RA leads to progressive joint destruction, disability and increased mortality, which seriously affects the health of patients, but its pathogenesis is still unclear. Bioinformatics provides a powerful method for the identification of disease biomarkers and related methods, and further promotes the research of disease etiology and pathogenesis. We conducted bioinformatics analysis on RA synovial tissue and finally identified 10 Hub genes (KIAA0101, FOXM1, EGFR, CDC20, BUB1B, TYMS, TOP2A, RRM2, JUN and CCNA2) and two key miRNAs (miR-520d-5p and miR-139-5p) related to RA synovial tissue. Pathway enrichment is significantly enriched in Epithelial cell signaling in Helicobacter pylori infection, ECM-receptor interaction, estrogen signaling pathway, cell cycle, ErbB signaling pathway, and GnRH signaling pathway. Immune cell analysis found that resting dendritic cells, B cells memory, dendritic cells activated, plasma cells, macrophages M1, mast cells resting and T cells regulatory have high expression in RA, while neutrophils, B cells naive and natural killer cells activated have low expression in RA.
The KIAA0101 gene encodes a proliferating cell nuclear antigen (PCNA) related factor, which acts as a regulator of DNA repair during DNA replication (8). Importantly, the interaction of PCNA-related factors with PCNA can increase the synthesis ability of DNA polymerase during the elongation of the leader strand, thereby accelerating the cell cycle process (9). The increase of cell proliferation in synovial fibroblasts in RA is related to the increase of PCNA level (10). Studies have found that the increased proliferation and decreased apoptosis of CD4+ T cells in RA synovium are also regulated by KIAA0101 gene expression (11). In this study, we found that KIAA0101 is highly expressed in RA synovial tissue, which further illustrates the correlation between KIAA0101 and RA. The protein encoded by FOXM1 is a transcriptional activator involved in cell proliferation. The encoded protein is phosphorylated in M phase and regulates the expression of several cell cycle genes, such as cyclin B1 and cyclin D1. The latest study found that the FOXM1/LINC00152 feedback loop regulates the proliferation and apoptosis of RA fibroblast-like synovial cells through the Wnt/β-catenin signaling pathway (12). The FoxM1 inhibitor Streptococcus thiol inhibits the formation of human osteoclasts and may become a potential target for RA treatment (13). In this study, we found that FOXM1 is highly expressed in RA synovial tissue, which is consistent with previous research conclusions. The protein encoded by EGFR is a transmembrane glycoprotein, which is a member of the protein kinase superfamily. EGFR is a cell surface protein that binds to epidermal growth factor, thereby inducing receptor dimerization and tyrosine autophosphorylation, leading to cell proliferation. The expression of EGFR variant III (EGFRvIII) was detected in the synovial tissue and FLS (fibroblast-like synovial cells) of patients with aggressive RA. In FLS, EGFRvIII autophosphorylation destroys the proliferation, migration, invasion and anti-apoptosis ability of FLS expressing EGFRvIII (14). RA is associated with rs17337023 polymorphism and elevated serum EGFR protein levels (15). In this study, we found that EGFR is low expressed in RA synovial lesions and is a potential biomarker in RA synovial lesions.
CDC20 seems to act as a regulatory protein, interacting with several other proteins at multiple points in the cell cycle. Previous studies have also found that CDC20 is a potential biomarker in RA synovitis (16), we found that CDC20 is highly expressed in RA synovitis, which shows that CDC20 plays an important role in RA synovial disease. TYMS has attracted people's interest as a target of cancer chemotherapeutic agents. It is considered to be the main site of action of 5-fluorouracil and some folate analogs. The polymorphism of this gene is not only related to the etiology of tumor formation, but also has a certain impact on the efficacy of methotrexate in RA patients (17). In this study, we found that TYMS is highly expressed in RA synovial lesions. RRM2 encodes one of the two different subunits of ribonucleotide reductase, which catalyzes the formation of deoxyribonucleotides from ribonucleotides. Studies have found that an enhanced RRM2 siRNA can be delivered to RA fibroblast-like synovial cells through liposome-protamine-DNA-siRNA complex and cell permeability peptide (18). In this study, we found that RRM2 is highly expressed in RA synovial lesions, which may be closely related to this transmission mechanism. JUN may be a transforming gene of avian sarcoma virus 17, which encodes a protein that is highly similar to the viral protein and directly interacts with specific target DNA sequences to regulate gene expression. The latest study found that functional cfos/cjun mutants may change the transactivation ability of AP-1 complex, leading to local joint inflammation or destruction in RA patients (19). This study found that Jun is low in RA synovial tissue, which provides a new direction for the treatment of RA.
BUB1B encodes a kinase involved in spindle checkpoint function. The protein is located at the centromere and plays a role in the promotion of complex/circular body (APC/C) in the later stage of inhibition, delaying the occurrence of later stage and ensuring correct chromosome separation. TOP2A encodes DNA topoisomerase, an enzyme that controls and changes the topological state of DNA during the transcription process. This ribozyme is involved in processes such as chromosome condensation, chromatid separation, and torsional stress relief that occur during DNA transcription and replication. TOP2A is the target of many anticancer drugs, and many mutations of this gene are related to the development of drug resistance. The protein encoded by CCNA2 belongs to the highly conserved cyclin family, and its members play a role in regulating the cell cycle. This protein binds and activates cyclin-dependent kinase 2, thereby promoting the conversion of G1/S and G2/M. The correlation between BUB1B, TOP2A , CCNA2 and RA has not been reported so far. In this study, we found that BUB1B, TOP2A and CCNA2 are highly expressed in RA synovial lesions, and are potential biomarkers in the process of RA synovial lesions. Further research in synovial lesions is of great significance to the research on the mechanism and treatment of RA.
We also found two key miRNAs (miR-520d-5p and miR-139-5p). Previous studies have found that miR-520d-5p can promote the survival of human dermal fibroblasts exposed to a lethal dose of ultraviolet radiation (20). Undifferentiated collagen-bound miR-520d-5p has anti-tumor effect on undifferentiated cancer cells in a mouse xenograft model (21). Patients with Parkinson's disease increase serum miR-520d-5p by regulating the expression of brain plasmin (22). In recent years, studies have found that miR-520d-5p can not only reduce the mutations of liver cancer cells and iPSC derivatives, but also play a role of tumor suppressor genes in cervical cancer by targeting PTK2 (23, 24). MiR-520d-5p also has a certain correlation with bone metabolism.,studies have found that miR-520d-5p regulates cartilage formation and chondrocyte metabolism by targeting HDAC1 (25). MiR-139 5p is related to many diseases. Both endogenous and exogenous miR-139 5p can inhibit the development of clostridia-related colorectal cancer (26). Upregulation of miR-139-5p not only can reduce the oxidative stress and apoptosis of rat hippocampal neurons induced by epileptiform discharges by regulating the Notch pathway(27), but also can protect diabetic mice from liver tissue damage and oxidative stress by inhibiting the Notch signaling pathway(28). MiR-139-5p not only can negatively regulate PMP22 by targeting the NF-κB signaling pathway to inhibit gastric cancer cell proliferation (29), but also can regulate the proliferation, apoptosis and cell cycle of uterine leiomyoma cells by targeting TPD52 (30). However, the correlation between miR-520d-5p and miR-139-5p and RA has not been reported. In this study, we found that miR-520d-5p and miR-139-5p are potential biomarkers in RA synovial lesions , Will be a new research direction.
We also obtained some immune cell related to RA synovial lesions. Compared with other immune activation markers, neutrophils are at the center of RA pathology (31),The ratio of neutrophils to lymphocytes has great potential in predicting sustained remission of RA (32). Plasmacytoid dendritic cells participate in the local inflammatory environment of RA (33). B cells memory play an important role in the pathogenesis of RA. With the emergence of B cell targeted therapy, the regulation of B cells memory seems to be a key therapeutic target (34). The baseline expression of the B cell naive and B cell memory marker FCRL5 can predict the response of RA to rituximab (RTX) (35). The infiltration of inflammatory cells, especially the role of macrophages M1 that secrete a variety of inflammatory cytokines in RA cannot be ignored. In order to alleviate synovial inflammation, macrophages M1 must be eliminated or converted to an anti-inflammatory M2 phenotype. Folic acid modified silver nanoparticles (FA-AgNPs) can be actively introduced into macrophages M1, synergistically induce the reduction of macrophages M1 and the polarization of macrophages M2, thereby effectively treating RA (36). Mast cells are immune cells that infiltrate the lubricating membrane. Their infiltration in the synovium of patients with early RA has been shown to be related to systemic inflammation, disease activity, and autoantibody positivity. Moreover, after using conventional synthetic disease-modifying anti-rheumatic drugs to treat early RA, mast cell-positive synovitis still exists (37). T cells Regulatory may participate in the process of RA bone destruction by mediating inflammatory immunity. The development of RA is related to the compartment defect of CD4+Foxp3+ T cells regulatory. Studies have found that the compartment defect of CD4+Foxp3+ T regulatory is negatively correlated with RA activity and antibody levels. Methotrexate treatment of early RA patients increased the proportion and absolute number of CD4+Foxp3+ T regulatory cells with high levels of activation markers, suggesting that CD4+Foxp3+ T regulatory cells may be specific cell markers for successful RA treatment (1). Elevated serum IL-2 levels in patients with active RA are associated with abnormal levels of peripheral blood natural killer cells (38). Overexpression of IL-15 in RA can induce the proliferation and differentiation of natural killer cells. The expression of NKp46 and CD158e on natural killer cells may be a sign of the severity of RA (39). Although the relationship between these immune cells and RA has mostly been studied in the past, the role of dendritic cells resting, dendritic cells activated, mast cells resting and natural killer cells activated in RA synovial disease The role has not been clearly reported. In this study, we found that dendritic cells resting, dendritic cells activated, and mast cells resting are have high expression in RA, while natural killer cells activated have low expression in RA. It provides a new research idea for the pathogenesis of RA synovial lesions.