Single-cell epigenomics and transcriptomics of diabetic gastroparesis in humans

项目摘要/摘要 与糖尿病(DM)的其他并发症类似，糖尿病胃肠病(DGE)反映器官- 糖尿病相关的内分泌、代谢和免疫/炎症障碍可能导致特定的功能障碍。 DGE的治疗是无效的，治疗的是症状，而不是疾病本身。因此，并与 RFA-DK-20-030的任务，这项建议试图揭示DGP的细胞和分子机制 以及其相关的非溃疡性消化不良，在仔细研究表型的患者中。我们关注的是两者之间的联系 免疫功能障碍、ICC、血糖和线粒体功能障碍。 具体目标如下：目的1.分析转录组与基因表达的关系 糖尿病和非糖尿病患者单个胃免疫细胞表观基因组、胃排空和血糖 有上消化道症状。目的2.确定转录组和表观基因组之间的关系 糖尿病和非糖尿病上消化道症状患者外周血单个核细胞和单个胃免疫细胞的变化 目的3.探讨单个胃ICC转录组和表观基因组之间的关系。 糖尿病和非糖尿病上消化道症状患者外周血中免疫细胞和单个核细胞的变化 这些研究将在体内进行研究(即评估DM的表型、胃肠道 症状和GE)，然后进行体外评估(即单个循环的转录组和表观基因组 45例袖状胃切除术患者(15例)的外周血单核细胞、单个胃CD45细胞和单个ICC 3组患者分别为非DM正常GE、DM正常GE、DM延迟GE)。这项建议是 以Bharucha博士和OrDog之间已建立的工作台到床边的合作为基础并以此为基础 通过他们的互补专业知识，加深了我们对糖尿病胃轻瘫的了解。它 力求更好地了解其发病机制，并通过对外周免疫细胞的研究也鉴定出 DGE的新生物标志物。

PROJECT SUMMARY/ABSTRACT Similar to other complications of diabetes mellitus (DM), diabetic gastroenteropathy (DGE) reflects organ- specific dysfunctions likely due to DM-related endocrine, metabolic and immune/inflammatory disturbances. Therapies for DGE are ineffective and address the symptoms, not the disease itself. Hence, and aligned with the mission of RFA-DK-20-030, this proposal seeks to uncover the cellular and molecular mechanisms of DGp and its relative, non-ulcer dyspepsia, in carefully phenotyped patients. We focus on the links between dysimmunity, ICC, glycemia, and mitochondrial dysfunction. The specific aims are as follows: Aim 1. To analyze the relationship between the transcriptome and epigenome of single gastric immune cells, gastric emptying (GE), and glycemia in DM and non-DM patients with upper GI symptoms. Aim 2. To determine the relationship between the transcriptome and epigenome of single circulating PBMCs and single gastric immune cells in DM and non-DM patients with upper GI symptoms. Aim 3. To investigate the relationship between the transcriptome and epigenome of single gastric ICC and immune cells and single circulating PBMCs in DM and non-DM patients with upper GI symptoms. These studies will be investigated with in vivo (i.e., assessment of the DM phenotype, gastrointestinal symptoms, and GE) followed by ex vivo assessments (i.e., transcriptome and epigenome of single circulating PBMCs, single gastric CD45+ cells, and single ICC) in 45 patients undergoing sleeve gastrectomy (i.e., 15 patients in each of 3 groups: non-DM + normal GE, DM + normal GE, DM + delayed GE). This proposal is anchored by, and builds on, an established bench-to-bedside collaboration between Drs. Bharucha and Ordog which, through their complementary expertise, has enhanced our understanding of diabetic gastroparesis. It seeks to better understand the pathogenesis, and through the studies in peripheral immune cells also identify novel biomarkers, of DGE.