title: Refining molecular pathways leading to calcific aortic valve stenosis by studying gene expression profile of normal and calcified stenotic human aortic valves.
abstract: BACKGROUND
  Calcific aortic valve stenosis (AS) is a major societal and economic burden that is rising after the current shift toward an older population. Understanding the pathobiology of AS is crucial to implementing better preventive and therapeutic options. Research conducted during the past decade clearly points to active molecular and cellular processes involved in disease pathogenesis. However, no genomic approaches were used to identify genes and pathways that are differentially regulated in aortic valves of patients with and without AS.
  
  
  RESULTS
  A large-scale quantitative measurements of gene expression was performed on 5 normal and 5 AS valves using Affymetrix GeneChips. A total of 409 and 306 genes were significantly up- and downregulated in AS valves, respectively. The 2 most highly upregulated genes were matrix metalloproteinase 12 and chitinase 3-like 1. The upregulation of these 2 biologically relevant genes in AS was validated by real-time polymerase chain reaction in 38 aortic valves (12 normal and 26 AS). To provide a global biological validation of the whole-genome gene expression analysis, the microarray experiment was repeated in a second set of aortic valves with (n=5) or without (n=5) AS. There was an overrepresentation of small P values among genes claimed significant in the first microarray experiment. A total of 223 genes were replicated (P<0.05 and fold change >1.2), including matrix metalloproteinase 12 and chitinase 3-like 1.
  
  
  CONCLUSIONS
  This study reveals many unrecognized genes potentially implicated in the pathogenesis of AS. These new genes were overlaid on known pathological pathways leading to AS to refine our molecular understanding of this disease.
authors.affiliation: Institut universitaire de cardiologie et de pneumologie de Québec, Laval University, Pavillon Margeritte-d'Youville, Y4190, 2725, Chemin Sainte-Foy, Québec City, Québec, Canada. yohan.bosse@crhl.ulaval.ca
authors.forename: Yohan
authors.initials: Y
authors.lastname: Bossé
authors.forename: Ahmed
authors.initials: A
authors.lastname: Miqdad
authors.forename: Dominique
authors.initials: D
authors.lastname: Fournier
authors.forename: Andrée
authors.initials: A
authors.lastname: Pépin
authors.forename: Philippe
authors.initials: P
authors.lastname: Pibarot
authors.forename: Patrick
authors.initials: P
authors.lastname: Mathieu
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000378:metabolism* / Q000473:pathology; D001024:Aortic Valve Stenosis / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D002114:Calcinosis / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D020869:Gene Expression Profiling; D005786:Gene Expression Regulation; D006801:Humans; D008297:Male; D008875:Middle Aged; D020411:Oligonucleotide Array Sequence Analysis