Extracell Vesicles Circ Nucl Acids. 2026 Aug 18;7(3):1297-1313. doi: 10.20517/evcna.2026.24. eCollection 2026.
ABSTRACT
Aim: Transcatheter pulmonary valve replacement (TPVR) is a crucial intervention for severe pulmonary regurgitation (PR). Extracellular vesicle (EV) surface proteins reflect cardiovascular pathology. This study employed a proximity barcoding assay (PBA) to dynamically monitor EV protein profiles during TPVR. Methods: In this study, 40 biological plasma samples were analyzed in triplicate, including 10 from healthy controls (N group) and 30 from TPVR patients across three time points: preoperative (T1 group), 1 day postoperative (T2 group), and 1 week postoperative (T3 group). We performed combinatorial and functional analyses of membrane proteins across different groups and evaluated their predictive performance. EV subpopulations were clustered and characterized. Results: Compared with the N group, patients in the T1 group exhibited significantly downregulated expression of DSCAML1, ALCAM, and LAG3 proteins, while CD8A, NECTIN1, and LGR5 were significantly upregulated (P < 0.001; AUC: 0.94-1.00). Postoperatively, the expression of ALCAM and LAG3 rapidly rebounded. The ALCAM&CD36&DSCAML1&PECAM1 combination was significantly elevated in the control group, whereas CD36&CD8A&DSCAML1&TACSTD2 was reduced. Gene Ontology (GO) analysis indicated associations with response to stress, side of membrane, and protein binding pathways. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis revealed enrichment in the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (PKB/AKT) signaling pathway. Subpopulation analysis revealed that Cluster 1 was significantly elevated, whereas Cluster 2 was markedly decreased in the disease group. Additionally, Cluster 4 dominated in the T3 group. Furthermore, CD8A is most abundant in Cluster 1, while DSCAML1 dominates in Clusters 2 and 4. Conclusion: This study provides the first dynamic profiles and subpopulation characteristics of plasma EVs in patients undergoing TPVR, establishing a molecular atlas of perioperative right ventricular remodeling.
PMID:42898751 | PMC:PMC13678174 | DOI:10.20517/evcna.2026.24