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Szydełko J, Czop M, Petniak A, Lenart-Lipińska M, Kocki J, Zapolski T, Matyjaszek-Matuszek B. Identification of plasma miR-4505, miR-4743-5p and miR-4750-3p as novel diagnostic biomarkers for coronary artery disease in patients with type 2 diabetes mellitus: a case-control study. Cardiovasc Diabetol 2024; 23:278. [PMID: 39080630 PMCID: PMC11287982 DOI: 10.1186/s12933-024-02374-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Accepted: 07/23/2024] [Indexed: 08/03/2024] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD) are commonly coexisting clinical entities with still growing incidence worldwide. Recently, circulating microRNAs (miRNAs) have emerged as novel molecular players in cardiometabolic diseases. This study aimed to identify a specific miRNA signature as a candidate biomarker for CAD in T2DM and to delineate potential miRNA-dependent mechanisms contributing to diabetic atherosclerosis. METHODS A total of 38 plasma samples from T2DM patients with and without CAD, CAD patients and healthy controls were collected for expression profiling of 2,578 miRNAs using microarrays. To investigate the regulatory role of differentially expressed (DE)-miRNA target genes, functional annotation and pathway enrichment analyses were performed utilizing multiple bioinformatics tools. Then, protein-protein interaction networks were established leveraging the STRING database in Cytoscape software, followed by cluster analysis and hub gene identification. Reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) was carried out for microarray data validation in the larger replication cohort of 94 participants. Receiver operating characteristic analysis was applied to evaluate the diagnostic values of miRNAs. Multivariate logistic regression analysis was used to develop miRNA-based diagnostic models. RESULTS In the discovery stage, overexpression of hsa-miR-4505, hsa-miR-4743-5p, hsa-miR-6846-5p, and down-regulation of hsa-miR-3613-3p, hsa-miR-4668-5p, hsa-miR-4706, hsa-miR-6511b-5p, hsa-miR-6750-5p, hsa-miR-4750-3p, hsa-miR-320e, hsa-miR-4717-3p, hsa-miR-7850-5p were detected in T2DM-CAD patients. The DE-miRNA target genes were significantly enriched in calcium ion binding, regulation of actin cytoskeleton, and gene expression. hsa-miR-4505, hsa-miR-4743-5p, and hsa-miR-4750-3p were found to be involved in fatty acid metabolism, leukocyte transendothelial migration, and neurotrophin signaling pathway. Dysregulation of hsa-miR-4505, hsa-miR-4743-5p, and hsa-miR-4750-3p in T2DM-CAD patients compared with T2DM subjects and controls (all p < 0.001) was further confirmed by RT-qPCR. All validated miRNAs demonstrated good discriminatory values for T2DM-CAD (AUC = 0.833-0.876). The best performance in detecting CAD in T2DM was achieved for a combination of three miRNAs (AUC = 0.959, 100% sensitivity, 86.67% specificity). CONCLUSIONS Our study revealed a unique profile of plasma-derived miRNAs in T2DM patients with CAD. Potential miRNA-regulated pathways were also identified, exploring the underlying pathogenesis of CAD in T2DM. We developed a specific three-miRNA panel of hsa-miR-4505, hsa-miR-4743-5p and hsa-miR-4750-3p, that could serve as a novel non-invasive biomarker for CAD in patients with T2DM.
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Affiliation(s)
- Joanna Szydełko
- Department of Endocrinology, Diabetology and Metabolic Diseases, Medical University of Lublin, Jaczewskiego 8, 20-090, Lublin, Poland.
| | - Marcin Czop
- Department of Clinical Genetics, Medical University of Lublin, Radziwillowska 11, 20-080, Lublin, Poland
| | - Alicja Petniak
- Department of Clinical Genetics, Medical University of Lublin, Radziwillowska 11, 20-080, Lublin, Poland
| | - Monika Lenart-Lipińska
- Department of Endocrinology, Diabetology and Metabolic Diseases, Medical University of Lublin, Jaczewskiego 8, 20-090, Lublin, Poland
| | - Janusz Kocki
- Department of Clinical Genetics, Medical University of Lublin, Radziwillowska 11, 20-080, Lublin, Poland
| | - Tomasz Zapolski
- Department of Cardiology, Medical University of Lublin, Jaczewskiego 8, 20-090, Lublin, Poland
| | - Beata Matyjaszek-Matuszek
- Department of Endocrinology, Diabetology and Metabolic Diseases, Medical University of Lublin, Jaczewskiego 8, 20-090, Lublin, Poland
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Jankauskas SS, Mone P, Avvisato R, Varzideh F, De Gennaro S, Salemme L, Macina G, Kansakar U, Cioppa A, Frullone S, Gambardella J, Di Mauro M, Tesorio T, Santulli G. miR-181c targets Parkin and SMAD7 in human cardiac fibroblasts: Validation of differential microRNA expression in patients with diabetes and heart failure with preserved ejection fraction. Mech Ageing Dev 2023; 212:111818. [PMID: 37116731 DOI: 10.1016/j.mad.2023.111818] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 04/15/2023] [Accepted: 04/19/2023] [Indexed: 04/30/2023]
Abstract
BACKGROUND Cardiac fibrosis represents a key feature in the pathophysiology of heart failure with preserved ejection fraction (HFpEF), a condition highly prevalent amongst geriatric patients, especially if diabetic. The microRNA miR-181c has been shown to be associated with the response to exercise training in HFpEF patients and has been also linked to diabetic cardiovascular complications. However, the underlying mechanisms have not been fully elucidated. OBJECTIVE To measure circulating miR-181c in elderly patients with HFpEF and DM and identify gene targets pathophysiologically relevant in HFpEF. METHODS We quantified circulating miR-181c in frail older adults with a confirmed diagnosis of HFpEF and diabetes, and, as control, we enrolled age-matched subjects without HFpEF and without diabetes. We validated in human cardiac fibroblasts the molecular mechanisms linking miR-181c to a pro-fibrotic response. RESULTS 51 frail patients were included (34 patients with diabetes and HFpEF and 17 age-matched controls. We observed that miR-181c was significantly upregulated (p<0.0001) in HFpEF patients vs controls. We confirmed in vitro that miR-181c is targeting PRKN and SMAD7. CONCLUSIONS We demonstrate that miR-181c levels are significantly increased in frail elderly adults with diabetes and HFpEF and that miR-181c targets PRKN and SMAD7 in human cardiac fibroblasts.
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Affiliation(s)
- Stanislovas S Jankauskas
- Department of Medicine, Einstein Institute for Aging Research, Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, New York, NY 10461, USA
| | - Pasquale Mone
- Department of Medicine, Einstein Institute for Aging Research, Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, New York, NY 10461, USA; ASL Avellino, Avellino, 83100, Italy
| | - Roberta Avvisato
- Department of Medicine, Einstein Institute for Aging Research, Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, New York, NY 10461, USA
| | - Fahimeh Varzideh
- Department of Medicine, Einstein Institute for Aging Research, Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, New York, NY 10461, USA
| | | | - Luigi Salemme
- Casa di Cura "Montevergine", Mercogliano (Avellino), 83013, Italy
| | | | - Urna Kansakar
- Department of Medicine, Einstein Institute for Aging Research, Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, New York, NY 10461, USA
| | - Angelo Cioppa
- Casa di Cura "Montevergine", Mercogliano (Avellino), 83013, Italy
| | | | - Jessica Gambardella
- Department of Molecular Pharmacology, Fleischer Institute for Diabetes and Metabolism (FIDAM), Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Einstein Institute for Neuroimmunology and Inflammation (INI), Albert Einstein College of Medicine, New York, NY 10461, USA
| | | | - Tullio Tesorio
- Casa di Cura "Montevergine", Mercogliano (Avellino), 83013, Italy
| | - Gaetano Santulli
- Department of Medicine, Einstein Institute for Aging Research, Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, New York, NY 10461, USA; Department of Molecular Pharmacology, Fleischer Institute for Diabetes and Metabolism (FIDAM), Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Einstein Institute for Neuroimmunology and Inflammation (INI), Albert Einstein College of Medicine, New York, NY 10461, USA.
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Mone P, Lombardi A, Kansakar U, Varzideh F, Jankauskas SS, Pansini A, Marzocco S, De Gennaro S, Famiglietti M, Macina G, Frullone S, Santulli G. Empagliflozin Improves the MicroRNA Signature of Endothelial Dysfunction in Patients with Heart Failure with Preserved Ejection Fraction and Diabetes. J Pharmacol Exp Ther 2023; 384:116-122. [PMID: 36549862 PMCID: PMC9827502 DOI: 10.1124/jpet.121.001251] [Citation(s) in RCA: 44] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 04/29/2022] [Accepted: 06/06/2022] [Indexed: 01/12/2023] Open
Abstract
Endothelial dysfunction represents a key mechanism underlying heart failure with preserved ejection fraction (HFpEF), diabetes mellitus (DM), and frailty. However, reliable biomarkers to monitor endothelial dysfunction in these patients are lacking. In this study, we evaluated the expression of a panel of circulating microRNAs (miRs) involved in the regulation of endothelial function in a population of frail older adults with HFpEF and DM treated for 3 months with empagliflozin, metformin, or insulin. We identified a distinctive pattern of miRs that were significantly regulated in HFpEF patients compared to healthy controls and to HFpEF patients treated with the sodium glucose cotransporter 2 (SGLT2) inhibitor empagliflozin. Three miRs were significantly downregulated (miR-126, miR-342-3p, and miR-638) and two were significantly upregulated (miR-21 and miR-92) in HFpEF patients compared to healthy controls. Strikingly, two of these miRs (miR-21 and miR-92) were significantly reduced in HFpEF patients after the 3-month treatment with empagliflozin, whereas no significant differences in the profile of endothelial miRs were detected in patients treated with metformin or insulin. Taken together, our findings demonstrate for the first time that specific circulating miRs involved in the regulation of endothelial function are significantly regulated in frail HFpEF patients with DM and in response to SGLT2 inhibition. SIGNIFICANCE STATEMENT: We have identified a novel microRNA signature functionally involved in the regulation of endothelial function that is significantly regulated in frail patients with HFpEF and diabetes. Moreover, the treatment with the SGLT2 inhibitor empagliflozin caused a modification of some of these microRNAs in a direction that was opposite to what observed in HFpEF patients, indicating a rescue of endothelial function. Our findings are relevant for clinical practice inasmuch as we were able to establish novel biomarkers of disease and response to therapy.
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Affiliation(s)
- Pasquale Mone
- Department of Medicine, Fleischer Institute for Diabetes and Metabolism (FIDAM), Einstein Institute for Aging Research, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Albert Einstein College of Medicine, New York City, New York (P.M., A.L., U.K., F.V., S.S.J., G.S.); Azienda Sanitaria Locale (ASL) Avellino, Avellino, Italy (P.M., A.P., S.D.G., M.F., G.M., S.F.); University of Salerno, Fisciano, Italy (S.M.); International Translational Research and Medical Education Consortium (ITME) and Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy (G.S.); and Department of Molecular Pharmacology, Wilf Family Cardiovascular Research Institute, Institute for Neuroimmunology and Inflammation, Albert Einstein College of Medicine, New York City, New York (U.K., F.V., S.S.J., G.S.)
| | - Angela Lombardi
- Department of Medicine, Fleischer Institute for Diabetes and Metabolism (FIDAM), Einstein Institute for Aging Research, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Albert Einstein College of Medicine, New York City, New York (P.M., A.L., U.K., F.V., S.S.J., G.S.); Azienda Sanitaria Locale (ASL) Avellino, Avellino, Italy (P.M., A.P., S.D.G., M.F., G.M., S.F.); University of Salerno, Fisciano, Italy (S.M.); International Translational Research and Medical Education Consortium (ITME) and Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy (G.S.); and Department of Molecular Pharmacology, Wilf Family Cardiovascular Research Institute, Institute for Neuroimmunology and Inflammation, Albert Einstein College of Medicine, New York City, New York (U.K., F.V., S.S.J., G.S.)
| | - Urna Kansakar
- Department of Medicine, Fleischer Institute for Diabetes and Metabolism (FIDAM), Einstein Institute for Aging Research, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Albert Einstein College of Medicine, New York City, New York (P.M., A.L., U.K., F.V., S.S.J., G.S.); Azienda Sanitaria Locale (ASL) Avellino, Avellino, Italy (P.M., A.P., S.D.G., M.F., G.M., S.F.); University of Salerno, Fisciano, Italy (S.M.); International Translational Research and Medical Education Consortium (ITME) and Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy (G.S.); and Department of Molecular Pharmacology, Wilf Family Cardiovascular Research Institute, Institute for Neuroimmunology and Inflammation, Albert Einstein College of Medicine, New York City, New York (U.K., F.V., S.S.J., G.S.)
| | - Fahimeh Varzideh
- Department of Medicine, Fleischer Institute for Diabetes and Metabolism (FIDAM), Einstein Institute for Aging Research, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Albert Einstein College of Medicine, New York City, New York (P.M., A.L., U.K., F.V., S.S.J., G.S.); Azienda Sanitaria Locale (ASL) Avellino, Avellino, Italy (P.M., A.P., S.D.G., M.F., G.M., S.F.); University of Salerno, Fisciano, Italy (S.M.); International Translational Research and Medical Education Consortium (ITME) and Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy (G.S.); and Department of Molecular Pharmacology, Wilf Family Cardiovascular Research Institute, Institute for Neuroimmunology and Inflammation, Albert Einstein College of Medicine, New York City, New York (U.K., F.V., S.S.J., G.S.)
| | - Stanislovas S Jankauskas
- Department of Medicine, Fleischer Institute for Diabetes and Metabolism (FIDAM), Einstein Institute for Aging Research, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Albert Einstein College of Medicine, New York City, New York (P.M., A.L., U.K., F.V., S.S.J., G.S.); Azienda Sanitaria Locale (ASL) Avellino, Avellino, Italy (P.M., A.P., S.D.G., M.F., G.M., S.F.); University of Salerno, Fisciano, Italy (S.M.); International Translational Research and Medical Education Consortium (ITME) and Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy (G.S.); and Department of Molecular Pharmacology, Wilf Family Cardiovascular Research Institute, Institute for Neuroimmunology and Inflammation, Albert Einstein College of Medicine, New York City, New York (U.K., F.V., S.S.J., G.S.)
| | - Antonella Pansini
- Department of Medicine, Fleischer Institute for Diabetes and Metabolism (FIDAM), Einstein Institute for Aging Research, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Albert Einstein College of Medicine, New York City, New York (P.M., A.L., U.K., F.V., S.S.J., G.S.); Azienda Sanitaria Locale (ASL) Avellino, Avellino, Italy (P.M., A.P., S.D.G., M.F., G.M., S.F.); University of Salerno, Fisciano, Italy (S.M.); International Translational Research and Medical Education Consortium (ITME) and Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy (G.S.); and Department of Molecular Pharmacology, Wilf Family Cardiovascular Research Institute, Institute for Neuroimmunology and Inflammation, Albert Einstein College of Medicine, New York City, New York (U.K., F.V., S.S.J., G.S.)
| | - Stefania Marzocco
- Department of Medicine, Fleischer Institute for Diabetes and Metabolism (FIDAM), Einstein Institute for Aging Research, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Albert Einstein College of Medicine, New York City, New York (P.M., A.L., U.K., F.V., S.S.J., G.S.); Azienda Sanitaria Locale (ASL) Avellino, Avellino, Italy (P.M., A.P., S.D.G., M.F., G.M., S.F.); University of Salerno, Fisciano, Italy (S.M.); International Translational Research and Medical Education Consortium (ITME) and Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy (G.S.); and Department of Molecular Pharmacology, Wilf Family Cardiovascular Research Institute, Institute for Neuroimmunology and Inflammation, Albert Einstein College of Medicine, New York City, New York (U.K., F.V., S.S.J., G.S.)
| | - Stefano De Gennaro
- Department of Medicine, Fleischer Institute for Diabetes and Metabolism (FIDAM), Einstein Institute for Aging Research, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Albert Einstein College of Medicine, New York City, New York (P.M., A.L., U.K., F.V., S.S.J., G.S.); Azienda Sanitaria Locale (ASL) Avellino, Avellino, Italy (P.M., A.P., S.D.G., M.F., G.M., S.F.); University of Salerno, Fisciano, Italy (S.M.); International Translational Research and Medical Education Consortium (ITME) and Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy (G.S.); and Department of Molecular Pharmacology, Wilf Family Cardiovascular Research Institute, Institute for Neuroimmunology and Inflammation, Albert Einstein College of Medicine, New York City, New York (U.K., F.V., S.S.J., G.S.)
| | - Michele Famiglietti
- Department of Medicine, Fleischer Institute for Diabetes and Metabolism (FIDAM), Einstein Institute for Aging Research, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Albert Einstein College of Medicine, New York City, New York (P.M., A.L., U.K., F.V., S.S.J., G.S.); Azienda Sanitaria Locale (ASL) Avellino, Avellino, Italy (P.M., A.P., S.D.G., M.F., G.M., S.F.); University of Salerno, Fisciano, Italy (S.M.); International Translational Research and Medical Education Consortium (ITME) and Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy (G.S.); and Department of Molecular Pharmacology, Wilf Family Cardiovascular Research Institute, Institute for Neuroimmunology and Inflammation, Albert Einstein College of Medicine, New York City, New York (U.K., F.V., S.S.J., G.S.)
| | - Gaetano Macina
- Department of Medicine, Fleischer Institute for Diabetes and Metabolism (FIDAM), Einstein Institute for Aging Research, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Albert Einstein College of Medicine, New York City, New York (P.M., A.L., U.K., F.V., S.S.J., G.S.); Azienda Sanitaria Locale (ASL) Avellino, Avellino, Italy (P.M., A.P., S.D.G., M.F., G.M., S.F.); University of Salerno, Fisciano, Italy (S.M.); International Translational Research and Medical Education Consortium (ITME) and Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy (G.S.); and Department of Molecular Pharmacology, Wilf Family Cardiovascular Research Institute, Institute for Neuroimmunology and Inflammation, Albert Einstein College of Medicine, New York City, New York (U.K., F.V., S.S.J., G.S.)
| | - Salvatore Frullone
- Department of Medicine, Fleischer Institute for Diabetes and Metabolism (FIDAM), Einstein Institute for Aging Research, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Albert Einstein College of Medicine, New York City, New York (P.M., A.L., U.K., F.V., S.S.J., G.S.); Azienda Sanitaria Locale (ASL) Avellino, Avellino, Italy (P.M., A.P., S.D.G., M.F., G.M., S.F.); University of Salerno, Fisciano, Italy (S.M.); International Translational Research and Medical Education Consortium (ITME) and Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy (G.S.); and Department of Molecular Pharmacology, Wilf Family Cardiovascular Research Institute, Institute for Neuroimmunology and Inflammation, Albert Einstein College of Medicine, New York City, New York (U.K., F.V., S.S.J., G.S.)
| | - Gaetano Santulli
- Department of Medicine, Fleischer Institute for Diabetes and Metabolism (FIDAM), Einstein Institute for Aging Research, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Albert Einstein College of Medicine, New York City, New York (P.M., A.L., U.K., F.V., S.S.J., G.S.); Azienda Sanitaria Locale (ASL) Avellino, Avellino, Italy (P.M., A.P., S.D.G., M.F., G.M., S.F.); University of Salerno, Fisciano, Italy (S.M.); International Translational Research and Medical Education Consortium (ITME) and Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy (G.S.); and Department of Molecular Pharmacology, Wilf Family Cardiovascular Research Institute, Institute for Neuroimmunology and Inflammation, Albert Einstein College of Medicine, New York City, New York (U.K., F.V., S.S.J., G.S.)
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