Cardiovascular Diseases Clinical Trial
Official title:
Circulating Non-coding RNAs and Cardiovascular Outcomes in Patients With Dyslipidemia and Atherosclerosis
Cardiovascular diseases and stroke are the major causes of morbidity and death in Taiwan.
There is a clear need to identify novel mediators of atherosclerosis in dyslipidemic patients
to provide insights into the pathogenesis, to tailor clinical care based on cardiovascular
risks, and to develop new therapeutic strategies.
While the roles of lncRNAs in human diseases including cancer and neurodegenerative disorders
are beginning to emerge, it remains unclear how lncRNA regulation contributes to
atherosclerotic vascular diseases in patients with dyslipidemia. In this proposal, we seek to
apply next-generation sequencing technology to investigate circulating (plasma and peripheral
blood mononuclear cells [PBMC]) lncRNA expression in control subjects and in dyslipidemic
patients with and without atherosclerotic vascular diseases (CAD, ischemic stroke and PAOD).
The results from these experiments will lead to better understanding of how circulating
lncRNAs contribute to atherosclerotic cardiovascular complications.
Cardiovascular diseases and stroke are the major causes of morbidity and death in Taiwan.
Patients with dyslipidemia are prone to atherosclerosis, which predispose to various
cardiovascular pathology including coronary artery disease (CAD), ischemic stroke and
peripheral artery occlusive disease (PAOD). There are, however, no reliable biomarkers to
detect atherosclerotic vascular diseases among dyslipidemic patients or to predict the risks
of cardiovascular morbidities and mortality among patients with atherosclerosis. There is a
clear need to identify novel mediators of atherosclerosis in dyslipidemic patients to provide
insights into the pathogenesis, to tailor clinical care based on cardiovascular risks, and to
develop new therapeutic strategies.
It has become increasingly clear that the transcription of the eukaryotic genome is far more
pervasive and complex than previously appreciated. While the expression of messenger RNAs
(mRNAs) and microRNAs (miRNAs) account for only ~1% of all transcribed species, up to 90% of
the mammalian genome is transcribed as long non-coding RNAs (lncRNAs), a heterogeneous group
of non-coding transcripts longer than 200 nucleotides. LncRNAs have been shown to be
functional and involved in specific physiological and pathological processes through
epigenetic, transcriptional and post-transcriptional mechanisms. While the roles of lncRNAs
in human diseases including cancer and neurodegenerative disorders are beginning to emerge,
it remains unclear how lncRNA regulation contributes to atherosclerotic vascular diseases in
patients with dyslipidemia.
In this proposal, we seek to apply next-generation sequencing technology to investigate
circulating (plasma and peripheral blood mononuclear cells [PBMC]) lncRNA expression in
control subjects and in dyslipidemic patients with and without atherosclerotic vascular
diseases (CAD, ischemic stroke and PAOD). We will test the hypothesis that circulating lncRNA
expression signature can reflect the atherosclerotic disease states in patients with
dyslipidemia. A gene co-expression network analysis will be conducted to identify lncRNAs
that are functionally involved in the pathogenesis of atherosclerosis. With the experimental
results from an initial dyslipidemic cohort, we will establish an atherosclerosis scoring
model on the basis of circulating lncRNA expression signature to facilitate the detection of
atherosclerotic vascular diseases in patients with dyslipidemia. The accuracy, sensitivity
and specificity of the lncRNA-based atherosclerosis scoring system will then be tested in an
independent, large validation cohort. Next, we propose to test the hypothesis that
circulating lncRNAs can be novel prognostic biomarkers to predict atherosclerosis progression
and cardiovascular outcomes in dyslipidemic patients. The results from these experiments will
lead to better understanding of how circulating lncRNAs contribute to atherosclerotic
cardiovascular complications. These studies will also establish a set of novel, lncRNA-based
diagnostic and prognostic biomarker in dyslipidemic patients to improve clinical preventive
and therapeutic care. In addition, the findings from these studies will help to develop novel
therapeutic strategies to treat or prevent atherosclerotic vascular diseases in patients with
dyslipidemia.
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