Abstract

BackgroundPeripheral arterial disease (PAD) is a relatively common manifestation of systemic atherosclerosis that leads to progressive narrowing of the lumen of leg arteries. Circulating monocytes are in contact with the arterial wall and can serve as reporters of vascular pathology in the setting of PAD. We performed gene expression analysis of peripheral blood mononuclear cells (PBMC) in patients with PAD and controls without PAD to identify differentially regulated genes.MethodsPAD was defined as an ankle brachial index (ABI) ≤0.9 (n = 19) while age and gender matched controls had an ABI > 1.0 (n = 18). Microarray analysis was performed using Affymetrix HG-U133 plus 2.0 gene chips and analyzed using GeneSpring GX 11.0. Gene expression data was normalized using Robust Multichip Analysis (RMA) normalization method, differential expression was defined as a fold change ≥1.5, followed by unpaired Mann-Whitney test (P < 0.05) and correction for multiple testing by Benjamini and Hochberg False Discovery Rate. Meta-analysis of differentially expressed genes was performed using an integrated bioinformatics pipeline with tools for enrichment analysis using Gene Ontology (GO) terms, pathway analysis using Kyoto Encyclopedia of Genes and Genomes (KEGG), molecular event enrichment using Reactome annotations and network analysis using Ingenuity Pathway Analysis suite. Extensive biocuration was also performed to understand the functional context of genes.ResultsWe identified 87 genes differentially expressed in the setting of PAD; 40 genes were upregulated and 47 genes were downregulated. We employed an integrated bioinformatics pipeline coupled with literature curation to characterize the functional coherence of differentially regulated genes.ConclusionNotably, upregulated genes mediate immune response, inflammation, apoptosis, stress response, phosphorylation, hemostasis, platelet activation and platelet aggregation. Downregulated genes included several genes from the zinc finger family that are involved in transcriptional regulation. These results provide insights into molecular mechanisms relevant to the pathophysiology of PAD.

Highlights

  • Peripheral arterial disease (PAD) affects more than eight million adults in the United States and is associated with significant mortality and morbidity [1,2,3,4,5,6]

  • We report for the first time gene expression analysis of peripheral blood mononuclear cells (PBMC) to identify genes differentially expressed in patients with PAD

  • Gene expression profiling of circulating PBMC provided a global overview of differential gene expression in PAD; where 87 differentially expressed genes (47 upregulated genes and 39 downregulated genes)

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Summary

Introduction

Peripheral arterial disease (PAD) affects more than eight million adults in the United States and is associated with significant mortality and morbidity [1,2,3,4,5,6]. Gene expression analysis of peripheral blood mononuclear cells (PBMC) in asymptomatic individuals has previously revealed individual genetic variation and differentially regulated expression patterns [7,8]. Gene expression profiling studies of blood cells have identified differentially regulated genes and pathways in hypertension [9], coronary artery disease [10,11] and ischemic stroke [1,10,12,13,14,15,16]. Genes differentially expressed in PBMC in the setting of PAD have yet to be identified. We performed gene expression analysis to identify differentially expressed genes in PBMC in the setting of PAD. We performed gene expression analysis of peripheral blood mononuclear cells (PBMC) in patients with PAD and controls without PAD to identify differentially regulated genes

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