Insights on P2X7 in patients with abdominal aortic aneurysm and carotid atherosclerosis
Authors: Foglieni C , Lombardi M , Spartano L , Ardita V , Valente F B A , Galati N , Castellano R , Melissano G , Chiesa R , Baccellieri D 
Published: May 2024

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministero della Salute, Italia, Rete Cardiologica Nazionale

Background
Carotid atherosclerosis and abdominal aortic aneurysm (AAA) are co-morbidities [1]. P2X-purinoceptor-7 (P2X7) is expressed both in human AAA and atherosclerotic carotid plaque (CPL) and is instability-associated in CPL [2-4]. P2X7 is functionally related to miR-150 and miR-186 (two microRNA which modulate vascular cell proliferation) [5,6], and may be shed into the bloodstream in correlation with C-reactive protein increase [7]. Little is known about the possible association between AAA risk and circulating P2X7, miR-150 and miR-186 in patients with/without hemodinamically significant CPL.

Purpose
Our aim is exploring the possible relationship between circulating P2X7, target miRs clinical status and lesion dimensions in patients with CPL and/or AAA.

Methods
Male patients with AAA and/or CPL were characterized.CPL stenosis was assessed by Ecocolordoppler-TSA.
Eligible cohort included 20 patients with AAA undergoing aneurysmectomy [10 with CPL stenosis ≤40% (group A), 10with CPL stenosis &gt;40% (group B)], 10 patients with hemodinamically significant CPL and small or no AAA undergoing endarterectomy (group C) donating blood and vascular samples at surgery. Twelve healthy blood donors (group D) were enrolled as controls.
P2X7 protein was evaluated by ELISA. P2X7 gene, miR-150 and miR-186 were determined by RT-qPCR.

Results
In group A, CPL appeared mainly localized at carotid bulb, in group B extended along branches.
P2X7 gene was undetermined into serum and expressed without differences among groups in patient tissues. P2X7 protein was measurable in all serum samples and was lower in group B than in the others (p=0,0117, p=0,0009, p=0,0003 vs. group A, C, D, respectively) and in group C vs. D (p=0,0006). These data differentiated patients with hemodinamically significant CPLs with severe AAA from the other patients and all those with hemodinamically significant CPLs (irrespectively from AAA severity) from healthy individuals. In group B but not in the others, serum P2X7 was linearly associated to platelet concentration. In group C the amounts of P2X7 in CPL tissue and serum were negatively associated, whereas in group A and B the P2X7 levels in AAA tissue and serum were unrelated.
The miRs were detected into both serum and tissue and not correlated among them nor with circulating P2X7 protein. The serum miR-186, but not miR-150, was differentially expressed in group A vs. B (p=0,0266) and linearly related to AAA diameter in group B (p=0.0351).
P2X7 content and expressed gene (p=0,015, p= 0,023, respectively) and miR expressions (p=0,0418 for miR-186, p=0,0012 for miR-150) were more elevated in AAA vs. CPL tissues, highlighting the vascular heterogenicity.

Conclusions
Preliminary data suggest a role for P2X7 and miR-186 in profiling patients with hemodinamically significant CPL with/without high risk AAA, deserving further investigations.