1. Protein expression profiling suggests relevance of noncanonical pathways in isolated pulmonary embolism.
- Author
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Ten Cate V, Prochaska JH, Schulz A, Koeck T, Pallares Robles A, Lenz M, Eggebrecht L, Rapp S, Panova-Noeva M, Ghofrani HA, Meyer FJ, Espinola-Klein C, Lackner KJ, Michal M, Schuster AK, Strauch K, Zink AM, Laux V, Heitmeier S, Konstantinides SV, Münzel T, Andrade-Navarro MA, Leineweber K, and Wild PS
- Subjects
- Acute-Phase Proteins biosynthesis, Adult, Aged, Atherosclerosis complications, Comorbidity, Datasets as Topic, Female, Follow-Up Studies, Gene Expression Regulation, Glial Cell Line-Derived Neurotrophic Factor biosynthesis, Glial Cell Line-Derived Neurotrophic Factor genetics, Humans, Interferon-gamma biosynthesis, Interferon-gamma genetics, Interleukin-15 Receptor alpha Subunit biosynthesis, Interleukin-15 Receptor alpha Subunit genetics, Machine Learning, Male, Middle Aged, N-Acetylgalactosaminyltransferases biosynthesis, N-Acetylgalactosaminyltransferases genetics, Oxidative Stress, Prospective Studies, Protein Interaction Maps, Protein-Arginine Deiminase Type 2 biosynthesis, Protein-Arginine Deiminase Type 2 genetics, Pulmonary Embolism genetics, Pulmonary Embolism physiopathology, Pulmonary Surfactants, Quantitative Trait Loci, Venous Thromboembolism metabolism, Polypeptide N-acetylgalactosaminyltransferase, Proteome, Pulmonary Embolism metabolism, Transcriptome
- Abstract
Patients with isolated pulmonary embolism (PE) have a distinct clinical profile from those with deep vein thrombosis (DVT)-associated PE, with more pulmonary conditions and atherosclerosis. These findings suggest a distinct molecular pathophysiology and the potential involvement of alternative pathways in isolated PE. To test this hypothesis, data from 532 individuals from the Genotyping and Molecular Phenotyping of Venous ThromboEmbolism Project, a multicenter prospective cohort study with extensive biobanking, were analyzed. Targeted, high-throughput proteomics, machine learning, and bioinformatic methods were applied to contrast the acute-phase plasma proteomes of isolated PE patients (n = 96) against those of patients with DVT-associated PE (n = 276) or isolated DVT (n = 160). This resulted in the identification of shared molecular processes between PE phenotypes, as well as an isolated PE-specific protein signature. Shared processes included upregulation of inflammation, response to oxidative stress, and the loss of pulmonary surfactant. The isolated PE-specific signature consisted of 5 proteins: interferon-γ, glial cell line-derived neurotrophic growth factor, polypeptide N-acetylgalactosaminyltransferase 3, peptidyl arginine deiminase type-2, and interleukin-15 receptor subunit α. These proteins were orthogonally validated using cis protein quantitative trait loci. External replication in an independent population-based cohort (n = 5778) further validated the proteomic results and showed that they were prognostic for incident primary isolated PE in individuals without history of VTE (median time to event: 2.9 years; interquartile range: 1.6-4.2 years), supporting their possible involvement in the early pathogenesis. This study has identified molecular overlaps and differences between VTE phenotypes. In particular, the results implicate noncanonical pathways more commonly associated with respiratory and atherosclerotic disease in the acute pathophysiology of isolated PE., (© 2021 by The American Society of Hematology.)
- Published
- 2021
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