Abstract

Immune endothelial inflammation, underlying coronary heart disease (CHD) related phenotypes, could provide new insight into the pathobiology of the disease. We investigated DNA methylation level of the unique CpG island of HLA-G gene in CHD patients and evaluated the correlation with cardiac computed tomography angiography (CCTA) features. Thirty-two patients that underwent CCTA for suspected CHD were enrolled for this study. Obstructive CHD group included fourteen patients, in which there was a stenosis greater than or equal to 50% in one or more of the major coronary arteries detected; whereas subjects with Calcium (Ca) Score = 0, uninjured coronaries and with no obstructive CHD (no critical stenosis, NCS) were considered as control subjects (n = 18). For both groups, DNA methylation profile of the whole 5'UTR-CpG island of HLA-G was measured. The plasma soluble HLA-G (sHLA-G) levels were detected in all subjects by specific ELISA assay. Statistical analysis was performed using R software. For the first time, our study reported that 1) a significant hypomethylation characterized three specific fragments (B, C and F) of the 5'UTR-CpG island (p = 0.05) of HLA-G gene in CHD patients compared to control group; 2) the hypomethylation level of one specific fragment of 161bp (+616/+777) positively correlated with coronary Ca score, a relevant parameter of CCTA (p<0.05) between two groups evaluated and was predictive for disease severity. Reduced levels of circulating HLA-G molecules could derive from epigenetic marks. Epigenetics phenomena induce hypomethylation of specific regions into 5'UTR-CpG island of HLA-G gene in CHD patients with obstructive non critical stenosis vs coronary stenosis individuals.

Highlights

  • Coronary heart disease (CHD) shows a complex nature resulting from several interacting genetic/epigenetic risk factors, which are strongly affected by individual lifestyle [1,2]

  • Reduced levels of circulating human leukocyte antigen-G (HLA-G) molecules could derive from epigenetic marks

  • Some authors emphasized the key role of DNA methylation in regulating the human leukocyte antigen-G (HLA-G) gene expression involved in inflammatory-related pathways underlying CHD onset [13,14]

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Summary

Introduction

Coronary heart disease (CHD) shows a complex nature resulting from several interacting genetic/epigenetic risk factors, which are strongly affected by individual lifestyle [1,2]. Since genome-wide association studies (GWASs) present several limitations in explaining the genotype-phenotype relationship, major efforts have been made to design an epigenetic map able to bridge the gap between genome and environment providing novel useful non-invasive biomarkers for CHD [3,4,5,6,7]. We hypothesized that CpG island HLA-G DNA methylation profile in peripheral blood cells may provide putative useful non-invasive predictive biomarkers and drug targets, which may improve CHD precision medicine and personalized therapy [17,18,19]. Since CCTA is not invasive and offers a good diagnostic performance [20,21], the integrated analysis of plaque load changes and DNA methylation signatures affecting HLA-G gene regulation may represent a useful approach to improve risk stratification for CHD patients

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