TEDA International Cardiovascular Hospital, Tianjin and The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.
TEDA International Cardiovascular Hospital, Tianjin, China.
Ann Thorac Surg. 2014 Apr;97(4):1414-9. doi: 10.1016/j.athoracsur.2013.11.069. Epub 2014 Feb 22.
Congenital heart disease (CHD) is the most common birth defect in newborns. Plasma proteins may serve as indicators of disease and are a rich source for biomarker discovery, but little has been studied in CHD. We examined the hypothesis that plasma proteins may be altered and related to the pathologic changes of CHD.
Differential protein analysis was performed in the plasma of patients with tetralogy of Fallot, isolated ventricular septal defect, and normal controls by using two-dimensional electrophoresis and mass spectrometry. Candidate proteins that might be related to disease processes were further confirmed by enzyme-linked immunosorbent assay in the new samples (n=40).
Identified were 18 differentially expressed protein spots and 10 corresponding proteins or polypeptides. Among those, 2 downregulated proteins, gelsolin, ficolin-3, with significant clinical relevance, were further analyzed for validation. The plasma levels of gelsolin (76.30±4.42 vs 131.80±23.46 μg/mL in control; p=0.025, n=40 in each group) and ficolin-3 (4.93±0.36 vs 10.58±1.58 μg/mL in control; p=0.001, n=40 in each group) in tetralogy patients were significantly lower than those in normal controls. The ficolin-3 plasma level was also lower in the patients with isolated VSD (5.55±0.34 vs 10.58±1.58 μg/mL in control μg/mL; p=0.003, n=40 in each group).
We used proteomic methods to demonstrate for the first time the plasma protein changes in CHD patients that may reveal the possible mechanisms for the prolonged bleeding time in tetralogy patients and the susceptibility to pulmonary infections in patients with CHDs. These findings have strong clinical implications.
先天性心脏病(CHD)是新生儿中最常见的出生缺陷。血浆蛋白可以作为疾病的指标,是生物标志物发现的丰富来源,但在 CHD 中研究甚少。我们检验了这样一个假说,即血浆蛋白可能发生改变,并与 CHD 的病理变化有关。
采用二维电泳和质谱技术对法洛四联症、单纯室间隔缺损及正常对照患者的血浆进行差异蛋白分析。在新样本(n=40)中通过酶联免疫吸附试验进一步验证可能与疾病过程相关的候选蛋白。
鉴定出 18 个差异表达的蛋白斑点和 10 个相应的蛋白或多肽。其中,2 个下调蛋白,即有重要临床意义的凝胶蛋白和 ficolin-3,进一步进行了验证分析。法洛四联症患者的血浆凝胶蛋白(76.30±4.42 比对照组 131.80±23.46 μg/mL;p=0.025,每组 n=40)和 ficolin-3(4.93±0.36 比对照组 10.58±1.58 μg/mL;p=0.001,每组 n=40)水平明显降低。单纯室间隔缺损患者的 ficolin-3 血浆水平也较低(5.55±0.34 比对照组 10.58±1.58 μg/mL;p=0.003,每组 n=40)。
我们首次用蛋白质组学方法证明了 CHD 患者的血浆蛋白变化,这可能揭示了法洛四联症患者出血时间延长和 CHD 患者易发生肺部感染的可能机制。这些发现具有很强的临床意义。