Table 2.

Selection of 30 differentiating inflammation markers in untreated patients with MPS vs control subjects

MarkerEponymPathwayFunction
CD5  Pro-inflammatory Expressed on surface of T cells 
CD6  Pro-inflammatory Expressed on surface of T cells 
CD8A  Pro-inflammatory T-cell surface glycoprotein, coreceptor 
CD40  Pro-inflammatory Costimulatory protein on APCs 
CD244 NK-cell receptor 2B4 Pro-inflammatory Cell surface receptor of NK cells (and T cells) 
CCL4 MIP-1β Pro-inflammatory Chemoattractant for NK cells and monocytes, produced by neutrophils, monocytes, T cells, B cells, fibroblasts, endothelial, and epithelial cells. Increased with age 
CCL23 MIP-3 Pro-inflammatory Chemotactic for resting T cells and monocytes 
CXCL5 ENA78 Pro-inflammatory Produced following stimulation of cells with IL-1 or TNF-α, chemotactic for neutrophils 
CXCL 6 GCP-2 Pro-inflammatory Chemoattractant for neutrophils 
CXCL9 MIG Pro-inflammatory Induces chemotaxis of CTLs, NKs, and macrophages; promotes differentiation and multiplication of leukocytes. Also causes tissue extravasation 
IL7  Pro-inflammatory HGF secreted by stromal cells in BM and thymus. Also produced by keratinocytes, DCs, hepatocytes, neurons, and epithelial cells; not produced by lymphocytes. Stimulates differentiation of HSCs to myeloid progenitor cells and proliferation of all cells in lymphoid lineage (B/T/NK) 
IL.12B  Pro-inflammatory Expressed by activated macrophages; acts on T and NK cells; important for sustaining sufficient number of memory/effector T helper 1 cells 
IL.18R1  Pro-inflammatory Binds IL-18; induced by IFN-α and IL-12 in NK and T cells 
MCP.4 CCl13 Pro-inflammatory Induces chemotaxis in monocytes, eosinophils, T cells, basophils. Induced by IL-1 and TNF-α 
VEGFA  Pro-inflammatory Found prominently on endothelial cell membrane; also stimulates monocyte migration and increases microvascular permeability upon binding to its receptors (VEGFR1 and VEGFR2) and to heparan sulfate and heparin 
IL.10RB  Anti-inflammatory Together with IL-10RA required for IL-10–induced signal transduction 
LAP.TGF.β.1  Anti-inflammatory Part of complex with latent TGF-binding protein and TGF-β. Cleaved by MMP-9 and MMP-2, TGF-β induces development of regulatory T cells, has an inhibitory effect on B-cell proliferation, stimulates resting monocytes, and inhibits activated macrophages 
PD.L1 CD274 Anti-inflammatory Interacts with CXCL9, suppresses adaptive arm of immune system, reduces apoptosis in regulatory T cells. Expressed on T cells, NK cells, macrophages, myeloid DCs, B cells, epithelial cells, and vascular endothelial cells upon IFN-γ stimulation 
RANKL TRANCE/ TNFSF11 Bone homeostasis Receptor activator of NF-κB ligand. Osteoclastic activity is triggered via the osteoblasts’ surface-bound RANKL activating the osteoclasts’ surface-bound RANK 
OPG TNFRSF11B Bone homeostasis Osteoclastogenesis inhibitory factor and decoy receptor for RANKL. Also binds to TRAIL and inhibits TRAIL-induced apoptosis. GAGs also are ligands for OPG. Expressed on osteoblast lineage cells. Expression is highly regulated by estrogens. Upregulation of OPG suppresses osteoclastogenesis and bone resorption. Wnt and TGF-β are OPG-inducing cytokines 
AXIN1  Bone homeostasis Negative regulator of the Wnt pathway and can induce apoptosis 
SCF KIT-ligand Growth factor/ bone homeostasis Cytokine that binds to c-KIT receptor (CD117) and is important in the regulation of HSCs in the stem cell niche in the BM. It contributes to the self-renewal and maintenance of HSCs. Stromal cell surrounding HSCs release SCF. HSCs become less sensitive to SCF in adulthood 
CSF.1  Growth factor/bone homeostasis Hematopoietic growth factor, differentiates HSCs into macrophages, drives proliferation of a pro-inflammatory macrophage phenotype in acute kidney injury. Also released by osteoblasts, binds on osteoclasts inducing differentiation 
DNER  Growth factor/ bone homeostasis Δ/Notch-like epidermal growth factor-related receptor is an activator of the NOTCH1 pathway 
TRAIL TNFSF10 Apoptosis/bone homeostasis Produced by most normal tissue cells and induces caspase-8–dependent apoptosis after binding to death receptors DR4 and DR5. Also ligand for DcDR1 (TRAIL-neutralizing decoy-receptor), DcDR2 (activates NF-κB pathway), and OPG. TRAIL induces osteoclastogenesis by binding to specific TRAIL receptors on osteoclast precursor cell surfaces 
TWEAK TNFSF12 Apoptosis Ligand for TWEAKR receptor and can induce apoptosis via multiple pathways. Produced mainly by leukocytes, including monocytes, DCs, and NK cells 
MMP.1  ECM degradation MMP enzyme in ECM remodeling; targets collagen types I, II, and III. HGF activates MMP-1 activity via the Etsy transcription family 
MMP.10  ECM degradation MMP enzyme in ECM remodeling, targets among others proteoglycans, cleaves precursor of MMP.1 
uPA  ECM degradation uPA, primary substrate is plasminogen (precursor of plasmin). Activation of plasmin can trigger a proteolytic cascade that participates in thrombolysis or extracellular matrix degradation. uPA also can cleave pro-HGF. Ligand for uPAR, expressed by both osteoblasts and osteoclasts 
HGF SF ECM degradation/ growth factor Paracrine cellular growth, motility, and morphogenic factor secreted by mesenchymal cells as pro-HGF which is among others activated by uPA. Primarily targets epithelial and endothelial cells but also hemopoietic progenitor cells and T cells. HGF upregulates the expression of IL-11 from osteoclast-like cells and inhibits osteoblast differentiation. HGF increases production of MMP-1 and uPA. Has an antifibrotic effect in various organs 
MarkerEponymPathwayFunction
CD5  Pro-inflammatory Expressed on surface of T cells 
CD6  Pro-inflammatory Expressed on surface of T cells 
CD8A  Pro-inflammatory T-cell surface glycoprotein, coreceptor 
CD40  Pro-inflammatory Costimulatory protein on APCs 
CD244 NK-cell receptor 2B4 Pro-inflammatory Cell surface receptor of NK cells (and T cells) 
CCL4 MIP-1β Pro-inflammatory Chemoattractant for NK cells and monocytes, produced by neutrophils, monocytes, T cells, B cells, fibroblasts, endothelial, and epithelial cells. Increased with age 
CCL23 MIP-3 Pro-inflammatory Chemotactic for resting T cells and monocytes 
CXCL5 ENA78 Pro-inflammatory Produced following stimulation of cells with IL-1 or TNF-α, chemotactic for neutrophils 
CXCL 6 GCP-2 Pro-inflammatory Chemoattractant for neutrophils 
CXCL9 MIG Pro-inflammatory Induces chemotaxis of CTLs, NKs, and macrophages; promotes differentiation and multiplication of leukocytes. Also causes tissue extravasation 
IL7  Pro-inflammatory HGF secreted by stromal cells in BM and thymus. Also produced by keratinocytes, DCs, hepatocytes, neurons, and epithelial cells; not produced by lymphocytes. Stimulates differentiation of HSCs to myeloid progenitor cells and proliferation of all cells in lymphoid lineage (B/T/NK) 
IL.12B  Pro-inflammatory Expressed by activated macrophages; acts on T and NK cells; important for sustaining sufficient number of memory/effector T helper 1 cells 
IL.18R1  Pro-inflammatory Binds IL-18; induced by IFN-α and IL-12 in NK and T cells 
MCP.4 CCl13 Pro-inflammatory Induces chemotaxis in monocytes, eosinophils, T cells, basophils. Induced by IL-1 and TNF-α 
VEGFA  Pro-inflammatory Found prominently on endothelial cell membrane; also stimulates monocyte migration and increases microvascular permeability upon binding to its receptors (VEGFR1 and VEGFR2) and to heparan sulfate and heparin 
IL.10RB  Anti-inflammatory Together with IL-10RA required for IL-10–induced signal transduction 
LAP.TGF.β.1  Anti-inflammatory Part of complex with latent TGF-binding protein and TGF-β. Cleaved by MMP-9 and MMP-2, TGF-β induces development of regulatory T cells, has an inhibitory effect on B-cell proliferation, stimulates resting monocytes, and inhibits activated macrophages 
PD.L1 CD274 Anti-inflammatory Interacts with CXCL9, suppresses adaptive arm of immune system, reduces apoptosis in regulatory T cells. Expressed on T cells, NK cells, macrophages, myeloid DCs, B cells, epithelial cells, and vascular endothelial cells upon IFN-γ stimulation 
RANKL TRANCE/ TNFSF11 Bone homeostasis Receptor activator of NF-κB ligand. Osteoclastic activity is triggered via the osteoblasts’ surface-bound RANKL activating the osteoclasts’ surface-bound RANK 
OPG TNFRSF11B Bone homeostasis Osteoclastogenesis inhibitory factor and decoy receptor for RANKL. Also binds to TRAIL and inhibits TRAIL-induced apoptosis. GAGs also are ligands for OPG. Expressed on osteoblast lineage cells. Expression is highly regulated by estrogens. Upregulation of OPG suppresses osteoclastogenesis and bone resorption. Wnt and TGF-β are OPG-inducing cytokines 
AXIN1  Bone homeostasis Negative regulator of the Wnt pathway and can induce apoptosis 
SCF KIT-ligand Growth factor/ bone homeostasis Cytokine that binds to c-KIT receptor (CD117) and is important in the regulation of HSCs in the stem cell niche in the BM. It contributes to the self-renewal and maintenance of HSCs. Stromal cell surrounding HSCs release SCF. HSCs become less sensitive to SCF in adulthood 
CSF.1  Growth factor/bone homeostasis Hematopoietic growth factor, differentiates HSCs into macrophages, drives proliferation of a pro-inflammatory macrophage phenotype in acute kidney injury. Also released by osteoblasts, binds on osteoclasts inducing differentiation 
DNER  Growth factor/ bone homeostasis Δ/Notch-like epidermal growth factor-related receptor is an activator of the NOTCH1 pathway 
TRAIL TNFSF10 Apoptosis/bone homeostasis Produced by most normal tissue cells and induces caspase-8–dependent apoptosis after binding to death receptors DR4 and DR5. Also ligand for DcDR1 (TRAIL-neutralizing decoy-receptor), DcDR2 (activates NF-κB pathway), and OPG. TRAIL induces osteoclastogenesis by binding to specific TRAIL receptors on osteoclast precursor cell surfaces 
TWEAK TNFSF12 Apoptosis Ligand for TWEAKR receptor and can induce apoptosis via multiple pathways. Produced mainly by leukocytes, including monocytes, DCs, and NK cells 
MMP.1  ECM degradation MMP enzyme in ECM remodeling; targets collagen types I, II, and III. HGF activates MMP-1 activity via the Etsy transcription family 
MMP.10  ECM degradation MMP enzyme in ECM remodeling, targets among others proteoglycans, cleaves precursor of MMP.1 
uPA  ECM degradation uPA, primary substrate is plasminogen (precursor of plasmin). Activation of plasmin can trigger a proteolytic cascade that participates in thrombolysis or extracellular matrix degradation. uPA also can cleave pro-HGF. Ligand for uPAR, expressed by both osteoblasts and osteoclasts 
HGF SF ECM degradation/ growth factor Paracrine cellular growth, motility, and morphogenic factor secreted by mesenchymal cells as pro-HGF which is among others activated by uPA. Primarily targets epithelial and endothelial cells but also hemopoietic progenitor cells and T cells. HGF upregulates the expression of IL-11 from osteoclast-like cells and inhibits osteoblast differentiation. HGF increases production of MMP-1 and uPA. Has an antifibrotic effect in various organs 

Markers that were present in both the list of markers that were significantly different and had a log2 fold change >1.5 in the supervised analysis and the top 40 markers within the first principal component of PCA. Markers are categorized based on their relation to MPS pathology. APCs, antigen presenting cells; AXIN1, axis inhibition protein 1; BM, bone marrow; CCL, C-C motif chemokine ligand; CD, cluster of differentiation; CSF, colony-stimulating factor; CTLs, cytotoxic T lymphocytes; CXCL, C-C-C motif chemokine ligand; DcDR, decoy death receptor; DCs, dendritic cells; DNER, delta/notch-like epidermal growth factor-related receptor; DR, death receptor; ECM, extracellular matrix; ENA, epithelial-derived neutrophil-activating peptide; GAG, glycosaminoglycan; GCP-2, granulocyte chemotactic protein 2; HGF, hepatocyte growth factor; HSCs, hematopoietic stem cells; IFN, interferon; IL-1, interleukin 1; LAP.TGF.b.1, latency-associated peptide and transforming growth factor beta-1; MCP, monocyte chemoattractant protein; MIG, monokine induced by gamma interferon; MIP, macrophage inflammatory protein; MMP-9, matrix metalloproteinase-9; NK cell, natural killer cell; OPG, osteoprotegerin; PD.L1, programmed death ligand 1; RANK, receptor activator of nuclear factor kappa-B; RANKL, receptor activator of nuclear factor kappa-B ligand; SCF, stem cell factor; SF, scatter factor; TGF-β, transforming growth factor β; TNFSF, tumor necrosis factor superfamily; TRAIL, tumor necrosis factor related apoptosis-inducing ligand; TRANCE, TNF-related activation-induced cytokine; TWEAK, tumor necrosis factor weak inducer of apoptosis; TWEAKR, tumor necrosis factor weak inducer of apoptosis receptor; uPA urokinase-type plasminogen activator; uPAR, urokinase-type plasminogen activator receptor. VEGFA, vascular endothelial growth factor AVEGFR, vascular endothelial growth factor receptor.

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