ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx
Goldschmidt1
1. Pascal J. Goldschmidt, MD, FACC, FAHA
Edward Orgain Professor of Cardiology
Chairman, Department of Medicine
Duke University
Durham, North Carolina
AEHA 2006 Summit
Designer Genes: From
Plaque to Attack
2. Presenter Disclosure Information
FINANCIAL DISCLOSURE:
None
<Pascal J. Goldschmidt, MD, FACC, FAHA>
<Gene Expression Studies of Atherosclerosis>
UNLABELED/UNAPPROVED USES DISCLOSURE:
None
4. Healing hearts
Changing lives
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Can we identify a
molecular signature that
corresponds to arterial
repair by progenitor
cells?
Gene expression
profiling
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*P<0.05 vs Young ApoE -/- cells IV.
†
P<0.05 vs No cells and WT cells IP.
Effect of Age on Arterial Repair
Capacity: Quantitative
a) Old ApoE -/- cells IV (n=6)
b) Young ApoE -/- cells IV (n=6)
c) No cells (n=6)
d) WT cells IP (n=6)
e) WT cells IV, stroma-enriched (n=6)
f) WT cells IV, hematopoietic-enriched (n=6)
Treatments
*
†
0
10
20
30
Abdominal Aorta
Percent
Karra, Goldschmidt, Seo, In
Press, PNAS
Rauscher et al. Circulation.
2003;108:457
Goldschmidt and Peterson.
Science. 2003 (SAGE-KE)
farnesyl diphosphate farnesyl transferase 1
zinc finger RNA binding protein
RAB1, member RAS oncogene family
TGFB inducible early growth response 1
Fas (TNFRSF6)-associated via death domain
neurotrophic tyrosine kinase, receptor, type 3
protein tyrosine phosphatase, receptor type, M
wingless-related MMTV integration site 5B
snail homolog 2 (Drosophila)
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Over time, the capacity
of the marrow to
produce competent
stem cells capable of
arterial repair becomes
exhausted. Cause of
plaque destabilization?
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Predictive Modeling of Coronary Artery Disease
Based on Simultaneous Expression Pattern of 8 Genes (t1- Scores)
Granger et al. (Duke/GeneProt/Novartis)
Hypothesis: As circulating cells
(progenitor and inflammatory cells)
contribute to arterial repair/plaque
destabilization,
Can we array nucleated blood cells
to assess severity of coronary
artery disease?
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Previous Study Identified Susceptibility
Region on 3q13 for Coronary Artery Disease (CAD)
LOD score = 3.5, one LOD-unit down region: >20 Mb
3q13
Hauser ER. et al., AJHG,
2004 Sep;75(3):436-47
Chr 3
“A Genomewide Scan for
Early-Onset Coronary
Artery Disease in 438
Families: The GENECARD
Study”
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Novel Gene That Predicts Left Main Disease:
Limbic System Associated Membrane Protein
(LSAMP)
Known:
1. LSAMP mediates cell-cell adhesion in neurons.
Pimenta et al., Neuron 1995; 15(2):287-297
2. Overexpression of LSAMP inhibits renal cancer cell
proliferation. Chen et al., Cancer Cell 2003; 4:405-413
Unknown:
1. Is LSAMP involved in the pathogenesis of CAD?
2. Can LSAMP SNPs predict LM disease
AHA 2005: Liyong Wang, Ph.D.
Center for Human Genetics
Duke University Medical Center
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Prediction of LM-Disease by
LSAMP SNPs
P=0.003 P=0.132 P=0.002
rs1676232_a_rs4404477_a
LM Control
Set 1 102 149
Set 2 151 229
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Expression of LSAMP_1a Is
Downregulated in Aortas with Severe
Atherosclerosis Burden
Atherosclerosis Burden (N=sample size)
0
3
6
9
12
mRNALevel
(relativevalue)
P<0.001
*
*
mild/moderate moderate/severe
(N=3)
Severe
(N=7)(N=27)
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Conclusions
• Genomics has transformed our ability to
predict atherosclerosis, CAD, instability
• Genomic techniques are utmost useful to
discover disease mechanisms
• Early testing to predict plaque rupture and
other features of CAD via genomic
advances will become affordable during the
next five years
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Collaborators
Duke: IGSP
Department of Medicine Joe Nevins
DCRI Mike West
Chunming Dong
Geoff Kunz Center for
David Seo Demographic Studies
Shoukang Zhu Julia Kravtchenko
Xialin Liu Ken Manton
Lisa Satterwhite Ken land
Fred Rauscher Eric Stallart
Sreek Vemulapalli Department of Surgery
Ryan Schulties Carmello Milano
Ravi Karra Center for Human Genetics
Eric Peterson Beth Hauser
Grace Liang Department of Radiology
Olujimi Ajijola Bennett Chin
Department of Pediatrics
Joanne Kurtzberg
Notas del editor
To achieve different levels of disease, we used mice.
Mice with no disease are WT, 6wk chow
Mice with ealry disease are ApoE, 6 wk chow
Mice with intermediate disease are ApoE, 12 wk High Fat
Mice with moderate disease are ApoE, 16 wk High Fat
Disease extent characterized for each group of mice using Oil Red O staining and calculating the affected area
Can see by graph clear difference in lesion burden among groups
Composite pictures show that the major difference is actually at the aortic arch
We compared the expression profiles for aortas of different disease stages
We built a model with 197 genes to distinguish samples without disease from samples with early disease
The model distinguishing samples with early disease from intermediate disease used 146 genes
The model distinguishing samples with interemdiate disease from moderate disease uses 110 genes
The model distinguishing samples with no disease from moderate disease uses 650 genes
To verify that these patterns are indeed robust, we used cross-validation. All the models are able to cross-validate &gt; 96% of the samples.
At this point, we were a little befuddled in how to describe our list of genes. Therefore, we turned to Gene Ontology.
Gene Ontology terms allow for broad descriptions to be applied to a genes based on their inferred Biological process
We found an over-representation of genes for metabolism, inflammation, tissue remodeling, and once again inflammation