Welcome to visit Zhongnan Medical Journal Press Series journal website!

Associations among immunophenotype, plasma metabolites, and benign prostatic hyperplasia: a mediation Mendelian randomization study

Published on Jan. 25, 2025Total Views: 530 timesTotal Downloads: 211 timesDownloadMobile

Author: FAN Jiuming 1, 2, 3# ZHAO Yiqiao 3# JIA Haichang 2, 3 WANG Tiankun 2, 3, 4 HAN Yutong 1, 2 QIN Zihao 1, 2, 3 CHEN Ping 3 ZENG Xiantao 2, 3

Affiliation: 1. Department of Urology, Huaihe Hospital of Henan University, Kaifeng 475004, Henan Province, China 2. Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China 3. Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China 4. Department of General Surgery, Huaihe Hospital of Henan University, Kaifeng 475004, Henan Province, China

Keywords: Benign prostatic hyperplasia Mendelian randomization Immunophenotypes Plasma metabolites Exposure-mediator-outcome pathway Mediation analysis

DOI: 10.12173/j.issn.1004-5511.202412097

Reference: Fan JM, Zhao YQ, Jia HC, Wang TK, Han YT, Qi ZH, Chen P, Zeng XT. Associations among immunophenotype, plasma metabolites, and benign prostatic hyperplasia: a mediation Mendelian randomization study[J]. Yixue Xinzhi Zazhi, 2025, 35(1): 73-82. DOI: 10.12173/j.issn.1004-5511.202412097. [Article in Chinese]

  • Abstract
  • Full-text
  • References
Abstract

Objective  To explore the potential causal relationship between immune cells, plasma metabolites and benign prostatic hyperplasia (BPH) and the mediating role of plasma metabolism by using the mediated Mendelian randomization (MR) method.

Methods  Two-sample bidirectional MR analysis was used to predict the immune phenotype that may affect BPH, and immune cells that were adversely affected by BPH were excluded. Secondly, one-way two-sample MR analysis was used to screen plasma metabolites associated with BPH and whether they were affected by immune cells were explored. The causal relationship between plasma metabolites and BPH was evaluated by the same method. Finally, the mediating effect of plasma metabolites between immune cells and BPH was further estimated.

Results  Through bidirectional MR analysis, the study identified significant associations between eight immune cell phenotypes and BPH. IVW analysis revealed that five immune cell phenotypes were protective against BPH, while three phenotypes were significantly associated with increased BPH risk. In the MR analysis of blood metabolites and BPH, IVW results identified 17 blood metabolite markers with significant causal associations with BPH. Among these, eight metabolites were significantly linked to an increased risk of BPH, while nine metabolites were associated with a reduced risk. Mediation MR analysis identified two key causal pathways. The first pathway involves DP[CD4(+)CD8(+)]AC influencing BPH through the 5-methylthioadenosine (MTA) phosphate ratio [mediation proportion=-12.086%, 95%CI(-22.430%, -1.742%)]. The second pathway involves CD19 on IgD(-)CD24(- ) affecting BPH via deoxycholic acid glucuronide levels [mediation proportion=-11.230%, 95%CI(-21.873%, -0.588%)]. Both metabolites showed mediation proportions exceeding 10%, suggesting a significant mediatory role in the relationship between immune cells and BPH.

Conclusion This study highlights two distinct immune phenotypes associated with BPH, mediated by specific plasma metabolites through mediation MR analysis. These findings offer novel insights into the pathophysiology of BPH and identify potential biomarkers and therapeutic targets for its diagnosis and  management.

Full-text
Please download the PDF version to read the full text: download
References

1. Langan RC. Benign prostatic hyperplasia[J]. Prim Care, 2019, 46(2): 223-232. DOI: 10.1016/j.pop.2019.02.003.

2. Kim EH, Larson JA, Andriole GL. Management of benign prostatic hyperplasia[J]. Annu Rev Med, 2016, 67: 137-151. DOI: 10.1146/annurev-med-063014-123902.

3. Jin S, Xiang P, Liu J, et al. Activation of cGMP/PKG/p65 signaling associated with PDE5-Is downregulates CCL5 secretion by CD8 (+) T cells in benign prostatic hyperplasia[J]. Prostate, 2019, 79(8): 909-919. DOI: 10.1002/pros.23801.

4. Yang M, Xu Z, Zhuang Z. Macrophages affect immune inflammation and proliferation in benign prostatic hyperplasia via androgen receptor and CD40/CD40L signaling pathway[J]. Tissue Cell, 2020, 64: 101343. DOI: 10.1016/j.tice.2020.101343.

5. Ratajczak W, Laszczyńska M, Rył A, et al. Tissue immunoexpression of IL-6 and IL-18 in aging men with BPH and MetS and their relationship with lipid parameters and gut microbiota-derived short chain fatty acids[J]. Aging (Albany NY), 2023, 15(20): 10875-10896. DOI: 10.18632/aging.205091.

6. Li LY, Han J, Wu L, et al. Alterations of gut microbiota diversity, composition and metabonomics in testosterone-induced benign prostatic hyperplasia rats[J]. Mil Med Res, 2022, 9(1): 12. DOI: 10.1186/s40779-022-00373-4.

7. Zhu C, Wu J, Wu Y, et al. Triglyceride to high-density lipoprotein cholesterol ratio and total cholesterol to high-density lipoprotein cholesterol ratio and risk of benign prostatic hyperplasia in Chinese male subjects[J]. Front Nutr, 2022, 9: 999995. DOI: 10.3389/fnut.2022.999995.

8. Fu X, Liu J, Liu D, et al. Glucose-regulated protein 78 modulates cell growth, epithelial-mesenchymal transition, and oxidative stress in the hyperplastic prostate[J]. Cell Death Dis, 2022, 13(1): 78. DOI: 10.1038/s41419-022-04522-4.

9. Zendehdel A, Ansari M, Khatami F, et al. The effect of vitamin D supplementation on the progression of benign prostatic hyperplasia: a randomized controlled trial[J]. Clin Nutr, 2021, 40(5): 3325-3331. DOI: 10.1016/j.clnu.2020.11.005.

10. Ghadian A, Rezaei M. Combination therapy with omega-3 fatty acids plus tamsulocin and finasteride in the treatment of men with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH)[J]. Inflammopharmacology, 2017, 25(4): 451-458. DOI: 10.1007/s10787-017-0343-2.

11. Zhang S, Zhang X, Yang H, et al. Hurdle or thruster: glucose metabolism of T cells in anti-tumour immunity[J]. Biochim Biophys Acta Rev Cancer, 2024, 1879(1): 189022. DOI: 10.1016/j.bbcan.2023.189022.

12. Davey Smith G, Hemani G. Mendelian randomization: genetic anchors for causal inference in epidemiological studies[J]. Hum Mol Genet, 2014, 23(R1): R89-98. DOI: 10.1093/hmg/ddu328.

13. Orrù V, Steri M, Sidore C, et al. Complex genetic signatures in immune cells underlie autoimmunity and inform therapy[J]. Nat Genet, 2020, 52(10): 1036-1045. DOI: 10.1038/s41588-020-0684-4.

14. Chen Y, Lu T, Pettersson-Kymmer U, et al. Genomic atlas of the plasma metabolome prioritizes metabolites implicated in human diseases[J]. Nat Genet, 2023, 55(1): 44-53. DOI: 10.1038/s41588-022-01270-1.

15. Song Z, Li W, Han Y, et al. Association of immune cell traits with Parkinson's disease: a Mendelian randomization study[J]. Front Aging Neurosci, 2024, 16: 1340110. DOI: 10.3389/fnagi.2024. 1340110.

16. Du J, Fang L, Dong K, et al. Exploring the complex relationship between attention deficit hyperactivity disorder and the immune system: a bidirectional Mendelian randomization analysis[J]. J Affect Disord, 2025, 369: 854-860. DOI: 10.1016/j.jad.2024.10.050.

17. Hou S, Jin C, Shi B, et al. Causal inference between immune cells and glioblastoma: a bidirectional Mendelian randomization study[J]. J Cancer, 2025, 16(1): 171-181. DOI: 10.7150/jca. 100519.

18. Au Yeung SL, Schooling CM. Impact of glycemic traits, type 2 diabetes and metformin use on breast and prostate cancer risk: a Mendelian randomization study[J]. BMJ Open Diabetes Res Care, 2019, 7(1): e000872. DOI: 10.1136/bmjdrc-2019-000872.

19. Bochud M, Rousson V. Usefulness of Mendelian randomization in observational epidemiology[J]. Int J Environ Res Public Health, 2010, 7(3): 711-728. DOI: 10.3390/ijerph7030711.

20. Xu M, Zheng J, Hou T, et al. SGLT2 inhibition, choline metabolites, and cardiometabolic diseases: a mediation Mendelian randomization study[J]. Diabetes Care, 2022, 45(11): 2718-2728. DOI: 10.2337/dc22-0323.

21. Shao X, Yu R, Zhao H, et al. Causal relationship between genetically determined plasma metabolites and skin cancer: a two-sample Mendelian randomization study[J]. Arch Dermatol Res, 2024, 316(6): 214. DOI: 10.1007/s00403-024-03011-2.

22. Carter AR, Sanderson E, Hammerton G, et al. Mendelian randomisation for mediation analysis: current methods and challenges for implementation[J]. Eur J Epidemiol, 2021, 36(5): 465-478. DOI: 10.1007/s10654-021-00757-1.

23. Petrie HT, Zúñiga-Pflücker JC. Zoned out: functional mapping of stromal signaling microenvironments in the thymus[J]. Annu Rev Immunol, 2007, 25: 649-679. DOI: 10.1146/annurev.immunol. 23.021704.115715.

24. Overgaard NH, Jung JW, Steptoe RJ, et al. CD4+/CD8+ double-positive T cells: more than just a developmental stage?[J]. J Leukoc Biol, 2015, 97(1): 31-38. DOI: 10.1189/jlb.1RU0814-382.

25. Wang S, Shen H, Bai B, et al. Increased CD4(+)CD8(+) double-positive T cell in patients with primary Sjögren's syndrome correlated with disease activity[J]. J Immunol Res, 2021, 2021: 6658324. DOI: 10.1155/2021/6658324.

26. Parel Y, Chizzolini C. CD4+ CD8+ double positive (DP) T cells in health and disease[J]. Autoimmun Rev, 2004, 3(3): 215-220. DOI: 10.1016/j.autrev.2003.09.001.

27. Hirao J, Sugita K. Circulating CD4+CD8+ T lymphocytes in patients with Kawasaki disease[J]. Clin Exp Immunol, 1998, 111(2): 397-401. DOI: 10.1046/j.1365-2249.1998.00480.x.

28. Mizutani H, Katagiri S, Uejima K, et al. T-cell abnormalities in patients with idiopathic thrombocytopenic purpura: the presence of OKT4+8+ cells[J]. Scand J Haematol, 1985, 35(2): 233-239. DOI: 10.1111/j.1600-0609.1985.tb01580.x.

29. Parel Y, Aurrand-Lions M, Scheja A, et al. Presence of CD4+CD8+ double-positive T cells with very high interleukin-4 production potential in lesional skin of patients with systemic sclerosis[J]. Arthritis Rheum, 2007, 56(10): 3459-3467. DOI: 10.1002/art.22927.

30. Das G, Augustine MM, Das J, et al. An important regulatory role for CD4+CD8 alpha alpha T cells in the intestinal epithelial layer in the prevention of inflammatory bowel disease[J]. Proc Natl Acad Sci U S A, 2003, 100(9): 5324-5329. DOI: 10.1073/pnas.0831037100.

31. Vickman RE, Aaron-Brooks L, Zhang R, et al. TNF is a potential therapeutic target to suppress prostatic inflammation and hyperplasia in autoimmune disease[J]. Nat Commun, 2022, 13(1): 2133. DOI: 10.1038/s41467-022-29719-1.

32. Avila MA, García-Trevijano ER, Lu SC, et al. Methylthioadenosine[J]. Int J Biochem Cell Biol, 2004, 36(11): 2125-2130. DOI: 10.1016/j.biocel.2003.11.016.

33. Rattajak P, Aroonkesorn A, Smythe C, et al. 5'-Methylthioadenosine strongly suppresses RANKL-induced osteoclast differentiation and function via inhibition of RANK-NFATc1 signalling pathways[J]. Heliyon, 2023, 9(11): e22365. DOI: 10.1016/j.heliyon.2023.e22365.

34. Mary C, Duek P, Salleron L, et al. Functional identification of APIP as human mtnB, a key enzyme in the methionine salvage pathway[J]. PLoS One, 2012, 7(12): e52877. DOI: 10.1371/journal.pone.0052877.

35. Hung MH, Lee JS, Ma C, et al. Tumor methionine metabolism drives T-cell exhaustion in hepatocellular carcinoma[J]. Nat Commun, 2021, 12(1): 1455. DOI: 10.1038/s41467-021-21804-1.

36. Roberts ME, Kaminski D, Jenks SA, et al. Primary Sjögren's syndrome is characterized by distinct phenotypic and transcriptional profiles of IgD+ unswitched memory B cells[J]. Arthritis Rheumatol, 2014, 66(9): 2558-2569. DOI: 10.1002/art.38734.

37. Warnatz K, Denz A, Dräger R, et al. Severe deficiency of switched memory B cells (CD27(+)IgM(-)IgD(-)) in subgroups of patients with common variable immunodeficiency: a new approach to classify a heterogeneous disease[J]. Blood, 2002, 99(5): 1544-1551. DOI: 10.1182/blood.v99.5.1544.

38. Wahlström A, Sayin SI, Marschall HU, et al. Intestinal crosstalk between bile acids and microbiota and its impact on host metabolism[J]. Cell Metab, 2016, 24(1): 41-50. DOI: 10.1016/j.cmet.2016.05.005.

39. Kiriyama Y, Nochi H. The role of gut microbiota-derived lithocholic acid, deoxycholic acid and their derivatives on the function and differentiation of immune cells[J]. Microorganisms, 2023, 11(11): 2730. DOI: 10.3390/microorganisms11112730.

40. Wang L, Gong Z, Zhang X, et al. Gut microbial bile acid metabolite skews macrophage polarization and contributes to high-fat diet-induced colonic inflammation[J]. Gut Microbes, 2020, 12(1): 1-20. DOI: 10.1080/19490976.2020.1819155.

41. Hu J, Wang C, Huang X, et al. Gut microbiota-mediated secondary bile acids regulate dendritic cells to attenuate autoimmune uveitis through TGR5 signaling[J]. Cell Rep, 2021, 36(12): 109726. DOI: 10.1016/j.celrep.2021.109726.