Systemic immune profile in Prader-Willi syndrome: elevated matrix metalloproteinase and myeloperoxidase and reduced macrophage inhibitory factor

Sigrun Hope; Terje Nærland; Svein Olav Kolset; Thor Ueland; Ole A Andreassen; Marianne Nordstrøm

doi:10.1186/s13023-023-02730-5

Systemic immune profile in Prader-Willi syndrome: elevated matrix metalloproteinase and myeloperoxidase and reduced macrophage inhibitory factor

Orphanet J Rare Dis. 2023 Jul 10;18(1):185. doi: 10.1186/s13023-023-02730-5.

Authors

Sigrun Hope^{1

2

3}, Terje Nærland^{4

5}, Svein Olav Kolset⁶, Thor Ueland^{7

8

9}, Ole A Andreassen^{4

10

11}, Marianne Nordstrøm^{6

12

13}

Affiliations

¹ K.G. Jebsen Centre for Neurodevelopmental disorders, Institute of Clinical Medicine, University of Oslo, Oslo, Norway. sigrun.hope@ous-hf.no.
² Department of Neurohabilitation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway. sigrun.hope@ous-hf.no.
³ Nevsom, Department of Rare Diagnoses and Disabilities, Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway. sigrun.hope@ous-hf.no.
⁴ K.G. Jebsen Centre for Neurodevelopmental disorders, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁵ Nevsom, Department of Rare Diagnoses and Disabilities, Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.
⁶ Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
⁷ Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.
⁸ Institute of Clinical Medicine, University of Oslo, Rikshospitalet, Oslo, Norway.
⁹ K.G. Jebsen, TREC, University of Tromsø, Tromsø, Norway.
¹⁰ NORMENT: Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
¹¹ Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
¹² Frambu Resource Centre for Rare Disorders, Siggerud, Norway.
¹³ Unit for Rare Neuromuscular Disorders, Movement, Muscle and Neurodegeneration, Department of Neurology, Oslo University Hospital, Oslo, Norway.

Abstract

Background: Prader-Willi syndrome (PWS) is a rare genetic neurodevelopmental syndrome with highly increased risk of obesity and cardiovascular disease (CVD). Recent evidence suggests that inflammation is implicated in the pathogenesis. Here we investigated CVD related immune markers to shed light on pathogenetic mechanisms.

Methods: We performed a cross-sectional study with 22 participants with PWS and 22 healthy controls (HC), and compared levels of 21 inflammatory markers that reflect activity in different aspects of CVD related immune pathways and analyzed their association with clinical CVD risk factors.

Results: Serum levels of matrix metalloproteinase 9 (MMP-9) was (median (range)) 121 (182) ng/ml in PWS versus 44 (51) ng/ml in HC, p = 1 × 10^-9), myeloperoxidase (MPO) was 183 (696) ng/ml versus 65 (180) ng/ml, p = 1 × 10^-5) and macrophage inhibitory factor (MIF) was 46 (150) ng/ml versus 121 (163) ng/ml (p = 1 × 10^-3), after adjusting for age and sex. Also other markers tended to be elevated (OPG, sIL2RA, CHI3L1, VEGF) but not significantly after Bonferroni correction (p > 0.002). As expected PWS had higher body mass index, waist circumference, leptin, C-reactive protein, glycosylated hemoglobin (HbA1c), VAI and cholesterol, but MMP-9, MPO and MIF remained significantly different in PWS after adjustment for these clinical CVD risk factors.

Conclusion: PWS had elevated levels of MMP-9 and MPO and of reduced levels of MIF, which were not secondary to comorbid CVD risk factors. This immune profile suggests enhanced monocyte/neutrophil activation, impaired macrophage inhibition with enhanced extracellular matrix remodeling. These findings warrant further studies targeting these immune pathways in PWS.

Keywords: 15q11-q13; Cardiovascular; Cytokines; Extracellular matrix; Inflammation; MMP-9; Macrophage inhibitory factor; Myeloperoxidase; Obesity; Prader-Willi Syndrome.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cardiovascular Diseases*
Cross-Sectional Studies
Humans
Macrophages
Matrix Metalloproteinase 9
Peroxidase
Prader-Willi Syndrome*

Substances

Peroxidase
Matrix Metalloproteinase 9