ANCA相关性血管炎的心血管风险:单核细胞表型揭示血清学亚群之间的独特特征

IF 4.9 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Atherosclerosis Pub Date : 2024-08-10 DOI:10.1016/j.atherosclerosis.2024.118559
Yosta Vegting , Katie ML. Hanford , Aldo Jongejan , Gayle RS. Gajadin , Miranda Versloot , Nelly D. van der Bom-Baylon , Tamara Dekker , E. Lars Penne , Joost W. van der Heijden , Eline Houben , Frederike J. Bemelman , Annette E. Neele , Perry D. Moerland , Liffert Vogt , Jeffrey Kroon , Marc L. Hilhorst
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引用次数: 0

摘要

背景和目的抗中性粒细胞胞浆抗体(ANCA)相关性血管炎(AAV)与心血管风险增加有关,尤其是髓过氧化物酶AAV血清型(MPO-AAV)。单核细胞表型的不同改变可能会导致 AAV 患者动脉粥样硬化疾病的加速。使用大量 RNA 序列测定和流式细胞仪对单核细胞和单核细胞衍生巨噬细胞进行了广泛的表型分析。采用了反映单核细胞内在粘附和迁移能力的体外跨内皮迁移试验。结果单核细胞亚群分析表明,与健康对照组(HC)相比,活动性疾病期间经典单核细胞增多,而非经典单核细胞减少。RNA 序列分析显示,活动期 AAV 患者单核细胞中不同炎症通路和脂质代谢相关标记物的上调。在单核细胞固有的粘附和迁移能力方面未发现差异。与蛋白酶-3(PR3)-AAV相比,处于缓解期的MPO-AAV患者的单核细胞表达了与炎症、凝血、血小板结合和干扰素信号有关的基因,而PR3-AAV患者的单核细胞表达了表明急性炎症和单核细胞外渗的趋化因子受体(即CCR2和CCR5)。在疾病活动期,与 MPO-AAV 相比,PR3-AAV 与血清 CRP 升高和血小板计数增加有关。MPO-AAV 单核细胞与炎症基因的持续上调有关,而 PR3-AAV 单核细胞则表现出趋化因子受体的上调。这些分子变化可能在增加心血管风险以及 AAV 的潜在病理生理学中发挥作用。
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Cardiovascular risk in ANCA-associated vasculitis: Monocyte phenotyping reveals distinctive signatures between serological subsets

Background and aims

Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitides (AAV) is associated with an increased cardiovascular risk, particularly the myeloperoxidase AAV serotype (MPO-AAV). Distinct alterations in monocyte phenotypes may cause accelerated atherosclerotic disease in AAV.

Methods

A cohort including 43 AAV patients and 19 healthy controls was included for downstream analyses. Extensive phenotyping of monocytes and monocyte-derived macrophages was performed using bulk RNA-sequencing and flow cytometry. An in vitro transendothelial migration assay reflecting intrinsic adhesive and migratory capacities of monocytes was employed. Subsequent sub-analyses were performed to investigate differences between serological subtypes.

Results

Monocyte subset analysis showed increased classical monocytes during active disease, whereas non-classical monocytes were decreased compared to healthy controls (HC). RNA-sequencing revealed upregulation of distinct inflammatory pathways and lipid metabolism-related markers in monocytes of active AAV patients. No differences were detected in the intrinsic monocyte adhesion and migration capacity. Compared to proteinase-3(PR3)-AAV, monocytes of MPO-AAV patients in remission expressed genes related to inflammation, coagulation, platelet-binding and interferon signalling, whereas the expression of chemokine receptors indicative of acute inflammation and monocyte extravasation (i.e., CCR2 and CCR5) was increased in monocytes of PR3-AAV patients. During active disease, PR3-AAV was linked with elevated serum CRP and increased platelet counts compared to MPO-AAV.

Conclusions

These findings highlight changes in monocyte subset composition and activation, but not in the intrinsic migration capacity of AAV monocytes. MPO-AAV monocytes are associated with sustained upregulation of inflammatory genes, whereas PR3-AAV monocytes exhibit chemokine receptor upregulation. These molecular changes may play a role in elevating cardiovascular risk as well as in the underlying pathophysiology of AAV.

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来源期刊
Atherosclerosis
Atherosclerosis 医学-外周血管病
CiteScore
9.80
自引率
3.80%
发文量
1269
审稿时长
36 days
期刊介绍: Atherosclerosis has an open access mirror journal Atherosclerosis: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Atherosclerosis brings together, from all sources, papers concerned with investigation on atherosclerosis, its risk factors and clinical manifestations. Atherosclerosis covers basic and translational, clinical and population research approaches to arterial and vascular biology and disease, as well as their risk factors including: disturbances of lipid and lipoprotein metabolism, diabetes and hypertension, thrombosis, and inflammation. The Editors are interested in original or review papers dealing with the pathogenesis, environmental, genetic and epigenetic basis, diagnosis or treatment of atherosclerosis and related diseases as well as their risk factors.
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