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Machado FJDM, Marta-Enguita J, Gómez SU, Rodriguez JA, Páramo-Fernández JA, Herrera M, Zandio B, Aymerich N, Muñoz R, Bermejo R, Marta-Moreno J, López B, González A, Roncal C, Orbe J. Transcriptomic Analysis of Extracellular Vesicles in the Search for Novel Plasma and Thrombus Biomarkers of Ischemic Stroke Etiologies. Int J Mol Sci 2024; 25:4379. [PMID: 38673963 PMCID: PMC11050408 DOI: 10.3390/ijms25084379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/10/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
Accurate etiologic diagnosis provides an appropriate secondary prevention and better prognosis in ischemic stroke (IS) patients; still, 45% of IS are cryptogenic, urging us to enhance diagnostic precision. We have studied the transcriptomic content of plasma extracellular vesicles (EVs) (n = 21) to identify potential biomarkers of IS etiologies. The proteins encoded by the selected genes were measured in the sera of IS patients (n = 114) and in hypertensive patients with (n = 78) and without atrial fibrillation (AF) (n = 20). IGFBP-2, the most promising candidate, was studied using immunohistochemistry in the IS thrombi (n = 23) and atrium of AF patients (n = 13). In vitro, the IGFBP-2 blockade was analyzed using thromboelastometry and endothelial cell cultures. We identified 745 differentially expressed genes among EVs of cardioembolic, atherothrombotic, and ESUS groups. From these, IGFBP-2 (cutoff > 247.6 ng/mL) emerged as a potential circulating biomarker of embolic IS [OR = 8.70 (1.84-41.13) p = 0.003], which was increased in patients with AF vs. controls (p < 0.001) and was augmented in cardioembolic vs. atherothrombotic thrombi (p < 0.01). Ex vivo, the blockage of IGFBP-2 reduced clot firmness (p < 0.01) and lysis time (p < 0.001) and in vitro, diminished endothelial permeability (p < 0.05) and transmigration (p = 0.06). IGFBP-2 could be a biomarker of embolic IS and a new therapeutic target involved in clot formation and endothelial dysfunction.
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Affiliation(s)
- Florencio J. D. M. Machado
- Laboratory of Atherothrombosis, Cima Universidad de Navarra, 31008 Pamplona, Spain; (F.J.D.M.M.); (J.M.-E.); (S.U.G.); (J.A.R.); (J.A.P.-F.); (C.R.)
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
| | - Juan Marta-Enguita
- Laboratory of Atherothrombosis, Cima Universidad de Navarra, 31008 Pamplona, Spain; (F.J.D.M.M.); (J.M.-E.); (S.U.G.); (J.A.R.); (J.A.P.-F.); (C.R.)
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
- Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS)-Ictus, Instituto Salud Carlos III, 28029 Madrid, Spain; (B.Z.); (N.A.); (R.M.); (J.M.-M.)
| | - Susan U. Gómez
- Laboratory of Atherothrombosis, Cima Universidad de Navarra, 31008 Pamplona, Spain; (F.J.D.M.M.); (J.M.-E.); (S.U.G.); (J.A.R.); (J.A.P.-F.); (C.R.)
| | - Jose A. Rodriguez
- Laboratory of Atherothrombosis, Cima Universidad de Navarra, 31008 Pamplona, Spain; (F.J.D.M.M.); (J.M.-E.); (S.U.G.); (J.A.R.); (J.A.P.-F.); (C.R.)
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - José Antonio Páramo-Fernández
- Laboratory of Atherothrombosis, Cima Universidad de Navarra, 31008 Pamplona, Spain; (F.J.D.M.M.); (J.M.-E.); (S.U.G.); (J.A.R.); (J.A.P.-F.); (C.R.)
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Hematology Department, Clinica Universidad de Navarra, 31008 Pamplona, Spain
| | - María Herrera
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
- Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS)-Ictus, Instituto Salud Carlos III, 28029 Madrid, Spain; (B.Z.); (N.A.); (R.M.); (J.M.-M.)
- Neurology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Beatriz Zandio
- Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS)-Ictus, Instituto Salud Carlos III, 28029 Madrid, Spain; (B.Z.); (N.A.); (R.M.); (J.M.-M.)
- Neurology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Nuria Aymerich
- Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS)-Ictus, Instituto Salud Carlos III, 28029 Madrid, Spain; (B.Z.); (N.A.); (R.M.); (J.M.-M.)
- Neurology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Roberto Muñoz
- Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS)-Ictus, Instituto Salud Carlos III, 28029 Madrid, Spain; (B.Z.); (N.A.); (R.M.); (J.M.-M.)
- Neurology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Rebeca Bermejo
- Neurointervencionist Radiology, Hospital Universitario de Navarra, 31008 Pamplona, Spain;
| | - Javier Marta-Moreno
- Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS)-Ictus, Instituto Salud Carlos III, 28029 Madrid, Spain; (B.Z.); (N.A.); (R.M.); (J.M.-M.)
- Neurology Department, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IIS-Aragon), 50009 Zaragoza, Spain
| | - Begoña López
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Cardiovascular Diseases Program, Cima Universidad de Navarra, 31008 Pamplona, Spain
| | - Arantxa González
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Cardiovascular Diseases Program, Cima Universidad de Navarra, 31008 Pamplona, Spain
- Department of Pathology, Anatomy and Physiology, Universidad de Navarra, 31008 Pamplona, Spain
| | - Carmen Roncal
- Laboratory of Atherothrombosis, Cima Universidad de Navarra, 31008 Pamplona, Spain; (F.J.D.M.M.); (J.M.-E.); (S.U.G.); (J.A.R.); (J.A.P.-F.); (C.R.)
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Josune Orbe
- Laboratory of Atherothrombosis, Cima Universidad de Navarra, 31008 Pamplona, Spain; (F.J.D.M.M.); (J.M.-E.); (S.U.G.); (J.A.R.); (J.A.P.-F.); (C.R.)
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
- Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS)-Ictus, Instituto Salud Carlos III, 28029 Madrid, Spain; (B.Z.); (N.A.); (R.M.); (J.M.-M.)
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Ceelen D, Voors AA, Tromp J, van Veldhuisen DJ, Dickstein K, de Boer RA, Lang CC, Anker SD, Ng LL, Metra M, Ponikowski P, Figarska SM. Pathophysiological pathways related to high plasma GDF-15 concentrations in patients with heart failure. Eur J Heart Fail 2022; 24:308-320. [PMID: 34989084 PMCID: PMC9302623 DOI: 10.1002/ejhf.2424] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/24/2021] [Accepted: 01/03/2022] [Indexed: 11/11/2022] Open
Abstract
AIMS Elevated concentrations of Growth Differentiation factor 15 (GDF-15) in patients with heart failure (HF) have been consistently associated with worse clinical outcomes, but what disease mechanisms high GDF-15 concentrations represent remains unclear. Here, we aim to identify activated pathophysiological pathways related to elevated GDF-15 expression in patients with HF. METHODS AND RESULTS In 2279 patients with HF, we measured circulating levels of 363 biomarkers. Then, we performed a pathway over-representation analysis to identify key biological pathways between patients in the highest and lowest GDF-15 concentration quartiles. Data were validated in an independent cohort of 1705 patients with HF. In both cohorts, the strongest up-regulated biomarkers in those with high GDF-15 were fibroblast growth factor 23 (FGF-23), death receptor 5 (TRAIL-R2), WNT1-inducible-signaling pathway protein 1 (WISP-1), TNF Receptor Superfamily Member 11a (TNFRSF11A), leukocyte immunoglobulin-like receptor subfamily B member 4 (LILRB4), and Trefoil Factor 3 (TFF3). Pathway over-representation analysis revealed that high GDF-15 patients had increased activity of pathways related to inflammatory processes, notably positive regulation of chemokine production; response to interleukin 6 (IL-6); tumour necrosis factor (TNF) and death receptor activity; and positive regulation of T cell differentiation and inflammatory response. Furthermore, we found pathways involved in regulation of insulin-like growth factor (IGF) receptor signalling and regulatory pathways of tissue, bones, and branching structures. GDF-15 quartiles significantly predicted all-cause mortality and HF hospitalization. CONCLUSION Patients with HF and high plasma concentrations of GDF-15 are characterized by increased activation of inflammatory pathways and pathways related to IGF-1 regulation and bone/tissue remodelling.
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Affiliation(s)
- Daan Ceelen
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Adriaan A Voors
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Jasper Tromp
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.,National Heart Centre Singapore, Singapore
| | - Dirk J van Veldhuisen
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Kenneth Dickstein
- University of Bergen, Bergen, Norway.,Stavanger University Hospital, Stavanger, Norway
| | - Rudolf A de Boer
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Chim C Lang
- School of Medicine Centre for Cardiovascular and Lung Biology, Division of Medical Sciences, University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
| | - Stefan D Anker
- Department of Cardiology (CVK); and Berlin Institute of Health Center for Regenerative Therapies (BCRT); German Centre for Cardiovascular Research (DZHK) partner site Berlin; Charité Universitätsmedizin Berlin, Germany
| | - Leong L Ng
- Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, and NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Marco Metra
- Institute of Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Piotr Ponikowski
- Department of Heart Diseases, Wrocław Medical University, Wroclaw, Poland; Center for Heart Diseases, University Hospital in Wrocław, Wroclaw, Poland
| | - Sylwia M Figarska
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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Li Y, Li L, Wang C. Insulin-like growth factor binding protein 2 might be a novel therapeutic target in the treatment of heart failure. Int J Cardiol 2021; 332:163. [PMID: 33753188 DOI: 10.1016/j.ijcard.2021.03.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 03/17/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Ya Li
- Department of Cardiology, The Second People's Hospital of Liaocheng, Liaocheng 252000, PR China
| | - Li Li
- Department of Cardiology, Liaocheng People's Hospital, Liaocheng 252000, PR China
| | - Chunhui Wang
- Xiangyang Community Health Service Station, Hospital of Traditional Chinese Medicine of Liaocheng City, Liaocheng 252000, PR China.
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