期刊
CLINICAL AND TRANSLATIONAL MEDICINE
卷 11, 期 11, 页码 -出版社
JOHN WILEY & SONS LTD
DOI: 10.1002/ctm2.558
关键词
angiogenesis; arrhythmias; atrial fibrillation; atrial remodeling; epithelial-to-mesenchymal transition; extracellular matrix; transcriptome
资金
- ZonMW/NWO [106.146.310]
The study found that in atrial fibrillation (AF) patients, there was a decrease in epicardial cell gene expression, while an upregulation of epithelial-to-mesenchymal transition (EMT) and mesenchymal cell gene expression. Immunohistochemistry analysis showed thickening of the epicardium and an increase in (myo)fibroblast-like cells in the myocardium in AF patients. Additionally, endothelial cell proliferation, angiogenesis, and endothelial signaling were found to be upregulated in AF patients.
Background Improved understanding of the interconnectedness of structural remodeling processes in atrial fibrillation (AF) in patients could identify targets for future therapies. Methods We present transcriptome sequencing of atrial tissues of patients without AF, with paroxysmal AF, and persistent AF (total n = 64). RNA expression levels were validated in the same and an independent cohort with qPCR. Biological processes were assessed with histological and immunohistochemical analyses. Results In AF patients, epicardial cell gene expression decreased, contrasting with an upregulation of epithelial-to-mesenchymal transition (EMT) and mesenchymal cell gene expression. Immunohistochemistry demonstrated thickening of the epicardium and an increased proportion of (myo)fibroblast-like cells in the myocardium, supporting enhanced EMT in AF. We furthermore report an upregulation of endothelial cell proliferation, angiogenesis, and endothelial signaling. EMT and endothelial cell proliferation concurred with increased interstitial (myo)fibroblast-like cells and extracellular matrix gene expression including enhanced tenascin-C, thrombospondins, biglycan, and versican. Morphological analyses discovered increased and redistributed glycosaminoglycans and collagens in the atria of AF patients. Signaling pathways, including cell-matrix interactions, PI3K-AKT, and Notch signaling that could regulate mesenchymal cell activation, were upregulated. Conclusion Our results suggest that EMT and endothelial cell proliferation work in concert and characterize the (myo)fibroblast recruitment and ECM remodeling of AF. These processes could guide future research toward the discovery of targets for AF therapy.
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