The angiogenic gene profile of pulmonary endarterectomy specimens: Initial studyCentral MessagePerspective
Nezih Onur Ermerak, MD,
Betul Yilmaz, MD,
Saime Batirel, MD,
Sehnaz Olgun Yildizeli, MD,
Derya Kocakaya, MD,
Bulent Mutlu, MD,
Serpil Tas, MD,
Bedrettin Yildizeli, MD
Affiliations
Nezih Onur Ermerak, MD
Department of Thoracic Surgery, Marmara University School of Medicine, Istanbul, Turkey; Address for reprints: Nezih Onur Ermerak, MD, Department of Thoracic Surgery, Marmara University School of Medicine, Fevzi Cakmak Mah. Mimar Sinan Cad. No: 41, Ust Kaynarca, Pendik, İstanbul, 34899, Turkey.
Betul Yilmaz, MD
Department of Biochemistry, Marmara University School of Medicine, Istanbul, Turkey
Saime Batirel, MD
Department of Biochemistry, Marmara University School of Medicine, Istanbul, Turkey
Sehnaz Olgun Yildizeli, MD
Department of Biochemistry, Marmara University School of Medicine/Genetic and Metabolic Diseases Research and Investigation Center (GEMHAM), Marmara University, Istanbul, Turkey
Derya Kocakaya, MD
Department of Biochemistry, Marmara University School of Medicine/Genetic and Metabolic Diseases Research and Investigation Center (GEMHAM), Marmara University, Istanbul, Turkey
Bulent Mutlu, MD
Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey
Serpil Tas, MD
Department of Cardiovascular Surgery, Kosuyolu Training and Research Hospital, Istanbul, Turkey
Bedrettin Yildizeli, MD
Department of Thoracic Surgery, Marmara University School of Medicine, Istanbul, Turkey
Objectives: The underlying mechanisms for the development of chronic thromboembolic pulmonary hypertension and prognostic biomarkers are not clear yet. Thus, our aim is to assess and identify new biomarkers for the expression of 84 key genes linked to angiogenesis. Methods: Patients who had levels more than 1000 dynes·sec·cm−5 were included in the test group, and the other patients were included in the control group. Twelve specimens were taken from the patients. RT2 Profiler PCR Array (Qiagen) was used to quantify the expression of the 84 key genes. Results: Eight patients (6 male, 2 female, median age 54.4 ± 13.1 years) who underwent pulmonary endarterectomy were included. Pulmonary vascular resistance improved significantly from 811 ± 390 dyn/s/cm−5 to 413.3 ± 144.9 dyn/s/cm−5 (P .005) after surgery. Median length of hospital stay was 11.62 ± 2.97 days. The test group had a distinct pattern of impaired angiogenic and antiangiogenic genes. The expression levels of TGFA, TGFB1, THBS2, THBS1, TGFBR1, SERPINE1, SERPINF1, TGFB2, TIMP2, VEGFC, IFNA1, TNF, CXCL10, NOS3, IGF1, and MMP14 were downregulated in the specimens from the patients who had higher pulmonary vascular resistance values, whereas some genes, including PDGFA, showed upregulation that was statistically nonsignificant in the same group. Conclusions: These results can lead to the development of new markers that could predict adverse outcomes of patients with CTEPH. Identification of new markers that are related to worse outcomes would enable screening patients for early diagnosis and treatment.
