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The following is a summary of “Identification of host endotypes using peripheral blood transcriptomics in a prospective cohort of patients with endocarditis,” published in the September 2024 issue of Infectious Disease by Duarte-Herrera et al.
Host responses to infection play an essential role in endocarditis. However, whether there are distinct response profiles among patients with this condition remains imprecise.
Researchers conducted a retrospective study to use transcriptomics to determine endotypes in individuals with infective endocarditis.
They examined 32 patients with infective endocarditis, collecting clinical data and blood samples at diagnosis. RNA sequencing was performed to identify distinct gene expression patterns, including 2 clusters of endocarditis endotypes, EE1 and EE2. RNA sequencing was repeated after surgery, and deconvolution was employed to choose the transcriptionally active cell populations. Clinical data, survival, gene expression, and molecular pathways were compared between the endotypes. Additionally, the specified endotypes were validated in patients with COVID-19.
The results showed no difference between patients with EE1 and EE2. Still, patients with EE2 demonstrated improvements in genes related to T-cell maturation, a decline in STAT pathway activation, increased T-cell counts, and reduced neutrophil numbers. Surgery was performed with 14 patients (9 in EE1 and 5 in EE2), and in EE2, individuals shifted gene expression towards an EE1-like profile. In-hospital mortality was elevated in EE1 (56% vs 14%, P=0.027) with an adjusted hazard ratio of 12.987 (95% CI3.356 – 50]. Translation of these endotypes to patients with COVID-19 and patients without COVID-19 yielded identical cell populations and results.
They concluded that gene expression analysis of 2 distinct endotypes in patients with acute endocarditis is characterized by underlying pathogenetic mechanisms, surgical responses, and clinical outcomes.
Sources: ijidonline.com/article/S1201-9712(24)00306-0/fulltext
