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Nguyen TH, Chen LY, Khan NZ, Lindenbauer A, Bui VC, Zipfel PF, Heinrich D. The Binding of the SARS-CoV-2 Spike Protein to Platelet Factor 4: A Proposed Mechanism for the Generation of Pathogenic Antibodies. Biomolecules 2024; 14:245. [PMID: 38540666 PMCID: PMC10967930 DOI: 10.3390/biom14030245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/25/2024] [Accepted: 01/31/2024] [Indexed: 04/02/2024] Open
Abstract
Pathogenic platelet factor 4 (PF4) antibodies contributed to the abnormal coagulation profiles in COVID-19 and vaccinated patients. However, the mechanism of what triggers the body to produce these antibodies has not yet been clarified. Similar patterns and many comparable features between the COVID-19 virus and heparin-induced thrombocytopenia (HIT) have been reported. Previously, we identified a new mechanism of autoimmunity in HIT in which PF4-antibodies self-clustered PF4 and exposed binding epitopes for other pathogenic PF4/eparin antibodies. Here, we first proved that the SARS-CoV-2 spike protein (SP) also binds to PF4. The binding was evidenced by the increase in mass and optical intensity as observed through quartz crystal microbalance and immunosorbent assay, while the switching of the surface zeta potential caused by protein interactions and binding affinity of PF4-SP were evaluated by dynamic light scattering and isothermal spectral shift analysis. Based on our results, we proposed a mechanism for the generation of PF4 antibodies in COVID-19 patients. We further validated the changes in zeta potential and interaction affinity between PF4 and SP and found that their binding mechanism differs from ACE2-SP binding. Importantly, the PF4/SP complexes facilitate the binding of anti-PF4/Heparin antibodies. Our findings offer a fresh perspective on PF4 engagement with the SARS-CoV-2 SP, illuminating the role of PF4/SP complexes in severe thrombotic events.
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Affiliation(s)
- Thi-Huong Nguyen
- Institute for Bioprocessing and Analytical Measurement Techniques (iba), 37308 Heilbad Heiligenstadt, Germany
- Faculty of Mathematics and Natural Sciences, Technische Universität Ilmenau, 98694 Ilmenau, Germany
| | - Li-Yu Chen
- Institute for Bioprocessing and Analytical Measurement Techniques (iba), 37308 Heilbad Heiligenstadt, Germany
- Institute of Miccrobiology, Friedrich-Schiller-University, 07745 Jena, Germany
| | - Nida Zaman Khan
- Institute for Bioprocessing and Analytical Measurement Techniques (iba), 37308 Heilbad Heiligenstadt, Germany
- Faculty of Mathematics and Natural Sciences, Technische Universität Ilmenau, 98694 Ilmenau, Germany
| | - Annerose Lindenbauer
- Institute for Bioprocessing and Analytical Measurement Techniques (iba), 37308 Heilbad Heiligenstadt, Germany
| | - Van-Chien Bui
- Department of Water Supply and Wastewater Treatment, Eichsfeldwerke GmbH, 37308 Heilbad Heiligenstadt, Germany
| | - Peter F. Zipfel
- Institute of Miccrobiology, Friedrich-Schiller-University, 07745 Jena, Germany
| | - Doris Heinrich
- Institute for Bioprocessing and Analytical Measurement Techniques (iba), 37308 Heilbad Heiligenstadt, Germany
- Faculty of Mathematics and Natural Sciences, Technische Universität Ilmenau, 98694 Ilmenau, Germany
- Fraunhofer Institut für Silicatforschung, Neunerplatz, 97082 Würzburg, Germany
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Chen LY, Apte G, Lindenbauer A, Frant M, Nguyen TH. Effect of HIT Components on the Development of Breast Cancer Cells. Life (Basel) 2021; 11:life11080832. [PMID: 34440575 PMCID: PMC8399975 DOI: 10.3390/life11080832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/30/2021] [Accepted: 08/05/2021] [Indexed: 12/12/2022] Open
Abstract
Cancer cells circulating in blood vessels activate platelets, forming a cancer cell encircling platelet cloak which facilitates cancer metastasis. Heparin (H) is frequently used as an anticoagulant in cancer patients but up to 5% of patients have a side effect, heparin-induced thrombocytopenia (HIT) that can be life-threatening. HIT is developed due to a complex interaction among multiple components including heparin, platelet factor 4 (PF4), HIT antibodies, and platelets. However, available information regarding the effect of HIT components on cancers is limited. Here, we investigated the effect of these materials on the mechanical property of breast cancer cells using atomic force microscopy (AFM) while cell spreading was quantified by confocal laser scanning microscopy (CLSM), and cell proliferation rate was determined. Over time, we found a clear effect of each component on cell elasticity and cell spreading. In the absence of platelets, HIT antibodies inhibited cell proliferation but they promoted cell proliferation in the presence of platelets. Our results indicate that HIT complexes influenced the development of breast cancer cells.
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Affiliation(s)
- Li-Yu Chen
- Institute for Bioprocessing and Analytical Measurement Techniques, 37308 Heiligenstadt, Germany; (L.-Y.C.); (G.A.); (A.L.); (M.F.)
- Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, 07745 Jena, Germany
| | - Gurunath Apte
- Institute for Bioprocessing and Analytical Measurement Techniques, 37308 Heiligenstadt, Germany; (L.-Y.C.); (G.A.); (A.L.); (M.F.)
- Institute of Nanotechnology (INT) and Karlsruhe Nano Micro Facility, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany
| | - Annerose Lindenbauer
- Institute for Bioprocessing and Analytical Measurement Techniques, 37308 Heiligenstadt, Germany; (L.-Y.C.); (G.A.); (A.L.); (M.F.)
| | - Marion Frant
- Institute for Bioprocessing and Analytical Measurement Techniques, 37308 Heiligenstadt, Germany; (L.-Y.C.); (G.A.); (A.L.); (M.F.)
| | - Thi-Huong Nguyen
- Institute for Bioprocessing and Analytical Measurement Techniques, 37308 Heiligenstadt, Germany; (L.-Y.C.); (G.A.); (A.L.); (M.F.)
- Faculty of Mathematics and Natural Sciences, Technische Universität Ilmenau, 98694 Ilmenau, Germany
- Correspondence:
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Nguyen TH, Xu Y, Brandt S, Mandelkow M, Raschke R, Strobel U, Delcea M, Zhou W, Liu J, Greinacher A. Characterization of the interaction between platelet factor 4 and homogeneous synthetic low molecular weight heparins. J Thromb Haemost 2020; 18:390-398. [PMID: 31573759 PMCID: PMC7236814 DOI: 10.1111/jth.14657] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 09/25/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Heparins are usually produced from animal tissues. It is now possible to synthesize heparins. This provides the abilities to overcome shortages of heparin, to optimize biological effects, and to reduce adverse drug effects. Heparins interact with platelet factor 4 (PF4), which can induce an immune response causing thrombocytopenia. This side effect is called heparin-induced thrombocytopenia (HIT). We characterized the interaction of PF4 and HIT antibodies with oligosaccharides of 6-, 8-, 10-, and 12-mer size and a hypersulfated 12-mer (S12-mer). METHODS We utilized multiple methodologies including isothermal calorimetry, circular dichroism spectroscopy, single molecule force spectroscopy (SMFS), enzyme immunosorbent assay (EIA), and platelet aggregation test to characterize the interaction of synthetic heparin analogs with PF4 and anti-PF4/heparin antibodies. RESULTS The synthetic heparin-like compounds display stronger binding characteristics to PF4 than animal-derived heparins of corresponding lengths. Upon complexation with PF4, 6-mer and S12-mer heparins showed much lower enthalpy, induced less conformational changes in PF4, and interacted with weaker forces than 8-, 10-, and 12-mer heparins. Anti-PF4/heparin antibodies bind more weakly to complexes formed between PF4 and heparins ≤ 8-mer than with complexes formed between PF4 and heparins ≥ 10-mer. Addition of one sulfate group to the 12-mer resulted in a S12-mer, which showed substantial changes in its binding characteristics to PF4. CONCLUSIONS We provide a template for characterizing interactions of newly developed heparin-based anticoagulant drugs with proteins, especially PF4 and the resulting potential antigenicity.
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Affiliation(s)
- Thi-Huong Nguyen
- institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
- Institute for Bioprocessing and Analytical Measurement Techniques, Heiligenstadt, Germany
- ZIK HIKE—Center for Innovation Competence, Humoral Immune Reactions in Cardiovascular Diseases, University Greifswald, Greifswald, Germany
| | - Yongmei Xu
- Division of Chemical Biology and Medicinal Chemistry, School of Pharmacy, University of North Carolina, Eshelman, Chapel Hill, NC, USA
| | - Sven Brandt
- ZIK HIKE—Center for Innovation Competence, Humoral Immune Reactions in Cardiovascular Diseases, University Greifswald, Greifswald, Germany
| | - Martin Mandelkow
- ZIK HIKE—Center for Innovation Competence, Humoral Immune Reactions in Cardiovascular Diseases, University Greifswald, Greifswald, Germany
| | - Ricarda Raschke
- institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Ulrike Strobel
- institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Mihaela Delcea
- ZIK HIKE—Center for Innovation Competence, Humoral Immune Reactions in Cardiovascular Diseases, University Greifswald, Greifswald, Germany
- Division of Chemical Biology and Medicinal Chemistry, School of Pharmacy, University of North Carolina, Eshelman, Chapel Hill, NC, USA
| | - Wen Zhou
- Institute of Biochemistry, University Greifswald, Greifswald, Germany
| | - Jian Liu
- Institute of Biochemistry, University Greifswald, Greifswald, Germany
| | - Andreas Greinacher
- institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
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Nevzorova TA, Mordakhanova ER, Daminova AG, Ponomareva AA, Andrianova IA, Le Minh G, Rauova L, Litvinov RI, Weisel JW. Platelet factor 4-containing immune complexes induce platelet activation followed by calpain-dependent platelet death. Cell Death Discov 2019; 5:106. [PMID: 31263574 PMCID: PMC6591288 DOI: 10.1038/s41420-019-0188-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 05/29/2019] [Accepted: 06/05/2019] [Indexed: 01/23/2023] Open
Abstract
Heparin-induced thrombocytopenia (HIT) is a complication of heparin therapy sometimes associated with thrombosis. The hallmark of HIT is antibodies to the heparin/platelet factor 4 (PF4) complex that cause thrombocytopenia and thrombosis through platelet activation. Despite the clinical importance, the molecular mechanisms and late consequences of immune platelet activation are not fully understood. Here, we studied immediate and delayed effects of the complexes formed by human PF4 and HIT-like monoclonal mouse anti-human-PF4/heparin IgG antibodies (named KKO) on isolated human platelets in vitro. Direct platelet-activating effect of the KKO/PF4 complexes was corroborated by the overexpression of phosphatidylserine (PS) and P-selectin on the platelet surface. The immune platelet activation was accompanied by a decrease of the mitochondrial transmembrane potential (ΔΨm), concurrent with a significant gradual reduction of the ATP content in platelets, indicating disruption of energy metabolism. A combination of PS expression and mitochondrial depolarization induced by the PF4-containing immune complexes observed in a substantial fraction of platelets was considered as a sign of ongoing platelet death, as opposed to a subpopulation of activated live platelets with PS on the plasma membrane but normal ΔΨm. Both activated and dying platelets treated with KKO/PF4 formed procoagulant extracellular microvesicles bearing PS on their surface. Scanning and transmission electron microscopy revealed dramatic morphological changes of KKO/PF4-treated platelets, including their fragmentation, another indicator of cell death. Most of the effects of KKO/PF4 were prevented by an anti-FcγRII monoclonal antibody IV.3. The adverse functional and structural changes in platelets induced by the KKO/PF4 complexes were associated with strong time-dependent activation of calpain, but only trace cleavage of caspase 3. The results indicate that the pathogenic PF4-containing HIT-like immune complexes induce direct prothrombotic platelet activation via FcγRIIA receptors followed by non-apoptotic calpain-dependent death of platelets, which can be an important mechanism of thrombocytopenia during HIT development.
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Affiliation(s)
- Tatiana A. Nevzorova
- Institute of Fundamental Medicine and Biology, Kazan Federal University, 18 Kremlyovskaya St., Kazan, Russian Federation 420008 Russia
| | - Elmira R. Mordakhanova
- Institute of Fundamental Medicine and Biology, Kazan Federal University, 18 Kremlyovskaya St., Kazan, Russian Federation 420008 Russia
| | - Amina G. Daminova
- Institute of Fundamental Medicine and Biology, Kazan Federal University, 18 Kremlyovskaya St., Kazan, Russian Federation 420008 Russia
- Kazan Institute of Biochemistry and Biophysics, FRC Kazan Scientific Center of RAS, 2/31 Lobachevsky str., Kazan, Russian Federation 420111 Russia
| | - Anastasia A. Ponomareva
- Institute of Fundamental Medicine and Biology, Kazan Federal University, 18 Kremlyovskaya St., Kazan, Russian Federation 420008 Russia
- Kazan Institute of Biochemistry and Biophysics, FRC Kazan Scientific Center of RAS, 2/31 Lobachevsky str., Kazan, Russian Federation 420111 Russia
| | - Izabella A. Andrianova
- Institute of Fundamental Medicine and Biology, Kazan Federal University, 18 Kremlyovskaya St., Kazan, Russian Federation 420008 Russia
| | - Giang Le Minh
- Institute of Fundamental Medicine and Biology, Kazan Federal University, 18 Kremlyovskaya St., Kazan, Russian Federation 420008 Russia
| | - Lubica Rauova
- Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104 USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, 3401 Civic Center Blvd, Philadelphia, PA 19104 USA
| | - Rustem I. Litvinov
- Institute of Fundamental Medicine and Biology, Kazan Federal University, 18 Kremlyovskaya St., Kazan, Russian Federation 420008 Russia
- Department of Cell and Developmental Biology, University of Pennsylvania Perelman School of Medicine, 421 Curie Boulevard, Philadelphia, PA 19104 USA
| | - John W. Weisel
- Institute of Fundamental Medicine and Biology, Kazan Federal University, 18 Kremlyovskaya St., Kazan, Russian Federation 420008 Russia
- Department of Cell and Developmental Biology, University of Pennsylvania Perelman School of Medicine, 421 Curie Boulevard, Philadelphia, PA 19104 USA
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5
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Nguyen TH, Greinacher A. Distinct Binding Characteristics of Pathogenic Anti-Platelet Factor-4/Polyanion Antibodies to Antigens Coated on Different Substrates: A Perspective on Clinical Application. ACS NANO 2018; 12:12030-12041. [PMID: 30540167 DOI: 10.1021/acsnano.8b04487] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
The polyanion heparin, which is frequently used in patients, complexes with the platelet-derived cationic chemokine platelet factor (PF4, CXCL4). This results in the formation of anti-PF4/heparin antibodies (anti-PF4/H Abs). Anti-PF4/H Abs are classified into three groups: (i) nonpathogenic Abs (group 1) with no clinical relevance; (ii) pathogenic heparin-dependent Abs (group 2), which activate platelets and can cause the severe adverse drug effect heparin-induced thrombocytopenia (HIT); and (iii) pathogenic autoimmune-HIT Abs (group 3), in which group 3 anti-PF4/H Abs causes a HIT-like autoimmune disease in the absence of heparin. Enzyme immunoassays using PF4/H complexes coated on the solid phase for detection of anti-PF4/H Abs cannot differentiate between pathogenic and nonpathogenic anti-PF4/H Abs. By single-molecule force spectroscopy, we identify a specific feature of pathogenic group 2 and group 3 Abs antibodies that (in contrast to nonpathogenic group 1 Abs) their binding forces to PF4/H complexes coated on platelets were significantly higher compared with those of PF4/H complexes immobilized on a solid phase. Only group 3 Abs showed high binding forces to platelets without the addition of PF4. In the presence of 50 μg/mL PF4, group 2 Abs also showed high binding forces to platelets. In contrast, binding forces of group 1 Abs always remained low (<100 pN). Our findings may have major relevance for the development of clinically applicable solid-phase assays, which allow differentiation of pathogenic platelet-activating from nonpathogenic anti-PF4/H Abs. Membrane-based expression of antigens might also increase the specificity of other assays for the detection of pathogenic (auto)-antibodies in clinical medicine.
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Affiliation(s)
- Thi-Huong Nguyen
- Institute for Immunology and Transfusion Medicine , University Medicine Greifswald , 17475 Greifswald , Germany
- ZIK HIKE - Center for Innovation Competence, Humoral Immune Reactions in Cardiovascular Diseases , University of Greifswald , 17489 Greifswald , Germany
| | - Andreas Greinacher
- Institute for Immunology and Transfusion Medicine , University Medicine Greifswald , 17475 Greifswald , Germany
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6
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Pellequer JL, Parot P, Navajas D, Kumar S, Svetličić V, Scheuring S, Hu J, Li B, Engler A, Sousa S, Lekka M, Szymoński M, Schillers H, Odorico M, Lafont F, Janel S, Rico F. Fifteen years of Servitude et Grandeur
to the application of a biophysical technique in medicine: The tale of AFMBioMed. J Mol Recognit 2018; 32:e2773. [DOI: 10.1002/jmr.2773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
| | | | - Daniel Navajas
- Institute for Bioengineering of Catalonia and CIBER de Enfermedades Respiratorias; Universitat de Barcelona; Barcelona Spain
| | - Sanjay Kumar
- Departments of Bioengineering and Chemical & Biomolecular Engineering; University of California, Berkeley; Berkeley California USA
| | | | - Simon Scheuring
- Department of Anesthesiology, Department of Physiology and Biophysics; Weill Cornell Medicine; New York City New York USA
| | - Jun Hu
- Shanghai Advanced Research Institute; Chinese Academy of Sciences; Shanghai China
- Shanghai Institute of Applied Physics; Chinese Academy of Sciences; Shanghai China
| | - Bin Li
- Shanghai Advanced Research Institute; Chinese Academy of Sciences; Shanghai China
- Shanghai Institute of Applied Physics; Chinese Academy of Sciences; Shanghai China
| | - Adam Engler
- Department of Bioengineering; University of California San Diego; La Jolla California USA
| | - Susana Sousa
- i3S-Instituto de Investigação e Inovação em Saúde; Universidade do Porto; Porto Portugal
- INEB-Instituto de Engenharia Biomédica; Universidade do Porto; Porto Portugal
- ISEP-Instituto Superior de Engenharia; Politécnico do Porto; Portugal
| | - Małgorzata Lekka
- Institute of Nuclear Physics Polish Academy of Sciences; Kraków Poland
| | - Marek Szymoński
- Center for Nanometer-scale Science and Advanced Materials, NANOSAM, Faculty of Physics, Astronomy and Applied Computer Science; Jagiellonian University; Kraków Poland
| | | | - Michael Odorico
- Institut de Chimie Séparative de Marcoule (ICSM), CEA, CNRS, ENSCM, Univ Montpellier, Marcoule; Montpellier France
| | - Frank Lafont
- Center for Infection and Immunity of Lille, CNRS UMR 8204, INSERM U1019, CHU Lille, Institut Pasteur de Lille, Univ Lille; Lille France
| | - Sebastien Janel
- Center for Infection and Immunity of Lille, CNRS UMR 8204, INSERM U1019, CHU Lille, Institut Pasteur de Lille, Univ Lille; Lille France
| | - Felix Rico
- LAI, U1067, Aix-Marseille Univ, CNRS, INSERM; Marseille France
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Nguyen TH, Schuster N, Greinacher A, Aurich K. Uptake Pathways of Protein-Coated Magnetic Nanoparticles in Platelets. ACS APPLIED MATERIALS & INTERFACES 2018; 10:28314-28321. [PMID: 30067021 DOI: 10.1021/acsami.8b07588] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Magnetic nanoparticles have recently shown great potential in nonradioactive labeling of platelets. Platelet labeling efficiency is enhanced when particles are conjugated with proteins like human serum albumin (HSA). However, the optimal HSA density coated on particles and the uptake mechanism of single particles in platelets remain unclear. Here, we utilized single-molecule force spectroscopy (SMFS) and other complementary methods to characterize the interaction of particles when interacting with platelets and to determine the optimal HSA amount required to coat particles. An HSA concentration of 0.5-1.0 mg/mL for coating particles is most efficient for platelet labeling. Binding pathways could be elucidated by linking a single HSA particle to SMFS tips via polyethylene glycol (PEG) linkers of different lengths and allowing them to interact with immobilized platelets on the substrate. Depending on the PEG length (i.e., short ∼2 nm, medium ∼30 nm, and long ∼100 nm), particles interact differently with platelets as shown by one, two, or three force distributions, which correspond up to three different binding pathways, respectively. We propose a model that the short PEG linker allows the particle to interact only with the platelet membrane, whereas the medium and long PEG linkers promote the particle to transfer from open canalicular system to another target inside platelets. Our study optimizes magnetic platelet labeling and provides details of particle pathways in platelets.
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Affiliation(s)
- Thi-Huong Nguyen
- Institute for Immunology and Transfusion Medicine , University Medicine Greifswald , 17475 Greifswald , Germany
- ZIK HIKE-Center for Innovation Competence, Humoral Immune Reactions in Cardiovascular Diseases , University of Greifswald , 17489 Greifswald , Germany
| | - Nicola Schuster
- ZIK HIKE-Center for Innovation Competence, Humoral Immune Reactions in Cardiovascular Diseases , University of Greifswald , 17489 Greifswald , Germany
| | - Andreas Greinacher
- Institute for Immunology and Transfusion Medicine , University Medicine Greifswald , 17475 Greifswald , Germany
| | - Konstanze Aurich
- Institute for Immunology and Transfusion Medicine , University Medicine Greifswald , 17475 Greifswald , Germany
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8
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Rauova L, Arepally G, Poncz M, Cines DB. Molecular and cellular pathogenesis of heparin-induced thrombocytopenia (HIT). Autoimmun Rev 2018; 17:1046-1052. [PMID: 30103043 DOI: 10.1016/j.autrev.2018.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 05/09/2018] [Indexed: 01/19/2023]
Affiliation(s)
- Lubica Rauova
- Division of Hematology, Department of Pediatrics, Childrens Hospital of Philadelphia, USA; Department of Pediatrics, University of Pennsylvania, Perelman School of Medicine, USA
| | - Gowthami Arepally
- Division of Hematology, Department of Medicine, Duke University School of Medicine, USA
| | - Mortimer Poncz
- Division of Hematology, Department of Pediatrics, Childrens Hospital of Philadelphia, USA; Department of Pediatrics, University of Pennsylvania, Perelman School of Medicine, USA
| | - Douglas B Cines
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Perelman School of Medicine, USA; Department of Medicine, University of Pennsylvania, Perelman School of Medicine, USA.
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Bui VC, Nguyen TH. The Role of Single-Molecule Force Spectroscopy in Unraveling Typical and Autoimmune Heparin-induced Thrombocytopenia. Int J Mol Sci 2018; 19:E1054. [PMID: 29614814 PMCID: PMC5979551 DOI: 10.3390/ijms19041054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 03/26/2018] [Accepted: 03/31/2018] [Indexed: 02/07/2023] Open
Abstract
For the last two decades, heparins have been widely used as anticoagulants. Besides numerous advantages, up to 5% patients with heparin administration suffer from a major adverse drug effect known as heparin-induced thrombocytopenia (HIT). This typical HIT can result in deep vein thrombosis, pulmonary embolism, occlusion of a limb artery, acute myocardial infarct, stroke, and a systemic reaction or skin necrosis. The basis of HIT may lead to clinical insights. Recent studies using single-molecule force spectroscopy (SMFS)-based atomic force microscopy revealed detailed binding mechanisms of the interactions between platelet factor 4 (PF4) and heparins of different lengths in typical HIT. Especially, SMFS results allowed identifying a new mechanism of the autoimmune HIT caused by a subset of human-derived antibodies in patients without heparin exposure. The findings proved that not only heparin but also a subset of antibodies induce thrombocytopenia. In this review, the role of SMFS in unraveling a major adverse drug effect and insights into molecular mechanisms inducing thrombocytopenia by both heparins and antibodies will be discussed.
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Affiliation(s)
- Van-Chien Bui
- Institute for Immunology and Transfusion Medicine, University Medicine of Greifswald, 17475 Greifswald, Germany.
| | - Thi-Huong Nguyen
- Institute for Immunology and Transfusion Medicine, University Medicine of Greifswald, 17475 Greifswald, Germany.
- ZIK HIKE-Center for Innovation Competence, Humoral Immune Reactions in Cardiovascular, 17489 Greifswald, Germany.
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10
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Ozkan AD, Topal AE, Dikecoglu FB, Guler MO, Dana A, Tekinay AB. Probe microscopy methods and applications in imaging of biological materials. Semin Cell Dev Biol 2018; 73:153-164. [DOI: 10.1016/j.semcdb.2017.08.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 08/04/2017] [Accepted: 08/04/2017] [Indexed: 01/21/2023]
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11
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Anti-platelet factor 4/polyanion antibodies mediate a new mechanism of autoimmunity. Nat Commun 2017; 8:14945. [PMID: 28530237 PMCID: PMC5458132 DOI: 10.1038/ncomms14945] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 02/15/2017] [Indexed: 01/07/2023] Open
Abstract
Antibodies recognizing complexes of the chemokine platelet factor 4 (PF4/CXCL4) and polyanions (P) opsonize PF4-coated bacteria hereby mediating bacterial host defense. A subset of these antibodies may activate platelets after binding to PF4/heparin complexes, causing the prothrombotic adverse drug reaction heparin-induced thrombocytopenia (HIT). In autoimmune-HIT, anti-PF4/P-antibodies activate platelets in the absence of heparin. Here we show that antibodies with binding forces of approximately 60–100 pN activate platelets in the presence of polyanions, while a subset of antibodies from autoimmune-HIT patients with binding forces ≥100 pN binds to PF4 alone in the absence of polyanions. These antibodies with high binding forces cluster PF4-molecules forming antigenic complexes which allow binding of polyanion-dependent anti-PF4/P-antibodies. The resulting immunocomplexes induce massive platelet activation in the absence of heparin. Antibody-mediated changes in endogenous proteins that trigger binding of otherwise non-pathogenic (or cofactor-dependent) antibodies may also be relevant in other antibody-mediated autoimmune disorders. Antibodies against the platelet factor 4 (PF4) support bacterial host defence but in some cases may lead to heparin-induced thrombocytopenia (HIT). Nguyen et al. show that in autoimmune HIT a subset of antibodies binds strongly to PF4 causing its conformational change that leads to association of non-pathogenic PF4 antibodies and thrombotic platelet activation.
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