Columbia University, New York, New York.
University of Pennsylvania, Philadelphia, Pennsylvania.
Physiol Genomics. 2020 Apr 1;52(4):191-199. doi: 10.1152/physiolgenomics.00104.2019. Epub 2020 Feb 24.
Aortic valve sclerosis is a highly prevalent, poorly characterized asymptomatic manifestation of calcific aortic valve disease and may represent a therapeutic target for disease mitigation. Human aortic valve cusps and blood were obtained from 333 patients undergoing cardiac surgery ( = 236 for severe aortic stenosis, = 35 for asymptomatic aortic valve sclerosis, = 62 for no valvular disease), and a multiplex assay was used to evaluate protein expression across the spectrum of calcific aortic valve disease. A subset of six valvular tissue samples ( = 3 for asymptomatic aortic valve sclerosis, = 3 for severe aortic stenosis) was used to create RNA sequencing profiles, which were subsequently organized into clinically relevant gene modules. RNA sequencing identified 182 protein-encoding, differentially expressed genes in aortic valve sclerosis vs. aortic stenosis; 85% and 89% of expressed genes overlapped in aortic stenosis and aortic valve sclerosis, respectively, which decreased to 55% and 84% when we targeted highly expressed genes. Bioinformatic analyses identified six differentially expressed genes encoding key extracellular matrix regulators: TBHS2, SPARC, COL1A2, COL1A1, SPP1, and CTGF. Differential expression of key circulating biomarkers of extracellular matrix reorganization was observed in control vs. aortic valve sclerosis (osteopontin), control vs. aortic stenosis (osteoprotegerin), and aortic valve sclerosis vs. aortic stenosis groups (MMP-2), which corresponded to valvular mRNA expression. We demonstrate distinct mRNA and protein expression underlying aortic valve sclerosis and aortic stenosis. We anticipate that extracellular matrix regulators can serve as circulating biomarkers of early calcific aortic valve disease and as novel targets for early disease mitigation, pending prospective clinical investigations.
主动脉瓣硬化是一种普遍存在但特征不明显的无症状性主动脉瓣钙化疾病表现,可能是疾病缓解的治疗靶点。我们从 333 例行心脏手术的患者中获取了主动脉瓣瓣叶和血液(=236 例严重主动脉瓣狭窄,=35 例无症状性主动脉瓣硬化,=62 例无瓣膜疾病),并使用多重分析方法评估了整个主动脉瓣钙化疾病谱中的蛋白表达情况。我们选择了 6 个瓣膜组织样本(=3 例无症状性主动脉瓣硬化,=3 例严重主动脉瓣狭窄)进行 RNA 测序分析,随后将其组织成与临床相关的基因模块。RNA 测序确定了主动脉瓣硬化与主动脉瓣狭窄相比有 182 个编码蛋白的差异表达基因;主动脉瓣狭窄和主动脉瓣硬化中分别有 85%和 89%的表达基因重叠,当我们针对高表达基因时,重叠率分别降至 55%和 84%。生物信息学分析确定了 6 个差异表达的基因,它们编码关键的细胞外基质调节因子:TBHS2、SPARC、COL1A2、COL1A1、SPP1 和 CTGF。在对照组与主动脉瓣硬化组(骨桥蛋白)、对照组与主动脉瓣狭窄组(骨保护素)以及主动脉瓣硬化与主动脉瓣狭窄组(基质金属蛋白酶-2)中观察到关键细胞外基质重构的循环生物标志物存在差异表达,这与瓣膜 mRNA 表达相对应。我们证明了主动脉瓣硬化和主动脉瓣狭窄的基础存在明显的 mRNA 和蛋白表达差异。我们预计细胞外基质调节因子可以作为早期主动脉瓣钙化疾病的循环生物标志物,并作为早期疾病缓解的新靶点,有待前瞻性临床研究。
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