P0971IDENTIFICATION OF HUB GENES ASSOCIATED WITH THE DEPOSITION OF EXTRACELLULAR MATRIX AND SPECIFIC FOR DIABETIC NEPHROPATHY BY WEIGHTED GENE CO-EXPRESSION NETWORK ANALYSIS

Abstract Background and Aims Diabetic nephropathy (DN) and its most severe manifestation, end-stage renal disease (ESRD), remains one of the leading causes of reduced lifespan in people with diabetes. Identifying novel molecules that are involved in the pathogenesis of DN has both diagnostic and therapeutic implications. The gene co-expression network analysis (WGCNA) algorithm represents a novel systems biology approach that provide the approach of association between gene modules and clinical traits to find the module involvement into the certain phenotypic trait. The goal of this study was to identify hub genes and their roles in DN from the aspect of whole gene transcripts analysis. Method Various types of chronic kidney diseases (CKD), including DN, microarray-based mRNA gene expression data, listed in the Gene Expression Omnibus (GEO) database, were analyzed. Next, we constructed a weighted gene co-expression network and identified modules distinguishing DN from normal or other types of CKD by WGCNA. Functional annotations of the genes in modules specialized for DN were analyzed by Gene Ontology (GO) enrichment analysis. Through protein-protein interaction (PPI) analysis and hub gene screening, the hub genes specific for DN were obtained. Furthermore, we drew ROC curves to determine the diagnosis and differential diagnosis value to DN of hub genes. Finally, another study of microarray in the GEO database was selected to verify the expression level of hub genes and in the “Nephroseq” database, the correlation between the gene expression level and eGFR was analyzed. Results “GSE99339”, glomerular tissue microarray in 187 patients with a total of 10947 genes, was selected for analysis. After excluding the inappropriate cases, a total of 179 specimens were analyzed, including 14 cases of DN, 22 cases of focal segmental glomerulosclerosis (FSGS), 15 cases of hypertensive nephropathy (HT), 26 cases of IgA nephropathy (IgAN), 13 cases of minimal change disease (MCD), 21 cases of membranous nephropathy (MGN), 23 cases of rapidly progressive glomerulonephritis (RPGN), 30 cases of lupus nephritis (LN) and 14 cases of kidney tissue adjacent to tumor. Co-expression network analysis by WGCNA identified 23 distinct gene modules of the total 10947 genes and revealed “MEsaddlegreen” module was strongly correlated with DN (r=0,54), but not with other groups. GO functional annotation showed that these 64 genes in the “MEsaddlegreen” module mainly enriched in the deposition of extracellular matrix, which represents the specific and diagnostic pathophysiological process of DN. Further PPI and hub gene screening analysis revealed that LUM, ELN, FBLN1, MMP2, FBLN5 and FMOD can be served as hub genes, which had been proved to play an important role in the deposition of extracellular matrix. Furthermore, we found that the expression of hub genes was the highest in DN group and for the diagnosis value of DN by each gene, the area under the ROC curve is about 0.75∼0.95. The external verification of another study showed that compared with the normal control group, the expression of these hub genes was the highest in the DN group, and their expression level was negatively correlated with eGFR. Conclusion Using WGCNA and further bioinformatics approach, we identified six hub genes that appear to be identical to DN development. As such, they may represent potential diagnostic biomarkers as well as therapeutic targets with clinical utility.