1
|
Pérez-Carrillo L, Sánchez-Lázaro I, Triviño JC, Feijóo-Bandín S, Lago F, González-Juanatey JR, Martínez-Dolz L, Portolés M, Tarazón E, Roselló-Lletí E. Combining Serum miR-144-3p and miR-652-3p as Potential Biomarkers for the Early Diagnosis and Stratification of Acute Cellular Rejection in Heart Transplantation Patients. Transplantation 2023; 107:2064-2072. [PMID: 37606906 PMCID: PMC10442084 DOI: 10.1097/tp.0000000000004622] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/27/2023] [Accepted: 02/13/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND There is a dire need for specific, noninvasive biomarkers that can accurately detect cardiac acute cellular rejection (ACR) early. Previously, we described miR-144-3p as an excellent candidate for detecting grade ≥2R ACR. Now, we investigated the combination of miR-144-3p with miR-652-3p, other differentially expressed serum miRNA we previously described, to improve diagnostic accuracy mainly in mild rejection to avoid reaching severe stages. METHODS We selected miR-652-3p from a preliminary RNA-seq study to be validated by reverse transcription-quantitative polymerase chain reaction on 212 consecutive serum samples from transplantation recipients undergoing routine endomyocardial biopsies to subsequently combine them with miR-144-3p results and investigate their diagnostic capability. RESULTS We confirmed the miR-652-3p overexpression (P < 0.0001) and its capability to discriminate between patients with and without ACR of any grade (P < 0.0001). The combined serum levels of miR-144-3p and miR-652-3p were significantly higher in patients with rejection regardless of posttransplantation time (P < 0.0001). This combination resulted in a diagnostic efficacy for 1R (area under the curve = 0.794) and ≥2R (area under the curve = 0.892; P < 0.0001) that was superior to each biomarker alone. Furthermore, it was a strong independent predictor of ACR for 1R (odds ratio of 10.950; P < 0.0001) and ≥2R (odds ratio of 14.289; P < 0.01). CONCLUSIONS We demonstrated that an appropriate combination of blood-based biomarkers could exhibit greater efficiency for cardiac rejection diagnosis. The combined detection of abnormal expression of miR-144-3p and miR-652-3p in the serum of ACR patients can improve the diagnostic sensitivity of rejection at an early stage and contribute to increasing the diagnostic accuracy, mainly in the lower rejection grades.
Collapse
Affiliation(s)
- Lorena Pérez-Carrillo
- Clinical and Translational Research in Cardiology Unit, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain
| | - Ignacio Sánchez-Lázaro
- Clinical and Translational Research in Cardiology Unit, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain
- Heart Failure and Transplantation Unit, Cardiology Department, University and Polytechnic La Fe Hospital, Valencia, Spain
| | | | - Sandra Feijóo-Bandín
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain
- Cellular and Molecular Cardiology Research Unit, Department of Cardiology and Institute of Biomedical Research, University Clinical Hospital, Santiago de Compostela, Spain
| | - Francisca Lago
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain
- Cellular and Molecular Cardiology Research Unit, Department of Cardiology and Institute of Biomedical Research, University Clinical Hospital, Santiago de Compostela, Spain
| | - José Ramón González-Juanatey
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain
- Cellular and Molecular Cardiology Research Unit, Department of Cardiology and Institute of Biomedical Research, University Clinical Hospital, Santiago de Compostela, Spain
| | - Luis Martínez-Dolz
- Clinical and Translational Research in Cardiology Unit, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain
- Heart Failure and Transplantation Unit, Cardiology Department, University and Polytechnic La Fe Hospital, Valencia, Spain
| | - Manuel Portolés
- Clinical and Translational Research in Cardiology Unit, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain
| | - Estefanía Tarazón
- Clinical and Translational Research in Cardiology Unit, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain
| | - Esther Roselló-Lletí
- Clinical and Translational Research in Cardiology Unit, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain
| |
Collapse
|
2
|
Alpha-cardiac Actin Serum Expression Levels Detect Acute Cellular Rejection in Heart Transplant Patients. Transplantation 2023; 107:466-474. [PMID: 35939381 PMCID: PMC9875841 DOI: 10.1097/tp.0000000000004273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Given the central role of sarcomeric dysfunction in cardiomyocyte biology and sarcomere alterations described in endomyocardial biopsies of transplant patients with rejection, we hypothesized that the serum expression levels of genes encoding sarcomeric proteins were altered in acute cellular rejection (ACR). The aim of this study is to identify altered sarcomere-related molecules in serum and to evaluate their diagnostic accuracy for detecting rejection episodes. METHODS Serum samples from transplant recipients undergoing routine endomyocardial biopsies were included in an RNA sequencing analysis (n = 40). Protein concentrations of alpha-cardiac actin were determined using a specific enzyme-linked immunoassay (n = 80). RESULTS We identified 17 sarcomeric genes differentially expressed in patients with clinically relevant rejection (grade ≥2R ACR). A receiver operating characteristic curve was done to assess their accuracy for ACR detection and found that 6 relevant actins, myosins, and other sarcomere-related genes showed great diagnostic capacity with an area under the curve (AUC) > 0.800. Specifically, the gene encoding alpha-cardiac actin ( ACTC1 ) showed the best results (AUC = 1.000, P < 0.0001). We determine ACTC1 protein levels in a larger patient cohort, corroborating its overexpression and obtaining a significant diagnostic capacity for clinically relevant rejection (AUC = 0.702, P < 0.05). CONCLUSIONS Sarcomeric alterations are reflected in peripheral blood of patients with allograft rejection. Because of their precision to detect ACR, we propose sarcomere ACTC1 serum expression levels as potential candidate for to be included in the development of molecular panel testing for noninvasive ACR detection.
Collapse
|
3
|
Lozano-Edo S, Roselló-Lletí E, Sánchez-Lázaro I, Tarazón E, Portolés M, Ezzitouny M, Lopez-Vilella R, Arnau MA, Almenar L, Martínez-Dolz L. Cardiac Allograft Rejection Induces Changes in Nucleocytoplasmic Transport: RANGAP1 as a Potential Non-Invasive Biomarker. J Pers Med 2022; 12:jpm12060913. [PMID: 35743697 PMCID: PMC9225640 DOI: 10.3390/jpm12060913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/26/2022] [Accepted: 05/29/2022] [Indexed: 11/16/2022] Open
Abstract
The non-invasive diagnosis of acute cellular rejection (ACR) is a major challenge. We performed a molecular study analyzing the predictive capacity of serum RanGTPase AP1 (RANGAP1) for diagnosing ACR during the first year after heart transplantation (HT). We included the serum samples of 75 consecutive HT patients, extracted after clinical stability, to determine the RANGAP1 levels through ELISA. In addition, various clinical, analytical, and echocardiographic variables, as well as endomyocardial biopsy results, were collected. RANGAP1 levels were higher in patients who developed ACR (median 63.15 ng/mL; (inter-quartile range (IQR), 36.61–105.69) vs. 35.33 ng/mL (IQR, 19.18–64.59); p = 0.02). Receiver operating characteristic (ROC) curve analysis confirmed that RANGAP1 differentiated between patients with and without ACR (area under curve (AUC), 0.70; p = 0.02), and a RANGAP1 level exceeding the cut-off point (≥90 ng/mL) was identified as a risk factor for the development of ACR (OR, 6.8; p = 0.006). Two independent predictors of ACR identified in this study were higher RANGAP1 and N-terminal pro-brain natriuretic peptide levels. The analysis of the ROC curve of the model showed a significant AUC of 0.77, p = 0.001. Our findings suggest that RANGAP1 quantification facilitates risk prediction for the occurrence of ACR and could be considered as a novel non-invasive biomarker of ACR.
Collapse
Affiliation(s)
- Silvia Lozano-Edo
- Heart Failure and Transplantation Unit, Cardiology Department, University and Polytechnic La Fe Hospital, 46026 Valencia, Spain; (I.S.-L.); (M.E.); (R.L.-V.); (M.A.A.); (L.A.); (L.M.-D.)
- Clinical and Translational Research Group in Cardiology, Health Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (E.R.-L.); (E.T.); (M.P.)
- Correspondence:
| | - Esther Roselló-Lletí
- Clinical and Translational Research Group in Cardiology, Health Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (E.R.-L.); (E.T.); (M.P.)
- Center for Biomedical Research Network on Cardiovascular Diseases (Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares: CIBERCV), 28029 Madrid, Spain
| | - Ignacio Sánchez-Lázaro
- Heart Failure and Transplantation Unit, Cardiology Department, University and Polytechnic La Fe Hospital, 46026 Valencia, Spain; (I.S.-L.); (M.E.); (R.L.-V.); (M.A.A.); (L.A.); (L.M.-D.)
- Clinical and Translational Research Group in Cardiology, Health Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (E.R.-L.); (E.T.); (M.P.)
- Center for Biomedical Research Network on Cardiovascular Diseases (Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares: CIBERCV), 28029 Madrid, Spain
| | - Estefanía Tarazón
- Clinical and Translational Research Group in Cardiology, Health Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (E.R.-L.); (E.T.); (M.P.)
- Center for Biomedical Research Network on Cardiovascular Diseases (Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares: CIBERCV), 28029 Madrid, Spain
| | - Manuel Portolés
- Clinical and Translational Research Group in Cardiology, Health Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (E.R.-L.); (E.T.); (M.P.)
- Center for Biomedical Research Network on Cardiovascular Diseases (Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares: CIBERCV), 28029 Madrid, Spain
| | - Maryem Ezzitouny
- Heart Failure and Transplantation Unit, Cardiology Department, University and Polytechnic La Fe Hospital, 46026 Valencia, Spain; (I.S.-L.); (M.E.); (R.L.-V.); (M.A.A.); (L.A.); (L.M.-D.)
- Clinical and Translational Research Group in Cardiology, Health Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (E.R.-L.); (E.T.); (M.P.)
| | - Raquel Lopez-Vilella
- Heart Failure and Transplantation Unit, Cardiology Department, University and Polytechnic La Fe Hospital, 46026 Valencia, Spain; (I.S.-L.); (M.E.); (R.L.-V.); (M.A.A.); (L.A.); (L.M.-D.)
- Clinical and Translational Research Group in Cardiology, Health Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (E.R.-L.); (E.T.); (M.P.)
| | - Miguel Angel Arnau
- Heart Failure and Transplantation Unit, Cardiology Department, University and Polytechnic La Fe Hospital, 46026 Valencia, Spain; (I.S.-L.); (M.E.); (R.L.-V.); (M.A.A.); (L.A.); (L.M.-D.)
- Clinical and Translational Research Group in Cardiology, Health Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (E.R.-L.); (E.T.); (M.P.)
| | - Luis Almenar
- Heart Failure and Transplantation Unit, Cardiology Department, University and Polytechnic La Fe Hospital, 46026 Valencia, Spain; (I.S.-L.); (M.E.); (R.L.-V.); (M.A.A.); (L.A.); (L.M.-D.)
- Clinical and Translational Research Group in Cardiology, Health Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (E.R.-L.); (E.T.); (M.P.)
- Center for Biomedical Research Network on Cardiovascular Diseases (Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares: CIBERCV), 28029 Madrid, Spain
| | - Luis Martínez-Dolz
- Heart Failure and Transplantation Unit, Cardiology Department, University and Polytechnic La Fe Hospital, 46026 Valencia, Spain; (I.S.-L.); (M.E.); (R.L.-V.); (M.A.A.); (L.A.); (L.M.-D.)
- Clinical and Translational Research Group in Cardiology, Health Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (E.R.-L.); (E.T.); (M.P.)
- Center for Biomedical Research Network on Cardiovascular Diseases (Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares: CIBERCV), 28029 Madrid, Spain
| |
Collapse
|
4
|
Electron Microscopy Reveals Evidence of Perinuclear Clustering of Mitochondria in Cardiac Biopsy-Proven Allograft Rejection. J Pers Med 2022; 12:jpm12020296. [PMID: 35207783 PMCID: PMC8878136 DOI: 10.3390/jpm12020296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/08/2022] [Accepted: 02/15/2022] [Indexed: 12/18/2022] Open
Abstract
Acute cellular rejection is a major complication in heart transplantation. We focus on the analysis of new ultrastructural findings in cardiac biopsy rejection based on mitochondrial intracellular organization. This study includes heart transplanted patients from a single center who were referred for endomyocardial biopsies as a scheduled routine screening. Participants were divided into two groups: patients transplanted without allograft rejection (Grade 0R), and patients with biopsy-proven allograft rejection (Grade ≥ 2R). Using electronic microscopy, we detected a significant increase in the volume density of mitochondria (p < 0.0001) and dense bodies (p < 0.01) in the rejection group. The most relevant finding was the presence of local accumulations of mitochondria close to the nuclear envelope, pressing and molding the morphology of this membrane in all rejection samples (100%). We identified this perinuclear clustering of mitochondria phenomenon in a 68 ± 27% of the total cardiac nucleus observed from rejection samples. We did not observe this phenomenon in any non-rejection samples, reflecting excellent sensitivity and specificity. We have identified a specific phenomenon affecting the architecture of the nuclear membrane—perinuclear clustering of mitochondria—in endomyocardial biopsies from patients with cardiac rejection. This ultrastructural approach might complement and improve the diagnosis of rejection.
Collapse
|
5
|
Pérez-Carrillo L, Giménez-Escamilla I, Martínez-Dolz L, Sánchez-Lázaro IJ, Portolés M, Roselló-Lletí E, Tarazón E. Implication of Sphingolipid Metabolism Gene Dysregulation and Cardiac Sphingosine-1-Phosphate Accumulation in Heart Failure. Biomedicines 2022; 10:135. [PMID: 35052814 PMCID: PMC8773611 DOI: 10.3390/biomedicines10010135] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/05/2022] [Accepted: 01/07/2022] [Indexed: 12/24/2022] Open
Abstract
Disturbances in sphingolipid metabolism lead to biological function dysregulation in many diseases, but it has not been described in heart failure (HF). Sphingosine-1-phosphate (S1P) levels have not ever been measured in the myocardium. Therefore, we analyze the gene dysregulation of human cardiac tissue by mRNA-seq (n = 36) and ncRNA-seq (n = 50). We observed most major changes in the expression of genes belonging to de novo and salvage pathways, and the tight gene regulation by their miRNAs is largely dysregulated in HF. We verified using ELISA (n = 41) that ceramide and S1P accumulate in HF cardiac tissue, with an increase in the ceramide/S1P ratio of 57% in HF. Additionally, changes in left ventricular mass and diameters are directly related to CERS1 expression and inversely related to S1P levels. Altogether, we define changes in the main components of the sphingolipid metabolism pathways in HF, mainly de novo and salvage, which lead to an increase in ceramide and S1P in cardiac tissue, as well as an increase in the ceramide/S1P ratio in HF patients. Therapeutic gene modulation focused on restoring ceramide levels or reversing the ceramide/S1P ratio could be a potential therapy to be explored for HF patients.
Collapse
Affiliation(s)
- Lorena Pérez-Carrillo
- Myocardial Dysfunction and Cardiac Transplantation Unit, Health Research Institute Hospital La Fe (IIS La Fe), Avd. Fernando Abril Martorell 106, 46026 Valencia, Spain; (L.P.-C.); (I.G.-E.); (L.M.-D.); (I.J.S.-L.); (M.P.)
| | - Isaac Giménez-Escamilla
- Myocardial Dysfunction and Cardiac Transplantation Unit, Health Research Institute Hospital La Fe (IIS La Fe), Avd. Fernando Abril Martorell 106, 46026 Valencia, Spain; (L.P.-C.); (I.G.-E.); (L.M.-D.); (I.J.S.-L.); (M.P.)
| | - Luis Martínez-Dolz
- Myocardial Dysfunction and Cardiac Transplantation Unit, Health Research Institute Hospital La Fe (IIS La Fe), Avd. Fernando Abril Martorell 106, 46026 Valencia, Spain; (L.P.-C.); (I.G.-E.); (L.M.-D.); (I.J.S.-L.); (M.P.)
- Center for Biomedical Research Network on Cardiovascular Diseases (CIBERCV), Avd. Monforte de Lemos 3-5, 28029 Madrid, Spain
- Heart Failure and Transplantation Unit, Cardiology Department, University and Polytechnic La Fe Hospital, Avd. Fernando Abril Martorell 106, 46026 Valencia, Spain
| | - Ignacio José Sánchez-Lázaro
- Myocardial Dysfunction and Cardiac Transplantation Unit, Health Research Institute Hospital La Fe (IIS La Fe), Avd. Fernando Abril Martorell 106, 46026 Valencia, Spain; (L.P.-C.); (I.G.-E.); (L.M.-D.); (I.J.S.-L.); (M.P.)
- Center for Biomedical Research Network on Cardiovascular Diseases (CIBERCV), Avd. Monforte de Lemos 3-5, 28029 Madrid, Spain
- Heart Failure and Transplantation Unit, Cardiology Department, University and Polytechnic La Fe Hospital, Avd. Fernando Abril Martorell 106, 46026 Valencia, Spain
| | - Manuel Portolés
- Myocardial Dysfunction and Cardiac Transplantation Unit, Health Research Institute Hospital La Fe (IIS La Fe), Avd. Fernando Abril Martorell 106, 46026 Valencia, Spain; (L.P.-C.); (I.G.-E.); (L.M.-D.); (I.J.S.-L.); (M.P.)
- Center for Biomedical Research Network on Cardiovascular Diseases (CIBERCV), Avd. Monforte de Lemos 3-5, 28029 Madrid, Spain
| | - Esther Roselló-Lletí
- Myocardial Dysfunction and Cardiac Transplantation Unit, Health Research Institute Hospital La Fe (IIS La Fe), Avd. Fernando Abril Martorell 106, 46026 Valencia, Spain; (L.P.-C.); (I.G.-E.); (L.M.-D.); (I.J.S.-L.); (M.P.)
- Center for Biomedical Research Network on Cardiovascular Diseases (CIBERCV), Avd. Monforte de Lemos 3-5, 28029 Madrid, Spain
| | - Estefanía Tarazón
- Myocardial Dysfunction and Cardiac Transplantation Unit, Health Research Institute Hospital La Fe (IIS La Fe), Avd. Fernando Abril Martorell 106, 46026 Valencia, Spain; (L.P.-C.); (I.G.-E.); (L.M.-D.); (I.J.S.-L.); (M.P.)
- Center for Biomedical Research Network on Cardiovascular Diseases (CIBERCV), Avd. Monforte de Lemos 3-5, 28029 Madrid, Spain
| |
Collapse
|
6
|
Ezzitouny M, Roselló-Lletí E, Portolés M, Sánchez-Lázaro I, Arnau-Vives MÁ, Tarazón E, Gil-Cayuela C, Lozano-Edo S, López-Vilella R, Almenar-Bonet L, Martínez-Dolz L. Value of SERCA2a as a Biomarker for the Identification of Patients with Heart Failure Requiring Circulatory Support. J Pers Med 2021; 11:jpm11111122. [PMID: 34834474 PMCID: PMC8622248 DOI: 10.3390/jpm11111122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/20/2021] [Accepted: 10/29/2021] [Indexed: 01/03/2023] Open
Abstract
Background: Heart failure (HF) alters the nucleo-cytoplasmic transport of cardiomyocytes and reduces SERCA2a levels, essential for intracellular calcium homeostasis. We consider in this study whether the molecules involved in these processes can differentiate those patients with advanced HF and the need for mechanical circulatory support (MCS) as a bridge to recovery or urgent heart transplantation from those who are clinically stable and who are transplanted in an elective code. Material and method: Blood samples from 29 patients with advanced HF were analysed by ELISA, and the plasma levels of Importin5, Nucleoporin153 kDa, RanGTPase-Activating Protein 1 and sarcoplasmic reticulum Ca2+ ATPase were compared between patients requiring MCS and those patients without a MCS need prior to heart transplantation. Results: SERCA2a showed significantly lower levels in patients who had MCS compared to those who did not require it (0.501 ± 0.530 ng/mL vs. 1.123 ± 0.661 ng/mL; p = 0.01). A SERCA2a cut-off point of 0.84 ng/mL (AUC 0.812 ± 0.085, 95% CI: 0.646–0.979; p = 0.004) provided a 92% sensitivity, 62% specificity, 91% negative predictive value and 67% positive predictive value. Conclusions: In this cohort, patients with advanced HF and a need for MCS have shown significantly lower levels of SERCA2a as compared to stable patients without a need for MCS prior to heart transplantation. This is a small study with preliminary findings, and larger-powered dedicated studies are required to confirm and validate these results.
Collapse
Affiliation(s)
- Meryem Ezzitouny
- Heart Failure and Transplant Unit, Cardiology Department, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain; (I.S.-L.); (M.Á.A.-V.); (S.L.-E.); (R.L.-V.); (L.A.-B.); (L.M.-D.)
- Correspondence: ; Fax: +34-96-124-58-49
| | - Esther Roselló-Lletí
- Myocardial Dysfunction and Heart Transplant Group, Health Research Institute La Fe, 46026 Valencia, Spain; (E.R.-L.); (M.P.); (E.T.); (C.G.-C.)
- Center for Biomedical Research Network on Cardiovascular Diseases (Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares: CIBERCV), 28029 Madrid, Spain
| | - Manuel Portolés
- Myocardial Dysfunction and Heart Transplant Group, Health Research Institute La Fe, 46026 Valencia, Spain; (E.R.-L.); (M.P.); (E.T.); (C.G.-C.)
- Center for Biomedical Research Network on Cardiovascular Diseases (Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares: CIBERCV), 28029 Madrid, Spain
| | - Ignacio Sánchez-Lázaro
- Heart Failure and Transplant Unit, Cardiology Department, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain; (I.S.-L.); (M.Á.A.-V.); (S.L.-E.); (R.L.-V.); (L.A.-B.); (L.M.-D.)
- Myocardial Dysfunction and Heart Transplant Group, Health Research Institute La Fe, 46026 Valencia, Spain; (E.R.-L.); (M.P.); (E.T.); (C.G.-C.)
- Center for Biomedical Research Network on Cardiovascular Diseases (Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares: CIBERCV), 28029 Madrid, Spain
| | - Miguel Ángel Arnau-Vives
- Heart Failure and Transplant Unit, Cardiology Department, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain; (I.S.-L.); (M.Á.A.-V.); (S.L.-E.); (R.L.-V.); (L.A.-B.); (L.M.-D.)
- Myocardial Dysfunction and Heart Transplant Group, Health Research Institute La Fe, 46026 Valencia, Spain; (E.R.-L.); (M.P.); (E.T.); (C.G.-C.)
- Center for Biomedical Research Network on Cardiovascular Diseases (Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares: CIBERCV), 28029 Madrid, Spain
| | - Estefanía Tarazón
- Myocardial Dysfunction and Heart Transplant Group, Health Research Institute La Fe, 46026 Valencia, Spain; (E.R.-L.); (M.P.); (E.T.); (C.G.-C.)
- Center for Biomedical Research Network on Cardiovascular Diseases (Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares: CIBERCV), 28029 Madrid, Spain
| | - Carolina Gil-Cayuela
- Myocardial Dysfunction and Heart Transplant Group, Health Research Institute La Fe, 46026 Valencia, Spain; (E.R.-L.); (M.P.); (E.T.); (C.G.-C.)
| | - Silvia Lozano-Edo
- Heart Failure and Transplant Unit, Cardiology Department, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain; (I.S.-L.); (M.Á.A.-V.); (S.L.-E.); (R.L.-V.); (L.A.-B.); (L.M.-D.)
| | - Raquel López-Vilella
- Heart Failure and Transplant Unit, Cardiology Department, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain; (I.S.-L.); (M.Á.A.-V.); (S.L.-E.); (R.L.-V.); (L.A.-B.); (L.M.-D.)
| | - Luis Almenar-Bonet
- Heart Failure and Transplant Unit, Cardiology Department, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain; (I.S.-L.); (M.Á.A.-V.); (S.L.-E.); (R.L.-V.); (L.A.-B.); (L.M.-D.)
- Myocardial Dysfunction and Heart Transplant Group, Health Research Institute La Fe, 46026 Valencia, Spain; (E.R.-L.); (M.P.); (E.T.); (C.G.-C.)
- Center for Biomedical Research Network on Cardiovascular Diseases (Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares: CIBERCV), 28029 Madrid, Spain
| | - Luis Martínez-Dolz
- Heart Failure and Transplant Unit, Cardiology Department, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain; (I.S.-L.); (M.Á.A.-V.); (S.L.-E.); (R.L.-V.); (L.A.-B.); (L.M.-D.)
- Myocardial Dysfunction and Heart Transplant Group, Health Research Institute La Fe, 46026 Valencia, Spain; (E.R.-L.); (M.P.); (E.T.); (C.G.-C.)
- Center for Biomedical Research Network on Cardiovascular Diseases (Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares: CIBERCV), 28029 Madrid, Spain
| |
Collapse
|
7
|
Ortiz-Bautista C, Fernández-Avilés F, Delgado Jiménez JF. Serum biomarkers of acute rejection: Towards precision medicine in heart transplant. J Heart Lung Transplant 2021; 40:1090-1097. [PMID: 34330605 DOI: 10.1016/j.healun.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/31/2021] [Accepted: 07/02/2021] [Indexed: 11/25/2022] Open
Abstract
Despite the important changes in the management of heart transplantation in the recent decades, the use of endomyocardial biopsy is still necessary for the follow-up of these patients. However, this technique has several limitations, the most important being the substantial interobserver variability. In the last years multiple attempts have been made to find non-invasive assays for cardiac allograft surveillance, such as imaging modalities and serum biomarkers. This state-of-the-art review focuses on describing the different serum biomarkers that have been proposed for non-invasive diagnosis of acute rejection and that are paving the way towards precision medicine in the field of heart transplantation.
Collapse
Affiliation(s)
- Carlos Ortiz-Bautista
- Servicio de Cardiología, Instituto de Investigación Sanitaria Gregorio Marañón (Ii+GM), Hospital General Universitario Gregorio Marañón, Madrid, Spain; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, CIBERCV, Madrid, Spain.
| | - Francisco Fernández-Avilés
- Servicio de Cardiología, Instituto de Investigación Sanitaria Gregorio Marañón (Ii+GM), Hospital General Universitario Gregorio Marañón, Madrid, Spain; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, CIBERCV, Madrid, Spain; Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Juan F Delgado Jiménez
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, CIBERCV, Madrid, Spain; Facultad de Medicina, Universidad Complutense, Madrid, Spain; Servicio de Cardiología, Instituto de Investigación Sanitaria 12 de Octubre (i+12), Hospital Universitario 12 de Octubre, Madrid, Spain
| |
Collapse
|
8
|
Zhuo DX, Ginder K, Hardin EA. Markers of Immune Function in Heart Transplantation: Implications for Immunosuppression and Screening for Rejection. Curr Heart Fail Rep 2021; 18:33-40. [PMID: 33400150 DOI: 10.1007/s11897-020-00499-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/22/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE OF REVIEW Recent developments in high-throughput DNA and RNA sequencing technologies have facilitated the development of noninvasive assays to monitor heart transplant rejection. In this review, we summarize existing assays employed for the surveillance of allograft rejection, as well as promising future directions for such tests in the molecular biology field. RECENT FINDINGS The AlloMap genome expression profiling assay remains the only noninvasive test for rejection surveillance and is incorporated into the International Society of Heart and Lung Transplantation guidelines. Other efforts have focused on messenger RNA (mRNA), microRNA (miRNA), and donor-derived cell-free DNA (dd-cfDNA) as potential viable biomarkers. Mitochondrial pathways in allograft necroptosis and inflammation signaling may represent a novel direction for future research endeavors. Although endomyocardial biopsy remains the gold standard, several converging areas of molecular biology could soon yield successful alternative methods of heart transplant rejection monitoring, with the distinct advantage of avoiding procedural complications.
Collapse
Affiliation(s)
- David X Zhuo
- Fellow, Advanced Heart Failure and Transplant Cardiology, Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390-9047, USA
| | - Katie Ginder
- Nurse Practitioner, Advanced Heart Failure, Transplant, LVAD, Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - E Ashley Hardin
- Internal Medicine, Advanced Heart Failure and Transplant Cardiology, Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, 5959 Harry Hines Boulevard, Ste #HP.8.110, Dallas, TX, 75390-9047, USA.
| |
Collapse
|
9
|
Zhang H, Chen X, Zhang D, Liu L, Song J, Xu Y, Tian J. Identification of a Novel Six-Long Noncoding RNA Signature for Molecular Diagnosis of Dilated Cardiomyopathy. DNA Cell Biol 2020; 39:2174-2183. [PMID: 33146560 DOI: 10.1089/dna.2020.5670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Long noncoding RNAs (lncRNAs) may serve as potential molecular diagnostic markers to improve the capacity of earlier and more accurate diagnosis of dilated cardiomyopathy (DCM). We integrated five independent transcriptomic datasets (n = 504) from Gene Expression Omnibus for systematic identification of lncRNA-based diagnostic biomarkers in DCM. The multivariate logistic regression model based on the six lncRNAs (AC016722.3, AL589986.2, AC006007.1, AC092687.3, GS1-124K5.4, and AC007126.1) in the ceRNA networks showed high sensitivity and specificity (area under curves >0.8, p < 0.0001) of DCM diagnosis in the training and validation datasets. Functional analysis revealed that the autophagy, protein acetyltransferase, and DNA polymerase activity were associated with high levels of the six-lncRNA signature, while the collagen trimer, extracellular matrix structural constituent, and MHC protein complex were associated with low levels of the signature. Pathway analysis showed that high levels of the six-lncRNA signature were associated with upregulated selective autophagy, interleukin 17 signalings, and extracellular matrix interactions, while were associated with downregulated extracellular matrix organization and collagen formation. The identified six-lncRNA signature, with high performance in molecular diagnosis of DCM, might be applied in future clinical practices combined with traditional markers.
Collapse
Affiliation(s)
- Hui Zhang
- Department of Cardiology, Heart Centre, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Xiajing Chen
- Department of Cardiology, Heart Centre, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Danfeng Zhang
- Department of Cardiology, Heart Centre, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Lingjuan Liu
- Department of Cardiology, Heart Centre, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Jing Song
- Department of Bioinformatics, The Basic Medical School, Chongqing Medical University, Chongqing, China
| | - Yinyin Xu
- Clinical Laboratory of Yongchuan Hospital, Chongqing Medical University, Chongqing, China
| | - Jie Tian
- Department of Cardiology, Heart Centre, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| |
Collapse
|