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Marcella S, Petraroli A, Canè L, Ferrara AL, Poto R, Parente R, Palestra F, Cristinziano L, Modestino L, Galdiero MR, Monti M, Marone G, Triggiani M, Varricchi G, Loffredo S. Thymic stromal lymphopoietin (TSLP) is a substrate for tryptase in patients with mastocytosis. Eur J Intern Med 2023; 117:111-118. [PMID: 37500310 DOI: 10.1016/j.ejim.2023.07.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/13/2023] [Accepted: 07/21/2023] [Indexed: 07/29/2023]
Abstract
Mastocytosis is a heterogeneous disease associated to uncontrolled proliferation and increased density of mast cells in different organs. This clonal disorder is related to gain-of-function pathogenic variants of the c-kit gene that encodes for KIT (CD117) expressed on mast cell membrane. Thymic stromal lymphopoietin (TSLP) is a pleiotropic cytokine, which plays a key role in allergic disorders and several cancers. TSLP is a survival and activating factor for human mast cells through the engagement of the TSLP receptor. Activated human mast cells release several preformed mediators, including tryptase. Increased mast cell-derived tryptase is a diagnostic biomarker of mastocytosis. In this study, we found that in these patients serum concentrations of TSLP were lower than healthy donors. There was an inverse correlation between TSLP and tryptase concentrations in mastocytosis. Incubation of human recombinant TSLP with sera from patients with mastocytosis, containing increasing concentrations of tryptase, concentration-dependently decreased TSLP immunoreactivity. Similarly, recombinant β-tryptase reduced the immunoreactivity of recombinant TSLP, inducing the formation of a cleavage product of approximately 10 kDa. Collectively, these results indicate that TSLP is a substrate for human mast cell tryptase and highlight a novel loop involving these mediators in mastocytosis.
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Affiliation(s)
| | - Angelica Petraroli
- Department of Translational Medical Sciences, University of Naples Federico II, Naples 80131, Italy; World Allergy Organization (WAO) Center of Excellence, Naples 80131, Italy
| | - Luisa Canè
- Department of Translational Medical Sciences, University of Naples Federico II, Naples 80131, Italy; CEINGE Advanced Biotechnologies, Naples, Italy
| | - Anne Lise Ferrara
- Department of Translational Medical Sciences, University of Naples Federico II, Naples 80131, Italy; World Allergy Organization (WAO) Center of Excellence, Naples 80131, Italy
| | - Remo Poto
- Department of Translational Medical Sciences, University of Naples Federico II, Naples 80131, Italy; World Allergy Organization (WAO) Center of Excellence, Naples 80131, Italy
| | - Roberta Parente
- Division of Allergy and Clinical Immunology, University of Salerno, Fisciano (SA) 84084, Italy
| | - Francesco Palestra
- Department of Translational Medical Sciences, University of Naples Federico II, Naples 80131, Italy; World Allergy Organization (WAO) Center of Excellence, Naples 80131, Italy
| | - Leonardo Cristinziano
- Department of Translational Medical Sciences, University of Naples Federico II, Naples 80131, Italy; World Allergy Organization (WAO) Center of Excellence, Naples 80131, Italy
| | - Luca Modestino
- Department of Translational Medical Sciences, University of Naples Federico II, Naples 80131, Italy; World Allergy Organization (WAO) Center of Excellence, Naples 80131, Italy
| | - Maria Rosaria Galdiero
- Department of Translational Medical Sciences, University of Naples Federico II, Naples 80131, Italy; World Allergy Organization (WAO) Center of Excellence, Naples 80131, Italy; Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, Naples 80131, Italy
| | - Maria Monti
- CEINGE Advanced Biotechnologies, Naples, Italy; Department of Chemical Sciences, University of Naples Federico II, Naples 80126, Italy
| | - Gianni Marone
- Department of Translational Medical Sciences, University of Naples Federico II, Naples 80131, Italy; World Allergy Organization (WAO) Center of Excellence, Naples 80131, Italy; Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, Naples 80131, Italy; Institute of Experimental Endocrinology and Oncology (IEOS), National Research Council, Naples 80131, Italy
| | - Massimo Triggiani
- Division of Allergy and Clinical Immunology, University of Salerno, Fisciano (SA) 84084, Italy
| | - Gilda Varricchi
- Department of Translational Medical Sciences, University of Naples Federico II, Naples 80131, Italy; World Allergy Organization (WAO) Center of Excellence, Naples 80131, Italy; Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, Naples 80131, Italy; Institute of Experimental Endocrinology and Oncology (IEOS), National Research Council, Naples 80131, Italy.
| | - Stefania Loffredo
- Department of Translational Medical Sciences, University of Naples Federico II, Naples 80131, Italy; World Allergy Organization (WAO) Center of Excellence, Naples 80131, Italy; Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, Naples 80131, Italy; Institute of Experimental Endocrinology and Oncology (IEOS), National Research Council, Naples 80131, Italy.
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2
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Raj S, Unsworth LD. Targeting active sites of inflammation using inherent properties of tissue-resident mast cells. Acta Biomater 2023; 159:21-37. [PMID: 36657696 DOI: 10.1016/j.actbio.2023.01.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/12/2022] [Accepted: 01/10/2023] [Indexed: 01/18/2023]
Abstract
Mast cells play a pivotal role in initiating and directing host's immune response. They reside in tissues that primarily interface with the external environment. Activated mast cells respond to environmental cues throughout acute and chronic inflammation through releasing immune mediators via rapid degranulation, or long-term de novo expression. Mast cell activation results in the rapid release of a variety of unique enzymes and reactive oxygen species. Furthermore, the increased density of mast cell unique receptors like mas related G protein-coupled receptor X2 also characterizes the inflamed tissues. The presence of these molecules (either released mediators or surface receptors) are particular to the sites of active inflammation, and are a result of mast cell activation. Herein, the molecular design principles for capitalizing on these novel mast cell properties is discussed with the goal of manipulating localized inflammation. STATEMENT OF SIGNIFICANCE: Mast cells are immune regulating cells that play a crucial role in both innate and adaptive immune responses. The activation of mast cells causes the release of multiple unique profiles of biomolecules, which are specific to both tissue and disease. These unique characteristics are tightly regulated and afford a localized stimulus for targeting inflammatory diseases. Herein, these important mast cell attributes are discussed in the frame of highlighting strategies for the design of bioresponsive functional materials to target regions of inflammations.
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Affiliation(s)
- Shammy Raj
- Department of Chemical and Materials Engineering, Donadeo Innovation Centre for Engineering, 9211-116 Street NW, University of Alberta, Edmonton, AB, T6G1H9, Canada
| | - Larry D Unsworth
- Department of Chemical and Materials Engineering, Donadeo Innovation Centre for Engineering, 9211-116 Street NW, University of Alberta, Edmonton, AB, T6G1H9, Canada.
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Banafea GH, Bakhashab S, Alshaibi HF, Natesan Pushparaj P, Rasool M. The role of human mast cells in allergy and asthma. Bioengineered 2022; 13:7049-7064. [PMID: 35266441 PMCID: PMC9208518 DOI: 10.1080/21655979.2022.2044278] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Mast cells are tissue-inhabiting cells that play an important role in inflammatory diseases of the airway tract. Mast cells arise in the bone marrow as progenitor cells and complete their differentiation in tissues exposed to the external environment, such as the skin and respiratory tract, and are among the first to respond to bacterial and parasitic infections. Mast cells express a variety of receptors that enable them to respond to a wide range of stimulants, including the high-affinity FcεRI receptor. Upon initial contact with an antigen, mast cells are sensitized with IgE to recognize the allergen upon further contact. FcεRI-activated mast cells are known to release histamine and proteases that contribute to asthma symptoms. They release a variety of cytokines and lipid mediators that contribute to immune cell accumulation and tissue remodeling in asthma. Mast cell mediators trigger inflammation and also have a protective effect. This review aims to update the existing knowledge on the mediators released by human FcεRI-activated mast cells, and to unravel their pathological and protective roles in asthma and allergy. In addition, we highlight other diseases that arise from mast cell dysfunction, the therapeutic approaches used to address them, and fill the gaps in our current knowledge. Mast cell mediators not only trigger inflammation but may also have a protective effect. Given the differences between human and animal mast cells, this review focuses on the mediators released by human FcεRI-activated mast cells and the role they play in asthma and allergy.
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Affiliation(s)
- Ghalya H Banafea
- Biochemistry Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sherin Bakhashab
- Biochemistry Department, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Huda F Alshaibi
- Biochemistry Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Peter Natesan Pushparaj
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.,Center of Excellence in Genomic Medicine Research, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mahmood Rasool
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.,Center of Excellence in Genomic Medicine Research, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
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Rodrigues-Braz D, Zhao M, Yesilirmak N, Aractingi S, Behar-Cohen F, Bourges JL. Cutaneous and ocular rosacea: Common and specific physiopathogenic mechanisms and study models. Mol Vis 2021; 27:323-353. [PMID: 34035646 PMCID: PMC8131178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 05/11/2021] [Indexed: 11/21/2022] Open
Abstract
Rosacea is a chronic inflammatory disease that affects the face skin. It is clinically classified into the following four subgroups depending on its location and severity: erythematotelangiectatic, papulopustular, phymatous, and ocular. Rosacea is a multifactorial disease triggered by favoring factors, the pathogenesis of which remains imperfectly understood. Recognized mechanisms include the innate immune system, with the implication of Toll-like receptors (TLRs) and cathelicidins; neurovascular deregulation involving vascular endothelial growth factor (VEGF), transient receptor potential (TRP) ion channels, and neuropeptides; and dysfunction of skin sebaceous glands and ocular meibomian glands. Microorganisms, genetic predisposition, corticosteroid treatment, and ultraviolet B (UVB) radiation are favoring factors. In this paper, we review the common and specific molecular mechanisms involved in the pathogenesis of cutaneous and ocular rosacea and discuss laboratory and clinical studies, as well as experimental models.
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Affiliation(s)
- Daniela Rodrigues-Braz
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Université, Inserm, UMRS1138, Team 17, Physiopathology of ocular diseases: therapeutic innovations, Paris, France
| | - Min Zhao
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Université, Inserm, UMRS1138, Team 17, Physiopathology of ocular diseases: therapeutic innovations, Paris, France
| | - Nilufer Yesilirmak
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Université, Inserm, UMRS1138, Team 17, Physiopathology of ocular diseases: therapeutic innovations, Paris, France
- Department of Ophthalmology, Ankara Yildirim Beyazit University, Ankara, Turkey
- Ophtalmopole, Assistance Publique -Hôpitaux de Paris (AP-HP), Cochin Hospital, Paris, France
| | - Selim Aractingi
- Department of Dermatology, AP-HP, Cochin Hospital, Paris, France
| | - Francine Behar-Cohen
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Université, Inserm, UMRS1138, Team 17, Physiopathology of ocular diseases: therapeutic innovations, Paris, France
- Ophtalmopole, Assistance Publique -Hôpitaux de Paris (AP-HP), Cochin Hospital, Paris, France
| | - Jean-Louis Bourges
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Université, Inserm, UMRS1138, Team 17, Physiopathology of ocular diseases: therapeutic innovations, Paris, France
- Ophtalmopole, Assistance Publique -Hôpitaux de Paris (AP-HP), Cochin Hospital, Paris, France
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Vincent L, Lapointe C, Lo M, Gagnon H, Pejler G, Takai S, Day R, D'Orléans-Juste P. Mast Cell Degranulation Increases Mouse Mast Cell Protease 4-Dependent Vasopressor Responses to Big Endothelin-1 But Not Angiotensin I. J Pharmacol Exp Ther 2020; 376:213-221. [PMID: 33154104 DOI: 10.1124/jpet.120.000325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 11/02/2020] [Indexed: 12/15/2022] Open
Abstract
Mouse mast cell protease 4 (mMCP-4), the murine functional analog to the human chymase, is a serine protease synthesized and stored in mast cell secretory granules. Our previous studies reported physiologic and pathologic roles for mMCP-4 in the maturation and synthesis of the vasoactive peptide endothelin-1 (ET-1) from its precursor, big ET-1. The aim of this study was to investigate the impact of mast cell degranulation or stabilization on mMCP-4-dependent pressor responses after the administration of big ET-1 or angiotensin I (Ang I). In anesthetized mice, mast cell degranulation induced by compound 48/80 (C48/80) or stabilization by cromolyn enhanced or repressed, respectively, the dose-dependent vasopressor responses to big ET-1 in wild-type (WT) mice but not in mMCP-4 knockout mice in a chymase inhibitor (TY-51469)-sensitive fashion. In addition, mMCP-4-dependent hydrolysis of the fluorogenic substrate Suc-Leu-Leu-Val-Tyr-7-amino-4-methylcoumarin was depleted or enhanced in peritoneal mast cells isolated from mice pretreated with C48/80 or cromolyn, respectively. Furthermore, C48/80 or cromolyn markedly increased or abolished, respectively, ET-1 (1-31) conversion from exogenous big ET-1 in WT mice peritoneal fluid-isolated mast cells, in vitro. Finally, the vasopressor responses to Ang I were unaffected by mast cell activation or stabilization, whereas those induced by the angiotensin-converting enzyme-resistant Ang I analog, [Pro11, D-Ala12] Ang I, were potentiated by C48/80. Altogether, the present study shows that mast cell activation enhances the mMCP-4-dependent vasoactive properties of big ET-1 but not Ang I in the mouse model. SIGNIFICANCE STATEMENT: The current work demonstrates a significant role for mast cell stability in the cardiovascular pharmacology of big endothelin-1 but not angiotensin I in the murine systemic circulation.
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Affiliation(s)
- Laurence Vincent
- Department of Pharmacology and Physiology, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada (L.V., C.L., M.L., P.D.-J.); PhenoSwitch Bioscience Inc., Sherbrooke, Quebec, Canada (H.G.); Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden (G.P.); Department of Innovative Medicine, Osaka Medical College, Osaka, Japan (S.T.); and Department of Surgery, Division of Urology, Université de Sherbrooke, Sherbrooke, Quebec, Canada (R.D.)
| | - Catherine Lapointe
- Department of Pharmacology and Physiology, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada (L.V., C.L., M.L., P.D.-J.); PhenoSwitch Bioscience Inc., Sherbrooke, Quebec, Canada (H.G.); Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden (G.P.); Department of Innovative Medicine, Osaka Medical College, Osaka, Japan (S.T.); and Department of Surgery, Division of Urology, Université de Sherbrooke, Sherbrooke, Quebec, Canada (R.D.)
| | - Modou Lo
- Department of Pharmacology and Physiology, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada (L.V., C.L., M.L., P.D.-J.); PhenoSwitch Bioscience Inc., Sherbrooke, Quebec, Canada (H.G.); Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden (G.P.); Department of Innovative Medicine, Osaka Medical College, Osaka, Japan (S.T.); and Department of Surgery, Division of Urology, Université de Sherbrooke, Sherbrooke, Quebec, Canada (R.D.)
| | - Hugo Gagnon
- Department of Pharmacology and Physiology, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada (L.V., C.L., M.L., P.D.-J.); PhenoSwitch Bioscience Inc., Sherbrooke, Quebec, Canada (H.G.); Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden (G.P.); Department of Innovative Medicine, Osaka Medical College, Osaka, Japan (S.T.); and Department of Surgery, Division of Urology, Université de Sherbrooke, Sherbrooke, Quebec, Canada (R.D.)
| | - Gunnar Pejler
- Department of Pharmacology and Physiology, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada (L.V., C.L., M.L., P.D.-J.); PhenoSwitch Bioscience Inc., Sherbrooke, Quebec, Canada (H.G.); Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden (G.P.); Department of Innovative Medicine, Osaka Medical College, Osaka, Japan (S.T.); and Department of Surgery, Division of Urology, Université de Sherbrooke, Sherbrooke, Quebec, Canada (R.D.)
| | - Shinji Takai
- Department of Pharmacology and Physiology, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada (L.V., C.L., M.L., P.D.-J.); PhenoSwitch Bioscience Inc., Sherbrooke, Quebec, Canada (H.G.); Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden (G.P.); Department of Innovative Medicine, Osaka Medical College, Osaka, Japan (S.T.); and Department of Surgery, Division of Urology, Université de Sherbrooke, Sherbrooke, Quebec, Canada (R.D.)
| | - Robert Day
- Department of Pharmacology and Physiology, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada (L.V., C.L., M.L., P.D.-J.); PhenoSwitch Bioscience Inc., Sherbrooke, Quebec, Canada (H.G.); Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden (G.P.); Department of Innovative Medicine, Osaka Medical College, Osaka, Japan (S.T.); and Department of Surgery, Division of Urology, Université de Sherbrooke, Sherbrooke, Quebec, Canada (R.D.)
| | - Pedro D'Orléans-Juste
- Department of Pharmacology and Physiology, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada (L.V., C.L., M.L., P.D.-J.); PhenoSwitch Bioscience Inc., Sherbrooke, Quebec, Canada (H.G.); Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden (G.P.); Department of Innovative Medicine, Osaka Medical College, Osaka, Japan (S.T.); and Department of Surgery, Division of Urology, Université de Sherbrooke, Sherbrooke, Quebec, Canada (R.D.)
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Chen W, Werner F, Illerhaus A, Knopp T, Völker K, Potapenko T, Hofmann U, Frantz S, Baba HA, Rösch M, Zernecke A, Karbach S, Wenzel P, Kuhn M. Stabilization of Perivascular Mast Cells by Endothelial CNP (C-Type Natriuretic Peptide). Arterioscler Thromb Vasc Biol 2020; 40:682-696. [PMID: 31893950 DOI: 10.1161/atvbaha.119.313702] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Activated perivascular mast cells (MCs) participate in different cardiovascular diseases. Many factors provoking MC degranulation have been described, while physiological counterregulators are barely known. Endothelial CNP (C-type natriuretic peptide) participates in the maintenance of vascular barrier integrity, but the target cells and mechanisms are unclear. Here, we studied whether MCs are regulated by CNP. Approach and Results: In cultured human and murine MCs, CNP activated its specific GC (guanylyl cyclase)-B receptor and cyclic GMP signaling. This enhanced cyclic GMP-dependent phosphorylation of the cytoskeleton-associated VASP (vasodilator-stimulated phosphoprotein) and inhibited ATP-evoked degranulation. To elucidate the relevance in vivo, mice with a floxed GC-B (Npr2) gene were interbred with a Mcpt5-CreTG line to generate mice lacking GC-B in connective tissue MCs (MC GC-B knockout). In anesthetized mice, acute ischemia-reperfusion of the cremaster muscle microcirculation provoked extensive MC degranulation and macromolecule extravasation. Superfusion of CNP markedly prevented MC activation and endothelial barrier disruption in control but not in MC GC-B knockout mice. Notably, already under resting conditions, such knockout mice had increased numbers of degranulated MCs in different tissues, together with elevated plasma chymase levels. After transient coronary occlusion, their myocardial areas at risk and with infarction were enlarged. Moreover, MC GC-B knockout mice showed augmented perivascular neutrophil infiltration and deep vein thrombosis in a model of inferior vena cava ligation. CONCLUSIONS CNP, via GC-B/cyclic GMP signaling, stabilizes resident perivascular MCs at baseline and prevents their excessive activation under pathological conditions. Thereby CNP contributes to the maintenance of vascular integrity in physiology and disease.
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Affiliation(s)
- Wen Chen
- From the Institute of Physiology, University of Würzburg, Germany (W.C., F.W., K.V., T.P., M.K.).,Comprehensive Heart Failure Center (W.C., U.H., S.F., M.K.), University Hospital Würzburg, Germany
| | - Franziska Werner
- From the Institute of Physiology, University of Würzburg, Germany (W.C., F.W., K.V., T.P., M.K.)
| | - Anja Illerhaus
- Institute of Experimental Biomedicine (M.R., A.Z.), University Hospital Würzburg, Germany
| | - Tanja Knopp
- Department of Dermatology, University of Cologne, Germany (A.I.)
| | - Katharina Völker
- From the Institute of Physiology, University of Würzburg, Germany (W.C., F.W., K.V., T.P., M.K.)
| | - Tamara Potapenko
- From the Institute of Physiology, University of Würzburg, Germany (W.C., F.W., K.V., T.P., M.K.)
| | - Ulrich Hofmann
- Comprehensive Heart Failure Center (W.C., U.H., S.F., M.K.), University Hospital Würzburg, Germany
| | - Stefan Frantz
- Comprehensive Heart Failure Center (W.C., U.H., S.F., M.K.), University Hospital Würzburg, Germany
| | - Hideo A Baba
- Center of Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Germany (T.K., S.K., P.W.)
| | - Melanie Rösch
- Institute of Experimental Biomedicine (M.R., A.Z.), University Hospital Würzburg, Germany
| | - Alma Zernecke
- Institute of Experimental Biomedicine (M.R., A.Z.), University Hospital Würzburg, Germany
| | - Susanne Karbach
- Department of Dermatology, University of Cologne, Germany (A.I.).,Institute of Pathology, University Hospital Essen, University Duisburg-Essen (H.A.B.)
| | - Philip Wenzel
- Department of Dermatology, University of Cologne, Germany (A.I.).,Institute of Pathology, University Hospital Essen, University Duisburg-Essen (H.A.B.)
| | - Michaela Kuhn
- From the Institute of Physiology, University of Würzburg, Germany (W.C., F.W., K.V., T.P., M.K.).,Comprehensive Heart Failure Center (W.C., U.H., S.F., M.K.), University Hospital Würzburg, Germany
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