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

<h4>Background</h4>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 p...

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Main Authors: Feng Xiao, Rui Zheng, Di Yang, Kejiang Cao, Shijiang Zhang, Bingruo Wu, Yongfeng Shao, Bin Zhou
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0180230&type=printable
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author Feng Xiao
Rui Zheng
Di Yang
Kejiang Cao
Shijiang Zhang
Bingruo Wu
Yongfeng Shao
Bin Zhou
author_facet Feng Xiao
Rui Zheng
Di Yang
Kejiang Cao
Shijiang Zhang
Bingruo Wu
Yongfeng Shao
Bin Zhou
author_sort Feng Xiao
collection DOAJ
description <h4>Background</h4>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.<h4>Design</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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 anti-streptolysin O antibodies.<h4>Conclusion</h4>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.
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spelling doaj-art-8f5773bdb8344e459f75801d623f81762025-08-20T02:45:24ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01126e018023010.1371/journal.pone.0180230Sex-dependent aortic valve pathology in patients with rheumatic heart disease.Feng XiaoRui ZhengDi YangKejiang CaoShijiang ZhangBingruo WuYongfeng ShaoBin Zhou<h4>Background</h4>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.<h4>Design</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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 anti-streptolysin O antibodies.<h4>Conclusion</h4>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.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0180230&type=printable
spellingShingle Feng Xiao
Rui Zheng
Di Yang
Kejiang Cao
Shijiang Zhang
Bingruo Wu
Yongfeng Shao
Bin Zhou
Sex-dependent aortic valve pathology in patients with rheumatic heart disease.
PLoS ONE
title Sex-dependent aortic valve pathology in patients with rheumatic heart disease.
title_full Sex-dependent aortic valve pathology in patients with rheumatic heart disease.
title_fullStr Sex-dependent aortic valve pathology in patients with rheumatic heart disease.
title_full_unstemmed Sex-dependent aortic valve pathology in patients with rheumatic heart disease.
title_short Sex-dependent aortic valve pathology in patients with rheumatic heart disease.
title_sort sex dependent aortic valve pathology in patients with rheumatic heart disease
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0180230&type=printable
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AT shijiangzhang sexdependentaorticvalvepathologyinpatientswithrheumaticheartdisease
AT bingruowu sexdependentaorticvalvepathologyinpatientswithrheumaticheartdisease
AT yongfengshao sexdependentaorticvalvepathologyinpatientswithrheumaticheartdisease
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