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Zou X, Wang L, Wang S, Zhang Y, Ma J, Chen L, Li Y, Yao TX, Zhou H, Wu L, Tang Q, Ma S, Zhang X, Tang R, Yi Y, Liu R, Zeng Y, Zhang L. Promising therapeutic targets for ischemic stroke identified from plasma and cerebrospinal fluid proteomes: a multicenter Mendelian randomization study. Int J Surg 2024; 110:766-776. [PMID: 38016292 PMCID: PMC10871597 DOI: 10.1097/js9.0000000000000922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/09/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Ischemic stroke (IS) is more common every year, the condition is serious, and have a poor prognosis. New, efficient, and safe therapeutic targets are desperately needed as early treatment especially prevention and reperfusion is the key to lowering the occurrence of poorer prognosis. Generally circulating proteins are attractive therapeutic targets, this study aims to identify potential pharmacological targets among plasma and cerebrospinal fluid (CSF) proteins for the prevention and treatment of IS using a multicenter Mendelian randomization (MR) approach. METHODS First, the genetic instruments of 734 plasma and 151 CSF proteins were assessed for causative connections with IS from MEGASTROKE consortium by MR to identify prospective therapeutic targets. Then, for additional validation, plasma proteins from the deCODE consortium and the Fenland consortium, as well as IS GWAS data from the FinnGen cohort, the ISGC consortium and UK biobank, were employed. A thorough evaluation of the aforementioned possible pharmacological targets was carried out using meta-analysis. The robustness of MR results was then confirmed through sensitivity analysis using several techniques, such as bidirectional MR analysis, Steiger filtering, and Bayesian colocalization. Finally, methods like Protein-Protein Interaction (PPI) Networking were utilized to investigate the relationship between putative drug targets and therapeutic agents. RESULTS The authors discovered three proteins that may function as promising therapeutic targets for IS and meet the Bonferroni correction ( P <0.05/885=5.65×10 -5 ). Prekallikrein (OR=0.41, 95% CI: 0.27-0.63, P =3.61×10 -5 ), a protein found in CSF, has a 10-fold protective impact in IS, while the plasma proteins SWAP70 (OR=0.85, 95% CI: 0.80-0.91, P =1.64×10 -6 ) and MMP-12 (OR=0.92, 95% CI: 0.89-0.95, P =4.49×10 -6 ) of each SD play a protective role in IS. Prekallikrein, MMP-12, SWAP70 was replicated in the FinnGen cohort and ISGC database. MMP-12 (OR=0.93, 95% CI: 0.91-0.94, P <0.001), SWAP70 (OR=0.92, 95% CI: 0.90-0.94, P <0.001), and prekallikrein (OR=0.53, 95% CI: 0.33-0.72, P <0.001) may all be viable targets for IS, according to the combined meta-analysis results. Additionally, no evidence of reverse causality was identified, and Bayesian colocalization revealed MMP-12 (PPH 4 =0.995), SWAP70 (PPH 4 =0.987), and prekallikrein (PPH 4 =0.894) shared the same variant with IS, supporting the robustness of the aforementioned causation. Prekallikrein and MMP-12 were associated with the target protein of the current treatment of IS. Among them, Lanadelumab, a new drug whose target protein is a prekallikrein, may be a promising new drug for the treatment of IS. CONCLUSION The prekallikrein, MMP-12, and SWAP70 are causally associated with the risk of IS. Moreover, MMP-12 and prekallikrein may be treated as promising therapeutic targets for medical intervention of IS.
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Affiliation(s)
- Xuelun Zou
- Department of Neurology, Xiangya Hospital, Central South University
| | - Leiyun Wang
- Department of Pharmacy, Wuhan No.1 Hospital, Wuhan, Hubei, People’s Republic of China
| | - Sai Wang
- Department of Neurology, Xiangya Hospital, Central South University
| | - Yupeng Zhang
- Department of Neurology, Xiangya Hospital, Central South University
| | - Junyi Ma
- Department of Neurology, Xiangya Hospital, Central South University
| | - Lei Chen
- Department of Neurology, Xiangya Hospital, Central South University
| | - Ye Li
- Department of Neurology, Xiangya Hospital, Central South University
| | - Tian-Xing Yao
- Department of Neurology, Xiangya Hospital, Central South University
| | - Huifang Zhou
- Department of Neurology, Xiangya Hospital, Central South University
| | - Lianxu Wu
- Department of Neurology, Xiangya Hospital, Central South University
| | - Qiaoling Tang
- Department of Neurology, Xiangya Hospital, Central South University
| | - Siyuan Ma
- Department of Neurology, Xiangya Hospital, Central South University
| | - Xiangbin Zhang
- Department of Neurology, Xiangya Hospital, Central South University
| | - Rongmei Tang
- Department of Neurology, Xiangya Hospital, Central South University
| | - Yexiang Yi
- Department of Neurology, Xiangya Hospital, Central South University
| | - Ran Liu
- Department of Neurology, Xiangya Hospital, Central South University
| | - Yi Zeng
- Department of Geriatrics, Second Xiangya Hospital
| | - Le Zhang
- Department of Neurology, Xiangya Hospital, Central South University
- Human Brain Disease Biological Resources Platform of Hunan Province, Xiangya Hospital
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital
- Multi-Modal Monitoring Technology for Severe Cerebrovascular Disease of Human Engineering Research Center, Xiangya Hospital
- Brain Health Center of Hunan Province, Xiangya Hospital, Central South University, Changsha, Hunan
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Song Y, Zou X, Zeng Y, Zhang L, Mao X. Inflammatory bowel disease and the risk of intracerebral hemorrhage: A Mendelian randomization study and meta-analysis. Immun Inflamm Dis 2023; 11:e1048. [PMID: 37904677 PMCID: PMC10580698 DOI: 10.1002/iid3.1048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 09/22/2023] [Accepted: 09/29/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND The link between inflammatory bowel disease (IBD) and intracerebral hemorrhage (ICH) is still unclear. AIMS We conducted a Mendelian randomization research and meta-analysis to explore the impact of IBD and its subtypes (Crohn's disease [CD], ulcerative colitis [UC]) on the risk of ICH. METHODS Two large genome-wide association analysis studies of International Inflammatory Bowel Disease Genetics Consortium (IIBDGC) and International Stroke Genetics Consortium as exposure (IBD, UC, and CD) and outcome (ICH) in the initial stage. IBD, CD, UC GWAS data from the FinnGen consortium were adopted for the replication phase, and ultimately, the results of the initial stage and replication phase data were combined in a meta-analysis to evaluate the causal association between IBD and its subtypes and the risk of ICH. RESULTS In the initial stage, we found that in the IVW (odds ratio [OR] = 0.83, 95% confidence interval [CI]: 0.71-0.96, p = .01), MR-PRESSO (OR = 0.85, 95% CI: 0.75-0.97, p = .02) and MR.RAPS (OR = 0.86, 95% CI: 0.76-0.98, p = .02) method showed that UC is associated with the risk of ICH. The causal relationship between IBD, CD, and the risk of ICH cannot be found by the IVW method. IBD and its subtypes UC, CD, and risk of ICH cannot find the presence of heterogeneity and pleiotropy. In replication stage, IBD (OR = 0.74, 95% CI: 0.59-0.94, p = .0135) related to ICH, while the IVW approach did not establish a causal link in UC and CD. The meta-analysis still indicated that UC (OR = 0.83, 95% CI: 0.72-0.93, p < .05) would lessen the risk of ICH while the causality between IBD, CD, and ICH was unable to be established. CONCLUSION UC was causally related to ICH, but IBD and CD are not associated with ICH. The precise pathophysiological mechanism needs to be thoroughly investigated in more detail.
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Affiliation(s)
- Yanju Song
- Department of NeurologyChangsha Third HospitalChangshaHunanChina
| | - Xuelun Zou
- Department of Neurology, Xiangya HospitalCentral South UniversityChangshaHunanP.R. China
| | - Yi Zeng
- Department of Geriatrics, Second Xiangya HospitalCentral South UniversityChangshaHunanP.R. China
| | - Le Zhang
- Department of Neurology, Xiangya HospitalCentral South UniversityChangshaHunanP.R. China
- National Clinical Research Center for Geriatric Disorders, Xiangya HospitalCentral South UniversityChangshaHunanP.R. China
- Multi‐Modal Monitoring Technology for Severe Cerebrovascular Disease of Human Engineering Research Center, Xiangya HospitalCentral South UniversityChangshaHunanP.R. China
| | - Xinfa Mao
- Department of NeurologyChangsha Third HospitalChangshaHunanChina
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