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Lin28b regulates age-dependent differences in murine platelet function. Blood Adv 2020; 3:72-82. [PMID: 30622145 DOI: 10.1182/bloodadvances.2018020859] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 11/29/2018] [Indexed: 02/07/2023] Open
Abstract
Platelets are essential for hemostasis; however, several studies have identified age-dependent differences in platelet function. To better understand the origins of fetal platelet function, we have evaluated the contribution of the fetal-specific RNA binding protein Lin28b in the megakaryocyte/platelet lineage. Because activated fetal platelets have very low levels of P-selectin, we hypothesized that the expression of platelet P-selectin is part of a fetal-specific hematopoietic program conferred by Lin28b. Using the mouse as a model, we find that activated fetal platelets have low levels of P-selectin and do not readily associate with granulocytes in vitro and in vivo, relative to adult controls. Transcriptional analysis revealed high levels of Lin28b and Hmga2 in fetal, but not adult, megakaryocytes. Overexpression of LIN28B in adult mice significantly reduces the expression of P-selectin in platelets, and therefore identifies Lin28b as a negative regulator of P-selectin expression. Transplantation of fetal hematopoietic progenitors resulted in the production of platelets with low levels of P-selectin, suggesting that the developmental regulation of P-selectin is intrinsic and independent of differences between fetal and adult microenvironments. Last, we observe that the upregulation of P-selectin expression occurs postnatally, and the temporal kinetics of this upregulation are recapitulated by transplantation of fetal hematopoietic stem and progenitor cells into adult recipients. Taken together, these studies identify Lin28b as a new intrinsic regulator of fetal platelet function.
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Li L, Xu P, Zhang Z, Zhou X, Chen C, Lu C. Platelets can reflect the severity of Crohn's disease without the effect of anemia. Clinics (Sao Paulo) 2020; 75:e1596. [PMID: 32667493 PMCID: PMC7337217 DOI: 10.6061/clinics/2020/e1596] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 03/26/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Anemia and changes in platelets (PLT) are common in inflammatory bowel disease (IBD). In our study, we aimed to verify whether PLT count can independently reflect the severity of IBD. METHODS In our hospital, 137 Crohn's Disease (CD), 69 Ulcerative colitis (UC) patients, and 412 healthy controls were included to compare the differences in PLT count. In addition, the effect of anemia, C-reactive protein (CRP), age, CD activity index (CDAI) or Mayo on PLTs was also analyzed. If PLTs independently affected CD or UC, we used the receiver operating characteristic (ROC) curve to verify the diagnostic value and obtain the cut-off value of PLT. RESULTS CD and UC patients had higher PLT than controls (p<0.001, p<0.001; respectively). In CD patients, the results showed that patients with anemia (P<0.01), Iron Deficiency Anemia (IDA) (p<0.001), CRP≥8 mg/L (p=0.046), and CDAI≥150 (p<0.001) had higher PLT, while in UC patients, those with anemia (p=0.018), CRP≥8 mg/L (p=0.045), and Mayo≥3 (p=0.029) had higher PLT. Univariate analysis showed that CDAI was positively correlated with PLT count (p<0.001), while hemoglobin (p=0.001) and age (p<0.001) were negatively correlated with PLT in CD. In UC patients, Mayo (p=0.001) and CRP (p<0.001) were positively correlated with PLT, while hemoglobin (p=0.002) was negatively correlated. Finally, by linear stepwise multivariate analysis, we clarified the positive relationship between PLT and CD (p<0.001) by eliminating the interference of hemoglobin, and determined the cut-off value of PLT as 298×109/L. For UC, we did not obtain similar results. CONCLUSIONS PLT can be an indicator of disease severity in CD, while there is a lack of evidence regarding this finding in UC.
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Affiliation(s)
- Lin Li
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
- *Corresponding author. E-mail: /
| | - Ping Xu
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
- *Corresponding author. E-mail: /
| | - Zhongchen Zhang
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Xinxin Zhou
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Chunxiao Chen
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
- *Corresponding author. E-mail: /
| | - Chao Lu
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
- *Corresponding author. E-mail: /
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Kim Y, Goodman MD, Jung AD, Abplanalp WA, Schuster RM, Caldwell CC, Lentsch AB, Pritts TA. Microparticles from aged packed red blood cell units stimulate pulmonary microthrombus formation via P-selectin. Thromb Res 2019; 185:160-166. [PMID: 31821908 DOI: 10.1016/j.thromres.2019.11.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/31/2019] [Accepted: 11/24/2019] [Indexed: 01/11/2023]
Abstract
INTRODUCTION During storage, packed red blood cells undergo a series of physical, metabolic, and chemical changes collectively known as the red blood cell storage lesion. One key component of the red blood cell storage lesion is the accumulation of microparticles, which are submicron vesicles shed from erythrocytes as part of the aging process. Previous studies from our laboratory indicate that transfusion of these microparticles leads to lung injury, but the mechanism underlying this process is unknown. In the present study, we hypothesized that microparticles from aged packed red blood cell units induce pulmonary thrombosis. MATERIALS AND METHODS Leukoreduced, platelet-depleted, murine packed red blood cells (pRBCS) were prepared then stored for up to 14 days. Microparticles were isolated from stored units via high-speed centrifugation. Mice were transfused with microparticles. The presence of pulmonary microthrombi was determined with light microscopy, Martius Scarlet Blue, and thrombocyte stains. In additional studies microparticles were labelled with CFSE prior to injection. Murine lung endothelial cells were cultured and P-selectin concentrations determined by ELISA. In subsequent studies, P-selectin was inhibited by PSI-697 injection prior to transfusion. RESULTS We observed an increase in microthrombi formation in lung vasculature in mice receiving microparticles from stored packed red blood cell units as compared with controls. These microthrombi contained platelets, fibrin, and microparticles. Treatment of cultured lung endothelial cells with microparticles led to increased P-selectin in the media. Treatment of mice with a P-selectin inhibitor prior to microparticle infusion decreased microthrombi formation. CONCLUSIONS These data suggest that microparticles isolated from aged packed red blood cell units promote the development of pulmonary microthrombi in a murine model of transfusion. This pro-thrombotic event appears to be mediated by P-selectin.
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Affiliation(s)
- Young Kim
- Section of General Surgery, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Michael D Goodman
- Section of General Surgery, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Andrew D Jung
- Section of General Surgery, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - William A Abplanalp
- Section of General Surgery, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Rebecca M Schuster
- Section of General Surgery, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Charles C Caldwell
- Section of General Surgery, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Alex B Lentsch
- Section of General Surgery, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Timothy A Pritts
- Section of General Surgery, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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Ivanov II, Apta BHR, Bonna AM, Harper MT. Platelet P-selectin triggers rapid surface exposure of tissue factor in monocytes. Sci Rep 2019; 9:13397. [PMID: 31527604 PMCID: PMC6746844 DOI: 10.1038/s41598-019-49635-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 08/23/2019] [Indexed: 12/13/2022] Open
Abstract
Tissue factor (TF) plays a central role in haemostasis and thrombosis. Following vascular damage, vessel wall TF initiates the extrinsic coagulation cascade. TF can also be exposed by monocytes. Inflammatory or infectious stimuli trigger synthesis of new TF protein by monocytes over the course of hours. It has also been suggested that monocytes can expose TF within minutes when stimulated by activated platelets. Here, we have confirmed that monocytes rapidly expose TF in whole blood and further demonstrate that platelet P-selectin exposure is necessary and sufficient. Monocyte TF exposure increased within five minutes in response to platelet activation by PAR1-AP, PAR4-AP or CRP-XL. PAR1-AP did not trigger TF exposure on isolated monocytes unless platelets were also present. In whole blood, PAR1-AP-triggered TF exposure required P-selectin and PGSL-1. In isolated monocytes, although soluble recombinant P-selectin had no effect, P-selectin coupled to 2 µm beads triggered TF exposure. Cycloheximide did not affect rapid TF exposure, indicating that de novo protein synthesis was not required. These data show that P-selectin on activated platelets rapidly triggers TF exposure on monocytes. This may represent a mechanism by which platelets and monocytes rapidly contribute to intravascular coagulation.
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Affiliation(s)
- Ivelin I Ivanov
- Department of Pharmacology, University of Cambridge, Cambridge, United Kingdom
| | - Bonita H R Apta
- Department of Pharmacology, University of Cambridge, Cambridge, United Kingdom
| | - Arkadiusz M Bonna
- Department of Biochemistry, University of Cambridge, Cambridge, United Kingdom
| | - Matthew T Harper
- Department of Pharmacology, University of Cambridge, Cambridge, United Kingdom.
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Keppler-Noreuil KM, Lozier J, Oden N, Taneja A, Burton-Akright J, Sapp JC, Biesecker LG. Thrombosis risk factors in PIK3CA-related overgrowth spectrum and Proteus syndrome. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2019; 181:571-581. [PMID: 31490637 DOI: 10.1002/ajmg.c.31735] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 07/27/2019] [Accepted: 07/30/2019] [Indexed: 01/19/2023]
Abstract
Increased risk of thromboembolism has been recognized in individuals with mosaic overgrowth disorders, Proteus syndrome (PS) and PIK3CA-related overgrowth spectrum (PROS), including Klippel-Trenaunay syndrome and CLOVES syndrome. PS and PROS have distinct, yet overlapping clinical findings and are caused by somatic pathogenic variants in the PI3K/AKT gene signaling pathway. PS is caused by a single somatic activating AKT1 c.49G > A p.E17K variant while PROS can be caused one of multiple variants in PIK3CA. The role of prothrombotic factors, endothelial cell adhesion molecules, and vascular malformations in both PS and PROS have not been previously investigated. A pilot study of prospective clinical and laboratory evaluations with the purposes of identifying potential risk factors for thrombosis was conducted. Doppler ultrasounds and magnetic resonance angiogram/ venography (MRA/MRV) scans identified vascular malformations in PS and PROS that were not appreciated on physical examination. Abnormal D-dimers (0.60-2.0 mcg/ml) occurred in half of individuals, many having vascular malformations, but no thromboses. Soluble vascular endothelial markers, including thrombomodulin, soluble vascular adhesion molecule (sVCAM), soluble intercellular adhesion molecule (sICAM), E-selectin, and P-selectin were significantly higher in PS and PROS compared to controls. However, no single attribute was identified that explained the risk of thrombosis. Predisposition to thrombosis is likely multifactorial with risk factors including chronic stasis within vascular malformations, stasis from impaired mobility (e.g., following surgery), decreased anticoagulant proteins, and effects of AKT1 and PIK3CA variants on vascular endothelium. Based on our findings, we propose clinical recommendations for surveillance of thrombosis in PS and PROS.
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Affiliation(s)
- Kim M Keppler-Noreuil
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Jay Lozier
- Department of Laboratory Medicine, Warren Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Neal Oden
- Department of Biostatistics, The EMMES Corporation, Rockville, Maryland
| | - Anjali Taneja
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Jasmine Burton-Akright
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Julie C Sapp
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Leslie G Biesecker
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
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Nonbacterial Thrombotic Endocarditis Due to Primary Gallbladder Malignancy with Recurrent Stroke Despite Anticoagulation: Case Report and Literature Review. J Gen Intern Med 2019; 34:1934-1940. [PMID: 31313109 PMCID: PMC6712189 DOI: 10.1007/s11606-019-05166-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 11/29/2018] [Accepted: 06/20/2019] [Indexed: 10/26/2022]
Abstract
Nonbacterial thrombotic endocarditis (NBTE) associated with malignancy is rare; its infrequency and similarity to other diagnoses make it a significant diagnostic challenge. A 63-year-old woman on rivaroxaban for prior deep vein thrombosis presented with left upper extremity weakness and left facial droop with imaging demonstrating multiple strokes. Echocardiograms revealed mitral and aortic valve vegetations. The patient was switched to apixaban and started on vancomycin and ceftriaxone for presumed culture-negative endocarditis. Despite continuing apixaban, her hospital course was complicated by new acute embolic infarcts. Workup confirmed non-mucinous metastatic biliary adenocarcinoma. The patient was placed on a heparin drip then switched to low molecular weight heparin without further embolic events and was discharged to a rehabilitation facility in stable condition with plans for chemotherapy as an outpatient. These clinical, imaging, and histologic findings were consistent with a rare case of NBTE associated with primary non-mucinous gallbladder malignancy complicated by recurrent strokes in which direct oral anticoagulants did not provide adequate anticoagulation.
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Liu X, Gorzelanny C, Schneider SW. Platelets in Skin Autoimmune Diseases. Front Immunol 2019; 10:1453. [PMID: 31333641 PMCID: PMC6620619 DOI: 10.3389/fimmu.2019.01453] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 06/10/2019] [Indexed: 12/11/2022] Open
Abstract
Systemic lupus erythematosus (SLE), systemic sclerosis (SSc), and small vessel vasculitis are three autoimmune diseases frequently manifested in the skin. They share common pathogenic features, including production of autoantibodies, loss of tolerance to self-antigens, tissue necrosis and fibrosis, vasculopathy and activation of the coagulation system. Platelets occupy a central part within the coagulation cascade and are well-recognized for their hemostatic role. However, recent cumulative evidence implicates their additional and multifaceted immunoregulatory functions. Platelets express immune receptors and they store growth factors, cytokines, and chemokines in their granules enabling a significant contribution to inflammation. A plethora of activating triggers such as damage associated molecular patterns (DAMPs) released from damaged endothelial cells, immune complexes, or complement effector molecules can mediate platelet activation. Activated platelets further foster an inflammatory environment and the crosstalk with the endothelium and leukocytes by the release of immunoactive molecules and microparticles. Further insight into the pathogenic implications of platelet activation will pave the way for new therapeutic strategies targeting autoimmune diseases. In this review, we discuss the inflammatory functions of platelets and their mechanistic contribution to the pathophysiology of SSc, ANCA associated small vessel vasculitis and other autoimmune diseases affecting the skin.
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Affiliation(s)
- Xiaobo Liu
- Department of Dermatology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.,Department of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Gorzelanny
- Department of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan W Schneider
- Department of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Marin Oyarzún CP, Heller PG. Platelets as Mediators of Thromboinflammation in Chronic Myeloproliferative Neoplasms. Front Immunol 2019; 10:1373. [PMID: 31258539 PMCID: PMC6587101 DOI: 10.3389/fimmu.2019.01373] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 05/30/2019] [Indexed: 12/12/2022] Open
Abstract
Chronic myeloproliferative neoplasms (MPN) are stem cell disorders driven by mutations in JAK2, CALR, or MPL genes and characterized by myeloid proliferation and increased blood cell counts. They encompass three closely related conditions, including essential thrombocythemia, polycythemia vera, and primary myelofibrosis. Elevated levels of cytokines released by clonal and non-clonal cells generate a chronic proinflammatory state that contributes to disease pathogenesis. Thrombosis represents the most common cause of morbidity and mortality in MPN, although paradoxically, patients may also present with a bleeding diathesis. The mechanisms leading to thrombosis are complex and multiple and include increased blood cells together with qualitative abnormalities of red cells, leukocytes, and platelets that favor a prothrombotic activated phenotype. The functional interplay between blood cells, the clotting cascade, and dysfunctional endothelium contributes to hypercoagulability and this process is perpetuated by the effect of inflammatory cytokines. In addition to their well-known function in hemostasis, platelets contribute to innate immunity and inflammation and play a key role in MPN thromboinflammatory state. In vivo platelet activation leads to platelet aggregate formation and exposure of adhesion molecules which favor their interaction with activated neutrophils and monocytes leading to circulating platelet-leukocyte heterotypic aggregates. Platelets are recruited to the activated endothelium further enhancing the reciprocal activation of both cell types. Crosstalk between activated cells drives cytokine production, further fuelling the self-reinforcing thromboinflammatory loop. In addition, MPN platelets provide a procoagulant scaffold which triggers the coagulation cascade and platelet-derived microparticles amplify this response. Markers of platelet, leukocyte, endothelial and coagulation activation are increased in MPN patients although prospective studies are required to determine the potential value of these parameters for identifying patients at increased thrombotic risk. Thrombosis remains the main complication of MPN patients, with a high risk of recurrence despite adequate cytoreductive and antithrombotic treatment. Deeper insight into the mechanism favoring thrombosis development in this setting may lead to novel therapeutic approaches for MPN thrombosis. Considering the critical role of inflammation in the vascular risk, concomitant targeting of inflammatory pathways could potentially impact on primary or secondary prevention strategies.
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Affiliation(s)
- Cecilia P Marin Oyarzún
- Department of Hematology Research, National Scientific and Technical Research Council (CONICET), Institute of Medical Research (IDIM) "Dr. Alfredo Lanari", University of Buenos Aires, Buenos Aires, Argentina
| | - Paula G Heller
- Department of Hematology Research, National Scientific and Technical Research Council (CONICET), Institute of Medical Research (IDIM) "Dr. Alfredo Lanari", University of Buenos Aires, Buenos Aires, Argentina
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Opheim EN, Apelseth TO, Stanworth SJ, Eide GE, Hervig T. Multiple electrode aggregometry and thromboelastography in thrombocytopenic patients with haematological malignancies. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2019; 17:181-190. [PMID: 30747706 PMCID: PMC6596372 DOI: 10.2450/2018.0140-18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 11/07/2018] [Indexed: 01/22/2023]
Abstract
BACKGROUND In thrombocytopenic patients better assessment of bleeding risk than that provided by platelet count alone is required. Multiplate® aggregometry and thromboelastography (TEG) could be used, but information on their role in such patients is limited. The primary aim of this study was to investigate the feasibility of Multiplate® analyses in patients with haematological malignancies. A secondary aim was to explore whether a multiple logistic regression model combining Multiplate®, TEG, clinical and laboratory variables was associated with risk of bleeding. MATERIALS AND METHODS This was an exploratory, prospective observational study of thrombocytopenic patients with haematological malignancies. Total platelet count (TPC), white blood cell count, C-reactive protein (CRP) level, temperature and bleeding status were recorded daily. TEG and Multiplate® analyses with four agonists were performed on weekdays. RESULTS Ten patients were enrolled into the study. The median number of days in a study period was 21. Bleeding was observed on 64 of 298 study days. TPC <20×109/L and <10×109/L occurred on 119 and 25 days, respectively. When TPC was <33×109/L, many samples showed no aggregation, regardless of bleeding status. Despite this, the odds of World Health Organization (WHO) grade 2 bleeding decreased significantly as aggregation increased and Multiplate® had a negative predictive value (NPV) of 96% and a positive predictive value (PPV) of 19% for significant bleeding. In the multiple logistic regression model collagen-activated Multiplate® aggregation, TEG angle, TEG reaction time and CRP significantly affected the odds of WHO grade 2 bleeding. The combined model had a NPV of 99% and a PPV of 19%. DISCUSSION Our findings suggest that the markers of platelet function and haemostasis provided by Multiplate® aggregometry and TEG may add information to support prediction of bleeding, although platelet count still remains the most accessible analysis for routine testing.
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Affiliation(s)
- Elin N. Opheim
- Department of Clinical Science, University of Bergen, Norway
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Torunn O. Apelseth
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
- Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway
| | - Simon J. Stanworth
- NHS Blood and Transplant/Oxford University Hospitals NHS Trust, “John Radcliffe” Hospital, Oxford, United Kingdom
| | - Geir E. Eide
- Department of Global Public Health and Primary Care, University of Bergen, Norway
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Tor Hervig
- Department of Clinical Science, University of Bergen, Norway
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
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Jiang Z, Zhang R, Sun M, Liu Q, Wang S, Wang W, Zhao Q, Zhang H, Wang Y, Hou J, Yu B. Effect of Clopidogrel vs Ticagrelor on Platelet Aggregation and Inflammation Markers After Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction. Can J Cardiol 2018; 34:1606-1612. [DOI: 10.1016/j.cjca.2018.08.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 08/14/2018] [Accepted: 08/14/2018] [Indexed: 01/19/2023] Open
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Tawil N, Chennakrishnaiah S, Bassawon R, Johnson R, D'Asti E, Rak J. Single cell coagulomes as constituents of the oncogene-driven coagulant phenotype in brain tumours. Thromb Res 2018; 164 Suppl 1:S136-S142. [PMID: 29703472 DOI: 10.1016/j.thromres.2018.01.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 01/09/2018] [Accepted: 01/10/2018] [Indexed: 02/07/2023]
Abstract
Molecular profiling of human cancers revealed a startling diversity in disease-causing mechanisms superseding histological and anatomical commonalities. The emerging molecular subtypes and disease entities are often driven by distinct oncogenic pathways and their effectors, including those acting extracellularly on the vascular and coagulation systems. Indeed, several oncogenic mutations such as those affecting protein-coding genes (RAS, EGFR, PTEN, TP53) and non-coding RNA (microRNA) regulate multiple effectors of the coagulation system (coagulome), including tissue factor, protease activated receptors, clotting factors, mediators of platelet function and fibrinolysis. This is exemplified by differential coagulome profiles in the molecular subtypes of glioblastoma, medulloblastoma and other human tumours. There is mounting clinical evidence that the mutational status of cancer driver genes such as KRAS or IDH1 may influence the risk of venous thromboembolism in patients with colorectal, lung or brain cancers. Notably, single cell sequencing in glioblastoma revealed a remarkable intra-tumoural heterogeneity of cancer cell populations with regard to their individual coagulomes, suggesting a combinatorial and dynamic nature of the global pro-thrombotic phenotype. We suggest that the cellular complexity of specific cancers may define their mechanisms of interactions with the coagulation system, and the risks of thrombosis. Thus, more biologically- based, disease-specific and personalized approaches may be needed to diagnose and manage cancer-related thrombosis.
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Affiliation(s)
- Nadim Tawil
- McGill University, Montreal Children's Hospital, RI MUHC, Montreal, Quebec, Canada
| | | | - Rayhaan Bassawon
- McGill University, Montreal Children's Hospital, RI MUHC, Montreal, Quebec, Canada
| | - Radia Johnson
- McGill University, Montreal Children's Hospital, RI MUHC, Montreal, Quebec, Canada
| | - Esterina D'Asti
- McGill University, Montreal Children's Hospital, RI MUHC, Montreal, Quebec, Canada
| | - Janusz Rak
- McGill University, Montreal Children's Hospital, RI MUHC, Montreal, Quebec, Canada.
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Pawelczyk M, Glabiński A, Kaczorowska B, Baj Z. sP- and sE-selectin in stroke patients with metabolic disorders. Neurol Neurochir Pol 2018; 52:599-605. [DOI: 10.1016/j.pjnns.2018.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 05/25/2018] [Accepted: 08/03/2018] [Indexed: 10/28/2022]
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Soluble endothelial cell molecules and circulating endothelial cells in patients with venous thromboembolism. Blood Coagul Fibrinolysis 2018; 28:589-595. [PMID: 28661913 DOI: 10.1097/mbc.0000000000000650] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
: To evaluate the plasma levels of soluble endothelial cell molecules in patients with venous thromboembolism (VTE) out of the acute phase as compared with healthy individuals. We also investigated the possible associations of the soluble endothelial cell molecules among them, as well as with other clinical and laboratory data, including the numbers of circulating endothelial cells (CEC), circulating endothelial progenitor cells (CEP), and CEC expressing activation-related [cluster of differentiation (CD)54 and CD62E] and procoagulant (CD142) markers. In total, 15 patients with VTE and 20 normal individuals were studied. The CEC and CEP were quantified and characterized by flow cytometry. The soluble molecules studied included P-selectin, E-selectin, intercellular cell adhesion molecule 1, vascular cell adhesion molecule 1 and tissue factor (ELISA), and von Willebrand factor antigen (immunoturbidimetry). VTE patients had significantly higher levels of vascular cell adhesion molecule 1 and von Willebrand factor antigen and lower levels of soluble E-selectin than controls. They also showed significantly higher numbers of CEC, as of activated/procoagulant CEC and lower numbers of CEP, compared with controls. We did not find any correlation between the levels of soluble molecules and the numbers of endothelial cell in circulation, but there was with several clinical and laboratory data in VTE patients. Our results would suggest that in VTE patients, the endothelium remains activated and in some hypercoagulable state. The levels of soluble endothelial cell molecules did not seem to be directly related to the numbers of CEC and CEP neither reflected the number of activated CEC, which may be because of the different function that surface and soluble molecules may have.
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Trotta A, Velásquez LN, Milillo MA, Delpino MV, Rodríguez AM, Landoni VI, Giambartolomei GH, Pozner RG, Barrionuevo P. Platelets Promote Brucella abortus Monocyte Invasion by Establishing Complexes With Monocytes. Front Immunol 2018; 9:1000. [PMID: 29867977 PMCID: PMC5949576 DOI: 10.3389/fimmu.2018.01000] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 04/23/2018] [Indexed: 01/18/2023] Open
Abstract
Brucellosis is an infectious disease elicited by bacteria of the genus Brucella. Platelets have been extensively described as mediators of hemostasis and responsible for maintaining vascular integrity. Nevertheless, they have been recently involved in the modulation of innate and adaptive immune responses. Although many interactions have been described between Brucella abortus and monocytes/macrophages, the role of platelets during monocyte/macrophage infection by these bacteria remained unknown. The aim of this study was to investigate the role of platelets in the immune response against B. abortus. We first focused on the possible interactions between B. abortus and platelets. Bacteria were able to directly interact with platelets. Moreover, this interaction triggered platelet activation, measured as fibrinogen binding and P-selectin expression. We further investigated whether platelets were involved in Brucella-mediated monocyte/macrophage early infection. The presence of platelets promoted the invasion of monocytes/macrophages by B. abortus. Moreover, platelets established complexes with infected monocytes/macrophages as a result of a carrier function elicited by platelets. We also evaluated the ability of platelets to modulate functional aspects of monocytes in the context of the infection. The presence of platelets during monocyte infection enhanced IL-1β, TNF-α, IL-8, and MCP-1 secretion while it inhibited the secretion of IL-10. At the same time, platelets increased the expression of CD54 (ICAM-1) and CD40. Furthermore, we showed that soluble factors released by B. abortus-activated platelets, such as soluble CD40L, platelet factor 4, platelet-activating factor, and thromboxane A2, were involved in CD54 induction. Overall, our results indicate that platelets can directly sense and react to B. abortus presence and modulate B. abortus-mediated infection of monocytes/macrophages increasing their pro-inflammatory capacity, which could promote the resolution of the infection.
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Affiliation(s)
- Aldana Trotta
- Instituto de Medicina Experimental (IMEX), CONICET, Academia Nacional de Medicina, Buenos Aires, Argentina
| | - Lis N Velásquez
- Instituto de Medicina Experimental (IMEX), CONICET, Academia Nacional de Medicina, Buenos Aires, Argentina
| | - M Ayelén Milillo
- Instituto de Medicina Experimental (IMEX), CONICET, Academia Nacional de Medicina, Buenos Aires, Argentina
| | - M Victoria Delpino
- Instituto de Inmunología, Genética y Metabolismo (INIGEM), CONICET, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Ana M Rodríguez
- Instituto de Inmunología, Genética y Metabolismo (INIGEM), CONICET, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Verónica I Landoni
- Instituto de Medicina Experimental (IMEX), CONICET, Academia Nacional de Medicina, Buenos Aires, Argentina
| | - Guillermo H Giambartolomei
- Instituto de Inmunología, Genética y Metabolismo (INIGEM), CONICET, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Roberto G Pozner
- Instituto de Medicina Experimental (IMEX), CONICET, Academia Nacional de Medicina, Buenos Aires, Argentina
| | - Paula Barrionuevo
- Instituto de Medicina Experimental (IMEX), CONICET, Academia Nacional de Medicina, Buenos Aires, Argentina
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Støy S, Patel VC, Sturgeon JP, Manakkat Vijay GK, Lisman T, Bernal W, Shawcross DL. Platelet-leucocyte aggregation is augmented in cirrhosis and further increased by platelet transfusion. Aliment Pharmacol Ther 2018. [PMID: 29528132 DOI: 10.1111/apt.14600] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Thrombocytopenia and circulating dysfunctional immune cells are commonly observed in patients with cirrhosis. Platelets may form complexes with neutrophils, monocytes and T cells modulating their function. We recently reported increased frequencies of platelet-complexed neutrophils in cirrhosis with evidence of neutrophil activation upon contact with healthy platelets in vitro. Whether this occurs in vivo following platelet transfusion and contributes to systemic inflammation and endothelial activation is unknown. AIMS To characterise platelet-leucocyte aggregation in cirrhosis and to determine whether elective platelet transfusion results in perturbations associated with changes in markers of haemostasis, inflammation or endothelial activation. METHODS We collected blood from cirrhotics (n = 19) before and following elective platelet transfusion. We measured platelet-leucocyte aggregation, activation and function, and markers of platelet activation, systemic inflammation and endothelial activation by flow cytometry. Haemostasis was assessed by thromboelastometry and plasma haemostatic proteins. RESULTS We observed a 2.5-fold increase in platelet-complexed neutrophils in patients with cirrhosis compared with healthy subjects and twofold more platelets attached per monocyte and T cell. All platelet-complexed leucocytes expressed higher levels of activation markers and platelet-complexed neutrophils had higher resting oxidative burst and phagocytic capacity than their nonplatelet-complexed counterparts (P < 0.001); most pronounced in patients with cirrhosis. Paradoxically, platelet-complexed leucocyte frequency decreased with increasing MELD score. Platelet transfusion increased soluble CD40 ligand (platelet activation marker), the frequency of platelet-complexed monocytes (P < 0.05) and improved haemostatic status. CONCLUSION Cirrhotic patients have activated circulating platelet-complexed leucocytes with increased platelet-monocyte aggregation following elective platelet transfusion. Elective platelet transfusion might therefore exacerbate immune dysfunction in cirrhosis.
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Affiliation(s)
- S Støy
- Institute of Liver Studies and Transplantation, King's College London School of Medicine at King's College Hospital, London, UK.,Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus C, Denmark
| | - V C Patel
- Institute of Liver Studies and Transplantation, King's College London School of Medicine at King's College Hospital, London, UK
| | - J P Sturgeon
- Institute of Liver Studies and Transplantation, King's College London School of Medicine at King's College Hospital, London, UK
| | - G K Manakkat Vijay
- Institute of Liver Studies and Transplantation, King's College London School of Medicine at King's College Hospital, London, UK
| | - T Lisman
- Surgical Research Laboratory, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - W Bernal
- Liver Intensive Care Unit, King's College London School of Medicine at King's College Hospital, London, UK
| | - D L Shawcross
- Institute of Liver Studies and Transplantation, King's College London School of Medicine at King's College Hospital, London, UK
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68
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Alhamdi Y, Toh CH. Recent advances in pathophysiology of disseminated intravascular coagulation: the role of circulating histones and neutrophil extracellular traps. F1000Res 2017; 6:2143. [PMID: 29399324 PMCID: PMC5785716 DOI: 10.12688/f1000research.12498.1] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2017] [Indexed: 12/29/2022] Open
Abstract
Disseminated intravascular coagulation (DIC) is an acquired condition that develops as a complication of systemic and sustained cell injury in conditions such as sepsis and trauma. It represents major dysregulation and increased thrombin generation in vivo. A poor understanding and recognition of the complex interactions in the coagulation, fibrinolytic, inflammatory, and innate immune pathways have resulted in continued poor management and high mortality rates in DIC. This review focuses attention on significant recent advances in our understanding of DIC pathophysiology. In particular, circulating histones and neutrophil extracellular traps fulfil established criteria in DIC pathogenesis. Both are damaging to the vasculature and highly relevant to the cross talk between coagulation and inflammation processes, which can culminate in adverse clinical outcomes. These molecules have a strong potential to be novel biomarkers and therapeutic targets in DIC, which is still considered synonymous with 'death is coming'.
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Affiliation(s)
- Yasir Alhamdi
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | - Cheng-Hock Toh
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection and Global Health, University of Liverpool, Liverpool, UK.,Roald Dahl Haemostasis & Thrombosis Centre, Royal Liverpool University Hospital, Liverpool, UK
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Bruges G, Crespo G, Salazar V, Deglesne PA, Schneider H, Cabrera-Fuentes H, Schmitz ML, Preissner K, Lopéz M. Thrombin selectively induces transcription of genes in human monocytes involved in inflammation and wound healing. Thromb Haemost 2017; 112:992-1001. [DOI: 10.1160/th14-01-0034] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 05/21/2014] [Indexed: 12/31/2022]
Abstract
SummaryThrombin is essential for blood coagulation but functions also as a mediator of cellular signalling. Gene expression microarray experiments in human monocytes revealed thrombin-induced upregulation of a limited subset of genes, which are almost exclusively involved in inflammation and wound healing. Among these, the expression of F3 gene encoding for tissue factor (TF) was enhanced indicating that this physiological initiator of coagulation cascade may create a feed-forward loop to enhance blood coagulation. Activation of protease-activated receptor type 1 (PAR1) was shown to play a main role in promoting TF expression. Moreover, thrombin induced phosphorylation of ERK1/2, an event that is required for expression of thrombin-regulated genes. Thrombin also increased the expression of TF at the protein level in monocytes as evidenced by Western blot and immunostaining. Furthermore, FXa generation induced by thrombin-stimulated monocytes was abolished by a TF blocking antibody and therefore it is entirely attributable to the expression of tissue factor. This cellular activity of thrombin provides a new molecular link between coagulation, inflammation and wound healing.
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70
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Fu H, Hu D, Zhang L, Tang P. Role of extracellular vesicles in rheumatoid arthritis. Mol Immunol 2017; 93:125-132. [PMID: 29175592 DOI: 10.1016/j.molimm.2017.11.016] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 11/14/2017] [Accepted: 11/18/2017] [Indexed: 12/15/2022]
Abstract
Cell-derived extracellular vesicles (EVs) are involved in the pathogenesis of rheumatoid arthritis (RA), playing important roles in antigen presentation, inflammation, angiogenesis, cell-cell signal communication, thrombosis, and articular cartilage extracellular matrix degradation. Understanding the pathogenic mechanism of RA is important for developing therapies. The pathogenic indicators of RA, such as submicron-sized EVs, represent promising biomarkers for evaluating RA activity. This review summarizes the recent advances in understanding the pathogenesis of RA, and sheds light on the pathogenic as well as anti-inflammatory or immunosuppressive roles of EVs. We suggest that EVs could be harnessed as tools for drug delivery or targets for RA therapies.
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Affiliation(s)
- Haitao Fu
- Department of Orthopedics, the General Hospital of Chinese People's Liberation Army, Beijing 100853, China; School of Medicine, Nankai University, Tianjin 300110, China
| | - Die Hu
- Qingdao Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, China
| | - Licheng Zhang
- Department of Orthopedics, the General Hospital of Chinese People's Liberation Army, Beijing 100853, China
| | - Peifu Tang
- Department of Orthopedics, the General Hospital of Chinese People's Liberation Army, Beijing 100853, China.
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71
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Kamińska A, Enguita FJ, Stępień EŁ. Lactadherin: An unappreciated haemostasis regulator and potential therapeutic agent. Vascul Pharmacol 2017; 101:21-28. [PMID: 29169950 DOI: 10.1016/j.vph.2017.11.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 09/19/2017] [Accepted: 11/18/2017] [Indexed: 01/01/2023]
Abstract
Lactadherin is a small (53-66kDa) multifunctional glycoprotein belonging to the secreted extracellular matrix protein family. It has a multi-domain structure and is involved in many biological and physiological processes, including phagocytosis, angiogenesis, atherosclerosis, tissue remodeling, and haemostasis regulation. Lactadherin binds phosphatidylserine (PS)-enriched cell surfaces in a receptor-independent manner. Interaction between lactadherin and PS is crucial for regulation of blood coagulation processes. This review summarizes recent knowledge on the possible role of lactadherin in haemostasis control, emphasizing the great significance of the interaction between lactadherin and PS expressed on activated platelets and extracellular vesicles. The possible role of lactadherin as a therapeutic target and biomarker is also discussed.
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Affiliation(s)
- Agnieszka Kamińska
- Department of Medical Physics, Marian Smoluchowski Institute of Physics, Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, Prof. Stanisława Łojasiewicza 11 Street, Kraków 30-348, Poland.
| | - Francisco J Enguita
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Lisboa 1649-028, Portugal.
| | - Ewa Ł Stępień
- Department of Medical Physics, Marian Smoluchowski Institute of Physics, Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, Prof. Stanisława Łojasiewicza 11 Street, Kraków 30-348, Poland.
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Atallah E, Saad H, Bekelis K, Chalouhi N, Tjoumakaris S, Hasan D, Zarzour H, Smith M, Rosenwasser RH, Jabbour P. Safety and Efficacy of a 600-mg Loading Dose of Clopidogrel 24 Hours Before Pipeline Embolization Device Treatment. World Neurosurg 2017; 106:529-535. [DOI: 10.1016/j.wneu.2017.07.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 07/05/2017] [Accepted: 07/06/2017] [Indexed: 10/19/2022]
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The Interaction of Selectins and PSGL-1 as a Key Component in Thrombus Formation and Cancer Progression. BIOMED RESEARCH INTERNATIONAL 2017; 2017:6138145. [PMID: 28680883 PMCID: PMC5478826 DOI: 10.1155/2017/6138145] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 04/12/2017] [Accepted: 04/23/2017] [Indexed: 12/11/2022]
Abstract
Cellular interaction is inevitable in the pathomechanism of human disease. Formation of heterotypic cellular aggregates, between distinct cells of hematopoietic and nonhematopoietic origin, may be involved in events leading to inflammation and the complex process of cancer progression. Among adhesion receptors, the family of selectins with their ligands have been considered as one of the major contributors to cell-cell interactions. Consequently, the inhibition of the interplay between selectins and their ligands may have potential therapeutic benefits. In this review, we focus on the current evidence on the selectins as crucial modulators of inflammatory, thrombotic, and malignant disorders. Knowing that there is promiscuity in selectin binding, we outline the importance of a key protein that serves as a ligand for all selectins. This dimeric mucin, the P-selectin glycoprotein ligand 1 (PSGL-1), has emerged as a major player in inflammation, thrombus, and cancer development. We discuss the interaction of PSGL-1 with various selectins in physiological and pathological processes with particular emphasis on mechanisms that lead to severe disease.
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75
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Esper SA, Welsby IJ, Subramaniam K, John Wallisch W, Levy JH, Waters JH, Triulzi DJ, Hayanga JWA, Schears GJ. Adult extracorporeal membrane oxygenation: an international survey of transfusion and anticoagulation techniques. Vox Sang 2017; 112:443-452. [DOI: 10.1111/vox.12514] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 01/25/2017] [Accepted: 02/21/2017] [Indexed: 01/27/2023]
Affiliation(s)
- S. A. Esper
- Department of Anesthesiology; University of Pittsburgh; Pittsburgh PA USA
| | - I. J. Welsby
- Department of Anesthesiology; Duke University; Durham NC USA
| | - K. Subramaniam
- Department of Anesthesiology; University of Pittsburgh; Pittsburgh PA USA
| | - W. John Wallisch
- Department of Anesthesiology; University of Pittsburgh; Pittsburgh PA USA
| | - J. H. Levy
- Department of Anesthesiology; Duke University; Durham NC USA
| | - J. H. Waters
- Department of Anesthesiology; University of Pittsburgh; Pittsburgh PA USA
| | - D. J. Triulzi
- Department of Pathology; University of Pittsburgh; Pittsburgh PA USA
| | - J. W. A. Hayanga
- Department of Surgery; University of Pittsburgh; Pittsburgh PA USA
| | - G. J. Schears
- Department of Anesthesiology; Mayo Clinic; Rochester MN USA
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PSGL-1: A New Player in the Immune Checkpoint Landscape. Trends Immunol 2017; 38:323-335. [PMID: 28262471 DOI: 10.1016/j.it.2017.02.002] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/02/2017] [Accepted: 02/08/2017] [Indexed: 02/07/2023]
Abstract
P-selectin glycoprotein ligand-1 (PSGL-1) has long been studied as an adhesion molecule involved in immune cell trafficking and is recognized as a regulator of many facets of immune responses by myeloid cells. PSGL-1 also regulates T cell migration during homeostasis and inflammatory settings. However, recent findings indicate that PSGL-1 can also negatively regulate T cell function. Because T cell differentiation is finely tuned by multiple positive and negative regulatory signals that appropriately scale the magnitude of the immune response, PSGL-1 has emerged as an important checkpoint during this process. We summarize what is known regarding PSGL-1 structure and function and highlight how it may act as an immune checkpoint inhibitor in T cells.
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Affiliation(s)
- Stephen A Esper
- Department of Anesthesiology, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
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78
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Wang CM, Chen YH, Lee YC, Chang JS. Endoplasmic reticulum stress contributes to ferritin molecules-mediated macrophage migration via P-selectin glycoprotein ligand-1. Mol Nutr Food Res 2016; 61. [DOI: 10.1002/mnfr.201600458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 10/26/2016] [Accepted: 10/27/2016] [Indexed: 01/11/2023]
Affiliation(s)
- Chi-Mei Wang
- Department of Nutrition; MacKay Memorial Hospital; Taiwan
| | - Yue-Hwa Chen
- School of Nutrition and Health Sciences; College of Nutrition; Taipei Medical University; Taipei Taiwan
- Nutrition Research Center; Taipei Medical University Hospital; Taipei Taiwan
| | - Yu-Chieh Lee
- Graduate Institute of Medical Sciences; College of Medicine; Taipei Medical University; Taipei Taiwan
| | - Jung-Su Chang
- School of Nutrition and Health Sciences; College of Nutrition; Taipei Medical University; Taipei Taiwan
- Nutrition Research Center; Taipei Medical University Hospital; Taipei Taiwan
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Stähli BE, Gebhard C, Duchatelle V, Cournoyer D, Petroni T, Tanguay JF, Robb S, Mann J, Guertin MC, Wright RS, L L'Allier P, Tardif JC. Effects of the P-Selectin Antagonist Inclacumab on Myocardial Damage After Percutaneous Coronary Intervention According to Timing of Infusion: Insights From the SELECT-ACS Trial. J Am Heart Assoc 2016; 5:e004255. [PMID: 27852589 PMCID: PMC5210344 DOI: 10.1161/jaha.116.004255] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 10/07/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND The Effects of the P-Selectin Antagonist Inclacumab on Myocardial Damage After Percutaneous Coronary Intervention for Non-ST-Segment Elevation Myocardial Infarction (SELECT-ACS) trial suggested beneficial effects of inclacumab, a monoclonal antibody directed against P-selectin, on periprocedural myocardial damage. This study evaluated the effect of inclacumab on myocardial damage according to varying time intervals between study drug infusion and percutaneous coronary intervention (PCI). METHODS AND RESULTS Patients (n=544) enrolled in the SELECT-ACS trial and randomized to receive 1 infusion of placebo or inclacumab (5 or 20 mg/kg, administered between 1 and 24 hours before PCI) were divided according to the time interval between study drug infusion and PCI. The primary end point was the change in troponin I from baseline at 16 and 24 hours after PCI. In patients receiving inclacumab 20 mg/kg with a short (less than median) time interval between infusion and PCI, placebo-adjusted geometric mean percent changes in troponin I, creatine kinase-myocardial band, and peak troponin I at 24 hours were -45.6% (P=0.005), -30.7% (P=0.01), and -37.3% (P=0.02), respectively. No significant changes were observed in patients with a long (greater than median) time interval between infusion and PCI. Placebo-adjusted geometric mean percent changes in troponin I and creatine kinase-myocardial band were -43.5% (P=0.02) and -26.0% (P=0.07), respectively, when inclacumab 20 mg/kg was administered between 1 and 3 hours before PCI, whereas the drug had no effect with longer intervals. CONCLUSIONS Inclacumab 20 mg/kg significantly reduces myocardial damage after PCI in patients with non-ST-segment elevation myocardial infarction, and benefits are larger when the infusion is administered <3 hours before PCI. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT01327183.
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Affiliation(s)
- Barbara E Stähli
- Montreal Heart Institute, Université de Montréal, Montreal, Canada
| | | | | | - Daniel Cournoyer
- Montreal Health Innovations Coordinating Center (MHICC), Montreal, Canada
| | - Thibaut Petroni
- Montreal Heart Institute, Université de Montréal, Montreal, Canada
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Scalise V, Balia C, Cianchetti S, Neri T, Carnicelli V, Zucchi R, Franzini M, Corti A, Paolicchi A, Celi A, Pedrinelli R. Non enzymatic upregulation of tissue factor expression by gamma-glutamyl transferase in human peripheral blood mononuclear cells. Thromb J 2016; 14:45. [PMID: 27822142 PMCID: PMC5096335 DOI: 10.1186/s12959-016-0119-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 10/26/2016] [Indexed: 03/22/2023] Open
Abstract
Background Besides maintaining intracellular glutathione stores, gamma-glutamyltransferase(GGT) generates reactive oxygen species and activates NFkB, a redox-sensitive transcription factor key in the induction of Tissue Factor (TF) gene expression, the principal initiator of the clotting cascade. Thus, GGT might be involved in TF-mediated coagulation processes, an assumption untested insofar. Methods Experiments were run with either equine, enzymatically active GGT or human recombinant (hr) GGT, a wheat germ-derived protein enzymatically inert because of missing post-translational glycosylation. TF Procoagulant Activity (PCA, one-stage clotting assay), TF antigen(ELISA) and TFmRNA(real-time PCR) were assessed in unpooled human peripheral blood mononuclear cell(PBMC) suspensions obtained from healthy donors through discontinuous Ficoll/Hystopaque density gradient. Results Equine GGT increased PCA, an effect insensitive to GGT inhibition by acivicin suggesting mechanisms independent of its enzymatic activity, a possibility confirmed by the maintained stimulation in response to hrGGT, an enzymatically inactive molecule. Endotoxin(LPS) contamination of GGT preparations was excluded by heat inactivation studies and direct determination(LAL method) of LPS concentrations <0.1 ng/mL practically devoid of procoagulant effect. Inhibition by anti-GGT antibodies corroborated that conclusion. Upregulation by hrGGT of TF antigen and mRNA and its downregulation by BAY-11-7082, a NFkB inhibitor, and N-acetyl-L-cysteine, an antioxidant, was consistent with a NFkB-driven, redox-sensitive transcriptional site of action. Conclusions GGT upregulates TF expression independent of its enzymatic activity, a cytokine-like behaviour mediated by NFκB activation, a mechanism contributing to promote acute thrombotic events, a possibility in need, however, of further evaluation.
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Affiliation(s)
- Valentina Scalise
- Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa, Pisa, Italy
| | - Cristina Balia
- Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa, Pisa, Italy
| | - Silvana Cianchetti
- Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa, Pisa, Italy
| | - Tommaso Neri
- Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa, Pisa, Italy
| | - Vittoria Carnicelli
- Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa, Pisa, Italy
| | - Riccardo Zucchi
- Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa, Pisa, Italy
| | - Maria Franzini
- Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie in Medicina e Chirurgia, Università di Pisa, Pisa, Italy
| | - Alessandro Corti
- Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie in Medicina e Chirurgia, Università di Pisa, Pisa, Italy
| | - Aldo Paolicchi
- Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie in Medicina e Chirurgia, Università di Pisa, Pisa, Italy
| | - Alessandro Celi
- Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa, Pisa, Italy
| | - Roberto Pedrinelli
- Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa, Pisa, Italy
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Majumder B, Koganti S, Lowdell M, Rakhit R. Intracoronary platelet and monocyte activation status within platelet-monocyte complexes are determinants of inflammation in ST elevation myocardial infarction1. Clin Hemorheol Microcirc 2016; 64:35-46. [DOI: 10.3233/ch-162040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- B. Majumder
- Department of Cardiology, Royal Free Hospital, London, UK
| | - S. Koganti
- Department of Cardiology, Royal Free Hospital, London, UK
| | - M.W. Lowdell
- Department of Haematology, Royal Free Hospital, London, UK
| | - R.D. Rakhit
- Department of Cardiology, Royal Free Hospital, London, UK
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Effect of intravenous lidocaine on the transcerebral inflammatory response during cardiac surgery: a randomized-controlled trial. Can J Anaesth 2016; 63:1223-32. [PMID: 27470233 DOI: 10.1007/s12630-016-0704-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 06/13/2016] [Accepted: 07/13/2016] [Indexed: 10/21/2022] Open
Abstract
PURPOSE Postoperative cognitive dysfunction (POCD) occurs frequently after cardiac surgery. The pathophysiology of POCD remains elusive, but previous work showed that intravenous lidocaine may be protective against POCD, possibly by modulating cerebral inflammation. We hypothesized that intravenous lidocaine would attenuate the cerebral inflammatory response to cardiopulmonary bypass (CPB) by reducing the transcerebral activation gradients of platelets, leukocytes, and/or platelet-leukocyte conjugates. METHODS We studied 202 patients undergoing cardiac surgery with CPB in this prospective randomized double-blinded placebo-controlled trial. Subjects were randomized to receive either intravenous lidocaine (bolus + 48-hr infusion) or placebo (identical infusion volume and duration). Paired jugular venous and radial arterial blood samples were drawn at several time points and analyzed by fluorescence-activated cell sorting to identify activated platelets and platelet-leukocyte conjugates. Transcerebral activation gradients were calculated by subtracting arterial values from venous values and were compared between groups using repeated measures regression models with covariate adjustment for age, sex, surgery type, and CPB duration. RESULTS Beginning after aortic cross-clamp release and peaking ten minutes after the termination of CPB, the mean (SD) transcerebral activation gradient of platelet-monocyte conjugates decreased in lidocaine-treated vs placebo-treated patients [-1.84 (11.47) mean linear fluorescence intensity (MLFI) vs 1.46 (13.88) MLFI, respectively; mean difference, -4.08 MLFI; 95% confidence interval, -7.86 to -0.29; P = 0.03). No difference was seen at any time point for activated platelets or for platelet-neutrophil conjugates. CONCLUSION While lidocaine did not affect the systemic or transcerebral activation of platelets or leukocytes, we did observe a reduction in the transcerebral activation of platelet-monocyte conjugates after aortic cross-clamp release. This may be a manifestation of reduced cerebral inflammation during cardiopulmonary bypass in response to treatment with lidocaine. This trial was registered at ClinicalTrials.gov (NCT00938964).
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Affiliation(s)
- M. Broussas
- Laboratoire central d'Hématologie, Hôpital Robert Debré, Reims, France
| | | | - G. Potron
- Laboratoire central d'Hématologie, Hôpital Robert Debré, Reims, France
| | - P. Nguyen
- Laboratoire central d'Hématologie, Hôpital Robert Debré, Reims, France
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84
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Ray M, Roychoudhury S, Mukherjee S, Lahiri T. Occupational benzene exposure from vehicular sources in India and its effect on hematology, lymphocyte subsets and platelet P-selectin expression. Toxicol Ind Health 2016; 23:167-75. [DOI: 10.1177/0748233707080907] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Benzene exposure from vehicular sources and its health impact are relatively unexplored in India. We have investigated in this study hematology and lymphocyte subsets of 25 petrol pump attendants, 25 automobile service station workers and 35 controls matched for age, sex and socioeconomic conditions. The participants were non-smoking males of Kolkata (former Calcutta) in eastern India. Compared with controls, the workers had 3.8- times more trans,trans-muconic acid in urine, suggesting higher level of benzene exposure. The exposed subjects had decreased erythrocyte, hemoglobin, lymphocyte and platelet levels, but increased neutrophil, band cells, RBC aniso-poikilocytosis and target cells. In addition, CD4+, CD8+ and CD19+ cells were decreased by 37, 20 and 47% respectively, but CD 16+ 56+ NK cells were increased by 20%. P-selectin expression on platelet surface of the workers was significantly elevated ( P < 0.05), indicating upregulation of platelet activity. In summary, the study revealed high level of benzene exposure from vehicular sources in India, and the exposed subjects had hematological and immunological alterations. Toxicology and Industrial Health 2007; 23: 167—175.
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Affiliation(s)
- M.R. Ray
- Experimental Hematology Unit, Chittaranjan National Cancer Institute, 37, S. P. Mukherjee Road, Kolkata 700 026, India,
| | - S. Roychoudhury
- Department of Neuroendocrinology, Chittaranjan National Cancer Institute, 37, S. P. Mukherjee Road, Kolkata 700 026, India
| | - S. Mukherjee
- Experimental Hematology Unit, Chittaranjan National Cancer Institute, 37, S. P. Mukherjee Road, Kolkata 700 026, India
| | - T. Lahiri
- Department of Neuroendocrinology, Chittaranjan National Cancer Institute, 37, S. P. Mukherjee Road, Kolkata 700 026, India
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Abstract
In recent years, the traditional view of the hemostatic system as being regulated by a coagulation factor cascade coupled with platelet activation has been increasingly challenged by new evidence that activation of the immune system strongly influences blood coagulation and pathological thrombus formation. Leukocytes can be induced to express tissue factor and release proinflammatory and procoagulant molecules such as granular enzymes, cytokines, and damage-associated molecular patterns. These mediators can influence all aspects of thrombus formation, including platelet activation and adhesion, and activation of the intrinsic and extrinsic coagulation pathways. Leukocyte-released procoagulant mediators increase systemic thrombogenicity, and leukocytes are actively recruited to the site of thrombus formation through interactions with platelets and endothelial cell adhesion molecules. Additionally, phagocytic leukocytes are involved in fibrinolysis and thrombus resolution, and can regulate clearance of platelets and coagulation factors. Dysregulated activation of leukocyte innate immune functions thus plays a role in pathological thrombus formation. Modulation of the interactions between leukocytes or leukocyte-derived procoagulant materials and the traditional hemostatic system is an attractive target for the development of novel antithrombotic strategies.
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Vaddi K, Verstovsek S, Kiladjian JJ. Ruxolitinib: a targeted treatment option for patients with polycythemia vera. BLOOD AND LYMPHATIC CANCER-TARGETS AND THERAPY 2016; 6:7-19. [PMID: 31360077 PMCID: PMC6467337 DOI: 10.2147/blctt.s101185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Polycythemia vera (PV) is a chronic myeloproliferative neoplasm characterized by erythrocytosis and the presence of Janus kinase (JAK) 2V617F or similar mutations. This review summarizes the pathophysiology of PV, the challenges associated with traditional treatment options, and the scientific rationale and supportive clinical evidence for targeted therapy with ruxolitinib. Accumulating evidence indicates that activating mutations in JAK2 drive the PV disease state. Traditional PV treatment strategies, including aspirin, phlebotomy, and cytoreductive agents such as hydroxyurea, provide clinical benefits for some but not all patients and may not adequately treat PV-related symptoms. Furthermore, traditional treatment approaches are associated with potential side effects that may limit their usage and lead some patients to discontinue the treatment. Ruxolitinib is an orally available small-molecule tyrosine kinase inhibitor that is a potent and selective inhibitor of JAK1/JAK2. Ruxolitinib is approved in the US for patients with PV with an inadequate response or intolerance to hydroxyurea and in Europe for adults with PV who are resistant to or intolerant of hydroxyurea. In the Phase III RESPONSE registration trial, ruxolitinib was superior to the best available therapy in patients with PV who were resistant to or intolerant of hydroxyurea in controlling hematocrit levels, reducing spleen volume, and improving PV-related symptoms and quality-of-life measures. The most common nonhematologic adverse events in ruxolitinib-treated patients were headache, diarrhea, pruritus, and fatigue in the RESPONSE trial; hematologic adverse events were primarily grade 1 or 2. In the Phase IIIb nonregistration RELIEF trial, there were nonsignificant trends toward an improved symptom control in patients with PV on a stable hydroxyurea dose who were generally well controlled but reported disease-associated symptoms and switched to ruxolitinib vs those who continued hydroxyurea therapy. Updated treatment guidelines will be important for educating physicians about the role of ruxolitinib in the treatment of patients with PV.
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Affiliation(s)
- Kris Vaddi
- Drug Discovery, Incyte Corporation, Wilmington, DE,
| | - Srdan Verstovsek
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jean-Jacques Kiladjian
- Clinical Investigations Center, Hôpital Saint-Louis et Université Paris Diderot, Paris, France
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Balia C, Scalise V, Cianchetti S, Faita F, Neri T, Carnicelli V, Zucchi R, Celi A, Pedrinelli R. The effect of high glucose on the inhibitory action of C21, a selective AT2R agonist, of LPS-stimulated tissue factor expression in human mononuclear cells. JOURNAL OF INFLAMMATION-LONDON 2016; 13:14. [PMID: 27152091 PMCID: PMC4857424 DOI: 10.1186/s12950-016-0123-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 04/28/2016] [Indexed: 12/17/2022]
Abstract
Background Intimate links connect tissue factor (TF), the principal initiator of the clotting cascade, to inflammation, a cross-talk amplified by locally generated Angiotensin (AT) II, the effector arm of the Renin Angiotensin System (RAS). C21, a selective AT2R agonist, downregulates the transcriptional expression of TF in LPS-activated peripheral blood mononuclear cell(PBMC)s implying the existence of ATII type 2 receptor (AT2R)s whose stimulation attenuates inflammation-mediated procoagulant responses. High glucose, by activating key signalling pathways and increasing the cellular content of RAS components, augments TF expression and potentiates the inhibitory effect of AT1R antagonists. It is unknown, however, the impact of that stimulus on AT2R-mediated TF inhibition, an information useful to understand more precisely the role of that signal transduction pathway in the inflammation-mediated coagulation process. TF antigen (ELISA), procoagulant activity (PCA, 1-stage clotting assay) and TF-mRNA (real-time polymerase chain reaction) were assessed in PBMCs activated by LPS, a pro-inflammatory and procoagulant stimulus, exposed to either normal (N) or HG concentrations (5.5 and 50 mM respectively). Results HG upregulated TF expression, an effect abolished by BAY 11-7082, a NFκB inhibitor. C21 inhibited LPS-stimulated PCA, TFAg and mRNA to an extent independent of glucose concentration but the response to Olmesartan, an AT1R antagonist, was quite evidently potentiated by HG. Conclusions HG stimulates LPS-induced TF expression through mechanisms completely dependent upon NFkB activation. Both AT2R-stimulation and AT1R-blockade downregulate inflammation-mediated procoagulant response in PBMCs but HG impacts differently on the two different signal transduction pathways.
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Affiliation(s)
- Cristina Balia
- Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa, Lungarno Pacinotti 43, 56126 Pisa, Italy
| | - Valentina Scalise
- Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa, Lungarno Pacinotti 43, 56126 Pisa, Italy
| | - Silvana Cianchetti
- Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa, Lungarno Pacinotti 43, 56126 Pisa, Italy
| | - Francesca Faita
- Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa, Lungarno Pacinotti 43, 56126 Pisa, Italy
| | - Tommaso Neri
- Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa, Lungarno Pacinotti 43, 56126 Pisa, Italy
| | - Vittoria Carnicelli
- Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa, Lungarno Pacinotti 43, 56126 Pisa, Italy
| | - Riccardo Zucchi
- Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa, Lungarno Pacinotti 43, 56126 Pisa, Italy
| | - Alessandro Celi
- Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa, Lungarno Pacinotti 43, 56126 Pisa, Italy
| | - Roberto Pedrinelli
- Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa, Lungarno Pacinotti 43, 56126 Pisa, Italy
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Jacobs B, Obi A, Wakefield T. Diagnostic biomarkers in venous thromboembolic disease. J Vasc Surg Venous Lymphat Disord 2016; 4:508-17. [PMID: 27639008 DOI: 10.1016/j.jvsv.2016.02.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 02/29/2016] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Venous thromboembolism (VTE) is a common disease with serious, often fatal sequelae. The optimal strategy for diagnosis of VTE remains unclear, although considerable progress has been made in this area. Several new biomarkers have showed promise for diagnosis of VTE, and more are under active investigation. We reviewed the literature for studies evaluating these diagnostic biomarkers. METHODS We reviewed the English literature between 1990 and 2015, searching for papers evaluating diagnostic performance of biomarkers in VTE. RESULTS D-dimer, a fibrin degradation product, has been thoroughly investigated, and performs well in select populations, although it is best as a rule-out test because of its generally low specificity. Soluble P-selectin, a marker of endothelial activation, has shown good diagnostic performance in several studies but has not yet been adopted widely. Others, including cellular adhesion molecules, tissue factor, circulating microparticles, and C-reactive protein, are under investigation, with varying results in a few studies. CONCLUSIONS At this time, D-dimer and P-selectin remain the most clinically valuable. New biomarkers are needed for clinical use in VTE.
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Affiliation(s)
- Benjamin Jacobs
- Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, Mich.
| | - Andrea Obi
- Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, Mich
| | - Thomas Wakefield
- Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, Mich
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Blatt AZ, Saggu G, Kulkarni KV, Cortes C, Thurman JM, Ricklin D, Lambris JD, Valenzuela JG, Ferreira VP. Properdin-Mediated C5a Production Enhances Stable Binding of Platelets to Granulocytes in Human Whole Blood. THE JOURNAL OF IMMUNOLOGY 2016; 196:4671-4680. [PMID: 27183616 DOI: 10.4049/jimmunol.1600040] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 03/28/2016] [Indexed: 12/11/2022]
Abstract
Enhanced levels of platelet/granulocyte aggregates (PGAs) are found in patients suffering from many different inflammatory vascular diseases, and their formation in animal models of vascular disease is associated with increased thromboinflammation and worsened outcomes. The complement system, a part of the innate immune system, influences PGA formation, but the mechanisms for its effects are unknown. In this study, we have defined complement-mediated mechanisms that enhance PGA formation in human whole blood stimulated with thrombin receptor-activating peptide (TRAP) using ex vivo flow cytometry assays. We demonstrate that physiological properdin, a positive regulator of complement alternative pathway activity, increases PGA formation when added to TRAP-stimulated blood. All physiological properdin forms increase PGA formation, but properdin tetramers are the most efficient at increasing complement activity and PGA formation. Inhibition of endogenous properdin, either circulating in the blood or produced locally by leukocytes, impairs TRAP-mediated PGA formation to the same level as specific inhibition of either the alternative or classical pathway. Additionally, blocking the interaction of C5a with its cellular receptor prevents properdin-mediated increases in PGA formation. Adding either properdin tetramers or C5a to whole blood increases CD11b expression on granulocytes, and this increase is prevented by blockade of the C5a-C5a receptor axis. Finally, we demonstrate that the effects of properdin on PGA formation are tightly regulated by Factor H. Cumulatively, our data indicate that properdin enhances PGA formation via increased production of C5a, and that inhibition of properdin function has therapeutic potential to limit thromboinflammation in diseases characterized by increased PGA formation.
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Affiliation(s)
- Adam Z Blatt
- Department of Medical Microbiology and Immunology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Gurpanna Saggu
- Department of Medical Microbiology and Immunology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Koustubh V Kulkarni
- Department of Medical Microbiology and Immunology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Claudio Cortes
- Department of Biomedical Sciences, Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - Joshua M Thurman
- Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Daniel Ricklin
- Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - John D Lambris
- Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jesus G Valenzuela
- Vector Molecular Biology Section, LMVR, National Institute of Allergy and Infectious Diseases, NIH, Rockville, Maryland
| | - Viviana P Ferreira
- Department of Medical Microbiology and Immunology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
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Ketter P, Yu JJ, Cap AP, Forsthuber T, Arulanandam B. Pentraxin 3: an immune modulator of infection and useful marker for disease severity assessment in sepsis. Expert Rev Clin Immunol 2016; 12:501-7. [PMID: 26982005 DOI: 10.1586/1744666x.2016.1166957] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The acute phase protein pentraxin 3 (PTX3) is a pattern recognition receptor involved in regulation of the host immune response. This relatively newly discovered member of the pentraxin superfamily elicits both immunostimulatory and immunoregulatory functions preventing autoimmune pathology and orchestrated clearance of pathogens through opsonization of damage- and pathogen-associated molecular patterns (DAMP/PAMP). Thus, PTX3 has been described as a possible evolutionary precursor to immunoglobulins. While shown to provide protection against specific bacterial and fungal pathogens, persistent elevation of PTX3 levels following initial onset of infection appear to predict poor patient outcome and may contribute to disease sequelae such as tissue damage and coagulopathy. Measurement of PTX3 following onset of sepsis may improve patient risk assessment and thus be useful in guiding subsequent therapeutic interventions including steroidal anti-inflammatory and altered antibiotic therapies. In this review, we summarize the role of PTX3 in inflammatory syndromes and its utility as a marker of sepsis disease severity.
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Affiliation(s)
- Patrick Ketter
- a Blood and Coagulation Program , United States Army Institute of Surgical Research , JBSA-Fort Sam Houston , TX , USA
| | - Jieh-Juen Yu
- b Department of Biology , University of Texas at San Antonio , San Antonio , TX , USA
| | - Andrew P Cap
- a Blood and Coagulation Program , United States Army Institute of Surgical Research , JBSA-Fort Sam Houston , TX , USA
| | - Thomas Forsthuber
- b Department of Biology , University of Texas at San Antonio , San Antonio , TX , USA
| | - Bernard Arulanandam
- b Department of Biology , University of Texas at San Antonio , San Antonio , TX , USA
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Petrini S, Neri T, Lombardi S, Cordazzo C, Balìa C, Scalise V, Paggiaro P, Pedrinelli R, Celi A. Leptin induces the generation of procoagulant, tissue factor bearing microparticles by human peripheral blood mononuclear cells. Biochim Biophys Acta Gen Subj 2016; 1860:1354-61. [PMID: 27015759 DOI: 10.1016/j.bbagen.2016.03.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 03/20/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Obesity is linked to increased thrombotic risk. Circulating leptin concentration correlates with body mass index. Microparticles are small (.05-1 μm) vesicles shed by activated and apoptotic cells, involved in numerous pathophysiologically relevant phenomena including blood coagulation and thrombosis. We tested the hypothesis that leptin induces the shedding of procoagulant, tissue factor bearing microparticles by human peripheral blood mononuclear cells, and investigated the intracellular mechanisms leading to microparticle release upon incubation with leptin. METHODS Peripheral blood mononuclear cells were isolated from healthy donors. Cells were incubated with leptin in the presence or in the absence of a phospholipase C inhibitor, U73122, a calmodulin inhibitor, W-7, and three inhibitors of mitogen activated protein kinases. Microparticle generation was assessed as phosphatidylserine concentration with a prothrombinase assay and by cytofluorimetric analysis. Tissue factor expression on microparticles was measured with a one-stage clotting assay. Intracellular calcium concentration was assessed by a fluorescent probe. RESULTS Leptin increased intracellular calcium mobilization and stimulated the generation of tissue factor-bearing MP by peripheral blood mononuclear cells, as assessed by phosphatidylserine quantification, clotting tests and flow-cytometry. U73122, PD98059 (an extracellular signal-regulated kinase1/2 inhibitor), and W-7, significantly inhibited leptin-induced MP release. SB203580 (a p38 inhibitor), and SP600125 (a c-Jun N-terminal kinase inhibitor) had no effect. CONCLUSION Leptin-induced generation of procoagulant microparticles might represent a link between obesity and atherothrombotic risk. Inhibition of leptin-induced microparticle generation might prove a viable strategy for the reduction of such risk in obese individuals.
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Affiliation(s)
- Silvia Petrini
- Laboratorio di Biologia Cellulare Respiratoria, Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa and Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Tommaso Neri
- Laboratorio di Biologia Cellulare Respiratoria, Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa and Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Stefania Lombardi
- SSD Analisi ChimicoCliniche ed ImmunoAllergologia, USL 1, Massa e Carrara, Italy
| | - Cinzia Cordazzo
- Laboratorio di Biologia Cellulare Respiratoria, Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa and Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Cristina Balìa
- Laboratorio di Biologia Cellulare Respiratoria, Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa and Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Valentina Scalise
- Laboratorio di Biologia Cellulare Respiratoria, Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa and Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Pierluigi Paggiaro
- Laboratorio di Biologia Cellulare Respiratoria, Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa and Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Roberto Pedrinelli
- Laboratorio di Biologia Cellulare Respiratoria, Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa and Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Alessandro Celi
- Laboratorio di Biologia Cellulare Respiratoria, Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa and Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
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Thawley VJ, Sánchez MD, Drobatz KJ, King LG. Retrospective comparison of thromboelastography results to postmortem evidence of thrombosis in critically ill dogs: 39 cases (2005-2010). J Vet Emerg Crit Care (San Antonio) 2016; 26:428-36. [PMID: 26749078 DOI: 10.1111/vec.12441] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 06/14/2014] [Accepted: 08/06/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To determine whether there is an association between thromboelastography (TEG) data and necropsy evidence of thrombosis in a cohort of critically ill dogs. DESIGN Retrospective study (2005-2010). SETTING University teaching hospital. ANIMALS Thirty-nine client-owned critically ill dogs for which TEG was performed within 7 days of complete necropsy. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Thrombi were found in 26 (67%) dogs. Spayed females (n = 20) were significantly more likely to have thrombosis (P = 0.0127). No significant association was found between presence of thrombosis and any TEG parameter, the calculated coagulation index, results of coagulation testing, type of vascular access, or clinical diagnosis. D-dimers were significantly higher in dogs with thrombosis (P = 0.0207) and a weak positive correlation was found between D-dimer value and number of sites of thrombosis (ρ = 0.18, P = 0.0045). Dogs with WBC > 16 × 10(3) /μL were more likely to have thrombosis compared to others (odds ratio 5.56, 95% confidence interval 1.2-25.7, P = 0.025). CONCLUSIONS This study found no association between any TEG parameter and the presence of thrombosis on postmortem examination.
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Affiliation(s)
- Vincent J Thawley
- Section of Critical Care, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, 19104
| | - Melissa D Sánchez
- Department of Clinical Studies - Philadelphia, and the Laboratory of Pathology and Toxicology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, 19104
| | - Kenneth J Drobatz
- Section of Critical Care, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, 19104
| | - Lesley G King
- Section of Critical Care, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, 19104
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Totani L, Amore C, Di Santo A, Dell'Elba G, Piccoli A, Martelli N, Tenor H, Beume R, Evangelista V. Roflumilast inhibits leukocyte-platelet interactions and prevents the prothrombotic functions of polymorphonuclear leukocytes and monocytes. J Thromb Haemost 2016; 14:191-204. [PMID: 26484898 DOI: 10.1111/jth.13173] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 10/04/2015] [Indexed: 12/12/2022]
Abstract
UNLABELLED ESSENTIALS: Thrombosis is a major comorbidity in patients with chronic obstructive pulmonary disease (COPD). Roflumilast is a selective phosphodiesterase type-4 (PDE4) inhibitor approved for treatment of severe COPD. PDE4 blockade by roflumilast inhibits prothrombotic functions of neutrophils and monocytes. PDE4 inhibitors may reduce thrombotic risk in COPD as well as in other vascular diseases. BACKGROUND Roflumilast, an oral selective phosphodiesterase type 4 inhibitor, is approved for the treatment of severe chronic obstructive pulmonary disease (COPD). A recent meta-analysis of trials on COPD revealed that treatment with roflumilast was associated with a significant reduction in the rate of major cardiovascular events. The mechanisms of this effect remain unknown. OBJECTIVES We tested the hypothesis that roflumilast N-oxide (RNO), the active metabolite of roflumilast, curbs the molecular mechanisms required for leukocyte-platelet (PLT) interactions and prevents the prothrombotic functions of polymorphonuclear leukocytes (PMNs) and monocytes (MNs). METHODS Using well-characterized in vitro models, we analysed the effects of RNO on: (i) PMN adhesiveness; (ii) the release of neutrophil extracellular traps (NETs); and (iii) tissue factor expression in MNs. Key biochemical events underlying the inhibitory effects of RNO were defined. RESULTS AND CONCLUSIONS In PMNs, RNO prevented phosphoinositide 3-kinase (PI3K)-dependent phosphorylation of Akt on Ser473, and Src family kinase (SFK)-mediated Pyk2 phosphorylation on Tyr579-580, while inducing protein kinase A-mediated phosphorylation of C-terminal Src kinase, the major negative regulator of SFKs. Modulation of these signaling pathways by RNO resulted in a significant impairment of PMN adhesion to activated PLTs or human umbilical vein endothelial cells, mainly mediated by inhibition of the adhesive function of Mac-1. Moreover RNO curbed SFK/PI3K-mediated NET release by PMNs adherent on fibrinogen-coated surfaces. In MNs interacting with activated PLTs, RNO curbed PI3K-mediated expression of tissue factor. The efficacy of RNO was significantly potentiated by formoterol, a long acting β-adrenergic receptor agonist. This study reveals novel antithrombotic activities by which roflumilast may exert protective effects against cardiovascular comorbodities in COPD.
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Affiliation(s)
- L Totani
- Laboratory of Vascular Biology and Pharmacology, Fondazione Mario Negri Sud, Santa Maria Imbaro, Italy
| | - C Amore
- Laboratory of Vascular Biology and Pharmacology, Fondazione Mario Negri Sud, Santa Maria Imbaro, Italy
| | - A Di Santo
- Laboratory of Vascular Biology and Pharmacology, Fondazione Mario Negri Sud, Santa Maria Imbaro, Italy
| | - G Dell'Elba
- Laboratory of Vascular Biology and Pharmacology, Fondazione Mario Negri Sud, Santa Maria Imbaro, Italy
| | - A Piccoli
- Laboratory of Vascular Biology and Pharmacology, Fondazione Mario Negri Sud, Santa Maria Imbaro, Italy
| | - N Martelli
- Laboratory of Vascular Biology and Pharmacology, Fondazione Mario Negri Sud, Santa Maria Imbaro, Italy
| | - H Tenor
- Takeda Pharmaceuticals International GmbH, Glattpark-Opfikon, Switzerland
| | - R Beume
- Takeda Pharmaceuticals International GmbH, Glattpark-Opfikon, Switzerland
| | - V Evangelista
- Laboratory of Vascular Biology and Pharmacology, Fondazione Mario Negri Sud, Santa Maria Imbaro, Italy
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94
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Christersson C, Lindahl B, Siegbahn A. The composition and daily variation of microparticles in whole blood in stable coronary artery disease. Scandinavian Journal of Clinical and Laboratory Investigation 2015; 76:25-32. [PMID: 26405844 DOI: 10.3109/00365513.2015.1086928] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The knowledge of circadian variation of microparticles (MPs) in stable coronary artery disease (SCAD) is limited. The aim of this study was to evaluate the daily variation of platelet-, endothelial- and monocyte-derived MPs in whole blood and their tissue factor expression (TF) in SCAD and whether these MPs were related to other endothelial and coagulation markers. MATERIALS AND METHODS Serial blood samples from patients with SCAD were collected during one day. Flow cytometry was used to evaluate the amount of large MPs 0.5-1.0 μm, positive for annexin, and their expression of CD41, CD62P, CD144, CD14 and TF. The lag time and endogenous thrombin potential (ETP) was calculated by Calibrated Automated Thrombogram and soluble (s)P-selectin, sTF and vWF by ELISA. RESULTS The majority of MPs in whole blood consisted of CD41 + MPs with no significant daily variation. In contrast, the concentration of CD62P + MPs described a daily variation with the lowest concentrations found in the evening (p = 0.031). CD62P + and CD144 + MPs had the highest expression of TF, 52.6% and 42.9%, respectively, and correlated to the endothelial activity evaluated by vWF. There was a circadian rhythm of lag time (p < 0.001) and ETP (p = 0.001). The CD62P+, CD14 + and CD144 + MPs correlated to the lag time. CONCLUSION The different subsets of platelet-, endothelial- and monocyte-derived MPs do not present the same circadian variation and they differ in TF expression in SCAD. The MPs from activated platelets, endothelial cells and monocytes exist in low concentrations in whole blood but are related to the endothelial and coagulation activity found in SCAD.
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Affiliation(s)
| | - Bertil Lindahl
- a Department of Medical Sciences , Cardiology, Uppsala University , Uppsala , Sweden.,b Department of Medical Sciences , Uppsala Clinical Research Center (UCR), Uppsala University , Uppsala , Sweden
| | - Agneta Siegbahn
- c Department of Medical Sciences , Clinical Chemistry, Uppsala University , Uppsala , Sweden
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95
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Goddard A, Leisewitz AL, Kristensen AT, Schoeman JP. Platelet activation and platelet–leukocyte interaction in dogs naturally infected with Babesia rossi. Vet J 2015; 205:387-92. [DOI: 10.1016/j.tvjl.2015.05.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 05/01/2015] [Accepted: 05/17/2015] [Indexed: 12/01/2022]
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96
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Speth C, Rambach G, Würzner R, Lass-Flörl C, Kozarcanin H, Hamad OA, Nilsson B, Ekdahl KN. Complement and platelets: Mutual interference in the immune network. Mol Immunol 2015; 67:108-18. [DOI: 10.1016/j.molimm.2015.03.244] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 03/16/2015] [Accepted: 03/16/2015] [Indexed: 11/28/2022]
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97
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Malaponte G, Signorelli SS, Bevelacqua V, Polesel J, Taborelli M, Guarneri C, Fenga C, Umezawa K, Libra M. Increased Levels of NF-kB-Dependent Markers in Cancer-Associated Deep Venous Thrombosis. PLoS One 2015; 10:e0132496. [PMID: 26192925 PMCID: PMC4507873 DOI: 10.1371/journal.pone.0132496] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 06/15/2015] [Indexed: 12/17/2022] Open
Abstract
Several studies highlight the role of inflammatory markers in thrombosis as well as in cancer. However, their combined role in cancer-associated deep vein thrombosis (DVT) and the molecular mechanisms, involved in its pathophysiology, needs further investigations. In the present study, C-reactive protein, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1β), matrix metalloproteases-9 (MMP-9), vascular endothelial growth factor (VEGF), tissue factor (TF), fibrinogen and soluble P-selectin, were analyzed in plasma and in monocyte samples from 385 cancer patients, of whom 64 were concomitantly affected by DVT (+). All these markers were higher in cancer patients DVT+ than in those DVT-. Accordingly, significantly higher NF-kB activity was observed in cancer patients DVT+ than DVT-. Significant correlation between data obtained in plasma and monocyte samples was observed. NF-kB inhibition was associated with decreased levels of all molecules in both cancer DVT+ and DVT-. To further demonstrate the involvement of NF-kB activation by the above mentioned molecules, we treated monocyte derived from healthy donors with a pool of sera from cancer patients with and without DVT. These set of experiments further suggest the significant role played by some molecules, regulated by NF-kB, and detected in cancer patients with DVT. Our data support the notion that NF-kB may be considered as a therapeutic target for cancer patients, especially those complicated by DVT. Treatment with NF-kB inhibitors may represent a possible strategy to prevent or reduce the risk of DVT in cancer patients.
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Affiliation(s)
- Grazia Malaponte
- Department of Biomedical and Biotechnological Sciences, Section of General & Clinical Pathology and Oncology, University of Catania, Catania, Italy
| | - Salvatore S. Signorelli
- Department of Clinical and Experimental Medicine, University of Catania, Medical Angiology Unit, Garibaldi Hospital, Catania, Italy
- * E-mail:
| | - Valentina Bevelacqua
- Department of Biomedical and Biotechnological Sciences, Section of General & Clinical Pathology and Oncology, University of Catania, Catania, Italy
| | - Jerry Polesel
- Epidemiology and Biostatistics Unit, Centro di Riferimento Oncologico-National Cancer Institute, Aviano, Italy
| | - Martina Taborelli
- Epidemiology and Biostatistics Unit, Centro di Riferimento Oncologico-National Cancer Institute, Aviano, Italy
| | - Claudio Guarneri
- Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, Messina, Italy
| | - Concettina Fenga
- Department of Environmental and Health Sciences (S.A.S.T.A.S.), University of Messina, Messina, Italy
| | - Kazou Umezawa
- Department of Molecular Target Medicine Screening, Aichi Medical University, Nagakute, Japan
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, Section of General & Clinical Pathology and Oncology, University of Catania, Catania, Italy
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Compound 21, a selective angiotensin II type 2 receptor agonist, downregulates lipopolysaccharide-stimulated tissue factor expression in human peripheral blood mononuclear cells. Blood Coagul Fibrinolysis 2015; 25:501-6. [PMID: 24914880 DOI: 10.1097/mbc.0000000000000092] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Intricate interrelationships connect tissue factor (TF), the principal initiator of the clotting cascade, to inflammation, a cross-talk amplified by locally active angiotensin II, a proinflammatory agent with direct TF-stimulating properties mediated by the angiotensin II type 1 receptor (AT1R)s. However, angiotensin II also stimulates angiotensin II type 2 receptor (AT2R)s and they may as well contribute to TF expression, a possibility in need of further evaluation. We investigated the effect of C21, a highly specific AT2R agonist, on TF antigen (ELISA), procoagulant activity (PCA, one-stage clotting assay) and TF-mRNA (real-time PCR) in peripheral blood mononuclear cell (PBMC)s activated by lipopolysaccharide (LPS), a pro-inflammatory and procoagulant stimulus. C21 downregulated LPS-stimulated TF antigen, PCA and TF mRNA, an effect abolished by PD123 319, a selective AT2R antagonist, and left unchanged by omesartan, a selective AT1R antagonist. PD123 319 per se did not affect LPS-induced TF expression while omesartan inhibited and BAY 11-7082, a specific NFκB inhibitor, abolished endotoxin-activated procoagulant activity (PCA). C21, a selective AT2R agonist, downregulates the transcriptional expression of TF in LPS-activated PBMCs, a finding consistent with the existence in PBMCs of AT2Rs whose stimulation attenuates inflammation-mediated procoagulant responses. The data open insofar unexplored and potentially relevant facets to our understanding of the complex links connecting angiotensin II to inflammation and coagulation.
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99
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Iacoviello L, Di Castelnuovo A, de Curtis A, Agnoli C, Frasca G, Mattiello A, Matullo G, Ricceri F, Sacerdote C, Grioni S, Tumino R, Napoleone E, Lorenzet R, de Gaetano G, Panico S, Donati MB. Circulating Tissue Factor Levels and Risk of Stroke. Stroke 2015; 46:1501-7. [DOI: 10.1161/strokeaha.115.008678] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Accepted: 04/03/2015] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
Tissue factor (TF) expression is increased in inflammatory atherosclerotic plaques and has been related to their thrombogenicity. Blood-borne TF has been also demonstrated to contribute to thrombogenesis. However, few studies have evaluated the association of circulating levels of TF with stroke. We investigated the association of baseline circulating levels of TF with stroke events occurred in the European Prospective Investigation into Cancer and Nutrition-Italy cohort.
Methods—
Using a nested case–cohort design, a center-stratified random sample of 839 subjects (66% women; age range, 35–71 years) was selected as subcohort and compared with 292 strokes in a mean follow-up of 9 years. Blood samples were collected at baseline in citrate, plasma was stored in liquid nitrogen and TF was measured by ELISA (IMUBIND, TF ELISA, Instrumentation Laboratory, Milan, Italy). The odd ratios and 95% confidence intervals, adjusted by relevant confounders (covariates of TF) and stratified by center, were estimated by a Cox regression model using Prentice method.
Results—
Individuals in the highest compared with the lowest quartile of TF plasma levels had significantly increased risk of stroke (odds ratio
IVvsI quartile
, 2.01; 95% confidence interval, 1.25–3.23). The association was independent from several potential confounders (odds ratio
IVvsI quartile
, 1.91; 95% confidence interval, 1.15–3.19). No differences were observed between men and women. The increase in risk was restricted to ischemic strokes (odds ratio
IVvsI quartile
, 2.13; 95% confidence interval, 1.10–4.12; fully adjusted model), whereas high levels of TF were not associated with the risk of hemorrhagic stroke (odds ratio
IVvsI quartile
, 1.12; 95% confidence interval, 0.49–2.55; fully adjusted model).
Conclusions—
Our data provide evidence that elevated levels of circulating TF are potential risk factors for ischemic strokes.
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Affiliation(s)
- Licia Iacoviello
- From the Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy (L.I., A.D.C., A.d.C., G.d.G., M.B.D.); Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy (C.A., S.G.); Cancer Registry ASP, Ragusa, Italy (G.F., R.T.); Dipartimento di Medicina Clinica e Chirurgia, University of Naples “Federico II”, Napoli, Italy (A.M., S.P.); Department of
| | - Augusto Di Castelnuovo
- From the Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy (L.I., A.D.C., A.d.C., G.d.G., M.B.D.); Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy (C.A., S.G.); Cancer Registry ASP, Ragusa, Italy (G.F., R.T.); Dipartimento di Medicina Clinica e Chirurgia, University of Naples “Federico II”, Napoli, Italy (A.M., S.P.); Department of
| | - Amalia de Curtis
- From the Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy (L.I., A.D.C., A.d.C., G.d.G., M.B.D.); Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy (C.A., S.G.); Cancer Registry ASP, Ragusa, Italy (G.F., R.T.); Dipartimento di Medicina Clinica e Chirurgia, University of Naples “Federico II”, Napoli, Italy (A.M., S.P.); Department of
| | - Claudia Agnoli
- From the Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy (L.I., A.D.C., A.d.C., G.d.G., M.B.D.); Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy (C.A., S.G.); Cancer Registry ASP, Ragusa, Italy (G.F., R.T.); Dipartimento di Medicina Clinica e Chirurgia, University of Naples “Federico II”, Napoli, Italy (A.M., S.P.); Department of
| | - Graziella Frasca
- From the Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy (L.I., A.D.C., A.d.C., G.d.G., M.B.D.); Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy (C.A., S.G.); Cancer Registry ASP, Ragusa, Italy (G.F., R.T.); Dipartimento di Medicina Clinica e Chirurgia, University of Naples “Federico II”, Napoli, Italy (A.M., S.P.); Department of
| | - Amalia Mattiello
- From the Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy (L.I., A.D.C., A.d.C., G.d.G., M.B.D.); Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy (C.A., S.G.); Cancer Registry ASP, Ragusa, Italy (G.F., R.T.); Dipartimento di Medicina Clinica e Chirurgia, University of Naples “Federico II”, Napoli, Italy (A.M., S.P.); Department of
| | - Giuseppe Matullo
- From the Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy (L.I., A.D.C., A.d.C., G.d.G., M.B.D.); Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy (C.A., S.G.); Cancer Registry ASP, Ragusa, Italy (G.F., R.T.); Dipartimento di Medicina Clinica e Chirurgia, University of Naples “Federico II”, Napoli, Italy (A.M., S.P.); Department of
| | - Fulvio Ricceri
- From the Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy (L.I., A.D.C., A.d.C., G.d.G., M.B.D.); Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy (C.A., S.G.); Cancer Registry ASP, Ragusa, Italy (G.F., R.T.); Dipartimento di Medicina Clinica e Chirurgia, University of Naples “Federico II”, Napoli, Italy (A.M., S.P.); Department of
| | - Carlotta Sacerdote
- From the Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy (L.I., A.D.C., A.d.C., G.d.G., M.B.D.); Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy (C.A., S.G.); Cancer Registry ASP, Ragusa, Italy (G.F., R.T.); Dipartimento di Medicina Clinica e Chirurgia, University of Naples “Federico II”, Napoli, Italy (A.M., S.P.); Department of
| | - Sara Grioni
- From the Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy (L.I., A.D.C., A.d.C., G.d.G., M.B.D.); Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy (C.A., S.G.); Cancer Registry ASP, Ragusa, Italy (G.F., R.T.); Dipartimento di Medicina Clinica e Chirurgia, University of Naples “Federico II”, Napoli, Italy (A.M., S.P.); Department of
| | - Rosario Tumino
- From the Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy (L.I., A.D.C., A.d.C., G.d.G., M.B.D.); Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy (C.A., S.G.); Cancer Registry ASP, Ragusa, Italy (G.F., R.T.); Dipartimento di Medicina Clinica e Chirurgia, University of Naples “Federico II”, Napoli, Italy (A.M., S.P.); Department of
| | - Emanuela Napoleone
- From the Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy (L.I., A.D.C., A.d.C., G.d.G., M.B.D.); Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy (C.A., S.G.); Cancer Registry ASP, Ragusa, Italy (G.F., R.T.); Dipartimento di Medicina Clinica e Chirurgia, University of Naples “Federico II”, Napoli, Italy (A.M., S.P.); Department of
| | - Roberto Lorenzet
- From the Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy (L.I., A.D.C., A.d.C., G.d.G., M.B.D.); Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy (C.A., S.G.); Cancer Registry ASP, Ragusa, Italy (G.F., R.T.); Dipartimento di Medicina Clinica e Chirurgia, University of Naples “Federico II”, Napoli, Italy (A.M., S.P.); Department of
| | - Giovanni de Gaetano
- From the Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy (L.I., A.D.C., A.d.C., G.d.G., M.B.D.); Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy (C.A., S.G.); Cancer Registry ASP, Ragusa, Italy (G.F., R.T.); Dipartimento di Medicina Clinica e Chirurgia, University of Naples “Federico II”, Napoli, Italy (A.M., S.P.); Department of
| | - Salvatore Panico
- From the Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy (L.I., A.D.C., A.d.C., G.d.G., M.B.D.); Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy (C.A., S.G.); Cancer Registry ASP, Ragusa, Italy (G.F., R.T.); Dipartimento di Medicina Clinica e Chirurgia, University of Naples “Federico II”, Napoli, Italy (A.M., S.P.); Department of
| | - Maria Benedetta Donati
- From the Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy (L.I., A.D.C., A.d.C., G.d.G., M.B.D.); Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy (C.A., S.G.); Cancer Registry ASP, Ragusa, Italy (G.F., R.T.); Dipartimento di Medicina Clinica e Chirurgia, University of Naples “Federico II”, Napoli, Italy (A.M., S.P.); Department of
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100
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Diaz JA, Wrobleski SK, Alvarado CM, Hawley AE, Doornbos NK, Lester PA, Lowe SE, Gabriel JE, Roelofs KJ, Henke PK, Schaub RG, Wakefield TW, Myers DD. P-selectin inhibition therapeutically promotes thrombus resolution and prevents vein wall fibrosis better than enoxaparin and an inhibitor to von Willebrand factor. Arterioscler Thromb Vasc Biol 2015; 35:829-37. [PMID: 25657307 DOI: 10.1161/atvbaha.114.304457] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Aptamers are oligonucleotides targeting protein-protein interactions with pharmacokinetic profiles and activity reversal options. Although P-selectin and von Willebrand factor (vWF) have been implicated in the development of venous thrombosis (VT), no studies have directly compared aptamer efficacy with standard of care in VT. In this study, ARC5692, an anti-P-selectin aptamer, and ARC15105, an anti-vWF aptamer, were compared with low-molecular-weight heparin, enoxaparin, to test the efficacy of P-selectin or vWF inhibition in promoting thrombus resolution and preventing vein wall fibrosis, in a baboon model of VT. APPROACH AND RESULTS Groups were as follows: treatment arm: animals received P-selectin or vWF aptamer inhibitors or enoxaparin (n=3 per group). Controls received no treatment (n=3). Prophylactic arm: animals received P-selectin inhibitor (n=4) or vWF inhibitor (n=3). Treatment arm: P-selectin-inhibitor demonstrated a significant improvement in vein recanalization by magnetic resonance venography (73% at day 21), and significantly decreased vein wall collagen, compared with all groups. Anti-P-selectin equaled enoxaparin in maintaining valve competency by ultrasound. All control animals had compromised valve competency post thrombosis. Prophylactic arm: animals receiving P-selectin and vWF inhibitors demonstrated improved vein recanalization by magnetic resonance venography versus controls (80% and 85%, respectively, at day 21). Anti-P-selectin protected iliac valve function better than anti-vWF, and both improved valve function versus controls. No adverse bleeding events were observed. CONCLUSIONS The P-selectin inhibitor aptamer promoted iliac vein recanalization, preserved valve competency, and decreased vein wall fibrosis. The results of this work suggest that P-selectin inhibition maybe an ideal target in the treatment and prophylaxis of deep VT, warranting clinical trials.
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Affiliation(s)
- Jose A Diaz
- From the Section of Vascular Surgery, Department of Surgery, Conrad Jobst Vascular Research Laboratories (J.A.D., S.K.W., C.M.A., A.E.H., N.K.D., J.E.G., K.J.R., P.K.H., T.W.W., D.D.M.), Unit for Laboratory Animal Medicine (C.M.A., P.A.L., D.D.M.), and Department of Radiology (S.E.L.), University of Michigan, Ann Arbor; and Research and Development, Archemix Corporation, Cambridge, MA (R.G.S.).
| | - Shirley K Wrobleski
- From the Section of Vascular Surgery, Department of Surgery, Conrad Jobst Vascular Research Laboratories (J.A.D., S.K.W., C.M.A., A.E.H., N.K.D., J.E.G., K.J.R., P.K.H., T.W.W., D.D.M.), Unit for Laboratory Animal Medicine (C.M.A., P.A.L., D.D.M.), and Department of Radiology (S.E.L.), University of Michigan, Ann Arbor; and Research and Development, Archemix Corporation, Cambridge, MA (R.G.S.)
| | - Christine M Alvarado
- From the Section of Vascular Surgery, Department of Surgery, Conrad Jobst Vascular Research Laboratories (J.A.D., S.K.W., C.M.A., A.E.H., N.K.D., J.E.G., K.J.R., P.K.H., T.W.W., D.D.M.), Unit for Laboratory Animal Medicine (C.M.A., P.A.L., D.D.M.), and Department of Radiology (S.E.L.), University of Michigan, Ann Arbor; and Research and Development, Archemix Corporation, Cambridge, MA (R.G.S.)
| | - Angela E Hawley
- From the Section of Vascular Surgery, Department of Surgery, Conrad Jobst Vascular Research Laboratories (J.A.D., S.K.W., C.M.A., A.E.H., N.K.D., J.E.G., K.J.R., P.K.H., T.W.W., D.D.M.), Unit for Laboratory Animal Medicine (C.M.A., P.A.L., D.D.M.), and Department of Radiology (S.E.L.), University of Michigan, Ann Arbor; and Research and Development, Archemix Corporation, Cambridge, MA (R.G.S.)
| | - Nichole K Doornbos
- From the Section of Vascular Surgery, Department of Surgery, Conrad Jobst Vascular Research Laboratories (J.A.D., S.K.W., C.M.A., A.E.H., N.K.D., J.E.G., K.J.R., P.K.H., T.W.W., D.D.M.), Unit for Laboratory Animal Medicine (C.M.A., P.A.L., D.D.M.), and Department of Radiology (S.E.L.), University of Michigan, Ann Arbor; and Research and Development, Archemix Corporation, Cambridge, MA (R.G.S.)
| | - Patrick A Lester
- From the Section of Vascular Surgery, Department of Surgery, Conrad Jobst Vascular Research Laboratories (J.A.D., S.K.W., C.M.A., A.E.H., N.K.D., J.E.G., K.J.R., P.K.H., T.W.W., D.D.M.), Unit for Laboratory Animal Medicine (C.M.A., P.A.L., D.D.M.), and Department of Radiology (S.E.L.), University of Michigan, Ann Arbor; and Research and Development, Archemix Corporation, Cambridge, MA (R.G.S.)
| | - Suzan E Lowe
- From the Section of Vascular Surgery, Department of Surgery, Conrad Jobst Vascular Research Laboratories (J.A.D., S.K.W., C.M.A., A.E.H., N.K.D., J.E.G., K.J.R., P.K.H., T.W.W., D.D.M.), Unit for Laboratory Animal Medicine (C.M.A., P.A.L., D.D.M.), and Department of Radiology (S.E.L.), University of Michigan, Ann Arbor; and Research and Development, Archemix Corporation, Cambridge, MA (R.G.S.)
| | - Joy E Gabriel
- From the Section of Vascular Surgery, Department of Surgery, Conrad Jobst Vascular Research Laboratories (J.A.D., S.K.W., C.M.A., A.E.H., N.K.D., J.E.G., K.J.R., P.K.H., T.W.W., D.D.M.), Unit for Laboratory Animal Medicine (C.M.A., P.A.L., D.D.M.), and Department of Radiology (S.E.L.), University of Michigan, Ann Arbor; and Research and Development, Archemix Corporation, Cambridge, MA (R.G.S.)
| | - Karen J Roelofs
- From the Section of Vascular Surgery, Department of Surgery, Conrad Jobst Vascular Research Laboratories (J.A.D., S.K.W., C.M.A., A.E.H., N.K.D., J.E.G., K.J.R., P.K.H., T.W.W., D.D.M.), Unit for Laboratory Animal Medicine (C.M.A., P.A.L., D.D.M.), and Department of Radiology (S.E.L.), University of Michigan, Ann Arbor; and Research and Development, Archemix Corporation, Cambridge, MA (R.G.S.)
| | - Peter K Henke
- From the Section of Vascular Surgery, Department of Surgery, Conrad Jobst Vascular Research Laboratories (J.A.D., S.K.W., C.M.A., A.E.H., N.K.D., J.E.G., K.J.R., P.K.H., T.W.W., D.D.M.), Unit for Laboratory Animal Medicine (C.M.A., P.A.L., D.D.M.), and Department of Radiology (S.E.L.), University of Michigan, Ann Arbor; and Research and Development, Archemix Corporation, Cambridge, MA (R.G.S.)
| | - Robert G Schaub
- From the Section of Vascular Surgery, Department of Surgery, Conrad Jobst Vascular Research Laboratories (J.A.D., S.K.W., C.M.A., A.E.H., N.K.D., J.E.G., K.J.R., P.K.H., T.W.W., D.D.M.), Unit for Laboratory Animal Medicine (C.M.A., P.A.L., D.D.M.), and Department of Radiology (S.E.L.), University of Michigan, Ann Arbor; and Research and Development, Archemix Corporation, Cambridge, MA (R.G.S.)
| | - Thomas W Wakefield
- From the Section of Vascular Surgery, Department of Surgery, Conrad Jobst Vascular Research Laboratories (J.A.D., S.K.W., C.M.A., A.E.H., N.K.D., J.E.G., K.J.R., P.K.H., T.W.W., D.D.M.), Unit for Laboratory Animal Medicine (C.M.A., P.A.L., D.D.M.), and Department of Radiology (S.E.L.), University of Michigan, Ann Arbor; and Research and Development, Archemix Corporation, Cambridge, MA (R.G.S.)
| | - Daniel D Myers
- From the Section of Vascular Surgery, Department of Surgery, Conrad Jobst Vascular Research Laboratories (J.A.D., S.K.W., C.M.A., A.E.H., N.K.D., J.E.G., K.J.R., P.K.H., T.W.W., D.D.M.), Unit for Laboratory Animal Medicine (C.M.A., P.A.L., D.D.M.), and Department of Radiology (S.E.L.), University of Michigan, Ann Arbor; and Research and Development, Archemix Corporation, Cambridge, MA (R.G.S.)
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