Identification of Pyroptosis-Related Genes and Immune Landscape in Myocardial Ischemia–Reperfusion Injury

<b>Background</b>: Cardiomyocyte death is a key factor in myocardial ischemia-reperfusion injury (MI/RI), and the expression patterns and molecular mechanisms of pyroptosis-related genes (PRGs) in ischemia-reperfusion injury are poorly understood. <b>Methods</b>: The mouse MI/RI injury-related datasets GSE61592 and GSE160516 were obtained from the Gene Expression Omnibus database, and differential expression analysis was performed on each to identify differentially expressed genes (DEGs). The DEGs were intersected with the PRGs obtained from GeneCards to identify differentially expressed PRGs in MI/RI. Enrichment analysis identified key pathways, while PPI network analysis revealed hub genes. The expression patterns and immune cell infiltration of hub genes were also investigated. The molecular docking prediction of key genes was performed using MOE software in conjunction with the ZINC small molecular compounds database. Key gene expression was validated in an external dataset (GSE4105), a mouse MI/RI model, and an HL-1 cell hypoxia/reoxygenation model via RT-qPCR. <b>Results</b>: A total of 29 differentially expressed PRGs were identified, which are primarily associated with pathways such as "immune system process", "response to stress", "identical protein binding", and "extracellular region". Seven key genes (<i>Fkbp10</i>, <i>Apoe</i>, <i>Col1a2</i>, <i>Ppic</i>, <i>Tlr2</i>, <i>Fstl1</i>, <i>Serpinh1</i>) were screened, all strongly correlated with immune infiltration. Seven FDA-approved small molecule compounds exhibiting the highest docking potential with each key gene were selected based on a comprehensive evaluation of S-scores and hydrogen bond binding energies. <i>Apoe</i>, <i>Tlr2</i>, and <i>Serpinh1</i> were successfully validated across external datasets, the mouse MI/RI model, and the cardiomyocyte H/R model. <b>Conclusions</b>: <i>Apoe</i>, <i>Tlr2</i>, and <i>Serpinh1</i> may be key genes involved in MI/RI-related pyroptosis. Targeting these genes may provide new insights into the treatment of MI/RI.