in 84 proteins over a 10-year period of aging were related to changes in measures of body fat and distribution over the same period. METHODS Cardiovascular candidate proteins were measured using the proximal extension assay technique, along with BMI and waist-hip ratio (WHR), at ages 70, 75, and 80 in 1,016 participants of the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) cohort. Associations of changes in plasma protein levels, BMI, and WHR over time were analyzed using linear mixed models. RESULTS Changes in 19 and 16 proteins were significantly associated with changes in BMI and WHR, respectively (P < 0.00059), over the investigated 10-year period. Leptin and fatty acid-binding protein 4 were among the proteins most strongly associated with changes in both BMI and WHR. Four of the proteins significantly tracked with change in BMI (P < 0.00059) but not WHR (P > 0.05): endothelial cell-specific molecule 1, pentraxin-related protein PTX3, ST2 protein (also known as interleukin-1 receptor-like 1), and spondin-1. Five proteins tracked with change in WHR (P < 0.00059) but not BMI (P > 0.05): caspase-8, cathepsin L1, oxidized low-density lipoprotein receptor 1, interleukin-6 receptor subunit alpha, and C-C motif chemokine 20. CONCLUSIONS This is the first large longitudinal study of how changes in plasma protein signatures are associated with changes in measures of body fat and distribution over 10 years of aging.
Collapse
Affiliation(s)
- Lars Lind
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden
| | - Sylwia Figarska
- Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
- Stanford Cardiovascular Institute, Stanford, CA 94305, USA
- Stanford Diabetes Research Center, Stanford, CA 94305, USA
| | - Johan Sundström
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Tove Fall
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Johan Ärnlöv
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- School of Health and Social Sciences, Dalarna University, Falun, Sweden
| | - Erik Ingelsson
- Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
- Stanford Cardiovascular Institute, Stanford, CA 94305, USA
- Stanford Diabetes Research Center, Stanford, CA 94305, USA
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| |
Collapse
|
9
|
Figarska SM, Gustafsson S, Sundström J, Ärnlöv J, Mälarstig A, Elmståhl S, Fall T, Lind L, Ingelsson E. Associations of Circulating Protein Levels With Lipid Fractions in the General Population. Arterioscler Thromb Vasc Biol 2019; 38:2505-2518. [PMID: 30354202 DOI: 10.1161/atvbaha.118.311440] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Objective- Revealing patterns of associations between circulating protein and lipid levels could improve biological understanding of cardiovascular disease (CVD). In this study, we investigated the associations between proteins related to CVD and triglyceride (TG), total cholesterol, LDL (low-density lipoprotein), and HDL (high-density lipoprotein) cholesterol levels in individuals from the general population. Approach and Results- We measured plasma protein levels using the Olink ProSeek CVD I or II+III arrays and analyzed 57 proteins available in 3 population-based cohorts: EpiHealth (n=2029; 52% women; median age, 61 years), PIVUS (Prospective Study of the Vasculature in Uppsala Seniors; n=790; 51% women; all aged 70 years), and ULSAM (Uppsala Longitudinal Study of Adult Men; n=551; all men aged 77 years). A discovery analysis was performed in EpiHealth in a regression framework (adjusted for sex, age, body mass index, smoking, glucose levels, systolic blood pressure, blood pressure medication, diabetes mellitus medication, and CVD history), and associations with false discovery rate <0.05 were further tested in PIVUS and ULSAM, where a P value of 0.05 was considered a successful replication (validation false discovery rate of 0.1%). We used summary statistics from a genome-wide association study on each protein biomarker (meta-analysis of EpiHealth, PIVUS, ULSAM, and IMPROVE [Carotid Intima-Media Thickness and IMT-Progression as Predictors of Vascular Events in a High-Risk European Population]) and publicly available data from Global Lipids Genetics Consortium to perform Mendelian randomization analyses to address possible causality of protein levels. Of 57 tested proteins, 42 demonstrated an association with at least 1 lipid fraction; 35 were associated with TG, 15 with total cholesterol, 9 with LDL cholesterol, and 24 with HDL cholesterol. Among these associations, we found KIM-1 (kidney injury molecule-1), TNFR (TNF [tumor necrosis factor] receptor) 1 and 2, TRAIL-R2 (TRAIL [TNF-related apoptosis-inducing ligand] receptor 2), and RETN (resistin) to be associated with all 4 lipid fractions. Further, 15 proteins were related to both TG and HDL cholesterol in a consistent and biologically expected manner, that is, higher TG and lower HDL cholesterol or vice versa. Another common pattern of associations was concomitantly higher TG, total cholesterol, and LDL cholesterol, which is associated with higher CVD risk. We did not find evidence of causal links for protein levels. Conclusions- Our comprehensive analysis of plasma proteins and lipid fractions of 3370 individuals from the general population provides new information about lipid metabolism.
Collapse
Affiliation(s)
- Sylwia M Figarska
- From the Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, CA (S.M.F., E.I.).,Stanford Cardiovascular Institute, Stanford University, CA (S.M.F., E.I.), Uppsala University, Sweden
| | - Stefan Gustafsson
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory (S.G., T.F., E.I.), Uppsala University, Sweden
| | - Johan Sundström
- Department of Medical Sciences, Cardiovascular Epidemiology (J.S., L.L.), Uppsala University, Sweden.,Uppsala Clinical Research Center (J.S.), Uppsala University, Sweden
| | - Johan Ärnlöv
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden (J.Ä.).,School of Health and Social Sciences, Dalarna University, Falun, Sweden (J.Ä.)
| | - Anders Mälarstig
- Department of Medicine Solna, Cardiovascular Medicine Unit, Karolinska Institutet, Stockholm, Sweden (A.M.).,Pfizer Worldwide Research and Development, Stockholm, Sweden (A.M.)
| | - Sölve Elmståhl
- Division of Geriatric Medicine, Department of Clinical Sciences, Malmö University Hospital, Lund University, Sweden (S.E.)
| | - Tove Fall
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory (S.G., T.F., E.I.), Uppsala University, Sweden
| | - Lars Lind
- Department of Medical Sciences, Cardiovascular Epidemiology (J.S., L.L.), Uppsala University, Sweden
| | - Erik Ingelsson
- From the Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, CA (S.M.F., E.I.).,Stanford Cardiovascular Institute, Stanford University, CA (S.M.F., E.I.), Uppsala University, Sweden.,Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory (S.G., T.F., E.I.), Uppsala University, Sweden
| |
Collapse
|
10
|
Borné Y, Fagerberg B, Sallsten G, Hedblad B, Persson M, Melander O, Nilsson J, Orho-Melander M, Barregard L, Engström G. Biomarkers of blood cadmium and incidence of cardiovascular events in non-smokers: results from a population-based proteomics study. Clin Proteomics 2019; 16:21. [PMID: 31114450 PMCID: PMC6518646 DOI: 10.1186/s12014-019-9231-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 03/23/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Cadmium is a toxic metal with multiple adverse health effects, including risk of cardiovascular disease (CVD). The mechanistic link between cadmium and CVD is unclear. Our aim was to examine the associations between blood cadmium (B-Cd) and 88 potential protein biomarkers of CVD. METHODS B-Cd and 88 plasma proteins were measured in a community-based prospective cohort, the Malmö Diet and Cancer study. The primary analysis was performed in never smokers (n = 1725). Multiple linear regression was used with adjustments for age and sex, and correction for multiple comparisons using the false discovery rate method. Proteins significantly associated with B-Cd were replicated in long-term former smokers (n = 782). Significant proteins were then studied in relation to incidence of CVD (i.e., coronary events or ischemic stroke) in never smokers. RESULTS Fifteen proteins were associated with B-Cd in never smokers. Eight of them were replicated in long-term former smokers. Kidney injury molecule-1, fibroblast growth factor-23 (FGF23), tumor necrosis factor receptor-2, matrix metalloproteinase-12, cathepsin L1, urokinase plasminogen activator receptor, C-C motif chemokine-3 (CCL3), and chemokine (C-X3-C motif) ligand-1 were associated with B-Cd both in never smokers and long-term former smokers. Except for CCL3 and FGF23, these proteins were also significantly associated with incidence of CVD. CONCLUSIONS B-Cd in non-smokers was associated with eight potential plasma biomarkers of CVD and kidney injury. The results suggest pathways for the associations between B-Cd and CVD and kidney injury.
Collapse
Affiliation(s)
- Yan Borné
- Department of Clinical Sciences in Malmö, CRC, Lund University, Jan Waldenströms gata 35, 205 02 Malmö, Sweden
| | - Björn Fagerberg
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory for Cardiovascular and Metabolic Research, Sahlgrenska University Hospital, University of Gothenburg, 413 45 Gothenburg, Sweden
| | - Gerd Sallsten
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, University of Gothenburg, 413 45 Gothenburg, Sweden
| | - Bo Hedblad
- Department of Clinical Sciences in Malmö, CRC, Lund University, Jan Waldenströms gata 35, 205 02 Malmö, Sweden
| | - Margaretha Persson
- Department of Clinical Sciences in Malmö, CRC, Lund University, Jan Waldenströms gata 35, 205 02 Malmö, Sweden
| | - Olle Melander
- Department of Clinical Sciences in Malmö, CRC, Lund University, Jan Waldenströms gata 35, 205 02 Malmö, Sweden
| | - Jan Nilsson
- Department of Clinical Sciences in Malmö, CRC, Lund University, Jan Waldenströms gata 35, 205 02 Malmö, Sweden
| | - Marju Orho-Melander
- Department of Clinical Sciences in Malmö, CRC, Lund University, Jan Waldenströms gata 35, 205 02 Malmö, Sweden
| | - Lars Barregard
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, University of Gothenburg, 413 45 Gothenburg, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences in Malmö, CRC, Lund University, Jan Waldenströms gata 35, 205 02 Malmö, Sweden
| |
Collapse
|
11
|
Kraen M, Frantz S, Nihlén U, Engström G, Löfdahl CG, Wollmer P, Dencker M. Matrix Metalloproteinases in COPD and atherosclerosis with emphasis on the effects of smoking. PLoS One 2019; 14:e0211987. [PMID: 30789935 PMCID: PMC6383934 DOI: 10.1371/journal.pone.0211987] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 01/23/2019] [Indexed: 01/15/2023] Open
Abstract
Background Matrix metalloproteinases (MMP´s) are known biomarkers of atherosclerosis. MMP´s are also involved in the pathophysiological processes underlying chronic obstructive pulmonary disease (COPD). Cigarette smoking plays an important role in both disease states and is also known to affect the concentration and activity of MMP´s systemically. Unfortunately, the epidemiological data concerning the value of MMP´s as biomarkers of COPD and atherosclerosis with special regards to smoking habits are limited. Methods 450 middle-aged subjects with records of smoking habits and tobacco consumption were examined with comprehensive spirometry, carotid ultrasound examination and biomarker analysis of MMP-1, -3, -7, -10 and -12. Due to missing data 33 subjects were excluded. Results The remaining 417 participants were divided into 4 different groups. Group I (n = 157, no plaque and no COPD), group II (n = 136, plaque but no COPD), group III (n = 43, COPD but no plaque) and group IV (n = 81, plaque and COPD). Serum levels of MMP-1,-7,-10-12 were significantly influenced by smoking, and MMP-1, -3, -7 and-12 were elevated in subjects with COPD and carotid plaque. This remained statistically significant for MMP-1 and-12 after adjusting for traditional risk factors. Conclusion COPD and concomitant plaque in the carotid artery were associated with elevated levels of MMP-1 and -MMP-12 even when adjusting for risk factors. Further studies are needed to elucidate if these two MMP´s could be useful as biomarkers in a clinical setting. Smoking was associated with increased serum levels of MMP´s (except for MMP-3) and should be taken into account when interpreting serum MMP results.
Collapse
Affiliation(s)
- M. Kraen
- Clinical Physiology and Nuclear Medicine unit, Department of Translational Medicine, Malmö, Lund University, Malmö, Sweden
- * E-mail:
| | - S. Frantz
- Clinical Physiology and Nuclear Medicine unit, Department of Translational Medicine, Malmö, Lund University, Malmö, Sweden
| | - U. Nihlén
- Respiratory Medicine and Allergology unit, Department of Clinical Sciences, Lund, Lund University, Lund, Sweden
| | - G. Engström
- Cardiovascular Epidemiology research group, Department of Clinical Science, Malmö, Lund University, Malmö, Sweden
| | - C. G. Löfdahl
- Respiratory Medicine and Allergology unit, Department of Clinical Sciences, Lund, Lund University, Lund, Sweden
| | - P. Wollmer
- Clinical Physiology and Nuclear Medicine unit, Department of Translational Medicine, Malmö, Lund University, Malmö, Sweden
| | - M. Dencker
- Clinical Physiology and Nuclear Medicine unit, Department of Translational Medicine, Malmö, Lund University, Malmö, Sweden
| |
Collapse
|
12
|
Mytilinaiou M, Kyrou I, Khan M, Grammatopoulos DK, Randeva HS. Familial Hypercholesterolemia: New Horizons for Diagnosis and Effective Management. Front Pharmacol 2018; 9:707. [PMID: 30050433 PMCID: PMC6052892 DOI: 10.3389/fphar.2018.00707] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 06/12/2018] [Indexed: 12/11/2022] Open
Abstract
Familial hypercholesterolemia (FH) is a common genetic cause of premature cardiovascular disease (CVD). The reported prevalence rates for both heterozygous FH (HeFH) and homozygous FH (HoFH) vary significantly, and this can be attributed, at least in part, to the variable diagnostic criteria used across different populations. Due to lack of consistent data, new global registries and unified guidelines are being formed, which are expected to advance current knowledge and improve the care of FH patients. This review presents a comprehensive overview of the pathophysiology, epidemiology, manifestations, and pharmacological treatment of FH, whilst summarizing the up-to-date relevant recommendations and guidelines. Ongoing research in FH seems promising and novel therapies are expected to be introduced in clinical practice in order to compliment or even substitute current treatment options, aiming for better lipid-lowering effects, fewer side effects, and improved clinical outcomes.
Collapse
Affiliation(s)
- Maria Mytilinaiou
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - Ioannis Kyrou
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom.,Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham, United Kingdom.,Division of Translational and Experimental Medicine, Warwick Medical School, University of Warwick, Coventry, United Kingdom.,Centre of Applied Biological and Exercise Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom
| | - Mike Khan
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - Dimitris K Grammatopoulos
- Division of Translational and Experimental Medicine, Warwick Medical School, University of Warwick, Coventry, United Kingdom.,Institute of Precision Diagnostics and Translational Medicine, Coventry and Warwickshire Pathology Service, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - Harpal S Randeva
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom.,Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham, United Kingdom.,Division of Translational and Experimental Medicine, Warwick Medical School, University of Warwick, Coventry, United Kingdom.,Centre of Applied Biological and Exercise Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom.,Institute of Precision Diagnostics and Translational Medicine, Coventry and Warwickshire Pathology Service, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| |
Collapse
|
13
|
Cao X, Han C, Wen J, Guo X, Zhang K. Nicotine increases apoptosis in HUVECs cultured in high glucose/high fat via Akt ubiquitination and degradation. Clin Exp Pharmacol Physiol 2017; 45:198-204. [PMID: 28963785 DOI: 10.1111/1440-1681.12865] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 09/04/2017] [Accepted: 09/19/2017] [Indexed: 12/12/2022]
Abstract
It is well-documented that nicotine, the main active ingredient in cigarettes, results in endothelial cell injury in numerous diseases. However, whether nicotine plays a crucial role in endothelial cell injury in diabetes and the exact molecular mechanism that mediates this process have not been fully elucidated. The current study aimed to investigate the effects of nicotine on endothelial cell injury in diabetes and the specific molecular mechanism by which it plays a role. Human umbilical vein endothelial cells (HUVECs) were incubated in HG/HF media and treated with nicotine, PYR-41 (a selective ubiquitin E1 inhibitor), Akt-overexpressing adenovirus, or TTC3 and MUL1 shRNA adenovirus. Cell viability was subsequently detected by the CCK8 assay, and apoptosis was examined by caspase-3 cleavage and activity analysis. Compared to the HG/HF incubated group, nicotine incubation significantly decreased cell survival and increased apoptosis. Moreover, nicotine induced Akt degradation via UPS, and Akt overexpression blocked nicotine-induced apoptosis in HUVECs cultured in HG/HF media. Furthermore, the TTC3 and MUL1 shRNA adenovirus dramatically decreased the Akt ubiquitination and apoptosis induced by nicotine. These results indicate that nicotine-induced Akt ubiquitination and degradation occurs through TTC3 and MUL1 and results in a dramatic increase in apoptosis in HUVECs cultured in HG/HF media.
Collapse
Affiliation(s)
- Xiaofang Cao
- Center for Disease Control and Prevention of Baoji City, Baoji City, Shanxi Province, China
| | - Chunling Han
- Baoji Maternal and Child Health Hospital, Baoji City, Shanxi Province, China
| | - Jinsuo Wen
- Center for Disease Control and Prevention of Baoji City, Baoji City, Shanxi Province, China
| | - Xiaokun Guo
- Center for Disease Control and Prevention of Baoji City, Baoji City, Shanxi Province, China
| | - Kejian Zhang
- Center for Disease Control and Prevention of Baoji City, Baoji City, Shanxi Province, China
| |
Collapse
|
14
|
Gohar A, Gonçalves I, Vrijenhoek J, Haitjema S, van Koeverden I, Nilsson J, de Borst GJ, de Vries JP, Pasterkamp G, den Ruijter HM, Björkbacka H, de Jager SCA. Circulating GDF-15 levels predict future secondary manifestations of cardiovascular disease explicitly in women but not men with atherosclerosis. Int J Cardiol 2017; 241:430-436. [PMID: 28389123 DOI: 10.1016/j.ijcard.2017.03.101] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 02/01/2017] [Accepted: 03/20/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Elevated serum levels of growth differentiation factor-15 (GDF-15), is an established risk factor for a range of cardiovascular diseases. We aimed to evaluate the predictive value of plasma GDF-15 as a biomarker for secondary cardiovascular events (CVE) in patients with atherosclerosis undergoing carotid endarterectomy (CEA). Secondly, we determined whether plasma GDF-15 was associated with carotid plaque characteristics. METHODS Circulating GDF-15 levels were determined by Luminex assay in a cohort of 1056 patients from the Athero-Express biobank. Composite endpoint was defined as major CVE, death and peripheral vascular interventions. Findings were validated in 473 patients from the independent Carotid Plaque Imaging Project biobank. RESULTS GDF-15 levels did not associate with secondary CVE in the total cohort. However, following a significant interaction with sex, it was found to be strongly, independently predictive of secondary CVE in women but not men (quartile 4 vs. quartile 1: HR 3.04 [95% CI 1.35-6.86], p=0.007 in women vs. HR 0.96 [95% CI 0.66-1.40], p=0.845 in men). This was also observed in the validation cohort (women: HR 2.28 [95% CI 1.04-5.05], p=0.041), albeit dependent upon renal function. In addition, GDF-15 was associated with the presence of plaque smooth muscle cells and calcification. CONCLUSION High circulating GDF-15 levels are predictive of secondary CVE in women but not in men with carotid atherosclerotic disease undergoing CEA, suggesting a potential use for GDF-15 as a biomarker for secondary prevention in women. Sex differences in the role of GDF-15 in atherosclerotic disease deserve further interest.
Collapse
Affiliation(s)
- Aisha Gohar
- Laboratory for Experimental Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Clinical Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands
| | - Isabel Gonçalves
- Experimental Cardiovascular Research Unit, and Cardiology (coronary) Clinic, Department of Clinical Sciences, Malmö, Skåne University Hospital, Lund University, Sweden
| | - Joyce Vrijenhoek
- Laboratory for Experimental Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Saskia Haitjema
- Laboratory for Experimental Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Ian van Koeverden
- Laboratory for Experimental Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jan Nilsson
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences, Malmö, Skåne University Hospital, Lund University, Sweden
| | - Gert J de Borst
- Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jean-Paul de Vries
- Department of Vascular Surgery, St. Antonius Hospital Nieuwegein, Nieuwegein, the Netherlands
| | - Gerard Pasterkamp
- Laboratory for Experimental Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands; Laboratory for clinical chemistry and haematology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Hester M den Ruijter
- Laboratory for Experimental Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Harry Björkbacka
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences, Malmö, Skåne University Hospital, Lund University, Sweden
| | - Saskia C A de Jager
- Laboratory for Experimental Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands; Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands.
| |
Collapse
|