Article(id=1246459846653006342, tenantId=1146029695717560320, journalId=1246415837536497731, issueId=1246459843930903036, articleNumber=null, orderNo=null, doi=10.12307/2025.523, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1713283200000, receivedDateStr=2024-04-17, revisedDate=1720800000000, revisedDateStr=2024-07-13, acceptedDate=1717171200000, acceptedDateStr=2024-06-01, onlineDate=1775108785541, onlineDateStr=2026-04-02, pubDate=1766851200000, pubDateStr=2025-12-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1775108785541, onlineIssueDateStr=2026-04-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1775108785541, creator=13701087609, updateTime=1775108785541, updator=13701087609, issue=Issue{id=1246459843930903036, tenantId=1146029695717560320, journalId=1246415837536497731, year='2025', volume='29', issue='36', pageStart='7701', pageEnd='7920', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=1, specialIssue=null, createTime=1775108784853, creator=13701087609, updateTime=1775108852483, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1246460127511991018, tenantId=1146029695717560320, journalId=1246415837536497731, issueId=1246459843930903036, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1246460127511991019, tenantId=1146029695717560320, journalId=1246415837536497731, issueId=1246459843930903036, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=7909, endPage=7920, ext={EN=ArticleExt(id=1246459846946607629, articleId=1246459846653006342, tenantId=1146029695717560320, journalId=1246415837536497731, language=EN, title=Machine learning-based analysis of neutrophil-associated potential biomarkers for acute myocardial infarction, columnId=1246459846866915850, journalTitle=Chinese Journal of Tissue Engineering Research, columnName=Big data analysis, runingTitle=null, highlight=null, articleAbstract=
BACKGROUND:

Accurate early diagnosis and timely reperfusion therapy are important prerequisites for saving the lives and improving the prognosis of patients with acute myocardial infarction. Therefore, it is important to find ideal biomarkers for early diagnosis of acute myocardial infarction.

OBJECTIVE:

To analyze key genes associated with neutrophils by acute myocardial infarction through bioinformatics and machine learning to explore new biomarkers.

METHODS:

Differentially expressed genes were identified based on the Gene Expression Omnibus (GEO) database and Limma R package. Deconvolution algorithm was used to explore the immune cells infiltration level. Then, acute myocardial infarction and neutrophils-related biomarkers were screened by weighted gene co-expression network analysis (WGCNA), protein-protein interaction (PPI) networks, machine learning, and functional enrichment analysis. Receiver operating characteristic curve analysis was conducted to assess the diagnostic efficacy of biomarkers for acute myocardial infarction. Targeted drugs for biomarkers were screened through the STITCH and Herb database. Finally, the hospitalized patients who were first diagnosed with acute myocardial infarction in the Department of Cardiology of Affiliated Hospital of Guizhou Medical University from March to June 2023 were used as the experimental group, and the hospitalized patients who had no ischemic changes on electrocardiograms and no stenosis on coronary angiograms during the same period were used as the control group. Peripheral blood of the patients in the two groups was collected. The relative expressions of the genes were verified in the human peripheral blood samples by RT-qPCR.

RESULTS AND CONCLUSION:

(1) A total of 2 349 differentially expressed genes were obtained, and immune infiltration analysis revealed differences in immune cell scores such as B cells memory, NK cells resting, and Neutrophils between the disease and normal groups. (2) Using WGCNA, two gene modules, ME green and ME turquoise, were found to exhibit the highest correlation with neutrophil fine with acute myocardial infarction. (3) Twenty-four differential module genes were obtained after intersecting with differentially expressed genes. Functional enrichment analysis revealed that they were associated with a variety of processes such as innate immune response and defense response to bacteria. KEGG results showed that they were mainly associated with the tumor necrosis factor signaling pathway. (4) The genes mined by the machine learning algorithm took the intersection to obtain three genes, namely, S100A12, PTCH1, and LOC400499, all of which were greater than 0.7 by the area under the receiver operating characteristic curve in both the GSE48060 and GSE66360 datasets. They were considered as potential biomarkers. (5) Based on the STITCH and Herb databases, 11 target drugs were found for S100A12 and a total of 6 target drugs were found for PTCH1. (6) RT-qPCR results showed that S100A12, PTCH1, and LOC400499 were significantly differentially expressed in acute myocardial infarction patients compared with controls (P < 0.05). (7) S100A12, PTCH1, and LOC400499 may be potential diagnostic biomarkers for acute myocardial infarction, but their specificity in relation to acute myocardial infarction needs to be further investigated, in which S100A12 may be a potential target for regulating acute myocardial infarction.

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Yu Zhenqiu, Chief physician, Department of Hypertension, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, Guizhou Province, China
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背景:

精确的早期诊断和及时的再灌注治疗是挽救急性心肌梗死患者的生命并改善预后的重要前提条件。因此,寻找能够早期诊断急性心肌梗死的理想生物标志物尤为重要。

目的:

拟通过生物信息学和机器学习分析急性心肌梗死与中性粒细胞相关的关键基因,以探寻新的生物标志物。

方法:

基于GEO数据库和limma包鉴定急性心肌梗死的差异表达基因。使用反卷积算法探究免疫细胞浸润情况,然后结合加权基因共表达网络分析(Weighted gene co-expression network analysis,WGCNA)、蛋白互作网络和机器学习筛选急性心肌梗死与中性粒细胞相关的特征基因,并进行功能富集分析。用ROC曲线评估特征基因对急性心肌梗死的诊断价值。通过STITCH和Herb数据库筛查生物标志物的靶向药物。最后将在2023年3-6月于贵州医科大学附属医院心内科首次诊断为急性心肌梗死的住院患者作为实验组,同期心电图无缺血性改变、冠状动脉造影无狭窄的住院患者作为对照组,收集两组患者外周血,通过RT-qPCR验证基因在人外周血样本中的相对表达量。

结果与结论:

①共获得差异表达基因2 349个,免疫浸润分析发现B cells memory,NK cells resting和Neutrophils等免疫细胞评分在疾病和正常组之间存在差异;②使用WGCNA发现ME green和ME turquoise这两个基因模块与中性粒细胞与急性心肌梗死表现出最高的相关性;③与差异表达基因相交后获得24个差异模块基因,功能富集分析发现其与先天免疫反应、细菌的防御反应等多种过程相关;KEGG结果显示其主要与肿瘤坏死因子信号通路有关。④机器学习算法挖掘到的基因取交集后得到的特征基因为S100A12,PTCH1和LOC400499,在GSE48060和GSE66360数据集中的ROC曲线下面积均大于0.7,将其视为潜在的生物标志物。⑤基于STITCH和Herb数据库发现S100A12有11种靶向药物,PTCH1共发现6种靶向药物。⑥RT-qPCR结果显示,与对照组相比,急性心肌梗死患者中S100A12,PTCH1和LOC400499表达具有显著差异性(P < 0.05)。⑦S100A12,PTCH1和LOC400499可能是急性心肌梗死潜在的诊断生物标志物,但是其与急性心肌梗死相关的特异性尚需进一步研究,其中S100A12可能是调控急性心肌梗死的潜在靶点。

, correspAuthors=null, authorNote=null, correspAuthorsNote=
余振球,主任医师,贵州医科大学附属医院高血压科,贵州省贵阳市 550004
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作者贡献:

文章设计者为余振球和杨定燕。资料收集和数据分析者为杨定燕和杨中愉。杨定燕撰写论文。余振球审校。

Yang Dingyan, Master candidate, Department of Hypertension, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, Guizhou Province, China

杨定燕,女,1997年生,贵州省人,苗族,贵州医科大学在读硕士,主要从事心肌梗死相关研究。

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Yang Dingyan, Master candidate, Department of Hypertension, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, Guizhou Province, China

杨定燕,女,1997年生,贵州省人,苗族,贵州医科大学在读硕士,主要从事心肌梗死相关研究。

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Yang Dingyan, Master candidate, Department of Hypertension, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, Guizhou Province, China

杨定燕,女,1997年生,贵州省人,苗族,贵州医科大学在读硕士,主要从事心肌梗死相关研究。

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Panminerva Med. 2023; 65(3): 343-350., articleTitle=Protein kinase TBK1/IKKepsilon inhibitor Amlexanox improves cardiac function after acute myocardial infarction in rats, refAbstract=null)], funds=[Fund(id=1246459871269376295, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, awardId=gzwkjz2023-100, language=EN, fundingSource=Science and Technology Fund Project of Guizhou Provincial Health Commission(gzwkjz2023-100), fundOrder=null, country=null), Fund(id=1246459871386816811, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, awardId=gzwkjz2023-100, language=CN, fundingSource=贵州省卫生健康委科学技术基金项目(gzwkjz2023-100), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1246459855574291124, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, xref=1, ext=[AuthorCompanyExt(id=1246459855582679733, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, companyId=1246459855574291124, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1Department of Hypertension, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, Guizhou Province, China), AuthorCompanyExt(id=1246459855591068342, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, companyId=1246459855574291124, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1贵州医科大学附属医院高血压科,贵州省贵阳市 550004)]), AuthorCompany(id=1246459855704314555, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, xref=2, ext=[AuthorCompanyExt(id=1246459855712703164, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, companyId=1246459855704314555, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2North Sichuan Medical College, Nanchong 637100, Sichuan Province, China), AuthorCompanyExt(id=1246459855721091773, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, companyId=1246459855704314555, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2川北医学院,四川省南充市 637100)])], figs=[ArticleFig(id=1246459860594873295, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=EN, label=null, caption=null, figureFileSmall=AINibSZPgGvZ9PNF0Xa5YQ==, figureFileBig=STMiJDre/fJcTjMYgb9rSA==, tableContent=null), ArticleFig(id=1246459860674565080, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=CN, label=图1, caption=急性心肌梗死和健康样本中差异表达基因(GSE48060数据集)

图注:图A为GSE48060数据集中差异表达基因的火山图,横坐标表示差异倍数,纵坐标表示差异的显著性;红色的点表示上调基因,蓝色的点表示下调基因;B为急性心肌梗死和健康样本中86个差异表达基因的热图,每行表示一个基因在样品中的表达量,每列表示一个样品中基因的表达量。每个小方格表示每个样本的不同基因标准化之后的表达量,其颜色表示含量多少,表达量越高颜色越红,越少越蓝。

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图注:图A为GSE66030数据集中差异表达基因的火山图,横坐标表示差异倍数,纵坐标表示差异的显著性;红色的点表示上调基因,蓝色的点表示下调基因;B为急性心肌梗死和健康样本中2 349个差异表达基因的热图,每行表示一个基因在样品中的表达量,每列表示一个样品中基因的表达量。每个小方格表示每个样本的不同基因标准化之后的表达量,其颜色表示含量多少,表达量越高颜色越红,越少越蓝。

, figureFileSmall=phKeUd4J3+08Z2R6tXOXHw==, figureFileBig=tpaSFQzPJ9ZZ+K9dNydK8Q==, tableContent=null), ArticleFig(id=1246459861144326147, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=EN, label=null, caption=null, figureFileSmall=366rLj8cVD/QNX8m6M7vUw==, figureFileBig=hd2ee+4fdbM5J5Fp+v3E2A==, tableContent=null), ArticleFig(id=1246459861249183759, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=CN, label=图3, caption=免疫浸润分析结果

图注:图A为反卷积算法得到的免疫细胞柱状堆叠图,每一列表示每一例患者中不同免疫细胞评分高低情况,不同颜色表示不同类型的免疫细胞;图B为免疫细胞在正常疾病组中的免疫评分小提琴图展示,*P < 0.05,**P < 0.01,nsP > 0.05。MI为急性心肌梗死组,control为对照组。B cell naive为B幼稚细胞,B cell memory为B记忆细胞,Piasma cells为浆细胞,T cells CD8为CD8 T细胞,T cells CD4 naive为CD4 T幼稚细胞,T cells CD4 memory resting为静息的CD4 T记忆细胞;T cells follicular helper为T细胞滤泡辅助细胞;T cells regulatory (Tregs)为调节性T细胞;T cells gramma delta为γδ T细胞;NK cells resting为静息的NK细胞;NK cells activated为活化的NK细胞;Monocytes为单核细胞;Macrophages M0为M0型巨噬细胞;Macrophages M2为M2型巨噬细胞;Dendritic cells resting为静息的树突状细胞;Dendritic cells activated为活化的树突状细胞;Mast cells resting为静息的肥大细胞;Eosinophils为嗜酸性粒细胞;Neutrophils为中性粒细胞。

, figureFileSmall=366rLj8cVD/QNX8m6M7vUw==, figureFileBig=hd2ee+4fdbM5J5Fp+v3E2A==, tableContent=null), ArticleFig(id=1246459861345652760, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=EN, label=null, caption=null, figureFileSmall=wPF59IXHHbm6/jrhkLrYUQ==, figureFileBig=I663+/oOKEKAIlIilehy9w==, tableContent=null), ArticleFig(id=1246459861437927457, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=CN, label=图4, caption=样本和形状树形图

图注:此图分为两部分,上半部分表示样本聚类树形图,纵坐标为高度,高度越高基因表达越不相似;下半部分为表型性状热图,颜色越深表示表型与样本的基因表达量关系越密切。Sample dendrogram and trait heatmap为样本树状图和表型性状热图;MI为心肌梗死;Neutrophils为中性粒细胞。

, figureFileSmall=wPF59IXHHbm6/jrhkLrYUQ==, figureFileBig=I663+/oOKEKAIlIilehy9w==, tableContent=null), ArticleFig(id=1246459861559562280, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=EN, label=null, caption=null, figureFileSmall=2SVaCTwJ4DRwOTc/mOu17Q==, figureFileBig=Eu6VP/TUahf+pNCXm2HqxQ==, tableContent=null), ArticleFig(id=1246459861664419893, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=CN, label=图5, caption=无尺度软阈值的筛选结果

图注:两张图横轴均代表权重参数power值,左图纵轴表示signed R2,相关系数的平方越高,说明该网络越逼近无尺度分布;右图纵轴表示对应的基因模块中所有基因邻接函数的均值。

, figureFileSmall=2SVaCTwJ4DRwOTc/mOu17Q==, figureFileBig=Eu6VP/TUahf+pNCXm2HqxQ==, tableContent=null), ArticleFig(id=1246459861790249031, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=EN, label=null, caption=null, figureFileSmall=Hnpo+wW4TOfRirQtjvEKnw==, figureFileBig=HEaIToOrqhZ1/XW8IujOrg==, tableContent=null), ArticleFig(id=1246459861882523729, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=CN, label=图6, caption=聚类模块树形图

图注:纵坐标为高度,高度越高,数字越大,基因表达越不相似,树状图不同的分支代表不同的模块基因。Clustering of module eigengenes为模块基因聚类;Height为高度;MEgreen为绿色模块基因;MEpurple为紫色模块基因;MEturquoise为蓝绿色模块基因;MEyellow为黄色模块基因;MEblack为黑色模块基因;MEred为红色模块基因;MEmagenta为品红色模块基因;MEpink为粉色模块基因;MEgrey为粉色模块基因;MEblue为蓝色模块基因;MEbrown为棕色模块基因。

, figureFileSmall=Hnpo+wW4TOfRirQtjvEKnw==, figureFileBig=HEaIToOrqhZ1/XW8IujOrg==, tableContent=null), ArticleFig(id=1246459862012547169, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=EN, label=null, caption=null, figureFileSmall=Nd6wQWpAR5+LKI9sLYYmXg==, figureFileBig=IUkBe5Bpel8aOi5UagTU9w==, tableContent=null), ArticleFig(id=1246459865451876458, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=CN, label=图7, caption=模块识别与合并分析结果

图注:图的上半部分是一个层次聚类图,每个叶子结点都是一条竖线,代表一个基因;纵坐标为高度,高度越高基因表达越不相似;下半部分为基因模块,不同的颜色代表不同的模块,灰色的模块为未归类于任何共表达模块的基因组成。Height为高度;Dynamic Tree Cut为动态树剪切;Merged dynamic为动态合并相似模块后的颜色;Gene dendrogram and module color为基因树状图和模块颜色。

, figureFileSmall=Nd6wQWpAR5+LKI9sLYYmXg==, figureFileBig=IUkBe5Bpel8aOi5UagTU9w==, tableContent=null), ArticleFig(id=1246459865581899890, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=EN, label=null, caption=null, figureFileSmall=uiqTO+7MME/pKcdMngXfdQ==, figureFileBig=nMdwN6jOx0bnvaLDWrDkbA==, tableContent=null), ArticleFig(id=1246459865703534715, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=CN, label=图8, caption=模块基因和临床性状相关性分析结果图

图注:纵坐标为不同模块,横坐标为表型性状,颜色条带表示相关性范围;每一个方块表示模块基因和性状的相关性,红色表示正相关,蓝色表示负相关,颜色越深相关性越强。方块内的数字表示相关性和显著性。MI为心肌梗死;Neutrophils为中性粒细胞;Module-trait relationships为模块与表型特征关联图谱;MEgreen为绿色模块基因;MEturquoise为蓝绿色模块基因;MEblack为黑色模块基因;MEpurple为紫色模块基因;MEmagenta为品红色模块基因;MEblue为蓝色模块基因;MEpink为粉色模块基因;MEgrey为粉色模块基因。

, figureFileSmall=uiqTO+7MME/pKcdMngXfdQ==, figureFileBig=nMdwN6jOx0bnvaLDWrDkbA==, tableContent=null), ArticleFig(id=1246459865808392326, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=EN, label=null, caption=null, figureFileSmall=hKmldRk8Svgjff6lUs4J/Q==, figureFileBig=M09O8aXqD0i6be9dvLoa7Q==, tableContent=null), ArticleFig(id=1246459865942610066, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=CN, label=图9, caption=模块基因和差异表达基因的交集图

图注:图A为差异表达的上调基因的交集图;B为差异表达的下调基因的交集图。Module-gene为模块基因,up上调基因,down为下调基因。模块基因以粉色表示,GSE48060数据集中的差异表达基因以蓝色表示,GSE66360数据集中的差异表达基因以橘色表示,三者交集部分基因代表在差异表达的模块基因、GSE48060和GSE66360数据集中均存在。

, figureFileSmall=hKmldRk8Svgjff6lUs4J/Q==, figureFileBig=M09O8aXqD0i6be9dvLoa7Q==, tableContent=null), ArticleFig(id=1246459866047467673, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=EN, label=null, caption=null, figureFileSmall=BKMrRzspYMcnwaKceU7eaA==, figureFileBig=THUH/qoTgLefGQy2jBcFEQ==, tableContent=null), ArticleFig(id=1246459866143936673, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=CN, label=图10, caption=对24个差异模块基因进行GO富集分析结果图

图注:纵坐标表示GO富集前30条分析结果,横坐标表示基因数目;BP代表生物过程;CC代表细胞成分;MF代表分子功能。颜色表征差异的显著性。defense response to bacterium为对细菌的防御反应;response to corticosteroid为对皮质类固醇的反应;response to glucocorticoid为对糖皮质激素的反应;myeloid leukocyte mediated immunity为髓系白细胞介导免疫;animal organ regeneration为动物器官再生;negative regulation of oxidoreductase activity为氧化还原酶活性的负调控;neutrophil mediated immunity为中性粒细胞介导免疫;embryonic placenta morphogenesis为胚胎胎盘形态发生;labyrinthine layer morphogenesis为迷路层形态发生;branching involved in labyrinthine layer morphogenesis为分支参与迷路层的形态发生;specific granule为特定颗粒;endocytic vesicle为内吞囊泡;vesicle lumen为囊泡腔;cytoplasmic vesicle lumen为细胞质泡腔;secretory granule lumen为分泌颗粒腔;tertiary granule为三级颗粒;endocytic vesicle membrane为胞吞囊泡膜;specific granule lumen为特定颗粒内腔;tertiary granule membrane为三级颗粒膜;tertiary granule lumen为三级颗粒管腔;serine hydrolase activity为丝氨酸水解酶活性;serine-type peptidase activity为丝氨酸型肽酶活性;serine-type endopeptidase activity丝氨酸型内肽酶活性;hydrolase activity, acting on carbon-nitrogen (but not peptide) bonds为水解酶活性,作用于碳氮键(而不是肽键);calcium-dependent protein binding为钙依赖性蛋白结合;IgG binding为IgG结合;hydrolase activity, acting on carbon-nitrogen (but not peptide) bonds, in linear amidines为水解酶活性,作用于线性脒的碳氮键(而不是肽键);prostanoid receptor activity为前列腺素受体活性;RAGE receptor binding为RAGE受体结合;prostaglandin receptor activity为前列腺素受体活性。

, figureFileSmall=BKMrRzspYMcnwaKceU7eaA==, figureFileBig=THUH/qoTgLefGQy2jBcFEQ==, tableContent=null), ArticleFig(id=1246459866232017068, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=EN, label=null, caption=null, figureFileSmall=HJQEFQ91gyCTRBh+bIWv3A==, figureFileBig=chMArQKQ6rhegFTx8MkGvg==, tableContent=null), ArticleFig(id=1246459866324291764, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=CN, label=图11, caption=对24个差异模块基因进行KEGG富集分析结果图

图注:横坐标表示基因数目,纵坐标表示显著富集的通路,颜色表征差异的显著性。TNF signaling pathway为肿瘤坏死因子信号通路,Proteoglycans in cancer为蛋白聚糖,Pantothenate and CoA biosynthesis为泛酸盐和辅酶A生物合成;Neuroactive ligand-receptor nteraction为神经活性配体-受体相互作用,Glycosphingolipid biosynthesis-lacto and neolacto series为鞘糖脂生物合成-乳酸和新乳酸系列,Estrogen signaling pathway为雌激素信号通道,Arginine biosynthesis为精氨酸生物合成。

, figureFileSmall=HJQEFQ91gyCTRBh+bIWv3A==, figureFileBig=chMArQKQ6rhegFTx8MkGvg==, tableContent=null), ArticleFig(id=1246459866437537979, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=EN, label=null, caption=null, figureFileSmall=w8MeMzTj5iZhDTAtD5dwQA==, figureFileBig=rhikhLU8f/uvxx3P4zNEMQ==, tableContent=null), ArticleFig(id=1246459866571755718, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=CN, label=图12, caption=蛋白互作网络(PPI)分析结果图

图注:LogFC为对数差异倍数。S100A12为钙结合蛋白A12;PTCH1为修补1;LOC382210为THO复合体2;MGAM为麦芽糖酶;FCGR1B为FC γ受体1B;GZMA为颗粒酶A;PTGDR为前列腺素D2受体;AQP9为水通道蛋白9;MCEMP1为肥大细胞表达的膜蛋白;HP为肝素酶;MMP9为基质金属蛋白酶9;ASGR2为去唾液酸糖蛋白受体2;ARG1为精氨酸酶1;VNN1为血管非炎性分子1;KRT23为角蛋白23;SLPI为分泌性白细胞肽酶抑制因子;SOCS3为细胞因子信号传导抑制因子3;DSC2为桥粒糖蛋白2;ANXA3为膜联蛋白A3;SULT1B1为磺基转移酶家族;ADM为肾上腺髓质素。

, figureFileSmall=w8MeMzTj5iZhDTAtD5dwQA==, figureFileBig=rhikhLU8f/uvxx3P4zNEMQ==, tableContent=null), ArticleFig(id=1246459866676613323, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=EN, label=null, caption=null, figureFileSmall=KQF2Zq3GYGmRN7SxJbjWXQ==, figureFileBig=hTE6qqr8Iwpn81ohMTuQVQ==, tableContent=null), ArticleFig(id=1246459866764693714, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=CN, label=图13, caption=核心基因的筛选结果图

图注:图A为S100A12的蛋白互作网络(PPI)分析;B为Cytohubba筛选的24个模块基因中的核心基因。S100A12为钙结合蛋白A12;MGAM为麦芽糖酶;GZMA为颗粒酶A;PTGDR为前列腺素D2受体;AQP9为水通道蛋白9;MCEMP1为肥大细胞表达的膜蛋白;HP为肝素酶;MMP9为基质金属蛋白酶9;ASGR2为去唾液酸糖蛋白受体2;ARG1为精氨酸酶1;VNN1为血管非炎性分子1;SLPI为分泌性白细胞肽酶抑制因子;SOCS3为细胞因子信号传导抑制因子3;SULT1B1为磺基转移酶家族;ADM为肾上腺髓质素;ANXN3为膜联蛋白A3;PTGDR为前列腺素D2受体。

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图注:图A为支持向量模型算法筛选特征基因;B为广义线性模型算法筛选特征基因;C为随机森林模型算法筛选特征基因。图A-C横坐标均表示特征基因的个数,纵坐标均表示泛化误差;折线图线的趋势代表特征基因个数与泛化误差的关系。图D为支持向量模型、广义线性模型和随机森林模型算法的特征基因取交集确定候选生物标志物。rf代表随机森林模型;svm代表支持向量模型;glm代表广义线性模型。

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图注:图A,B分别为GSE48060数据集、GSE66360数据集中S100A12,PTCH1,LOC400499,SULT1B1 4个基因的ROC曲线分析。横坐标表示1-特异性,纵坐标表示敏感度。

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图注:图A为可能靶向调控S100A12的药物:amlexanox为氨来占诺;calcium ions为钙离子;sodium为钠;copper为铜;paquinimod为帕奎尼莫;crtric acid为柠檬酸;AGER为晚期糖基化终产物;NOX1为氧化酶1;seenomethicni。图B为可能靶向调控PTCH1的药物:quercitin为槲皮苷;17-bate-estradiol为17β雌二醇;trans-resverao为白藜芦醇;cyclopamine为氯丙咪嗪;meletin为槲皮素。

, figureFileSmall=ypSsPYB2dEPh1XIhjEdwog==, figureFileBig=cCJdRlWXTIdBsSkfwAVi5A==, tableContent=null), ArticleFig(id=1246459868962509067, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=EN, label=null, caption=null, figureFileSmall=+erEtNEC3mcL3Ahwgg4fHg==, figureFileBig=mTdgnwztuLHqci9p4XdALw==, tableContent=null), ArticleFig(id=1246459870917054737, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=CN, label=图17, caption=关键基因表达的RT-qPCR分析结果

图注:与对照组相比,aP < 0.05。

, figureFileSmall=+erEtNEC3mcL3Ahwgg4fHg==, figureFileBig=mTdgnwztuLHqci9p4XdALw==, tableContent=null), ArticleFig(id=1246459871021912347, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
基因名称引物序列(5’-3’)片段长度(bp)
S100A12正向:CAC ATT CCT GTG CAT TGA GG122
 反向:GGT GTC AAA ATG CCC CTT C 
PTCH1正向:ACA AAC TCC TGG TGC AAA CC207
 反向:CTT TGT CGT GGA CCC ATT C 
LOC400499正向:CTG CTT CCG GGT GGT AGA C291
 反向:TGA GTT TCC CGG CAT TCC AT 
β-actin正向:CTC GCT TCG GCA GCA CA96
 反向:AAC GCT TCA CGA ATT TGC GT 
), ArticleFig(id=1246459871118381339, tenantId=1146029695717560320, journalId=1246415837536497731, articleId=1246459846653006342, language=CN, label=表1, caption=

内参基因和生物标志物的引物序列

, figureFileSmall=null, figureFileBig=null, tableContent=
基因名称引物序列(5’-3’)片段长度(bp)
S100A12正向:CAC ATT CCT GTG CAT TGA GG122
 反向:GGT GTC AAA ATG CCC CTT C 
PTCH1正向:ACA AAC TCC TGG TGC AAA CC207
 反向:CTT TGT CGT GGA CCC ATT C 
LOC400499正向:CTG CTT CCG GGT GGT AGA C291
 反向:TGA GTT TCC CGG CAT TCC AT 
β-actin正向:CTC GCT TCG GCA GCA CA96
 反向:AAC GCT TCA CGA ATT TGC GT 
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急性心肌梗死与中性粒细胞相关潜在生物标志物的机器学习分析
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杨定燕 1 , 余振球 1 , 杨中愉 2
中国组织工程研究 | 大数据分析 2025,29(36): 7909-7920
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中国组织工程研究 | 大数据分析 2025, 29(36): 7909-7920
急性心肌梗死与中性粒细胞相关潜在生物标志物的机器学习分析
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杨定燕1, 余振球1, 杨中愉2
作者信息
  • 1贵州医科大学附属医院高血压科,贵州省贵阳市 550004
  • 2川北医学院,四川省南充市 637100
  • Yang Dingyan, Master candidate, Department of Hypertension, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, Guizhou Province, China

    杨定燕,女,1997年生,贵州省人,苗族,贵州医科大学在读硕士,主要从事心肌梗死相关研究。

通讯作者:

余振球,主任医师,贵州医科大学附属医院高血压科,贵州省贵阳市 550004
Machine learning-based analysis of neutrophil-associated potential biomarkers for acute myocardial infarction
Dingyan Yang1, Zhenqiu Yu1, Zhongyu Yang2
Affiliations
  • 1Department of Hypertension, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, Guizhou Province, China
  • 2North Sichuan Medical College, Nanchong 637100, Sichuan Province, China
出版时间: 2025-12-28 doi: 10.12307/2025.523
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背景:

精确的早期诊断和及时的再灌注治疗是挽救急性心肌梗死患者的生命并改善预后的重要前提条件。因此,寻找能够早期诊断急性心肌梗死的理想生物标志物尤为重要。

目的:

拟通过生物信息学和机器学习分析急性心肌梗死与中性粒细胞相关的关键基因,以探寻新的生物标志物。

方法:

基于GEO数据库和limma包鉴定急性心肌梗死的差异表达基因。使用反卷积算法探究免疫细胞浸润情况,然后结合加权基因共表达网络分析(Weighted gene co-expression network analysis,WGCNA)、蛋白互作网络和机器学习筛选急性心肌梗死与中性粒细胞相关的特征基因,并进行功能富集分析。用ROC曲线评估特征基因对急性心肌梗死的诊断价值。通过STITCH和Herb数据库筛查生物标志物的靶向药物。最后将在2023年3-6月于贵州医科大学附属医院心内科首次诊断为急性心肌梗死的住院患者作为实验组,同期心电图无缺血性改变、冠状动脉造影无狭窄的住院患者作为对照组,收集两组患者外周血,通过RT-qPCR验证基因在人外周血样本中的相对表达量。

结果与结论:

①共获得差异表达基因2 349个,免疫浸润分析发现B cells memory,NK cells resting和Neutrophils等免疫细胞评分在疾病和正常组之间存在差异;②使用WGCNA发现ME green和ME turquoise这两个基因模块与中性粒细胞与急性心肌梗死表现出最高的相关性;③与差异表达基因相交后获得24个差异模块基因,功能富集分析发现其与先天免疫反应、细菌的防御反应等多种过程相关;KEGG结果显示其主要与肿瘤坏死因子信号通路有关。④机器学习算法挖掘到的基因取交集后得到的特征基因为S100A12,PTCH1和LOC400499,在GSE48060和GSE66360数据集中的ROC曲线下面积均大于0.7,将其视为潜在的生物标志物。⑤基于STITCH和Herb数据库发现S100A12有11种靶向药物,PTCH1共发现6种靶向药物。⑥RT-qPCR结果显示,与对照组相比,急性心肌梗死患者中S100A12,PTCH1和LOC400499表达具有显著差异性(P < 0.05)。⑦S100A12,PTCH1和LOC400499可能是急性心肌梗死潜在的诊断生物标志物,但是其与急性心肌梗死相关的特异性尚需进一步研究,其中S100A12可能是调控急性心肌梗死的潜在靶点。

急性心肌梗死  /  中性粒细胞  /  生物标志物  /  差异分析  /  WGCNA  /  机器学习算法  /  免疫浸润分析  /  S100A12  /  PTCH1  /  LOC400499
BACKGROUND:

Accurate early diagnosis and timely reperfusion therapy are important prerequisites for saving the lives and improving the prognosis of patients with acute myocardial infarction. Therefore, it is important to find ideal biomarkers for early diagnosis of acute myocardial infarction.

OBJECTIVE:

To analyze key genes associated with neutrophils by acute myocardial infarction through bioinformatics and machine learning to explore new biomarkers.

METHODS:

Differentially expressed genes were identified based on the Gene Expression Omnibus (GEO) database and Limma R package. Deconvolution algorithm was used to explore the immune cells infiltration level. Then, acute myocardial infarction and neutrophils-related biomarkers were screened by weighted gene co-expression network analysis (WGCNA), protein-protein interaction (PPI) networks, machine learning, and functional enrichment analysis. Receiver operating characteristic curve analysis was conducted to assess the diagnostic efficacy of biomarkers for acute myocardial infarction. Targeted drugs for biomarkers were screened through the STITCH and Herb database. Finally, the hospitalized patients who were first diagnosed with acute myocardial infarction in the Department of Cardiology of Affiliated Hospital of Guizhou Medical University from March to June 2023 were used as the experimental group, and the hospitalized patients who had no ischemic changes on electrocardiograms and no stenosis on coronary angiograms during the same period were used as the control group. Peripheral blood of the patients in the two groups was collected. The relative expressions of the genes were verified in the human peripheral blood samples by RT-qPCR.

RESULTS AND CONCLUSION:

(1) A total of 2 349 differentially expressed genes were obtained, and immune infiltration analysis revealed differences in immune cell scores such as B cells memory, NK cells resting, and Neutrophils between the disease and normal groups. (2) Using WGCNA, two gene modules, ME green and ME turquoise, were found to exhibit the highest correlation with neutrophil fine with acute myocardial infarction. (3) Twenty-four differential module genes were obtained after intersecting with differentially expressed genes. Functional enrichment analysis revealed that they were associated with a variety of processes such as innate immune response and defense response to bacteria. KEGG results showed that they were mainly associated with the tumor necrosis factor signaling pathway. (4) The genes mined by the machine learning algorithm took the intersection to obtain three genes, namely, S100A12, PTCH1, and LOC400499, all of which were greater than 0.7 by the area under the receiver operating characteristic curve in both the GSE48060 and GSE66360 datasets. They were considered as potential biomarkers. (5) Based on the STITCH and Herb databases, 11 target drugs were found for S100A12 and a total of 6 target drugs were found for PTCH1. (6) RT-qPCR results showed that S100A12, PTCH1, and LOC400499 were significantly differentially expressed in acute myocardial infarction patients compared with controls (P < 0.05). (7) S100A12, PTCH1, and LOC400499 may be potential diagnostic biomarkers for acute myocardial infarction, but their specificity in relation to acute myocardial infarction needs to be further investigated, in which S100A12 may be a potential target for regulating acute myocardial infarction.

acute myocardial infarction  /  neutrophil  /  biomarker  /  differential analysis  /  WGCNA  /  machine learning algorithms  /  immune infiltration analysis  /  S100A12  /  PTCH1  /  LOC400499
杨定燕, 余振球, 杨中愉. 急性心肌梗死与中性粒细胞相关潜在生物标志物的机器学习分析. 中国组织工程研究, 2025 , 29 (36) : 7909 -7920 . DOI: 10.12307/2025.523
Dingyan Yang, Zhenqiu Yu, Zhongyu Yang. Machine learning-based analysis of neutrophil-associated potential biomarkers for acute myocardial infarction[J]. Chinese Journal of Tissue Engineering Research, 2025 , 29 (36) : 7909 -7920 . DOI: 10.12307/2025.523
急性心肌梗死是一个重大的公共卫生问题,通常由冠状动脉部分或完全闭塞导致心肌供血急剧减少或中断,使相应部位的心肌细胞持久的缺血缺氧而出现严重坏死,在全球有很高的致死率和致残率,危及大多数人的健康[1-2]。精准的早期诊断和及时的心肌再灌注治疗能挽救濒临坏死的心肌细胞或限制梗死面积扩大,减轻梗死后的心肌重塑,提高急性心肌梗死患者的生存率,改善预后。目前,临床上常用肌钙蛋白、肌酸激酶同工酶作为急性心肌梗死患者早期诊断的主要血清生物标志物。急性心肌梗死后肌钙蛋白和肌酸激酶同工酶由坏死的心肌细胞释放到外周血中,但这个过程需要一定的时间,一般为三四个小时,这限制了更早期对急性心肌梗死的识别,特别是对于早期症状和心电图不典型的老龄或糖尿病等患者[3-5]。此外,肌钙蛋白和肌酸激酶同工酶仅反映心肌受损的程度,不能很好地反映急性心肌梗死的发病机制和防治。
急性心肌梗死后,中性粒细胞作为最早被动员到梗死区域的白细胞,参与心肌修复和重塑的整个过程[6]。早期中性粒细胞通过分泌基质金属蛋白酶、髓过氧化物酶、活性氧等炎症递质,清除坏死的心肌细胞和基质碎片[7-8]。随后,中性粒细胞诱导巨噬细胞和自身极化,激活成纤维细胞,抑制促炎因子产生,促进白细胞介素10和转化生长因子β等的产生来激活抗炎反应促进瘢痕的生成和血运重建,从而促进梗死区域的愈合修复[9-11]。所以,早期中性粒细胞的适度活化是过渡到修复和重塑的必要条件,然而中性粒细胞的过度活化或消退延迟会导致心肌的不良重塑和功能障碍,最终导致心力衰竭,甚至死亡[12-14]。按机制来说,中性粒细胞及其炎症递质的调控可能是急性心肌梗死治疗的理想方法。研究发现,炎症期Dusp6缺乏能抑制中性粒细胞毒性作用从而改善心脏修复,并且这种抑制作用对其他免疫细胞的影响很小[15]。但是,除了白细胞介素1β的靶向药物Canakinuma可以降低急性心肌梗死后患者主要心血管事件的发生率外,仍然很难将免疫调节和抗炎治疗策略转化为临床实践[16]。因此,寻找新的急性心肌梗死与中性粒细胞相关的生物标志物可能不仅有助于急性心肌梗死的更早期识别,还可能有助于急性心肌梗死的防治。
微阵列分析能在短时间内发现影响疾病的基因,并且作为早期诊断的生物标志物[17]。然而,微阵列分析在重现性和灵敏度方面存在局限性。机器学习具有强大的计算能力,能够分析由数百到数千个样本和复杂的生物数据集,并从这些数据中提取有价值的生物学见解信息[18]。因此,机器学习为解释不同类型的组学数据提供了创新方法,从而识别了新的生物标记物,有助于精确的疾病预测、患者分层和开发新的治疗方法。
基因信息学试验,机器学习分析结合人外周血样本验证,独立样本t检验。
2023年6月至2024年3月在贵州医科大学附属医院临床研究中心实验室完成。
从GEO数据库(https://www.ncbi.nlm.nih.gov)中下载急性心肌梗死的RNA-seq数据。选取GSE48060和GSE66360数据集。其中GSE48060数据集包含31例入院48 h内急性心肌梗死患者的外周血样本和21例对照样本,主要用于差异分析和模型的构建;GSE66360数据集包含49例急性心肌梗死患者外周血样本和50例对照样本,用于差异基因筛选和模型的验证。
选取2023年3-6月在贵州医科大学附属医院心内科住院治疗的患者。将5例明确诊断为新发急性心肌梗死患者作为急性心肌梗死组;选取5例同期住院治疗的心电图无缺血性改变、冠状动脉造影无狭窄的患者为对照组;患者年龄均为30-60岁。急性心肌梗死的诊断符合第四版急性心肌梗死通用定义[4],即除需要心肌肌钙蛋白升高超过参考值上限第99百分位数外,同时还需至少一项心肌缺血证据:①心肌缺血的症状;②新发缺血性心电图改变;③新出现的病理性Q波;④影像学提示与缺血一致的新出现存活心肌的缺失或阶段性室壁运动异常;⑤冠状动脉造影或尸检证实冠状动脉血栓。研究方案于2023-05-16经贵州医科大学伦理审查批准(批准号:2022伦审第400号),遵循《赫尔辛基宣言》原则。所有参与者均充分了解研究目的、研究过程和潜在风险,均已签署知情同意书。
原始数据下载后,使用R语言(https://www.r-project.org/)进行归一化处理。随后利用R语言limma包鉴定GSE48060数据集和GSE66360数据集中急性心肌梗死组和对照组中的差异表达基因,差异筛选条件为P-value < 0.5和|log2FC| > 0.5。差异表达基因的火山图由R语言ggplot2包进行可视化处理。
免疫细胞浸润分析:利用反卷积算法计算GSE48060数据集中急性心肌梗死组和对照组的每个样本中22种免疫细胞比例,使用Wilcoxon检验评估每种免疫细胞的丰度的差异。
加权基因共表达网络分析(Weighted gene co-expression network analysisWGCNA)分析鉴定与中性粒细胞相关的模块基因:为了得到急性心肌梗死与中性粒细胞最相关的目标基因,文章对GSE48060数据集进行WGCNA分析。首先使用R语言WGCNA包的goodSamplesGenes函数检验样本的基因是否需要过滤,如果没有缺失值则返回TURE。利用pickSoftThreshold功能进行软阈值的筛选,筛选依据无尺度网络重要参数,设置软阈值β(即power值)需满足SFT.R.sq(即R2)大于0.85。构建基因层次聚类树,使用动态混合剪切算法对基因进行分配,得到模块基因,随后将相似性大的模块进行合并。模块识别后,并分析模块与急性心肌梗死和中性粒细胞之间的相关性,找到与之最相关的模块进行进一步分析。
差异表达筛选及功能富集分析:将GSE48060数据集和GSE66360数据集的差异表达基因与模块基因进行交集,交集取得的差异模块基因用作后续分析。随后使用R语言clusterProfiler包对差异模块基因进行KEGG和GO的富集分析,以确定差异模块基因的生物学功能和信号转导通路。
关键基因蛋白相互作用网络的构建:利用STRING数据库(https://cn.string-db.org/)对交集的差异模块基因进行蛋白互作网络(protein protein interaction,PPI)的构建,使用Cytoscape(https://cytoscape.org/)进行PPI网络的可视化和分析。
机器算法筛选候选生物标志物:采用随机森林模型,支持向量机模型和广义线性模型分别在GSE48060数据集中构建诊断模型,使用R语言caret包中的rfeControl函数筛选出特征基因,随后对3种方法筛选的特征基因取交集,得到3种算法中同时存在的基因作为候选生物标志物。
ROC曲线验证候选生物标志物的诊断能力:分别在GSE48060和GSE66360数据集中对候选生物标志物进行验证,确定生物标志物,并使用R语言pROC包绘制ROC曲线,曲线下的面积代表AUC值,一般AUC值越大,说明预测的较为准确。
单基因富集分析:以生物标志物为目的基因,分别计算所有基因和目的基因表达量的相关系数作为排序标准,以此来进行单基因富集分析。随后使用R语言clusterProfiler包进行富集分析,筛选条件为P-adjust < 0.05。
药物预测:将确定的生物标志物输入STITCH数据库(https://ngdc.cncb.ac.cn/databasecommons/database/id/208)和herb数据库(https://ngdc.cncb.ac.cn/databasecommons/database/id/7435)获得基因对应的药物靶点信息,使用Cytoscape将其进行可视化展示。
使用抗凝管采集患者外周血10 mL,2 000 r/min离心10 min,分离血浆,将其编号后保存于-80 ℃冰箱。使用RNA分离试剂盒从外周血中提取总RNA(EK-5301,广州亿涛生物科技公司)。使用SweScript RT II First Strand cDNA Synthesis Kit试剂盒(G332,武汉塞维尔科技有限公司)对cDNA进行反转录。使用2×RealStar Fast SYBR qPCR Mix预混试剂盒(A301,北京康润诚业生物科技有限公司)配置反应体系,反应条件:预变性95 ℃,2 min进行1个循环;95℃变性15 s;60 ℃退火/延伸30 s,进行40个循环。通过CPX 96Touch PCR仪(CFX96 Touch,美国Bio-Rad公司)测定mRNA表达量。使用β-actin为内参基因进行校正。按照2-ΔΔCt计算基因相对表达水平,其中,ΔCt=(目的基因Ct-内参Ct);ΔΔCt=(待测样品中目的基因ΔCt-参照样品中目的基因ΔCt)[19]。所有引物由广州艾基生物科技有限公司合成,相关基因的引物序列见表1
急性心肌梗死与中性粒细胞相关的生物标志物S100A12,PTCH1和LOC400499在外周血中的相对表达。
使用Graphad Prism 9.5统计学软件(GraphPad Software公司,美国)对RT-qPCR得到的相对表达量进行统计分析。计量资料符合正态分布,以表示。采用独立样本t检验比较两组间的差异。P < 0.05为差异有显著性意义。
在GSE48060数据集中得到疾病与正常相比显著差异表达基因共有86个,其中上调基因有31个,下调基因有55个,见图1。在GSE66360数据集中得到疾病与正常相比显著差异表达基因共有2 349个,其中上调基因有877个,下调基因有1 472个,见图2
图3A显示了每个样本中20种免疫细胞的丰度,M1型巨噬细胞和活化的肥大细胞丰度为0,故剔除。小提琴图表明记忆B细胞、静息的自然杀伤细胞和中性粒细胞的表达在急性心肌梗死组和对照组中存在显著差异,与对照组相比,中性粒细胞百分率显著升高,见图3B
文章对GSE48060的样本进行聚类,在去除异常值后,绘制了一个样本聚类树,见图4。文章将软阈值设为6(R2=0.85)用以构建无标度网络,见图5。聚集了11个模块,见图6,模块过多,将相似性大的模块合并后共有7个模块,见图7。计算并绘制每个模块与急性心肌梗死和中性粒细胞之间的相关性,见图8。结果表明,ME green和ME turquoise与急性心肌梗死和中性粒细胞相关性最高(P < 0.05),被认为是关键模块进行后续分析。
使用Ven图展示GSE48060数据集、GSE66360数据集差异基因与模块基因的交集,结果显示上调组存在20个交集基因,下调组存在4个交集基因,见图9,将这24个基因作为后续分析的潜在基因。
分别对24个差异模块基因进行基于KEGG和GO的富集分析,文章以P.adjust < 0.05的条件对富集到的通路进行筛选,最终结果显示24个mRNA共富集到355个GO条目,如图10展示,Top前30条的条目,包括生物学过程、细胞组分和分子功能。生物学过程主要富集于炎症反应、对细菌的防御反应、中性粒细胞介导的免疫反应等方面;细胞组分主要富集于内吞囊泡膜、三级颗粒及特定颗粒流明等方面;分子功能富集于丝氨酸水解酶活性、丝氨酸型肽酶活性、RAGE受体结合等方面。KEGG富集结果显示富集到7条KEGG通路,如图11所示,肿瘤坏死因子信号通路、神经活性配体-受体相互作用及雌激素信号通路显著富集。
为了解这24个基因的关联,文章构建了一个PPI网络。该网络由包含21个节点,76条边组成,见图12。其中S100A12与16种蛋白具有相互作用,见图13,通过Cytohubba筛选24个差异模块基因中的核心基因,获得了MMP9,S100A12,VNN1和AQP9为核心基因。
图14A-C所示,使用支持向量模型算法得到14个特征基因,分别为S100A12,PTCH1,DSC2,ADM,MGAM,LOC400499,HP,ANXA3,MMP9,SOCS3,SLPI,MCEMP1,SULT1B1,TDRD9,使用广义线性模型算法得到8个特征基因,分别为PTCH1,MGAM,SULT1B1,LOC400499,S100A12,GZMA,HP和SOCS3,使用随机森林模型算法得到16个特征基因,分别为LOC400499,ASGR2,PTCH1,PTGDR,ANXA3,SULT1B1,SOCS3,ARG1,GZMA,SLPI,FCGR1B,MCEMP1,DSC2,S100A12,B3GNT5和A2M_AS1。
将支持向量模型算法得到14个特征基因,广义线性模型算法得到8个特征基因,随机森林模型算法得到16个特征基因进行取交集后,得到的4个基因为在3种机器学习算法中同时存在的基因分别为S100A12,PTCH1,LOC400499和SULT1B1,见图14D,将其定为候选的生物标志物。
在GES48060数据集中分析急性心肌梗死和对照样本之间与中性粒细胞相关的候选标志物的表达,并构建ROC曲线。图15A中所有基因的AUC值都大于0.78,4个基因构建模型的AUC值为0.92,说明这4个基因对于区分疾病和对照样本具有一定的准确性。
在GSE66360数据集同样绘制4个基因的ROC曲线,结果见图15B,结果显示4个基因中S100A12,PTCH1和LOC400499基因的AUC值均大于0.7,综合模型的AUC值为0.95,说明S100A12,PTCH1和LOC400499这3个基因效果较为可靠,将这3个基因视为急性心肌梗死的潜在诊断生物标志物。
S100A12基因输入STITCH数据库(http://stitch.embl.de/)后获得对应的药物靶点信息有10种,PTCH1基因在STITCH数据库结果得到1个药物。随后将PTCH1基因输入到herb数据库(http://herb.ac.cn/)中得到5个药物,S100A12基因在herb数据库结果得到1个药物。使用Cytoscape软件进行靶点-药物网络构建,如图16所示,Paquinimod,Amlexanox,quercitin及17-bate-estradiol等可能具有治疗急性心肌梗死的作用。
共收集了5例急性心肌梗死患者和5例对照组的外周血浆,为了验证数据集的可靠性,采用RT-qPCR来验证临床样本中上述3个基因的表达水平。结果显示,与正常对照组相比,急性心肌梗死患者中S100A12的表达上调(P < 0.05),见图17,PTCH1和LOC400499表达显著下调(P < 0.05),见图17
急性心肌梗死发病后临床医师一般根据典型的临床症状、心电图和传统的生物标志物肌钙蛋白及肌酸激酶同工酶水平进行诊断,随后进行溶栓或经皮冠状动脉介入术等再灌注治疗[20]。精准的早期诊断和及早治疗对于挽救患者生命和改善预后十分重要。而传统的生物标志物在外周血升高从而被检测到的时间为三四个小时,无法更早期识别急性心肌梗死患者。因此,寻找新的更早期诊断生物标志物非常重要。
中性粒细胞是一种多形核细胞,被认为是先天免疫反应的主要参与者,与其分泌的炎症递质和蛋白酶在急性心肌梗死急性期和修复期中发挥着十分重要的作用。因此,文章使用了一系列生物信息学和机器学习的分析方法进行急性心肌梗死与中性粒细胞相关生物标志物的筛选,以期得到可能识别更早期急性心肌梗死的生物标志物以及新的与中性粒细胞相关的基因靶点。最终将S100A12,PTCH1和LOC400499视为诊断急性心肌梗死的潜在生物标志物。为了进一步探讨这3个基因在急性心肌梗死中的临床意义,文章收集了急性心肌梗死患者经皮冠状动脉介入术后的外周血,采用RT-qPCR检测这3个基因的表达水平,发现这3个基因在对照组和急性心肌梗死组中表达具有显著差异,可能是急性心肌梗死潜在的诊断生物标志物。随后,文章通过Cytohubba筛选24个差异模块基因中的核心基因,结合3种机器算法得到的生物标志物,文章推测,差异表达显著的S100A12可能在急性心肌梗死中起关键调控作用,有可能成为急性心肌梗死的潜在调控靶点。
S100A12是一种在正常条件下主要存在于中性粒细胞的胞浆内的S100蛋白家族成员。当细胞受损和/或活化,S100A12会被转移到胞膜然后分泌到胞外,进入血液循环并招募更多的中性粒细胞、单核细胞等到达炎症部位并活化,完成起始和调节炎症反应及诱导细胞调亡等过程的发生[21-22]。因此,S100A12也被认为是促炎因子。大量的研究表明,S100A12在急性心肌梗死中也发挥着十分重要的作用。在ST段抬高型心肌梗死患者中S100A12显著升高,胸痛后2 h内达到峰值[23]。一项经过52周严格生活方式控制的研究中,63例患有心血管疾病或具有2种及以上心血管疾病危险因素的参与者外周血中,S100A12是减少显著的基因之一[24],这表明S100A12的表达是可调节的。一项利用AC16细胞构建缺血再灌注损伤模型的研究中发现S100A12表达水平大幅上调。随后,此研究进行S100A12敲除,发现敲除S100A12不仅能通过提高细胞活力和减少乳酸脱氢酶的释放来抑制缺血再灌注孙损伤诱导的AC16细胞损伤,还能减少细胞凋亡以及一些炎性细胞因子的产生,恢复氧化-抗氧化因子的平衡,提示S100A12可能是治疗缺血再灌注损伤的潜在靶点[25]
PTCH1除了在多种癌症中表达,如肺癌、乳腺癌、前列腺癌、卵巢癌、结肠癌、脑癌、肾上腺皮质癌和黑色素瘤,在心肌细胞和血管平滑肌细胞也有表达,是Sonic Hedgehog(Shh)配体的受体[26-28]。PTCH1与Shh结合后激活下游信号分子参与冠状脉管系统和心脏功能的稳定维持。在急性心肌梗死的大鼠中,阻断PTCH1的表达导致梗死面积增加、心功能障碍加剧,而过表达PTCH1能抑制心肌细胞凋亡,改善心功能,这可能是通过增强边界区脉管系统和最大限度减少组织缺氧来实现的,这些研究也表明,PTCH1可能是急性心肌梗死的潜在治疗靶点[29-30]。LOC400499在人体多种组织中低表达,然而很少有研究关注LOC400499在心血管疾病方面的作用,在急性心肌梗死中的生物学作用仍不清楚。因此,需进一步研究来验证文章的发现。
文章还预测了基因的靶向药物,以期辅助急性心肌梗死的治疗。通过靶点预测帕奎莫德、氨来占诺、槲皮素和17β雌二醇等可能具有治疗急性心肌梗死的作用。帕奎莫德也称为ABR-215757,在动脉粥样硬化中通过影响S100A12表达减少病变,减轻炎症细胞浸润,缩小坏死核心以及降低钙化和弹性纤维降解程度[31]。另外,氨来占诺和槲皮素对急性心肌梗死后大鼠的心功能发挥保护作用[32-33],但这些基因靶向药物还需进步一研究证实,以期为急性心肌梗死治疗带来最大效益。
然而,文章存在一定的局限性。首先,样本总数相对较少,这可能会限制差异基因的发现,降低研究的准确性。其次,数据集外周血的收集时间是在紧急经皮冠状动介入术前,而文章的血浆样本是在紧急经皮冠状动脉介入术后立即收集的,不同的时间点和干预因素可能会对S100A12等蛋白水平产生影响。文章对S100A12,PTCH1和LOC400499 mRNA相对表达的测定,其时效性和成本性及可及性,尚需进一步进行大规模、前瞻性、国际多中心研究进一步验证。
综上所述,通过生物信息学分析和机器学习方法确认了3个与急性心肌梗死和中性粒细胞相关的基因,分别为S100A12,PTCH1和LOC400499,可能是更早期诊断急性心肌梗死的生物标志物,但是其与急性心肌梗死相关的特异性尚需进一步研究,其中S100A12可能是调控急性心肌梗死的潜在靶点。
  • 贵州省卫生健康委科学技术基金项目(gzwkjz2023-100)
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2025年第29卷第36期
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doi: 10.12307/2025.523
  • 接收时间:2024-04-17
  • 首发时间:2026-04-02
  • 出版时间:2025-12-28
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  • 收稿日期:2024-04-17
  • 修回日期:2024-07-13
  • 录用日期:2024-06-01
基金
Science and Technology Fund Project of Guizhou Provincial Health Commission(gzwkjz2023-100)
贵州省卫生健康委科学技术基金项目(gzwkjz2023-100)
作者信息
    1贵州医科大学附属医院高血压科,贵州省贵阳市 550004
    2川北医学院,四川省南充市 637100

通讯作者:

余振球,主任医师,贵州医科大学附属医院高血压科,贵州省贵阳市 550004
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