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Xing H, Pang H, Du T, Yang X, Zhang J, Li M, Zhang S. Establishing a Risk Prediction Model for Atherosclerosis in Systemic Lupus Erythematosus. Front Immunol 2021; 12:622216. [PMID: 33936038 PMCID: PMC8085548 DOI: 10.3389/fimmu.2021.622216] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 02/19/2021] [Indexed: 12/21/2022] Open
Abstract
Background and aims: Patients with systemic lupus erythematosus (SLE) have a significantly higher incidence of atherosclerosis than the general population. Studies on atherosclerosis prediction models specific for SLE patients are very limited. This study aimed to build a risk prediction model for atherosclerosis in SLE. Methods: RNA sequencing was performed on 67 SLE patients. Subsequently, differential expression analysis was carried out on 19 pairs of age-matched SLE patients with (AT group) or without (Non-AT group) atherosclerosis using peripheral venous blood. We used logistic least absolute shrinkage and selection operator regression to select variables among differentially expressed (DE) genes and clinical features and utilized backward stepwise logistic regression to build an atherosclerosis risk prediction model with all 67 patients. The performance of the prediction model was evaluated by area under the curve (AUC), calibration curve, and decision curve analyses. Results: The 67 patients had a median age of 42.7 (Q1-Q3: 36.6-51.2) years, and 20 (29.9%) had atherosclerosis. A total of 106 DE genes were identified between the age-matched AT and Non-AT groups. Pathway analyses revealed that the AT group had upregulated atherosclerosis signaling, oxidative phosphorylation, and interleukin (IL)-17-related pathways but downregulated T cell and B cell receptor signaling. Keratin 10, age, and hyperlipidemia were selected as variables for the risk prediction model. The AUC and Hosmer-Lemeshow test p-value of the model were 0.922 and 0.666, respectively, suggesting a relatively high discrimination and calibration performance. The prediction model had a higher net benefit in the decision curve analysis than that when predicting with age or hyperlipidemia only. Conclusions: We built an atherosclerotic risk prediction model with one gene and two clinical factors. This model may greatly assist clinicians to identify SLE patients with atherosclerosis, especially asymptomatic atherosclerosis.
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Affiliation(s)
- Haiping Xing
- State Key Laboratory of Complex Severe and Rare Diseases, Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Haiyu Pang
- State Key Laboratory of Complex Severe and Rare Diseases, Medical Research Center, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Tian Du
- State Key Laboratory of Complex Severe and Rare Diseases, Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.,School of Medicine, Tsinghua University, Beijing, China.,Department of Breast Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xufei Yang
- State Key Laboratory of Complex Severe and Rare Diseases, Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Jing Zhang
- Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Mengtao Li
- Key Laboratory of Rheumatology and Clinical Immunology, Department of Rheumatology, National Clinical Research Center for Dermatologic and Immunologic Diseases, Ministry of Science & Technology, Ministry of Education, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Shuyang Zhang
- State Key Laboratory of Complex Severe and Rare Diseases, Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.,School of Medicine, Tsinghua University, Beijing, China
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Aavik E, Lumivuori H, Leppänen O, Wirth T, Häkkinen SK, Bräsen JH, Beschorner U, Zeller T, Braspenning M, van Criekinge W, Mäkinen K, Ylä-Herttuala S. Global DNA methylation analysis of human atherosclerotic plaques reveals extensive genomic hypomethylation and reactivation at imprinted locus 14q32 involving induction of a miRNA cluster. Eur Heart J 2014; 36:993-1000. [PMID: 25411193 DOI: 10.1093/eurheartj/ehu437] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 10/22/2014] [Indexed: 12/17/2022] Open
Abstract
AIMS We conducted a genome-wide analysis to identify differentially methylated genes in atherosclerotic lesions. METHODS DNA methylation at promoters, exons and introns was identified by massive parallel sequencing. Gene expression was analysed by microarrays, qPCR, immunohistochemistry and western blots. RESULTS Globally, hypomethylation of chromosomal DNA predominates in atherosclerotic plaques and two-thirds of genes showing over 2.5-fold differential in DNA methylation are up-regulated in comparison to healthy mammary arteries. The imprinted chromatin locus 14q32 was identified for the first time as an extensively hypomethylated area in atherosclerosis with highly induced expression of miR127, -136, -410, -431, -432, -433 and capillary formation-associated gene RTL1. The top 100 list of hypomethylated promoters exhibited over 1000-fold enrichment for miRNAs, many of which mapped to locus 14q32. Unexpectedly, also gene body hypermethylation was found to correlate with stimulated mRNA expression. CONCLUSION Significant changes in genomic methylation were identified in atherosclerotic lesions. The most prominent gene cluster activated via hypomethylation was detected at imprinted chromosomal locus 14q32 with several clustered miRNAs that were up-regulated. These results suggest that epigenetic changes are involved in atherogenesis and may offer new potential therapeutic targets for vascular diseases.
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Affiliation(s)
- Einari Aavik
- Department of Biotechnology and Molecular Medicine, A. I. Virtanen Institute, Kuopio, University of Eastern Finland, PO Box 1627 (Neulaniementie 2), Kuopio, FIN-70211, Finland
| | - Henri Lumivuori
- Department of Biotechnology and Molecular Medicine, A. I. Virtanen Institute, Kuopio, University of Eastern Finland, PO Box 1627 (Neulaniementie 2), Kuopio, FIN-70211, Finland
| | - Olli Leppänen
- Centre for R&D, Uppsala University/County Council of Gävleborg, Gävle, Sweden
| | - Thomas Wirth
- Department of Biotechnology and Molecular Medicine, A. I. Virtanen Institute, Kuopio, University of Eastern Finland, PO Box 1627 (Neulaniementie 2), Kuopio, FIN-70211, Finland
| | - Sanna-Kaisa Häkkinen
- Department of Biotechnology and Molecular Medicine, A. I. Virtanen Institute, Kuopio, University of Eastern Finland, PO Box 1627 (Neulaniementie 2), Kuopio, FIN-70211, Finland
| | - Jan-Hinrich Bräsen
- Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - Ulrich Beschorner
- Department of Angiology, Universitäts-Herzzentrum Freiburg Bad Krozingen, Bad Krozingen, Germany
| | - Thomas Zeller
- Department of Angiology, Universitäts-Herzzentrum Freiburg Bad Krozingen, Bad Krozingen, Germany
| | | | - Wim van Criekinge
- Laboratory for Bioinformatics and Computational Genomics, Ghent University, Ghent, Belgium
| | - Kimmo Mäkinen
- Vascular Surgery Unit, Kuopio University Hospital, Kuopio, Finland
| | - Seppo Ylä-Herttuala
- Department of Biotechnology and Molecular Medicine, A. I. Virtanen Institute, Kuopio, University of Eastern Finland, PO Box 1627 (Neulaniementie 2), Kuopio, FIN-70211, Finland Science Service Center and Gene Therapy Unit, Kuopio University Hospital, Kuopio, Finland
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Bökenkamp R, van Brempt R, van Munsteren JC, van den Wijngaert I, de Hoogt R, Finos L, Goeman J, Groot ACGD, Poelmann RE, Blom NA, DeRuiter MC. Dlx1 and Rgs5 in the ductus arteriosus: vessel-specific genes identified by transcriptional profiling of laser-capture microdissected endothelial and smooth muscle cells. PLoS One 2014; 9:e86892. [PMID: 24489801 PMCID: PMC3904938 DOI: 10.1371/journal.pone.0086892] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 12/17/2013] [Indexed: 12/31/2022] Open
Abstract
Closure of the ductus arteriosus (DA) is a crucial step in the transition from fetal to postnatal life. Patent DA is one of the most common cardiovascular anomalies in children with significant clinical consequences especially in premature infants. We aimed to identify genes that specify the DA in the fetus and differentiate it from the aorta. Comparative microarray analysis of laser-captured microdissected endothelial (ECs) and vascular smooth muscle cells (SMCs) from the DA and aorta of fetal rats (embryonic day 18 and 21) identified vessel-specific transcriptional profiles. We found a strong age-dependency of gene expression. Among the genes that were upregulated in the DA the regulator of the G-protein coupled receptor 5 (Rgs5) and the transcription factor distal-less homeobox 1 (Dlx1) exhibited the highest and most significant level of differential expression. The aorta showed a significant preferential expression of the Purkinje cell protein 4 (Pcp4) gene. The results of the microarray analysis were validated by real-time quantitative PCR and immunohistochemistry. Our study confirms vessel-specific transcriptional profiles in ECs and SMCs of rat DA and aorta. Rgs5 and Dlx1 represent novel molecular targets for the regulation of DA maturation and closure.
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Affiliation(s)
- Regina Bökenkamp
- Department of Pediatric Cardiology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Intensive Care, Leiden University Medical Center, Leiden, The Netherlands
- * E-mail:
| | - Ronald van Brempt
- Department of Intensive Care, Leiden University Medical Center, Leiden, The Netherlands
- Johnson and Johnson Pharmaceutical Research and Development, Beerse, Belgium
| | | | | | - Ronald de Hoogt
- Johnson and Johnson Pharmaceutical Research and Development, Beerse, Belgium
| | - Livio Finos
- Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands
| | - Jelle Goeman
- Biostatistics, Department for Health Evidence, Radboud University Medical Center, Nimegen, The Netherlands
| | - Adriana Cornelia Gittenberger-de Groot
- Department of Anatomy and Embryology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Robert Eugen Poelmann
- Department of Anatomy and Embryology, Leiden University Medical Center, Leiden, The Netherlands
| | - Nicolaas Andreas Blom
- Department of Pediatric Cardiology, Leiden University Medical Center, Leiden, The Netherlands
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Moon MC, Yau L, Wright B, Zahradka P. Injury-induced expression of cytokeratins 8 and 18 by vascular smooth muscle cells requires concurrent activation of cytoskeletal and growth factor receptors. Can J Physiol Pharmacol 2008; 86:223-31. [PMID: 18432282 DOI: 10.1139/y08-019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Cytokeratins are not present in the vascular smooth muscle cells (VSMCs) of normal arteries, but they are detectable in the VSMCs of atherosclerotic lesions. A correlation between cytokeratin expression and VSMC phenotype is proposed, but an examination of VSMCs after mechanical injury has yet to be performed. Immunohistochemistry was used to monitor proteins in arterial sections. Western blotting enabled quantification of protein levels. Angioplasty of porcine femoral artery in vivo and porcine coronary artery in vitro served as models of vascular injury. Cytokeratins 8 and 18 were expressed by VSMCs in porcine femoral artery lesions 14 days after balloon angioplasty. Cytokeratins were also present in the neointima of porcine coronary artery segments placed into organ culture for 4 days. Cytokeratin expression was decreased in the presence of inhibitors that affect MAP kinase, PI3 kinase, Src kinase, and G protein, but not in the presence of an AT1 receptor antagonist. Cytokeratin expression also occurred when VSMCs were plated onto collagen in the presence of serum. We conclude that mechanical injury induces expression of cytokeratin 8 and 18 both in vitro and in vivo by synthetic VSMCs that migrate into the neointima. Furthermore, cytokeratin expression requires cellular attachment to extracellular matrix proteins in conjunction with mitogenic stimulation.
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Yokoyama U, Minamisawa S, Adachi-Akahane S, Akaike T, Naguro I, Funakoshi K, Iwamoto M, Nakagome M, Uemura N, Hori H, Yokota S, Ishikawa Y. Multiple transcripts of Ca2+ channel α1-subunits and a novel spliced variant of the α1C-subunit in rat ductus arteriosus. Am J Physiol Heart Circ Physiol 2006; 290:H1660-70. [PMID: 16272207 DOI: 10.1152/ajpheart.00100.2004] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Voltage-dependent Ca2+ channels (VDCCs), which consist of multiple subtypes, regulate vascular tone in developing arterial smooth muscle, including the ductus arteriosus (DA). First, we examined the expression of VDCC subunits in the Wistar rat DA during development. Among α1-subunits, α1C and α1G were the most predominant isoforms. Maternal administration of vitamin A significantly increased α1C- and α1G-transcripts. Second, we examined the effect of VDCC subunits on proliferation of DA smooth muscle cells. We found that 1 μM nitrendipine (an L-type Ca2+ channel blocker) and kurtoxin (a T-type Ca2+ channel blocker) significantly decreased [3H]thymidine incorporation and that 3 μM efonidipine (an L- and T-type Ca2+ channel blocker) further decreased [3H]thymidine incorporation, suggesting that L- and T-type Ca2+ channels are involved in smooth muscle cell proliferation in the DA. Third, we found that a novel alternatively spliced variant of the α1C-isoform was highly expressed in the neointimal cushion of the DA, where proliferating and migrating smooth muscle cells are abundant. The basic channel properties of the spliced variant did not differ from those of the conventional α1C-subunit. We conclude that multiple VDCC subunits were identified in the DA, and, in particular, α1C- and α1G-subunits were predominant in the DA. A novel spliced variant of the α1C-subunit gene may play a distinct role in neointimal cushion formation in the DA.
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Affiliation(s)
- Utako Yokoyama
- Dept. of Pediatrics, Yokohama City University, Kanazawa-ku, Yokohama 236-0004, Japan
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Pérez-Martínez C, García-Iglesias MJ, Durán-Navarrete AJ, Espinosa-Alvarez J, García-Fernández RA, Lorenzana-Robles N, Fernández-Pérez S, García-Marín JF. Histopathological and Immunohistochemical Characteristics of Two Canine Lipid-Rich Mammary Carcinomas. ACTA ACUST UNITED AC 2005; 52:61-6. [PMID: 15737173 DOI: 10.1111/j.1439-0442.2005.00690.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Clinicopathological and immunohistochemical findings of two uncommon canine lipid-rich mammary carcinomas are described. The predominant histological feature in both tumours was the presence of at least 80% of cells with intracytoplasmic vacuoles which stained positively with Sudan IV but not with alcian-blue periodic acid-schiff method. In both tumours, small groups of non-vacuolated cells were identified among the vacuolated cells. However, histological and immunohistochemical differences were also found between these tumours. Thus, one of them was composed of tumour cells with a large and single vacuole, which were arranged in lobular pattern, while the other neoplasm showed an intraductal growth of tumour cells with a fine vacuolated cytoplasm. Immunohistochemically, in the first tumour most vacuolated cells were positive for CK (cytokeratin)8-7, indicating a secretory epithelial immunophenotype while CK5 and CK8-7-expressing non-vacuolated cells were associated with luminal duct immunophenotype. However, in the second tumour the expression of CK14 in most of vacuolated cells and alpha-smooth muscle actin (alpha-SMA) in non-vacuolated cells, alone or in combination with CK5 suggested a myoepithelial immunophenotype for both cell types. These results suggest heterogeneity of the cell type and growth pattern for this type of canine tumour as has been described in women but not in dogs.
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Affiliation(s)
- C Pérez-Martínez
- Histology and Pathological Anatomy Section, Department of Animal Pathology; Animal Medicine, Faculty of Veterinary Science, University of León, 24071 León, Spain.
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Iwata J, Fletcher CD. Immunohistochemical detection of cytokeratin and epithelial membrane antigen in leiomyosarcoma: a systematic study of 100 cases. Pathol Int 2000; 50:7-14. [PMID: 10692172 DOI: 10.1046/j.1440-1827.2000.01001.x] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Although 'aberrant' expression of the epithelial markers, cytokeratin (CK) and epithelial membrane antigen (EMA), in leiomyosarcoma has been described previously, there has not been a study of this phenomenon with clinicopathological correlation in a large series of lesions at different anatomical sites. We investigated systematically the immunohistochemical reactivity for CK and EMA in 100 cases of leiomyosarcoma. CK and EMA were positive in 38% and 44% of the cases, respectively. Although staining was usually focal, extensive immunoreactivity was observed in 11% with CK and 6% with EMA. There was no correlation between immunoreactivity for CK and EMA in leiomyosarcomas and non-neoplastic smooth muscle at the same location. Immunoreactivity for CK and EMA was not correlated with the location, age, sex, histological grade, or histological features, except for more frequent EMA positivity in vascular and uterine tumors than in soft tissue cases. These results indicate that CK and/or EMA-positive leiomyosarcomas do not have distinctive clinicopathological features differing from those of negative cases. However, the considerable frequency of immunoreactivity for these epithelial markers in leiomyosarcoma, occasionally with diffuse and strong immunopositivity, should be recognized as a potentially serious diagnostic pitfall in the differential diagnosis of other malignant spindle cell neoplasms.
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Affiliation(s)
- J Iwata
- Department of Pathology, Kochi Medical School, Kochi, Japan
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Gittenberger-de Groot AC, DeRuiter MC, Bergwerff M, Poelmann RE. Smooth muscle cell origin and its relation to heterogeneity in development and disease. Arterioscler Thromb Vasc Biol 1999; 19:1589-94. [PMID: 10397674 DOI: 10.1161/01.atv.19.7.1589] [Citation(s) in RCA: 143] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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