Co-expression gene network analysis reveals novel regulatory pathways involved in porto-sinusoidal vascular disease

BACKGROUND & AIMS

Porto-sinusoidal vascular disease (PSVD) is a rare vascular liver disease of unknown etiology that causes portal hypertension. It usually affects young individuals and shortens live expectancy. The deregulated pathways involved in PSVD development are unknown and therefore we lack curative treatments. The purpose of this study was to integrate transcriptomic and clinical data by comprehensive network-based modeling in order to uncover altered biological processes in patients with PSVD.

METHODS

We obtained liver tissue samples from 20 consecutive patients with PSVD and 21 sex- and age-matched patients with cirrhosis and 13 histologically normal livers (HNL) (initial cohort) and performed transcriptomic analysis. Microarray data were analyzed using weighted gene correlation network analysis to identify clusters of highly correlated genes differently expressed in patients with PSVD. We next evaluated the molecular pathways enriched in patients with PSVD and the core-related genes from the most significantly enriched pathways in patients with PSVD. Our main findings were validated using RNA sequencing in a different cohort of PSVD, cirrhosis and HNL (n = 8 for each group).

RESULTS

Patients with PSVD have a distinctive genetic profile enriched mainly in canonical pathways involving hemostasis and coagulation but also lipid metabolism and oxidative phosphorylation. Serpin family (SERPINC1), the apolipoproteins (APOA, APOB, APOC), ATP synthases (ATP5G1, ATP5B), fibrinogen genes (FGB, FGA) and alpha-2-macroglobulin were identified as highly connective genes that may have an important role in PSVD pathogenesis.

CONCLUSION

PSVD has a unique transcriptomic profile and we have identified deregulation of pathways involved in vascular homeostasis as the main pathogenic event of disease development.

LAY SUMMARY

Porto-sinusoidal vascular disease is a rare but life-shortening disease that affects mainly young people. Knowledge of the disrupted pathways involved in its development will help to identify novel therapeutic targets and new treatments. Using a systems biology approach, we identify that pathways regulating endothelial function and tone may act as drivers of porto-sinusoidal vascular disease.

Sex work among men who have sex with men and transgender women in Bogotá

This qualitative study examined sex work among internally displaced male and transgender female sex workers in Bogotá, Colombia. Internal displacement has occurred in Colombia as a result of decades of conflict among armed groups and has created large-scale migration from rural to urban areas. Informed by the polymorphous model of sex work, which posits that contextual conditions shape the experience of sex work, we examined three main research questions. The first dealt with how internal displacement was related to the initiation of sex work; the second concerned the effect of agency on sex worker satisfaction; and the third examined how sex work in this context was related to HIV and other risks. Life history interviews were conducted with 26 displaced individuals who had done sex work: 14 were men who have sex with men and 12 were transgender women (natal males). Findings revealed that many participants began doing sex work in the period immediately after displacement, because of a lack of money, housing, and social support. HIV risk was greater during this time due to limited knowledge of HIV and inexperience negotiating safer sex with clients. Other findings indicated that sex workers who exerted more control and choice in the circumstances of their work reported greater satisfaction. In addition, we found that although many sex workers insisted on condom use with clients, several noted that they would sometimes have unprotected sex for additional money. Specific characteristics affecting the experience of sex work among the transgender women were also discussed.

Armed conflict, homonegativity and forced internal displacement: implications for HIV among Colombian gay, bisexual and transgender individuals

Colombia has endured six decades of civil unrest, population displacement and violence. We examined the relationships between contextual conditions, displacement and HIV among gay, bisexual and transgender individuals in Bogotá, Colombia. A total of 19 key informants provided information about internal displacement of sexual minorities. Life-history interviews were conducted with 42 participants aged 18 to 48 years and included questions about displacement experiences, sexual behaviour, life prior to displacement and participants' economic and social situation in Bogotá. The interplay of a variety of factors - including internal conflict and violence, homonegativity and 'social cleansing', gender and sexual identity and poverty - strongly shaped the varied experiences of displacement. Migration, sexual violence, exchange sex and low rates of HIV testing were risk factors that increased vulnerability for HIV in this displaced sample. Although displacement and HIV in Colombia are major problems, both are understudied.

[Experimental laparoscopic renal autograft as learning laparoscopic model]

INTRODUCTION

Laparoscopic surgery requires a long training period of time in which the complexity of the training is increased.

GOALS

The technique presented in this paper has been developed in order to find an experimental model that allows us to improve the learning of the vascular suture. Our main goal was to evaluate this technique as an experimental model for the vacular anastomosis, not to obtain a functional autotransplant. In this regard, here we summarize our experience during the first two cases performed.

MATERIAL AND METHODS

Laparoscopic renal autotransplant was perfomed in female lab pigs weighing 15-20 kg. International Experimental Animal Care rules were accomplished.

RESULTS

After sacrifizing the animals, only one case of vascular thrombosis was observed. The other cases showed normal arterial and venous flow.

CONCLUSIONS

Experimental Renal Laparoscopic autotransplant constitutes a good surgical model. We are trying to implement the technique in the clinics in the next future.

Retinopathy in haemoglobin C trait

Retinopathy associated with sickle-C and sickle cell disease is well described. Sickle trait and haemoglobin C trait are generally considered benign conditions, with infrequent systemic manifestations. Rare cases of retinopathy in sickle trait, in the presence of contributory factors, exist and we recently reported three such patients. The occurrence of retinopathy in haemoglobin C trait is even less well documented. Haemoglobin C does not cause red blood cell sickling but is known to decrease erythrocyte plasticity and increase blood viscosity. We report three cases in which haemoglobin C trait was associated with significant peripheral vascular occlusion and seafan formation (confirmed by fluorescein angiography) similar to that seen in sickle retinopathy. Two patients had coexistent systemic disease (hypertension and diabetes mellitus). Vitreous haemorrhage was the presenting feature in two patients. It is evident that haemoglobin C trait may be associated with sight-threatening complications.

Presumed occlusion of posterior ciliary arteries following central retinal vein decompression surgery

OBJECTIVE

Sectioning of the posterior scleral ring has been advocated in the treatment of central retinal vein occlusion. We reviewed cases in which this surgery apparently produced sectioning or closure of the short and long posterior ciliary arteries that resulted in a triangular area of choroidal ischemia and permanent chorioretinal lesions.

DESIGN

Case series.

SETTING

Clinic-based vitreoretinal referral practice.

PATIENTS

Four eyes of three patients whose ages ranged from 17 to 53 years underwent sectioning of the posterior scleral rings as treatment for central retinal vein occlusion.

MAIN OUTCOME MEASURES

Findings from complete ophthalmologic evaluation.

RESULTS

All patients had either an oval or a triangular area of choroidal ischemia nasal to the optic disc and had permanent chorioretinal lesions.

CONCLUSIONS

Valid basis for performing this operation requires further investigation.