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Sanchez BG, Gasalla JM, Sánchez-Chapado M, Bort A, Diaz-Laviada I. Increase in Ischemia-Modified Albumin and Pregnancy-Associated Plasma Protein-A in COVID-19 Patients. J Clin Med 2021; 10:jcm10235474. [PMID: 34884175 PMCID: PMC8658290 DOI: 10.3390/jcm10235474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/14/2021] [Accepted: 11/17/2021] [Indexed: 12/24/2022] Open
Abstract
This study was undertaken due to the urgent need to explore reliable biomarkers for early SARS-CoV-2 infection. We performed a retrospective study analyzing the serum levels of the cardiovascular biomarkers IL-6, TNF-α, N-terminal pro-B natriuretic peptide, cardiac troponin T (cTnT), ischemia-modified albumin (IMA) and pregnancy-associated plasma protein-A (PAPP-A) in 84 patients with COVID-19.Patients were divided into three groups according to their RT-qPCR and IgG values: acute infection (n = 35), early infection (n = 25) or control subjects (n = 24). Levels of biomarkers were analyzed in patient serum samples using commercially available ELISA kits. Results showed a significant increase in IMA and PAPP-A levels in the early infected patients. Moreover, multivariate analysis and receiver operating characteristic (ROC) curve showed that IMA and PAPP-A had excellent discrimination value for the early stage of COVID-19. For IMA, the area under the ROC curve (AUC) had a value of 0.94 (95% confidence interval (CI): 0.881–0.999). Likewise, the serum level of PAPP-A was significantly higher in patients with early infection than in the control subjects (AUC = 0.801 (95% CI: 0.673–0.929)). The combined use of IMA and PAPP-A enhanced the sensitivity for total SARS-CoV-2-infected patients to 93%. These results suggest that the increased levels of PAPP-A and IMA shed light on underlying mechanisms of COVID-19 physiopathology and might be used as efficient biomarkers with high sensitivity and specificity for the early stage of COVID-19. Importantly, when monitoring pregnancy and cardiovascular diseases using PAPP-A or IMA levels, a SARS-CoV-2 infection should be discarded for proper interpretation of the results.
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Affiliation(s)
- Belén G. Sanchez
- Department of Systems Biology, School of Medicine and Health Sciences, University of Alcalá, 28871 Alcalá de Henares, Spain; (B.G.S.); (J.M.G.)
| | - Jose M. Gasalla
- Department of Systems Biology, School of Medicine and Health Sciences, University of Alcalá, 28871 Alcalá de Henares, Spain; (B.G.S.); (J.M.G.)
- Clinical Biochemistry Service, Principe de Asturias Hospital, 28805 Alcalá de Henares, Spain
| | - Manuel Sánchez-Chapado
- Department of Urology, Principe de Asturias Hospital, 28805 Alcalá de Henares, Spain;
- Department of Surgery, Medical and Social Sciences, School of Medicine and Health Sciences, University of Alcalá, 28871 Alcalá de Henares, Spain
| | - Alicia Bort
- Department of Systems Biology, School of Medicine and Health Sciences, University of Alcalá, 28871 Alcalá de Henares, Spain; (B.G.S.); (J.M.G.)
- Correspondence: (A.B.); (I.D.-L.)
| | - Inés Diaz-Laviada
- Department of Systems Biology, School of Medicine and Health Sciences, University of Alcalá, 28871 Alcalá de Henares, Spain; (B.G.S.); (J.M.G.)
- Chemical Research Institute “Andrés M. del Río” (IQAR), Alcalá University, 28871 Alcalá de Henares, Spain
- Correspondence: (A.B.); (I.D.-L.)
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Jin C, Gao S, Li D, Shi X, Hu Z, Wang C, Xiao J, Sheng Z, Ding Z, Zhang D, Wang D, Wang T, Yang F, Yang Y, Wang X, Wu L, Xu Y. MiR-182-5p Inhibits the Proliferation of Vascular Smooth Muscle Cells Induced by ox-LDL Through Targeting PAPPA. Int Heart J 2020; 61:822-830. [DOI: 10.1536/ihj.19-708] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Chaolong Jin
- Department of Cardiovascular Color Doppler, Heart Center, The First Affiliated Hospital of Anhui Medical University
| | - Shan Gao
- Department of Pharmacology, Basic Medical College, Anhui Medical University
| | - Dayuan Li
- Department of Cardiovascular Color Doppler, Heart Center, The First Affiliated Hospital of Anhui Medical University
| | - Xuegong Shi
- Department of Cardiovascular Color Doppler, Heart Center, The First Affiliated Hospital of Anhui Medical University
| | - Zhangyue Hu
- Department of Cardiology, The Second Affiliated Hospital of Anhui Medical University
| | - Chunmiao Wang
- Department of Cardiology, Heart Center, The First Affiliated Hospital of Anhui Medical University
| | - Jie Xiao
- Department of Cardiovascular Color Doppler, Heart Center, The First Affiliated Hospital of Anhui Medical University
| | - Zhe Sheng
- Department of Cardiovascular Color Doppler, Heart Center, The First Affiliated Hospital of Anhui Medical University
| | - Zhifeng Ding
- Department of Cardiovascular Color Doppler, Heart Center, The First Affiliated Hospital of Anhui Medical University
| | - Dingxin Zhang
- Department of Cardiovascular Color Doppler, Heart Center, The First Affiliated Hospital of Anhui Medical University
| | - Di Wang
- Department of Cardiovascular Color Doppler, Heart Center, The First Affiliated Hospital of Anhui Medical University
| | - Tingting Wang
- Department of Cardiovascular Color Doppler, Heart Center, The First Affiliated Hospital of Anhui Medical University
| | - Fang Yang
- Department of Cardiovascular Color Doppler, Heart Center, The First Affiliated Hospital of Anhui Medical University
| | - Ying Yang
- Department of Cardiovascular Color Doppler, Heart Center, The First Affiliated Hospital of Anhui Medical University
| | - Xinglong Wang
- Department of Cardiovascular Color Doppler, Heart Center, The First Affiliated Hospital of Anhui Medical University
| | - Liping Wu
- Department of Cardiovascular Color Doppler, Heart Center, The First Affiliated Hospital of Anhui Medical University
| | - Yue Xu
- Department of Cardiovascular Color Doppler, Heart Center, The First Affiliated Hospital of Anhui Medical University
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Pregnancy-Associated Plasma Protein A Induces Inflammatory Cytokine Expression by Activating IGF-I/PI3K/Akt Pathways. Mediators Inflamm 2019; 2019:8436985. [PMID: 31582904 PMCID: PMC6754940 DOI: 10.1155/2019/8436985] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 07/10/2019] [Accepted: 08/13/2019] [Indexed: 12/12/2022] Open
Abstract
Pregnancy-associated plasma protein A (PAPP-A) was previously reported to be an inflammatory biomarker and a prognostic marker of acute coronary syndrome (ACS) and involved in the process of atherosclerosis and plaque rupture. However, the role of PAPP-A in inflammation is poorly understood. In this study, we aimed to investigate the role of PAPP-A in macrophage activation and inflammatory cytokine production. RAW264.7 macrophages were treated with or without PAPP-A. Reverse-transcriptase quantitative real-time PCR (RT-qPCR) and Western blot were performed to detect gene and protein expressions. The concentration of monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) in culture supernatants was determined by ELISA. Results showed that PAPP-A significantly stimulated the expression of MCP-1, TNF-α, and IL-6 at both transcriptional and translational levels in a dose-dependent and time-dependent manner. The secretion of these inflammatory cytokines by macrophages was also increased after PAPP-A treatment. Moreover, PAPP-A activated the IGF-I/PI3K/Akt signaling pathway in macrophages. The PAPP-A-mediated upregulation of MCP-1, TNF-α, and IL-6 mRNA and protein levels were strongly inhibited by PI3K inhibitors or IGF-IR siRNA, indicating that the upregulation of MCP-1, TNF-α, and IL-6 could involve the IGF-I/PI3K/Akt pathway. Together, this study demonstrates that PAPP-A activates the macrophage signaling pathway (IGF-I/PI3K/Akt), which drives the expression and production of inflammatory cytokines known to contribute to the initiation and progression of ACS. These findings indicate that PAPP-A may play a proinflammatory role in the pathophysiology of ACS and serve as a potential therapeutic target.
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Hjortebjerg R, Thomsen KL, Agnholt J, Frystyk J. The IGF system in patients with inflammatory bowel disease treated with prednisolone or infliximab: potential role of the stanniocalcin-2 / PAPP-A / IGFBP-4 axis. BMC Gastroenterol 2019; 19:83. [PMID: 31159802 PMCID: PMC6547608 DOI: 10.1186/s12876-019-1000-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 05/23/2019] [Indexed: 01/09/2023] Open
Abstract
Background Patients with inflammatory bowel disease (IBD) present with reduced serum insulin-like growth factor I (IGF-I). Anti-inflammatory treatment with prednisolone or infliximab ameliorates symptoms and increases circulating IGF-I, but prednisolone induces catabolism, whereas infliximab may promote protein synthesis. Recently, stanniocalcin-2 (STC2) was discovered as a novel inhibitor of the enzyme pregnancy-associated plasma protein-A (PAPP-A), which modulates IGF-I activity. PAPP-A can cleave IGF binding protein-4 (IGFBP-4), upon which IGF-I is liberated. We hypothesized that prednisolone and infliximab exert different effects on levels of STC2, PAPP-A, and IGFBP-4, thereby explaining the distinct metabolic effects of prednisolone and infliximab. Methods Thirty-eight patients with active IBD treated with either prednisolone (n = 17) or infliximab (n = 21) were examined before and after 7 days of treatment. Circulating levels of IGF-I, IGF-II, IGFBP-3, PAPP-A, and STC2 were measured by immunoassays. Intact IGFBP-4 and two IGFBP-4 fragments were determined by a novel immunoassay. Bioactive IGF was assessed by cell-based IGF receptor activation assay. Concentrations of IGFBP-4, PAPP-A, and STC2 on day 0 and 7 were compared to healthy control subjects. Results Following seven days of prednisolone treatment, total and bioactive IGF-I were increased (p < 0.001 and p < 0.05, respectively). Upon infliximab treatment, total IGF-I levels were augmented (p < 0.05), yet IGF bioactivity remained unaltered. Intact IGFBP-4 and the two IGFBP-4 fragments generated upon cleavage by PAPP-A were all decreased following treatment with either prednisolone or infliximab (all p < 0.05). PAPP-A levels were only increased by infliximab (p = 0.005), whereas the inhibitor STC2 did not respond to any of the treatments. Conclusion IGF-I and IGFBP-4 concentrations were markedly altered in patients with IBD and near-normalized with disease remission following treatment with prednisolone or infliximab. Thus, IGFBP-4 may modulate IGF bioavailability in IBD. The effect of immunosuppression did not appear to extend beyond the regulation of IGF and IGFBP-4, as neither PAPP-A nor STC2 were discernibly affected. Trial registration ClinicalTrials.gov: NCT00955123. Date of registration: August 7, 2009 (retrospectively registered).
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Affiliation(s)
- Rikke Hjortebjerg
- Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark. .,The Danish Diabetes Academy, Odense, Denmark.
| | - Karen L Thomsen
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Jørgen Agnholt
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Jan Frystyk
- Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.,Department of Clinical Research, Faculty of Health, University of Southern Denmark, Odense, Denmark.,Department of Endocrinology, Odense University Hospital, Odense, Denmark
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Pregnancy-associated plasma protein-A is a stronger predictor for adverse cardiovascular outcomes after acute coronary syndrome in type-2 diabetes mellitus. Cardiovasc Diabetol 2017; 16:45. [PMID: 28381225 PMCID: PMC5382447 DOI: 10.1186/s12933-017-0526-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 03/27/2017] [Indexed: 01/05/2023] Open
Abstract
Background The risk prediction of pregnancy-associated plasma protein-A (PAPP-A) for future cardiovascular (CV) events post acute coronary syndrome (ACS) in patients with type-2 diabetes mellitus (T2DM) was investigated in comparison to other risk factors. Methods PAPP-A was measured at hospital admission in 320 consecutive ACS patients (136 with T2DM and 184 without). All patients were followed for 2 years for occurrence of CV death, non-fatal MI or stroke. Effect of PAPP-A on the CV event risk was estimated using Cox regression models. Receiver operating characteristics (ROC) curves were generated to demonstrate the sensitivity and specificity of PAPP-A in predicting CV events. Results ACS patients with T2DM had higher PAPP-A (19.29 ± 16.36 vs. 13.29 ± 13.90 ng/ml, p < 0.001) and higher rate of CV events 2 years post ACS (27.2 vs. 13.6%, p = 0.002) than those without. Higher levels of PAPP-A were significantly associated with increased risk of CV events during 2-year follow-up [HR = 2.97 for 1 SD increase in log10(PAPP-A), 95% CI 2.11–4.18, p < 0.001] in T2DM and (HR = 3.16, 95% CI 2.27–4.39, p < 0.001) in non-T2DM. Among patients with T2DM, PAPP-A showed a larger area under the curve (AUC 0.79) that was significantly more predictive than hsCRP (AUC 0.64), eGFR (AUC 0.66) and LVEF < 50% (AUC 0.52); predictive ability did not improve significantly by including those factors into the model. Conclusions Patients with T2DM had higher levels of PAPP-A and increased risk of CV events. Elevated PAPP-A compared to other risk factors was a stronger predictor for future CV events 2 years post ACS in patients with T2DM. Trial registration ISRCTN10805074. Registered on 20 January 2017, retrospectively registered.
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Denninger KCM, Litman T, Marstrand T, Moller K, Svensson L, Labuda T, Andersson Å. Kinetics of gene expression and bone remodelling in the clinical phase of collagen-induced arthritis. Arthritis Res Ther 2015; 17:43. [PMID: 25889670 PMCID: PMC4391727 DOI: 10.1186/s13075-015-0531-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 01/19/2015] [Indexed: 01/08/2023] Open
Abstract
Introduction Pathological bone changes differ considerably between inflammatory arthritic diseases and most studies have focused on bone erosion. Collagen-induced arthritis (CIA) is a model for rheumatoid arthritis, which, in addition to bone erosion, demonstrates bone formation at the time of clinical manifestations. The objective of this study was to use this model to characterise the histological and molecular changes in bone remodelling, and relate these to the clinical disease development. Methods A histological and gene expression profiling time-course study on bone remodelling in CIA was linked to onset of clinical symptoms. Global gene expression was studied with a gene chip array system. Results The main histopathological changes in bone structure and inflammation occurred during the first two weeks following the onset of clinical symptoms in the joint. Hereafter, the inflammation declined and remodelling of formed bone dominated. Global gene expression profiling showed simultaneous upregulation of genes related to bone changes and inflammation in week 0 to 2 after onset of clinical disease. Furthermore, we observed time-dependent expression of genes involved in early and late osteoblast differentiation and function, which mirrored the histopathological bone changes. The differentially expressed genes belong to the bone morphogenetic pathway (BMP) and, in addition, include the osteoblast markers integrin-binding sialoprotein (Ibsp), bone gamma-carboxyglutamate protein (Bglap1), and secreted phosphoprotein 1 (Spp1). Pregnancy-associated protein A (Pappa) and periostin (Postn), differentially expressed in the early disease phase, are proposed to participate in bone formation, and we suggest that they play a role in early bone formation in the CIA model. Comparison to human genome-wide association studies (GWAS) revealed differential expression of several genes associated with human arthritis. Conclusions In the CIA model, bone formation in the joint starts shortly after onset of clinical symptoms, which results in bony fusion within one to two weeks. This makes it a candidate model for investigating the relationship between inflammation and bone formation in inflammatory arthritis. Electronic supplementary material The online version of this article (doi:10.1186/s13075-015-0531-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Katja C M Denninger
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, Copenhagen, Ø DK-2100, Denmark. .,Disease Pharmacology/Molecular Biomedicine, LEO Pharma A/S, Industriparken 55, Ballerup, DK-2750, Denmark.
| | - Thomas Litman
- Disease Pharmacology/Molecular Biomedicine, LEO Pharma A/S, Industriparken 55, Ballerup, DK-2750, Denmark.
| | - Troels Marstrand
- Disease Pharmacology/Molecular Biomedicine, LEO Pharma A/S, Industriparken 55, Ballerup, DK-2750, Denmark.
| | - Kristian Moller
- Disease Pharmacology/Molecular Biomedicine, LEO Pharma A/S, Industriparken 55, Ballerup, DK-2750, Denmark.
| | - Lars Svensson
- Disease Pharmacology/Molecular Biomedicine, LEO Pharma A/S, Industriparken 55, Ballerup, DK-2750, Denmark.
| | - Tord Labuda
- Disease Pharmacology/Molecular Biomedicine, LEO Pharma A/S, Industriparken 55, Ballerup, DK-2750, Denmark.
| | - Åsa Andersson
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, Copenhagen, Ø DK-2100, Denmark.
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Evaluation of the role of maternal serum high-sensitivity C-reactive protein in predicting early pregnancy failure. Reprod Biomed Online 2015; 30:268-74. [DOI: 10.1016/j.rbmo.2014.11.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 11/14/2014] [Accepted: 11/18/2014] [Indexed: 01/21/2023]
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