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Iwuji K, Kanu A, Stroever S, Nugent K, Hamood A, Scott C, Navarro S. Clinical significance of BPI-ANCA in patients with cystic fibrosis: a single center prospective study. Sci Rep 2023; 13:18138. [PMID: 37875496 PMCID: PMC10598027 DOI: 10.1038/s41598-023-45273-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 10/17/2023] [Indexed: 10/26/2023] Open
Abstract
Recurrent pulmonary exacerbation due to infection and inflammation remain the major cause of mortality and morbidity in patients with cystic fibrosis (CF). Increased levels of BPI-ANCA have been linked to Pseudomonas colonization and pulmonary exacerbations in patients with CF. The majority of these studies were done in Europe, and it is unclear whether similar findings are true in CF patients who lives in United States. In our single center study of 47 patients with CF, the prevalence of BPI-ANCA was 19% at baseline and 15% at annual follow-up visit. Overall, there were no statistical differences noted in FEV1 and frequency of pulmonary exacerbations in CF patients who were positive for BPI-ANCA compared to those who were negative for BPI-ANCA. The role of BPI-ANCA in patients with CF still remains unclear.
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Affiliation(s)
- Kenneth Iwuji
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
| | - Adaobi Kanu
- Department of Pediatrics/Pulmonology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Stephanie Stroever
- Clinical Research Institute, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Kenneth Nugent
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Abdul Hamood
- Department of Immunology & Molecular Microbiology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Chris Scott
- Clinical Research Institute, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Stephany Navarro
- Department of Immunology & Molecular Microbiology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
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Theprungsirikul J, Skopelja-Gardner S, Rigby WF. Killing three birds with one BPI: Bactericidal, opsonic, and anti-inflammatory functions. J Transl Autoimmun 2021; 4:100105. [PMID: 34142075 PMCID: PMC8187252 DOI: 10.1016/j.jtauto.2021.100105] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 05/10/2021] [Accepted: 05/15/2021] [Indexed: 01/17/2023] Open
Abstract
Bactericidal/permeability-increasing protein (BPI) is an anti-microbial protein predominantly expressed in azurophilic granules of neutrophils. BPI has been shown to mediate cytocidal and opsonic activity against Gram-negative bacteria, while also blunting inflammatory activity of lipopolysaccharide (LPS). Despite awareness of these functions in vitro, the magnitude of the contribution of BPI to innate immunity remains unclear, and the nature of the functional role of BPI in vivo has been submitted to limited investigation. Understanding this role takes on particular interest with the recognition that autoimmunity to BPI is tightly linked to a specific infectious trigger like Pseudomonas aeruginosa in chronic lung infection. This has led to the notion that anti-BPI autoantibodies compromise the activity of BPI in innate immunity against P. aeruginosa, which is primarily mediated by neutrophils. In this review, we explore the three main mechanisms in bactericidal, opsonic, and anti-inflammatory of BPI. We address the etiology and the effects of BPI autoreactivity on BPI function. We explore BPI polymorphism and its link to multiple diseases. We summarize BPI therapeutic potential in both animal models and human studies, as well as offer therapeutic approaches to designing a sustainable and promising BPI molecule.
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Affiliation(s)
- Jomkuan Theprungsirikul
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Sladjana Skopelja-Gardner
- Division of Rheumatology, Department of Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - William F.C. Rigby
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- Division of Rheumatology, Department of Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
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Theprungsirikul J, Skopelja-Gardner S, Burns AS, Wierzbicki RM, Rigby WFC. Bactericidal/Permeability-Increasing Protein Preeminently Mediates Clearance of Pseudomonas aeruginosa In Vivo via CD18-Dependent Phagocytosis. Front Immunol 2021; 12:659523. [PMID: 33981306 PMCID: PMC8107240 DOI: 10.3389/fimmu.2021.659523] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/07/2021] [Indexed: 12/30/2022] Open
Abstract
Chronic Pseudomonas aeruginosa infection mysteriously occurs in the airways of patients with cystic fibrosis (CF), bronchiectasis (BE), and chronic obstructive pulmonary disease (COPD) in the absence of neutrophil dysfunction or neutropenia and is strongly associated with autoimmunity to bactericidal permeability-increasing protein (BPI). Here, we define a critical role for BPI in in vivo immunity against P. aeruginosa. Wild type and BPI-deficient (Bpi-/-) mice were infected with P. aeruginosa, and bacterial clearance, cell infiltrates, cytokine production, and in vivo phagocytosis were quantified. Bpi-/- mice exhibited a decreased ability to clear P. aeruginosa in vivo in concert with increased neutrophil counts and cytokine release. Bpi-/- neutrophils displayed decreased phagocytosis that was corrected by exogenous BPI in vitro. Exogenous BPI also enhanced clearance of P. aeruginosa in Bpi-/- mice in vivo by increasing P. aeruginosa uptake by neutrophils in a CD18-dependent manner. These data indicate that BPI plays an essential role in innate immunity against P. aeruginosa through its opsonic activity and suggest that perturbations in BPI levels or function may contribute to chronic lung infection with P. aeruginosa.
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Affiliation(s)
- Jomkuan Theprungsirikul
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Sladjana Skopelja-Gardner
- Division of Rheumatology, Department of Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Ashley S. Burns
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Rachel M. Wierzbicki
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - William F. C. Rigby
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- Division of Rheumatology, Department of Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
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Mares SE, King MM, Kubo A, Khanov AA, Lutter EI, Youssef N, Patrauchan MA. carP, encoding a Ca 2+-regulated putative phytase, is evolutionarily conserved in Pseudomonas aeruginosa and has potential as a biomarker. MICROBIOLOGY (READING, ENGLAND) 2021; 167:001004. [PMID: 33295862 PMCID: PMC8131022 DOI: 10.1099/mic.0.001004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 11/24/2020] [Indexed: 01/16/2023]
Abstract
Pseudomonas aeruginosa infects patients with cystic fibrosis, burns, wounds and implants. Previously, our group showed that elevated Ca2+ positively regulates the production of several virulence factors in P. aeruginosa, such as biofilm formation, production of pyocyanin and secreted proteases. We have identified a Ca2+-regulated β-propeller putative phytase, CarP, which is required for Ca2+ tolerance, regulation of the intracellular Ca2+ levels, and plays a role in Ca2+ regulation of P. aeruginosa virulence. Here, we studied the conservation of carP sequence and its occurrence in diverse phylogenetic groups of bacteria. In silico analysis revealed that carP and its two paralogues PA2017 and PA0319 are primarily present in P. aeruginosa and belong to the core genome of the species. We identified 155 single nucleotide alterations within carP, 42 of which lead to missense mutations with only three that affected the predicted 3D structure of the protein. PCR analyses with carP-specific primers detected P. aeruginosa specifically in 70 clinical and environmental samples. Sequence comparison demonstrated that carP is overall highly conserved in P. aeruginosa isolated from diverse environments. Such evolutionary preservation of carP illustrates its importance for P. aeruginosa adaptations to diverse environments and demonstrates its potential as a biomarker.
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Affiliation(s)
- Sergio E. Mares
- Department of Microbiology and Molecular Genetics, Oklahoma State University, Stillwater, OK 74078, USA
| | - Michelle M. King
- Department of Microbiology and Molecular Genetics, Oklahoma State University, Stillwater, OK 74078, USA
| | - Aya Kubo
- Department of Microbiology and Molecular Genetics, Oklahoma State University, Stillwater, OK 74078, USA
| | - Anna A. Khanov
- Department of Microbiology and Molecular Genetics, Oklahoma State University, Stillwater, OK 74078, USA
| | - Erika I. Lutter
- Department of Microbiology and Molecular Genetics, Oklahoma State University, Stillwater, OK 74078, USA
| | - Noha Youssef
- Department of Microbiology and Molecular Genetics, Oklahoma State University, Stillwater, OK 74078, USA
| | - Marianna A. Patrauchan
- Department of Microbiology and Molecular Genetics, Oklahoma State University, Stillwater, OK 74078, USA
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Low-Avidity Autoantibodies against Bactericidal/Permeability-Increasing Protein Occur in Gram-Negative and Gram-Positive Bacteremia. Infect Immun 2020; 88:IAI.00444-20. [PMID: 32747603 PMCID: PMC7504969 DOI: 10.1128/iai.00444-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 07/24/2020] [Indexed: 12/14/2022] Open
Abstract
Antibody autoreactivity against bactericidal/permeability-increasing protein (BPI) is strongly associated with Pseudomonas aeruginosa infection in cystic fibrosis (CF), non-CF bronchiectasis (BE), and chronic obstructive pulmonary disease (COPD). We examined the pathogen-specific nature of this autoreactivity by examining antibodies to BPI in bacteremia patients. Antibodies to BPI and bacterial antigens were measured in sera by ELISA from five patient cohorts (n = 214). Antibody autoreactivity against bactericidal/permeability-increasing protein (BPI) is strongly associated with Pseudomonas aeruginosa infection in cystic fibrosis (CF), non-CF bronchiectasis (BE), and chronic obstructive pulmonary disease (COPD). We examined the pathogen-specific nature of this autoreactivity by examining antibodies to BPI in bacteremia patients. Antibodies to BPI and bacterial antigens were measured in sera by ELISA from five patient cohorts (n = 214). Antibody avidity was investigated. Bacteremic patient sera (n = 32) exhibited IgG antibody autoreactivity against BPI in 64.7% and 46.7% of patients with positive blood cultures for P. aeruginosa and Escherichia coli, respectively. Autoantibody titers correlated with IgG responses to bacterial extracts and lipopolysaccharide (LPS). A prospective cohort of bacteremic patient sera exhibited anti-BPI IgG responses in 23/154 (14.9%) patients with autoreactivity present at the time of positive blood cultures in patients with Gram-negative and Gram-positive bacteria, including 8/60 (13.3%) patients with Staphylococcus aureus. Chronic tissue infection with S. aureus was associated with BPI antibody autoreactivity in 2/15 patients (13.3%). Previously, we demonstrated that BPI autoreactivity in CF patient sera exhibits high avidity. Here, a similar pattern was seen in BE patient sera. In contrast, sera from patients with bacteremia exhibited low avidity. These data indicate that low-avidity IgG responses to BPI can arise acutely in response to bacteremia and that this association is not limited to P. aeruginosa. This is to be contrasted with chronic respiratory infection with P. aeruginosa, suggesting that either the chronicity or the site of infection selects for the generation of high-avidity responses, with biologic consequences for airway immunity.
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Serum BPI as a novel biomarker in asthma. Allergy Asthma Clin Immunol 2020; 16:50. [PMID: 32565845 PMCID: PMC7301491 DOI: 10.1186/s13223-020-00450-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 06/05/2020] [Indexed: 01/07/2023] Open
Abstract
Background Neutrophils, eosinophils and inflammatory cells contribute to asthmatic inflammation. The anti-bactericidal/permeability-increasing protein (BPI), produced by neutrophils, peripheral blood monocytes or epithelial cells, can neutralize lipopolysaccharide activity and enhance phagocytosis regulation function. This study aimed to assess the clinical significance of BPI in asthmatic patients. Methods We recruited 18 controlled asthma, 39 uncontrolled asthma and 35 healthy controls individuals. Clinical characteristics (age, gender, allergy history, body mass index (BMI) and smoking history), clinical indicators [whole blood count, forced expiratory volume in one second as percentage of predicted volume (FEV1% predicted), IgE level, high sensitivity C-reactive protein (hs-CRP) and fractional expiratory nitric oxide (FeNO)] and serum BPI levels were measured to compare among each group. We then evaluated the correlation between BPI, clinical characteristics and clinical indicators. Finally, linear regression analysis was performed to exclude the influence of other factors and to find the independent influencing factors of BPI. Results Our results showed that the serum BPI levels increased by twofold in the controlled asthma group (12.83 ± 6.04 ng/mL) and threefold in the uncontrolled asthma group (18.10 ± 13.48 ng/mL), compared to the healthy control group (6.00 ± 2.58 ng/mL) (p < 0.001). We further found that serum BPI levels were positively correlated with the hs-CRP (p = 0.002). There was no significant association among BPI, age, gender, BMI, allergy, blood eosinophils, blood neutrophils, IgE, FeNO or FEV1% predicted. Conclusion BPI levels were increased in asthma and positively correlated with hs-CRP. BPI as a potential asthma biomarker that still needs further research.
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Tian Y, Zeng T, Tan L, Wu Y, Yu J, Huang J, Pei Z. Clinical significance of BPI-ANCA detecting in COPD patients with Pseudomonas aeruginosa colonization. J Clin Lab Anal 2019; 33:e22908. [PMID: 31106488 PMCID: PMC6642326 DOI: 10.1002/jcla.22908] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 03/21/2019] [Accepted: 04/15/2019] [Indexed: 11/30/2022] Open
Abstract
Background Antineutrophil cytoplasmic autoantibodies against neutrophil granule bactericidal/permeability‐increasing protein (BPI‐ANCA) has been found in many inflammatory diseases, such as COPD, which can reduce the killing effect of BPI on Gram‐negative bacteria. This study was aimed to assess the clinical significance of BPI‐ANCA detecting in COPD patients with Pseudomonas aeruginosa (P aeruginosa) colonization. Methods A total of 216 COPD patients with lung P aeruginosa colonization, 244 patients with P aeruginosa infection from June 2015 to June 2018, and 100 healthy individuals were included. Serum BPI‐ANCA, tumor necrosis factor (TNF)‐α, and interleukin (IL)‐6 and IL‐1β levels were detected by ELISA, and the lung function of the patients was measured at stable clinical stages. Patients with COPD were grouped according to BPI‐ANCA detection and GOLD criteria, and serum TNF‐α, IL‐6, and IL‐1β levels and indices reflecting lung function were compared and analyzed between groups. Results Positive rate of BPI‐ANCA in COPD patients with P aeruginosa colonization was 48.15%; and compared with BPI‐ANCA(‐) group, FEV1%pred and FEV1/FVC(%) in BPI‐ANCA(+) patients were significantly decreased, while TNF‐α, IL‐6, and IL‐1β levels were elevated. There were 31.73% and 36.54% BPI‐ANCA(+) patients with severe and very severe airflow limitation, respectively, which was significantly higher than that in the BPI‐ANCA(‐) group. FEV1%pred and FEV1/FVC(%) were negatively correlated with TNF‐α, IL‐6, IL‐1β, and NEU%. C‐reactive protein (CRP) was negatively correlated with FEV1%pred, yet not significantly correlated with FEV1/FVC(%). Conclusion BPI‐ANCA positivity is associated with inflammatory status in COPD patients with pulmonary P aeruginosa colonization and can be used as a potential biomarker assessing disease severity.
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Affiliation(s)
- Yongjian Tian
- Department of Clinical Laboratory, Jiangxi Province Key Laboratory of Laboratory Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Tingting Zeng
- Department of Clinical Laboratory, Jiangxi Province Key Laboratory of Laboratory Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Liming Tan
- Department of Clinical Laboratory, Jiangxi Province Key Laboratory of Laboratory Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yang Wu
- Department of Clinical Laboratory, Jiangxi Province Key Laboratory of Laboratory Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jianlin Yu
- Department of Clinical Laboratory, Jiangxi Province Key Laboratory of Laboratory Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jiayi Huang
- Department of Clinical Laboratory, Jiangxi Province Key Laboratory of Laboratory Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Zihuang Pei
- Department of Clinical Laboratory, Jiangxi Province Key Laboratory of Laboratory Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China
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