Gene expression profiling in elderly patients with familial hypercholesterolemia with and without coronary heart disease.

Atherosclerosis

Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Norway; Norwegian National Advisory Unit on Familial Hypercholesterolemia, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital Aker, Norway. Electronic address:

Published: May 2024

AI Article Synopsis

  • Elderly familial hypercholesterolemia (FH) patients usually face high risks of coronary heart disease (CHD), but a subset remains free of CHD, suggesting the existence of protective factors.
  • A study analyzed gene expression in blood cells from elderly FH patients with and without CHD, aiming to uncover potential cardioprotective gene profiles.
  • Results indicated that while no significant gene expression differences were found between the two FH groups after adjustments, certain genes related to lipid metabolism and immune response showed nominal differences, highlighting a less atherogenic profile in event-free individuals.

Article Abstract

Background And Aims: Elderly familial hypercholesterolemia (FH) patients are at high risk of coronary heart disease (CHD) due to high cholesterol burden and late onset of effective cholesterol-lowering therapies. A subset of these individuals remains free from any CHD event, indicating the potential presence of protective factors. Identifying possible cardioprotective gene expression profiles could contribute to our understanding of CHD prevention and future preventive treatment. Therefore, this study aimed to investigate gene expression profiles in elderly event-free FH patients.

Methods: Expression of 773 genes was analysed using the Nanostring Metabolic Pathways Panel, in peripheral blood mononuclear cells (PBMCs) from FH patients ≥65 years without CHD (FH event-free, n = 44) and with CHD (FH CHD, n = 39), and from healthy controls ≥70 years (n = 39).

Results: None of the genes were differentially expressed between FH patients with and without CHD after adjusting for multiple testing. However, at nominal p < 0.05, we found 36 (5%) differentially expressed genes (DEGs) between the two FH groups, mainly related to lipid metabolism (e.g. higher expression of ABCA1 and ABCG1 in FH event-free) and immune responses (e.g. lower expression of STAT1 and STAT3 in FH event-free). When comparing FH patients to controls, the event-free group had fewer DEGs than the CHD group; 147 (19%) and 219 (28%) DEGs, respectively.

Conclusions: Elderly event-free FH patients displayed a different PBMC gene expression profile compared to FH patients with CHD. Differences in gene expression compared to healthy controls were more pronounced in the CHD group, indicating a less atherogenic gene expression profile in event-free individuals. Overall, identification of cardioprotective factors could lead to future therapeutic targets.

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http://dx.doi.org/10.1016/j.atherosclerosis.2024.117507DOI Listing

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