Differentially expressed RNAs, such as genes, miRNAs, lncRNAs and ceRNAs, have been discovered in several published studies on NEC, but limited integrated analysis among different NEC datasets and studies involving TFs in NEC have been established. NEC is a multiple etiologically guided intestinal inflammatory disease. Thus, changes in more than one gene or non-coding RNA may lead to inflammatory response, and it is necessary to establish an integrated network that allows discovery of critical disease-related genes, hub genes or pathogenicity of key clusters involved in the pathological processes of NEC. To our knowledge, this is the first study to construct a miRNA–TF–gene network to predict hub genes and clusters which show higher relevance than other differentially expressed RNAs or TFs in NEC. One hundred and twenty-three co-DEGs and 14 DEMis were identified. After hub gene identification, TF prediction, pairs foundation and FFL/FBL filtration, the miRNA–TF–hub gene interaction network was formed. Based on this network, previously published NEC-related candidate genes (TLR4 [9, 31], NFKB1 [32])and RNAs (Hsa-miR-223 [10]) and novel miRNA–TF–gene triplets that showed great connection towards several fundamental pathogenic pathways were identified. We would like to discuss some of the novel NEC miRNA–gene pairs, TF–gene pairs and gene families in the interaction network, hoping that they will be validated in the future and lead to greater comprehension towards the pathogenesis of NEC.
Table 1 ranks of 15 nodes in the interaction network by five parameters
MCC Maximal Clique Centrality, EPC Edge Percolated Component
In the present study, hsa-miR-200a had the highest MCC/degree/EPC/Closeness/Betweenness among all miRNAs in the interaction network. Hsa-miR-200b, hsa-miR-200c, hsa-miR-429 and hsa-miR-141 also showed adequate closeness and betweenness. These results suggest us that the miR-200 family might have great value or function in NEC. The miR-200 family, composed of 5 members [33] (141, 200a, 200b,200c and 429), were associated by gene expression in various tissues at corresponding times and spaces. Expression of miR-200 family members is mainly associated with neurodegenerative diseases such as Parkinson`s disease or Alzheimer`s disease [34–37] and renal/pulmonary fibrosis [38, 39]. Moreover, miR-200 family have shown tumor-promoting as well as tumor-suppressive effects in multiple cancer types, including colorectal cancer [40, 41], bladder cancer [42, 43], prostate cancer [44, 45], ovarian cancer [46] and so on. In NEC, miR-141 expression is altered during the inflammatory response along with TLR4 [47, 48]. Additionally, miR-200a-3p/141-3p regulate RIPK1 [49, 50], and has been well-studied for its participation in inflammation and cell death [51, 52]. Interestingly, even though all these miR-200 families show great relevance in inflammation, miR-200a has specifically been shown to be related to inflammation-related genes, e.g., TLR4 or CXCL5 [53, 54]. To our knowledge, only one published pathological experiment regarding miR-200a in NEC via RIPK1 has been published [50]. Thus, we would like to discuss further about miR-200a and its downstream TFs or genes.
In the predicted miRNA–TF–hub gene interaction network, 4 hub genes (AGT, CXCL5, PLEK and TLR4) and 3 TFs (GATA3, JUN, NFKB1) were related to miR-200a. Firstly, we would like to discuss 4 hub genes. C-X-C motif chemokine ligand 5 (CXCL5), also named as neutrophil activating peptide 78 (ENA-78), is from the CXC subfamily of chemokines. CXCL5 has been known as a crucial biomarker in most of cancers and had different bioprocess in each type of cancer. CXCL5 was up-regulated in inflammatory bowel disease (IBD) models and patients [55, 56], but the mechanism of CXCL5 in IBD or NEC were hardly validated and few articles regarding CXCL5 and Hsa-miR-200a have been published. TLR4 is a well-known gene in the pathogenesis of NEC, its activation by lipopolysaccharide develops the dysfunction of intestinal epithelium and the activation of inflammatory storm in NEC. In recent years, TLR4 has been further demonstrated to be involved in the regeneration of intestinal epithelial cells (IEC) mediated by IGF-1 produced by macrophages [57], and the TLR4-NFKB signaling axis where TLR4 is located was confirmed to be regulated by MD2 and TRPM7 [58, 59]. The relationship between TLR4 and miRNA has been well studied including Hsa-miR-200a, so few articles about this relationship were found in recent years. Pleckstrin (PLEK) is a mediator of in several pathways and located in cytoplasm and ruffle membrane. In the published articles related to intestinal inflammation, PLEK only appeared in the articles calculating the DEGs, the mechanism of PLEK in intestinal inflammation is still unclear. In GO terms of co-DEGs, PLEK was found in the metabolic processes of various chemicals. Angiotensinogen (AGT) is the precursor of the angiotensin converting enzyme (ACE) which has been known to be in the renin-angiotensin system and mediate sodium homeostasis, blood pressure and inflammation. In GO analysis of co-DEGs, GO terms containing AGT mainly included protein-lipid complex subunit organization, plasma lipoprotein particle organization, lipid localization and lipid transport. Most of these GO terms were accompanied with APOC1, APOC3 and SOAT2. Published articles confirmed that AGT is responsible for acute renal injury [60] and acute pancreatitis [61], and overexpressed AGT correlates with the worst survival of rectum and stomach adenocarcinoma [62]. But none of articles regarding AGT and intestinal disease have been published. Similarly, three TFs (GATA3 [63], JUN [64], NFKB1 [65]) that was related to miR-200a were all validated in the inflammatory response. Because these TFs were only predicted without validated data, they would be discussed based on set parameters from the interaction network in the following paragraph.
For the interaction network, parameters (MCC, Degree, EPC, Closeness and Betweenness) calculated by topology algorithm in interaction network determined which node was critical in the pathogenesis of NEC. CXCL5 had the highest MCC, degree and EPC amongst the hub genes and was regulated by three TFs (GATA3, JUN and NKFB1) that were all related to miR-200a, showing its significance in the interaction network. Overview of CXCL5 has been briefly discussed in the previous paragraph, furthermore, CXCL5 is mainly produced by immune cells, mesenchymal cells and fibroblasts [66–68]. After binding with CXCR2 receptor, CXCL5 recruits T lymphocytes, B lymphocytes and eosinophils to participate in immune response [69], e.g. neutrophil recruitment and tissue injury in acute inflammatory states [70]. In intestinal inflammatory diseases, CXCL5 affects immune cell aggregation during intestinal infection mainly by affecting neutrophil extravasation in the submucosa and neutrophil interstitial migration [71]. Altogether, it is strongly suggested that an implicit correlation between CXCL5 and NEC should be explored, especially in the immune tolerance foundation of preterm infants.
Because TFs were predicted in the interaction network and miRNAs and genes were measured by array with expression profiling, we used the set parameters mentioned above to discriminate the significance among TFs in the interaction network. As a result, RELA, JUN and GATA3 were ranked as top three TFs which were screen out for further discussion. RELA is a gene encoding p65 that constructs a p65/p50 heterodimer complexed with IκB proteins [72]. This p65/p50 heterodimer is the inactive state of NF-κB, which is a well-known factor involved in almost all inflammatory responses. Interestingly, recent finding suggest that RELA transcription activation domains (TADs) increase DNA-binding affinity, especially the binding to nonspecific DNA sequences that leads to overwhelming gene translation and severe inflammatory responses [73]. JUN has a JUN family and participates in the c-Jun/fos and activator protein-1 (AP-1) signaling pathways that control the degree of inflammatory response [74]. Unfortunately, JUN has multiple isoforms, each with different downstream target genes or upstream target miRNAs. Thus, a limited amount of discussion about NEC in regard to JUN can be accomplished. GATA3 is mainly expressed in group 2 innate lymphoid cells, adaptive CD4+T helper type 2 (Th2) cells and regulatory T (Treg) cell as a crucial transcription factor [75, 76], GATA3 mediates the development and function of these two cells, and BRD4 has been shown to inhibit the expression of GATA3 and thus affect the differentiation and normal function of Th2 cells [77]. GATA3 has also been shown in regulating Treg cell accompanied with Foxp3 and Setd2 [63, 76]. In lamina propria of small intestine, Lymphoid tissue inducer cell could be dysfunctional when GATA3 was deficient and led to fate determination failure [78]. Moreover, CXCL5 is expressed in immune cells where GATA3 co-located, Hsa-miR-200a was also related to both CXCL5 and GATA3. Hsa-miR-200a-GATA3-CXCL5 interactions are likely to play a key role in the inflammatory response and epithelial dysregulation in NEC.
Some limitations exist in this study. Limited human NEC colon tissue expression data are available. Thus, it is hard to limit type II error in this study. None of the classifications regarding severity or survival in NEC patients exists, results of DEGs and DEMis might be influenced by these clinical differences. Although the relationships in the interaction network are mainly based on scientific experiments, some of them are just predicted interactions. Relationships among miRNA–TF, miRNA–mRNA and TF–mRNA pairs need to be validated by cross-linking immunoprecipitation or qRT-PCR in NEC samples and identified by proper functional experiment. There are multiple miRNAs, TFs and mRNAs to analyze, such as those involved in pyroptosis, preterm immune tolerance status and TF family isoforms. RNA binding protein (RBP) were failed to map in the interaction network due to none of circRNA expression array data availability and RBP is associated with circRNA and miRNA, we believed that it would be nice to add RNA binding proteins when circRNA was present in the network. The database containing miRNA degradation is rare and incomplete so miRNA degradation was not predicted in the interaction network. Discovery and discussion of these miRNAs, TFs and mRNAs may lead to worthwhile information regarding the entire network. Finally, several methods were used for network analysis, and inevitable loss by other methods might lead to some new undiscovered findings.