Gene expression signatures, pathways and networks in carotid atherosclerosis
2016 (English)In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 279, no 3, 293-308 p.Article in journal (Refereed) PublishedText
BackgroundEmbolism from unstable atheromas in the carotid bifurcation is a major cause of stroke. Here, we analysed gene expression in endarterectomies from patients with symptomatic (S) and asymptomatic (AS) carotid stenosis to identify pathways linked to plaque instability. MethodsMicroarrays were prepared from plaques (n = 127) and peripheral blood samples (n = 96) of S and AS patients. Gene set enrichment, pathway mapping and network analyses of differentially expressed genes were performed. ResultsThese studies revealed upregulation of haemoglobin metabolism (P = 2.20E-05) and bone resorption (P = 9.63E-04) in S patients. Analysis of subgroups of patients indicated enrichment of calcification and osteoblast differentiation in S patients on statins, as well as inflammation and apoptosis in plaques removed >1 month compared to <2 weeks after symptom. By prediction profiling, a panel of 30 genes, mostly transcription factors, discriminated between plaques from S versus AS patients with 78% accuracy. By meta-analysis, common gene networks associated with atherosclerosis mapped to hypoxia, chemokines, calcification, actin cytoskeleton and extracellular matrix. A set of dysregulated genes (LMOD1, SYNPO2, PLIN2 and PPBP) previously not described in atherosclerosis were identified from microarrays and validated by quantitative PCR and immunohistochemistry. ConclusionsOur findings confirmed a central role for inflammation and proteases in plaque instability, and highlighted haemoglobin metabolism and bone resorption as important pathways. Subgroup analysis suggested prolonged inflammation following the symptoms of plaque instability and calcification as a possible stabilizing mechanism by statins. In addition, transcriptional regulation may play an important role in the determination of plaque phenotype. The results from this study will serve as a basis for further exploration of molecular signatures in carotid atherosclerosis.
Place, publisher, year, edition, pages
Wiley-Blackwell, 2016. Vol. 279, no 3, 293-308 p.
atherosclerosis, carotid plaques, gene expression, microarrays
Other Clinical Medicine
IdentifiersURN: urn:nbn:se:kth:diva-184542DOI: 10.1111/joim.12448ISI: 000371617800008PubMedID: 26620734ScopusID: 2-s2.0-84958933712OAI: oai:DiVA.org:kth-184542DiVA: diva2:917339
FunderSwedish Research Council, K2009-65X-2233-01-3, K2013-65X-06816-30-4, 349-2007-8703Swedish Heart Lung FoundationScience for Life Laboratory - a national resource center for high-throughput molecular bioscience
QC 201604062016-04-062016-04-012016-04-06Bibliographically approved