# CITE-Seq Analysis Reveals a Differential Natural Killer Cell SPON2 Expression in Cardiovascular Disease Patients Impacted by Human-Cytomegalovirus Serostatus and Diabetes

## TL;DR

This study shows that Natural Killer cells in cardiovascular disease patients have different SPON2 expression levels influenced by HCMV and diabetes.

## Contribution

The study identifies SPON2 as a potential biomarker in cardiovascular disease influenced by HCMV and diabetes.

## Key findings

- Higher SPON2 expression in blood NK cells correlates with severe stenosis in CAD patients.
- Lower SPON2 in plaque tissue is linked to adaptive NK cell gene signatures and pro-inflammatory states.
- SPON2 levels are affected by HCMV and diabetes, suggesting diagnostic and prognostic relevance.

## Abstract

Coronary artery disease (CAD) is linked to atherosclerosis plaque formation. In pro-inflammatory conditions, human Natural Killer (NK) cell frequencies in blood or plaque decrease; however, NK cells are underexplored in CAD pathogenesis, inflammatory mechanisms, and CAD comorbidities, such as human cytomegalovirus (HCMV) infection and diabetes. Analysis of PBMC CITE-seq data from sixty-one CAD patients revealed higher blood NK cell SPON2 expression in CAD patients with higher stenosis severity. Conversely, NK cell SPON2 expression was lower in pro-inflammatory atherosclerosis plaque tissue with an enriched adaptive NK cell gene signature. In CAD patients with higher stenosis severity, peripheral blood NK cell SPON2 expression was lower in patients with high HCMV-induced adaptive NK cell frequencies and corresponded to lower PBMC TGFβ transcript expression with dependency on diabetes status. These results suggest that high NK cell SPON2 expression is linked to atherosclerosis pro-homeostatic status and may have diagnostic and prognostic implications in cardiovascular disease.