1
|
Li Y, Qian J, Dong X, Zhao J, Wang Q, Wang Y, Zeng X, Tian Z, Li M. The prognosis and management of reclassified systemic lupus erythematosus associated pulmonary arterial hypertension according to 2022 ESC/ERS guidelines. Arthritis Res Ther 2024; 26:109. [PMID: 38802957 DOI: 10.1186/s13075-024-03338-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/06/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND AND AIMS The 2022 European Society of Cardiology/European Respiratory Society (ESC/ERS) guideline has recently revised the hemodynamic definition of pulmonary arterial hypertension. However, there is currently limited research on the prognosis and treatment of system lupus erythematosus-associated pulmonary arterial hypertension (SLE-PAH) patients that have been reclassified by the new hemodynamic definition. This study aims to analyze the prognosis of newly reclassified SLE-PAH patients and provide recommendations for the management strategy. METHODS This retrospective study analyzed records of 236 SLE-PAH patients who visited Peking Union Medical College Hospital (PUMCH) from 2011 to 2023, among whom 22 patients were reclassified into mild SLE-PAH (mean pulmonary arterial pressure (mPAP) of 21-24 mmHg, pulmonary vascular resistance (PVR) of 2-3 WU, and PAWP ≤ 15 mmHg) according to the guidelines and 14 were defined as unclassified SLE-PAH patients (mPAP 21-24 mmHg and PVR ≤ 2 WU). The prognosis was compared among mild SLE-PAH, unclassified SLE-PH, and conventional SLE-PAH patients (mPAP ≥ 25 mmHg and PVR > 3WU). Besides, the effectiveness of pulmonary arterial hypertension (PAH)-specific therapy was evaluated in mild SLE-PAH patients. RESULTS Those mild SLE-PAH patients had significantly longer progression-free time than the conventional SLE-PAH patients. Among the mild SLE-PAH patients, 4 did not receive PAH-specific therapy and had a similar prognosis as patients not receiving specific therapy. CONCLUSIONS This study supports the revised hemodynamic definition of SLE-PAH in the 2022 ESC/ERS guideline. Those mild and unclassified SLE-PH patients had a better prognosis, demonstrating the possibility and significance of early diagnosis and intervention for SLE-PAH. This study also proposed a hypothesis that IIT against SLE might be sufficient for those reclassified SLE-PAH patients.
Collapse
Grants
- 2021YFC25013015, 2017YFC0907601, 2017YFC0907602, 2017YFC0907603, and 2008BAI59B02 Chinese National Key Research R&D Program
- 2021YFC25013015, 2017YFC0907601, 2017YFC0907602, 2017YFC0907603, and 2008BAI59B02 Chinese National Key Research R&D Program
- 2021YFC25013015, 2017YFC0907601, 2017YFC0907602, 2017YFC0907603, and 2008BAI59B02 Chinese National Key Research R&D Program
- 2021YFC25013015, 2017YFC0907601, 2017YFC0907602, 2017YFC0907603, and 2008BAI59B02 Chinese National Key Research R&D Program
- 2021YFC25013015, 2017YFC0907601, 2017YFC0907602, 2017YFC0907603, and 2008BAI59B02 Chinese National Key Research R&D Program
- 2021YFC25013015, 2017YFC0907601, 2017YFC0907602, 2017YFC0907603, and 2008BAI59B02 Chinese National Key Research R&D Program
- 2021YFC25013015, 2017YFC0907601, 2017YFC0907602, 2017YFC0907603, and 2008BAI59B02 Chinese National Key Research R&D Program
- 2012AA02A513 Chinese National High Technology Research and Development Program, Ministry of Science and Technology
- 2012AA02A513 Chinese National High Technology Research and Development Program, Ministry of Science and Technology
- 2012AA02A513 Chinese National High Technology Research and Development Program, Ministry of Science and Technology
- 2012AA02A513 Chinese National High Technology Research and Development Program, Ministry of Science and Technology
- 2012AA02A513 Chinese National High Technology Research and Development Program, Ministry of Science and Technology
- 2012AA02A513 Chinese National High Technology Research and Development Program, Ministry of Science and Technology
- 2012AA02A513 Chinese National High Technology Research and Development Program, Ministry of Science and Technology
- 2019ZX09734001-002-004 '13th Five-Year' National Science and Technology Major Project for New Drugs of the Ministry of Science and Technology of China
- 2019ZX09734001-002-004 '13th Five-Year' National Science and Technology Major Project for New Drugs of the Ministry of Science and Technology of China
- 2019ZX09734001-002-004 '13th Five-Year' National Science and Technology Major Project for New Drugs of the Ministry of Science and Technology of China
- 2019ZX09734001-002-004 '13th Five-Year' National Science and Technology Major Project for New Drugs of the Ministry of Science and Technology of China
- 2019ZX09734001-002-004 '13th Five-Year' National Science and Technology Major Project for New Drugs of the Ministry of Science and Technology of China
- 2019ZX09734001-002-004 '13th Five-Year' National Science and Technology Major Project for New Drugs of the Ministry of Science and Technology of China
- 2019ZX09734001-002-004 '13th Five-Year' National Science and Technology Major Project for New Drugs of the Ministry of Science and Technology of China
- 2019-I2M-2-008 Medical and health science and technology innovation project of Chinese Academy of Medical Sciences
- 2019-I2M-2-008 Medical and health science and technology innovation project of Chinese Academy of Medical Sciences
- 2019-I2M-2-008 Medical and health science and technology innovation project of Chinese Academy of Medical Sciences
- 2019-I2M-2-008 Medical and health science and technology innovation project of Chinese Academy of Medical Sciences
- 2019-I2M-2-008 Medical and health science and technology innovation project of Chinese Academy of Medical Sciences
- 2019-I2M-2-008 Medical and health science and technology innovation project of Chinese Academy of Medical Sciences
- 2019-I2M-2-008 Medical and health science and technology innovation project of Chinese Academy of Medical Sciences
- 81900054 Youth Program of National Natural Science Foundation of China
Collapse
Affiliation(s)
- Yutong Li
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Peking Union Medical College Hospital, Peking Union Medical College Hospital (PUMCH), Beijing, 100730, China
| | - Junyan Qian
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Peking Union Medical College Hospital, Peking Union Medical College Hospital (PUMCH), Beijing, 100730, China
| | - Xingbei Dong
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Peking Union Medical College Hospital, Peking Union Medical College Hospital (PUMCH), Beijing, 100730, China
| | - Jiuliang Zhao
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Peking Union Medical College Hospital, Peking Union Medical College Hospital (PUMCH), Beijing, 100730, China
| | - Qian Wang
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Peking Union Medical College Hospital, Peking Union Medical College Hospital (PUMCH), Beijing, 100730, China
| | - Yanhong Wang
- Department of Epidemiology and Bio-Statistics, Institute of Basic Medical Sciences, China Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiaofeng Zeng
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Peking Union Medical College Hospital, Peking Union Medical College Hospital (PUMCH), Beijing, 100730, China
| | - Zhuang Tian
- Department of Cardiology, Dongcheng District, Peking Union Medical College Hospital, No.1 Shuai Fu Yuan, Wang Fu Jing, Beijing, 100730, China.
| | - Mengtao Li
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Peking Union Medical College Hospital, Peking Union Medical College Hospital (PUMCH), Beijing, 100730, China.
| |
Collapse
|
3
|
Giriyappagoudar M, Vastrad B, Horakeri R, Vastrad C. Study on Potential Differentially Expressed Genes in Idiopathic Pulmonary Fibrosis by Bioinformatics and Next-Generation Sequencing Data Analysis. Biomedicines 2023; 11:3109. [PMID: 38137330 PMCID: PMC10740779 DOI: 10.3390/biomedicines11123109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 12/24/2023] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a chronic progressive lung disease with reduced quality of life and earlier mortality, but its pathogenesis and key genes are still unclear. In this investigation, bioinformatics was used to deeply analyze the pathogenesis of IPF and related key genes, so as to investigate the potential molecular pathogenesis of IPF and provide guidance for clinical treatment. Next-generation sequencing dataset GSE213001 was obtained from Gene Expression Omnibus (GEO), and the differentially expressed genes (DEGs) were identified between IPF and normal control group. The DEGs between IPF and normal control group were screened with the DESeq2 package of R language. The Gene Ontology (GO) and REACTOME pathway enrichment analyses of the DEGs were performed. Using the g:Profiler, the function and pathway enrichment analyses of DEGs were performed. Then, a protein-protein interaction (PPI) network was constructed via the Integrated Interactions Database (IID) database. Cytoscape with Network Analyzer was used to identify the hub genes. miRNet and NetworkAnalyst databaseswereused to construct the targeted microRNAs (miRNAs), transcription factors (TFs), and small drug molecules. Finally, receiver operating characteristic (ROC) curve analysis was used to validate the hub genes. A total of 958 DEGs were screened out in this study, including 479 up regulated genes and 479 down regulated genes. Most of the DEGs were significantly enriched in response to stimulus, GPCR ligand binding, microtubule-based process, and defective GALNT3 causes HFTC. In combination with the results of the PPI network, miRNA-hub gene regulatory network and TF-hub gene regulatory network, hub genes including LRRK2, BMI1, EBP, MNDA, KBTBD7, KRT15, OTX1, TEKT4, SPAG8, and EFHC2 were selected. Cyclothiazide and rotigotinethe are predicted small drug molecules for IPF treatment. Our findings will contribute to identification of potential biomarkers and novel strategies for the treatment of IPF, and provide a novel strategy for clinical therapy.
Collapse
Affiliation(s)
- Muttanagouda Giriyappagoudar
- Department of Radiation Oncology, Karnataka Institute of Medical Sciences (KIMS), Hubballi 580022, Karnataka, India;
| | - Basavaraj Vastrad
- Department of Pharmaceutical Chemistry, K.L.E. Socitey’s College of Pharmacy, Gadag 582101, Karnataka, India;
| | - Rajeshwari Horakeri
- Department of Computer Science, Govt First Grade College, Hubballi 580032, Karnataka, India;
| | - Chanabasayya Vastrad
- Biostatistics and Bioinformatics, Chanabasava Nilaya, Bharthinagar, Dharwad 580001, Karnataka, India
| |
Collapse
|