Key result
INOCA patients had significantly lower gene expression of CD31 (p<0.0001) and higher expression of HYAL2 (p<0.0001) in peripheral blood mononuclear cells compared to patients with obstructive CCS.
Why the study?
Precise guidelines for diagnosing and treating non-obstructive CAD are lacking, driving the need for non-invasive diagnostic tools and biological differentiation from obstructive chronic coronary syndrome.
Are there distinct gene expression profiles in PBMCs that can differentiate INOCA from obstructive chronic coronary syndrome?
Observational (n=38)
Are there distinct gene expression profiles in PBMCs that can differentiate INOCA from obstructive chronic coronary syndrome?
Distinct gene expression profiles in PBMCs, including reduced cell adhesion and inflammation markers and increased HYAL2, may serve as non-invasive biomarkers to differentiate INOCA from obstructive coronary disease.
Answers are grounded in this paper and cite their sources.
May aid biomarker identification in INOCA microvascular dysfunction; leaves open validation before diagnostic use.
Up to 4 million patients with signs of myocardial ischemia have no obstructive coronary artery disease (CAD). The absence of precise guidelines for diagnosis and treatment in non-obstructive CAD encourages the scientific community to fill the gap knowledge, to provide non-invasive and less expensive diagnostic tools. The aim of our study was to explore the biological profile of Ischemia with Non-Obstructive Coronary Arteries (INOCA) patients with microvascular dysfunction compared to patients presenting with obstructive chronic coronary syndrome (ObCCS) in order to find specific hallmarks of each clinical condition. We performed a gene expression array from peripheral blood mononuclear cells (PBMCs) isolated from INOCA (n = 18) and ObCCS (n = 20) patients. Our results showed a significantly reduced gene expression of molecules involved in cell adhesion, signaling, vascular motion, and inflammation in INOCA as compared to the ObCCS group. In detail, we found lower expression of Platelet and Endothelial Cell Adhesion Molecule 1 (CD31, p < 0.0001), Intercellular Adhesion Molecule-1 (ICAM1, p = 0.0004), Tumor Necrosis Factor (TNF p = 0.0003), Transferrin Receptor (TFRC, p = 0.002), and Vascular Endothelial Growth Factor A (VEGFA, p = 0.0006) in the INOCA group compared with ObCCS. Meanwhile, we observed an increased expression of Hyaluronidase (HYAL2, p < 0.0001) in INOCA patients in comparison to ObCCS. The distinct expression of molecular biomarkers might allow an early and non-invasive differential diagnosis between ObCCS and INOCA, improving clinical management and treatment options, in the era of personalized medicine.
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Bonanni et al. (2022) conducted an observational in Ischemia with Non-Obstructive Coronary Arteries (INOCA) (n=38). Ischemia with Non-Obstructive Coronary Arteries (INOCA) vs. Obstructive chronic coronary syndrome (ObCCS) was evaluated on Gene expression from peripheral blood mononuclear cells (p=<0.0001). INOCA patients had significantly lower gene expression of CD31 (p<0.0001) and higher expression of HYAL2 (p<0.0001) in peripheral blood mononuclear cells compared to patients with obstructive CCS.
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