RÉSUMÉ
OBJETIVO: Investigar o efeito da expressão de RNAm dos SMADs e de microRNAs (miRNAs) que possuem o TGFB1 como alvo na expressão gênica (RNAm e proteína) de TGF-ß1 e seu papel na fisiopatologia da angiogênese em pacientes com mielofibrose (MF) e trombocitemia essencial (TE). MÉTODOS: Foram incluídos 21 pacientes com MF primária (MFP), 21 com MF pós-TE (MFPTE) e 24 com TE, além de 98 indivíduos controles pareados de acordo com gênero e idade com os pacientes. As análises realizadas no sangue periférico foram: quantificação das concentrações plasmáticas e de RNAm de TGFB1, VEGFA e FGF2; quantificação de RNAm de SMADs 1 a 7 e de miRNAs 193a-5p, 369-5p, 542-5p, 590-3p, e 590- 5p; e detecção das mutações JAK2V617F (com quantificação alélica), MPLW515K/L e CALR. Em 26 biópsias de medula óssea dos pacientes, foram determinados o grau de microvasculatura (angiogênese estimada - CD34), a imunoexpressão de TGF-b1 ativo, TGF-ß1 latente e c-MPL. RESULTADOS: As concentrações de TGF- ß1 plasmático foram semelhantes entre os pacientes e controles, enquanto o VEGFA plasmático foi maior em todos os grupos de pacientes comparados aos seus controles. O FGF2 plasmático também foi maior em todos os grupos de pacientes, e a expressão de seu RNAm foi maior nos pacientes com TE do que em seus controles. As expressões de SMADs e de miRNAs foram semelhantes entre pacientes e controles. TGF-ß1 e FGF2 plasmáticos apresentaram correlações positivas nos pacientes com MFP, e correlações negativas nos seus controles, assim como nos controles de MFPTE. Em todos os grupos estudados foi observada correlação positiva entre TGF-ß1 e VEGFA plasmáticos. Além disso, foram demonstrados diferentes perfis de correlações entre a expressão gênica de TGF-ß1 e os diversos SMADs e miRNAs em cada grupo de pacientes e controles. Os pacientes com MFP com maior angiogênese (de acordo com a mediana da concentração plasmática de VEGFA e FGF2) apresentaram maiores concentrações plasmáticas de TGF-ß1 do que aqueles com menor angiogênese. A angiogênese medular estimada (CD34) não foi diferente entre os três grupos de pacientes estudados. Além disso, não foram encontradas correlações entre a imunoexpressão de CD34 e as expressões de RNAm de TGFB1, VEGFA e FGF2 medulares nem em leucócitos de sangue periférico, ou a concentrações plasmáticas de TGF-ß1, VEGFA e FGF2. As imunoexpressões de TGF-b1 ativo, TGF-ß1 latente e c-MPL foram semelhantes entre os três grupos de pacientes. As frequências das mutações avaliadas foram similares às descritas na literatura. Os pacientes com MFPTE portadores de mutação CALR apresentaram menores concentrações plasmáticas de VEGFA e FGF2 do que os JAK2V617F positivos, enquanto os pacientes com TE portadores de mutação CALR exibiram menores concentrações plasmáticas de TGF-ß1 do que os portadores de JAK2V617F. CONCLUSÕES: O presente trabalho permitiu confirmar a correlação positiva entre o TGF-ß1 com outros dois marcadores de angiogênese (VEGFA e FGF2). As expressões de SMADs e de miRNAs estudados foram semelhantes entre pacientes e controles, visto não haver diferenças na expressão gênica de TGF-ß1. Entretanto, disparidades encontradas nas correlações entre a expressão gênica de TGF-ß1 e diferentes SMADs e miRNAs nos pacientes e controles poderiam indicar que a regulação da expressão gênica de TGF-ß1 nas doenças estudadas seja distinta da apresentada nos indivíduos sem essas doenças
AIM: To investigate the effects of the expression of SMADs mRNA and microRNAs (miRNAs) that target TGFB1 in TGF-ß1 gene expression (mRNA and protein) and its role in the angiogenesis pathophysiology in myelofibrosis (MF) and essential thrombocythemia (ET) patients. METHODS: Twenty-one primary MF (PMF), twenty-one MF post-ET (MPET) and twenty-four ET patients were included, besides 98 controls matched for gender and age with patients. In peripheral blood were assessed: TGF-ß1, VEGFA and FGF2 plasmatic levels and mRNA quantification; SMADs 1 to 7 mRNA quantification and miRNAs 193a-5p, 369-5p, 542-5p, 590-3p, and 590-5p quantification; and detection of JAK2V617F (and allele burden), MPLW515K/L and CALR mutations. Estimated angiogenesis (microvessel grade - CD34), active TGF-b1, latent TGF-ß and c-MPL immunoexpression were determined in 26 bone marrow biopsies. RESULTS: Plasmatic TGF-ß1 levels were similar in patients and controls, while all the patients groups had higher plasmatic VEGFA than controls. Plasmatic FGF2 was higher in all the patients groups, and its mRNA expression was higher in ET patients than in controls. No differences in SMADs and miRNAs expression were found between patients and controls. There was a positive correlation between plasmatic TGF-ß1 and FGF2 in PMF, and a negative correlation between these variables in their controls, as well as in MPET controls. In all studied groups, there was a positive correlation between plasmatic TGF-ß1 and VEGF. In addition, different profiles of correlations were demonstrated between TGF-ß1 gene expression and the several SMADs and miRNAs studied in each group of patients and controls. PMF patients with higher angiogenesis (according to the median of VEGFA and FGF2 plasma levels) had higher plasmatic TGF-ß1 levels than those with lower angiogenesis. Estimated angiogenesis (CD34) in bone marrow biopsies were not different among PMF, MPET and ET patients. Moreover, there were no correlation between CD34 immunoexpression and TGFB1, VEGFA and FGF2 mRNA bone marrow or peripheral blood expression or plasmatic levels, as well as latent TGF-ß1, active TGF-b1, and c-MPL immunoexpression were similar in patients studied groups. The frequencies of evaluated mutations were similar to previously reported. MPET patients harboring CALR mutations had lower plasmatic VEGFA and FGF2 than JAK2V617F mutated, while ET patients carrying CALR mutations had lower plasmatic TGF-ß1 than JAK2V617F mutated. CONCLUSIONS: This study confirmed the positive correlation among TGF-ß1 and two other markers of angiogenesis (VEGFA and FGF2). SMADs and miRNAs expressions were similar between patients and controls, since there were no differences in TGF-ß1 gene expression between patients and controls. However, disparities found in the correlations between TGF-ß1 gene expression and different SMADs and miRNAs in patients and controls may indicate that TGF-ß1 gene expression regulation in studied diseases is distinct from those presented by individuals without these diseases
Sujet(s)
Expression des gènes , microARN/analyse , Protéines Smad/analyse , Myélofibrose primitive , Thrombocytémie essentielle , Cytokines , HématologieRÉSUMÉ
OBJECTIVE: Adenosine deaminase acts on adenosine and deoxyadenosine metabolism and modulates the immune response. The adenosine deaminase G22A polymorphism (20q.11.33) influences the level of adenosine deaminase enzyme expression, which seems to play a key role in maintaining pregnancy. The adenosine deaminase 2 phenotype has been associated with a protective effect against recurrent spontaneous abortions in European Caucasian women. The aim of this study was to investigate whether the G22A polymorphism of the adenosine deaminase gene is associated with recurrent spontaneous abortions in Brazilian women. METHODS: A total of 311 women were recruited to form two groups: G1, with a history of recurrent spontaneous abortions (N = 129), and G2, without a history of abortions (N = 182). Genomic DNA was extracted from peripheral blood with a commercial kit and PCR-RFLP analysis was used to identify the G22A genetic polymorphism. Fisher's exact test and odds ratio values were used to compare the proportions of adenosine deaminase genotypes and alleles between women with and without a history of recurrent spontaneous abortion (p<0.05). The differences between mean values for categorical data were calculated using unpaired t tests. The Hardy-Weinberg equilibrium was assessed with a chi-square test. RESULTS: Statistically significant differences were identified for the frequencies of adenosine deaminase genotypes and alleles between the G1 and G2 groups when adjusted for maternal age. CONCLUSIONS:The results suggest that the adenosine deaminase *2 allele is associated with a low risk for recurrent spontaneous abortions, but this association is dependent on older age.