BMPR2 promoter methylation and its expression in valvular heart disease complicated with pulmonary artery hypertension

Abstract

Valvular heart disease (VHD) is a common heart disease that affects blood flow. It usually requires heart surgery. Valvular heart disease complicated with pulmonary artery hypertension (VHD-PAH) may be lethal due to heart failure that results from increased heart burden. It is important for these patients to seek early treatment in order to minimize the heart damage. However, there is no reliable diagnosis method in VHD. In this study, we found DNA methylation was increased at the promoter of BMPR2 gene in the VHD patients compared with the healthy controls. This finding was confirmed by an independent cohort study of VHD patients and healthy controls. In addition, BMPR2 mRNA levels were reduced in the plasma of the VHD patients. There is strong correlation between BMPR2 promoter DNA methylation and the severity of VHD. Indeed, we found that both BMPR2 promoter DNA methylation and BMPR2 mRNA levels in the plasma are good biomarkers of VHD by themselves, with the respective AUC value of 0.879 and 0.725, respectively. When they were used in combination, the diagnostic value was even better, with the AUC value of 0.93. Consistent with the results in the VHD patients, we observed decreased BMPR2 and increased fibrosis in the lung of a PAH model mouse. BMPR2 was also decreased in the hearts of the PAH mice, whereas BMP4 was increased. Furthermore, BMPR2 was reduced in the heart valve tissue samples of human VHD patients after valve replacement with moderate/severe PAH compared with those with mild PAH. There was also increased apoptosis in the hearts of the PAH mice. BMPR2 promoter DNA methylation and its expression appear to be good biomarkers for VHD. Our results also suggest that DNA methylation may cause PAH through deregulation of BMP signaling and increased apoptosis.

Study on potential differentially expressed genes in idiopathic pulmonary fibrosis by bioinformatics and next generation sequencing data analysis

“…By performing DEGs analysis, 479 up regulated and 479 down regulated DEGs were successfully identified (|logFC| > 0.512 for up regulated genes, |logFC| < -0.831 for down regulated genes and adjust P-value < .05), respectively. Involvement of SLCO1A2 molecule) [315], DACH1 [316], PNPLA3 [317], FGF9 [192], SLC7A11 [193], SGPP1 [318], VIP (vasoactive intestinal peptide) [319], KCNJ2 [320], KL (klotho) [321], SMAD6 [135], BMPR2 [322], APOA1 [323], CALCRL (calcitonin receptor like receptor) [324], INSIG1 [325], RASGRF1 [198], LRRK2 [326], TLR3 [327], ADRB1 [328], SLC22A3 [329], CA2 [330], SNX10 [331], LIFR (LIF receptor subunit alpha) [332], TLR8 [333], CMPK2 [334], GATA3 [335], RSPO2 [336], CCR2 [205], NEK7 [337], TLR7 [338], BEX1 [339], EFNB2 [340], CAV1 [341], ARRB1 [342], TRPC3 [343], CR1 [344], PEG10 [345], DLL4 [346], MEFV (MEFV innate immuity regulator, pyrin) [347], TFPI (tissue factor pathway inhibitor) [348], EPAS1 [349], FADS1 [215], DKK2 [350], CACNA2D2 [351], DPP6 [352]…”

Unraveling the epigenetic landscape of pulmonary arterial hypertension: implications for personalized medicine development

“…Accumulating evidence suggests that DNA methylation is involved in the regulation of bone morphogenetic protein receptor type 2 (BMPR2), a member of the TGF-β superfamily [ 43 – 45 ]. To date, autosomal dominant mutations causing haploinsufficiency or loss of BMPR2 function account for 70% of familial PAH (FPAH) cases and 20% of sporadic cases of idiopathic PAH [ 46 ].…”

Epigenetic regulation of programmed cell death in hypoxia-induced pulmonary arterial hypertension

“…Due to the regulatory role in tumors, DNA methylation may regulate targets associated with programmed cell death in PAH. Indeed, DNA methylation in the promoter region of BMPR2 induces PAH by regulating BMP signaling pathways and increasing cell apoptosis ( 83 ). It is worth noting that more investigations are required to ascertain the involvement of DNA methylation in the processes of ferroptosis, autophagy, and pyroptosis in PAH.…”