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<p><em>CYP1B1</em>, <em>VEGFA</em>, <em>BCL2</em>, and <em>CDKN1A</em> Affect the Development of Chronic Obstructive Pulmonary Disease</p>

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O R I G I N A L R E S E A R C H

CYP1B1, VEGFA, BCL2

, and

CDKN1A

Affect the

Development of Chronic Obstructive Pulmonary

Disease

This article was published in the following Dove Press journal: International Journal of Chronic Obstructive Pulmonary Disease

Danlei Yang1

Ying Yan2

Fen Hu1

Tao Wang 1

1Department of Respiratory and Critical

Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030,

People’s Republic of China;2Department

of Respiratory and Critical Care

Medicine, Ningxia People’s Hospital,

Yinchuan 750002, People’s Republic of

China

Purpose: Chronic obstructive pulmonary disease (COPD) is a progressive lung disease characterized by poor airflow. The purpose of this study was to explore the mechanisms involved in the development of COPD.

Patients and Methods: The mRNA expression profile GSE100281, consisting of 79 COPD and 16 healthy samples, was acquired from the Gene Expression Omnibus database. The differentially expressed genes (DEGs) between COPD samples and healthy samples were analyzed using the limma package. Functional enrichment analysis for the DEGs was carried out using the Database for Annotation, Visualization, and Integrated Discovery (DAVID) tool. Furthermore, DEG-compound pairs were predicted using the Comparative Toxicogenomics Database. The KEGG metabolite IDs corresponding to the compounds were also obtained through the MetaboAnalyst pipeline. Based on the diffusion algorithm, the metabolite network was constructed. Finally, the expression levels of key genes were determined using quantitative PCR (qPCR).

Results:There were 594 DEGs identified between the COPD and healthy samples, includ-ing 242 upregulated and 352 downregulated genes. A total of 696 DEG-compound pairs, such as BCL2-C00469 (ethanol) and BCL2-C00389 (quercetin) pairs, were predicted. CYP1B1, VEGFA, BCL2, andCDKN1Awere included in the top 10 DEG-compound pairs. Additionally, 57 metabolites were obtained. In particular, hsa04750 (inflammatory mediator regulation of TRP channels)-C00469 (ethanol) and hsa04152 (AMPK signaling pathway)-C00389 (quercetin) pairs were found in the metabolite network. The results of qPCR showed that the expression of CYP1B1, VEGFA, BCL2, and CDKN1Awas consistent with that predicted using bioinformatic analysis.

Conclusion: CYP1B1, VEGFA, BCL2, andCDKN1Amay play important functions in the development and progression of COPD.

Keywords: chronic obstructive pulmonary disease, differentially expressed genes, enrichment analysis, disease metabolites, metabolite network

Introduction

Chronic obstructive pulmonary disease (COPD), which manifest as either chronic bronchitis or emphysema, is characterized by poor airflow.1The primary symptoms of COPD are cough, shortness of breath, and expectoration.2,3COPD is a progressive disease that may further develop into cor pulmonale and respiratory failure.4,5Tobacco smoking and air pollution are the main risk factors of COPD, while metabolic disturbances have a critical influence on this disease.6COPD is also associated with increased chronic inflammatory responses to toxic particles or gases in the airways and Correspondence: Tao Wang

Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang

Avenue, Wuhan 430030, People’s

Republic of China Tel +86-13971477320

Email Tomwang_1095@163.com

International Journal of Chronic Obstructive Pulmonary Disease

Dove

press

open access to scientific and medical research

Open Access Full Text Article

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lungs.7In 2015, COPD has impacted 174.5 million people that lead to 3.2 million deaths globally.8Thus, the pathogen-esis of COPD should be further investigated to improve COPD treatment strategies.

The expression of pleomorphic adenoma gene like-2 (PLAGL2) is significantly higher in COPD patients than that in healthy smokers, suggesting that PLAGL2 over-expression may be involved in the mechanisms underlying the development and progression of COPD.9Further, over-expression of nuclear factor-κB2 (NF-κB2) is related to the expression of cyclooxygenase-2 (COX-2), interleukin-1 beta (IL-1β), and interleukin-8 (IL-8), which are also asso-ciated with the pathogenesis of COPD.10,11 Prostaglandin E2 (PGE2) is an important cyclic component that is responsible for fibroblast senescence and inflammation in COPD patients. Regulation of the PGE2 signaling pathway may suppressfibroblast senescence and inflammation dur-ing disease progression.12 Moreover, the interleukin-4/ interleukin-13 (IL-4/IL-13) receptor complex induces the overproduction of mucus and enhances the viscosity of the airway surface liquid in patients with COPD and bronchial asthma by promoting pendrin expression.13 However, despite the previous reports, the mechanisms involved in the development of COPD have not been fully elucidated. Willis-Owen et al generated the COPD-related dataset GSE100281 to analyze global gene transcription. In their study, the differential gene expression between healthy and COPD samples was analyzed using limma package, while the patterns of transcriptional coordination were analyzed using weighed gene co-expression network analysis (WGCNA). They found 1826 transcripts showing COPD-related variations, where 18 transcripts exhibited more than 2-fold change in expression.14 In the current study, the GSE100281 dataset was analyzed again. However, the study differed from their analyses in that enrichment ana-lysis followed the screening for the differentially expressed genes (DEGs) between COPD and healthy sam-ples. Additionally, prediction of disease metabolites and metabolite network analysis were also performed, which were not mentioned in the study by Willis-Owen et al The

findings of our study might help establish the theoretical foundation for developing novel therapies for COPD.

Materials and Methods

Data Source

The mRNA expression profile GSE100281 (sequencing platform: GPL11532

[HuGene-1_1-st] Affymetrix Human Gene 1.1 ST Array [transcript (gene) version]) was extracted from Gene Expression Omnibus (GEO, http://www.ncbi.nlm.nih.gov/ geo/) database. GSE100281 is composed of mRNA expres-sion profiles from 79 COPD and 16 healthy samples.

Data Preprocessing and Differential

Expression Analysis

The raw data expression matrix was obtained using the R Affy package (version 1.56.0, http://bioconductor.org/packages/ release/bioc/html/affy.html).15 Data preprocessing, including background adjustment, quantile normalization,final summar-ization, and log base 2 scaling, was conducted using the robust multi-array average (RMA) method.16 Combined with the platform annotation files, probe IDs were mapped to the gene symbols. Probes without corresponding gene symbols were removed. For several probes that matched with only one gene symbol, the mean expression value of the probes was calculated and considered as thefinal gene expression value.

Using the R limma package (version 3.34.9, http:// bioconductor.org/packages/release/bioc/html/limma.html), differential expression analysis was performed on COPD and healthy samples.17The p-values obtained using t-test were adjusted according to the Benjamini & Hochberg method.18,19 Genes with adjusted p-values < 0.05 were considered as differentially expressed.

Functional Enrichment Analysis

To identify the Gene Ontology (GO) functional terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) path-ways involved with COPD, the DEGs were analyzed using Database for Annotation, Visualization, and Integrated Discovery (DAVID) tool (version 6.8, https://david. ncifcrf.gov/).20–22 GO terms and KEGG pathways with p-value < 0.05 and count > 1 were considered significant.

Prediction of Disease Metabolites

Using“Pulmonary Disease”and“Chronic Obstructive”as key words, the genes and compounds directly correlated with COPD were searched from the Comparative Toxicogenomics Database (http://ctd.mdibl.org/).23 The DEGs-associated compounds with Reference.Count > 1 were screened. The KEGG metabolite IDs corresponding to the compounds were also obtained using the Compound ID Conversion tool in the MetaboAnalyst database (http:// www.metaboanalyst.ca).24

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Metabolite Network Analysis

The R package was used for pathway enrichment analysis of the identified disease metabolites.25 Utilizing KEGG database as the background, a differential pathway net-work composed of pathways, compounds, reactions, enzymes, and KEGG modules was built according to the results of the functional enrichment analysis.22 Based on the diffusion algorithm, heatflows from a given metabolite node and diffuses to the differential pathway network.26 Heat diffusion caused the change of node scores in the differential pathway network. The p-values of the diffu-sion scores were obtained using the displacement test.27 The top 100 nodes with p-value < 0.05 were selected for constructing the gene-metabolite network.

The formula for calculating the diffusion scores was T = -KI - 1*G, where G is the inputted metabolite (ie if it is the inputted metabolite, G is 1; otherwise, G is 0) and KI is the matrix.

Validation with CTD Database

The genes directly associated with COPD were extracted from the CTD database. The parameter was set with an inference score > 5. The inference score reflects the degree of similarity between the CTD chemical–gene–disease net-works and a similar scale-free random network. A high score means a high probability that the inference network has atypical connectivity. Furthermore, Venn diagram ana-lysis was performed to identify the genes shared between the CTD databases and the identified DEGs.

Quantitative PCR (qPCR)

Based on the bioinformatics analysis results, the expression of key genes were verified in six CAD andfive normal blood samples. Total RNA was extracted using TRIzol reagent (Invitrogen, Carlsbad, CA, USA) following the manufac-turer’s instructions. The purity and quality of the extracted RNA were determined using the Infinite M100 PRO microplate reader ((Tecan, Männedorf, Switzerland). Complementary DNA (cDNA) was synthesized from high quality total RNA using PrimeScript™RT Master Mix (No. RR036A, Takara Bio USA, Mountain View, CA, USA). Real-time qPCR was performed to validate gene expression using Power SYBR™Green PCR Master Mix (No. A25742, Thermo Fisher Scientific, Waltham, MA, USA) on the 7900HT Fast Real-Time PCR System (Applied Biosystems, Foster City, CA, USA), with the following thermal cycling conditions: 50 °C for 2 min, 95 °C for 10 min, followed by

40 cycles at 95 °C for 10 s and 60 °C for 30 s. The melting curve was analyzed from 60 °C to 95 °C at an increment of 0.5 °C/10 s. The primer sequences for the genes were as follows:CYP1B1, forward 5ʹ-GGCAGAATTGGATCAGGT CG-3ʹ;CYP1B1, reverse 5ʹ-TGTGGTAGCCCAAGACAGA GG-3ʹ; VEGFA, forward 5ʹ-GAGGGCAGAATCATCACGA AG-3ʹ; VEGFA, reverse 5ʹ-CACCAGGGTCTCGATTGGA T-3ʹ; BCL2, forward 5ʹ-GACTTCGCCGAGATGTCCAG -3ʹ; BCL2, reverse 5ʹ-GGTGCCGGTTCAGGTACTCA-3ʹ; CDKN1A, forward 5ʹ-TGGCACCTCACCTGCTCTG-3ʹ; CDKN1A, reverse 5ʹ-CGGCGTTTGGAGTGGTAGA-3ʹ;GA PDH, forward 5ʹ-TGACAACTTTGGTATCGTGGAAGG -3ʹ; GAPDH, reverse 5ʹ-AGGCAGGGATGATGTTCTGGA GAG-3ʹ. The relative quantification of gene expression was based on the comparative CT (2−ΔΔCT) method. Statistical analysis was performed using GraphPad Prism 5 (GraphPad Software, San Diego, CA, USA). Data were presented as mean ± standard deviation (SD), with a statistical signifi -cance of P < 0.05.

Results

Differential Expression Analysis

Box plots showed that the medians of data after normal-ization were at the same level (Figure 1). Therefore, data preprocessing improved the quality of in silico data used for bioinformatics analysis. There were 594 DEGs, includ-ing 242 upregulated and 352 downregulated genes, between the COPD and healthy samples. The heatmap and volcano plot displaying the DEGs are presented in

Figure 2.

Functional Enrichment Analysis

The upregulated and downregulated genes were sepa-rately subjected to functional enrichment analysis. The top 5 results of GO terms and KEGG pathway analysis are shown in Figure 3. The upregulated genes were mainly implicated in the endocytosis pathway, with top GO terms being associated with signal transduction (GO_biological process, GO_BP), mem-brane (GO_cellular component, GO_CC), and protein binding (GO_molecular function, GO_MF). However, the downregulated genes were involved in the oxidative phosphorylation pathway, with top GO terms being asso-ciated with mitochondrial electron transport, NADH to ubiquinone (GO_BP), mitochondrion (GO_CC), and NADH dehydrogenase (ubiquinone) activity (GO_MF).

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Prediction of Disease Metabolites

From the 21,555 genes and 4900 compounds directly related to COPD, a total of 123 compounds, 243 DEGs, and 696 DEG-compound pairs were screened. The top 10 DEG-compound pairs, including cytochrome P450 family 1 subfamily B member 1 (CYP1B1), vascular endothelial growth factor A (VEGFA), B cell leukemia/ lymphoma 2 (BCL2), and cyclin dependent kinase inhi-bitor 1A (CDKN1A), are presented in Table 1. Furthermore, 57 compounds with corresponding KEGG metabolite IDs were obtained. In particular, both C00469 (ethanol) and C00389 (quercetin) were found to be related with BCL2.

Metabolite Network Analysis

Based on the differential pathway network, there were 9994 nodes and 33,828 edges identified. Among the 57 metabo-lites, 23 metabolites matched with nodes and edges in the differential pathway network. In addition, a gene-metabolite

network composed of 77 nodes and 106 edges was con-structed (Figure 4). Particularly, the hsa04750 (inflammatory mediator regulation of TRP channels)-C00469 (ethanol) and hsa04152 (AMPK signaling pathway)-C00389 (quercetin) pairs were discovered in the network.

Validation with CTD Database

A total of 12,455 COPD-associated genes were obtained from the CTD database. The results of Venn diagram analysis are shown inFigure 5andSupplemental Table 1. There were 221 shared genes, including CYP1B1, VEGFA, BCL2, and CDKN1A, between the COPD-associated genes and the 243 DEGs.

Expression Levels of Key Genes

Based on in silico analysis, the key genesCYP1B1, VEGFA, BCL2, andCDKN1Awere selected for validation using qPCR. As shown inFigure 6, the expression levels ofCYP1B1and CDKN1Awere significantly upregulated (P < 0.05) in COPD

GSM2677138GSM2677137GSM2677136GSM2677135GSM2677133GSM2677132GSM2677131GSM2677130GSM2677129GSM2677128GSM2677127GSM2677126GSM2677125GSM2677134GSM2677057GSM2677124GSM2677123GSM2677122GSM2677121GSM2677120GSM2677119GSM2677118GSM2677117GSM2677116GSM2677115GSM2677114GSM2677113GSM2677112GSM2677111GSM2677110GSM2677109GSM2677108GSM2677107GSM2677106GSM2677105GSM2677104GSM2677103GSM2677102GSM2677101GSM2677100GSM2677099GSM2677098GSM2677097GSM2677096GSM2677095GSM2677093GSM2677092GSM2677094GSM2677091GSM2677090GSM2677089GSM2677088GSM2677087GSM2677086GSM2677085GSM2677083GSM2677082GSM2677084GSM2677081GSM2677080GSM2677079GSM2677078GSM2677077GSM2677076GSM2677074GSM2677075GSM2677073GSM2677072GSM2677071GSM2677070GSM2677069GSM2677067GSM2677068GSM2677066GSM2677065GSM2677064GSM2677063GSM2677062GSM2677061GSM2677059GSM2677058GSM2677060GSM2677056GSM2677055GSM2677054GSM2677053GSM2677052GSM2677051GSM2677050GSM2677049GSM2677048GSM2677047GSM2677046GSM2677045

50 100 150 200

Data Before normalization

gene e

xpression

GSM2677138GSM2677137GSM2677136GSM2677135GSM2677133GSM2677132GSM2677131GSM2677130GSM2677129GSM2677128GSM2677127GSM2677126GSM2677125GSM2677134GSM2677057GSM2677124GSM2677123GSM2677122GSM2677121GSM2677120GSM2677119GSM2677118GSM2677117GSM2677116GSM2677115GSM2677114GSM2677113GSM2677112GSM2677111GSM2677110GSM2677109GSM2677108GSM2677107GSM2677106GSM2677105GSM2677104GSM2677103GSM2677102GSM2677101GSM2677100GSM2677099GSM2677098GSM2677097GSM2677096GSM2677095GSM2677093GSM2677092GSM2677094GSM2677091GSM2677090GSM2677089GSM2677088GSM2677087GSM2677086GSM2677085GSM2677083GSM2677082GSM2677084GSM2677081GSM2677080GSM2677079GSM2677078GSM2677077GSM2677076GSM2677074GSM2677075GSM2677073GSM2677072GSM2677071GSM2677070GSM2677069GSM2677067GSM2677068GSM2677066GSM2677065GSM2677064GSM2677063GSM2677062GSM2677061GSM2677059GSM2677058GSM2677060GSM2677056GSM2677055GSM2677054GSM2677053GSM2677052GSM2677051GSM2677050GSM2677049GSM2677048GSM2677047GSM2677046GSM2677045

2 4 6 8 10

Data After normalization

Figure 1Box plots showing the medians of the mRNA expression data before and after normalization. The red and blue plots represent the chronic obstructive pulmonary disease (COPD) and healthy samples, respectively.

0 Ro

hy COPD

A

B

Figure 2Volcano plot and heatmap displaying the differentially expressed genes (DEGs). (A) Volcano plot of the DEGs. The red and blue dots represent the upregulated and downregulated genes, respectively. (B) Heatmap of the DEGs. The red and blue sample strips represent the chronic obstructive pulmonary disease (COPD) and healthy samples, respectively.

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signal transduction movement of cell or subcellular component regulation of cell shape cellular response to transforming growth factor beta stimulus apoptotic process membrane nucleolus cytosol sarcomere nucleoplasm protein binding structural constituent of muscle ATP binding ubiquitin−protein transferase activity nucleotide binding Endocytosis Ubiquitin mediated proteolysis Chronic myeloid leukemia Bladder cancer MicroRNAs in cancer

0 50 100

Count

Te

rm

Category

GOTERM_BP_DIRECT

GOTERM_CC_DIRECT

GOTERM_MF_DIRECT

KEGG_PATHWAY up_DEG_TERM

mitochondrial electron transport, NADH to ubiquinone mitochondrial respiratory chain complex I assembly tricarboxylic acid cycle fatty acid beta−oxidation mitochondrial ATP synthesis coupled proton transport mitochondrion mitochondrial inner membrane mitochondrial matrix mitochondrial respiratory chain complex I mitochondrial proton−transporting ATP synthase complex NADH dehydrogenase (ubiquinone) activity electron carrier activity fatty−acyl−CoA binding proton−transporting ATP synthase activity, rotational mechanism NAD binding Oxidative phosphorylation Metabolic pathways Non−alcoholic fatty liver disease (NAFLD) Citrate cycle (TCA cycle) Carbon metabolism

0 30 60 90 120

Count

Te

rm

Category

GOTERM_BP_DIRECT

GOTERM_CC_DIRECT

GOTERM_MF_DIRECT

KEGG_PATHWAY down_DEG_TERM

A

B

Figure 3The Gene Ontology (GO)_biological process (BP), GO_cellular component (CC), and GO_molecular function (MF) functional terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways identified after functional enrichment analysis of the differentially expressed genes (DEGs). (A) Top 5 results for the upregulated genes. (B) Top 5 results for the downregulated genes.

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samples than in the control. By contrast, the expression levels of BCL2 and VEGFA were significantly downregulated (P < 0.05) in COPD samples than in the control. These results

were consistent with the results previously obtained from the bioinformatics analysis.

Discussion

In the present study, 594 DEGs consisting of 242 upre-gulated genes and 352 downreupre-gulated genes between COPD samples and healthy samples were screened and functionally analyzed. A total of 696 DEG-compound pairs, including CYP1B1, VEGFA, BCL2, and CDKN1A, and 57 metabolites were obtained. Moreover, both C00469 (ethanol) and C00389 (quercetin) were found to be associated with BCL2. In the gene-metabolite net-work, the hsa04750 (inflammatory mediator regulation of TRP channels)-C00469 (ethanol) and hsa04152 (AMPK signaling pathway)-C00389 (quercetin) pairs were also identified.

Table 1 The Top 10 Differentially Expressed Gene (DEG)-Compound Pairs

Chemical Name Gene Symbol Reference Count

Tetrachlorodibenzodioxin CYP1B1 243

Oxygen VEGFA 60

Cobaltous chloride VEGFA 47

Tetrachlorodibenzodioxin CYP1B1 44

Resveratrol BCL2 32

Quercetin BCL2 29

Resveratrol CDKN1A 24

Cobaltous chloride VEGFA 20

Resveratrol CDKN1A 19

Tetrachlorodibenzodioxin CDKN1A 16

R02533

1.14.17.1

R02535

C00547 R02532

hsa04261

R08385

C06866

3.4.22.62 R02352

hsa05226 C00410

C15493

hsa05224

1.1.1.64

R05198 R00746

R09091 R09479

R00754 hsa04750

hsa05034 R01838

R02353

C00535 R01836

hsa04915 hsa04540

C00469

3.5.1.98

hsa04152 hsa04012

C00389 C00951

hsa04530

2.7.10.1

M00389

R06538

3.4.22.49

R02216

R02160 M00684

hsa04114 hsa05211 2.7.10.2

hsa04917

hsa05200

hsa05100

R07973 R07975

C07130

R07972

R07974

R07976

R07971 C00067

R08384 hsa04672

C00735 R08995 3.4.22.64

R02836 R02834

3.4.22.58

3.4.22.57

3.5.4.38 7.6.2.2

hsa04920

hsa05222 3.4.21.77 C00155

hsa04621

hsa04926

hsa05215

hsa05223 R01283

1.14.11.29

Figure 4Constructed gene-metabolite network. The red, purple, blue, and orange circles and the green inverted triangle represent the pathway, module, enzyme, reaction, and disease metabolite, respectively.

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The levels of CYP1B1mRNA are known to be upregu-lated in alveolar epithelial type II (ATII) cells relative to that in hepatocytes. In addition, increasedCYP2C19and reduced CYP2J2levels have been detected in the ATII cells of COPD patients relative to that in smokers without COPD.28 CYP1A1, CYP1B1, CYP2J2, CYP2E1, CYP2B6, and CYP3A5 encode proteins that are localized in the lungs; thus, these proteins may activate the COPD-associated compounds.29The transcription factor T-box (TBX) and its targetCDKN2Aare involved in the pathogenesis of COPD by affecting senescence. The expression of CDKN1A, CDKN2A, and caveolin 1 (CAV1) is known to be higher in the peripheral lungs of COPD patients.30 CDKN1A,

Figure 6Expression levels ofCYP1B1, VEGFA, BCL2, andCDKN1Aquantified using qPCR. *P<0.05. Figure 5Results of the Venn diagram analysis.

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a biomarker of cell cycle arrest and premature ageing, is upregulated in COPD patients, which is related to skeletal muscle wasting.31,32Skeletal muscle dysfunction is common in COPD patients. A previous study identified 18 genes, includingCDKN1A, that were upregulated in the quadriceps of COPD patients relative to that in healthy controls.14These results suggest thatCYP1B1andCDKN1Amight be impli-cated in the pathogenesis of COPD.

Decreased miR-503 function promotes the release of VEGF from lung fibroblasts, thereby mediating vascular homeostasis in patients with COPD.33VEGFcan be used to diagnose COPD in healthy donors (HD), with better overall accuracy and Youden’s index (YI), whileIL-8can be used to diagnose cancer in both HD and COPD patients.34The serum levels ofVEGFand its soluble receptor sVEGF R2 are higher in COPD patients than that in the control; therefore,VEGFand sVEGF R1 may be involved in aberrant pulmonary vascular remodeling in COPD patients.35VEGF overexpression pro-motes the development of Th2 inflammatory disorders such as asthma, whileVEGFdownregulation can affect the mechan-isms of viral disorders including COPD.36Therefore,VEGFA may also be involved in the development of COPD.

BCL2 is implicated in apoptotic regulation and lung function, which may be correlated with the development and progression of COPD.37 The BCL2 family members mediate cell apoptosis through maintenance of mitochon-drial membrane potential, which promotes the develop-ment of COPD and affects its severity.38 Through the AMPK/mTOR signaling pathway, β-arrestin2 reduces the expression of inflammatory cytokines in the BEAS-2B bronchial epithelial cells by suppressing autophagy.39 Thus,BCL2 may also be associated with the progression of COPD through the hsa04750 (inflammatory mediator regulation of TRP channels)-C00469 (ethanol)-BCL2and hsa04152 (AMPK signaling pathway)-C00389 (quercetin)-BCL2pairs.

Conclusion

A total of 594 DEGs between COPD and healthy samples were identified. The key genes CYP1B1, VEGFA, BCL2, andCDKN1A may affect the mechanisms underlying the development and progression of COPD. Specifically, BCL2 may be involved in the development of COPD via inflammation-mediated regulation of TRP channels and AMPK signaling pathway. However, in-depth experimen-tal studies are still needed to confirm these results.

Funding

This study was supported by the National Natural Science Foundation of China (81470252, 81170049, 81570325).

Disclosure

The authors declare no conflicts of interest in this work.

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International Journal of Chronic Obstructive Pulmonary Disease downloaded from https://www.dovepress.com/ by 118.70.13.36 on 24-Aug-2020

Figure

Figure 1 Box plots showing the medians of the mRNA expression data before and after normalization
Figure 3 The Gene Ontology (GO)_biological process (BP), GO_cellular component (CC), and GO_molecular function (MF) functional terms and Kyoto Encyclopedia ofGenes and Genomes (KEGG) pathways identified after functional enrichment analysis of the differenti
Table 1 The Top 10 Differentially Expressed Gene (DEG)-Compound Pairs
Figure 5 Results of the Venn diagram analysis.

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