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Liu SY, Wang Q, Zhou H, Tong N, Chang R, Wang FZ, Guo P, Li X, Zhou YB, Li ZZ. Adrenomedullin improved endothelial dysfunction via receptor-Akt pathway in rats with obesity-related hypertension. Hypertens Res 2024; 47:2157-2171. [PMID: 38769138 DOI: 10.1038/s41440-024-01701-y] [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: 08/04/2023] [Revised: 01/28/2024] [Accepted: 04/07/2024] [Indexed: 05/22/2024]
Abstract
Obesity-related hypertension (OH) is accompanied by obvious endothelial dysfunction, which contributes to increased peripheral vascular resistance and hypertension. Adrenomedullin (ADM), a multifunctional active peptide, is elevated in obese humans. The OH rats induced by high fat diet (HFD) for 28 weeks and the human umbilical vein endothelial cells (HUVECs)-treated by palmitic acid (PA) were used to investigate the effects of ADM on endothelial dysfunction and the underlying mechanisms. Vascular reactivity was assessed using mesenteric arteriole rings, and the protein expression levels were examined by Western blot analysis. Compared with the control rats, OH rats exhibited hypertension and endothelial dysfunction, along with reduced eNOS protein expression and Akt activation, and increased protein expression of proinflammatory cytokines and ROS levels. Four-week ADM administration improved hypertension and endothelial function, increased eNOS protein expression and Akt activation, and attenuated endothelial inflammation and oxidative stress in OH rats. In vitro experiment, the antagonism of ADM receptors with ADM22-52 and the suppression of Akt signaling with A6730 significantly blocked ADM-caused increase of NO content and activation of eNOS and Akt, and inhibited the anti-inflammatory and anti-oxidant effect of ADM in PA-stimulated HUVECs. These data indicate that endothelial dysfunction in OH rats is partially attributable to the decreased NO level, and the increased inflammation and oxidative stress. ADM improves endothelial function and exerts hypotensive effect depending on the increase of NO, and its anti-inflammatory and anti-oxidant effect via receptor-Akt pathway.
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Affiliation(s)
- Si-Yu Liu
- Department of Physiology, Nanjing Medical University, Nanjing, Jiangsu, 211166, China
| | - Qian Wang
- Department of Physiology, Nanjing Medical University, Nanjing, Jiangsu, 211166, China
| | - Hong Zhou
- Department of Physiology, Nanjing Medical University, Nanjing, Jiangsu, 211166, China
| | - Ning Tong
- Department of Neurology of Heze Municipal Hospital, Heze, 274000, China
| | - Rui Chang
- Department of Physiology, Nanjing Medical University, Nanjing, Jiangsu, 211166, China
| | - Fang-Zheng Wang
- Department of Physiology, Nanjing Medical University, Nanjing, Jiangsu, 211166, China
| | - Ping Guo
- Department of Cardiology, Nanjing BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University Nanjing, Nanjing, 210021, Jiangsu, China
| | - Xin Li
- Department of Cardiology, Nanjing BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University Nanjing, Nanjing, 210021, Jiangsu, China
| | - Ye-Bo Zhou
- Department of Physiology, Nanjing Medical University, Nanjing, Jiangsu, 211166, China.
| | - Zhen-Zhen Li
- Department of Physiology, Nanjing Medical University, Nanjing, Jiangsu, 211166, China.
- Department of Cardiology, Nanjing BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University Nanjing, Nanjing, 210021, Jiangsu, China.
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Aminu M, Hong L, Vokes N, Schmidt ST, Saad M, Zhu B, Le X, Tina C, Sheshadri A, Wang B, Jaffray D, Futreal A, Lee JJ, Byers LA, Gibbons D, Heymach J, Chen K, Cheng C, Zhang J, Wu J. Joint multi-omics discriminant analysis with consistent representation learning using PANDA. RESEARCH SQUARE 2024:rs.3.rs-4353037. [PMID: 38798352 PMCID: PMC11118856 DOI: 10.21203/rs.3.rs-4353037/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Integrative multi-omics analysis provides deeper insight and enables better and more realistic modeling of the underlying biology and causes of diseases than does single omics analysis. Although several integrative multi-omics analysis methods have been proposed and demonstrated promising results in integrating distinct omics datasets, inconsistent distribution of the different omics data, which is caused by technology variations, poses a challenge for paired integrative multi-omics methods. In addition, the existing discriminant analysis-based integrative methods do not effectively exploit correlation and consistent discriminant structures, necessitating a compromise between correlation and discrimination in using these methods. Herein we present PAN-omics Discriminant Analysis (PANDA), a joint discriminant analysis method that seeks omics-specific discriminant common spaces by jointly learning consistent discriminant latent representations for each omics. PANDA jointly maximizes between-class and minimizes within-class omics variations in a common space and simultaneously models the relationships among omics at the consistency representation and cross-omics correlation levels, overcoming the need for compromise between discrimination and correlation as with the existing integrative multi-omics methods. Because of the consistency representation learning incorporated into the objective function of PANDA, this method seeks a common discriminant space to minimize the differences in distributions among omics, can lead to a more robust latent representations than other methods, and is against the inconsistency of the different omics. We compared PANDA to 10 other state-of-the-art multi-omics data integration methods using both simulated and real-world multi-omics datasets and found that PANDA consistently outperformed them while providing meaningful discriminant latent representations. PANDA is implemented using both R and MATLAB, with codes available at https://github.com/WuLabMDA/PANDA.
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Affiliation(s)
- Muhammad Aminu
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lingzhi Hong
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Natalie Vokes
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Stephanie T. Schmidt
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Maliazurina Saad
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Bo Zhu
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Xiuning Le
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Cascone Tina
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ajay Sheshadri
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Bo Wang
- Department of Medical Biophysics, University of Toronto, Ontario, Canada
| | - David Jaffray
- Office of the Chief Technology and Digital Officer, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Andy Futreal
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - J. Jack Lee
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lauren A. Byers
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Don Gibbons
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - John Heymach
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ken Chen
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Chao Cheng
- Department of Medicine, Institution of Clinical and Translational Research, Baylor College of Medicine, Houston, TX, USA
| | - Jianjun Zhang
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jia Wu
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Xie Y, Shi H, Han B. Bioinformatic analysis of underlying mechanisms of Kawasaki disease via Weighted Gene Correlation Network Analysis (WGCNA) and the Least Absolute Shrinkage and Selection Operator method (LASSO) regression model. BMC Pediatr 2023; 23:90. [PMID: 36829193 PMCID: PMC9951419 DOI: 10.1186/s12887-023-03896-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 02/07/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND Kawasaki disease (KD) is a febrile systemic vasculitis involvingchildren younger than five years old. However, the specific biomarkers and precise mechanisms of this disease are not fully understood, which can delay the best treatment time, hence, this study aimed to detect the potential biomarkers and pathophysiological process of KD through bioinformatic analysis. METHODS The Gene Expression Omnibus database (GEO) was the source of the RNA sequencing data from KD patients. Differential expressed genes (DEGs) were screened between KD patients and healthy controls (HCs) with the "limma" R package. Weighted gene correlation network analysis (WGCNA) was performed to discover the most corresponding module and hub genes of KD. The node genes were obtained by the combination of the least absolute shrinkage and selection operator (LASSO) regression model with the top 5 genes from five algorithms in CytoHubba, which were further validated with the receiver operating characteristic curve (ROC curve). CIBERSORTx was employed to discover the constitution of immune cells in KDs and HCs. Functional enrichment analysis was performed to understand the biological implications of the modular genes. Finally, competing endogenous RNAs (ceRNA) networks of node genes were predicted using online databases. RESULTS A total of 267 DEGs were analyzed between 153 KD patients and 92 HCs in the training set, spanning two modules according to WGCNA. The turquoise module was identified as the hub module, which was mainly enriched in cell activation involved in immune response, myeloid leukocyte activation, myeloid leukocyte mediated immunity, secretion and leukocyte mediated immunity biological processes; included type II diabetes mellitus, nicotinate and nicotinamide metabolism, O-glycan biosynthesis, glycerolipid and glutathione metabolism pathways. The node genes included ADM, ALPL, HK3, MMP9 and S100A12, and there was good performance in the validation studies. Immune cell infiltration analysis revealed that gamma delta T cells, monocytes, M0 macrophage, activated dendritic cells, activated mast cells and neutrophils were elevated in KD patients. Regarding the ceRNA networks, three intact networks were constructed: NEAT1/NORAD/XIST-hsa-miR-524-5p-ADM, NEAT1/NORAD/XIST-hsa-miR-204-5p-ALPL, NEAT1/NORAD/XIST-hsa-miR-524-5p/hsa-miR-204-5p-MMP9. CONCLUSION To conclude, the five-gene signature and three ceRNA networks constructed in our study are of great value in the early diagnosis of KD and might help to elucidate our understanding of KD at the RNA regulatory level.
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Affiliation(s)
- Yaxue Xie
- Department of Pediatrics, Shandong Provincial Hospital, Shandong University, Jinan, 250021, Shandong, China
| | - Hongshuo Shi
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, 250021, Shandong, China
| | - Bo Han
- Department of Pediatrics, Shandong Provincial Hospital, Shandong University, Jinan, 250021, Shandong, China. .,Department of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.
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Kuiper R, Wright VJ, Habgood-Coote D, Shimizu C, Huigh D, Tremoulet AH, van Keulen D, Hoggart CJ, Rodriguez-Manzano J, Herberg JA, Kaforou M, Tempel D, Burns JC, Levin M. Bridging a diagnostic Kawasaki disease classifier from a microarray platform to a qRT-PCR assay. Pediatr Res 2023; 93:559-569. [PMID: 35732822 PMCID: PMC9988687 DOI: 10.1038/s41390-022-02148-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/18/2022] [Accepted: 05/25/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Kawasaki disease (KD) is a systemic vasculitis that mainly affects children under 5 years of age. Up to 30% of patients develop coronary artery abnormalities, which are reduced with early treatment. Timely diagnosis of KD is challenging but may become more straightforward with the recent discovery of a whole-blood host response classifier that discriminates KD patients from patients with other febrile conditions. Here, we bridged this microarray-based classifier to a clinically applicable quantitative reverse transcription-polymerase chain reaction (qRT-PCR) assay: the Kawasaki Disease Gene Expression Profiling (KiDs-GEP) classifier. METHODS We designed and optimized a qRT-PCR assay and applied it to a subset of samples previously used for the classifier discovery to reweight the original classifier. RESULTS The performance of the KiDs-GEP classifier was comparable to the original classifier with a cross-validated area under the ROC curve of 0.964 [95% CI: 0.924-1.00] vs 0.992 [95% CI: 0.978-1.00], respectively. Both classifiers demonstrated similar trends over various disease conditions, with the clearest distinction between individuals diagnosed with KD vs viral infections. CONCLUSION We successfully bridged the microarray-based classifier into the KiDs-GEP classifier, a more rapid and more cost-efficient qRT-PCR assay, bringing a diagnostic test for KD closer to the hospital clinical laboratory. IMPACT A diagnostic test is needed for Kawasaki disease and is currently not available. We describe the development of a One-Step multiplex qRT-PCR assay and the subsequent modification (i.e., bridging) of the microarray-based host response classifier previously described by Wright et al. The bridged KiDs-GEP classifier performs well in discriminating Kawasaki disease patients from febrile controls. This host response clinical test for Kawasaki disease can be adapted to the hospital clinical laboratory.
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Affiliation(s)
| | - Victoria J Wright
- Department of Infectious Disease, Imperial College London, London, UK
| | | | - Chisato Shimizu
- Department of Pediatrics, Rady Children's Hospital and University of California San Diego, La Jolla, CA, USA
| | | | - Adriana H Tremoulet
- Department of Pediatrics, Rady Children's Hospital and University of California San Diego, La Jolla, CA, USA
| | | | - Clive J Hoggart
- Department of Infectious Disease, Imperial College London, London, UK.,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | | | - Jethro A Herberg
- Department of Infectious Disease, Imperial College London, London, UK
| | - Myrsini Kaforou
- Department of Infectious Disease, Imperial College London, London, UK
| | | | - Jane C Burns
- Department of Pediatrics, Rady Children's Hospital and University of California San Diego, La Jolla, CA, USA
| | - Michael Levin
- Department of Infectious Disease, Imperial College London, London, UK
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Zhang M, Ke B, Zhuo H, Guo B. Diagnostic model based on bioinformatics and machine learning to distinguish Kawasaki disease using multiple datasets. BMC Pediatr 2022; 22:512. [PMID: 36042431 PMCID: PMC9425821 DOI: 10.1186/s12887-022-03557-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 08/17/2022] [Indexed: 12/03/2022] Open
Abstract
Background Kawasaki disease (KD), characterized by systemic vasculitis, is the leading cause of acquired heart disease in children. Herein, we developed a diagnostic model, with some prognosis ability, to help distinguish children with KD. Methods Gene expression datasets were downloaded from Gene Expression Omnibus (GEO), and gene sets with a potential pathogenic mechanism in KD were identified using differential expressed gene (DEG) screening, pathway enrichment analysis, random forest (RF) screening, and artificial neural network (ANN) construction. Results We extracted 2,017 DEGs (1,130 with upregulated and 887 with downregulated expression) from GEO. The Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses showed that the DEGs were significantly enriched in innate/adaptive immune response-related processes. Subsequently, the results of weighted gene co-expression network analysis and DEG screening were combined and, using RF and ANN, a model with eight genes (VPS9D1, CACNA1E, SH3GLB1, RAB32, ADM, GYG1, PGS1, and HIST2H2AC) was constructed. Classification results of the new model for KD diagnosis showed excellent performance for different datasets, including those of patients with KD, convalescents, and healthy individuals, with area under the curve values of 1, 0.945, and 0.95, respectively. Conclusions We used machine learning methods to construct and validate a diagnostic model using multiple bioinformatic datasets, and identified molecules expected to serve as new biomarkers for or therapeutic targets in KD. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03557-y.
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Affiliation(s)
- Mengyi Zhang
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, 610041, PR, Sichuan Province, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Bocuo Ke
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, 610041, PR, Sichuan Province, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Huichuan Zhuo
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, 610041, PR, Sichuan Province, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Binhan Guo
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, 610041, PR, Sichuan Province, China. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
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Liu D, Song M, Jing F, Liu B, Yi Q. Diagnostic Value of Immune-Related Genes in Kawasaki Disease. Front Genet 2021; 12:763496. [PMID: 34956318 PMCID: PMC8709561 DOI: 10.3389/fgene.2021.763496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 11/11/2021] [Indexed: 12/19/2022] Open
Abstract
Kawasaki disease (KD) is a systemic vasculitis that predominantly damages medium- and small-sized vessels, and mainly causes coronary artery lesions (CALs). The diagnostic criterion of KD mainly depends on clinical features, so children could be easily misdiagnosed and could suffer from CALs. Through analysis, a total of 14 immune-related DEGs were obtained, of which IL1B, ADM, PDGFC, and TGFA were identified as diagnostic markers of KD. Compared with the non-KD group, KD patients contained a higher proportion of naive B cells, activated memory CD4 T cells, gamma delta T cells, and neutrophils, while the proportions of memory B cells, CD8 T cells, activated memory CD4 T cells, and activated NK cells were relatively lower. In conclusion, immune-related genes can be used as diagnostic markers of KD, and the difference in immune cells between KD and non-KD might provide new insight into understanding the pathogenesis of KD.
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Affiliation(s)
- Dong Liu
- Department of Cardiovascular Medicine, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.,Department of Pediatrics, Sichuan Clinical Research Center for Birth Defects, The Affliated Hospital of Southwest Medical University, Luzhou, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Meixuan Song
- Department of Gastrointestinal Surgery, The Affliated Hospital of Southwest Medical University, Luzhou, China
| | - Fengchuan Jing
- Department of Cardiovascular Medicine, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Bin Liu
- Department of Pediatrics, Sichuan Clinical Research Center for Birth Defects, The Affliated Hospital of Southwest Medical University, Luzhou, China
| | - Qijian Yi
- Department of Cardiovascular Medicine, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
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Hicar MD. Antibodies and Immunity During Kawasaki Disease. Front Cardiovasc Med 2020; 7:94. [PMID: 32671098 PMCID: PMC7326051 DOI: 10.3389/fcvm.2020.00094] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 04/30/2020] [Indexed: 12/14/2022] Open
Abstract
The cause of Kawasaki disease (KD), the leading cause of acquired heart disease in children, is currently unknown. Epidemiology studies support that an infectious disease is involved in at least starting the inflammatory cascade set off during KD. Clues from epidemiology support that humoral immunity can have a protective effect. However, the role of the immune system, particularly of B cells and antibodies, in pathogenesis of KD is still unclear. Intravenous immunoglobulin (IVIG) and other therapies targeted at modulating inflammation can prevent development of coronary aneurysms. A number of autoantibody responses have been reported in children with KD and antibodies have been generated from aneurysmal plasma cell infiltrates. Recent reports show that children with KD have similar plasmablast responses as other children with infectious diseases, further supporting an infectious starting point. As ongoing studies are attempting to identify the etiology of KD through study of antibody responses, we sought to review the role of humoral immunity in KD pathogenesis, treatment, and recovery.
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Affiliation(s)
- Mark Daniel Hicar
- University at Buffalo, Buffalo, NY, United States.,John R. Oishei Children's Hospital, Buffalo, NY, United States.,Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
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Ko TM, Kuo HC, Chang JS, Chen SP, Liu YM, Chen HW, Tsai FJ, Lee YC, Chen CH, Wu JY, Chen YT. CXCL10/IP-10 is a biomarker and mediator for Kawasaki disease. Circ Res 2015; 116:876-83. [PMID: 25605650 DOI: 10.1161/circresaha.116.305834] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
RATIONALE Kawasaki disease (KD), an acute febrile vasculitis, is the most common cause of acquired heart disease in childhood; however, diagnosing KD can be difficult. OBJECTIVE To identify unique proteomic biomarkers that can be used to facilitate earlier diagnosis of KD. METHODS AND RESULTS We enrolled 214 children with fever and clinical features suggestive of KD. Of those, only 100 were diagnosed with KD. Their plasma samples were globally analyzed for cytokines, chemokines, and cell adhesion molecules using an unbiased, large-scale, quantitative protein array. This study was conducted in 3 stages: discovery, replication, and blinded validation. During the discovery phase (n [KD]=37; n [control]=20), the expression of interleukin-17F, sCD40L, E-selectin, CCL23 (myeloid progenitor inhibitory factor 1), and CXCL10 (IFN-γ-inducible protein 10 [IP-10]) were upregulated during the acute phase in patients with KD when compared with that in the controls. A notable increase was observed in the IP-10 levels (KD, 3037 ± 226.7 pg/mL; control, 672 ± 130.4 pg/mL; P=4.1 × 10(-11)). Receiver-operating characteristic analysis of the combined discovery and replication data (n [KD]=77; n [control]=77) showed that the IP-10 level had high area under the curve values (0.94 [95% confidence interval, 0.9055-0.9778]; sensitivity, 100%; and specificity, 77%). With 1318 pg/mL as the optimal cutoff, the blinded validation study confirmed that the IP-10 levels were a good predictor of KD. With intravenous immunoglobulin treatment, the IP-10 levels returned to normal. The downstream receptor of IP-10, CXCR3, was activated in the T cells of patients with acute KD. CONCLUSIONS IP-10 may be used as a biomarker to facilitate KD diagnosis, and it may provide clues about the pathogenesis of KD.
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Affiliation(s)
- Tai-Ming Ko
- From the Institute of Biomedical Sciences (T.-M.K., S.-P.C., Y.-M.L., H.-W.C., C.-H.C., J.-Y.W., Y.-T.C.) and Institute of Cellular and Organismic Biology (Y.-C.L.), Academia Sinica, Taipei, Taiwan; Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (H.-C.K.); Chang Gung University College of Medicine, Taoyuan, Taiwan (H.-C.K.); Department of Pediatric Cardiology, Children's Hospital of China Medical University, Taichung, Taiwan (J.-S.C.); School of Medicine (J.-S.C.), School of Chinese Medicine (F.-J.T.), and Department of Medical Genetics (F.-J.T., C.-H.C., J.-Y.W.), China Medical University Hospital, Taichung, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan (F.-J.T.); and Department of Pediatrics, Duke University Medical Center, Durham, NC (Y.-T.C.)
| | - Ho-Chang Kuo
- From the Institute of Biomedical Sciences (T.-M.K., S.-P.C., Y.-M.L., H.-W.C., C.-H.C., J.-Y.W., Y.-T.C.) and Institute of Cellular and Organismic Biology (Y.-C.L.), Academia Sinica, Taipei, Taiwan; Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (H.-C.K.); Chang Gung University College of Medicine, Taoyuan, Taiwan (H.-C.K.); Department of Pediatric Cardiology, Children's Hospital of China Medical University, Taichung, Taiwan (J.-S.C.); School of Medicine (J.-S.C.), School of Chinese Medicine (F.-J.T.), and Department of Medical Genetics (F.-J.T., C.-H.C., J.-Y.W.), China Medical University Hospital, Taichung, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan (F.-J.T.); and Department of Pediatrics, Duke University Medical Center, Durham, NC (Y.-T.C.)
| | - Jeng-Sheng Chang
- From the Institute of Biomedical Sciences (T.-M.K., S.-P.C., Y.-M.L., H.-W.C., C.-H.C., J.-Y.W., Y.-T.C.) and Institute of Cellular and Organismic Biology (Y.-C.L.), Academia Sinica, Taipei, Taiwan; Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (H.-C.K.); Chang Gung University College of Medicine, Taoyuan, Taiwan (H.-C.K.); Department of Pediatric Cardiology, Children's Hospital of China Medical University, Taichung, Taiwan (J.-S.C.); School of Medicine (J.-S.C.), School of Chinese Medicine (F.-J.T.), and Department of Medical Genetics (F.-J.T., C.-H.C., J.-Y.W.), China Medical University Hospital, Taichung, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan (F.-J.T.); and Department of Pediatrics, Duke University Medical Center, Durham, NC (Y.-T.C.)
| | - Shih-Ping Chen
- From the Institute of Biomedical Sciences (T.-M.K., S.-P.C., Y.-M.L., H.-W.C., C.-H.C., J.-Y.W., Y.-T.C.) and Institute of Cellular and Organismic Biology (Y.-C.L.), Academia Sinica, Taipei, Taiwan; Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (H.-C.K.); Chang Gung University College of Medicine, Taoyuan, Taiwan (H.-C.K.); Department of Pediatric Cardiology, Children's Hospital of China Medical University, Taichung, Taiwan (J.-S.C.); School of Medicine (J.-S.C.), School of Chinese Medicine (F.-J.T.), and Department of Medical Genetics (F.-J.T., C.-H.C., J.-Y.W.), China Medical University Hospital, Taichung, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan (F.-J.T.); and Department of Pediatrics, Duke University Medical Center, Durham, NC (Y.-T.C.)
| | - Yi-Min Liu
- From the Institute of Biomedical Sciences (T.-M.K., S.-P.C., Y.-M.L., H.-W.C., C.-H.C., J.-Y.W., Y.-T.C.) and Institute of Cellular and Organismic Biology (Y.-C.L.), Academia Sinica, Taipei, Taiwan; Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (H.-C.K.); Chang Gung University College of Medicine, Taoyuan, Taiwan (H.-C.K.); Department of Pediatric Cardiology, Children's Hospital of China Medical University, Taichung, Taiwan (J.-S.C.); School of Medicine (J.-S.C.), School of Chinese Medicine (F.-J.T.), and Department of Medical Genetics (F.-J.T., C.-H.C., J.-Y.W.), China Medical University Hospital, Taichung, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan (F.-J.T.); and Department of Pediatrics, Duke University Medical Center, Durham, NC (Y.-T.C.)
| | - Hui-Wen Chen
- From the Institute of Biomedical Sciences (T.-M.K., S.-P.C., Y.-M.L., H.-W.C., C.-H.C., J.-Y.W., Y.-T.C.) and Institute of Cellular and Organismic Biology (Y.-C.L.), Academia Sinica, Taipei, Taiwan; Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (H.-C.K.); Chang Gung University College of Medicine, Taoyuan, Taiwan (H.-C.K.); Department of Pediatric Cardiology, Children's Hospital of China Medical University, Taichung, Taiwan (J.-S.C.); School of Medicine (J.-S.C.), School of Chinese Medicine (F.-J.T.), and Department of Medical Genetics (F.-J.T., C.-H.C., J.-Y.W.), China Medical University Hospital, Taichung, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan (F.-J.T.); and Department of Pediatrics, Duke University Medical Center, Durham, NC (Y.-T.C.)
| | - Fuu-Jen Tsai
- From the Institute of Biomedical Sciences (T.-M.K., S.-P.C., Y.-M.L., H.-W.C., C.-H.C., J.-Y.W., Y.-T.C.) and Institute of Cellular and Organismic Biology (Y.-C.L.), Academia Sinica, Taipei, Taiwan; Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (H.-C.K.); Chang Gung University College of Medicine, Taoyuan, Taiwan (H.-C.K.); Department of Pediatric Cardiology, Children's Hospital of China Medical University, Taichung, Taiwan (J.-S.C.); School of Medicine (J.-S.C.), School of Chinese Medicine (F.-J.T.), and Department of Medical Genetics (F.-J.T., C.-H.C., J.-Y.W.), China Medical University Hospital, Taichung, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan (F.-J.T.); and Department of Pediatrics, Duke University Medical Center, Durham, NC (Y.-T.C.)
| | - Yi-Ching Lee
- From the Institute of Biomedical Sciences (T.-M.K., S.-P.C., Y.-M.L., H.-W.C., C.-H.C., J.-Y.W., Y.-T.C.) and Institute of Cellular and Organismic Biology (Y.-C.L.), Academia Sinica, Taipei, Taiwan; Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (H.-C.K.); Chang Gung University College of Medicine, Taoyuan, Taiwan (H.-C.K.); Department of Pediatric Cardiology, Children's Hospital of China Medical University, Taichung, Taiwan (J.-S.C.); School of Medicine (J.-S.C.), School of Chinese Medicine (F.-J.T.), and Department of Medical Genetics (F.-J.T., C.-H.C., J.-Y.W.), China Medical University Hospital, Taichung, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan (F.-J.T.); and Department of Pediatrics, Duke University Medical Center, Durham, NC (Y.-T.C.)
| | - Chien-Hsiun Chen
- From the Institute of Biomedical Sciences (T.-M.K., S.-P.C., Y.-M.L., H.-W.C., C.-H.C., J.-Y.W., Y.-T.C.) and Institute of Cellular and Organismic Biology (Y.-C.L.), Academia Sinica, Taipei, Taiwan; Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (H.-C.K.); Chang Gung University College of Medicine, Taoyuan, Taiwan (H.-C.K.); Department of Pediatric Cardiology, Children's Hospital of China Medical University, Taichung, Taiwan (J.-S.C.); School of Medicine (J.-S.C.), School of Chinese Medicine (F.-J.T.), and Department of Medical Genetics (F.-J.T., C.-H.C., J.-Y.W.), China Medical University Hospital, Taichung, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan (F.-J.T.); and Department of Pediatrics, Duke University Medical Center, Durham, NC (Y.-T.C.)
| | - Jer-Yuarn Wu
- From the Institute of Biomedical Sciences (T.-M.K., S.-P.C., Y.-M.L., H.-W.C., C.-H.C., J.-Y.W., Y.-T.C.) and Institute of Cellular and Organismic Biology (Y.-C.L.), Academia Sinica, Taipei, Taiwan; Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (H.-C.K.); Chang Gung University College of Medicine, Taoyuan, Taiwan (H.-C.K.); Department of Pediatric Cardiology, Children's Hospital of China Medical University, Taichung, Taiwan (J.-S.C.); School of Medicine (J.-S.C.), School of Chinese Medicine (F.-J.T.), and Department of Medical Genetics (F.-J.T., C.-H.C., J.-Y.W.), China Medical University Hospital, Taichung, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan (F.-J.T.); and Department of Pediatrics, Duke University Medical Center, Durham, NC (Y.-T.C.).
| | - Yuan-Tsong Chen
- From the Institute of Biomedical Sciences (T.-M.K., S.-P.C., Y.-M.L., H.-W.C., C.-H.C., J.-Y.W., Y.-T.C.) and Institute of Cellular and Organismic Biology (Y.-C.L.), Academia Sinica, Taipei, Taiwan; Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (H.-C.K.); Chang Gung University College of Medicine, Taoyuan, Taiwan (H.-C.K.); Department of Pediatric Cardiology, Children's Hospital of China Medical University, Taichung, Taiwan (J.-S.C.); School of Medicine (J.-S.C.), School of Chinese Medicine (F.-J.T.), and Department of Medical Genetics (F.-J.T., C.-H.C., J.-Y.W.), China Medical University Hospital, Taichung, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan (F.-J.T.); and Department of Pediatrics, Duke University Medical Center, Durham, NC (Y.-T.C.).
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9
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Hoang LT, Shimizu C, Ling L, Naim ANM, Khor CC, Tremoulet AH, Wright V, Levin M, Hibberd ML, Burns JC. Global gene expression profiling identifies new therapeutic targets in acute Kawasaki disease. Genome Med 2014; 6:541. [PMID: 25614765 PMCID: PMC4279699 DOI: 10.1186/s13073-014-0102-6] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 10/30/2014] [Indexed: 12/18/2022] Open
Abstract
Background Global gene expression profiling can provide insight into the underlying pathophysiology of disease processes. Kawasaki disease (KD) is an acute, self-limited vasculitis whose etiology remains unknown. Although the clinical illness shares certain features with other pediatric infectious diseases, the occurrence of coronary artery aneurysms in 25% of untreated patients is unique to KD. Methods To gain further insight into the molecular mechanisms underlying KD, we investigated the acute and convalescent whole blood transcriptional profiles of 146 KD subjects and compared them with the transcriptional profiles of pediatric patients with confirmed bacterial or viral infection, and with healthy control children. We also investigated the transcript abundance in patients with different intravenous immunoglobulin treatment responses and different coronary artery outcomes. Results The overwhelming signature for acute KD involved signaling pathways of the innate immune system. Comparison with other acute pediatric infections highlighted the importance of pathways involved in cell motility including paxillin, relaxin, actin, integrins, and matrix metalloproteinases. Most importantly, the IL1β pathway was identified as a potential therapeutic target. Conclusion Our study revealed the importance of the IL-1 signaling pathway and a prominent signature of innate immunity and cell migration in the acute phase of the illness. Electronic supplementary material The online version of this article (doi:10.1186/s13073-014-0102-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Chisato Shimizu
- Department of Pediatrics, University of California San Diego and Rady Children's Hospital, La Jolla, CA 92093 USA
| | - Ling Ling
- Genome Institute of Singapore, Singapore City, Singapore
| | | | | | - Adriana H Tremoulet
- Department of Pediatrics, University of California San Diego and Rady Children's Hospital, La Jolla, CA 92093 USA
| | - Victoria Wright
- Section for Pediatrics, Division of Medicine, Imperial College, London, UK
| | - Michael Levin
- Section for Pediatrics, Division of Medicine, Imperial College, London, UK
| | | | - Jane C Burns
- Department of Pediatrics, University of California San Diego and Rady Children's Hospital, La Jolla, CA 92093 USA
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10
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Rowley AH. Can a systems biology approach unlock the mysteries of Kawasaki disease? WILEY INTERDISCIPLINARY REVIEWS-SYSTEMS BIOLOGY AND MEDICINE 2013; 5:221-9. [PMID: 23293016 DOI: 10.1002/wsbm.1202] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Kawasaki disease (KD) is a systemic inflammatory illness of childhood that particularly affects the coronary arteries. It can lead to coronary artery aneurysms, myocardial infarction, and sudden death. Clinical and epidemiologic data support an infectious cause, and the etiology remains unknown, but recent data support infection with a 'new' virus. Genetic factors influence KD susceptibility; the incidence is 10-fold higher in children of Asian when compared with Caucasian ethnicity. Recent research has identified genes affecting immune response that are associated with KD susceptibility and outcome. A re-examination of the pathologic features of KD has yielded a three process model of KD vasculopathy, providing a framework for understanding the KD arterial immune response and the damage it inflicts and for identifying new therapeutic targets for KD patients with coronary artery abnormalities. The researcher is faced with many challenges in determining the pathogenesis of KD. A systems biology approach incorporating genomics, proteomics, transcriptomics, and microbial bioinformatics analysis of high-throughput sequence data from KD tissues could provide the keys to unlocking the mysteries of this potentially fatal illness of childhood.
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Affiliation(s)
- Anne H Rowley
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, The Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
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11
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Fury W, Tremoulet AH, Watson VE, Best BM, Shimizu C, Hamilton J, Kanegaye JT, Wei Y, Kao C, Mellis S, Lin C, Burns JC. Transcript abundance patterns in Kawasaki disease patients with intravenous immunoglobulin resistance. Hum Immunol 2010; 71:865-73. [PMID: 20600450 DOI: 10.1016/j.humimm.2010.06.008] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2010] [Revised: 05/30/2010] [Accepted: 06/04/2010] [Indexed: 11/19/2022]
Abstract
Intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD) patients comprise at least 20% of treated patients and are at high risk for coronary artery abnormalities. If identified early in the course of the disease, such patients may benefit from additional anti-inflammatory therapy. The aim of this study was to compare the transcript abundance between IVIG resistant and -responsive KD patients, to identify biomarkers that might differentiate between these two groups and to generate new targets for therapies in IVIG resistant KD patients. We compared the transcript abundance profiles of whole-blood RNA on Agilent arrays from acute and convalescent KD subjects and age-similar, healthy controls. KD subjects were stratified as IVIG resistant or -responsive based on response to initial IVIG therapy. Transcript abundance was higher for IL-1 pathway genes (IL-1 receptor, interleukin receptor associated kinase, p38 mitogen-activated protein kinase), and MMP-8. These findings point to candidate biomarkers that may predict IVIG resistance in acute KD patients. The results also underscore the importance of the IL-1 pathway as a mediator of inflammation in KD and suggest that IL-1 or its receptor may be reasonable targets for therapy, particularly for IVIG resistant patients.
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Affiliation(s)
- Wen Fury
- Regeneron Pharmaceuticals, Inc., Tarrytown, New York, USA
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12
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Xu MG, Men LN, Zhao CY, Zhao X, Wang YX, Meng XC, Shen DR, Meng BY, Zhang Q, Wang T. The number and function of circulating endothelial progenitor cells in patients with Kawasaki disease. Eur J Pediatr 2010; 169:289-96. [PMID: 19548000 DOI: 10.1007/s00431-009-1014-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2009] [Accepted: 06/09/2009] [Indexed: 01/19/2023]
Abstract
Kawasaki disease (KD) is associated with coronary artery injury. Studies have shown that the endothelial progenitor cell (EPC) participates in the process of arterial repair. Data have been reported that the number of EPC increased significantly in the subacute phase of KD. However, until now, there are no data about the functions of EPC in KD patients. The present study was designed to further investigate the number and functions of EPC in KD. Ten KD patients in the acute phase and ten healthy volunteers were recruited and attributed to the KD group and control group, respectively. The circulating CD34/kinase insert domain-containing receptor double positive cells were evaluated in the two groups using flow cytometry. In vitro assays were used to measure the functions of EPC, including proliferation, adhesion, and migration activities. The plasma levels of nitric oxide (NO), tumor necrosis factor-alpha (TNF-alpha), and high sensitivity C-reactive protein (hs-CRP) were also assessed in both groups. The number of EPC in the KD group was significantly higher than that of the control group (0.021 +/- 0.007% vs. 0.014 +/- 0.003%, P < 0.05). The migratory response of EPC was significantly decreased in the KD group, compared with that of the control group (5.50 +/- 1.78 vs. 3.40 +/- 1.35 cells/high power field, P < 0.01). Similarly, the proliferative and adhesive activities of EPC in the KD group were also decreased (0.47 +/- 0.08 vs. 0.66 +/- 0.07, P < 0.01; 6.5 +/- 2.12 vs. 11.2 +/- 2.04 cells/high power field, P < 0.01). The plasma NO, TNF-alpha, and hs-CRP levels in the KD group were higher than those of the control group (54.10 +/- 11.78 vs. 38.80 +/- 11.10 mumol/l, P < 0.01; 48.20 +/- 7.42 vs. 37.00 +/- 11.12 pg/ml, P < 0.05; 87.10 +/- 30.18 vs. 5.30 +/- 3.37 mg/l, P < 0.01). The number of circulating EPC positively correlated with the level of NO (r = 0.92, P < 0.001), and the functions of EPC negatively correlated with the levels of TNF-alpha and hs-CRP, respectively. In Kawasaki disease, the number of EPC was enhanced and the functions of EPC were attenuated. The two-way regulation of circulating EPC in KD patients may be associated with the disorders of cytokines or messengers in KD patients.
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Affiliation(s)
- Ming-Guo Xu
- The Cardiovascular Center, Shen-Zhen Children's Hospital, No 7019, Yi Tian Rd, Fu Tian District, 518026 Shenzhen, China.
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13
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Ogata S, Ogihara Y, Nomoto K, Akiyama K, Nakahata Y, Sato K, Minoura K, Kokubo K, Kobayashi H, Ishii M. Clinical score and transcript abundance patterns identify Kawasaki disease patients who may benefit from addition of methylprednisolone. Pediatr Res 2009; 66:577-84. [PMID: 19680167 DOI: 10.1203/pdr.0b013e3181baa3c2] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Intravenous immunoglobulin (IVIG) treatment-resistant patients are high risk of developing coronary artery lesions with Kawasaki disease. The IVIG-responsive (Group A; n = 6) and IVIG-resistant patients (Group B) were predicted before starting the initial treatment using the Egami scoring system and randomly allocated as a single-IVIG treatment group (group B1; n = 6) or as a IVIG-plus-methylprednisolone (IVMP) combined therapy group (group B2; n = 5). We investigated the transcript abundance in the leukocytes of those patients using a microarray analysis. Five patients in group A and one patient in group B1 responded to initial IVIG treatment. All group B2 patients responded to IVIG-plus-IVMP combined therapy. Before performing these treatments, those transcripts related to IVIG resistance and to the development of coronary artery lesions, such as IL1R, IL18R, oncostatin M, suppressor of cytokine signaling-3, S100A12 protein, carcinoembryonic antigen-related cell adhesion molecule-1, matrix metallopeptidase-9, and polycythemia rubra vera-1, were more abundant in group B patients in comparison with group A patients. Moreover, those transcripts in group B2 patients were more profoundly and broadly suppressed than group B1 patients after treatment. This study elucidated the molecular mechanism of the effectiveness of IVIG-plus-IVMP combined therapy.
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Affiliation(s)
- Shohei Ogata
- Department of Pediatrics, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
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14
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15
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Popper SJ, Shimizu C, Shike H, Kanegaye JT, Newburger JW, Sundel RP, Brown PO, Burns JC, Relman DA. Gene-expression patterns reveal underlying biological processes in Kawasaki disease. Genome Biol 2008; 8:R261. [PMID: 18067656 PMCID: PMC2246263 DOI: 10.1186/gb-2007-8-12-r261] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2007] [Revised: 07/13/2007] [Accepted: 12/11/2007] [Indexed: 01/03/2023] Open
Abstract
Analysis of patterns of gene expression in peripheral blood from children with Kawasaki disease revealed dynamic and variable gene expression programs involving neutrophil activation and apoptosis. Background Kawasaki disease (KD) is an acute self-limited vasculitis and the leading cause of acquired heart disease in children in developed countries. No etiologic agent(s) has been identified, and the processes that mediate formation of coronary artery aneurysms and abatement of fever following treatment with intravenous immunoglobulin (IVIG) remain poorly understood. Results In an initial survey, we used DNA microarrays to examine patterns of gene expression in peripheral whole blood from 20 children with KD; each was sampled during the acute, subacute, and convalescent phases of the illness. Acute KD was characterized by increased relative abundance of gene transcripts associated with innate immune and proinflammatory responses and decreased abundance of transcripts associated with natural killer cells and CD8+ lymphocytes. There was significant temporal variation in transcript levels during the acute disease phase and stabilization thereafter. We confirmed these temporal patterns in a second cohort of 64 patients, and identified additional inter-individual differences in transcript abundance. Notably, higher levels of transcripts of the gene for carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) were associated with an increased percentage of unsegmented neutrophils, fewer days of illness, higher levels of C-reactive protein, and subsequent non-response to IVIG; this last association was confirmed by quantitative reverse transcription PCR in a third cohort of 33 patients, and was independent of day of illness. Conclusion Acute KD is characterized by dynamic and variable gene-expression programs that highlight the importance of neutrophil activation state and apoptosis in KD pathogenesis. Our findings also support the feasibility of extracting biomarkers associated with clinical prognosis from gene-expression profiles of individuals with systemic inflammatory illnesses.
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Affiliation(s)
- Stephen J Popper
- Departments of Microbiology and Immunology, and Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA.
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16
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Higman VA, Blundell CD, Mahoney DJ, Redfield C, Noble MEM, Day AJ. Plasticity of the TSG-6 HA-binding loop and mobility in the TSG-6-HA complex revealed by NMR and X-ray crystallography. J Mol Biol 2007; 371:669-84. [PMID: 17585936 DOI: 10.1016/j.jmb.2007.05.073] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2007] [Revised: 05/18/2007] [Accepted: 05/24/2007] [Indexed: 10/23/2022]
Abstract
Tumour necrosis factor-stimulated gene-6 (TSG-6) is a glycosaminoglycan-binding protein expressed during inflammatory and inflammation-like processes. Previously NMR structures were calculated for the Link module of TSG-6 (Link_TSG6) in its free state and when bound to an octasaccharide of hyaluronan (HA(8)). Heparin was found to compete for HA binding even though it interacts at a site that is distinct from the HA-binding surface. Here we present crystallography data on the free protein, and (15)N NMR relaxation data for the uncomplexed and HA(8)-bound forms of Link_TSG6. Although the Link module is comparatively rigid overall, the free protein shows a high degree of mobility in the beta4/beta5 loop and at the Cys47-Cys68 disulfide bond, both of which are regions involved in HA binding. When bound to HA(8), this dynamic behaviour is dampened, but not eliminated, suggesting a degree of dynamic matching between the protein and sugar that may decrease the entropic penalty of complex formation. A further highly dynamic residue is Lys54, which is distant from the HA-binding site, but was previously shown to be involved in heparin binding. When HA is bound, Lys54 becomes less mobile, providing evidence for an allosteric effect linking the HA and heparin-binding sites. A mechanism is suggested involving the beta2-strand and alpha2-helix. The crystal structure of free Link_TSG6 contains five molecules in the asymmetric unit that are highly similar to the NMR structure and support the dynamic behaviour seen near the HA-binding site: they show little or no electron density for the beta4/beta5 loop and display multiple conformations for the Cys47-Cys68 disulfide bond. The crystal structures were used in docking calculations with heparin. An extended interface between a Link_TSG6 dimer and heparin 11-mer was identified that is in excellent agreement with previous mutagenesis and calorimetric data, providing the basis for further investigation of this interaction.
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Affiliation(s)
- Victoria A Higman
- MRC Immunochemistry Unit, University of Oxford, South Parks Road, Oxford, OX1 3QU, UK
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17
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Sapan CV, Reisner HM, Lundblad RL. Antibody therapy (IVIG): evaluation of the use of genomics and proteomics for the study of immunomodulation therapeutics. Vox Sang 2007; 92:197-205. [PMID: 17348868 DOI: 10.1111/j.1423-0410.2006.00877.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND OBJECTIVES Intravenous immunoglobulin (IVIG) is used for an increasingly diverse number of therapeutic applications as an immunomodulation drug. Although it has demonstrated therapeutic effectiveness, the mechanism of action of IVIG in these disorders is poorly understood; this lack of understanding complicates rational clinical application and reimbursement for 'off-label' use. MATERIALS AND METHODS Selected literature on the clinical use of IVIG as an immunomodulation drug is reviewed. We present a brief description of DNA microarray and protein microarray technology and the application of such technologies to the study of immune system cells. The several studies on the application of DNA microarray technology to study gene expression in response to IVIG are presented. RESULTS There is increasing data on the use of DNA microarray and protein microarray technology to study gene expression in immune system cells including T cells, B cells, macrophages, and leucocytes. There is less information on the effect of IVIG on gene expression in immune system cells. However, there is sufficient information available to suggest that this is a practical approach with the caveat that such work will require careful experimental design and clear definition of the normal population. CONCLUSIONS DNA and protein microarray assays can be used to (i) provide rational indications for the clinical use of IVIG, (ii) provide for specific analysis of raw material and end product IVIG in screening for content related to immunomodulation, and (iii) accelerate the development of next generation products which would be more focused and/or targeted therapeutics.
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Affiliation(s)
- C V Sapan
- Department of Pathology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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Mazer BD, Al-Tamemi S, Yu JW, Hamid Q. Immune supplementation and immune modulation with intravenous immunoglobulin. J Allergy Clin Immunol 2005; 116:941-4. [PMID: 16210080 DOI: 10.1016/j.jaci.2005.07.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2005] [Revised: 07/26/2005] [Accepted: 07/27/2005] [Indexed: 11/27/2022]
MESH Headings
- DiGeorge Syndrome/therapy
- Guillain-Barre Syndrome/immunology
- Guillain-Barre Syndrome/therapy
- Humans
- Hypersensitivity, Immediate/immunology
- Hypersensitivity, Immediate/therapy
- Immunoglobulins, Intravenous/administration & dosage
- Immunoglobulins, Intravenous/therapeutic use
- Immunologic Deficiency Syndromes/immunology
- Immunologic Deficiency Syndromes/pathology
- Immunologic Deficiency Syndromes/therapy
- Mucocutaneous Lymph Node Syndrome/immunology
- Mucocutaneous Lymph Node Syndrome/pathology
- Mucocutaneous Lymph Node Syndrome/therapy
- Purpura, Thrombocytopenic, Idiopathic/immunology
- Purpura, Thrombocytopenic, Idiopathic/pathology
- Purpura, Thrombocytopenic, Idiopathic/therapy
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Affiliation(s)
- Bruce D Mazer
- Meakins Christie Laboratories, McGill University, Montreal, Canada
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Abe J, Jibiki T, Noma S, Nakajima T, Saito H, Terai M. Gene expression profiling of the effect of high-dose intravenous Ig in patients with Kawasaki disease. THE JOURNAL OF IMMUNOLOGY 2005; 174:5837-45. [PMID: 15843588 DOI: 10.4049/jimmunol.174.9.5837] [Citation(s) in RCA: 106] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Kawasaki disease (KD) is an acute vasculitis of infants and young children, preferentially affecting the coronary arteries. Intravenous infusion of high dose Ig (IVIG) effectively reduces systemic inflammation and prevents coronary artery lesions in KD. To investigate the mechanisms underlying the therapeutic effects of IVIG, we examined gene expression profiles of PBMC and purified monocytes obtained from acute patients before and after IVIG therapy. The results suggest that IVIG suppresses activated monocytes and macrophages by altering various functional aspects of the genes of KD patients. Among the 18 commonly decreased transcripts in both PBMC and purified monocytes, we selected six genes, FCGR1A, FCGR3A, CCR2, ADM, S100A9, and S100A12, and confirmed the microarray results by real-time RT-PCR. Moreover, the expressions of FcgammaRI and FcgammaRIII on monocytes were reduced after IVIG. Plasma S100A8/A9 heterocomplex, but not S100A9, levels were elevated in patients with acute KD compared with those in febrile controls. Furthermore, S100A8/A9 was rapidly down-regulated in response to IVIG therapy. Persistent elevation of S100A8/A9 after IVIG was found in patients who later developed coronary aneurysms. These results indicate that the effects of IVIG in KD may be mediated by suppression of an array of immune activation genes in monocytes, including those activating FcgammaRs and the S100A8/A9 heterocomplex.
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Affiliation(s)
- Jun Abe
- Department of Allergy and Immunology, National Research Institute for Child Health and Development, Tokyo, Japan.
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Mahoney DJ, Mulloy B, Forster MJ, Blundell CD, Fries E, Milner CM, Day AJ. Characterization of the interaction between tumor necrosis factor-stimulated gene-6 and heparin: implications for the inhibition of plasmin in extracellular matrix microenvironments. J Biol Chem 2005; 280:27044-55. [PMID: 15917224 DOI: 10.1074/jbc.m502068200] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
TSG-6, the secreted product of tumor necrosis factor-stimulated gene-6, is not constitutively expressed but is up-regulated in various cell-types during inflammatory and inflammation-like processes. The mature protein is comprised largely of contiguous Link and CUB modules, the former binding several matrix components such as hyaluronan (HA) and aggrecan. Here we show that this domain can also associate with the glycosaminoglycan heparin/heparan sulfate. Docking predictions and site-directed mutagenesis demonstrate that this occurs at a site distinct from the HA binding surface and is likely to involve extensive electrostatic contacts. Despite these glycosaminoglycans binding to non-overlapping sites on the Link module, the interaction of heparin can inhibit subsequent binding to HA, and it is possible that this occurs via an allosteric mechanism. We also show that heparin can modify another property of the Link module, i.e. its potentiation of the anti-plasmin activity of inter-alpha-inhibitor (IalphaI). Experiments using the purified components of IalphaI indicate that TSG-6 only binds to the bikunin chain and that this is at a site on the Link module that overlaps the HA binding surface. The association of heparin with the Link module significantly increases the anti-plasmin activity of the TSG-6.IalphaI complex. Changes in plasmin activity have been observed previously at sites of TSG-6 expression, and the results presented here suggest that TSG-6 is likely to contribute to matrix remodeling, at least in part, through down-regulation of the protease network, especially in locations containing heparin/heparan sulfate proteoglycans. The differential effects of HA and heparin on TSG-6 function provide a mechanism for its regulation and functional partitioning in particular tissue microenvironments.
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Affiliation(s)
- David J Mahoney
- Medical Research Council Immunochemistry Unit, University of Oxford, United Kingdom
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