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Yu Q, Yang J, Wang J, Yu R, Li J, Cheng J, Hu Y, Li Z, Zheng N, Zhang Z, Li X, Wang Y, Du W, Zhu K, Chen X, Su J. DNA methylation profile in the whole blood of acute coronary syndrome patients with aspirin resistance. J Clin Lab Anal 2022; 37:e24821. [PMID: 36550638 PMCID: PMC9833987 DOI: 10.1002/jcla.24821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/07/2022] [Accepted: 12/10/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Aspirin resistance (AR) results in major adverse cardiovascular events, and DNA methylation might participate in the regulation of this pathological process. METHODS In present study, a sum of 35 patients with AR and 35 non-AR (NAR) controls were enrolled. Samples from 5 AR and 5 NAR were evaluated in an 850 BeadChip DNA methylation assay, and another 30 AR versus 30 NAR were evaluated to validate the differentially methylated CpG loci (DML). Then, qRT-PCR was used to investigate the target mRNA expression of genes at CpG loci. Finally, Gene Ontology (GO) as well as Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed to reveal the enriched pathways. RESULTS The AR and NAR groups displayed significant differences in DNA methylation at 7707 positions, with 270 hypermethylated sites (e.g., cg09555818 located in APOC2) and 7437 sites hypomethylated sites (e.g., cg26828689 located in SLC12A5). Six DML were validated by pyrosequencing, and it was confirmed that DNA methylation (cg16391727, cg21008208, cg21293749, and cg13945576) was related to the increasing risk of AR. The relative mRNA expression of the ROR1 gene was also associated with AR (p = 0.007), suggesting that the change of cg21293749 in DNA methylation might lead to differential ROR1 mRNA expression, ultimately resulting in AR. Furthermore, the identified differentially methylated sites were associated with the molecular pathways such as circadian rhythms and insulin secretion. CONCLUSION Hence, the distinct DNA methylation might play a vital role in the biological regulation of AR through the pathways such as circadian rhythms.
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Affiliation(s)
- Qinglin Yu
- Department of Traditional Chinese Internal MedicineNingbo No. 1 HospitalNingboChina
| | - Jin Yang
- Department of GeriatricsNingbo No. 1 HospitalNingboChina
| | - Jiang Wang
- Department of CardiologyNingbo No.1 HospitalNingboChina,Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang ProvinceNingboChina
| | - Ruoyan Yu
- Department of CardiologyNingbo No.1 HospitalNingboChina,Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang ProvinceNingboChina
| | - Jiyi Li
- Department of CardiologyYuyao People's Hospital of Zhejiang ProvinceYuyaoChina
| | - Ji Cheng
- Department of Emergency, HwaMei HospitalUniversity of Chinese Academy of SciencesNingboChina
| | - Yingchu Hu
- Department of CardiologyNingbo No.1 HospitalNingboChina,Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang ProvinceNingboChina
| | - Zhenwei Li
- Department of CardiologyNingbo No.1 HospitalNingboChina,Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang ProvinceNingboChina
| | - Nan Zheng
- Department of Cardiology, HwaMei HospitalUniversity of Chinese Academy of SciencesNingboChina
| | - Zhaoxia Zhang
- Department of CardiologyNingbo No.1 HospitalNingboChina,Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang ProvinceNingboChina
| | - Xiaojing Li
- Department of GeriatricsNingbo No. 1 HospitalNingboChina
| | - Yong Wang
- Department of CardiologyNingbo No.1 HospitalNingboChina,Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang ProvinceNingboChina
| | - Weiping Du
- Department of CardiologyNingbo No.1 HospitalNingboChina,Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang ProvinceNingboChina
| | - Keqi Zhu
- Department of Traditional Chinese Internal MedicineNingbo No. 1 HospitalNingboChina
| | - Xiaomin Chen
- Department of CardiologyNingbo No.1 HospitalNingboChina,Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang ProvinceNingboChina
| | - Jia Su
- Department of CardiologyNingbo No.1 HospitalNingboChina,Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang ProvinceNingboChina
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2
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Yang J, Yu Q, Xu Z, Zheng N, Zhong J, Li J, Liu Y, Xu H, Su J, Ji L, Chen X. Clopidogrel Resistance Is Associated With DNA Methylation of Genes From Whole Blood of Humans. Front Genet 2021; 11:583215. [PMID: 33519892 PMCID: PMC7844369 DOI: 10.3389/fgene.2020.583215] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 11/26/2020] [Indexed: 12/31/2022] Open
Abstract
Antiplatelet therapy has become a cornerstone in the treatment of coronary heart disease (CHD). However, due to high-residual-platelet-reactivity, clopidogrel resistance (CR) is a common phenomenon, and it is rarely known about the relationship between CR and epigenetic changes. This study compared the whole genomic methylation patterns of blood samples from patients with CR (n = 6) and non-CR (n = 6) with the Human Methylation 850K BeadChip assay. We explored differentially methylated CpG sites, genes, and pathways using bioinformatics profiling. The CR and control groups showed significantly different DNA methylation at 7,098 sites, with 979 sites showing hypermethylation and 6,119 sites showing hypomethylation. The pyrosequencing method was used to validate four differentially methylated CpG loci (cg23371584, cg15971518, cg04481923, cg22507406), confirming that DNA methylation was associated with the risk of CR (30 CR vs. 30 non-CR). The relative mRNA expression of the four genes (BTG2, PRG2, VTRNA2-1, PER3) corresponding to the loci above was also associated with CR, suggesting that alterations in DNA methylation may affect the expression of these four genes, eventually resulting in CR. Additionally, differentially methylated sites are partially related to genes and pathways that play key roles in process of circadian entrainment, insulin secretion, and so on. Hence, the mechanism and biological regulation of CR might be reflected through these epigenetic alterations, but future research will need to address the causal relationships.
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Affiliation(s)
- Jin Yang
- Department of Cardiology, Ningbo No. 1 Hospital, Ningbo, China
| | - Qinglin Yu
- Department of Traditional Chinese Internal Medicine, Ningbo No. 1 Hospital, Ningbo, China
| | - Zhifeng Xu
- Department of Cardiology, Zhenhai People's Hospital, Ningbo, China
| | - Nan Zheng
- Department of Cardiology, Ningbo No. 1 Hospital, Ningbo, China.,Department of Cardiology, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jinyan Zhong
- Department of Cardiology, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jiyi Li
- Department of Cardiology, Yuyao People's Hospital of Zhejiang Province, Yuyao, China
| | - Yahui Liu
- Key Laboratory, Ningbo No. 1 Hospital, Ningbo, China
| | - Hongyu Xu
- Department of Gerontology, Ningbo No. 1 Hospital, Ningbo, China
| | - Jia Su
- Department of Cardiology, Ningbo No. 1 Hospital, Ningbo, China
| | - Lindan Ji
- Department of Biochemistry, School of Medicine, Ningbo University, Ningbo, China
| | - Xiaomin Chen
- Department of Cardiology, Ningbo No. 1 Hospital, Ningbo, China
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3
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Chen Z, Xiong ZF, Liu X. Research progress on the interaction between circadian clock and early vascular aging. Exp Gerontol 2021; 146:111241. [PMID: 33453324 DOI: 10.1016/j.exger.2021.111241] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 12/15/2022]
Abstract
Considerable researches implicate that the circadian clock regulates the responsive rhythms of organs and sets the orderly aging process of cells indirectly. It influences an array of diverse biological process including intestinal flora, peripheral inflammatory responses, and redox homeostasis. People with sleep disoders and other kinds of circadian disruptions are prone to have vascular aging earlier. Meanwhile, those people are always faced with chronic vascular inflammation. It has not been elucidated that the specific mechanism of the interaction between the circadian system and early vascular aging. To explore the biphasic relationship between vascular aging and the circadian system, we summarize what is linking circadian clock with early vascular aging through four major prospect: inflammatory process, oxidative stress response, intestinal flora, and cellular senescence. Meanwhile, we discuss the hypothesis that the deterioration of circadian rhythms may exacerbate the process of early vascular aging, leading to the cardiovascular diseases. It will help us to provide new ideas for understanding the process of vascular aging and exploring the possible ways to design personalized chronotherapies.
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Affiliation(s)
- Zhuoying Chen
- Department of Geriatrics, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430077, China
| | - Zhi-Fan Xiong
- Department of Gastroenterology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430077, China
| | - Xiangjie Liu
- Department of Geriatrics, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430077, China.
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4
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van Diemen JJK, Madsen MC, Vrancken P, de Bie K, van der Bom JG, Veen G, Bonten TN, Fuijkschot WW, Smulders YM, Thijs A. Evening aspirin intake results in higher levels of platelet inhibition and a reduction in reticulated platelets - a window of opportunity for patients with cardiovascular disease? Platelets 2020; 32:821-827. [PMID: 32838616 DOI: 10.1080/09537104.2020.1809643] [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: 01/08/2023]
Abstract
Cardiovascular events occur most frequently in the early morning. Similarly, the release of reticulated platelets (RP) by megakaryocytes has a peak in the late night and early morning. Which aspirin regimen most effectively inhibits platelets during these critical hours is unknown. Hence, the primary objective of this trial was to assess platelet function and RP levels at 8.00 AM, in stable cardiovascular (CVD) patients, during three different aspirin regimens. In this open-label randomized cross-over study subjects were allocated to three sequential aspirin regimens: once-daily (OD) 80 mg morning; OD-evening, and twice-daily (BID) 40 mg. Platelet function was measured at 8.00 AM & 8.00 PM by serum Thromboxane B2 (sTxB2) levels, the Platelet Function Analyzer (PFA)-200® Closure Time (CT), Aspirin Reaction Units (ARU, VerifyNow®), and RP levels. In total, 22 patients were included. At 8.00 AM, sTxB2 levels were the lowest after OD-evening in comparison with OD-morning (p = <0.01), but not in comparison with BID. Furthermore, RP levels were similar at 8.00 AM, but statistically significantly reduced at 8.00 PM after OD-evening (p = .01) and BID (p = .02) in comparison with OD-morning. OD-evening aspirin intake results in higher levels of platelet inhibition during early morning hours and results in a reduction of RP levels in the evening. These findings may, if confirmed by larger studies, be relevant to large groups of patients taking aspirin to reduce cardiovascular risk.
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Affiliation(s)
- J J K van Diemen
- Department of Internal Medicine, Amsterdam UMC, Location VU University, Amsterdam, The Netherlands
| | - M C Madsen
- Department of Internal Medicine, Amsterdam UMC, Location VU University, Amsterdam, The Netherlands
| | - P Vrancken
- Department of Internal Medicine, Amsterdam UMC, Location VU University, Amsterdam, The Netherlands
| | - K de Bie
- Department of Internal Medicine, Amsterdam UMC, Location VU University, Amsterdam, The Netherlands
| | - J G van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.,JJ Van Rood Center for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands
| | - G Veen
- Department of Cardiology, Amsterdam UMC, Location VU University, Amsterdam, The Netherlands
| | - T N Bonten
- Department of Public Health & Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - W W Fuijkschot
- Department of Internal Medicine, Amsterdam UMC, Location VU University, Amsterdam, The Netherlands
| | - Y M Smulders
- Department of Internal Medicine, Amsterdam UMC, Location VU University, Amsterdam, The Netherlands
| | - A Thijs
- Department of Internal Medicine, Amsterdam UMC, Location VU University, Amsterdam, The Netherlands
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5
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Buurma M, van Diemen JJK, Thijs A, Numans ME, Bonten TN. Circadian Rhythm of Cardiovascular Disease: The Potential of Chronotherapy With Aspirin. Front Cardiovasc Med 2019; 6:84. [PMID: 31281821 PMCID: PMC6595227 DOI: 10.3389/fcvm.2019.00084] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 06/04/2019] [Indexed: 01/05/2023] Open
Abstract
Almost all the systems in our body adhere to a daily 24 h rhythm. The cardiovascular system is also affected by this 24 h rhythm. In the morning there is a change in various cardiovascular processes, including platelet aggregability. These changes may play a role in the relative excess of early morning cardiovascular events. The number of recurrent cardiovascular diseases (CVD) could, in theory, be reduced by responding to this 24 h rhythm with timed medication intake (chronotherapy), which also applies to aspirin. Multiple studies on chronotherapy with low-dose aspirin are promising, showing a decrease in early morning platelet activity with evening intake compared with morning intake. However, in order to further demonstrate its clinical impact, randomized trials with cardiovascular events as a primary outcome are needed. This review discusses the available evidence of the effects of circadian rhythm on CVD and the potential positive effect of chronotherapy with aspirin.
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Affiliation(s)
- Marleen Buurma
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
| | - Jeske J. K. van Diemen
- Department of Internal Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Abel Thijs
- Department of Internal Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Mattijs E. Numans
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
| | - Tobias N. Bonten
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
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Racca C, van Diemen JJK, Fuijkschot WW, Spit K, Bonten TN, Numans ME, van der Bom JG, Smulders YM, Thijs A. Aspirin intake in the morning is associated with suboptimal platelet inhibition, as measured by serum Thromboxane B2, during infarct-prone early-morning hours. Platelets 2018; 30:871-877. [DOI: 10.1080/09537104.2018.1528347] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Cati Racca
- Department of Internal Medicine, Amsterdam University Medical Center, VU University, Amsterdam, The Netherlands
| | | | - Wessel Willem Fuijkschot
- Department of Internal Medicine, Amsterdam University Medical Center, VU University, Amsterdam, The Netherlands
| | - Karlinde Spit
- Department of Internal Medicine, Amsterdam University Medical Center, VU University, Amsterdam, The Netherlands
| | - Tobias Nicolaas Bonten
- Department of Public Health & Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mattijs Everard Numans
- Department of Public Health & Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Johanna Gerarda van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
- JJ van Rood Center for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands
| | - Yvo Michiel Smulders
- Department of Internal Medicine, Amsterdam University Medical Center, VU University, Amsterdam, The Netherlands
| | - Abel Thijs
- Department of Internal Medicine, Amsterdam University Medical Center, VU University, Amsterdam, The Netherlands
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7
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Gruber SC, Freynhofer MK, Willheim M, Weiss TW, Egger F, Hübl W, Huber K. Twenty-four-hour time dependency of clopidogrel effects in patients with acute coronary syndromes: The CiCAD-Study. Platelets 2018; 30:506-512. [PMID: 29869937 DOI: 10.1080/09537104.2018.1478399] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Long-term evidence shows an increased risk of cardiovascular events in the morning hours and recent studies in aspirin-treated patients have shown increased platelet reactivity at the end of the dosing interval. Similar pharmacodynamic analyses of adenosine-diphosphate (ADP) receptor inhibitors are scarce. We therefore investigated changes in clopidogrel-dependent platelet function and activation over 24 h and whether enhanced platelet turnover might explain diurnal variability of platelet function and activation. Twenty-one patients after acute coronary syndromes (ACS) on maintenance doses of clopidogrel (75 mg) and aspirin (100 mg) Once per day (OD) were included. Blood was collected at five time points in 24 h. Platelet function and activation was analyzed by vasodilator-stimulated phosphoprotein-phosphorylation (VASP-P), Verify Now, multiple electrode aggregometry (MEA), and platelet PAC-1 and P-selectin (P-sel) expression. Additionally, platelet count, mean platelet volume (MPV), and reticulated platelet fraction (RPF) were analyzed. There was significant diurnal variability of clopidogrel effects as documented with VASP-P, Verify Now, and PAC-1 and P-sel (all p < 0.05), whereas MEA did not differ over 24 h. Neither MPV nor RPF varied significantly over 24 h. In patients with high RPF, platelet function and activation was significantly higher in all assays, compared to patients with low RPF (all p < 0.05). However, the changes over time in low versus high RPF groups were similar. ADP-dependent platelet function and activation recovers significantly at the end of the 24-h dosing interval in patients with ACS on a maintenance dose of clopidogrel and aspirin. Although platelet function and activation is increased in patients with higher RPF, platelet turnover might not explain the observed diurnal variability.
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Affiliation(s)
- Susanne Claudia Gruber
- a 3rd Medical Department, Cardiology and Intensive Care Medicine , Wilhelminenhospital , Vienna , Austria
| | - Matthias Karl Freynhofer
- a 3rd Medical Department, Cardiology and Intensive Care Medicine , Wilhelminenhospital , Vienna , Austria
| | - Martin Willheim
- b Department of Laboratory Medicine , Wilhelminenhospital , Vienna , Austria
| | - Thomas Werner Weiss
- a 3rd Medical Department, Cardiology and Intensive Care Medicine , Wilhelminenhospital , Vienna , Austria
| | - Florian Egger
- a 3rd Medical Department, Cardiology and Intensive Care Medicine , Wilhelminenhospital , Vienna , Austria
| | - Wolfgang Hübl
- b Department of Laboratory Medicine , Wilhelminenhospital , Vienna , Austria
| | - Kurt Huber
- a 3rd Medical Department, Cardiology and Intensive Care Medicine , Wilhelminenhospital , Vienna , Austria.,c Ludwig Boltzmann Cluster for Cardiovascular Research , Vienna , Austria
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