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March 27, 2026Journal of Inflammation Research2 citationsOpen Access

SULF1 and EPB41L3: Potential Biomarkers of Acute Myocardial Infarction and the Vascular Inflammatory Milieu

HZHouyong ZhuXXXiaoqun XuXZXinyu Zhu

Key Result

SULF1 and EPB41L3 mRNA expression levels were significantly upregulated in the peripheral blood of patients with acute myocardial infarction compared to controls.

Key Points

  • This research aims to assess the expression patterns of SULF1 and EPB41L3 as biomarkers in acute myocardial infarction (AMI).
  • Screened differentially expressed genes from two public microarray datasets.
  • Utilized Gene Ontology and pathway analysis for functional profiling.
  • Collected whole-blood samples from 29 patients with coronary artery disease for gene expression measurement using qPCR.
  • Applied multivariate logistic regression and bootstrap resampling for robustness analysis.
  • Conducted exploratory single-cell expression analysis and drug–gene interaction predictions.
  • SULF1 and EPB41L3 were consistently upregulated in AMI based on bioinformatics analysis.
  • Clinical validation revealed significantly higher expression of both genes in AMI patients compared to controls.
  • Statistical significance remained after multivariate adjustment.
  • Single-cell data indicated expression in endothelial cells and fibroblasts.
  • Drug prediction pointed to metoprolol and paclitaxel as potential modulators of SULF1.

Study Design

Type

Case-Control (n=29)

Multicenter

Yes

Structured PICO

Are SULF1 and EPB41L3 mRNA expression levels elevated in the peripheral blood of patients with acute myocardial infarction compared to those with non-obstructive coronary artery disease?

P
Population
29 patients (17 with acute myocardial infarction and 12 with non-obstructive coronary artery disease), mean age 57.86 years, 44.8% female. Key exclusions: diabetes, known ejection fraction <30% or NYHA Class IV symptoms, severe hepatic or renal dysfunction, cancer-related diseases, connective tissue diseases, pregnant or breastfeeding.
C
Comparator
Non-obstructive coronary artery disease controls (stenosis of the left main coronary artery ≤30%, or stenosis of any other major coronary artery ≤50%)
O
Outcome
Expression levels of SULF1 and EPB41L3 mRNA in peripheral whole-blood samples measured by quantitative real-time PCR (qPCR)surrogate

SULF1 and EPB41L3 are significantly upregulated in the peripheral blood of patients with acute myocardial infarction, suggesting their potential as novel biomarkers for AMI and vascular inflammation.

Main Result

Absolute Event Rate: 1.04% vs 0.95%

p-value: p=0.036

Limitations

  • Modest sample size of 29 patients
  • Whole blood is a mixed sample containing various cell types, limiting cell-specific insights
  • Causal relationship between the biomarkers and acute myocardial infarction remains unclear
  • Drug interaction findings are based solely on bioinformatic predictions

Abstract

Background and Objective: Coronary endothelial dysfunction is considered one of the key pathological components in acute myocardial infarction (AMI). This study aimed to explore the expression patterns and potential significance of the differentially expressed genes SULF1 and EPB41L3 in AMI by integrating bioinformatics analysis and clinical validation. Methods: Differentially expressed genes (DEGs) were screened from two public microarray datasets (GSE66360 and GSE132651). Their functional profiles were summarized via Gene Ontology and pathway analysis. In parallel, whole-blood samples from 29 patients with coronary artery disease were collected, and gene expression was measured using quantitative real-time PCR (qPCR). Multivariate logistic regression was adjusted, and bootstrap resampling was applied to assess robustness. Exploratory single-cell expression analysis and drug–gene interaction prediction were also performed. Results: Bioinformatics analysis identified SULF1 and EPB41L3 as consistently upregulated in AMI. In clinical samples, both genes showed significantly higher expression in AMI patients compared with non-obstructive coronary artery disease controls (P=0.036 and 0.021), and this association remained significant after multivariate adjustment (P=0.039 and 0.034). Single-cell data indicated expression in endothelial cells and fibroblasts. Drug prediction suggested metoprolol and paclitaxel as potential modulators of SULF1. Conclusion: This study, through integrated analysis, first validated the upregulated expression of candidate biomarkers SULF1 and EPB41L3 in the peripheral blood of AMI patients within a clinical cohort. Combined with their baseline expression profiles in cell types associated with vascular inflammation such as endothelial cells, these findings suggest that these two genes may be involved in the pathological process of AMI. This research provides new candidate targets and clues for exploring the molecular mechanisms of AMI. Keywords: acute myocardial infarction, endothelial dysfunction, SULF1, EPB41L3, inflammation

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Cite This Study

Zhu et al. (2026) conducted a case-control in Acute Myocardial Infarction (n=29). SULF1 and EPB41L3 mRNA expression levels were significantly upregulated in the peripheral blood of patients with acute myocardial infarction compared to controls.

synapsesocial.com/papers/69c6207d15a0a509bde18fe7https://doi.org/10.2147/jir.s594275
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