The transcriptomic features of heart failure.
To identify the differentially expressed genes and the critical signaling pathways and transcription factors during the development of heart failure, we analyzed the expression data of failing heart and normal heart tissues from previously published GEO datasets GSE5460 [4], GSE16499 [5] and GSE68316 [6]. Totally, 252 samples were collected, including 36 normal heart tissues and 216 failing heart tissues. The search strategies used for accessing the gene datasets were described in the flowchart (Fig. 1).
First, we analyzed the globe expression profiling of failing heart tissues in each dataset. Compared with the normal heart tissues, the differentially expressed genes in failing heart tissues (P<0.01) were selected for further studies. This resulted in the identification of 2184 differentially expressed genes in GSE5406, 1644 differentially expressed genes in GSE16499 and 3477 differentially expressed genes in GSE68316 dataset (Fig. 2a). Among all the differentially expressed genes, only 4 genes were commonly up regulated and 86 genes were commonly down regulated in GSE5406, GSE16499 and GSE68316 datasets (Fig. 2b). In GSE16499 and GSE68316 datasets, the number of down regulated genes was for more than the up regulated genes (Fig. 2a). In GSE16499 dataset, 1407 genes were suppressed in failing heart tissues. While, only 237 genes were activated in failing heart tissues. Those results suggested that the depletion of cardiomyocytes and loss of mechanical functions in cardiac remodeling were induced by the suppression of heart specific genes.
Metabolism and insulin signaling pathway are suppressed in failing heart patients.
To reveal the functional relevance of the common differentially expressed genes in failing heart tissues, we performed functional signaling pathway enrichment analysis through DAVID [22] and GSEA [23] assay. Pyrimidine, purine metabolism signaling pathway and cysteine, methionine metabolism signaling pathway were highly enriched through DAVID analysis (Fig. 3a). Heatmap presentations showed that NME1, POLE3, POLD2, ENTPD6, PNP genes from pyrimidine, purine metabolism signaling pathway and LDHA, AHCY, AMD1 genes from cysteine, methionine metabolism signaling pathway were all down regulated in failing heart tissues in GSE5406, GSE16499 and GSE68316 datasets (Fig. 3b), suggesting the suppression of those pathways in the development of heart failure.
Through GSEA analysis, we found that the insulin signaling pathway was negatively correlated with the failing heart expression profiling (Fig. 3c), suggesting the inactivation of insulin signaling pathway in the development of heart failure. Fox example, MAP2K1 is a critical downstream gene of insulin signaling pathway [24]. We showed that MAP2K1 was down regulated in failing heart tissues in GSE5406, GSE16499 and GSE68316 datasets (Fig. 3d).
The association between heart failure, inactivation of metabolism pathways and insulin resistance was well established [24]. The cardiac metabolism, growth and survival in the heart were dependent on insulin signaling pathway [25]. Loss of insulin signaling pathway induced cardiac energy deficiency and accelerated the heart failure progress [26]. All those observations confirmed the enriched singling pathways derived from the GEO datasets.
Transcription factors MYC and C/EBP are negatively associated with in failing heart expression profiling.
Except signaling pathways, the transcription factors enriched in failing heart tissues were also identified through DAVID analysis. We found that transcription factor MYC was highly associated with the differentially expressed genes in GSE5406, GSE16499 and GSE68316 datasets (Fig. 4a). Interestingly, TP53 and E2F genes were both highly enriched (Fig. 4a). TP53 and E2F family genes were reported to mediate the cardiac growth and development [27]. However, the functions of MYC in the development of heart failure are unclear.
Similar results were obtained using GSEA assay. We found that transcription factor MYC was negatively associated with the failing heart expression profiling in all three GEO datasets (Fig. 4b). Additionally, we showed that transcription factor C/EBP was also negatively correlated with the failing heart expression profiling (Fig. 4c).
C/EBP is a CCAAT/enhancer-binding protein transcription factor which regulates cell growth and differentiation. Previous results showed that C/EBPβ protected against pathological cardiac remodeling [9]. C/EBPβ was also a master regulator of metabolism pathways and insulin resistance [12]. All those reports implied the potential roles of C/EBPβ in the development of heart failure.
Transcription factors MYC and C/EBPβ are down regulated in failing heart tissues.
Next, we detected the expression of MYC and C/EBPβ in failing heart and normal heart tissues. Previous report showed that MYC was increased in pathological hypertrophy [28]. Inhibition of MYC was a potential therapeutic approach in the treatment of hypertrophic cardiomyopathy [29]. On the contrary, we found the down regulation of MYC expression in failing heart tissues in GSE5406 and GSE16499 datasets (Fig. 5a). Similarly, we found that C/EBPβ was down regulated in failing heart tissues, compared with normal heart tissues in all GSE5406, GSE16499 and GSE68316 datasets (Fig. 5b).
Since MYC and C/EBPβ were both down regulated in failing heart tissues, we tested the correlation between MYC and C/EBPβ expression in GSE5406 and GSE16499 datasets. We found that C/EBPβ expression was positively correlated with MYC expression. Heart tissues with high C/EBPβ expression were also with high MYC expression (Fig. 5c). All those results emphasized the important roles of MYC and C/EBPβ in heart failure development.
MYC and C/EBPβ target genes are down regulated in failing heart tissues.
Transcription factors are usually the master regulators of disease and regulate multiple target genes . In the GSEA assay, we identified 62 MYC target genes and 22 C/EBPβ target genes. Consistent with the decreased expressions of MYC and C/EBPβ in failing heart tissues, MYC target genes were down regulated in failing heart tissues, compared with normal heart tissues (Fig. 6a). C/EBPβ target genes were also suppressed in failing heart tissues in GSE16499 dataset, as demonstrated in the heatmap (Fig. 6b).
Interestingly, we found that some genes, for example, EIF4A1, SYNCRIP, ARF6 and C/EBPβ, were both MYC and C/EBPβ downstream target genes (Fig. 6c). We showed that SYNCRIP gene expression was particularly down regulated in failing heart tissues in all GSE5406, GSE16499 and GSE68316 datasets (Fig. 6d).
The MYC and C/EBPβ mediated transcriptional networks.
To further explore MYC and its connection to downstream target genes, the MYC mediated regulatory network was constructed using Cytoscape. As expected, as a MYC target gene, C/EBPβ was connected with MYC through the transduction of multiple genes (Fig. 7a). Furthermore, through literature research, we found that some MYC target genes were previously reported involving the development of heart failure, including STAT3 [30], PRMT1 [31], PRKCH [32] and HSPA4 [33] (Fig. 7a).
Similarly, the C/EBPβ mediated regulatory network was constructed (Fig. 7b). Some C/EBPβ target genes, for example, OSMR [34], MAP2K3 [35] and CDKN1B [36] also have been studied in heart failure developmental progress (Fig. 7b). All those results highlighted the importance of MYC, C/EBPβ and their downstream target genes in heart failure development. The functions of other MYC and C/EBPβ target genes should be further studied to reveal their connections with heart failure.