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Therapeutic Targets for Heart Failure Identified Using Proteomics and Mendelian Randomization

Henry, Albert; Gordillo-Maranon, Maria; Finan, Chris; Schmidt, Amand F; Ferreira, João Pedro; Karra, Ravi; Sundström, Johan; ... Lumbers, R Thomas; + view all (2022) Therapeutic Targets for Heart Failure Identified Using Proteomics and Mendelian Randomization. Circulation 10.1161/CIRCULATIONAHA.121.056663. (In press). Green open access

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Abstract

Background: Heart failure (HF) is a highly prevalent disorder for which disease mechanisms are incompletely understood. The discovery of disease-associated proteins with causal genetic evidence provides an opportunity to identify new therapeutic targets. Methods: We investigated the observational and causal associations of 90 cardiovascular proteins, which were measured using affinity-based proteomic assays. First, we estimated the associations of 90 cardiovascular proteins with incident heart failure by means of a fixed-effect meta-analysis of four population-based studies, comprising a total of 3,019 participants with 732 HF events. The causal effects of HF-associated proteins were then investigated by Mendelian randomization (MR), using cis-protein quantitative loci genetic instruments identified from genome-wide association studies (GWAS) in over 30,000 individuals. To improve the precision of causal estimates, we implemented an MR model that accounted for linkage disequilibrium between instruments and tested the robustness of causal estimates through a multiverse sensitivity analysis that included up to 120 combinations of instrument selection parameters and MR models per protein. The druggability of candidate proteins was surveyed, and mechanism of action and potential on-target side effects were explored with cross-trait MR analysis. Results: 44/90 proteins were positively associated with risk of incident HF (P < 6.0 x 10-4). Among these, eight proteins had evidence of a causal association with HF that was robust to multiverse sensitivity analysis: higher CSF-1 (macrophage colony-stimulating factor 1), Gal-3 (galectin-3) and KIM-1 (kidney injury molecule 1) were positively associated with risk of HF, whereas higher ADM (adrenomedullin), CHI3L1 (chitinase-3-like protein 1), CTSL1 (cathepsin L1), FGF-23 (fibroblast growth factor 23) and MMP-12 (Matrix metalloproteinase-12) were protective. Therapeutics targeting ADM and Gal-3 are currently under evaluation in clinical trials, and all the remaining proteins were considered druggable, except KIM-1. Conclusions: We identified 44 circulating proteins that were associated with incident HF, of which eight showed evidence of a causal relationship and seven were druggable, including adrenomedullin which represents a particularly promising drug target. Our approach demonstrates a tractable roadmap for the triangulation of population genomic and proteomic data for the prioritization of therapeutic targets for complex human diseases.

Type: Article
Title: Therapeutic Targets for Heart Failure Identified Using Proteomics and Mendelian Randomization
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1161/CIRCULATIONAHA.121.056663
Publisher version: https://doi.org/10.1161/CIRCULATIONAHA.121.056663
Language: English
Additional information: © 2021 The Authors. Circulation is published on behalf of the American Heart Association, Inc., by Wolters Kluwer Health, Inc. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics > Infectious Disease Informatics
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > Div of Biosciences
URI: https://discovery.ucl.ac.uk/id/eprint/10145591
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