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Molnár A, Juha M, Bulajcsík K, Tabák ÁG, Tislér A, Ledó N. Proposal of a novel cardiovascular risk prediction score in lupus nephritis. Front Immunol 2024; 15:1405463. [PMID: 39114663 PMCID: PMC11305119 DOI: 10.3389/fimmu.2024.1405463] [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: 04/22/2024] [Accepted: 07/08/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction Patients with systemic lupus erythematosus are prone to develop cardiovascular disease (CVD), and have increased morbidity and mortality. Methods We conducted a retrospective analysis on lupus nephritis patients to assess the occurrence and predictors of major adverse cardiovascular events (MACE). Data were collected from patients who underwent kidney biopsy between 2005 and 2020. Statistical analysis was performed to unveil correlations. Results 91 patients were analyzed in this period, with a mean age of 37.3 ± 12.3 years and 86% being female. The mean follow-up time was 62 ± 48 months. 15.38% of the patients underwent at least one MACE. Two patients deceased of CVD. Increased age (35.81 ± 11.14 vs 45.5 ± 15.11 years, p=0.012) entailed a higher occurrence of MACEs. Neutrophil count (5.15 ± 2.83 vs 7.3 ± 2.99 Giga/L, p=0.001) was higher, whereas diastolic blood pressure (DBP) was lower (89.51 ± 10.96 vs 78.43 ± 6.9 mmHg, p<0.001) at the time of the biopsy in patients with MACE. Age, neutrophil count, and DBP proved to be independent predictors of MACEs. We propose a new model (CANDE - Cardiovascular risk based on Age, Neutrophil count, and Diastolic blood pressure Estimation score) calculated from these variables, which predicts the probability of MACE occurrence. Conclusion This study underscores the importance of actively screening for cardiovascular risks in this vulnerable patient population. Age, neutrophil count, and diastolic blood pressure have been established as independent risk factors for MACE in lupus nephritis. The CANDE score derived from these parameters may serve as a prompt, cost-effective, and easily accessible estimation tool for assessing the likelihood of major adverse cardiovascular risk. These findings emphasize the necessity for comprehensive management strategies addressing both immune dysregulation and cardiovascular risk factors in systemic lupus erythematosus to mitigate adverse outcomes.
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Affiliation(s)
- Adél Molnár
- Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary
| | - Márk Juha
- Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary
| | - Klaudia Bulajcsík
- Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary
| | - Ádám Gy. Tabák
- Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary
- Institute of Preventive Medicine and Public Health, Semmelweis University Faculty of Medicine, Budapest, Hungary
- UCL Brain Sciences, University College London, London, United Kingdom
| | - András Tislér
- Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary
| | - Nóra Ledó
- Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary
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2
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Monzavi SM, Alirezaei A, Shariati-Sarabi Z, Tavakol Afshari J, Mahmoudi M, Dormanesh B, Jahandoost F, Khoshdel AR, Etemad Rezaie A. Efficacy analysis of hydroxychloroquine therapy in systemic lupus erythematosus: a study on disease activity and immunological biomarkers. Inflammopharmacology 2018; 26:1175-1182. [PMID: 29987550 DOI: 10.1007/s10787-018-0512-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 06/22/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Hydroxychloroquine (HCQ) is a widely prescribed medication to patients with systemic lupus erythematosus (SLE), with potential anti-inflammatory effects. This study was performed to investigate the efficacy of HCQ therapy by serial assessment of disease activity and serum levels of proinflammatory cytokines in SLE patients. METHODS In this prospective cohort study, 41 newly diagnosed SLE patients receiving 400 mg HCQ per day were included. Patients requiring statins and immunosuppressive drugs except prednisolone at doses lower than 10 mg/day were excluded. Outcome measures were assessed before commencement of HCQ therapy (baseline visit) as well as in two follow-up visits (1 and 2 months after beginning the HCQ therapy). Serum samples of 41 age-matched healthy donors were used as controls. RESULTS Median levels of IL-1β (p < 0.001), IL-6 (p = 0.001), and TNF-α (p < 0.001) were significantly higher, whereas, median CH50 level was significantly lower (p < 0.001) in SLE patients compared with controls. Two-month treatment with HCQ resulted in significant decrease in SLEDAI-2K (p < 0.001), anti-dsDNA (p < 0.001), IL-1β (p = 0.003), IL-6 (p < 0.001) and TNF-α (p < 0.001) and a significant increase in CH50 levels (p = 0.012). The reductions in SLEDAI-2K and serum levels of IL-1β and TNF-α were significantly greater in the first month compared with the reductions in the second month. CONCLUSION HCQ therapy is effective on clinical improvement of SLE patients through interfering with inflammatory signaling pathways, reducing anti-DNA autoantibodies and normalizing the complement activity.
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Affiliation(s)
- Seyed Mostafa Monzavi
- Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Aida Alirezaei
- Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Internal Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Zhaleh Shariati-Sarabi
- Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Internal Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Jalil Tavakol Afshari
- Immunology Research Center, Buali Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahmoud Mahmoudi
- Immunology Research Center, Buali Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Faezeh Jahandoost
- Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Internal Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Ali Etemad Rezaie
- Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
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Pacheco Y, Barahona-Correa J, Monsalve DM, Acosta-Ampudia Y, Rojas M, Rodríguez Y, Saavedra J, Rodríguez-Jiménez M, Mantilla RD, Ramírez-Santana C, Molano-González N, Anaya JM. Cytokine and autoantibody clusters interaction in systemic lupus erythematosus. J Transl Med 2017; 15:239. [PMID: 29178890 PMCID: PMC5702157 DOI: 10.1186/s12967-017-1345-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 11/16/2017] [Indexed: 02/06/2023] Open
Abstract
Background Evidence supports the existence of different subphenotypes in systemic lupus erythematosus (SLE) and the pivotal role of cytokines and autoantibodies, which interact in a highly complex network. Thus, understanding how these complex nonlinear processes are connected and observed in real-life settings is a major challenge. Cluster approaches may assist in the identification of these subphenotypes, which represent such a phenomenon, and may contribute to the development of personalized medicine. Therefore, the relationship between autoantibody and cytokine clusters in SLE was analyzed. Methods This was an exploratory study in which 67 consecutive women with established SLE were assessed. Clinical characteristics including disease activity, a 14-autoantibody profile, and a panel of 15 serum cytokines were measured simultaneously. Mixed-cluster methodology and bivariate analyses were used to define autoantibody and cytokine clusters and to identify associations between them and related variables. Results First, three clusters of autoantibodies were defined: (1) neutral, (2) antiphospholipid antibodies (APLA)-dominant, and (3) anti-dsDNA/ENA-dominant. Second, eight cytokines showed levels above the threshold thus making possible to find 4 clusters: (1) neutral, (2) chemotactic, (3) G-CSF dominant, and (4) IFNα/Pro-inflammatory. Furthermore, the disease activity was associated with cytokine clusters, which, in turn, were associated with autoantibody clusters. Finally, when all biomarkers were included, three clusters were found: (1) neutral, (2) chemotactic/APLA, and (3) IFN/dsDNA, which were also associated with disease activity. Conclusion These results support the existence of three SLE cytokine-autoantibody driven subphenotypes. They encourage the practice of personalized medicine, and support proof-of-concept studies. Electronic supplementary material The online version of this article (10.1186/s12967-017-1345-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yovana Pacheco
- Center for Autoimmune Diseases Research (CREA) School of Medicine and Health Sciences, Universidad del Rosario, Carrera 26 # 63B-51, Bogota, Colombia
| | - Julián Barahona-Correa
- Center for Autoimmune Diseases Research (CREA) School of Medicine and Health Sciences, Universidad del Rosario, Carrera 26 # 63B-51, Bogota, Colombia
| | - Diana M Monsalve
- Center for Autoimmune Diseases Research (CREA) School of Medicine and Health Sciences, Universidad del Rosario, Carrera 26 # 63B-51, Bogota, Colombia
| | - Yeny Acosta-Ampudia
- Center for Autoimmune Diseases Research (CREA) School of Medicine and Health Sciences, Universidad del Rosario, Carrera 26 # 63B-51, Bogota, Colombia
| | - Manuel Rojas
- Center for Autoimmune Diseases Research (CREA) School of Medicine and Health Sciences, Universidad del Rosario, Carrera 26 # 63B-51, Bogota, Colombia
| | - Yhojan Rodríguez
- Center for Autoimmune Diseases Research (CREA) School of Medicine and Health Sciences, Universidad del Rosario, Carrera 26 # 63B-51, Bogota, Colombia
| | - Juliana Saavedra
- Center for Autoimmune Diseases Research (CREA) School of Medicine and Health Sciences, Universidad del Rosario, Carrera 26 # 63B-51, Bogota, Colombia
| | - Mónica Rodríguez-Jiménez
- Center for Autoimmune Diseases Research (CREA) School of Medicine and Health Sciences, Universidad del Rosario, Carrera 26 # 63B-51, Bogota, Colombia
| | - Rubén D Mantilla
- Center for Autoimmune Diseases Research (CREA) School of Medicine and Health Sciences, Universidad del Rosario, Carrera 26 # 63B-51, Bogota, Colombia
| | - Carolina Ramírez-Santana
- Center for Autoimmune Diseases Research (CREA) School of Medicine and Health Sciences, Universidad del Rosario, Carrera 26 # 63B-51, Bogota, Colombia
| | - Nicolás Molano-González
- Center for Autoimmune Diseases Research (CREA) School of Medicine and Health Sciences, Universidad del Rosario, Carrera 26 # 63B-51, Bogota, Colombia
| | - Juan-Manuel Anaya
- Center for Autoimmune Diseases Research (CREA) School of Medicine and Health Sciences, Universidad del Rosario, Carrera 26 # 63B-51, Bogota, Colombia.
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Impacts of Anti-dsDNA Antibody on In Vitro Fertilization-Embryo Transfer and Frozen-Thawed Embryo Transfer. J Immunol Res 2017; 2017:8596181. [PMID: 28540311 PMCID: PMC5429951 DOI: 10.1155/2017/8596181] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 03/27/2017] [Indexed: 11/30/2022] Open
Abstract
Our purpose is to explore whether anti-dsDNA antibody, which was demonstrated to enter living cells and induced apoptosis, could adversely affect reproductive outcomes. A total of 259 women receiving the in vitro fertilization-embryo transfer (IVF) cycle were enrolled in this study, including 52 women with positive ANA and anti-dsDNA (ANA+/anti-dsDNA+ group), 86 women with positive ANA and negative anti-dsDNA (ANA+/anti-dsDNA− group), and 121 women with negative ANA and anti-dsDNA (ANA−/anti-dsDNA− group). 136 nonpregnant women among 259 patients in the IVF-ET cycle were enrolled in the hormone replacement therapy frozen-thawed embryo transfer (HRT-TET) cycle. We compared basic characters and IVF outcomes among three groups in fresh embryo transfer and frozen-thawed embryo transfer cycle, respectively. The number of retrieved oocytes, available embryos, and high-quality embryos in the ANA+/anti-dsDNA+ group was lower than those in the other two groups in the fresh embryo transfer cycle. The rates of fertilization, implantation, and clinical pregnancy in the ANA+/anti-dsDNA+ group were the lowest, while the early miscarriage rate was the highest in the ANA+/anti-dsDNA+ group both in the fresh embryo transfer cycle and in the frozen-thawed embryo transfer cycle. Our data suggested that anti-dsDNA antibody may be the essential marker for defective oocytes or embryos in infertile women with any type of ANA.
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5
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Im SW, Pravinsagar P, Im SR, Jang YJ. Variable Heavy Chain Domain Derived from a Cell-Penetrating Anti-DNA Monoclonal Antibody for the Intracellular Delivery of Biomolecules. Immunol Invest 2017; 46:500-517. [DOI: 10.1080/08820139.2017.1301466] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sun-Woo Im
- Department of Biomedical Sciences, Graduate School of Medicine, and Department of Microbiology, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - Pavithra Pravinsagar
- Department of Biomedical Sciences, Graduate School of Medicine, and Department of Microbiology, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - Sae-Ran Im
- Department of Biomedical Sciences, Graduate School of Medicine, and Department of Microbiology, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - Young-Ju Jang
- Department of Biomedical Sciences, Graduate School of Medicine, and Department of Microbiology, School of Medicine, Ajou University, Suwon, Republic of Korea
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Alekseeva LA, Mironova NL, Brenner EV, Kurilshikov AM, Patutina OA, Zenkova MA. Alteration of the exDNA profile in blood serum of LLC-bearing mice under the decrease of tumour invasion potential by bovine pancreatic DNase I treatment. PLoS One 2017; 12:e0171988. [PMID: 28222152 PMCID: PMC5319761 DOI: 10.1371/journal.pone.0171988] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 01/30/2017] [Indexed: 12/20/2022] Open
Abstract
Taking into account recently obtained data indicating the participation of circulating extracellular DNA (exDNA) in tumorigenesis, enzymes with deoxyribonucleic activity have again been considered as potential antitumour and antimetastatic drugs. Previously, using murine Lewis lung carcinoma and hepatocellular carcinoma A1 tumour models, we have shown the antimetastatic activity of bovine DNase I, which correlates with an increase of DNase activity and a decrease of exDNA concentration in the blood serum of tumour-bearing mice. In this work, using next-generation sequencing on the ABS SOLiD™ 5.500 platform, we performed a search for molecular targets of DNase I by comparing the exDNA profiles of healthy animals, untreated animals with Lewis lung carcinoma (LLC) and those with LLC treated with DNase I. We found that upon DNase I treatment of LLC-bearing mice, together with inhibition of metastasis, a number of strong alterations in the patterns of exDNA were observed. The major differences in exDNA profiles between groups were: i) the level of GC-poor sequences increased during tumour development was reduced to that of healthy mice; ii) levels of sequences corresponding to tumour-associated genes Hmga2, Myc and Jun were reduced in the DNase I-treated group in comparison with non-treated mice; iii) 224 types of tandem repeat over-presented in untreated LLC-bearing mice were significantly reduced after DNase I treatment. The most important result obtained in the work is that DNase I decreased the level of B-subfamily repeats having homology to human ALU repeats, known as markers of carcinogenesis, to the level of healthy animals. Thus, the obtained data lead us to suppose that circulating exDNA plays a role in tumour dissemination, and alteration of multiple molecular targets in the bloodstream by DNase I reduces the invasive potential of tumours.
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Affiliation(s)
- Ludmila A. Alekseeva
- Institute of Chemical Biology and Fundamental Medicine, SB RAS, Novosibirsk, Russia
| | - Nadezhda L. Mironova
- Institute of Chemical Biology and Fundamental Medicine, SB RAS, Novosibirsk, Russia
| | - Evgenyi V. Brenner
- Institute of Chemical Biology and Fundamental Medicine, SB RAS, Novosibirsk, Russia
| | | | - Olga A. Patutina
- Institute of Chemical Biology and Fundamental Medicine, SB RAS, Novosibirsk, Russia
| | - Marina A. Zenkova
- Institute of Chemical Biology and Fundamental Medicine, SB RAS, Novosibirsk, Russia
- * E-mail:
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7
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Poirier M, Simard JC, Girard D. Silver nanoparticles of 70 nm and 20 nm affect differently the biology of human neutrophils. J Immunotoxicol 2015; 13:375-85. [PMID: 26619040 DOI: 10.3109/1547691x.2015.1106622] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
The influence of size of nanoparticles (NP), especially in regard to pulmonary toxicity, has been widely investigated. In general, NP with smaller diameters are more pro-inflammatory in vivo, at least in terms of neutrophil influx. Nevertheless, the influence of size of NP on polymorphonuclear neutrophil (PMN) cell biology is poorly documented. In the study here, it was decided to determine if AgNP with a diameter of 70 nm (AgNP70) will alter the biology of human PMN similarly to AgNP20 previously reported to induce apoptosis and inhibit de novo protein synthesis. The results here indicated that, in contrast to AgNP20, AgNP70 delayed PMN apoptosis. However, both AgNP20 and AgNP70 inhibited de novo protein synthesis. Both forms of AgNP did not significantly increase reactive oxygen species (ROS) production, but AgNP20 significantly increased the cell production of the CXCL8 chemokine (IL-8). In addition, AgNP20, but not AgNP70, induced the release of albumin and matrix metalloproteinase-9 (MMP-9/gelatinase B) into culture supernatants. Consistent with this latter observation, gelatinase activity was increased by AgNP20, as assessed by zymography. From these outcomes, it is concluded that two NP with different initial diameters can possess similar - as well as distinct - biological properties in modulating human PMN functions. These outcomes are testimony to the complexity of the modes of action of NP at the cellular level.
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Affiliation(s)
- Michelle Poirier
- a Laboratory for the Research on Inflammation and Physiology of Granulocytes , University of Québec, INRS-Institut Armand-Frappier , Laval , Québec , Canada
| | - Jean-Christophe Simard
- a Laboratory for the Research on Inflammation and Physiology of Granulocytes , University of Québec, INRS-Institut Armand-Frappier , Laval , Québec , Canada
| | - Denis Girard
- a Laboratory for the Research on Inflammation and Physiology of Granulocytes , University of Québec, INRS-Institut Armand-Frappier , Laval , Québec , Canada
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8
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Im SR, Im SW, Chung HY, Pravinsagar P, Jang YJ. Cell- and nuclear-penetrating anti-dsDNA autoantibodies have multiple arginines in CDR3 of VH and increase cellular level of pERK and Bcl-2 in mesangial cells. Mol Immunol 2015; 67:377-87. [DOI: 10.1016/j.molimm.2015.06.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 06/19/2015] [Accepted: 06/24/2015] [Indexed: 01/27/2023]
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9
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Karim MY, Yong PFK, D'Cruz DP. Clinical importance of autoantibodies in lupus nephritis. Expert Rev Clin Immunol 2014; 3:937-47. [DOI: 10.1586/1744666x.3.6.937] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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10
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Deranged bioenergetics and defective redox capacity in T lymphocytes and neutrophils are related to cellular dysfunction and increased oxidative stress in patients with active systemic lupus erythematosus. Clin Dev Immunol 2011; 2012:548516. [PMID: 22007252 PMCID: PMC3191817 DOI: 10.1155/2012/548516] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2011] [Revised: 06/23/2011] [Accepted: 07/12/2011] [Indexed: 01/16/2023]
Abstract
Urinary excretion of N-benzoyl-glycyl-Nε-(hexanonyl)lysine, a biomarker of oxidative stress, was higher in 26 patients with active systemic lupus erythematosus (SLE) than in 11 non-SLE patients with connective tissue diseases and in 14 healthy volunteers. We hypothesized that increased oxidative stress in active SLE might be attributable to deranged bioenergetics, defective reduction-oxidation (redox) capacity, or other factors. We demonstrated that, compared to normal cells, T lymphocytes (T) and polymorphonuclear neutrophils (PMN) of active SLE showed defective expression of facilitative glucose transporters GLUT-3 and GLUT-6, which led to increased intracellular basal lactate and decreased ATP production. In addition, the redox capacity, including intracellular GSH levels and the enzyme activity of glutathione peroxidase (GSH-Px) and γ-glutamyl-transpeptidase (GGT), was decreased in SLE-T. Compared to normal cells, SLE-PMN showed decreased intracellular GSH levels, and GGT enzyme activity was found in SLE-PMN and enhanced expression of CD53, a coprecipitating molecule for GGT. We conclude that deranged cellular bioenergetics and defective redox capacity in T and PMN are responsible for cellular immune dysfunction and are related to increased oxidative stress in active SLE patients.
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11
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Muñoz LE, Janko C, Grossmayer GE, Frey B, Voll RE, Kern P, Kalden JR, Schett G, Fietkau R, Herrmann M, Gaipl US. Remnants of secondarily necrotic cells fuel inflammation in systemic lupus erythematosus. ACTA ACUST UNITED AC 2009; 60:1733-42. [PMID: 19479824 DOI: 10.1002/art.24535] [Citation(s) in RCA: 98] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Patients with systemic lupus erythematosus (SLE) are often characterized by cellular as well as humoral deficiencies in the recognition and phagocytosis of dead and dying cells. The aim of this study was to investigate whether the remnants of apoptotic cells are involved in the induction of inflammatory cytokines in blood-borne phagocytes. METHODS We used ex vivo phagocytosis assays comprising cellular and humoral components and phagocytosis assays with isolated granulocytes and monocytes to study the phagocytosis of secondarily necrotic cell-derived material (SNEC). Cytokines were measured by multiplex bead array technology. RESULTS We confirmed the impaired uptake of various particulate targets, including immunoglobulin-opsonized beads, by granulocytes and monocytes from patients with SLE compared with healthy control subjects. Surprisingly, blood-borne phagocytes from two-thirds of the patients with SLE took up SNEC, which was rarely phagocytosed by phagocytes from healthy control subjects or patients with rheumatoid arthritis. Supplementation of healthy donor blood with IgG fractions derived from patients with SLE transferred the capability to take up SNEC to the phagocytes of healthy donors. Phagocytosis-promoting immune globulins also induced secretion of huge amounts of cytokines by blood-borne phagocytes following uptake of SNEC. CONCLUSION Opsonization of SNEC by autoantibodies from patients with SLE fosters its uptake by blood-borne monocytes and granulocytes. Autoantibody-mediated phagocytosis of SNEC is accompanied by secretion of inflammatory cytokines, fueling the inflammation that contributes to the perpetuation of autoimmunity in SLE.
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Affiliation(s)
- Luis E Muñoz
- University Hospital of Erlangen, Department of Radiation Oncology, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
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12
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Sakly N, Mirshahi P, Ducros E, Soria J, Ghedira I, Mirshahi M. Angiogenic activity in sera of patients with systemic lupus erythematosus. Lupus 2009; 18:705-12. [DOI: 10.1177/0961203309103087] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Angiogenesis plays a critical role in the pathogenesis of several connective tissue diseases. There is, however, relatively little information available on the role of angiogenesis in systemic lupus erythematosus (SLE). The aim of this study was to investigate the angiogenic activity in sera of patients with SLE and to determine the association between angiogenic activity and clinical complications. Sera from 66 Tunisian females with SLE and from 32 healthy blood donors were studied for their angiogenic activity using the in-vitro tube formation test on Matrigel. Samples were divided into five groups according to their angiogenic activity, which was scored from 0 (no angiogenesis) to 4 (high angiogenic activity). Samples from each group were then tested randomly to assess serum concentration of vascular endothelial growth factor (VEGF). No correlation was found between angiogenic activity scores and serum VEGF levels. Considering angiogenesis assessment in-vitro, sera of patients with SLE showed a much higher angiogenic activity than healthy controls since a high angiogenic score (score 4) is present in 43.9% of patients and in 6.3% of controls ( P < 0.0002). This high angiogenic activity is not correlated with disease activity; however, SLE patients with anti-dsDNA antibodies and those with nephritis showed higher angiogenic activity compared with patients without these complications since score 4 is found in 50.9% and 67.9% versus 9.1% ( P = 0.017) and 26.3% ( P < 0.001), respectively. In conclusion, our study showed that high serum angiogenic activity in SLE was not correlated with the VEGF levels. We suggest the use of the ‘in-vitro’ tube formation test as a better tool to study the angiogenic potential of sera. We found that in patients with SLE, serum angiogenic activity is increased compared with healthy controls. This high angiogenic activity is associated with renal complications and with the presence of anti-dsDNA antibodies. These findings suggest an involvement of angiogenesis disturbance in the pathogenesis of SLE.
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Affiliation(s)
- N Sakly
- Faculty of Pharmacy, Research Unit 03/UR/07-2, Monastir 5000, Tunisia; Faculty of Medicine, UMRS 872, CRC, Paris VI 15 rue de l’Ecole de Médecine, 75006 Paris, France
| | - P Mirshahi
- Faculty of Medicine, UMRS 872, CRC, Paris VI 15 rue de l’Ecole de Médecine, 75006 Paris, France
| | - E Ducros
- Faculty of Medicine, UMRS 872, CRC, Paris VI 15 rue de l’Ecole de Médecine, 75006 Paris, France
| | - J Soria
- Faculty of Medicine, UMRS 872, CRC, Paris VI 15 rue de l’Ecole de Médecine, 75006 Paris, France
| | - I Ghedira
- Faculty of Pharmacy, Research Unit 03/UR/07-2, Monastir 5000, Tunisia; Laboratory of Immunology, Farhat Hached Hospital, Sousse 4000, Tunisia
| | - M Mirshahi
- Faculty of Medicine, UMRS 872, CRC, Paris VI 15 rue de l’Ecole de Médecine, 75006 Paris, France
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13
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Song YC, Sun GH, Lee TP, Huang JC, Yu CL, Chen CH, Tang SJ, Sun KH. Arginines in the CDR of anti-dsDNA autoantibodies facilitate cell internalizationviaelectrostatic interactions. Eur J Immunol 2008; 38:3178-90. [DOI: 10.1002/eji.200838678] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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14
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Armstrong DJ, Crockard AD, Wisdom BG, Whitehead EM, Bell AL. Accelerated apoptosis in SLE neutrophils cultured with anti-dsDNA antibody isolated from SLE patient serum: a pilot study. Rheumatol Int 2006; 27:153-6. [PMID: 17009017 DOI: 10.1007/s00296-006-0219-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2006] [Accepted: 07/01/2006] [Indexed: 10/24/2022]
Abstract
Increased numbers of apoptotic neutrophils are found in SLE, related to disease activity and levels of anti-dsDNA antibody. The mechanism of increased apoptosis is not clear, but anti-dsDNA antibody has been shown to induce apoptosis in neutrophils from normal subjects and in certain cell lines. In this study, polyclonal anti-dsDNA antibody was isolated from the serum of a patient with active SLE, and was shown to substantially accelerate apoptosis in neutrophils from SLE patients as compared with neutrophils from healthy control or rheumatoid arthritis subjects.
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Affiliation(s)
- David J Armstrong
- Department of Rheumatology, Musgrave Park Hospital, Stockman's Lane, Belfast, BT9 7JB, UK.
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Qing X, Zavadil J, Crosby MB, Hogarth MP, Hahn BH, Mohan C, Gilkeson GS, Bottinger EP, Putterman C. Nephritogenic anti-DNA antibodies regulate gene expression in MRL/lpr mouse glomerular mesangial cells. ACTA ACUST UNITED AC 2006; 54:2198-210. [PMID: 16804897 DOI: 10.1002/art.21934] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Lupus-associated IgG anti-double-stranded DNA antibodies are thought to be pathogenic in the kidney due to cross-reaction with glomerular antigens, leading subsequently to immune complex formation in situ and complement activation. We undertook this study to determine if pathogenic anti-DNA antibodies may also contribute to renal damage by directly influencing mesangial gene expression. METHODS Complementary DNA microarray gene profiling was performed in primary mesangial cells (derived from lupus-prone MRL/lpr mice) treated with pathogenic, noncomplexed anti-DNA antibodies. Significant gene up-regulation induced by anti-DNA antibodies as determined by microarray analysis was further investigated by real-time polymerase chain reaction and methods to detect the relevant proteins. Induction of proinflammatory genes by pathogenic antibodies was confirmed by comparing gene expression in glomeruli of old versus young MRL/lpr mice, and by antibody injection in vivo. RESULTS Pathogenic, but not nonpathogenic, antibodies significantly induced a number of transcripts, including CXCL1/KC, LCN2, iNOS, CX3CL1/fractalkine, SERPINA3G, and IkappaBalpha ("marker genes"). Blocking of Fcgamma receptors or using Fcgamma chain-knockout mesangial cells had no effect on the gene regulation effect of the pathogenic antibody R4A, indicating a non-Fc-dependent mechanism. The glomerular expression of these marker genes increased over time with the development of glomerular antibody deposition and active nephritis in MRL/lpr mice. Moreover, injection of R4A into SCID mice in vivo significantly up-regulated glomerular marker gene expression. CONCLUSION These findings indicate that the renal pathogenicity of anti-DNA antibodies may be attributed in part to their ability to directly modulate gene expression in kidney mesangial cells through both Fc-dependent and non-Fc-dependent mechanisms.
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MESH Headings
- Acute-Phase Proteins/genetics
- Acute-Phase Proteins/metabolism
- Animals
- Antibodies, Antinuclear/adverse effects
- Antibodies, Antinuclear/pharmacology
- Cells, Cultured
- Chemokine CX3CL1
- Chemokine CXCL1
- Chemokines, CX3C/genetics
- Chemokines, CX3C/metabolism
- Chemokines, CXC/genetics
- Chemokines, CXC/metabolism
- Female
- I-kappa B Proteins/genetics
- I-kappa B Proteins/metabolism
- Intercellular Signaling Peptides and Proteins/genetics
- Intercellular Signaling Peptides and Proteins/metabolism
- Kidney Diseases/chemically induced
- Kidney Diseases/physiopathology
- Lipocalin-2
- Lipocalins
- Lupus Vasculitis, Central Nervous System/genetics
- Lupus Vasculitis, Central Nervous System/metabolism
- Lupus Vasculitis, Central Nervous System/pathology
- Membrane Proteins/genetics
- Membrane Proteins/metabolism
- Mesangial Cells/drug effects
- Mesangial Cells/metabolism
- Mesangial Cells/pathology
- Mice
- Mice, Inbred BALB C
- Mice, Inbred MRL lpr/genetics
- Mice, Knockout
- Mice, SCID
- NF-KappaB Inhibitor alpha
- Nitric Oxide Synthase Type II/genetics
- Nitric Oxide Synthase Type II/metabolism
- Proto-Oncogene Proteins/genetics
- Proto-Oncogene Proteins/metabolism
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Serpins/genetics
- Serpins/metabolism
- Up-Regulation/drug effects
- Up-Regulation/physiology
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Affiliation(s)
- Xiaoping Qing
- Division of Rheumatology, Forchheimer 701N, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA
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16
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Abstract
The regulation of death pathways in neutrophils has been of long interest, but the relevance of neutrophil apoptosis to the pathogenesis and treatment of autoimmune diseases has only recently been becoming recognized. This brief review addresses the relevant pathways by which neutrophil apoptosis is regulated and summarizes the current understanding regarding the potential role of apoptotic neutrophils in the initiation and/or propagation of autoimmunity, as well as the applicability of modulation of neutrophil death in the treatment of autoimmune diseases.
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Affiliation(s)
- Stanford L Peng
- Inflammation, Autoimmunity, and Transplantation Research, Roche Palo Alto, 3431 Hillview Avenue, M/S R7-101, Palo Alto, CA, 94304, USA.
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17
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Chen Z, Fadiel A, Naftolin F, Eichenbaum KD, Xia Y. Circulation DNA: biological implications for cancer metastasis and immunology. Med Hypotheses 2005; 65:956-61. [PMID: 16054303 DOI: 10.1016/j.mehy.2005.04.042] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2005] [Accepted: 04/28/2005] [Indexed: 11/18/2022]
Abstract
Circulation cell free DNA (cf-DNA) is of considerable interest to oncology researchers seeking to isolate specific cancer markers. Here, we focus on the origin and biological implications of cf-DNA, exploring its potential roles in cancer biology and medicine. We hypothesize that cf-DNA is primarily released by living cancer cells in addition to apoptotic or necrotic cancer cells for three reasons: (1) following radiotherapy, cf-DNA quantities are significantly reduced in a high percentage of patients although radiation-induced massive apoptosis is expected; (2) cancer cell DNA concentration in cultured supernatants increases with cell proliferation when few apoptotic or necrotic cells are present; and (3) DNA concentration increases in normal lymphocyte cultures following stimulation with phytohemagglutinin, lipopolysaccharide or antigen. Our hypotheses have major biological implications in cancer biology. First, cancer cf-DNA may transform normal cells and form adjacent or remote metastases or second primary cancer. In this context, we also have raised an alarming advice that the cancer may be potentially infectious. Secondly, if a normal cf-DNA contains cytokine sequence, it may behave like an intrinsic DNA vaccine, producing therapeutic cytokine. If normal cf-DNA contains a sequence of a non-mutated oncogene or tumor suppressor gene, homologous recombination with the cancer genome may occur leading to knock out mutated oncogene or tumor suppressor gene that could thus elicit a spontaneous remission of cancer.
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Affiliation(s)
- Z Chen
- Yale University School of Medicine, New Haven, CT 06520, USA
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18
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Abstract
Lupus nephritis (LN) is a prototypic autoimmune disease. Its immunopathogenesis is characterized by the loss of self-tolerance. In this article, we review our current understanding of the disease mediators of LN. There is ample evidence to suggest a pathogenic role of nephritogenic autoantibodies. These antibodies cross react with nucleosomal epitopes, and the in vivo generation of nucleosomes requires apoptosis. Furthermore, there is an intriguing and paradoxical relationship between complement and systemic lupus erythematosus (SLE). Immune complex-mediated activation of complement through the classic pathway is traditionally believed to be a major mechanism by which tissue injury occurs. In contrast, hereditary deficiencies of complement components increase the risk of SLE. Finally, the roles of reactive nitrogen and oxygen species are emphasized.
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Affiliation(s)
- Sydney Tang
- Division of Nephrology, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China
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19
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Böhm I. Apoptosis: the link between autoantibodies and leuko-/lymphocytopenia in patients with lupus erythematosus. Scand J Rheumatol 2005; 33:409-16. [PMID: 15794201 DOI: 10.1080/03009740410006907] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To analyse the relation between serum autoantibodies and leuko-/lymphocytopenia in patients with lupus erythematosus (LE). METHODS Laboratory routine analyses (white blood cell counts, autoantibody detection), and flow cytometry (annexin V, CD3, CD4, CD8, CD95, F(ab)2 anti-human IgG) have been performed in LE-patients versus healthy controls. In vitro, the influence of pooled serum containing anti-dsDNA antibodies has been analysed on the CD95 expression. RESULTS Leukocytes, lymphocytes, CD3+, CD3+ CD4+, and CD3+ CD8+ cells from LE-patients were significantly reduced compared with controls. Patients with autoantibodies had significantly lower absolute cell counts than those without. Apoptosis was increased in LE versus controls (p < 0.04). The percentage of CD95+ T-cells was increased, and the absolute number of CD95+ cells was reduced in LE. In vitro up-regulation of CD95 could be detected on T-cells of healthy donors. Induction of CD95 seems to be donor-dependent. CONCLUSION The data suggest that autoantibodies may be associated with blood cytopenias. CD95 seems to play a central role in this signalling cascade. The underlying mechanism is unclear, but seems to be autoantibody-related apoptosis induction.
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Affiliation(s)
- I Böhm
- Department of Radiology, University of Bonn, Germany.
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20
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Böhm I. Environment-dependent down-modulation of CD45 cell surface expression on polymorphonuclear cells. J Clin Lab Anal 2004; 18:187-94. [PMID: 15103684 PMCID: PMC6808115 DOI: 10.1002/jcla.20021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
CD45, a transmembrane protein tyrosine phosphatase, regulates important cell functions. Its involvement in clearing tissues from dead or dying cells by polymorphonuclear cells (PMNs) is unclear. Therefore, in this study the influence of exogenous factors (e.g., temperature and phagocytosis) on the CD45 expression on PMNs (in patients with lupus erythematosus (LE) vs. controls) was analysed by flow cytometry. The data showed a significant down-regulation of CD45 at 4 degrees C in controls, but not on LE-PMNs. In the presence of targets, CD45 was significantly decreased (P<0.00002). Substrate-dependent down-regulation was greater in the presence of nuclei than in the presence of dead cells(68.98%+/-2.28% vs. 47.89%+/-2.75%; P<0.002), and on LE-PMNs than on control-PMNs (45.93%+/-4.92% vs. 53.65%+/-2.2%). Target pretreatment with anti-dsDNA antibody-containing serum resulted in a lower CD45 expression compared to treatment with normal serum. This effect was more pronounced on PMNs of LE patients than on those of controls. Phagocytosis was inversely correlated with CD45 expression (P<0.0007). These data suggest that phagocytic clearance of cellular debris by PMNs may modulate the function of the effector cells, and that anti-dsDNA antibodies apparently enhance the phagocytic clearance.
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Affiliation(s)
- Ingrid Böhm
- Department of Radiology, University of Bonn, Bonn, Germany.
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21
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Putterman C. New approaches to the renal pathogenicity of anti-DNA antibodies in systemic lupus erythematosus. Autoimmun Rev 2004; 3:7-11. [PMID: 15003182 DOI: 10.1016/s1568-9972(03)00082-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2003] [Accepted: 05/26/2003] [Indexed: 11/23/2022]
Abstract
Autoantibodies against double stranded (ds) DNA are not only a helpful serological marker for diagnosis of systemic lupus erythematosus (SLE), but have also been shown to be crucial in the pathogenesis of lupus nephritis. However, the question of how anti-dsDNA antibodies contribute to renal damage is unresolved. Many authorities believe that indirect binding (mediated by nuclear antigens) or direct cross-reactivity of anti-dsDNA antibodies with kidney antigens are important determinants of anti-dsDNA nephritogenicity. An alternative hypothesis for the renal pathogenicity of anti-dsDNA antibodies was proposed more than 20 years ago, namely that certain autoantibodies could penetrate into living cells and thus induce damage. Work from several laboratories has recently provided firm support for this iconoclastic theory, which contradicted prevailing immunologic dogma that cell interiors are inaccessible to antibodies. Here, we review the evidence that anti-dsDNA antibodies may penetrate into living cells, and discuss which intracellular events may follow from binding of anti-dsDNA antibodies to the cell surface and subsequent intracellular penetration. Determining the mechanism by which anti-dsDNA antibodies induce renal injury is important for understanding a major disease manifestation of lupus, and may lead to the development of novel approaches to the treatment of lupus renal disease.
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Affiliation(s)
- Chaim Putterman
- Irving and Ruth Claremon Research Laboratory, Division of Rheumatology, Ullmann 1223, Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY 10461, USA.
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22
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Hsieh SC, Yu HS, Lin WW, Sun KH, Tsai CY, Huang DF, Tsai YY, Yu CL. Anti-SSB/La is one of the antineutrophil autoantibodies responsible for neutropenia and functional impairment of polymorphonuclear neutrophils in patients with systemic lupus erythematosus. Clin Exp Immunol 2003; 131:506-16. [PMID: 12605705 PMCID: PMC1808654 DOI: 10.1046/j.1365-2249.2003.02084.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2002] [Indexed: 11/20/2022] Open
Abstract
Decreased number and impaired functions of polymorphonuclear neutrophils (PMN) due to the presence of anti-PMN autoantibodies in the serum render patients with systemic lupus erythematosus (SLE) susceptible to bacterial infections. However, the cognate antigens and pathological mechanisms of anti-PMN autoantibodies in SLE are rarely reported in the literature. In this study, we found approximately 20% of SLE sera contained anti-PMN autoantibodies detected by human PMN-coated cellular ELISA. A membrane protein with molecular weight of 50 kDa was identified as the cognate antigen of anti-PMN in Western blot after membrane-biotinylation and streptavidin column elution. The 50 kDa molecule was proved to be SSB/La after immunoscreening, molecular cloning and nucleotide sequencing of the gene from the human leucocyte cDNA library. Human anti-SSB/La autoantibodies purified from active SLE sera passing through the recombinant SSB/La conjugated Sepharose 4B affinity column could bind and penetrate into normal human PMN. Functional analysis revealed that the anti-SSB/La autoantibodies exerted a number of potent effects on human PMN, including suppressed phagocytosis, accelerated apoptosis and enhanced IL-8 production. These in vitro results suggest that anti-SSB/La is one of the anti-PMN autoantibodies capable of penetrating into PMN and responsible for neutropenia and functional impairment of PMN in patients with SLE.
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Affiliation(s)
- S-C Hsieh
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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