Exploring the Causal Link Between Autoimmune Diseases and Pulmonary Arterial Hypertension: A Bidirectional Mendelian Randomization Study

Background: Pulmonary arterial hypertension (PAH) is a severe vascular disorder with a multifactorial etiology, including potential genetic predispositions. Understanding the causal relationship between autoimmune diseases and the risk of developing PAH can inform clinical strategies for prevention...

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Main Authors: Chao Ma, Cheng Gong, Bin Wang, Yangmeina Li, Yongxiang Qian, Xiaoying Zhang, Dongmei Di, Min Wang
Format: Article
Language:English
Published: Ubiquity Press 2025-07-01
Series:Global Heart
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Online Access:https://account.globalheartjournal.com/index.php/up-j-gh/article/view/1445
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author Chao Ma
Cheng Gong
Bin Wang
Yangmeina Li
Yongxiang Qian
Xiaoying Zhang
Dongmei Di
Min Wang
author_facet Chao Ma
Cheng Gong
Bin Wang
Yangmeina Li
Yongxiang Qian
Xiaoying Zhang
Dongmei Di
Min Wang
author_sort Chao Ma
collection DOAJ
description Background: Pulmonary arterial hypertension (PAH) is a severe vascular disorder with a multifactorial etiology, including potential genetic predispositions. Understanding the causal relationship between autoimmune diseases and the risk of developing PAH can inform clinical strategies for prevention and treatment. Methods: We conducted a two-sample Mendelian Randomization (MR) analysis to evaluate the causal effect of genetic predisposition to five autoimmune diseases (systemic lupus erythematosus [SLE], rheumatoid arthritis [RA], inflammatory bowel disease [IBD], multiple sclerosis [MS], and type 1 diabetes [T1D]) on the risk of PAH. This involved employing various MR methods (IVW, MR-Egger, Weighted median, Simple mode, and Weighted mode), as well as conducting tests for heterogeneity and horizontal pleiotropy. Results: The analysis revealed a significant association between genetic predisposition to RA and IBD with an increased risk of PAH (RA: OR = 1.28, 95% CI [1.01–1.61], p = 0.042; IBD: OR = 1.29, 95% CI [1.01–1.64], p = 0.043). However, no association was observed between genetically determined MS, SLE, and T1D with the risk of PAH (MS: p = 0.876; SLE: p = 0.564; T1D: p = 0.061). Additionally, tests for heterogeneity and pleiotropy provided no evidence of their influence, suggesting the robustness of these associations. Reverse MR analysis also indicated no significant effect of PAH on the genetic susceptibility to these autoimmune diseases. Conclusion: The findings suggest a possible genetic causative link between RA and IBD and the risk of developing PAH. Conversely, genetic predisposition to MS, SLE, and T1D does not appear to influence PAH risk. Understanding these relationships may offer insights into the pathophysiology of PAH and inform screening strategies within at-risk populations.
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spelling doaj-art-6238b888548c44fdb02d42fbaf08456b2025-08-21T12:35:35ZengUbiquity PressGlobal Heart2211-81792025-07-01201585810.5334/gh.14451426Exploring the Causal Link Between Autoimmune Diseases and Pulmonary Arterial Hypertension: A Bidirectional Mendelian Randomization StudyChao Ma0https://orcid.org/0009-0001-3668-7161Cheng Gong1https://orcid.org/0009-0004-3641-9484Bin Wang2Yangmeina Li3https://orcid.org/0009-0002-3546-5708Yongxiang Qian4Xiaoying Zhang5Dongmei Di6Min Wang7https://orcid.org/0000-0002-5624-6363Department of Cardiothoracic Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province 213003Department of Cardiothoracic Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province 213003Department of Cardiothoracic Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province 213003Department of Otolaryngology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province 213003Department of Cardiothoracic Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province 213003Department of Cardiothoracic Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province 213003Department of Cardiothoracic Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province 213003Department of Cardiothoracic Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province 213003Background: Pulmonary arterial hypertension (PAH) is a severe vascular disorder with a multifactorial etiology, including potential genetic predispositions. Understanding the causal relationship between autoimmune diseases and the risk of developing PAH can inform clinical strategies for prevention and treatment. Methods: We conducted a two-sample Mendelian Randomization (MR) analysis to evaluate the causal effect of genetic predisposition to five autoimmune diseases (systemic lupus erythematosus [SLE], rheumatoid arthritis [RA], inflammatory bowel disease [IBD], multiple sclerosis [MS], and type 1 diabetes [T1D]) on the risk of PAH. This involved employing various MR methods (IVW, MR-Egger, Weighted median, Simple mode, and Weighted mode), as well as conducting tests for heterogeneity and horizontal pleiotropy. Results: The analysis revealed a significant association between genetic predisposition to RA and IBD with an increased risk of PAH (RA: OR = 1.28, 95% CI [1.01–1.61], p = 0.042; IBD: OR = 1.29, 95% CI [1.01–1.64], p = 0.043). However, no association was observed between genetically determined MS, SLE, and T1D with the risk of PAH (MS: p = 0.876; SLE: p = 0.564; T1D: p = 0.061). Additionally, tests for heterogeneity and pleiotropy provided no evidence of their influence, suggesting the robustness of these associations. Reverse MR analysis also indicated no significant effect of PAH on the genetic susceptibility to these autoimmune diseases. Conclusion: The findings suggest a possible genetic causative link between RA and IBD and the risk of developing PAH. Conversely, genetic predisposition to MS, SLE, and T1D does not appear to influence PAH risk. Understanding these relationships may offer insights into the pathophysiology of PAH and inform screening strategies within at-risk populations.https://account.globalheartjournal.com/index.php/up-j-gh/article/view/1445pulmonary arterial hypertensionautoimmune diseasesrheumatoid arthritisinflammatory bowel diseasemendelian randomization
spellingShingle Chao Ma
Cheng Gong
Bin Wang
Yangmeina Li
Yongxiang Qian
Xiaoying Zhang
Dongmei Di
Min Wang
Exploring the Causal Link Between Autoimmune Diseases and Pulmonary Arterial Hypertension: A Bidirectional Mendelian Randomization Study
Global Heart
pulmonary arterial hypertension
autoimmune diseases
rheumatoid arthritis
inflammatory bowel disease
mendelian randomization
title Exploring the Causal Link Between Autoimmune Diseases and Pulmonary Arterial Hypertension: A Bidirectional Mendelian Randomization Study
title_full Exploring the Causal Link Between Autoimmune Diseases and Pulmonary Arterial Hypertension: A Bidirectional Mendelian Randomization Study
title_fullStr Exploring the Causal Link Between Autoimmune Diseases and Pulmonary Arterial Hypertension: A Bidirectional Mendelian Randomization Study
title_full_unstemmed Exploring the Causal Link Between Autoimmune Diseases and Pulmonary Arterial Hypertension: A Bidirectional Mendelian Randomization Study
title_short Exploring the Causal Link Between Autoimmune Diseases and Pulmonary Arterial Hypertension: A Bidirectional Mendelian Randomization Study
title_sort exploring the causal link between autoimmune diseases and pulmonary arterial hypertension a bidirectional mendelian randomization study
topic pulmonary arterial hypertension
autoimmune diseases
rheumatoid arthritis
inflammatory bowel disease
mendelian randomization
url https://account.globalheartjournal.com/index.php/up-j-gh/article/view/1445
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