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Pizzo H, Mirocha J, Choi J, Garrison J, Haas M, Zhang X, Kamil ES, Kim I, Jordan SC, Puliyanda DP. Pre-transplant angiotensin II receptor type I antibodies in pediatric renal transplant recipients: An observational cohort study. Pediatr Transplant 2022; 26:e14400. [PMID: 36168673 DOI: 10.1111/petr.14400] [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: 05/27/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The role of angiotensin II type 1 receptor antibodies (AT1R-Ab) in pediatric renal transplantation is unclear. Here, we evaluated pre-transplant AT1R-Ab on transplant outcomes in the first 5 years. Secondary analysis compared pre-transplant AT1R-Ab levels by age. METHODS Thirty-six patients, 2-20 years old, were divided into two groups: pre-transplant AT1R-Ab- (<17 U/ml; n = 18) and pre-transplant AT1R-Ab+ (≥17 U/ml; n = 18). eGFR was determined at 6-month, 1-, 2-, and 4-year post-transplant. Allograft biopsies were performed in the setting of strong HLA-DSA (MFI > 10 000), AT1R-Ab ≥17 U/ml, and/or elevated creatinine. RESULTS Mean age in pre-transplant AT1R-Ab- was 13.3 years vs. 11.0 in pre-transplant AT1R-Ab+ (p = 0.16). At 6 months, mean eGFR was 111.3 ml/min/1.73 m2 in pre-transplant AT1R-Ab- vs. 100.2 in pre-transplant AT1R-Ab + at 1 year, 103.6 ml/min/1.73 m2 vs. 100.5; at 2 years, 98.9 ml/min/1.73 m2 vs. and 93.7; at 4 years, 72.6 ml/min/1.73 m2 vs. 80.9. 11/36 patients had acute rejection (6 in pre-transplant AT1R-Ab-, 5 in pre-transplant AT1R-Ab + ). There was no difference in rejection rates. All 6 subjects with de novo HLA-DSA and AT1R-Ab ≥17 U/ml at the time of biopsy experienced rejection. Mean age in those with the AT1R-Ab ≥40 U/ml was 10.0 years vs. 13.2 in those <40 U/ml (p = 0.07). CONCLUSION In our small cohort, pre-transplant AT1R-Ab ≥17 U/ml was not associated with reduced graft function or rejection. The pathogenicity of pre-transplant AT1R-Ab in pediatric kidney transplantation requires further investigation.
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Affiliation(s)
- Helen Pizzo
- Pediatric Nephrology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - James Mirocha
- Biostatistics Core, Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Jua Choi
- Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Jonathan Garrison
- Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Mark Haas
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, California, Los Angeles, USA
| | - Xiaohai Zhang
- HLA and Immunogenetics Laboratory, Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Elaine S Kamil
- Pediatric Nephrology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Irene Kim
- Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Stanley C Jordan
- Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Dechu P Puliyanda
- Pediatric Nephrology, Cedars-Sinai Medical Center, Los Angeles, California, USA
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2
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Wang Z, Feng W, Liu J. Current understanding of autoantibody against angiotensin II type 1 receptor in preeclampsia. J Matern Fetal Neonatal Med 2020; 35:4089-4094. [PMID: 33249950 DOI: 10.1080/14767058.2020.1846709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Preeclampsia (PE) remains a leading cause of fetal and maternal mortality. Angiotensin II type 1 receptor autoantibody (AT1-AA) is implicated in the dysregulation of the renin-angiotensin-aldosterone system. A strong relationship between AT1-AA and the occurrence and severity of PE has been confirmed in previous literature. Recent evidences suggested that AT1-AA was responsible for blood pressure elevation, reactive oxygen species synthesis, and inflammatory factors release and engaged in multiple signaling cascades. The inhibition of AT1-AA might be a potential therapeutic target in future days. Here we reviewed the current understanding of AT1-AA, aiming to provide clarity surrounding the role of AT1-AA in PE.
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Affiliation(s)
- Zheng Wang
- Department of Pharmacology, School of Medicine, Xi'an Jiaotong University, Xi'an, China.,Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Weiyi Feng
- Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jinjun Liu
- Department of Physiology and Pathophysiology, School of Medicine, Xi'an Jiaotong University, Xi'an, China
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3
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Wang M, Yin X, Zhang S, Mao C, Cao N, Yang X, Bian J, Hao W, Fan Q, Liu H. Autoantibodies against AT1 Receptor Contribute to Vascular Aging and Endothelial Cell Senescence. Aging Dis 2019; 10:1012-1025. [PMID: 31595199 PMCID: PMC6764731 DOI: 10.14336/ad.2018.0919] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 09/19/2018] [Indexed: 12/23/2022] Open
Abstract
Vascular aging predisposes the elderly to the progression of many aging-related vascular disorders and leads to deterioration of cardiovascular diseases (CVD). However, the underlying mechanisms have not been clearly elucidated. Agonistic autoantibodies against angiotensin II type 1 (AT1) receptor (AT1-AAs) have been demonstrated to be pro-inflammatory and contribute to the progression of atherosclerosis. However, the association between AT1-AAs and vascular aging has not been defined. Peripheral arterial disease (PAD) is an acknowledged vascular aging-related disease. In this study, AT1-AAs were detected in the sera of patients with PAD and the positive rate was 44.44% (n=63) vs. 17.46% in non-PAD volunteers (n=63). In addition, case-control analysis showed that AT1-AAs level was positively correlated with PAD. To reveal the causal relationship between AT1-AAs and vascular aging, an AT1-AAs-positive rat model was established by active immunization. The carotid pulse wave velocity was higher, and the aortic endothelium-dependent vasodilatation was attenuated significantly in the immunized rats. Morphological staining showed thickening of the aortic wall. Histological examination showed that levels of the senescent markers were increased in the aortic tissue, mostly located at the endothelium. In addition, purified AT1-AAs-IgGs from both the immunized rats and PAD patients induced premature senescence in cultured human umbilical vein endothelial cells. These effects were significantly blocked by the AT1 receptor blocker. Taken together, our study demonstrates that AT1-AAs contribute to the progression of vascular aging and induce EC senescence through AT1 receptor. AT1-AA is a novel biomarker of vascular aging and aging-related CVD that acts to accelerate EC senescence.
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Affiliation(s)
- Meili Wang
- 1Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China.,2Beijing Key Laboratory of Metabolic Disorders Related Cardiovascular Disease, Capital Medical University, Beijing, China
| | - Xiaochen Yin
- 1Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China.,2Beijing Key Laboratory of Metabolic Disorders Related Cardiovascular Disease, Capital Medical University, Beijing, China
| | - Suli Zhang
- 1Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China.,2Beijing Key Laboratory of Metabolic Disorders Related Cardiovascular Disease, Capital Medical University, Beijing, China
| | - Chenfeng Mao
- 3Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China.,4Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Ning Cao
- 1Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China.,2Beijing Key Laboratory of Metabolic Disorders Related Cardiovascular Disease, Capital Medical University, Beijing, China
| | - Xiaochun Yang
- 5Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jingwei Bian
- 1Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China.,2Beijing Key Laboratory of Metabolic Disorders Related Cardiovascular Disease, Capital Medical University, Beijing, China
| | - Weiwei Hao
- 1Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China.,2Beijing Key Laboratory of Metabolic Disorders Related Cardiovascular Disease, Capital Medical University, Beijing, China
| | - Qian Fan
- 5Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Huirong Liu
- 1Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China.,2Beijing Key Laboratory of Metabolic Disorders Related Cardiovascular Disease, Capital Medical University, Beijing, China
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4
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Shapouri-Moghaddam A, Saeed Modaghegh MH, Rahimi HR, Ehteshamfar SM, Tavakol Afshari J. Molecular mechanisms regulating immune responses in thromboangiitis obliterans: A comprehensive review. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2019; 22:215-224. [PMID: 31156780 PMCID: PMC6528722 DOI: 10.22038/ijbms.2019.31119.7513] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Thromboangiitis obliterans (TAO) is a thrombotic-occlusive as well as an inflammatory peripheral vascular disease with unknown etiology. Recent evidence has supported the immunopathogenesis of the disease, however, the factors contributing to the altered immune function and vascular tissue inflammation are still unclear. This review was intended to collate the more current knowledge on the regulatory molecules involved in TAO from an immunoreactive perspective. The homeostasis of the immune system as well as a variety of progenitor cell populations appear to be affected during TAO and these alterations are associated with intrinsic signaling defects that are directing to an improved understanding of the crosstalk between angiogenesis and the immune system, as well as the potential of new co-targeting strategies applying both immunotherapy and angiogenic therapy.
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Affiliation(s)
- Abbas Shapouri-Moghaddam
- Immunology Research Group, Bu-Ali Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Hamid Reza Rahimi
- Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Modern Sciences and Technologies, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyyed-Morteza Ehteshamfar
- Immunology Research Group, Bu-Ali Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Jalil Tavakol Afshari
- Immunology Research Group, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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5
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Mathis KW, Taylor EB, Ryan MJ. Anti-CD3 antibody therapy attenuates the progression of hypertension in female mice with systemic lupus erythematosus. Pharmacol Res 2017; 120:252-257. [PMID: 28400152 DOI: 10.1016/j.phrs.2017.04.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 03/30/2017] [Accepted: 04/06/2017] [Indexed: 10/19/2022]
Abstract
Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disorder with prevalent hypertension that significantly contributes to the mortality in this patient population. Pre-clinical and clinical evidence suggests that anti-CD3 antibody therapy may attenuate the development of autoimmune diseases like SLE. However, it is unclear whether this treatment impacts the development of the prevalent hypertension associated with SLE. The present study was designed to determine whether anti-CD3 antibody treatment attenuates the progression of hypertension in female SLE mice with already established renal disease (albuminuria ≥100mg/dL). Female SLE (NZBWF1) and control (NZW) mice were administered either an antibody to CD3ε, a component of the T cell receptor complex expressed on all T cells, or IgG antibody (isotype control) for up to 4 weeks (intranasal; 25μg/week). Spleen weight was lower in SLE mice treated with anti-CD3 antibody than in IgG-treated SLE mice, suggesting that immune system hyperactivity is decreased. Circulating anti-dsDNA autoantibodies were increased in SLE mice compared to controls and were blunted in the anti-CD3-treated SLE mice. The development of hypertension was attenuated in anti-CD3 treated mice with SLE independently of changes in renal injury (assessed by urinary albumin). These data suggest anti-CD3 therapy during autoimmune disease may have added clinical benefit to attenuate cardiovascular risk factors like hypertension.
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Affiliation(s)
- Keisa W Mathis
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA
| | - Erin B Taylor
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA
| | - Michael J Ryan
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA.
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6
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Abadir PM, Jain A, Powell LJ, Xue QL, Tian J, Hamilton RG, Bennett DA, Finucane T, Walston JD, Fedarko NS. Discovery and Validation of Agonistic Angiotensin Receptor Autoantibodies as Biomarkers of Adverse Outcomes. Circulation 2016; 135:449-459. [PMID: 27903588 DOI: 10.1161/circulationaha.116.022385] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 11/11/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND Agonistic angiotensin II type 1 receptor autoantibodies (AT1RaAbs) have not been associated with functional measures or risk for adverse health outcomes. AT1RaAbs could be used to stratify patient risk and to identify patients who can benefit from angiotensin receptor blocker treatment. METHODS Demographic and physiological covariates were measured in a discovery set of community-dwelling adults from Baltimore (N=255) and AT1RaAb associations with physical function tests and outcomes assessed. A group from Chicago (N=60) was used for validation of associations and to explore the impact of angiotensin receptor blocker treatment. RESULTS The Baltimore group had 28 subjects with falls, 32 frail subjects, and 5 deaths. Higher AT1RaAbs correlated significantly with interleukin-6 (Spearman r=0.33, P<0.0001), systolic blood pressure (Spearman r=0.28, P<0.0001), body mass index (Spearman r=0.28, P<0.0001), weaker grip strength (Spearman r=-0.34, P<0.01), and slower walking speed (Spearman r=-0.30, P<0.05). Individuals with high AT1RaAbs were 3.9 (95% confidence interval, 1.38-11.0) times more likely to be at high risk after adjusting for age (P<0.05). Every 1 µg/mL increase in AT1RaAbs increased the odds of falling 30% after adjusting for age, sex, body mass index, and blood pressure. The Chicago group had 46 subjects with falls and 60 deaths. Serum AT1RaAb levels were significantly correlated with grip strength (Spearman r=-0.57, P<0.005), walking speed (Spearman r=-0.47, P<0.005), and falls (Spearman r=0.30, P<0.05). Every 1 µg/mL increase in AT1RaAbs, decreased time to death by 9% after adjusting for age, sex, body mass index, and blood pressure. Chronic treatment with angiotensin receptor blockers was associated with better control of systolic blood pressure and attenuation of decline in both grip strength and time to death. CONCLUSIONS In older individuals, higher AT1RaAb levels were associated with inflammation, hypertension, and adverse outcomes. Angiotensin receptor blocker treatment may blunt the harm associated with high levels of AT1RaAb.
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Affiliation(s)
- Peter M Abadir
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - Alka Jain
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - Laura J Powell
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - Qian-Li Xue
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - Jing Tian
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - Robert G Hamilton
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - David A Bennett
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - Thomas Finucane
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - Jeremy D Walston
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - Neal S Fedarko
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.).
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7
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Bjerre A, Tangeraas T, Heidecke H, Dragun D, Dechend R, Staff AC. Angiotensin II type 1 receptor antibodies in childhood kidney transplantation. Pediatr Transplant 2016; 20:627-32. [PMID: 27251358 DOI: 10.1111/petr.12728] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/26/2016] [Indexed: 12/23/2022]
Abstract
Angiotensin II type 1 receptor antibodies (AT1 RAb) have emerged as non-HLA Ab present in patients with acute AMR and risk of graft loss. Furthermore, AT1 RAb have been shown to increase angiotensin II sensitivity which may play a role in the development of CVD and hypertension. Data on AT1 RAb in stable transplant recipients are lacking. The aim of this study was to analyze the levels of AT1 RAb in a cohort of stable patients after kidney transplantation (tx) in childhood. A cross-sectional study of 30 children (median age 14, range 3-19 yr, median time since tx five yr) and 28 adults who were transplanted in childhood (median age 26, range 20-40 yr, median time since tx 18 yr) transplanted between 1993-2006 and 1983-2002, respectively, was performed. Healthy controls were 51 healthy children (5-8 yr) and 199 healthy donors (median age 56.5 yr, range 42-83 yr). Plasma AT1 RAb were analyzed by immunoassay. Median total AT1 RAb IgG concentration was significantly higher in the pediatric-tx group as compared to the adult-tx group (40.0 and 10.95 U/mL, p < 0.0001). For both groups, the tx group showed higher levels: the pediatric-tx group vs. control group (40.0 vs. 13.3 U/mL, p = 0.0006) and the adult-tx group vs. adult control group (10.95 vs. 6.5 U/mL, p < 0.0001). Age was the strongest indicator of high levels of AT1 RAb IgG (p = 0.0003). AT1 RAb total IgG levels are significantly higher in a stable pediatric-tx cohort as compared to adult-tx patients and healthy controls of comparable age groups. The relevance of our findings in relation to age, time since tx, previous or future rejection, and CVD risk merits future studies.
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Affiliation(s)
- Anna Bjerre
- Department of Pediatrics, Oslo University Hospital, Oslo, Norway
| | - Trine Tangeraas
- Department of Pediatrics, Oslo University Hospital, Oslo, Norway
| | | | - Duska Dragun
- Department of Nephrology and Intensive Care Medicine, Charité Hospital, Berlin, Germany
| | - Ralf Dechend
- Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrueck Center for Molecular Medicine, and HELIOS Clinic-Berlin, Berlin, Germany
| | - Anne Cathrine Staff
- Department of Obstetrics and Department of Gynecology, Oslo University Hospital and University of Oslo, Oslo, Norway
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8
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Valenzuela NM, Reed EF. Antibodies in transplantation: the effects of HLA and non-HLA antibody binding and mechanisms of injury. Methods Mol Biol 2014; 1034:41-70. [PMID: 23775730 DOI: 10.1007/978-1-62703-493-7_2] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Until recently, allograft rejection was thought to be mediated primarily by alloreactive T cells. Consequently, immunosuppressive approaches focused on inhibition of T cell activation. While short-term graft survival has significantly improved and rejection rates have dropped, acute rejection has not been eliminated and chronic rejection remains the major threat to long-term graft survival. Increased attention to humoral immunity in experimental systems and in the clinic has revealed that donor specific antibodies (DSA) can mediate and promote acute and chronic rejection. Herein, we detail the effects of alloantibody, particularly HLA antibody, binding to graft vascular and other cells, and briefly summarize the experimental methods used to assess such outcomes.
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Affiliation(s)
- Nicole M Valenzuela
- Department of Pathology and Laboratory Medicine, UCLA Immunogenetics Center, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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9
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Jin Z, Zhang W, Chai W, Zheng Y, Zhi J. Antibodies against AT1 receptors are associated with vascular endothelial and smooth muscle function impairment: protective effects of hydroxysafflor yellow A. PLoS One 2013; 8:e67020. [PMID: 23826187 PMCID: PMC3691132 DOI: 10.1371/journal.pone.0067020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 05/13/2013] [Indexed: 12/04/2022] Open
Abstract
Ample evidence has shown that autoantibodies against AT1 receptors (AT1-AA) are closely associated with human cardiovascular disease. The aim of this study was to investigate mechanisms underlying AT1-AA-induced vascular structural and functional impairments in the formation of hypertension, and explore ways for preventive treatment. We used synthetic peptide corresponding to the sequence of the second extracellular loop of the AT1 receptor (165–191) to immunize rats and establish an active immunization model. Part of the model received preventive therapy by losartan (20 mg/kg/day) and hyroxysafflor yellow A (HSYA) (10 mg/kg/day). The result show that systolic blood pressure (SBP) and heart rate (HR) of immunized rats was significantly higher, and closely correlated with the plasma AT1-Ab titer. The systolic response of thoracic aortic was increased, but diastolic effects were attenuated markedly. Histological observation showed that the thoracic aortic endothelium of the immunized rats became thinner or ruptured, inflammatory cell infiltration, medial smooth muscle cell proliferation and migration, the vascular wall became thicker. There was no significant difference in serum antibody titer between losartan and HSYA groups and the immunized group. The vascular structure and function were reversed, and plasma biochemical parameters were also improved significantly in the two treatment groups. These results suggest that AT1-Ab could induce injury to vascular endothelial cells, and proliferation of smooth muscle cells. These changes were involved in the formation of hypertension. Treatment with AT1 receptor antagonists and anti oxidative therapy could block the pathogenic effect of AT1-Ab on vascular endothelial and smooth muscle cells.
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MESH Headings
- Acetylcholine/pharmacology
- Animals
- Antibodies/pharmacology
- Aorta/drug effects
- Aorta/pathology
- Aorta/physiopathology
- Aorta/ultrastructure
- Blood Pressure/drug effects
- Cardiotonic Agents/pharmacology
- Chalcone/analogs & derivatives
- Chalcone/pharmacology
- Diastole/drug effects
- Endothelins/blood
- Endothelium, Vascular/drug effects
- Endothelium, Vascular/pathology
- Endothelium, Vascular/physiopathology
- Endothelium, Vascular/ultrastructure
- Heart Rate/drug effects
- Humans
- Immunization
- In Vitro Techniques
- Indomethacin/pharmacology
- Lipoproteins, LDL/blood
- Male
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/pathology
- Muscle, Smooth, Vascular/physiopathology
- Muscle, Smooth, Vascular/ultrastructure
- Myocardial Contraction/drug effects
- NG-Nitroarginine Methyl Ester/pharmacology
- Nitric Oxide/blood
- Nitroprusside/pharmacology
- Quinones/pharmacology
- Rats
- Rats, Wistar
- Receptor, Angiotensin, Type 1/immunology
- Systole/drug effects
- Vasodilation/drug effects
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Affiliation(s)
- Zhu Jin
- Department of Physiology, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China
| | - Wenhui Zhang
- Department of Physiology, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China
| | - Weiran Chai
- Department of Assisted Reproductive Technology Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Yanqian Zheng
- Department of Physiology, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China
| | - Jianming Zhi
- Department of Physiology, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China
- * E-mail:
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10
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Lake JE, Tseng CH, Currier JS. A pilot study of telmisartan for visceral adiposity in HIV infection: the metabolic abnormalities, telmisartan, and HIV infection (MATH) trial. PLoS One 2013; 8:e58135. [PMID: 23516440 PMCID: PMC3597631 DOI: 10.1371/journal.pone.0058135] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 01/30/2013] [Indexed: 11/18/2022] Open
Abstract
Background Visceral adiposity in the setting of HIV infection and antiretroviral therapy (ART) is not fully understood, and treatment options remain limited. Telmisartan, an angiotensin receptor blocker and partial PPAR-γ agonist, has been shown to decrease visceral fat and improve metabolic and inflammatory parameters in HIV-uninfected subjects. Methods HIV-infected subjects with HIV-1 RNA <50 copies/mL on ART and (women/men) waist circumference >94/95 cm or waist: hip ratio >0.88/0.94 received open-label telmisartan 40 mg po daily for 24 weeks. Adipose tissue (AT) volumes were quantified by L4–L5 single slice computed tomography. Metabolic and inflammatory markers were obtained fasting. Thirty-five subjects provided 80% power to detect a 10% 24-week decrease in visceral AT (VAT, two-sided α = 0.05). Results Thirty-five subjects enrolled and completed the protocol. At entry (median or %): age 49 years, 43% female, 77% non-white, 91% non-smokers, CD4+ T cell count 590 cells/mm3, BMI 31 kg/m2. AT responses were heterogeneous, with statistically significant losses of median (IQR) total (TAT, 2.9% (−9.8, 0.7), p = 0.03) and subcutaneous (SAT, −2.7% (−9.8, 1.1), p = 0.03) AT, but not VAT (−2.7% (−20.5, 14.2), p = 0.53). Significant decreases in waist circumference and waist:hip ratio occurred (both p<0.001) without BMI or weight changes. In an exploratory analysis, significant increases in TNF-α occurred among female subjects without changes in other inflammatory or metabolic markers. No related adverse events occurred. Conclusions Telmisartan was well tolerated. Small losses of AT from all depots were observed after 24 weeks of telmisartan therapy. Further study is needed to determine whether HIV-infected patients can receive metabolic benefits from telmisartan. Trial Registration ClinicalTrials.gov NCT01088295
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Affiliation(s)
- Jordan E Lake
- Division of Infectious Diseases, Department of Medicine, University of California Los Angeles, Los Angeles, California, USA.
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11
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Rossitto G, Regolisti G, Rossi E, Negro A, Nicoli D, Casali B, Toniato A, Caroccia B, Seccia TM, Walther T, Rossi GP. Elevation of Angiotensin-II Type-1-Receptor Autoantibodies Titer in Primary Aldosteronism as a Result of Aldosterone-Producing Adenoma. Hypertension 2013; 61:526-33. [DOI: 10.1161/hypertensionaha.112.202945] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Giacomo Rossitto
- From the Department of Medicine—DIMED, Internal Medicine 4, Padua University—School of Medicine, Padova, Italy (G.Ro., B.C., T.M.S., G.P.R.); Department of Internal Medicine, Santa Maria Nuova Hospital, Reggio Emilia, Italy (G.Re., E.R., A.N., D.N., B.C.); Surgical Pathology Unit, Department of Medical and Surgical Sciences, Padua University, Padua, Italy (A.T.); Hull York Medical School, Hull University, Cottingham, UK (T.W.)
| | - Giuseppe Regolisti
- From the Department of Medicine—DIMED, Internal Medicine 4, Padua University—School of Medicine, Padova, Italy (G.Ro., B.C., T.M.S., G.P.R.); Department of Internal Medicine, Santa Maria Nuova Hospital, Reggio Emilia, Italy (G.Re., E.R., A.N., D.N., B.C.); Surgical Pathology Unit, Department of Medical and Surgical Sciences, Padua University, Padua, Italy (A.T.); Hull York Medical School, Hull University, Cottingham, UK (T.W.)
| | - Ermanno Rossi
- From the Department of Medicine—DIMED, Internal Medicine 4, Padua University—School of Medicine, Padova, Italy (G.Ro., B.C., T.M.S., G.P.R.); Department of Internal Medicine, Santa Maria Nuova Hospital, Reggio Emilia, Italy (G.Re., E.R., A.N., D.N., B.C.); Surgical Pathology Unit, Department of Medical and Surgical Sciences, Padua University, Padua, Italy (A.T.); Hull York Medical School, Hull University, Cottingham, UK (T.W.)
| | - Aurelio Negro
- From the Department of Medicine—DIMED, Internal Medicine 4, Padua University—School of Medicine, Padova, Italy (G.Ro., B.C., T.M.S., G.P.R.); Department of Internal Medicine, Santa Maria Nuova Hospital, Reggio Emilia, Italy (G.Re., E.R., A.N., D.N., B.C.); Surgical Pathology Unit, Department of Medical and Surgical Sciences, Padua University, Padua, Italy (A.T.); Hull York Medical School, Hull University, Cottingham, UK (T.W.)
| | - Davide Nicoli
- From the Department of Medicine—DIMED, Internal Medicine 4, Padua University—School of Medicine, Padova, Italy (G.Ro., B.C., T.M.S., G.P.R.); Department of Internal Medicine, Santa Maria Nuova Hospital, Reggio Emilia, Italy (G.Re., E.R., A.N., D.N., B.C.); Surgical Pathology Unit, Department of Medical and Surgical Sciences, Padua University, Padua, Italy (A.T.); Hull York Medical School, Hull University, Cottingham, UK (T.W.)
| | - Bruno Casali
- From the Department of Medicine—DIMED, Internal Medicine 4, Padua University—School of Medicine, Padova, Italy (G.Ro., B.C., T.M.S., G.P.R.); Department of Internal Medicine, Santa Maria Nuova Hospital, Reggio Emilia, Italy (G.Re., E.R., A.N., D.N., B.C.); Surgical Pathology Unit, Department of Medical and Surgical Sciences, Padua University, Padua, Italy (A.T.); Hull York Medical School, Hull University, Cottingham, UK (T.W.)
| | - Antonio Toniato
- From the Department of Medicine—DIMED, Internal Medicine 4, Padua University—School of Medicine, Padova, Italy (G.Ro., B.C., T.M.S., G.P.R.); Department of Internal Medicine, Santa Maria Nuova Hospital, Reggio Emilia, Italy (G.Re., E.R., A.N., D.N., B.C.); Surgical Pathology Unit, Department of Medical and Surgical Sciences, Padua University, Padua, Italy (A.T.); Hull York Medical School, Hull University, Cottingham, UK (T.W.)
| | - Brasilina Caroccia
- From the Department of Medicine—DIMED, Internal Medicine 4, Padua University—School of Medicine, Padova, Italy (G.Ro., B.C., T.M.S., G.P.R.); Department of Internal Medicine, Santa Maria Nuova Hospital, Reggio Emilia, Italy (G.Re., E.R., A.N., D.N., B.C.); Surgical Pathology Unit, Department of Medical and Surgical Sciences, Padua University, Padua, Italy (A.T.); Hull York Medical School, Hull University, Cottingham, UK (T.W.)
| | - Teresa Maria Seccia
- From the Department of Medicine—DIMED, Internal Medicine 4, Padua University—School of Medicine, Padova, Italy (G.Ro., B.C., T.M.S., G.P.R.); Department of Internal Medicine, Santa Maria Nuova Hospital, Reggio Emilia, Italy (G.Re., E.R., A.N., D.N., B.C.); Surgical Pathology Unit, Department of Medical and Surgical Sciences, Padua University, Padua, Italy (A.T.); Hull York Medical School, Hull University, Cottingham, UK (T.W.)
| | - Thomas Walther
- From the Department of Medicine—DIMED, Internal Medicine 4, Padua University—School of Medicine, Padova, Italy (G.Ro., B.C., T.M.S., G.P.R.); Department of Internal Medicine, Santa Maria Nuova Hospital, Reggio Emilia, Italy (G.Re., E.R., A.N., D.N., B.C.); Surgical Pathology Unit, Department of Medical and Surgical Sciences, Padua University, Padua, Italy (A.T.); Hull York Medical School, Hull University, Cottingham, UK (T.W.)
| | - Gian Paolo Rossi
- From the Department of Medicine—DIMED, Internal Medicine 4, Padua University—School of Medicine, Padova, Italy (G.Ro., B.C., T.M.S., G.P.R.); Department of Internal Medicine, Santa Maria Nuova Hospital, Reggio Emilia, Italy (G.Re., E.R., A.N., D.N., B.C.); Surgical Pathology Unit, Department of Medical and Surgical Sciences, Padua University, Padua, Italy (A.T.); Hull York Medical School, Hull University, Cottingham, UK (T.W.)
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