Association between immune cells and cardiovascular disease risk: a genome-wide association study in European populations

doi:10.12307/2026.350

Chinese Journal of Tissue Engineering Research ›› 2026, Vol. 30 ›› Issue (23): 5992-5999.doi: 10.12307/2026.350

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Association between immune cells and cardiovascular disease risk: a genome-wide association study in European populations

Huang Zhe1, Shang Baoling2, 3, Yao Gengzhen2, 3, Pan Guangming2, 3

1Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China; 2Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, Guangdong Province, China; 3The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong Province, China

Received:2025-06-06 Accepted:2025-08-12 Online:2026-08-18 Published:2025-12-31
Contact: Yao Gengzhen, MD, Associated chief physician, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, Guangdong Province, China; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong Province, China Corresponding author: Pan Guangming, MD, PhD, Chief physician, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, Guangdong Province, China; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong Province, China
About author:Huang Zhe, MS candidate, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
Supported by:
The Key Research Laboratory Construction Project of National Administration of Traditional Chinese Medicine (Lingnan TCM Academic School Inheritance), No. [2012]27-5 (to SBL [project participant]); Inheriting the Academic Experience of the Seventh Batch of National Veteran TCM Experts of National Administration of Traditional Chinese Medicine, No. [2022]76 (to YGZ); Key Discipline Construction Project for Talent Cultivation of National Administration of Traditional Chinese Medicine, No. 0102023703 (to SBL [project participant]); Project of Traditional Chinese Medicine Bureau of Guangdong Province, No. 20215004 (to SBL [project participant]); Guangzhou Science and Technology Plan Project, No. 2023A03J0230 (to YGZ); Traditional Chinese Medicine Academic School Inheritance Studio Construction Project of Guangdong Provincial Hospital of Chinese Medicine, No. [2013]233 (to SBL [project participant])

Abstract

Abstract: BACKGROUND: Previous studies have linked immune cells to cardiovascular disease risk. As confounding factors are incompletely addressed, the causal relationship between them remains unclear.
OBJECTIVE: To evaluate the potential causal relationship between immune cells and cardiovascular disease.
METHODS: The source of research data mainly involves three databases: Genome-Wide Association Study (GWAS) database (GWAS Catalog, jointly maintained by the National Institute of Human Genomics and the European Institute of Bioinformatics), UK biobank (a database of British population genomics, health and disease phenotype supported by the British government and Wellcome Foundation), and IEU OpenGWAS (a GWAS database developed by the MRC Epidemiology Unit of the University of Britos in the United Kingdom, which mainly focuses on European populations). All of them are open databases. The study has been approved by the institutional review board. It employed a two-sample Mendelian randomization approach with 731 immune cell phenotypes as exposure factors and seven types of cardiovascular diseases (atrial fibrillation, dilated cardiomyopathy, coronary atherosclerotic heart disease, heart failure, hypertrophic cardiomyopathy, hypertension, and valvular heart disease) as outcome factors. The primary methods used for Mendelian randomization analysis and sensitivity analysis were inverse variance weighting and weighted median, aiming to evaluate heterogeneity and pleiotropy.
RESULTS AND CONCLUSION: (1) After false discovery rate correction, immunophenotypes exerted a statistically significant effect on atrial fibrillation and hypertension. Five types of cells were related to atrial fibrillation risk, including CD11c on monocytes [odds ratio (OR)=0.917; 95% confidence interval (CI): 0.876-0.960), FSC-A on myeloid dendritic cells (OR=0.942; 95% CI: 0.910-0.974), CX3CR1 on CD14+ CD16- monocytes (OR=1.045; 95% CI: 1.022-1.070), CX3CR1 on monocytes (OR=1.050; 95% CI: 1.024-1.076), and CX3CR1 on CD14+ CD16+ monocytes (OR=1.050; 95% CI: 1.024-1.077). Three immunophenotypes that exert a protective effect on hypertension were identified: CD19 on switched memory B cells (OR= 0.986, 95% CI: 0.980-0.993), CD25++ CD8+ T cells (OR=0.993; 95% CI: 0.990-0.997) and CD25++ CD8+ T cells (OR=0.993; 95% CI: 0.989-0.996). No underlying heterogeneity or horizontal pleiotropy was observed in the sensitivity analysis. (2) The study found a causal relationship between four types of monocytes and one type of myeloid dendritic cells and atrial fibrillation, and a potential causal relationship between one type of memory B cells and two types of T cells and hypertension, suggesting the necessity of considering immune cell phenotypes in monitoring and treating atrial fibrillation and hypertension. This study, based on public datasets, offers important implications for understanding the relationship between immune cell subtypes and cardiovascular disease in the Chinese population, with particular relevance for atrial fibrillation and hypertension management strategies in China.

Key words: cardiovascular disease, immunity, immune cell subtypes, Genome-Wide Association Study (GWAS), Mendelian randomization, atrial fibrillation, hypertension

CLC Number:

Huang Zhe, Shang Baoling, Yao Gengzhen, Pan Guangming. Association between immune cells and cardiovascular disease risk: a genome-wide association study in European populations[J]. Chinese Journal of Tissue Engineering Research, 2026, 30(23): 5992-5999.

Figures/Tables 1

此次研究共纳入2 707个免疫表型相关单核苷酸多态性进行孟德尔随机化分析，分析过程中未使用代理单核苷酸多态性替换缺失变异，以确保工具变量的一致性。被纳入的所有单核苷酸多态性均为F > 10，适合作为强工具变量。 2.1 免疫表型与心房颤动的因果效应固定效应逆方差加权法模型显示，43种免疫表型对心房颤动具有保护效应。经错误发现率校正(P < 0.05)后，有2种免疫细胞表型对心房颤动具有保护作用，分别是CD11c on monocytes(OR=0.917，95%CI：0.876-0.960，P=0.02)及FSC-A on myeloid dendritic cells(OR=0.942，95%CI：0.910-0.974，P=0.03)；对于髓样树突状细胞FSC-A，加权中位数及加权模式分析趋势一致，P > 0.05；同时逆方差加权分析显示，CX3CR1 on CD14+ CD16- monocytes(OR=1.05，95%CI：1.024-1.077，P=0.02)、CX3CR1 on monocytes(OR=1.050，95%CI：1.024-1.076，P=0.02)及CX3CR1 on CD14+ CD16+ monocyte(OR=1.050，95%CI：1.024-1.077，P=0.02)水平的升高会增加心房颤动发病风险，运用Weighted mode法的分析结果类似，但MR-Egger及Weighted median法分析结果显示无显著差异(图1)。基于Cochran’s Q及MR-Egger截距，上述5项关联均未发现水平多效性。 2.2 免疫表型对高血压的因果效应逆方差加权结果提示37种免疫表型与高血压风险相关，OR=0.987-1.010。经错误发现率校正(P < 0.05)后，CD19 on switched memory B cells水平较高的患者高血压患病率为对照组的0.986倍(95%CI：0.980-0.993，P=0.02)；CD25++ CD8+ T cell百分比(OR=0.993，95%CI：0.990-0.997，P=0.047)及绝对计数(OR=0.993，95%CI：0.989-0.996，P=0.02)亦对高血压起到保护作用(图2)。敏感性分析均未发现异质性或水平多效性。 2.3 免疫表型与其他5种心血管疾病的因果效应逆方差加权结果提示以下免疫表型与冠状动脉粥样硬化性心脏病具有一定相关性：CD24+CD27+ B cell百分比(OR=0.899，95%CI：0.810-0.998，P=0.04)、SSC-A on granulocytes(OR=1.07，95%CI：1.013-1.133，P=0.01)及FSC-A on myeloid dendritic cells(OR=1.64，95%CI：1.004-1.127，P=0.03)。对于扩张型心肌病，固定效应逆方差加权分析显示4种免疫表型具有保护作用：CD19 on memory B cells(OR=0.649，95%CI：0.432-0.976，P=0.04)、CD45 on CD33-HLADR-(OR=0.807，95%CI：0.657-0.990，P=0.04)、CD19 on CD24+ CD27+ B cells(OR=0.665，95%CI：0.452-0.979，P=0.04)及FSC-A on monocyte(OR=0.680，95%CI：0.479-0.967，P=0.03)。另外，有2种免疫表型与扩张型心肌病发病风险增加相关：CD8 on CD39+ CD8+ T cells (OR=1.347，95%CI：1.102-1.647，P=0.03)及Naive CD8+ T cell绝对计数(OR=1.729，95%CI：1.002-2.981，P=0.04)。在24种与心力衰竭存在因果关联的免疫表型中，18种亚型具有保护作用(OR=0.905-0.982)，6种增加心力衰竭发病风险(OR=1.002-1.105)。在肥厚型心肌病人群中，9种免疫表型降低肥厚型心肌病发病风险(OR=0.227-0.734)，8种增加肥厚型心肌病发病风险(OR=1.153-2.642)。在瓣膜性心脏病的孟德尔随机化分析中，固定效应逆方差加权分析显示14种免疫表型具有保护作用(OR=0.827-0.999)，另有3种免疫表型可增加瓣膜性心脏病发病风险(OR=1.028-1.036)。在以上分析中，Cochran’s Q及MR-Egger的P均> 0.05，表明使用随机效应逆方差加权法的因果估计可信，同时上述关联无异质性或多效性。然而经错误发现率校正(检验水平P < 0.05)后，免疫细胞表型与以上5种心血管疾病在统计学上无显著关联。"

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Association between immune cells and cardiovascular disease risk: a genome-wide association study in European populations

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