Abstract
Background: Carotid artery stenosis (CAS) is caused by the formation of atherosclerotic plaques inside the arterial wall and accounts for 20–30% of all strokes. The development of an early, noninvasive diagnostic method and the identification of high-risk patients for ischemic stroke is essential to the management of CAS in clinical practice.Methods: We used the data-independent acquisition (DIA) technique to conduct a urinary proteomic study in patients with CAS and healthy controls. We identified the potential diagnosis and risk stratification biomarkers of CAS. And Ingenuity pathway analysis was used for functional annotation of differentially expressed proteins (DEPs). Furthermore, receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic values of DEPs.Results: A total of 194 DEPs were identified between CAS patients and healthy controls by DIA quantification. The bioinformatics analysis showed that these DEPs were correlated with the pathogenesis of CAS. We further identified 32 DEPs in symptomatic CAS compared to asymptomatic CAS, and biological function analysis revealed that these proteins are mainly related to immune/inflammatory pathways. Finally, a biomarker panel of six proteins (ACP2, PLD3, HLA-C, GGH, CALML3, and IL2RB) exhibited potential diagnostic value in CAS and good discriminative power for differentiating symptomatic and asymptomatic CAS with high sensitivity and specificity.Conclusions: Our study identified novel potential urinary biomarkers for noninvasive early screening and risk stratification of CAS.
Highlights
Carotid artery stenosis (CAS) is characterized by the formation of atherosclerotic plaques in the arterial wall and accounts for approximately 20–30% of all strokes (Wijeratne et al, 2020).Stroke is the second leading cause of mortality and a leading cause of adult disability worldwide, making prevention of stroke one of the most important priorities in healthcare (Feigin et al, 2014; Banerjee and Chimowitz, 2017; Feigin et al, 2018).Atherosclerosis (AS) is central to the pathogenesis of CAS
A total of 194 differentially expressed proteins (DEPs) were identified between CAS patients and healthy controls by data-independent acquisition (DIA) quantification
We further identified 32 DEPs in symptomatic CAS compared to asymptomatic CAS, and biological function analysis revealed that these proteins are mainly related to immune/inflammatory pathways
Summary
Carotid artery stenosis (CAS) is characterized by the formation of atherosclerotic plaques in the arterial wall and accounts for approximately 20–30% of all strokes (Wijeratne et al, 2020).Stroke is the second leading cause of mortality and a leading cause of adult disability worldwide, making prevention of stroke one of the most important priorities in healthcare (Feigin et al, 2014; Banerjee and Chimowitz, 2017; Feigin et al, 2018).Atherosclerosis (AS) is central to the pathogenesis of CAS. Carotid artery stenosis (CAS) is characterized by the formation of atherosclerotic plaques in the arterial wall and accounts for approximately 20–30% of all strokes (Wijeratne et al, 2020). AS usually occur at sites of blood flow disturbance. It was thought to be triggered by subendothelial retention of cholesterol-containing lipoproteins, flow-mediated inflammation within the endothelial cells, and inflammatory cell infiltration (Hansson et al, 2015). The risk factors for CAS are associated with traditional atherosclerotic risk factors such as hypertension, diabetes, dyslipidemia, smoking, and advanced age (Dharmakidari et al, 2017; Wijeratne et al, 2020). Carotid artery stenosis (CAS) is caused by the formation of atherosclerotic plaques inside the arterial wall and accounts for 20–30% of all strokes. The development of an early, noninvasive diagnostic method and the identification of high-risk patients for ischemic stroke is essential to the management of CAS in clinical practice
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