Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania.
Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Shock. 2018 Jul;50(1):53-59. doi: 10.1097/SHK.0000000000001029.
We have previously reported evidence that Black individuals appear to have a significantly higher incidence of infection-related hospitalizations compared with White individuals. It is possible that the host immune response is responsible for this vital difference. In support of such a hypothesis, the aim of this study was to determine whether Black and White individuals exhibit differential whole blood gene network activation.
We examined whole blood network activation in a subset of patients (n = 22 pairs, propensity score matched (1:1) Black and White patients) with community-acquired pneumonia (CAP) from the Genetic and Inflammatory Markers of Sepsis study. We employed day one whole blood transcriptomic data generated from this cohort and constructed co-expression graphs for each racial group. Pearson correlation coefficients were used to weight edges. Spectral thresholding was applied to ascribe significance. Innovative graph theoretical methods were then invoked to detect densely connected gene networks and provide differential structural analysis.
Propensity matching was employed to reduce potential bias due to confounding variables. Although Black and White patients had similar socio- and clinical demographics, we identified novel differences in molecular network activation-dense subgraphs known as paracliques that displayed complete gene connection for both White (three paracliques) and Black patients (one paraclique). Specifically, the genes that comprised the paracliques in the White patients include circadian loop, cell adhesion, mobility, proliferation, tumor suppression, NFκB, and chemokine signaling. However, the genes that comprised the paracliques in the Black patients include DNA and messenger RNA processes, and apoptosis signaling. We investigated the distribution of Black paracliques across White paracliques. Black patients had five paracliques (with almost complete connection) comprised of genes that are critical for host immune response widely distributed across 22 parcliques in the White population. Anchoring the analysis on two critical inflammatory mediators, interleukin (IL)-6 and IL-10 identified further differential network activation among the White and Black patient populations.
These results demonstrate that, at the molecular level, Black and White individuals may experience different activation patterns with CAP. Further validation of the gene networks we have identified may help pinpoint genetic factors that increase host susceptibility to community-acquired pneumonia, and may lay the groundwork for personalized management of CAP.
我们之前的研究表明,与白人相比,黑人个体似乎更容易因感染而住院。这可能是由于宿主免疫反应所致。为支持这一假说,本研究旨在确定黑人与白人个体是否存在全血基因网络激活的差异。
我们检测了来自社区获得性肺炎(CAP)遗传和炎症标志物研究(Genetic and Inflammatory Markers of Sepsis study)的患者亚组(n=22 对,按倾向评分 1:1 匹配的黑人和白人患者)的全血网络激活情况。我们使用了从该队列中生成的第一天全血转录组数据,并为每个种族群体构建了共表达图。使用 Pearson 相关系数来加权边。应用谱阈值赋予显著性。然后调用创新的图论方法来检测密集连接的基因网络并提供差异结构分析。
采用倾向评分匹配以减少混杂变量引起的潜在偏倚。尽管黑人和白人患者具有相似的社会和临床特征,但我们在分子网络激活的密集子图(称为旁区)中发现了新的差异,这些旁区显示了白人和黑人患者的完全基因连接(白人有三个旁区,黑人有一个旁区)。具体而言,构成白人旁区的基因包括昼夜节律环、细胞黏附、迁移、增殖、肿瘤抑制、NFκB 和趋化因子信号。然而,构成黑人旁区的基因包括 DNA 和信使 RNA 过程和细胞凋亡信号。我们研究了黑人旁区在白人旁区中的分布。黑人患者有五个旁区(几乎完全连接),包含宿主免疫反应的关键基因,广泛分布于白人人群的 22 个旁区中。以白细胞介素(IL)-6 和 IL-10 这两个关键炎症介质为分析锚点,进一步确定了白人患者和黑人患者群体之间的差异网络激活。
这些结果表明,在分子水平上,黑人与白人个体在患 CAP 时可能经历不同的激活模式。对我们鉴定的基因网络的进一步验证可能有助于确定增加宿主对社区获得性肺炎易感性的遗传因素,并为 CAP 的个体化管理奠定基础。