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Mattila J, Pitkänen N, Järveläinen H. Common variable immunodeficiency-an independent risk factor for atherosclerotic cardiovascular diseases. Front Cardiovasc Med 2023; 10:1289675. [PMID: 38028500 PMCID: PMC10663274 DOI: 10.3389/fcvm.2023.1289675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Atherosclerosis, a disease of chronic inflammation of the arterial wall, is the main cause of most cardiovascular diseases (CVDs). Common variable immunodeficiency (CVID), a group of diseases characterized by frequent infections due to defective antibody production and lack of human immunoglobulins, plays a role in immune activation and inflammation. Thus, it can be hypothesized that CVID increases the risk for atherosclerotic CVDs. On the other hand, it is also possible that CVID patients are protected from atherosclerotic CVDs based on their life-long immunoglobulin therapy. Here, we examined whether patients with CVID have an increased risk for atherosclerotic CVDs or whether they are protected from these diseases. Using an electronic patient database registry search of a population of 83 CVID patients and their age- and sex-matched, tenfold larger control population we demonstrate that CVID patients have a statistically significantly higher risk for coronary heart disease (OR 2.4, p = 0.015) and peripheral vascular disease (OR 12.5, p < 0.001). Regarding cerebrovascular disease, there was a trend towards CVID patients having more strokes or ischemic attacks, but the difference was not statistically significant (OR 2.0, p = 0.133). The combined OR for CVID patients for atherosclerotic CVDs was 2.6 (p = 0.001). CVID population had more hypertension, but smoking was more seldom. There were no statistically significant differences in the incidence of diabetes or levels of serum total, HDL or LDL cholesterol, or glycosylated hemoglobin A1c between CVID patients and their controls. CVID patients had infections more frequently and the OR for autoimmune diseases was 3.8 (p < 0.001). Finally, a multivariate logistic analysis showed that CVID is an independent risk factor for atherosclerotic CVDs (p = 0.002). The present study demonstrates for the first time that CVID is an independent risk factor for atherosclerotic CVDs. Further studies are required to fully understand the exact mechanisms behind this.
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Affiliation(s)
- Juho Mattila
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Niina Pitkänen
- Auria Biobank, Turku University Hospital and University of Turku, Turku, Finland
| | - Hannu Järveläinen
- Institute of Biomedicine, University of Turku, Turku, Finland
- Department of Internal Medicine, Satasairaala Central Hospital, Satakunta Hospital District, Pori, Finland
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2
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Dib L, Koneva LA, Edsfeldt A, Zurke YX, Sun J, Nitulescu M, Attar M, Lutgens E, Schmidt S, Lindholm MW, Choudhury RP, Cassimjee I, Lee R, Handa A, Goncalves I, Sansom SN, Monaco C. Lipid-associated macrophages transition to an inflammatory state in human atherosclerosis increasing the risk of cerebrovascular complications. NATURE CARDIOVASCULAR RESEARCH 2023; 2:656-672. [PMID: 38362263 PMCID: PMC7615632 DOI: 10.1038/s44161-023-00295-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 05/31/2023] [Indexed: 02/17/2024]
Abstract
The immune system is integral to cardiovascular health and disease. Targeting inflammation ameliorates adverse cardiovascular outcomes. Atherosclerosis, a major underlying cause of cardiovascular disease (CVD), is conceptualised as a lipid-driven inflammation where macrophages play a non-redundant role. However, evidence emerging so far from single cell atlases suggests a dichotomy between lipid associated and inflammatory macrophage states. Here, we present an inclusive reference atlas of human intraplaque immune cell communities. Combining scRNASeq of human surgical carotid endarterectomies in a discovery cohort with bulk RNASeq and immunohistochemistry in a validation cohort (the Carotid Plaque Imaging Project-CPIP), we reveal the existence of PLIN2hi/TREM1hi macrophages as a toll-like receptor-dependent inflammatory lipid-associated macrophage state linked to cerebrovascular events. Our study shifts the current paradigm of lipid-driven inflammation by providing biological evidence for a pathogenic macrophage transition to an inflammatory lipid-associated phenotype and for its targeting as a new treatment strategy for CVD.
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Grants
- FS/18/63/34184 British Heart Foundation
- Novo Nordisk Fonden (Novo Nordisk Foundation)
- British Heart Foundation (BHF)
- Fondation Leducq
- European Commission (EC)
- Kennedy Trust for Rheumatology Research (KENN161701, KENN202101, KENN192004), Oxford NIHR Biomedical Research Centre.
- Vetenskapsrådet (Swedish Research Council)
- The Swedish Society for Medical Research, Crafoord foundation; The Swedish Society of Medicine, the Swedish Heart and Lung Foundation, Diabetes foundation, SUS foundation, Lund University Diabetes Center, The Knut and Alice Wallenberg foundation, the Medical Faculty at Lund University and Region Skåne.
- Kennedy Trust for Rheumatology Research (KENN161701, KENN202101, KENN192004)
- Netcare-Physicians-Partnership trust
- Stiftelsen för Strategisk Forskning (Swedish Foundation for Strategic Research)
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Affiliation(s)
- Lea Dib
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Lada A. Koneva
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Andreas Edsfeldt
- Department of Clinical Sciences Malmö, Clinical Research Center, Lund University, Malmö, Sweden
- Department of Cardiology, Skåne University Hospital, Malmö, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Yasemin-Xiomara Zurke
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Jiangming Sun
- Department of Clinical Sciences Malmö, Clinical Research Center, Lund University, Malmö, Sweden
| | - Mihaela Nitulescu
- Department of Clinical Sciences Malmö, Clinical Research Center, Lund University, Malmö, Sweden
| | - Moustafa Attar
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Esther Lutgens
- Cardiovascular Medicine and Immunology, Mayo Clinic, Rochester, MN USA
| | - Steffen Schmidt
- Roche Pharma Research and Early Development, RNA Therapeutics Research, Roche Innovation Center Copenhagen, Hørsholm, Denmark
| | - Marie W. Lindholm
- Roche Pharma Research and Early Development, RNA Therapeutics Research, Roche Innovation Center Copenhagen, Hørsholm, Denmark
| | | | - Ismail Cassimjee
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Regent Lee
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Ashok Handa
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Isabel Goncalves
- Department of Clinical Sciences Malmö, Clinical Research Center, Lund University, Malmö, Sweden
- Department of Cardiology, Skåne University Hospital, Malmö, Sweden
| | - Stephen N. Sansom
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Claudia Monaco
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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3
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Taylor JA, Hutchinson MA, Gearhart PJ, Maul RW. Antibodies in action: the role of humoral immunity in the fight against atherosclerosis. Immun Ageing 2022; 19:59. [PMID: 36461105 PMCID: PMC9717479 DOI: 10.1186/s12979-022-00316-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 11/21/2022] [Indexed: 12/03/2022]
Abstract
The sequestering of oxidation-modified low-density lipoprotein by macrophages results in the accumulation of fatty deposits within the walls of arteries. Necrosis of these cells causes a release of intercellular epitopes and the activation of the adaptive immune system, which we predict leads to robust autoantibody production. T cells produce cytokines that act in the plaque environment and further stimulate B cell antibody production. B cells in atherosclerosis meanwhile have a mixed role based on subclass. The current model is that B-1 cells produce protective IgM antibodies in response to oxidation-specific epitopes that work to control plaque formation, while follicular B-2 cells produce class-switched antibodies (IgG, IgA, and IgE) which exacerbate the disease. Over the course of this review, we discuss further the validation of these protective antibodies while evaluating the current dogma regarding class-switched antibodies in atherosclerosis. There are several contradictory findings regarding the involvement of class-switched antibodies in the disease. We hypothesize that this is due to antigen-specificity, and not simply isotype, being important, and that a closer evaluation of these antibodies' targets should be conducted. We propose that specific antibodies may have therapeutical potential in preventing and controlling plaque development within a clinical setting.
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Affiliation(s)
- Joshua A. Taylor
- grid.419475.a0000 0000 9372 4913Laboratory of Molecular Biology and Immunology, National Institute on Aging, NIH, Baltimore, MD USA ,grid.21107.350000 0001 2171 9311Graduate Program in Immunology, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Mark A. Hutchinson
- grid.419475.a0000 0000 9372 4913Laboratory of Molecular Biology and Immunology, National Institute on Aging, NIH, Baltimore, MD USA
| | - Patricia J. Gearhart
- grid.419475.a0000 0000 9372 4913Laboratory of Molecular Biology and Immunology, National Institute on Aging, NIH, Baltimore, MD USA
| | - Robert W. Maul
- grid.419475.a0000 0000 9372 4913Laboratory of Molecular Biology and Immunology, National Institute on Aging, NIH, Baltimore, MD USA
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4
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Shikatani EA, Besla R, Ensan S, Upadhye A, Khyzha N, Li A, Emoto T, Chiu F, Degousee N, Moreau JM, Perry HM, Thayaparan D, Cheng HS, Pacheco S, Smyth D, Noyan H, Zavitz CCJ, Bauer CMT, Hilgendorf I, Libby P, Swirski FK, Gommerman JL, Fish JE, Stampfli MR, Cybulsky MI, Rubin BB, Paige CJ, Bender TP, McNamara CA, Husain M, Robbins CS. c-Myb Exacerbates Atherosclerosis through Regulation of Protective IgM-Producing Antibody-Secreting Cells. Cell Rep 2020; 27:2304-2312.e6. [PMID: 31116977 DOI: 10.1016/j.celrep.2019.04.090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 03/09/2019] [Accepted: 04/17/2019] [Indexed: 11/17/2022] Open
Abstract
Mechanisms that govern transcriptional regulation of inflammation in atherosclerosis remain largely unknown. Here, we identify the nuclear transcription factor c-Myb as an important mediator of atherosclerotic disease in mice. Atherosclerosis-prone animals fed a diet high in cholesterol exhibit increased levels of c-Myb in the bone marrow. Use of mice that either harbor a c-Myb hypomorphic allele or where c-Myb has been preferentially deleted in B cell lineages revealed that c-Myb potentiates atherosclerosis directly through its effects on B lymphocytes. Reduced c-Myb activity prevents the expansion of atherogenic B2 cells yet associates with increased numbers of IgM-producing antibody-secreting cells (IgM-ASCs) and elevated levels of atheroprotective oxidized low-density lipoprotein (OxLDL)-specific IgM antibodies. Transcriptional profiling revealed that c-Myb has a limited effect on B cell function but is integral in maintaining B cell progenitor populations in the bone marrow. Thus, targeted disruption of c-Myb beneficially modulates the complex biology of B cells in cardiovascular disease.
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Affiliation(s)
- Eric A Shikatani
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S1A1, Canada
| | - Rickvinder Besla
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S1A1, Canada.
| | - Sherine Ensan
- Department of Immunology, University of Toronto, Toronto, ON M5S1A1, Canada
| | - Aditi Upadhye
- Division of Cardiology, Robert Berne Cardiovascular Center, University of Virginia, Charlottesville, VA 22908, USA
| | - Nadiya Khyzha
- Toronto General Research Institute, University Health Network, Toronto, ON M5G1L7, Canada
| | - Angela Li
- Department of Immunology, University of Toronto, Toronto, ON M5S1A1, Canada
| | - Takuo Emoto
- Toronto General Research Institute, University Health Network, Toronto, ON M5G1L7, Canada
| | - Felix Chiu
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S1A1, Canada
| | - Norbert Degousee
- Toronto General Research Institute, University Health Network, Toronto, ON M5G1L7, Canada
| | - Joshua M Moreau
- Department of Immunology, University of Toronto, Toronto, ON M5S1A1, Canada
| | - Heather M Perry
- Division of Cardiology, Robert Berne Cardiovascular Center, University of Virginia, Charlottesville, VA 22908, USA
| | - Danya Thayaparan
- McMaster Immunology Research Centre, McMaster University, Hamilton, ON L8S148, Canada
| | - Henry S Cheng
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S1A1, Canada
| | - Shaun Pacheco
- Toronto General Research Institute, University Health Network, Toronto, ON M5G1L7, Canada
| | - David Smyth
- Toronto General Research Institute, University Health Network, Toronto, ON M5G1L7, Canada
| | - Hossein Noyan
- Toronto General Research Institute, University Health Network, Toronto, ON M5G1L7, Canada
| | - Caleb C J Zavitz
- Toronto General Research Institute, University Health Network, Toronto, ON M5G1L7, Canada
| | - Carla M T Bauer
- Hoffmann-La Roche, pRED, Pharma Research & Early Development, DTA Inflammation, Nutley, NJ 07110, USA
| | - Ingo Hilgendorf
- Department of Cardiology and Angiology I, Heart Center, University of Freiburg, Freiburg, Germany
| | - Peter Libby
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Filip K Swirski
- Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | | | - Jason E Fish
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S1A1, Canada; Toronto General Research Institute, University Health Network, Toronto, ON M5G1L7, Canada
| | - Martin R Stampfli
- McMaster Immunology Research Centre, McMaster University, Hamilton, ON L8S148, Canada
| | - Myron I Cybulsky
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S1A1, Canada; Toronto General Research Institute, University Health Network, Toronto, ON M5G1L7, Canada; Peter Munk Cardiac Centre, Toronto, ON M5G1L7, Canada
| | - Barry B Rubin
- Peter Munk Cardiac Centre, Toronto, ON M5G1L7, Canada
| | - Christopher J Paige
- Department of Immunology, University of Toronto, Toronto, ON M5S1A1, Canada; Toronto General Research Institute, University Health Network, Toronto, ON M5G1L7, Canada; Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G2M9, Canada
| | - Timothy P Bender
- Division of Cardiology, Robert Berne Cardiovascular Center, University of Virginia, Charlottesville, VA 22908, USA; Beirne B. Carter Center for Immunology Research, University of Virginia Health System, Charlottesville, VA 22903, USA
| | - Coleen A McNamara
- Division of Cardiology, Robert Berne Cardiovascular Center, University of Virginia, Charlottesville, VA 22908, USA
| | - Mansoor Husain
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S1A1, Canada; Toronto General Research Institute, University Health Network, Toronto, ON M5G1L7, Canada; Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G2M9, Canada; Peter Munk Cardiac Centre, Toronto, ON M5G1L7, Canada; McEwen Centre for Regenerative Medicine, Toronto, ON, Canada
| | - Clinton S Robbins
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S1A1, Canada; Department of Immunology, University of Toronto, Toronto, ON M5S1A1, Canada; Toronto General Research Institute, University Health Network, Toronto, ON M5G1L7, Canada; Peter Munk Cardiac Centre, Toronto, ON M5G1L7, Canada.
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5
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Taguchi K, Hamamoto S, Okada A, Sugino T, Unno R, Ando R, Gao B, Tozawa K, Kohri K, Yasui T. Helper T-cell signaling and inflammatory pathway lead to formation of calcium phosphate but not calcium oxalate stones on Randall's plaques. Int J Urol 2019; 26:670-677. [PMID: 30919502 DOI: 10.1111/iju.13950] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 02/17/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVES To elucidate the difference in the lithogenesis of calcium oxalate and calcium phosphate stones. METHODS Renal papillary tissues were obtained from 23 idiopathic calcium oxalate and seven calcium phosphate stone patients who had undergone endoscopic lithotripsy. Samples were individually collected from two different regions in each patient: the papillary mucosa containing Randall's plaque and mucosa not containing Randall's plaque. A microarray analysis was carried out on those tissues to compare their gene expression patterns. Furthermore, a causal pathway analysis comparing their differences was carried out. RESULTS Cluster analysis showed that gene expression profiles of calcium phosphate stone patients markedly differed from those of calcium oxalate stone patients. Disease and function analysis showed that Randall's plaque-containing tissues of calcium phosphate stone-forming patients had significantly higher movement and migration of mononuclear leukocytes, and lower tendency toward infection and lymph node formation than Randall's plaque-containing tissues of calcium oxalate stone formers. Additional pathway analysis showed increased immune cell signaling in calcium phosphate formers, such as the helper T cell 1 and 2 pathways, which was confirmed by their messenger ribonucleic acid expression. CONCLUSIONS The present results show the upregulation of helper T-cell signaling pathways in Randall's plaque-containing papillae in calcium phosphate, but not in calcium oxalate stone formers. Thus, helper T-cell immune responses and the related inflammatory processes seem to lead to the formation of calcium phosphate stones on Randall's plaques.
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Affiliation(s)
- Kazumi Taguchi
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shuzo Hamamoto
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Atsushi Okada
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Teruaki Sugino
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Rei Unno
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Ryosuke Ando
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Bing Gao
- Department of Cell Biology and Genetics, China-Japan Kidney Stone Research Center, Shenyang Medical College, Shenyang, China
| | - Keiichi Tozawa
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kenjiro Kohri
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takahiro Yasui
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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6
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Tay C, Liu YH, Kanellakis P, Kallies A, Li Y, Cao A, Hosseini H, Tipping P, Toh BH, Bobik A, Kyaw T. Follicular B Cells Promote Atherosclerosis via T Cell–Mediated Differentiation Into Plasma Cells and Secreting Pathogenic Immunoglobulin G. Arterioscler Thromb Vasc Biol 2018; 38:e71-e84. [DOI: 10.1161/atvbaha.117.310678] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 03/14/2018] [Indexed: 12/20/2022]
Abstract
Objective—
B cells promote or protect development of atherosclerosis. In this study, we examined the role of MHCII (major histocompatibility II), CD40 (cluster of differentiation 40), and Blimp-1 (B-lymphocyte–induced maturation protein) expression by follicular B (FO B) cells in development of atherosclerosis together with the effects of IgG purified from atherosclerotic mice.
Approach and Results—
Using mixed chimeric
Ldlr
−/−
mice whose B cells are deficient in MHCII or CD40, we demonstrate that these molecules are critical for the proatherogenic actions of FO B cells. During development of atherosclerosis, these deficiencies affected T–B cell interactions, germinal center B cells, plasma cells, and IgG. As FO B cells differentiating into plasma cells require Blimp-1, we also assessed its role in the development of atherosclerosis. Blimp-1-deficient B cells greatly attenuated atherosclerosis and immunoglobulin—including IgG production, preventing IgG accumulation in atherosclerotic lesions; Blimp-1 deletion also attenuated lesion proinflammatory cytokines, apoptotic cell numbers, and necrotic core. To determine the importance of IgG for atherosclerosis, we purified IgG from atherosclerotic mice. Their transfer but not IgG from nonatherosclerotic mice into
Ldlr
−/−
mice whose B cells are Blimp-1-deficient increased atherosclerosis; transfer was associated with IgG accumulating in atherosclerotic lesions, increased lesion inflammatory cytokines, apoptotic cell numbers, and necrotic core size.
Conclusions—
The mechanism by which FO B cells promote atherosclerosis is highly dependent on their expression of MHCII, CD40, and Blimp-1. FO B cell differentiation into IgG-producing plasma cells also is critical for their proatherogenic actions. Targeting B–T cell interactions and pathogenic IgG may provide novel therapeutic strategies to prevent atherosclerosis and its adverse cardiovascular complications.
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Affiliation(s)
- Christopher Tay
- From the Vascular Biology and Atherosclerosis Lab, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (C.T., Y.-H.L., P.K., Y.L., A.C., H.H., A.B., T.K.)
| | - Yu-Han Liu
- From the Vascular Biology and Atherosclerosis Lab, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (C.T., Y.-H.L., P.K., Y.L., A.C., H.H., A.B., T.K.)
| | - Peter Kanellakis
- From the Vascular Biology and Atherosclerosis Lab, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (C.T., Y.-H.L., P.K., Y.L., A.C., H.H., A.B., T.K.)
| | - Axel Kallies
- Walter and Eliza Hall Institute, Parkville, Victoria, Australia (A.K.)
| | - Yi Li
- From the Vascular Biology and Atherosclerosis Lab, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (C.T., Y.-H.L., P.K., Y.L., A.C., H.H., A.B., T.K.)
| | - Anh Cao
- From the Vascular Biology and Atherosclerosis Lab, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (C.T., Y.-H.L., P.K., Y.L., A.C., H.H., A.B., T.K.)
| | - Hamid Hosseini
- From the Vascular Biology and Atherosclerosis Lab, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (C.T., Y.-H.L., P.K., Y.L., A.C., H.H., A.B., T.K.)
| | - Peter Tipping
- Department of Medicine, Centre for Inflammatory Diseases (P.T., B.-H.T., T.K)
| | - Ban-Hock Toh
- Department of Medicine, Centre for Inflammatory Diseases (P.T., B.-H.T., T.K)
| | - Alex Bobik
- From the Vascular Biology and Atherosclerosis Lab, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (C.T., Y.-H.L., P.K., Y.L., A.C., H.H., A.B., T.K.)
- Department of Immunology (A.B.), Monash University, Melbourne, Victoria, Australia
| | - Tin Kyaw
- From the Vascular Biology and Atherosclerosis Lab, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (C.T., Y.-H.L., P.K., Y.L., A.C., H.H., A.B., T.K.)
- Department of Medicine, Centre for Inflammatory Diseases (P.T., B.-H.T., T.K)
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7
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Zhang C, Huang Z, Jing H, Fu W, Yuan M, Xia W, Cai L, Gan X, Chen Y, Zou M, Long M, Wang J, Wang M, Xu D. SAK-HV Triggered a Short-period Lipid-lowering Biotherapy Based on the Energy Model of Liver Proliferation via a Novel Pathway. Am J Cancer Res 2017; 7:1749-1769. [PMID: 28529649 PMCID: PMC5436525 DOI: 10.7150/thno.18415] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 03/02/2017] [Indexed: 01/13/2023] Open
Abstract
The accumulations of excess lipids within liver and serum are defined as non-alcoholic fatty liver disease (NAFLD) and hyperlipemia respectively. Both of them are components of metabolic syndrome that greatly threaten human health. Here, a recombinant fusion protein (SAK-HV) effectively treated NAFLD and hyperlipemia in high-fat-fed ApoE-/- mice, quails and rats within just 14 days. Its triglyceride and cholesterol-lowering effects were significantly better than that of atorvastatin during the observation period. We explored the lipid-lowering mechanism of SAK-HV by the hepatic transcriptome analysis and serials of experiments both in vivo and in vitro. Unexpectedly, SAK-HV triggered a moderate energy and material-consuming liver proliferation to dramatically decrease the lipids from both serum and liver. We provided the first evidence that PGC-1α mediated the hepatic synthesis of female hormones during liver proliferation, and proposed the complement system-induced PGC-1α-estrogen axis via the novel STAT3-C/EBPβ-PGC-1α pathway in liver as a new energy model for liver proliferation. In this model, PGC-1α ignited and fueled hepatocyte activation as an “igniter”; PGC-1α-induced estrogen augmented the energy supply of PGC-1α as an “ignition amplifier”, then triggered the hepatocyte state transition from activation to proliferation as a “starter”, causing triglyceride and cholesterol-lowering effects via PPARα-mediated fatty acid oxidation and LDLr-mediated cholesterol uptake, respectively. Collectively, the SAK-HV-triggered distinctive lipid-lowering strategy based on the new energy model of liver proliferation has potential as a novel short-period biotherapy against NAFLD and hyperlipemia.
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8
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Abstract
Atherosclerosis is a chronic inflammatory disease that is initiated by the retention and accumulation of cholesterol-containing lipoproteins, particularly low-density lipoprotein, in the artery wall. In the arterial intima, lipoprotein components that are generated through oxidative, lipolytic, and proteolytic activities lead to the formation of several danger-associated molecular patterns, which can activate innate immune cells as well as vascular cells. Moreover, self- and non-self-antigens, such as apolipoprotein B-100 and heat shock proteins, can contribute to vascular inflammation by triggering the response of T and B cells locally. This process can influence the initiation, progression, and stability of plaques. Substantial clinical and experimental data support that the modulation of adaptive immune system may be used for treating and preventing atherosclerosis. This may lead to the development of more selective and less harmful interventions, while keeping host defense mechanisms against infections and tumors intact. Approaches such as vaccination might become a realistic option for cardiovascular disease, especially if they can elicit regulatory T and B cells and the secretion of atheroprotective antibodies. Nevertheless, difficulties in translating certain experimental data into new clinical therapies remain a challenge. In this review, we discuss important studies on the function of T- and B-cell immunity in atherosclerosis and their manipulation to develop novel therapeutic strategies against cardiovascular disease.
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Affiliation(s)
- Daniel F J Ketelhuth
- From the Department of Medicine, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
| | - Göran K Hansson
- From the Department of Medicine, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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9
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Vuilleumier N, Montecucco F, Hartley O. Autoantibodies to apolipoprotein A-1 as a biomarker of cardiovascular autoimmunity. World J Cardiol 2014; 6:314-326. [PMID: 24944761 PMCID: PMC4062126 DOI: 10.4330/wjc.v6.i5.314] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 03/18/2014] [Indexed: 02/06/2023] Open
Abstract
Immune-driven inflammation plays an important part in atherogenesis and is therefore believed to be key to the development of cardiovascular disease (CVD), which is currently the leading cause of death in the Western world. By fulfilling some of the Koch postulates, atherogenesis has even been proposed to be considered as an autoimmune disease, raising the hope that CVD could be prevented by immunomodulation. Nevertheless, the role of the immune system and autoimmune reactions in atherosclerosis appear to be a double edged-sword, with both pro-atherogenic and anti-atherogenic attributes. Hence, if immunomodulation is to become a therapeutic option for atherosclerosis and CVD, it will be crucial to correctly identify patients who might benefit from targeted suppression of deleterious autoimmune responses. This could be achieved, for example, by the detection of disease-associated autoantibodies. In this work, we will review the currently available clinical, in vitro, and animal studies dedicated to autoantibodies against apolipoprotein A-1 (anti-apoA-1 IgG), the major proteic fraction of high density lipoprotein. Current clinical studies indicate that high levels of anti-apoA-1 IgG are associated with a worse cardiovascular prognosis. In addition, in vitro and animal studies indicate a pro-inflammatory and pro-atherogenic role, supporting the hypothesis that these autoantibodies may play a direct causal role in CVD, and furthermore that they could potentially represent a therapeutic target for CVD in the future.
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Chyu KY, Shah PK. Advances in immune-modulating therapies to treat atherosclerotic cardiovascular diseases. THERAPEUTIC ADVANCES IN VACCINES 2014; 2:56-66. [PMID: 24757525 PMCID: PMC3991155 DOI: 10.1177/2051013613514327] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
In addition to hypercholesterolemia, innate and adaptive immune mechanisms play a critical role in atherogenesis, thus making immune-modulation therapy a potentially attractive way of managing atherosclerotic cardiovascular disease. These immune-modulation strategies include both active and passive immunization and confer beneficial reduction in atherosclerosis. Preclinical studies have demonstrated promising results and we review current knowledge on the complex role of the immune system and the potential for immunization as an immune-modulation therapy for atherosclerosis.
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Affiliation(s)
- Kuang-Yuh Chyu
- Oppenheimer Atherosclerosis Research Center, Division of Cardiology, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Prediman K Shah
- Division of Cardiology, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, 127 South San Vicente Boulevard, Suite A-3307, Los Angeles, CA 90048, USA
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Stokowska A, Olsson S, Holmegaard L, Jood K, Blomstrand C, Jern C, Pekna M. Cardioembolic and small vessel disease stroke show differences in associations between systemic C3 levels and outcome. PLoS One 2013; 8:e72133. [PMID: 23977229 PMCID: PMC3748011 DOI: 10.1371/journal.pone.0072133] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 07/05/2013] [Indexed: 01/24/2023] Open
Abstract
Background Activation of the complement system has been proposed to play a role in the pathophysiology of stroke. As the specific involvement of the complement proteins may be influenced by stroke etiology, we compared plasma C3 and C3a levels in patients with cardioembolic (CE) and small vessel disease (SVD) subtypes of ischemic stroke and control subjects and evaluated their association to outcome at three months and two years. Methodology/Principal Findings Plasma C3 and C3a levels in 79 CE and 79 SVD stroke patients, sampled within 10 days and at three months after stroke, and age- and sex-matched control subjects from The Sahlgrenska Academy Study on Ischemic Stroke were measured by ELISA. Functional outcome was assesed with modified Rankin Scale. In the CE group, plasma C3 levels were elevated only in the acute phase, whereas C3a was elevated at both time points. The follow-up phase plasma C3 levels in the upper third were associated with an increased risk of unfavorable outcome at three months (OR 7.12, CI 1.72–29.46, P = 0.007) as well as after two years (OR 8.25, CI 1.61–42.28, P = 0.011) after stroke. These associations withstand adjustment for age and sex. Conversely, three-month follow-up plasma C3a/C3 level ratios in the middle third were associated with favorable outcome after two years both in the univariate analysis (OR 0.19, CI 0.05–0.82, P = 0.026) and after adjustment for age and sex (OR 0.19, CI 0.04–0.88, P = 0.033). In the SVD group, plasma C3 and C3a levels were elevated at both time points but showed no significant associations with outcome. Conclusions Plasma C3 and C3a levels are elevated after CE and SVD stroke but show associations with outcome only in CE stroke.
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Affiliation(s)
- Anna Stokowska
- Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- * E-mail:
| | - Sandra Olsson
- Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Lukas Holmegaard
- Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Katarina Jood
- Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Christian Blomstrand
- Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Christina Jern
- Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Marcela Pekna
- Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Wigren M, Nilsson J, Kolbus D. Lymphocytes in atherosclerosis. Clin Chim Acta 2012; 413:1562-8. [PMID: 22565046 DOI: 10.1016/j.cca.2012.04.031] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 04/29/2012] [Accepted: 04/29/2012] [Indexed: 02/08/2023]
Abstract
It is well established that atherosclerosis is caused by an inflammatory process in the arterial intima. However, it is only in recent years that it has become clear that this inflammation is modulated by immune responses against plaque antigens. These antigens are primarily believed to be modified self-antigens such as oxidized LDL. The immune system is challenged to determine whether these antigens should be regarded self and tolerated or non-self and eliminated. The latter will result in plaque development while the first will be protective. T cells are key effectors of both types of responses. An activation of regulatory T cells inhibits auto-reactive T effector cells and is anti-inflammatory. In contrast, if Th1 cells become activated in the plaque this is associated with increased inflammation and disease progression. The role of B cells in atherosclerosis remains to be clarified but some species of athero-protective antibodies have been identified. The elucidation of role of immune system in atherosclerosis has revealed new targets for intervention and both vaccines and antibody-based therapies are presently in or due to enter clinical testing.
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Affiliation(s)
- Maria Wigren
- Department of Clinical Sciences Malmö, Lund University, Sweden
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Wohlin M, Sundström J, Lannfelt L, Axelsson T, Syvänen AC, Andrén B, Basu S, Lind L. Apolipoprotein E epsilon4 genotype is independently associated with increased intima-media thickness in a recessive pattern. Lipids 2007; 42:451-6. [PMID: 17426996 DOI: 10.1007/s11745-007-3045-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2006] [Accepted: 02/23/2007] [Indexed: 11/26/2022]
Abstract
Polymorphisms in the apolipoprotein E (Apo E) gene have been associated with lipid levels, carotid intima media thickness (CCA-IMT), inflammation and cardiovascular disease (CVD). Earlier findings suggested an association of the Apo E alleles with increased CCA-IMT following a recessive pattern. Whether associations might be independent of C-reactive protein (CRP), lipid levels and other CVD risk factors is not known. We investigated the relationships between Apo E (epsilon2, epsilon3 and epsilon4 alleles) and CCA-IMT, measured by B-mode ultrasound, in dominant and recessive models in a community-based sample of 437 men 75 years of age. In men homozygous for the epsilon4 allele CCA-IMT was significantly increased by 0.13 mm to 0.86 +/- 0.16 mm compared to 0.73 +/- 0.19 mm in non- epsilon4-carriers (P = 0.0012) and 0.73 +/- 0.21 mm in epsilon4 heterozygous (P = 0.0044) in unadjusted recessive models. The association between Apo E epsilon4 genotype and CCA-IMT was independent of Apo E epsilon2 and Apo E epsilon3 alleles, CRP, lipid variables (TG, LDL, HDL) and other CVD risk factors (smoking, hypertension, body mass index, diabetes) (P = 0.018). No relations between Apo E genotype and CCA-IMT were observed in dominant models. No significant associations between the Apo E epsilon2 and epsilon3 alleles and CCA-IMT were found. In this study, men homozygous with the ApoE epsilon4 allele had thicker CCA-IMT, independently of Apo E epsilon2 and epsilon3 alleles, CRP, lipid variables (TG, LDL, HDL) and other CVD risk factors (smoking, hypertension, body mass index, diabetes), suggesting CCA-IMT to be modified by the ApoE epsilon4 genotype in a recessive pattern.
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Affiliation(s)
- M Wohlin
- Department of Public Health and Caring Sciences/Geriatrics and Clinical Nutrition, Faculty of Medicine, Uppsala University, Uppsala Science Park, 751 85, Uppsala, Sweden.
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