TY - JOUR
T1 - Complement C5 Protein as a Marker of Subclinical Atherosclerosis
AU - Martínez-López, Diego
AU - Roldan-Montero, Raquel
AU - García-Marqués, Fernando
AU - Nuñez, Estefania
AU - Jorge, Inmaculada
AU - Camafeita, Emilio
AU - Minguez, Pablo
AU - Rodriguez de Cordoba, Santiago
AU - López-Melgar, Beatriz
AU - Lara-Pezzi, Enrique
AU - Fernández-Ortiz, Antonio
AU - Ibáñez, Borja
AU - Valdivielso, Jose Manuel
AU - Fuster, Valentín
AU - Michel, Jean Baptiste
AU - Blanco-Colio, Luis Miguel
AU - Vázquez, Jesús
AU - Martin-Ventura, Jose Luis
N1 - Publisher Copyright:
© 2020 The Authors
PY - 2020/4/28
Y1 - 2020/4/28
N2 - Background: The mechanisms underlying early atherosclerotic plaque formation are not completely understood. Moreover, plasma biomarkers of subclinical atherosclerosis are lacking. Objectives: The purpose of this study was to analyze the temporal and topologically resolved protein changes taking place in human aortas with early atherosclerosis to find new potential diagnostic and/or therapeutic targets. Methods: The protein composition of healthy aortas (media layer) or with early atheroma (fatty streak and fibrolipidic, media and intima layers) was analyzed by deep quantitative multiplexed proteomics. Further analysis was performed by Western blot, immunohistochemistry, real-time polymerase chain reaction, and enzyme-linked immunosorbent assay. Plasma levels of complement C5 were analyzed in relation to the presence of generalized (>2 plaques) or incipient (0 to 2 plaques) subclinical atherosclerosis in 2 independent clinical cohorts (PESA [Progression of Early Subclinical Atherosclerosis] [n = 360] and NEFRONA [National Observatory of Atherosclerosis in Nephrology] [n = 394]). Results: Proteins involved in lipid transport, complement system, immunoglobulin superfamily, and hemostasis are increased in early plaques. Components from the complement activation pathway were predominantly increased in the intima of fibrolipidic plaques. Among them, increased C5 protein levels were further confirmed by Western blot, enzyme-linked immunosorbent assay and immunohistochemistry, and associated with in situ complement activation. Plasma C5 was significantly increased in individuals with generalized subclinical atherosclerosis in both PESA and NEFRONA cohorts, independently of risk factors. Moreover, in the PESA study, C5 plasma levels positively correlated with global plaque volume and coronary calcification. Conclusions: Activation of the complement system is a major alteration in early atherosclerotic plaques and is reflected by increased C5 plasma levels, which have promising value as a novel circulating biomarker of subclinical atherosclerosis.
AB - Background: The mechanisms underlying early atherosclerotic plaque formation are not completely understood. Moreover, plasma biomarkers of subclinical atherosclerosis are lacking. Objectives: The purpose of this study was to analyze the temporal and topologically resolved protein changes taking place in human aortas with early atherosclerosis to find new potential diagnostic and/or therapeutic targets. Methods: The protein composition of healthy aortas (media layer) or with early atheroma (fatty streak and fibrolipidic, media and intima layers) was analyzed by deep quantitative multiplexed proteomics. Further analysis was performed by Western blot, immunohistochemistry, real-time polymerase chain reaction, and enzyme-linked immunosorbent assay. Plasma levels of complement C5 were analyzed in relation to the presence of generalized (>2 plaques) or incipient (0 to 2 plaques) subclinical atherosclerosis in 2 independent clinical cohorts (PESA [Progression of Early Subclinical Atherosclerosis] [n = 360] and NEFRONA [National Observatory of Atherosclerosis in Nephrology] [n = 394]). Results: Proteins involved in lipid transport, complement system, immunoglobulin superfamily, and hemostasis are increased in early plaques. Components from the complement activation pathway were predominantly increased in the intima of fibrolipidic plaques. Among them, increased C5 protein levels were further confirmed by Western blot, enzyme-linked immunosorbent assay and immunohistochemistry, and associated with in situ complement activation. Plasma C5 was significantly increased in individuals with generalized subclinical atherosclerosis in both PESA and NEFRONA cohorts, independently of risk factors. Moreover, in the PESA study, C5 plasma levels positively correlated with global plaque volume and coronary calcification. Conclusions: Activation of the complement system is a major alteration in early atherosclerotic plaques and is reflected by increased C5 plasma levels, which have promising value as a novel circulating biomarker of subclinical atherosclerosis.
KW - biomarkers
KW - complement system
KW - proteomics
KW - subclinical atherosclerosis
UR - http://www.scopus.com/inward/record.url?scp=85083692994&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2020.02.058
DO - 10.1016/j.jacc.2020.02.058
M3 - Article
C2 - 32327104
AN - SCOPUS:85083692994
SN - 0735-1097
VL - 75
SP - 1926
EP - 1941
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 16
ER -