Sex-dependent aortic valve pathology in patients with rheumatic heart disease

Feng Xiao, Rui Zheng, Di Yang, Kejiang Cao, Shijiang Zhang, Bingruo Wu, Yongfeng Shao, Bin Zhou

Research output: Contribution to journalArticle

Abstract

Background: Rheumatic heart disease is an autoimmune disease caused by group A streptococci infection and frequently affects the aortic valve. Sex differences are common in the disease progression, treatment, and outcome. However, little is known about the sex differences in the pathology of aortic valves in rheumatic heart disease. Design: We studied the end-stage calcific aortic valves from male versus female patients to reveal the sex-dependent pathology differences and molecular changes associated with requiring valve replacement. Methods: Aortic valves from 39 patients with rheumatic heart disease (19 males and 20 females) were collected at the time of aortic valve replacement for comparative pathology, immunohistochemistry, and gene expression analyses. Clinical characteristics were also analyzed and compared between the two groups. Results: Aortic valves from female patients exhibited increased expression of collagens, infiltration of monocytes/macrophages and neovascularization. Aortic valves from female patients also had increased expression of inflammatory genes involved in the NFKB pathway (phosphorylated NFKB p65 subunit, IL8, and NOS3) and Th1 cytokine genes (IFNA and IL12B). The severe valve pathology in female patients was correlated with a higher serum level of antistreptolysin O antibodies. Conclusion: Inflammation is more prominent in aortic valves of female patients with rheumatic heart disease. This sex difference may contribute to the severe valve pathology and worse outcome of female patients.

Original languageEnglish (US)
Article numbere0180230
JournalPLoS One
Volume12
Issue number6
DOIs
StatePublished - Jun 1 2017

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Rheumatic Heart Disease
heart diseases
Pathology
Aortic Valve
gender
gender differences
Sex Characteristics
Genes
Antistreptolysin
Macrophages
Interleukin-8
Gene Expression
Infiltration
autoimmune diseases
Gene expression
Streptococcus
Molecular Pathology
angiogenesis
disease course
monocytes

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Sex-dependent aortic valve pathology in patients with rheumatic heart disease. / Xiao, Feng; Zheng, Rui; Yang, Di; Cao, Kejiang; Zhang, Shijiang; Wu, Bingruo; Shao, Yongfeng; Zhou, Bin.

In: PLoS One, Vol. 12, No. 6, e0180230, 01.06.2017.

Research output: Contribution to journalArticle

Xiao, Feng ; Zheng, Rui ; Yang, Di ; Cao, Kejiang ; Zhang, Shijiang ; Wu, Bingruo ; Shao, Yongfeng ; Zhou, Bin. / Sex-dependent aortic valve pathology in patients with rheumatic heart disease. In: PLoS One. 2017 ; Vol. 12, No. 6.
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