title: Identification of candidate genes in scleroderma-related pulmonary arterial hypertension.
abstract: We hypothesize that pulmonary arterial hypertension (PAH)-associated genes identified by expression profiling of peripheral blood mononuclear cells (PBMCs) from patients with idiopathic pulmonary arterial hypertension (IPAH) can also be identified in PBMCs from scleroderma patients with PAH (PAH-SSc). Gene expression profiles of PBMCs collected from IPAH (n = 9), PAH-SSc (n = 10) patients, and healthy controls (n = 5) were generated using HG_U133A_2.0 GeneChips and were processed by the RMA/GCOS_1.4/SAM_1.21 data analysis pipeline. Disease severity in consecutive patients was assessed by functional status and hemodynamic measurements. The expression profiles were analyzed using PAH severity-stratification, and identified candidate genes were validated with real-time polymerase chain reaction (PCR). Transcriptomics of PBMCs from IPAH patients was highly comparable with that of PMBCs from PAH-SSc patients. The PBMC gene expression patterns significantly correlate with right atrium pressure (RA) and cardiac index (CI), which are known predictors of survival in PAH. Array stratification by RA and CI identified 364 PAH-associated candidate genes. Gene ontology (GO) analysis revealed significant (Z(score) > 1.96) alterations in angiogenesis genes according to PAH severity: matrix metalloproteinase 9 (MMP9) and vascular endothelial growth factor (VEGF) were significantly upregulated in mild as compared with severe PAH and healthy controls, as confirmed by real-time PCR. These data demonstrate that PBMCs from patients with PAH-SSc carry distinct transcriptional expression. Furthermore, our findings suggest an association between angiogenesis-related gene expression and severity of PAH in PAH-SSc patients. Deciphering the role of genes involved in vascular remodeling and PAH development may reveal new treatment targets for this devastating disorder.
authors: Division of Allergy and Clinical Immunology, Johns Hopkins University, Baltimore, MD 21224, USA.
authors: Dmitry N
authors: DN
authors: Grigoryev
authors: Stephen C
authors: SC
authors: Mathai
authors: Micah R
authors: MR
authors: Fisher
authors: Reda E
authors: RE
authors: Girgis
authors: Ari L
authors: AL
authors: Zaiman
authors: Traci
authors: T
authors: Housten-Harris
authors: Christopher
authors: C
authors: Cheadle
authors: Li
authors: L
authors: Gao
authors: Laura K
authors: LK
authors: Hummers
authors: Hunter C
authors: HC
authors: Champion
authors: Joe G N
authors: JG
authors: Garcia
authors: Fredrick M
authors: FM
authors: Wigley
authors: Rubin M
authors: RM
authors: Tuder
authors: Kathleen C
authors: KC
authors: Barnes
authors: Paul M
authors: PM
authors: Hassoun
mesh_terms: D000368:Aged; D005260:Female; D020869:Gene Expression Profiling; D020022:Genetic Predisposition to Disease; D006801:Humans; D006976:Hypertension, Pulmonary / Q000235:genetics*; D007963:Leukocytes, Mononuclear / Q000378:metabolism; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000235:genetics*; D008875:Middle Aged; D010865:Pilot Projects; D011651:Pulmonary Artery / Q000503:physiopathology; D012595:Scleroderma, Systemic / Q000235:genetics* / Q000503:physiopathology; D012720:Severity of Illness Index; D015854:Up-Regulation / Q000235:genetics; D042461:Vascular Endothelial Growth Factor A / Q000235:genetics*
chemical_list: D042461:Vascular Endothelial Growth Factor A; D020780:Matrix Metalloproteinase 9