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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>Analysis of Vaccine-related Networks using Semantic MEDLINE and the Vaccine Ontology</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Yuji Zhang</string-name>
          <email>Zhang.Yuji@mayo.edu</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Cui Tao</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Yongqun He</string-name>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Pradip Kanjamala</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Hongfang Liu</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Department of Health Sciences Research, Mayo College of Medicine</institution>
          ,
          <addr-line>Rochester, MN 55905</addr-line>
          ,
          <country country="US">USA</country>
        </aff>
        <aff id="aff1">
          <label>1</label>
          <institution>Unit of Laboratory of Animal Medicine, University of Michigan</institution>
          ,
          <addr-line>Ann Arbor, MI 48109</addr-line>
          ,
          <country country="US">USA</country>
        </aff>
      </contrib-group>
      <abstract>
        <p>A major challenge in the vaccine research has been to identify important vaccine-related networks and logically explain the results. In this paper, we showed that networkbased analysis of vaccine-related networks can discover the underlying structure information consistent with that captured by the Vaccine Ontology and propose new hypotheses for vaccine disease or gene associations. First, a vaccine-vaccine network was inferred using a bipartite network projection strategy on the vaccine-disease network extracted from the Semantic MEDLINE database. In total, 76 vaccines and 573 relationships were identified to construct the vaccine network. The shortest paths between all pairs of vaccines were calculated within the vaccine network. The correlation between the shortest paths of vaccine pairs and their semantic similarities in the Vaccine Ontology was then investigated. Second, a vaccinegene network was also constructed, in which several important vaccine-related genes were identified. This study demonstrated that a combinatorial analysis using literature knowledgebase, semantic technology, and ontology is able to reveal unidentified important knowledge critical to biomedical research and public health and generate testable hypotheses for future experimental verification.</p>
      </abstract>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>INTRODUCTION</title>
      <p>
        Vaccines have been one of the most successful public
health interventions to date with most vaccine-preventable
diseases having declined in the United States by at least
95-99% (1994). However, vaccine development is getting
more difficult as more complex organisms become
vaccine targets. In recent years, drug repositioning has been
growing in last few years and achieved a number of
successes for existing drugs such as Viagra
        <xref ref-type="bibr" rid="ref12">(Goldstein, Lue
et al. 1998)</xref>
        and thalidomide
        <xref ref-type="bibr" rid="ref30">(Singhal, Mehta et al. 1999)</xref>
        .
      </p>
      <p>
        By definition, drug repositioning is the “process of
finding new users outside the scope of the original medical
indications for existing drugs or compounds”
        <xref ref-type="bibr" rid="ref7">(Chong and
Sullivan 2007)</xref>
        . In 2009, more than 30% of the 51 new
should
addressed:
medicines and vaccines were developed based on
previous marketed products. This suggested that drug
repositioning has drawn great attention from the both industry
and academic institutes
        <xref ref-type="bibr" rid="ref13 ref34">(Graul, Sorbera et al. 2010)</xref>
        .
      </p>
      <p>
        However, many of these drug repositioning have been
serendipitous discoveries
        <xref ref-type="bibr" rid="ref2">(Ashburn and Thor 2004)</xref>
        or on
observable clinical phenotypes, which are lack of
systematic ways to identify new targets. Recent research has
shown that bioinformatics-based approaches can aid to
reposition drugs based on the complex relationships
among drugs, diseases and genes
        <xref ref-type="bibr" rid="ref23">(Liu, Fang et al. 2013)</xref>
        .
      </p>
      <p>Such approaches can also be applied in the future vaccine
development.</p>
      <p>
        In recent years, high-throughput biological data and
computational systems biology approaches has provided
an unprecedented opportunity to understand the disease
etiology and its underlying cellular subsystems.
Biological knowledge such as drug-disease networks, and
biomedical ontologies have accelerated the development of
network-based approaches to understanding disease
etiology
        <xref ref-type="bibr" rid="ref19 ref26 ref4">(Ideker and Sharan 2008; Barabasi, Gulbahce et al.
2011)</xref>
        and drug action (network pharmacology)
        <xref ref-type="bibr" rid="ref24 ref3 ref5">(Berger
and Iyengar 2009; Mathur and Dinakarpandian 2011)</xref>
        .
      </p>
      <p>
        Such approaches could also be applied in the vaccine
research, aiming to investigate the vaccine-related
associations derived from public knowledgebase such as
PUBMED literature abstracts. For example, a Vaccine
Ontology (VO)-based literature mining research was
reported last year to study all gene interactions associated
with fever alone or both fever and vaccine
        <xref ref-type="bibr" rid="ref18 ref29 ref32">(Hur, Ozgur et
al. 2012)</xref>
        . This study focused on the retrieval of gene-gene
associations based on their direct interactions in the
context of fever and vaccine. The centrality-based network
approach
        <xref ref-type="bibr" rid="ref25">(Ozgur, Vu et al. 2008)</xref>
        evaluated the level of
importance for each gene in extracted gene interaction
network. Novel gene interactions were identified to be
essential in fever- or vaccine-related networks that could
not be found before. A similar VO and centrality-based
literature mining approach was also used to analyse
vaccine-associated IFN- gene interaction network
        <xref ref-type="bibr" rid="ref26">(Ozgur,
Xiang et al. 2011)</xref>
        . Ball et al. compiled a network
consisting of 6,428 nodes (74 vaccines and 6,354 adverse events)
and more than 1.4 million interlinkages, derived from
      </p>
      <p>
        Vaccine Adverse Event Reporting System (VAERS)
        <xref ref-type="bibr" rid="ref24 ref3">(Ball
and Botsis 2011)</xref>
        . This network demonstrated a scale-free
property, in which certain vaccines and adverse events act
as “hubs”. Such network analysis approaches complement
current statistical techniques by offering a novel way to
visualize and evaluate vaccine adverse event data.
However, the relationships among different vaccines in the
context of vaccine-vaccine and vaccine-gene networks
have not been well studied yet. A systematic level
investigation of such relationships will help us understand
better how vaccines are related to each other and whether
such information can complement the existing knowledge
such as VO.
      </p>
      <p>To analyse the possible common protective immunity
or adverse event mechanisms among different vaccines, it
is critical to study all possible vaccine-vaccine and
vaccine-gene associations using network analysis approaches.</p>
      <p>
        The hypotheses behind this are: (1) if two vaccines have
coupling relationship with common disease(s)/gene(s),
they are linked in the vaccine network; (2) the closer two
vaccines are in the vaccine network, the more similar they
are in the context of literature knowledgebase, such as
Semantic MEDLINE
        <xref ref-type="bibr" rid="ref26 ref28">(Rindflesch, Kilicoglu et al. 2011)</xref>
        .
      </p>
      <p>In this paper, we proposed a network-based approach to
investigate the underlying relationships among vaccines
in the context of the vaccine-related network derived from
Semantic MEDLINE. The distances of the vaccines were
further compared with their semantic similarities in the
VO. The results demonstrated that the structure
information of vaccine network is consistent with that captured
by VO. Such network-based analysis can serve as an
independent data resource to construct and evaluate
biomedical ontologies. In addition, the vaccine-gene network
was also constructed based on Semantic MEDLINE
information, in which important vaccine-related genes were
identified and further investigated by VO and related
independent resources.</p>
      <p>The rest of the paper is organized as follows. Section 2
introduces the data resources and the proposed
networkbased framework. Section 3 illustrates the results
generated from each step in the proposed computational
framework. Section 4 provides a thorough discussion of the
results and concludes the paper.</p>
      <p>
        In this study, we use Semantic MEDLINE as the data
resource to build the networks. Semantic MEDLINE
        <xref ref-type="bibr" rid="ref26 ref28">(Rindflesch, Kilicoglu et al. 2011)</xref>
        is a National Library of
Fig. 1. Overview of the proposed framework. The proposed method consists of three steps: 1) Extraction of vaccine-related associations from Semantic
MEDLINE using ontology based terms; 2) Network based analyses to identify vaccine-vaccine associations and vaccine-gene associations; 3) Evaluation of
inferred vaccine-vaccine and vaccine-gene relationships using vaccine ontology hierarchical structure and literature validation.
Medicine (NLM) initiated project which provides a public
2 MATERIALS AND METHODS available database that contains comprehensive resources
In this section, we describe the data resources and prepro- with structured annotations for information extracted from
cessing method in this work. We then introduce our pro- more than 19 million MEDLINE abstracts. Since the
posed network-based approach for investigating vaccine- Semantic MEDLINE is a comprehensive resource that
related associations derived from PubMed literature ab- contains heterogeneous data with different features
exstracts. The evaluation of the discovered vaccine-vaccine tracted, our previous research has reorganized this data
and vaccine-gene relationships is conducted based on the source and optimized it for informatics analysis
        <xref ref-type="bibr" rid="ref1 ref18 ref29 ref32">(Tao,
VO hierarchy and logical definitions. Fig. 1 illustrates the Zhang et al. 2012)</xref>
        . Using the Unified Medical language
steps of the proposed approach. System (UMLS) semantic types and groups (2012), we
extracted unique associations among diseases, genes, and
2.1 Data Resources and preprocessing drugs, and represented them in six Resource Description
2.1.1. Data Resources Framework (RDF) graphs. In this paper, we used our
optimized Semantic MEDLINE RDF data as the data source
to perform network analysis for vaccine-related networks.
      </p>
      <p>Our RDF-based Semantic MEDLINE resource
currently contains 843k disease-disease, 111k disease-gene,
1277k disease-drug, 248k drug-gene, 1900k drug-drug,
and 49k gene-gene associations. Since this resource
contains high-level terms (e.g., gene, protein, disease) that are
not useful for network analysis, we further manually
filtered out these terms using the following strategy. For
disease terms, we only included those terms that are
included in ICD9. For gene terms, we only include those
terms that have an Entrez gene ID.
2.1.2.</p>
      <sec id="sec-1-1">
        <title>Data extraction</title>
        <p>We identified those associations relevant to vaccines only.
Specifically, vaccine terms were identified based on
SNOMED CT (http://www.ihtsdo.org/snomed-ct). All the
terms under the SNOMED CT term Vaccine (CUI:
C0042210) were first extracted. A manual review by 3
experts further removed those common terms (e.g.,
bacteria vaccine) or animal vaccine terms.
2.2
2.2.1.</p>
        <sec id="sec-1-1-1">
          <title>Network analysis of Vaccine Network</title>
        </sec>
      </sec>
      <sec id="sec-1-2">
        <title>Projection of bipartite vaccine-disease network</title>
        <p>In graph theory, a bipartite network is composed of two
non-overlapping sets of nodes and links that connect one
node in the first node set with one node in the second
node set. The properties of bipartite networks are often
investigated by considering the one-mode projection of
the bipartite network. The one-mode projection network
can be created by connecting two nodes in the same node
set if they have at least one common neighboring node in
the other node set. For instance, the vaccine-disease
association network is one bipartite network: vaccines and
diseases constitute two node sets, and links are generated
between vaccine and disease if they are associated in the
Semantic MEDLINE. Therefore, the vaccine-vaccine
network can be investigated by projecting vaccine-disease
associations to vaccine-vaccine associations, in which two
vaccines are connected if they are associated with at least
one same disease. In this work, all links were generated
based on the associations extracted from Semantic
MEDLINE as described in Section 2.1. A vaccine-vaccine
network was generated consisting of all the links
identified in vaccine-disease associations.
2.2.2.</p>
      </sec>
      <sec id="sec-1-3">
        <title>Network distance between vaccines</title>
        <p>
          The distance between any two vaccines in the vaccine
network was calculated as the length of the shortest path
between them
          <xref ref-type="bibr" rid="ref10 ref22">(Fekete, Vattay et al. 2009)</xref>
          . The
hierarchical clustering analysis was performed on the distance
matrix of all vaccines
          <xref ref-type="bibr" rid="ref14">(Guess and Wilson 2002)</xref>
          . A heat
map was generated based on the clustering analysis
results.
2.2.3.
        </p>
      </sec>
      <sec id="sec-1-4">
        <title>Analysis of vaccine-gene network</title>
        <p>
          The vaccine-gene network was constructed by
vaccinegene associations extracted from the drug-gene
associations in our RDF-based data resource. The important
vaccine-related genes were identified by their significant
higher node degree compared to other vaccine/gene in the
same network. The Cytoscape tool
          <xref ref-type="bibr" rid="ref26 ref31">(Smoot, Ono et al. 2011)</xref>
          was selected to visualize the network. Cytoscape is an
open-source platform for integration, visualization and
analysis of biological networks. Its functionalities can be
extended through Cytoscape plugins. Scientists from
different research fields have contributed over 160 useful
plugins so far. These comprehensive features allow us to
perform thorough network level analyses and
visualization of our association tables, and integration with other
biological networks in the future.
The community-based Vaccine Ontology (VO) has
included over 4,000 vaccine-specific terms, including all
licensed human and veterinary vaccines currently used in
the USA. Logical axioms have been defined in VO to
represent the relations among vaccine terms
          <xref ref-type="bibr" rid="ref26">(Ozgur,
Xiang et al. 2011)</xref>
          . The Semantic MEDLINE analysis
uses SNOMED terms to represent various vaccines. VO
has established automatic mapping between SNOMED
vaccine terms and VO terms. Based on the mapping, we
first extracted all vaccine terms from the Semantic
MEDLINE and mapped to VO. The ontology term
retrieval tool OntoFox
          <xref ref-type="bibr" rid="ref34">(Xiang, Courtot et al. 2010)</xref>
          was then
applied to obtain the hierarchies of the total vaccines or
subgroups of the vaccines identified in this study.
3
3.1
        </p>
      </sec>
    </sec>
    <sec id="sec-2">
      <title>RESULTS</title>
      <sec id="sec-2-1">
        <title>The overall network view</title>
        <p>In total, 76 vaccines, annotated by the SNOMED CT term
Vaccine (CUI: C0042210), were used to extract related
vaccine-disease and vaccine-gene associations from the
drug-disease and drug-gene association tables
respectively. In the vaccine-disease network, there were 1127 nodes
(178 vaccines and 949 diseases) and 1741 vaccine-disease
associations. In the vaccine-gene network, there were 170
nodes (85 vaccines and 85 genes) and 94 vaccine-gene
associations. One vaccine network was generated by the
projection of the vaccine-disease bipartite network,
consisting of 76 vaccines and 573 associations. This vaccine
network was then used to analyze the vaccine
relationships. The derived vaccine-gene network was also
investigated by the VO knowledge.
3.2</p>
      </sec>
      <sec id="sec-2-2">
        <title>Analysis of vaccine network</title>
        <p>Fig. 2 showed a heat map of hierarchical analysis results,
providing a direct visualization of potential
vaccinevaccine associations. Here we selected four relatively big
vaccine-vaccine association groups on the diagonal from
Fig. 2 and explain them in detail:</p>
        <p>
          1) This group contains 18 very widely-studied
vaccines. Many interesting results are obtained from the
analysis of this group of vaccine-disease-vaccine
associations. For example, the results from this group show that
influenza vaccines and Rabies vaccines have been
associated with the induction of a severe adverse event
GuillainBarré syndrome (GBS)
          <xref ref-type="bibr" rid="ref15 ref16 ref18 ref29 ref32">(Hemachudha, Griffin et al. 1988;
Hartung, Keller-Stanislawski et al. 2012)</xref>
          . GBS is a rare
disorder in which a person’s own immune system
damages their nerve cells, causing muscle weakness and
sometimes paralysis. This group also includes five other
vaccines associating with nervous system disorder, including
Pertussis Vaccine
          <xref ref-type="bibr" rid="ref33">(Wardlaw 1988)</xref>
          ,
Diphtheria-TetanusPertussis Vaccine
          <xref ref-type="bibr" rid="ref9">(Corkins, Grose et al. 1991)</xref>
          , Hepatitis
B Vaccines
          <xref ref-type="bibr" rid="ref21 ref8">(Comenge and Girard 2006)</xref>
          , Chickenpox
Vaccine
          <xref ref-type="bibr" rid="ref18 ref29 ref32 ref6">(Bozzola, Tozzi et al. 2012)</xref>
          , and Poliovirus
Vaccine
          <xref ref-type="bibr" rid="ref10 ref11 ref22">(Friedrich 1998; Korsun, Kojouharova et al. 2009)</xref>
          .
As shown by a VO hierarchical structure layout (Fig. 3),
these seven vaccines belong to different bacterial or viral
vaccines. The Diphtheria-Tetanus-Pertussis vaccine
(DTP) is a combination vaccine that contains three
individual vaccine components, including a Pertussis vaccine.
DTP is asserted in VO as a subclass of
“DiphtheriaTetanus vaccine”. Different from SNOMED, VO
logically defines vaccines based on their relation to the pathogen
organisms defined in the NCBI_Taxon ontology. Since
multiple inheritances are not used in VO, an inference
using an ontology reasoner was used to infer that the DTP
is also Bordetella pertussis vaccine (i.e., Pertussis
vaccine) (Fig. 3). It is likely that the association of the
combination vaccine DTP with neurological disorder is at
least partially due to the Pertussis vaccine component.
        </p>
        <p>Our study also identified many other diseases
associating with different vaccines. For example, five vaccines
(e.g., pertussis vaccine) were found to be associated with
various types of antimicrobial susceptibility, and eight
vaccines (e.g., influenza vaccine) have been co-studied
with patients having the asthma condition. Due to the
relative poor annotation of the vaccine data in the
Semantic MEDLINE system, the vaccines identified in the
semantic analysis were poorly classified. The incorporation
of VO in the study clearly classifies these vaccines,
leading to better understanding of the result of the Semantic
MEDLINE analysis.</p>
        <p>2) This group of vaccines, including Q fever vaccine,
Parvovirus vaccine, and Tick-borne encephalitis vaccine,
is associated with the common disease “Delayed
Hypersensitivity”. Delayed type reactions may occur at days
after vaccination and often raise serious safety concerns.
Delayed hypersensitivity is not antibody-mediated but
rather is a type of cell-mediated response. The study of
common vaccines and related gene and pathway features
related to the delayed reaction will help to reveal the
cause of DTR and eventually prevent it. While these
vaccines are developed against different bacterial or viral
diseases, there may be similarities among these vaccines,
such as common vaccine ingredients (e.g., adjuvant) and a
shared target to some common biological pathway in
humans. An identification of these common features may
indicate a common cause of the DTR.</p>
        <p>
          3) This group of vaccines is associated with the
common disease “Mumps”. The vaccines in this group include
Mumps Vaccine, “measles, mumps, rubella, varicella
vaccine”, and “diphtheria-tetanus-pertussis-haemophilus b
conjugate vaccine” (DTP-Hib). The first two vaccines
protect against Mumps. DTP-Hib was compared with a
Mumps vaccine in a study
          <xref ref-type="bibr" rid="ref17">(Henderson, Oates et al. 2004)</xref>
          .
        </p>
        <p>
          4) This vaccine group consists of seven vaccines (e.g.,
Brucella abortus vaccine and bovine rhinotracheitis
vaccine) with direct associations between them. They are all
associated with the common term “calve” in the literature
abstracts. Since “calve disease” has a synonym
“Scheuermann’s Disease”, these vaccines have all been linked to
“Scheuermann’s Disease”. This is due to the ambiguity of
the Nature Language Processing (NLP) process. This can
be improved by future improvement of the disambiguity
capacity of NLP tools.
In the vaccine-gene network, many genes were found to
interact with different vaccines. For example, our study
identified that CD40LG (CD40 ligand) is closely
associated with five vaccines: Diphtheria toxoid vaccine,
Cholera vaccine, Tetanus vaccine, Chickenpox vaccine, and
inactivated poliovirus vaccine (Fig. 4). CD40LG plays an
important role in antigen presentation and stimulation of
cytotoxic T lymphocytes
          <xref ref-type="bibr" rid="ref20">(Kornbluth 2000)</xref>
          . CD40LG can
also be used in rational vaccine adjuvant design
          <xref ref-type="bibr" rid="ref21 ref8">(Kornbluth and Stone 2006)</xref>
          . Our finding confirms the
important role of CD40LG and provides specific details
on how this immune factor interacts with various bacterial
and viral vaccines.
        </p>
      </sec>
    </sec>
    <sec id="sec-3">
      <title>4 DISCUSSIONS AND FUTURE WORK</title>
      <p>
        In this paper, we proposed a novel network-based
approach to investigate the vaccine relationships in the
context of vaccine network extracted from PubMed literature
abstracts. The investigations of vaccine-vaccine,
vaccinedisease, and vaccine-gene networks demonstrate that such
literature-based associations can be better analyzed using
VO and such a combinatorial analysis is able to reveal the
association patterns and identify new knowledge. The
identified vaccine-vaccine associations based on
vaccinedisease distance analysis are consistent with their VO
categories and often lead to the generation of new
hypotheses. Our studies discovered some novel
vaccinevaccine relationships by discovering a group of vaccines
associated with some common diseases as demonstrated
in the heat map analysis in the Results section. Due to the
incompleteness of such information existing in the
literature abstracts, such vaccine-vaccine associations need
further validation in independent databases or through
future experimental studies. For example, while our
analysis reveals associations between a group of vaccines and
neurological adverse events, it is noted that the evidences
of these associations, although reported by some PubMed
abstracts, are not necessarily commonly acknowledged
        <xref ref-type="bibr" rid="ref18 ref29 ref32">(Sarntivijai, Xiang et al. 2012)</xref>
        . More analysis may be
required for clarification.
      </p>
      <p>Future extensions of this work include: (1)
integration of more comprehensive vaccine-disease association
databases (e.g., VAERS system) to construct more
complete vaccine-related networks; (2) generation of
vaccinerelated gene network by extending the neighbour genes of
vaccine-associated genes; (3) network-based investigation
of the relationships among vaccines and other drugs using
vaccine-drug associations; (4) investigation on possible
ways to improve the network by assigning weights or
confident rates to different types of associations or
associations from different sources.</p>
    </sec>
    <sec id="sec-4">
      <title>ACKNOWLEDGEMENTS</title>
      <p>This project was supported by the National Institute of
Health grants 5R01LM009959-02 to HL, and
R01AI081062 to YH.</p>
    </sec>
  </body>
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