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Mourino-Alvarez L, Baldan-Martin M, Gonzalez-Calero L, Martinez-Laborde C, Sastre-Oliva T, Moreno-Luna R, Lopez-Almodovar LF, Sanchez PL, Fernandez-Aviles F, Vivanco F, Padial LR, Akerstrom F, Alvarez-Llamas G, de la Cuesta F, Barderas MG. Patients with calcific aortic stenosis exhibit systemic molecular evidence of ischemia, enhanced coagulation, oxidative stress and impaired cholesterol transport. Int J Cardiol 2016; 225:99-106. [PMID: 27716559 DOI: 10.1016/j.ijcard.2016.09.089] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 09/21/2016] [Accepted: 09/23/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND The most common valve diseases are calcific aortic stenosis (AS) and aortic regurgitation (AR). The former is characterized by thickening of valve leaflets followed by progressive calcification, which produces progressive aortic valve (AV) narrowing, increased pressure afterload on the left ventricle (LV) and subsequent LV hypertrophy. On the other hand, AR is due to malcoaptation of the valve leaflets with resultant diastolic reflux of blood from aorta back to the LV producing volume and pressure overload and progressive LV dilatation. In order to isolate the molecular mechanisms taking place during AS, we have used an integrated "-omic" approach to compare plasma samples from AS and from AR patients used as controls. The final purpose of this work is to find molecular changes in response to the calcification of the AV, diminishing the effects of the AV dysfunction. METHODS AND RESULTS Using two-dimensional difference gel electrophoresis (2D-DIGE) and gas chromatography coupled to mass spectrometry (GC-MS) in a cohort of 6 subjects, we have found differences in 24 protein spots and 19 metabolites, respectively. Among them, 7 proteins and 3 metabolites have been verificated by orthogonal techniques (SRM or turbidimetry): fibrinogen beta and gamma chain, vitronectin, apolipoprotein C-II, antithrombin III, haptoglobin, succinic acid, pyroglutamic acid and alanine. Classification according to their main function showed alterations related to coagulation, inflammation, oxidative stress, response to ischemia and lipid metabolism, defining 4 different molecular panels that characterize AS with high specificity and sensitivity. CONCLUSION These results may facilitate management of these patients by making faster diagnostics of the disease and better understand these pathways for regulating its progression.
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Affiliation(s)
- Laura Mourino-Alvarez
- Department of Vascular Physiopathology, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain
| | - Montserrat Baldan-Martin
- Department of Vascular Physiopathology, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain
| | | | | | - Tamara Sastre-Oliva
- Department of Vascular Physiopathology, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain
| | - Rafael Moreno-Luna
- Department of Vascular Physiopathology, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain
| | | | - Pedro L Sanchez
- Department of Cardiology, Hospital Universitario de Salamanca-IBSAL, Salamanca, Spain; Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Fernando Vivanco
- Department of Immunology, IIS-Fundacion Jimenez Diaz, Madrid, Spain
| | - Luis R Padial
- Department of Cardiology, Hospital Virgen de la Salud, SESCAM, Toledo, Spain
| | - Finn Akerstrom
- Department of Cardiology, Hospital Virgen de la Salud, SESCAM, Toledo, Spain
| | | | - Fernando de la Cuesta
- Department of Vascular Physiopathology, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain
| | - María G Barderas
- Department of Vascular Physiopathology, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain.
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5
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Baldan-Martin M, Mourino-Alvarez L, Gonzalez-Calero L, Moreno-Luna R, Sastre-Oliva T, Ruiz-Hurtado G, Segura J, Lopez JA, Vazquez J, Vivanco F, Alvarez-Llamas G, Ruilope LM, de la Cuesta F, Barderas MG. Plasma Molecular Signatures in Hypertensive Patients With Renin–Angiotensin System Suppression. Hypertension 2016; 68:157-66. [DOI: 10.1161/hypertensionaha.116.07412] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 04/27/2016] [Indexed: 01/08/2023]
Abstract
Albuminuria is a risk factor strongly associated with cardiovascular disease, the first cause of death in the general population. It is well established that renin–angiotensin system suppressors prevent the development of new-onset albuminuria in naïf hypertensive patients and diminish its excretion, but we cannot forget the percentage of hypertensive patients who develop de novo albuminuria. Here, we applied multiple proteomic strategy with the purpose to elucidate specific molecular pathways involved in the pathogenesis and provide predictors and chronic organ damage indicators. Briefly, 1143 patients were followed up for a minimum period of 3 years. One hundred and twenty-nine hypertensive patients chronically renin–angiotensin system suppressed were recruited, classified in 3 different groups depending on their albuminuria levels (normoalbuminuria, de novo albuminuria, and sustained albuminuria), and investigated by multiple proteomic strategies. Our strategy allowed us to perform one of the deepest plasma proteomic analysis to date, which has shown 2 proteomic signatures: (1) with predictive value of de novo albuminuria and (2) sustained albuminuria indicator proteins. These proteins are involved in inflammation, immune as well as in the proteasome activation occurring in situations of endoplasmic reticulum stress. Furthermore, these results open the possibility of a future strategy based on anti-immune therapy to treat hypertension which could help to prevent the development of albuminuria and, hence, the progression of kidney damage.
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Affiliation(s)
- Montserrat Baldan-Martin
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Laura Mourino-Alvarez
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Laura Gonzalez-Calero
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Rafael Moreno-Luna
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Tamara Sastre-Oliva
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Gema Ruiz-Hurtado
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Julian Segura
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Juan Antonio Lopez
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Jesus Vazquez
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Fernando Vivanco
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Gloria Alvarez-Llamas
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Luis M. Ruilope
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Fernando de la Cuesta
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Maria G. Barderas
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
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