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Blood DNA methylation profiling identifies cathepsin Z dysregulation in pulmonary arterial hypertension

Lookup NU author(s): Dr James Lordan



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2024, The Author(s).Pulmonary arterial hypertension (PAH) is characterised by pulmonary vascular remodelling causing premature death from right heart failure. Established DNA variants influence PAH risk, but susceptibility from epigenetic changes is unknown. We addressed this through epigenome-wide association study (EWAS), testing 865,848 CpG sites for association with PAH in 429 individuals with PAH and 1226 controls. Three loci, at Cathepsin Z (CTSZ, cg04917472), Conserved oligomeric Golgi complex 6 (COG6, cg27396197), and Zinc Finger Protein 678 (ZNF678, cg03144189), reached epigenome-wide significance (p < 10−7) and are hypermethylated in PAH, including in individuals with PAH at 1-year follow-up. Of 16 established PAH genes, only cg10976975 in BMP10 shows hypermethylation in PAH. Hypermethylation at CTSZ is associated with decreased blood cathepsin Z mRNA levels. Knockdown of CTSZ expression in human pulmonary artery endothelial cells increases caspase-3/7 activity (p < 10−4). DNA methylation profiles are altered in PAH, exemplified by the pulmonary endothelial function modifier CTSZ, encoding protease cathepsin Z.

Publication metadata

Author(s): Ulrich A, Wu Y, Draisma H, Wharton J, Swietlik EM, Cebola I, Vasilaki E, Balkhiyarova Z, Jarvelin M-R, Auvinen J, Herzig K-H, Coghlan JG, Lordan J, Church C, Howard LS, Pepke-Zaba J, Toshner M, Wort SJ, Kiely DG, Condliffe R, Lawrie A, Graf S, Morrell NW, Wilkins MR, Prokopenko I, Rhodes CJ

Publication type: Article

Publication status: Published

Journal: Nature Communications

Year: 2024

Volume: 15

Issue: 1

Online publication date: 06/01/2024

Acceptance date: 28/12/2023

Date deposited: 20/02/2024

ISSN (electronic): 2041-1723

Publisher: Nature Research


DOI: 10.1038/s41467-023-44683-0

PubMed id: 38184627


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Funder referenceFunder name
BHF Basic Science Research fellowships (FS/15/59/31839 & FS/SBSRF/21/31025)
BHF Senior Basic Science Research fellowship (FS/18/52/33808)
Academy of Medical Sciences Springboard fellowship (SBF004\1095)
Michael J. Fox Foundation for Parkinson’s Research and funding partners
the British Heart Foundation (BHF SP/12/12/29836)
the European Union’s Horizon 2020 research and innovation programme (LONGITOOLS, H2020-SC1-2019-874739)
Royal Society and Wellcome Trust Sir Henry Dale Fellowship (224662/Z/21/Z)
the British Heart Foundation Centre for Research Excellence award (RE/18/4/34215)
the Diabetes UK (BDA number: 20/0006307)
the UK Medical Research Council (MR/K020919/1)