Diminished platelet production and enhanced platelet destruction are the familiar characters of ITP (
24). However, the first hit for dysregulation of the immune system in ITP remains unknown (
25). Understanding the molecular and physiopathological mechanisms of ITP requires many efforts to design new preventive and therapeutic strategies. Due to the interaction of genes and environmental factors in common human diseases, a more integrated biological approach is needed to solve these complexities (
26). DNA microarrays are used as a powerful technique in biomedical research. This method has attracted much attention from scientists because of its ability to identify thousands of genes and even the entire genome simultaneously (
26). Systemic network analysis of high-throughput data is the most useful technique to explain the important implications of life science. Network features, such as composition and topology are highly relevant to vital cellular functions, so they are critical in biological science research (
27). This study tries to find essential genes and mechanisms by bioinformatics analysis of GSE46922 microarray data, which are different between the newly diagnosed and the chronic ITP. This study identifies, 131 DEGs, consisting of 78 up-regulated genes and 53 down-regulated genes, which are differentially expressed between, the newly diagnosed ITP and chronic ITP-.
Our enrichment analysis of the up-regulated DEGs showed that autophagy played a significant role in ITP. There is evidence that the positive regulation of autophagy is the most relevant biological process in ITP associated with the expressed genes in the chronic phase. Autophagy induces to the maintenance of platelet life and physiological functions (
28). Improper expression of molecules in the autophagy pathway has been also determined in ITP patients lymphocytes (
29). Elevating platelet autophagy has been also shown to diminish platelet destruction by prohibiting apoptosis and amending platelet viability (
28). Besides, particular evidence implied that megakaryocytes undergo autophagy in ITP patients (
30). The apoptotic process was diminished in accordance with activate autophagy process in chronic ITP.
Our study has shown that down-regulated genes in the chronic phase were mainly enriched in the Notch signaling, closely related to hematopoiesis, which involves the evolving hematopoietic system to generate hematopoietic stem cells and the development of immune cells like in T-cells or progress several autoimmune diseases like ITP (
32). Rania Mohsen Gawdat
et al. found the correlation of
Notch1/Hes1 gene expression levels in Egyptian paediatric patients with newly diagnosed and persistent primary ITP (
31,
32). We detected this pathway in newly diagnosed ITP while down-regulated in the chronic phase, and this data has shown that the Notch pathway is replaced by the
ErbB signaling pathway, mRNA surveillance pathway, and Estrogen signaling pathway over time to display the chronic phase symptom. Also molecular crosstalk among Notch signaling pthway with
ErbB and Estrogen signaling pathways was acknowledged in breast cancer (
33). This study also confirms the crosstalk between emerging
ErbB and Estrogen pathway and inhibition of the Notch signaling pathway in ITP. The mRNA surveillance pathway was enriched by the up-regulated genes related to the quality control mechanism that targets aberrant mRNAs for degradation (
34). This pathway was not reported for ITP but confirm this mechanism in autoimmune disease and cellular defense against virus invasion. Mutations affecting the mRNA surveillance machinery cause chronic activation of defense programs, resulting in autoimmune phenotypes. The Systemic lupus erythematosus (SLE) as a human autoinflammatory and autoimmune disorders are notably linked to this system deviation (
34). ITP manifests several symptoms of mimicking diseases like SLE; therefore, one might be aware of this similarity emphasizing with several investigations. Besides, this pathway enriched from down-regulated genes in the chronic phase; it implies that the chronic phase of ITP can be due to perturbations in the pathways.
The network analysis also demonstrated that there are interactions among the DEGs.
Our network analysis revealed a set of candidate genes (three up-regulated and three down-regulated) for the investigation of biomarkers or molecular mechanisms of ITP, which was significantly correlated with chronic ITP, including BUB3, GRK5, SF1, VIM, ARRB1, and RHOG.
Our network analysis also verifies the Notch signaling pathway in ITP. In this study, ARRB1 was considered a hub-bottleneck protein with a high degree and high betweenness centrality value. This protein is strongly related to the Notch signaling pathway. Due to its unique features, it has an attractive advantage for drug targeting.
One of the essential genes that play an indispensable role in the maturation of hematopoietic precursors is
Vimentin (
VIM) that belongs to hub-bottleneck protein. Alteration in expression of
VIM has been recognized in the maturation process of the megakaryocytic, granulomonocytic, erythroid, and lymphoid lineages (
35). Up-regulated
VIM has been also shown in the formation of fully active macrophage-like cells and macrophage polykaryons (
36).
Rho GTPases (
RhoG) is one of the crucial members of our analysis, which has a central regulatory role in platelet production and megakaryocyte maturation (
37).
One of the most important genes in this research was
SF1. In addition to being a hub, integrating TF’s expression data into Cytoscape indicated that
SF1 is also a TF. Kenichi Yoshida
et al. reported that there is a mutation in
SF1 in hematologic malignancies, but its frequency was not at confidence level for presentation to clinical associations (
38).
The G-protein-coupled receptor kinase 5 (GRK5) is a critical member of the threonine/serine kinase family that phosphorylates and regulates the G-protein-coupled receptor (GPCR) signaling pathway. GRK5 has a key role in several diseases; for example, GRK5 is a decisive pathogenic factor in early Alzheimer’s disease, hepatic steatosis and metabolic disorders such as type II diabetes and obesity, injured and failing heart and cancer (
39-
44). GRK
5 also has multiple roles in
TLR (Toll-Like Receptor) signaling, which were described as a family of receptors involved in recognizing pathogen-associated molecular patterns (PAMPs) derived from microbes. Moreover, the importance of
TLRs has been identified in several inflammatory diseases, including non-infectious diseases (
45,
46). In addition, detection of GRK5 expression provides a target for determining the effectiveness of drugs and determining patient prognosis in cancer (
47).
The
BUB3 is one of the mitotic checkpoint proteins specified by a group of evolutionarily conserved genes. It is believed that the failure of the
BUB gene family as a surveillance system is a critical components of the regulatory process which causes genomic instability. This gene family encodes proteins that are a part of a large multi-protein kinetochore complex (
48,
49). The
BUB3’s importance was found in colorectal cancer at a young age and in low-grade breast cancers (
50, 51).
The use of omics technology to identify the mechanism of disease and the discovery of biomarkers has received much attention in recent years. Microarray and proteomics approaches can help to solve biological complexities by creating an extensive list of expressed transcripts that are simultaneously (
52). As mentioned in the introduction, Zheng and his colleagues were able to introduce six important markers for the diagnosis of ITP by using Proteomics technology in 2016 (
11). However, they have not yet been used in the clinic. Our study using microarray data analysis introduces six new markers that can clarify the pathogenesis of the ITP and need many examinations for clinic application.
Box plot of expression data by analyzing GSE46922 that contain seven newly diagnosed ITP and six chronic ITP samples
(A) network with 1137 nodes and 2647 edges. Unregulated hub genes were shown with red triangle nodes while down-regulated represented with green color (B) Significant modules selected from the network. Pink modules illustrated up-regulated genes, while green nodes illustrated down-regulated genes. Seed nodes are shown in rectangular shape
Visualization in Cytoscape of interactions between TFs, modules and hub-TFs. TFs are shown as triangle. Hubs are displayed in red ellipses. Modules showed by number with different color that contains the nodes are hub (red node), seed (green node) and TF (yellow and red triangle). There is just one red rectangle in module No.2 related to the node that is hub-seed gene. Red triangle related to the nodes are hub-TFs and green triangle is a node related seed-TFs. SF1 and ATF2 are hub-TFs and ZNF382 is a seed-TF. ZNF382 and SF1 are the members of modules No.1 and No.2 respectively
| Category | Term | P-Value |
|---|
| Annotation Cluster 1 | Enrichment Score: 1.6089173346492356 | |
| GO:1902589 | single-organism organelle organization | 0.005313 |
| GO:0000226 | microtubule cytoskeleton organization | 0.020728 |
| GO:0007017 | microtubule-based process | 0.026109 |
| Annotation Cluster 2 | Enrichment Score: 1.5454786370206883 | |
| GO:0010506 | regulation of autophagy | 0.003125 |
| GO:0010508 | positive regulation of autophagy | 0.03688 |
| Annotation Cluster 3 | Enrichment Score: 1.1276637957883262 | |
| GO:0000075 | cell cycle checkpoint | 0.010137 |
| GO:0022402 | cell cycle process | 0.010174 |
| GO:0000077 | DNA damage checkpoint | 0.017372 |
| GO:0007049 | cell cycle | 0.017944 |
| GO:0031570 | DNA integrity checkpoint | 0.020624 |
| GO:0007093 | mitotic cell cycle checkpoint | 0.020967 |
| GO:0045930 | negative regulation of mitotic cell cycle | 0.047204 |
| Annotation Cluster 4 | Enrichment Score: 1.0524732568167308 | |
| GO:0016043 | cellular component organization | 0.03475 |
| GO:0006996 | organelle organization | 0.046543 |
| GO:0071840 | cellular component organization or biogenesis | 0.04844 |
| Annotation Cluster 5 | Enrichment Score: 0.9254147029064898 | |
| GO:0031344 | regulation of cell projection organization | 0.004985 |
| GO:0010975 | regulation of neuron projection development | 0.018065 |
| GO:0030030 | cell projection organization | 0.020064 |
| GO:0031346 | positive regulation of cell projection organization | 0.02586 |
| GO:0031175 | neuron projection development | 0.030331 |
| GO:0030182 | neuron differentiation | 0.035135 |
| Annotation Cluster 6 | Enrichment Score: 0.9097209940740182 | |
| GO:0043170 | macromolecule metabolic process | 0.001037 |
| GO:0010468 | regulation of gene expression | 0.008941 |
| GO:0060255 | regulation of macromolecule metabolic process | 0.008953 |
| GO:0019222 | regulation of metabolic process | 0.011749 |
| GO:0044260 | cellular macromolecule metabolic process | 0.014544 |
| GO:0010467 | gene expression | 0.017106 |
| GO:0010558 | negative regulation of macromolecule biosynthetic process | 0.033922 |
| GO:0009892 | negative regulation of metabolic process | 0.038268 |
| GO:0010605 | negative regulation of macromolecule metabolic process | 0.041577 |
| GO:0031327 | negative regulation of cellular biosynthetic process | 0.043543 |
| GO:0031324 | negative regulation of cellular metabolic process | 0.044105 |
| GO:0009890 | negative regulation of biosynthetic process | 0.047731 |
| GO:0051172 | negative regulation of nitrogen compound metabolic process | 0.048092 |
| Annotation Cluster 8 | Enrichment Score: 0.7138986023041735 | |
| GO:0007062 | sister chromatid cohesion | 0.011798 |
| GO:0000819 | sister chromatid segregation | 0.049886 |
| Annotation Cluster 11 | Enrichment Score: 0.5802981069084664 | |
| GO:0090150 | establishment of protein localization to membrane | 0.046903 |
| Annotation Cluster 17 | Enrichment Score: 0.42916203800540753 | |
| GO:0018108 | peptidyl-tyrosine phosphorylation | 0.009263 |
| GO:0018212 | peptidyl-tyrosine modification | 0.00948 |
| Annotation Cluster 18 | Enrichment Score: 0.40498640863411367 | |
| GO:0018108 | peptidyl-tyrosine phosphorylation | 0.009263 |
| GO:0018212 | peptidyl-tyrosine modification | 0.00948 |
| GO:0044260 | cellular macromolecule metabolic process | 0.014544 |
| GO:0061097 | regulation of protein tyrosine kinase activity | 0.023351 |
| Category | Term | P-Value |
|---|
| Annotation Cluster 2 | Enrichment Score: 0.7613112520752194 | |
| GO:0044267 | cellular protein metabolic process | 0.011896 |
| GO:0043412 | macromolecule modification | 0.01846 |
| GO:0019538 | protein metabolic process | 0.018791 |
| GO:0006807 | nitrogen compound metabolic process | 0.019514 |
| GO:0009059 | macromolecule biosynthetic process | 0.021932 |
| GO:0043170 | macromolecule metabolic process | 0.028871 |
| GO:0044249 | cellular biosynthetic process | 0.033903 |
| GO:0034641 | cellular nitrogen compound metabolic process | 0.034934 |
| GO:0044237 | cellular metabolic process | 0.043685 |
| GO:0008152 | metabolic process | 0.044952 |
| GO:0044238 | primary metabolic process | 0.04675 |
| GO:0006464 | cellular protein modification process | 0.047376 |
| GO:0036211 | protein modification process | 0.047376 |
| GO:0009058 | biosynthetic process | 0.048575 |
| GO:0071704 | organic substance metabolic process | 0.04992 |
| Annotation Cluster 3 | Enrichment Score: 0.7085147802867421 | |
| GO:0051817 | modification of morphology or physiology of other organism involved in symbiotic interaction | 0.023652 |
| GO:0035821 | modification of morphology or physiology of other organism | 0.033336 |
| Annotation Cluster 5 | Enrichment Score: 0.5438770693729118 | |
| GO:0016570 | histone modification | 0.005122 |
| GO:0016569 | covalent chromatin modification | 0.012772 |
| GO:0006325 | chromatin organization | 0.012912 |
| GO:0090630 | activation of GTPase activity | 0.017421 |
| GO:0032092 | positive regulation of protein binding | 0.017839 |
| GO:0006996 | organelle organization | 0.019368 |
| GO:0018205 | peptidyl-lysine modification | 0.01994 |
| GO:0051817 | modification of morphology or physiology of other organism involved in symbiotic interaction | 0.023652 |
| GO:0071333 | cellular response to glucose stimulus | 0.026068 |
| GO:0071331 | cellular response to hexose stimulus | 0.027564 |
| GO:0071326 | cellular response to monosaccharide stimulus | 0.027564 |
| GO:0051276 | chromosome organization | 0.029444 |
| GO:0006915 | apoptotic process | 0.030391 |
| GO:0071322 | cellular response to carbohydrate stimulus | 0.032253 |
| GO:0035821 | modification of morphology or physiology of other organism | 0.033336 |
| GO:0001678 | cellular glucose homeostasis | 0.034432 |
| GO:0012501 | programmed cell death | 0.042073 |
| GO:0016571 | histone methylation | 0.0443 |
| GO:0006464 | cellular protein modification process | 0.047376 |
| GO:0036211 | protein modification process | 0.047376 |
| GO:0043433 | negative regulation of sequence-specific DNA binding transcription factor activity | 0.048006 |
| GO:0051099 | positive regulation of binding | 0.0499 |
| Term | Description | P-value | Genes |
|---|
| Up-regulated DEGs |
| 1 | hsa04012 | ErbB signaling pathway | 0.033682 | PAK2, ABL2, AKT3 |
| 2 | hsa03015 | mRNA surveillance pathway | 0.036574 | PCF11, GSPT1, MSI2 |
| 3 | hsa04915 | Estrogen signaling pathway | 0.042636 | FKBP5, AKT3, ATF2 |
| Down-regulated DEGs |
| 1 | hsa04330 | Notch signaling pathway | 0.009201 | HDAC1;MFNG;DTX1 |
| UniProtKB ID | Gene name | Degree | Betweeness centrality |
|---|
| Up-regulated |
| 1 | P15336 | ATF2 | 124 | 0.095148 |
| 2 | P08670 | VIM | 111 | 0.123853* |
| 3 | Q13177 | PAK2 | 101 | 0.07973 |
| 4 | Q15637 | SF1 | 90 | 0.084552 |
| 5 | O43684 | BUB3 | 85 | 0.058294 |
| 6 | O94913 | PCF11 | 77 | 0.037986 |
| 7 | Q9Y243 | PCF12 | 62 | 0.03668 |
| 8 | Q969H0 | FBXW7 | 53 | 0.025345 |
| 9 | P15170 | GSPT1 | 49 | 0.037137 |
| 10 | P30622 | CLIP1 | 46 | 0.012378 |
| 11 | P42684 | ABL2 | 42 | 0.023944 |
| Down-regulated |
| 1 | P49407 | ARRB1 | 125 | 0.121072* |
| 2 | P52292 | KPNA2 | 81 | 0.066201 |
| 3 | P34947 | GRK5 | 59 | 0.036356 |
| 4 | P49411 | TUFM | 56 | 0.035678 |
| 5 | P84095 | RHOG | 40 | 0.028479 |
| 6 | Q9Y6I9 | TEX264 | 40 | 0.055543 |
| Added by network |
| 1 | Q13547 | RPD3L1 | 202 | 0.236783* |
| 2 | Q71U36 | Tubulin B-alpha-1 | 134 | 0.135022* |
| 3 | Q7L7X3 | PSK2 | 42 | 0.017018 |
| UniProtKB ID | Gene name | Betweenness centrality | Degree |
|---|
| Up-regulated |
| 1 | Q9BXC9 | BBS2 | 1 | 27 |
| 2 | Q96P16 | RPRD1A | 1 | 24 |
| 3 | Q8N3X1 | FNBP4 | 1 | 6 |
| 4 | Q9UJT0 | TUBE1 | 1 | 2 |
| 5 | Q8WWZ7 | ABCA5 | 1 | 2 |
| 6 | Q8N5X7 | EIF4E3 | 1 | 2 |
| 7 | Q8NDV7 | TNRC6A | 0.44370861 | 27 |
| 8 | Q92609 | TBC1D5 | 0.48979592 | 11 |
| 9 | P08670 | VIM | 0.41453744 | 111* |
| Down-regulated |
| 1 | Q6NUQ4 | TMEM214 | 1 | 13 |
| 2 | Q9NQ92 | COPRS | 1 | 8 |
| 3 | Q9Y6X3 | MAU2 | 1 | 5 |
| 4 | A0A087X2D5 | MRPL45 | 0.807327 | 37 |
| 5 | Q66K14 | TBC1D9B | 0.76268116 | 14 |
| 6 | P49407 | ARRB1 | 0.12107173 | 125* |
| Added by network |
| 1 | Q13618 | CUL3 | 0.48846676 | 2 |
| 2 | Q13547 | RPD3L1 | 0.23678326 | 202* |
| 3 | Q9H492 | MAP1LC3A | 0.23550725 | 2 |
| 4 | Q9H0R8 | GABARAPL1 | 0.23550725 | 2 |
| 5 | Q71U36 | Tubulin B-alpha-1 | 0.13502234 | 134* |
| Gene name | Gene ID | Degree | Betweeness centrality | M | Biological process |
|---|
| Up-regulated |
| 1 | VIM | P08670 | 111 | 0.12385346 | 1.077912156 | positive regulation of protein ubiquitination involved in ubiquitin-dependent protein catabolic process (GO:2000060) |
| 2 | SF1 | Q15637 | 90 | 0.08455183 | 2.419055031 | mRNA splice site selection (GO:0006376),spliceosomal complex assembly (GO:0000245),mRNA 3'-splice site recognition (GO:0000389) |
| 3 | BUB3 | O43684 | 85 | 0.05829374 | 0.846438817 | regulation of translation (GO:0006417) |
| Down-regulated |
| 1 | ARRB1 | P49407 | 125 | 0.12107173 | -1.855926621 | regulation of Notch signaling pathway (GO:0008593), negative regulation of sequence-specific DNA binding transcription factor activity (GO:0043433), negative regulation of NF-kappaB transcription factor activity (GO:0032088), positive regulation of histone H4 acetylation (GO:0090240), desensitization of G-protein coupled receptor protein signaling pathway (GO:0002029), regulation of histone H4 acetylation (GO:0090239), positive regulation of cellular metabolic process (GO:0031325), contractile actin filament bundle assembly (GO:0030038), stress fiber assembly (GO:0043149), negative regulation of cytokine production (GO:0001818), positive regulation of peptidyl-lysine acetylation (GO:2000758), negative regulation of interleukin-8 production (GO:0032717), modification-dependent protein catabolic process (GO:0019941) |
| 2 | GRK5 | P34947 | 59 | 0.03635575 | -0.896145434 | tachykinin receptor signaling pathway (GO:0007217), regulation of signal transduction (GO:0009966), positive regulation of cell proliferation (GO:0008284), regulation of cell proliferation (GO:0042127) |
| 3 | RHOG | P84095 | 40 | 0.02847864 | -1.37279767 | Rac protein signal transduction (GO:0016601), activation of GTPase activity (GO:0090630), positive regulation of GTPase activity (GO:0043547), positive regulation of cell proliferation (GO:0008284), engulfment of apoptotic cell (GO:0043652), phagocytosis, engulfment (GO:0006911), neutrophil degranulation (GO:0043312),neutrophil activation involved in immune response (GO:0002283), neutrophil mediated immunity (GO:0002446), regulation of cell proliferation (GO:0042127) |