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Lai SJ, Kameda T, Morita M, Yamagata Y, Nishizaka K, Horiuchi Y, Kobayashi Y, Usami Y, Liu JJ, Kasama T, Tozuka M, Ohkawa R. Characterization of novel truncated apolipoprotein A-I in human high-density lipoprotein generated by sequential treatment with myeloperoxidase and chymase. Biochimie 2024; 218:34-45. [PMID: 37774825 DOI: 10.1016/j.biochi.2023.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 10/01/2023]
Abstract
High-density lipoprotein (HDL) cholesterol is a well-known biomarker, which has been associated with reduction in the risk of cardiovascular diseases (CVD). However, some HDL anti-atherosclerotic functions may be impaired without altered HDL-cholesterol (HDL-C) level via its dysfunctional proteins or other physiological reactions in vivo. We previously showed that activated mast cell-derived chymase could modestly cleave apolipoprotein A-I (apoA-I) in HDL3, and further easily cleave lipid-free apoA-I. In contrast, myeloperoxidase (MPO) secreted by macrophages, the main cell type in atherosclerotic plaques, could oxidize HDL proteins, which might modify their tertiary structures, increasing their susceptibility to other enzymes. Here we focused on the co-modification and impact of chymase and MPO, usually secreted during inflammation from cells with possible co-existence in atheromas, on HDL. Only after sequential treatment with MPO and then chymase, two novel truncated apoA-I fragments were generated from HDL. One fragment was 16.5 kDa, and the cleavage site by chymase after MPO modification was the C-terminal of Tyr100 in apoA-I, cross-validated by three different mass spectrometry methods. This novel apoA-I fragment can be trapped in HDL particles to avoid kidney glomerular filtration and has a specific site for antibody generation for ELISA tests. As such, its quantification can be useful in predicting patients with CVD having normal HDL-C levels.
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Affiliation(s)
- Shao-Jui Lai
- Clinical Bioanalysis and Molecular Biology, Field of Applied Laboratory Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Takahiro Kameda
- Clinical Bioanalysis and Molecular Biology, Field of Applied Laboratory Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Maasa Morita
- Clinical Bioanalysis and Molecular Biology, Field of Applied Laboratory Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan; Clinical Laboratory, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yuka Yamagata
- Clinical Bioanalysis and Molecular Biology, Field of Applied Laboratory Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Kaoruko Nishizaka
- Clinical Bioanalysis and Molecular Biology, Field of Applied Laboratory Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Yuna Horiuchi
- Clinical Bioanalysis and Molecular Biology, Field of Applied Laboratory Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan; Department of Clinical Laboratory Technology, Faculty of Medical Sciences, Juntendo University, 6-8-1, Hinode, Urayasu, Chiba, 279-0013, Japan
| | - Yukihiro Kobayashi
- Department of Laboratory Medicine, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto City, Nagano, 390-8621, Japan
| | - Yoko Usami
- Department of Laboratory Medicine, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto City, Nagano, 390-8621, Japan
| | - Jun-Jen Liu
- School of Medical Laboratory Science and Biotechnology, Taipei Medical University, No. 250, Wuxing St., Xinyi Dist., Taipei City, 110301, Taiwan, ROC
| | - Takeshi Kasama
- HiPep Laboratories, 486-46 Nakatsukasa-cho, Kamigyo-ku, Kyoto, 602-8158, Japan
| | - Minoru Tozuka
- Clinical Bioanalysis and Molecular Biology, Field of Applied Laboratory Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan; Life Science Research Center, Nagano Children's Hospital, 3100 Toyoshina, Azumino, 399-8288, Japan
| | - Ryunosuke Ohkawa
- Clinical Bioanalysis and Molecular Biology, Field of Applied Laboratory Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
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Elieh-Ali-Komi D, Bot I, Rodríguez-González M, Maurer M. Cellular and Molecular Mechanisms of Mast Cells in Atherosclerotic Plaque Progression and Destabilization. Clin Rev Allergy Immunol 2024; 66:30-49. [PMID: 38289515 DOI: 10.1007/s12016-024-08981-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2024] [Indexed: 03/28/2024]
Abstract
Mast cells (MCs) are commonly recognized for their crucial involvement in the pathogenesis of allergic diseases, but over time, it has come to light that they also play a role in the pathophysiology of non-allergic disorders including atherosclerosis. The involvement of MCs in the pathology of atherosclerosis is supported by their accumulation in atherosclerotic plaques upon their progression and the association of intraplaque MC numbers with acute cardiovascular events. MCs that accumulate within the atherosclerotic plaque release a cocktail of mediators through which they contribute to neovascularization, plaque progression, instability, erosion, rupture, and thrombosis. At a molecular level, MC-released proteases, especially cathepsin G, degrade low-density lipoproteins (LDL) and mediate LDL fusion and binding of LDL to proteoglycans (PGs). Through a complicated network of chemokines including CXCL1, MCs promote the recruitment of among others CXCR2+ neutrophils, therefore, aggravating the inflammation of the plaque environment. Additionally, MCs produce extracellular traps which worsen inflammation and contribute to atherothrombosis. Altogether, evidence suggests that MCs actively, via several underlying mechanisms, contribute to atherosclerotic plaque destabilization and acute cardiovascular syndromes, thus, making the study of interventions to modulate MC activation an interesting target for cardiovascular medicine.
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Affiliation(s)
- Daniel Elieh-Ali-Komi
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Ilze Bot
- Division of BioTherapeutics, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | | | - Marcus Maurer
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany.
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Nguyen SD, Maaninka K, Mäyränpää MI, Baumann M, Soliymani R, Lee-Rueckert M, Jauhiainen M, Kovanen PT, Öörni K. Neutrophil proteinase 3 - An LDL- and HDL-proteolyzing enzyme with a potential to contribute to cholesterol accumulation in human atherosclerotic lesions. Biochim Biophys Acta Mol Cell Biol Lipids 2022; 1867:159225. [PMID: 36058498 DOI: 10.1016/j.bbalip.2022.159225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/25/2022] [Accepted: 08/27/2022] [Indexed: 10/14/2022]
Affiliation(s)
- Su Duy Nguyen
- Wihuri Research Institute, Haartmaninkatu 8, 00290 Helsinki, Finland
| | - Katariina Maaninka
- Wihuri Research Institute, Haartmaninkatu 8, 00290 Helsinki, Finland; EV Group, Molecular and Integrative Biosciences Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Finland; CURED, Drug Research Program, Faculty of Pharmacy, Division of Pharmaceutical Biosciences, University of Helsinki, Finland
| | - Mikko I Mäyränpää
- Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Marc Baumann
- Institute of Biomedicine, Department of Biochemistry and Developmental Biology, Meilahti Clinical Proteomics Core Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Helsinki Institute of Life Sciences, University of Helsinki, Helsinki, Finland
| | - Rabah Soliymani
- Institute of Biomedicine, Department of Biochemistry and Developmental Biology, Meilahti Clinical Proteomics Core Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Helsinki Institute of Life Sciences, University of Helsinki, Helsinki, Finland
| | | | - Matti Jauhiainen
- Minerva Foundation Institute for Medical Research, Biomedicum, Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland
| | - Petri T Kovanen
- Wihuri Research Institute, Haartmaninkatu 8, 00290 Helsinki, Finland
| | - Katariina Öörni
- Wihuri Research Institute, Haartmaninkatu 8, 00290 Helsinki, Finland; Molecular and Integrative Biosciences, Faculty of Biological and Environmental Sciences, University of Helsinki, Helsinki, Finland.
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Lee-Rueckert M, Lappalainen J, Kovanen PT, Escola-Gil JC. Lipid-Laden Macrophages and Inflammation in Atherosclerosis and Cancer: An Integrative View. Front Cardiovasc Med 2022; 9:777822. [PMID: 35237673 PMCID: PMC8882850 DOI: 10.3389/fcvm.2022.777822] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 01/18/2022] [Indexed: 12/12/2022] Open
Abstract
Atherosclerotic arterial plaques and malignant solid tumors contain macrophages, which participate in anaerobic metabolism, acidosis, and inflammatory processes inherent in the development of either disease. The tissue-resident macrophage populations originate from precursor cells derived from the yolk sac and from circulating bone marrow-derived monocytes. In the tissues, they differentiate into varying functional phenotypes in response to local microenvironmental stimulation. Broadly categorized, the macrophages are activated to polarize into proinflammatory M1 and anti-inflammatory M2 phenotypes; yet, noticeable plasticity allows them to dynamically shift between several distinct functional subtypes. In atherosclerosis, low-density lipoprotein (LDL)-derived cholesterol accumulates within macrophages as cytoplasmic lipid droplets thereby generating macrophage foam cells, which are involved in all steps of atherosclerosis. The conversion of macrophages into foam cells may suppress the expression of given proinflammatory genes and thereby initiate their transcriptional reprogramming toward an anti-inflammatory phenotype. In this particular sense, foam cell formation can be considered anti-atherogenic. The tumor-associated macrophages (TAMs) may become polarized into anti-tumoral M1 and pro-tumoral M2 phenotypes. Mechanistically, the TAMs can regulate the survival and proliferation of the surrounding cancer cells and participate in various aspects of tumor formation, progression, and metastasis. The TAMs may accumulate lipids, but their type and their specific roles in tumorigenesis are still poorly understood. Here, we discuss how the phenotypic and functional plasticity of macrophages allows their multifunctional response to the distinct microenvironments in developing atherosclerotic lesions and in developing malignant tumors. We also discuss how the inflammatory reactions of the macrophages may influence the development of atherosclerotic plaques and malignant tumors, and highlight the potential therapeutic effects of targeting lipid-laden macrophages in either disease.
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Affiliation(s)
| | | | - Petri T. Kovanen
- Wihuri Research Institute, Helsinki, Finland
- *Correspondence: Petri T. Kovanen
| | - Joan Carles Escola-Gil
- Institut d'Investigacions Biomèdiques (IIB) Sant Pau and CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Barcelona, Spain
- Joan Carles Escola-Gil
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Razeghian-Jahromi I, Karimi Akhormeh A, Razmkhah M, Zibaeenezhad MJ. Immune system and atherosclerosis: Hostile or friendly relationship. Int J Immunopathol Pharmacol 2022; 36:3946320221092188. [PMID: 35410514 PMCID: PMC9009140 DOI: 10.1177/03946320221092188] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Coronary artery disease has remained a major health challenge despite enormous
progress in prevention, diagnosis, and treatment strategies. Formation of
atherosclerotic plaque is a chronic process that is developmentally influenced
by intrinsic and extrinsic determinants. Inflammation triggers atherosclerosis,
and the fundamental element of inflammation is the immune system. The immune
system involves in the atherosclerosis process by a variety of immune cells and
a cocktail of mediators. It is believed that almost all main components of this
system possess a profound contribution to the atherosclerosis. However, they
play contradictory roles, either protective or progressive, in different stages
of atherosclerosis progression. It is evident that monocytes are the first
immune cells appeared in the atherosclerotic lesion. With the plaque growth,
other types of the immune cells such as mast cells, and T lymphocytes are
gradually involved. Each cell releases several cytokines which cause the
recruitment of other immune cells to the lesion site. This is followed by
affecting the expression of other cytokines as well as altering certain
signaling pathways. All in all, a mix of intertwined interactions determine the
final outcome in terms of mild or severe manifestations, either clinical or
subclinical. Therefore, it is of utmost importance to precisely understand the
kind and degree of contribution which is made by each immune component in order
to stop the growing burden of cardiovascular morbidity and mortality. In this
review, we present a comprehensive appraisal on the role of immune cells in the
atherosclerosis initiation and development.
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Affiliation(s)
- Iman Razeghian-Jahromi
- Cardiovascular Research Center, 571605Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Karimi Akhormeh
- Cardiovascular Research Center, 571605Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahboobeh Razmkhah
- Shiraz Institute for Cancer Research, 48435Shiraz University of Medical Sciences, Shiraz, Iran
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CRISPR/dCas9 Transcriptional Activation of Endogenous Apolipoprotein AI and Paraoxonase 1 in Enterocytes Alleviates Endothelial Cell Dysfunction. Biomolecules 2021; 11:biom11121769. [PMID: 34944413 PMCID: PMC8698862 DOI: 10.3390/biom11121769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/19/2021] [Accepted: 11/23/2021] [Indexed: 11/17/2022] Open
Abstract
Atherosclerosis is the main cause of cardiovascular diseases with high prevalence worldwide. A promising therapeutic strategy to reverse atherosclerotic process is to improve the athero-protective potential of high-density lipoproteins (HDL). Since the small intestine is a source of HDL, we aimed to activate transcription of the endogenous HDL major proteins, apolipoprotein AI (ApoAI) and paraoxonase 1 (PON1), in enterocytes, and to evaluate their potential to correct the pro-inflammatory status of endothelial cells (EC). Caco-2 enterocytes were transfected with CRISPR activation plasmids targeting ApoAI or PON1, and their gene and protein expression were measured in cells and conditioned medium (CM). ATP binding cassette A1 and G8 transporters (ABCA1, ABCG8), scavenger receptor BI (SR-BI), and transcription regulators peroxisome proliferator-activated receptor γ (PPARγ), liver X receptors (LXRs), and sirtuin-1 (SIRT1) were assessed. Anti-inflammatory effects of CM from transfected enterocytes were estimated through its ability to inhibit tumor necrosis factor α (TNFα) activation of EC. Transcriptional activation of ApoAI or PON1 in enterocytes induces: (i) increase of their gene and protein expression, and secretion in CM; (ii) stimulation of ABCA1/G8 and SR-BI; (iii) upregulation of PPARγ, LXRs, and SIRT1. CM from transfected enterocytes attenuated the TNFα-induced inflammatory and oxidative stress in EC, by decreasing TNF receptor 1, monocyte chemoattractant protein-1, and p22phox. In conclusion, transcriptional activation of endogenous ApoAI or PON1 in enterocytes by CRISPR/dCas9 system is a realistic approach to stimulate biogenesis and function of major HDL proteins which can regulate cholesterol efflux transporters and reduce the inflammatory stress in activated EC.
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Apolipoprotein-AI and AIBP synergetic anti-inflammation as vascular diseases therapy: the new perspective. Mol Cell Biochem 2021; 476:3065-3078. [PMID: 33811580 DOI: 10.1007/s11010-020-04037-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 12/22/2020] [Indexed: 12/24/2022]
Abstract
Vascular diseases (VDs) including pulmonary arterial hypertension (PAH), atherosclerosis (AS) and coronary arterial diseases (CADs) contribute to the higher morbidity and mortality worldwide. Apolipoprotein A-I (Apo A-I) binding protein (AIBP) and Apo-AI negatively correlate with VDs. However, the mechanism by which AIBP and apo-AI regulate VDs still remains unexplained. Here, we provide an overview of the role of AIBP and apo-AI regulation of vascular diseases molecular mechanisms such as vascular energy homeostasis imbalance, oxidative and endoplasmic reticulum stress and inflammation in VDs. In addition, the role of AIBP and apo-AI in endothelial cells (ECs), vascular smooth muscle (VSMCs) and immune cells activation in the pathogenesis of VDs are explained. The in-depth understanding of AIBP and apo-AI function in the vascular system may lead to the discovery of VDs therapy.
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Cochran BJ, Ong KL, Manandhar B, Rye KA. APOA1: a Protein with Multiple Therapeutic Functions. Curr Atheroscler Rep 2021; 23:11. [PMID: 33591433 DOI: 10.1007/s11883-021-00906-7] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2021] [Indexed: 01/11/2023]
Abstract
PURPOSE OF THE REVIEW Apolipoprotein (APO) A1, the main apolipoprotein of plasma high-density lipoproteins (HDLs), has several well documented cardioprotective functions. A number of additional potentially beneficial functions of APOA1 have recently been identified. This review is concerned with the therapeutic potential of all of these functions in multiple disease states. RECENT FINDINGS Knowledge of the beneficial functions of APOA1 in atherosclerosis, thrombosis, diabetes, cancer, and neurological disorders is increasing exponentially. These insights have led to the development of clinically relevant peptides and APOA1-containing, synthetic reconstituted HDL (rHDL) preparations that mimic the functions of full-length APOA1. APOA1 is a multifunctional apolipoprotein that has therapeutic potential in several diseases. Translation of this knowledge into the clinic is likely to be dependent on the efficacy and bioavailability of small peptides and synthetic rHDL preparations that are currently under investigation, or in development.
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Affiliation(s)
- Blake J Cochran
- Lipid Research Group, School of Medical Sciences, Faculty of Medicine, University of New South Wales Sydney, Level 4E Wallace Wurth Building, Kensington, New South Wales, 2052, Australia
| | - Kwok-Leung Ong
- Lipid Research Group, School of Medical Sciences, Faculty of Medicine, University of New South Wales Sydney, Level 4E Wallace Wurth Building, Kensington, New South Wales, 2052, Australia
| | - Bikash Manandhar
- Lipid Research Group, School of Medical Sciences, Faculty of Medicine, University of New South Wales Sydney, Level 4E Wallace Wurth Building, Kensington, New South Wales, 2052, Australia
| | - Kerry-Anne Rye
- Lipid Research Group, School of Medical Sciences, Faculty of Medicine, University of New South Wales Sydney, Level 4E Wallace Wurth Building, Kensington, New South Wales, 2052, Australia.
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Inoue Y, Okamoto T, Honda T, Nukui Y, Akashi T, Takemura T, Tozuka M, Miyazaki Y. Disruption in the balance between apolipoprotein A-I and mast cell chymase in chronic hypersensitivity pneumonitis. IMMUNITY INFLAMMATION AND DISEASE 2020; 8:659-671. [PMID: 33016012 PMCID: PMC7654418 DOI: 10.1002/iid3.355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 09/21/2020] [Indexed: 02/06/2023]
Abstract
Background Apolipoprotein A‐I (apoA‐I) has an antifibrotic effect in idiopathic pulmonary fibrosis. Although pulmonary fibrosis is associated with poor prognosis of patients with hypersensitivity pneumonitis (HP), little is known regarding the role of apoA‐I in the pathogenesis of HP. Methods Two‐dimensional electrophoresis, immunoblotting, and enzyme‐linked immunosorbent assays were performed for the identification and quantification of apoA‐I in bronchoalveolar lavage fluid (BALF) from patients with acute and chronic HP. To investigate the degradation of apoA‐I, apoA‐I was incubated with BALF. Moreover, the role of apoA‐I in TGF‐β1‐induced epithelial–mesenchymal transition of A549 cells was examined. Results The concentration of apoA‐I in the BALF was significantly lower in chronic HP (n = 56) compared with acute HP (n = 31). The expression level of apoA‐I was also low in the lung tissues of chronic HP. ApoA‐I was degraded by BALF from HP patients. The number of chymase‐positive mast cells in the alveolar parenchyma was inversely correlated with apoA‐I levels in the BALF of chronic HP patients. In vitro experiment using A549 cells, untreated apoA‐I inhibited TGF‐β1‐induced epithelial–mesenchymal transition, although this trend was not observed in the chymase‐treated apoA‐I. Conclusions A decrease of apoA‐I was associated with the pathogenesis of chronic HP in terms of pulmonary fibrosis and mast cell chymase attenuated the protective effect of apoA‐I against pulmonary fibrosis. Furthermore, apoA‐I could be a crucial molecule associated with lung fibrogenesis of HP.
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Affiliation(s)
- Yukihisa Inoue
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tsukasa Okamoto
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takayuki Honda
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshihisa Nukui
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takumi Akashi
- Department of Pathology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tamiko Takemura
- Department of Pathology, Japan Red Cross Centre, Tokyo, Japan
| | - Minoru Tozuka
- Department of Analytical Laboratory Chemistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasunari Miyazaki
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
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Soppert J, Lehrke M, Marx N, Jankowski J, Noels H. Lipoproteins and lipids in cardiovascular disease: from mechanistic insights to therapeutic targeting. Adv Drug Deliv Rev 2020; 159:4-33. [PMID: 32730849 DOI: 10.1016/j.addr.2020.07.019] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 12/12/2022]
Abstract
With cardiovascular disease being the leading cause of morbidity and mortality worldwide, effective and cost-efficient therapies to reduce cardiovascular risk are highly needed. Lipids and lipoprotein particles crucially contribute to atherosclerosis as underlying pathology of cardiovascular disease and influence inflammatory processes as well as function of leukocytes, vascular and cardiac cells, thereby impacting on vessels and heart. Statins form the first-line therapy with the aim to block cholesterol synthesis, but additional lipid-lowering drugs are sometimes needed to achieve low-density lipoprotein (LDL) cholesterol target values. Furthermore, beyond LDL cholesterol, also other lipid mediators contribute to cardiovascular risk. This review comprehensively discusses low- and high-density lipoprotein cholesterol, lipoprotein (a), triglycerides as well as fatty acids and derivatives in the context of cardiovascular disease, providing mechanistic insights into their role in pathological processes impacting on cardiovascular disease. Also, an overview of applied as well as emerging therapeutic strategies to reduce lipid-induced cardiovascular burden is provided.
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Affiliation(s)
- Josefin Soppert
- Institute for Molecular Cardiovascular Research (IMCAR), University Hospital Aachen, Aachen, Germany
| | - Michael Lehrke
- Medical Clinic I, University Hospital Aachen, Aachen, Germany
| | - Nikolaus Marx
- Medical Clinic I, University Hospital Aachen, Aachen, Germany
| | - Joachim Jankowski
- Institute for Molecular Cardiovascular Research (IMCAR), University Hospital Aachen, Aachen, Germany; Department of Pathology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht University, the Netherlands
| | - Heidi Noels
- Institute for Molecular Cardiovascular Research (IMCAR), University Hospital Aachen, Aachen, Germany; Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, the Netherlands.
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Abu Hamdeh S, Khoonsari PE, Shevchenko G, Gordh T, Ericson H, Kultima K. Increased CSF Levels of Apolipoproteins and Complement Factors in Trigeminal Neuralgia Patients-In Depth Proteomic Analysis Using Mass Spectrometry. THE JOURNAL OF PAIN 2020; 21:1075-1084. [PMID: 32553624 DOI: 10.1016/j.jpain.2020.03.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 11/27/2019] [Accepted: 03/14/2020] [Indexed: 01/03/2023]
Abstract
The main cause of trigeminal neuralgia (TN) is compression of a blood vessel at the root entry zone of the trigeminal nerve. However, a neurovascular conflict does not seem to be the only etiology and other mechanisms are implicated in the development of the disease. We hypothesized that TN patients may have distinct protein expression in the CSF. In this study, lumbar CSF from TN patients (n = 17), scheduled to undergo microvascular decompression, and from controls (n = 20) was analyzed and compared with in depth mass spectrometry TMTbased quantitative proteomics. We identified 2552 unique proteins, of which 46 were significantly altered (26 increased, and 20 decreased, q-value < .05) in TN patients compared with controls. An over-representation analysis showed proteins involved in high-density lipoprotein, such as Apolipoprotein A4, Apolipoprotein M, and Apolipoprotein A1, and the extracellular region, including proteins involved in the complement cascade to be over-represented. We conclude that TN patients have distinct protein expression in the CSF compared to controls. The pathophysiological background of the protein alterations found in this study warrants further investigation in future studies. PERSPECTIVE: In this article, cerebrospinal fluid from patients with trigeminal neuralgia was analyzed using in depth shotgun proteomics, revealing 46 differentially expressed proteins compared to controls. Among these, apolipoproteins and proteins involved in the complement system were elevated and significantly over-represented, implying an inflammatory component in the pathophysiology of the disease.
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Affiliation(s)
- Sami Abu Hamdeh
- Department of Neuroscience, Neurosurgery, Uppsala University, Uppsala, Sweden.
| | - Payam Emami Khoonsari
- Department of Medical Sciences, Chemical Chemistry, Uppsala University, Uppsala, Sweden
| | - Ganna Shevchenko
- Department of Chemistry-BMC, Analytical Chemistry, Uppsala University, Uppsala, Sweden
| | - Torsten Gordh
- Department of Surgical Sciences, Anesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden
| | - Hans Ericson
- Department of Neuroscience, Neurosurgery, Uppsala University, Uppsala, Sweden
| | - Kim Kultima
- Department of Medical Sciences, Chemical Chemistry, Uppsala University, Uppsala, Sweden; Department of Neuroscience, Neurosurgery, Uppsala University, Uppsala, Sweden
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Affiliation(s)
- Megan A. Slack
- Saha Cardiovascular Research Center and Department of Physiology, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Scott M. Gordon
- Saha Cardiovascular Research Center and Department of Physiology, University of Kentucky College of Medicine, Lexington, KY, USA
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Mast Cells as Potential Accelerators of Human Atherosclerosis-From Early to Late Lesions. Int J Mol Sci 2019; 20:ijms20184479. [PMID: 31514285 PMCID: PMC6770933 DOI: 10.3390/ijms20184479] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 08/21/2019] [Accepted: 09/04/2019] [Indexed: 02/06/2023] Open
Abstract
Mast cells are present in atherosclerotic lesions throughout their development. The process of atherogenesis itself is characterized by infiltration and retention of cholesterol-containing blood-derived low-density lipoprotein (LDL) particles in the intimal layer of the arterial wall, where the particles become modified and ingested by macrophages, resulting in the formation of cholesterol-filled foam cells. Provided the blood-derived high-density lipoproteins (HDL) particles are able to efficiently carry cholesterol from the foam cells back to the circulation, the early lesions may stay stable or even disappear. However, the modified LDL particles also trigger a permanent local inflammatory reaction characterized by the presence of activated macrophages, T cells, and mast cells, which drive lesion progression. Then, the HDL particles become modified and unable to remove cholesterol from the foam cells. Ultimately, the aging foam cells die and form a necrotic lipid core. In such advanced lesions, the lipid core is separated from the circulating blood by a collagenous cap, which may become thin and fragile and susceptible to rupture, so causing an acute atherothrombotic event. Regarding the potential contribution of mast cells in the initiation and progression of atherosclerotic lesions, immunohistochemical studies in autopsied human subjects and studies in cell culture systems and in atherosclerotic mouse models have collectively provided evidence that the compounds released by activated mast cells may promote atherogenesis at various steps along the path of lesion development. This review focuses on the presence of activated mast cells in human atherosclerotic lesions. Moreover, some of the molecular mechanisms potentially governing activation and effector functions of mast cells in such lesions are presented and discussed.
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Abstract
Atherosclerotic cardiovascular disease is a leading cause of death and morbidity globally. Over the past several years, arterial inflammation has been implicated in the pathophysiology of athero-thrombosis, substantially confirming what pathologist Rudolf Virchow had observed in the 19th century. Lipid lowering, lifestyle changes, and modification of other risk factors have reduced cardiovascular complications of athero-thrombosis, but a substantial residual risk remains. In view of the pathogenic role of inflammation in athero-thrombosis, directly targeting inflammation has emerged as an additional potential therapeutic option; and some early promising results have been suggested by the Canakinumab Anti-inflammatory Thrombosis Outcome Study (CANTOS), in which canakinumab, a fully human monoclonal antibody targeting the pro-inflammatory and pro-atherogenic cytokine interleukin 1 beta, was shown to reduce cardiovascular events.
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Affiliation(s)
- Prediman K Shah
- Helga and Walter Oppenheimer Atherosclerosis Research Center, Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Dalgisio Lecis
- Helga and Walter Oppenheimer Atherosclerosis Research Center, Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA.,Department of Cardiovascular Medicine, "Tor Vergata" University of Rome, Rome, Italy
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15
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Lu HS, Schmidt AM, Hegele RA, Mackman N, Rader DJ, Weber C, Daugherty A. Reporting Sex and Sex Differences in Preclinical Studies. Arterioscler Thromb Vasc Biol 2019; 38:e171-e184. [PMID: 30354222 DOI: 10.1161/atvbaha.118.311717] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Hong S Lu
- From the Department of Physiology, Saha Cardiovascular Research Center, University of Kentucky, Lexington (H.S.L., A.D.)
| | - Ann Marie Schmidt
- Diabetes Research Program, Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, New York University Langone Medical Center, New York, NY (A.M.S.)
| | - Robert A Hegele
- Department of Medicine and Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada (R.A.H.)
| | - Nigel Mackman
- Department of Medicine, University of North Carolina at Chapel Hill (N.M.)
| | - Daniel J Rader
- Department of Medicine (D.J.R.), Perelman School of Medicine, University of Pennsylvania, Philadelphia.,Department of Genetics (D.J.R.), Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Christian Weber
- Department of Medicine, Institute for Cardiovascular Prevention, Ludwig-Maximilians-Universität, Munich, Germany (C.W.).,German Centre for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany (C.W.)
| | - Alan Daugherty
- From the Department of Physiology, Saha Cardiovascular Research Center, University of Kentucky, Lexington (H.S.L., A.D.)
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Bot I, Mulder MT, Indhirajanti S, van Daele PLA, Roeters van Lennep JE. Reply to: "The "cholesterol paradox" in patients with mastocytosis". Atherosclerosis 2019; 284:262-263. [PMID: 30871724 DOI: 10.1016/j.atherosclerosis.2019.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 02/22/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Ilze Bot
- Division of BioTherapeutics, Leiden Academic Centre for Drug Research, Leiden University, Leiden, the Netherlands
| | - Monique T Mulder
- Department of Internal Medicine, Laboratory Vascular Medicine, Erasmus MC, Rotterdam, the Netherlands
| | - Swasti Indhirajanti
- Department of Internal Medicine, Franciscus Gasthuis & Vlietland, the Netherlands
| | - Paul L A van Daele
- Department of Internal Medicine, Division Immunology, and Department of Immunology, Erasmus MC, Rotterdam, the Netherlands
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17
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Deficiency of mouse mast cell protease 4 mitigates cardiac dysfunctions in mice after myocardium infarction. Biochim Biophys Acta Mol Basis Dis 2019; 1865:1170-1181. [PMID: 30639224 DOI: 10.1016/j.bbadis.2019.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/26/2018] [Accepted: 01/08/2019] [Indexed: 12/11/2022]
Abstract
Mouse mast cell protease-4 (mMCP4) is a chymase that has been implicated in cardiovascular diseases, including myocardial infarction (MI). This study tested a direct role of mMCP4 in mouse post-MI cardiac dysfunction and myocardial remodeling. Immunoblot and immunofluorescent double staining demonstrated mMCP4 expression in cardiomyocytes from the infarct zone from mouse heart at 28 day post-MI. At this time point, mMCP4-deficient Mcpt4-/- mice showed no difference in survival from wild-type (WT) control mice, yet demonstrated smaller infarct size, improved cardiac functions, reduced macrophage content but increased T-cell accumulation in the infarct region compared with those of WT littermates. mMCP4-deficiency also reduced cardiomyocyte apoptosis and expression of TGF-β1, p-Smad2, and p-Smad3 in the infarct region, but did not affect collagen deposition or α-smooth muscle actin expression in the same area. Gelatin gel zymography and immunoblot analysis revealed reduced activities of matrix metalloproteinases and expression of cysteinyl cathepsins in the myocardium, macrophages, and T cells from Mcpt4-/- mice. Immunoblot analysis also found reduced p-Smad2 and p-Smad3 in the myocardium from Mcpt4-/- mice, yet fibroblasts from Mcpt4-/- mice showed comparable levels of p-Smad2 and p-Smad3 to those of WT fibroblasts. Flow cytometry, immunoblot analysis, and immunofluorescent staining demonstrated that mMCP4-deficiency reduced the expression of proapoptotic cathepsins in cardiomyocytes and protected cardiomyocytes from H2O2-induced apoptosis. This study established a role of mMCP4 in mouse post-MI dysfunction by regulating myocardial protease expression and cardiomyocyte death without significant impact on myocardial fibrosis or survival post-MI in mice.
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18
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Haas MJ, Jurado-Flores M, Hammoud R, Plazarte G, Onstead-Haas L, Wong NC, Mooradian AD. Regulation of apolipoprotein A-I gene expression by the histamine H1 receptor: Requirement for NF-κB. Life Sci 2018; 208:102-110. [DOI: 10.1016/j.lfs.2018.07.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 06/27/2018] [Accepted: 07/12/2018] [Indexed: 01/22/2023]
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19
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Houde M, Schwertani A, Touil H, Desbiens L, Sarrhini O, Lecomte R, Lepage M, Gagnon H, Takai S, Pejler G, Jacques D, Gobeil F, Day R, D'Orléans-Juste P. Mouse Mast Cell Protease 4 Deletion Protects Heart Function and Survival After Permanent Myocardial Infarction. Front Pharmacol 2018; 9:868. [PMID: 30233357 PMCID: PMC6127244 DOI: 10.3389/fphar.2018.00868] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 07/17/2018] [Indexed: 01/08/2023] Open
Abstract
Chymase, a mast cell serine protease involved in the generation of multiple cardiovascular factors, such as angiotensin II and endothelin-1 (ET-1), is elevated and participates in tissue degeneration after permanent myocardial infarction (PMI). Anesthetized 4-month old male wild-type (WT) C57BL/6J mice and mouse mast cell protease-4 knockout (mMCP-4 KO) congeners were subjected to ligation of the left anterior descending (LAD) coronary artery. A group of mice was then subjected to Kaplan-Meier 28-day survival analysis. In another group of mice, 18F-fluorodeoxyglucose positron emission tomography (PET) was performed to evaluate heart function and the infarcted zone 3 days post-PMI surgery. Cardiac morphology following PMI was evaluated on formalin-fixed heart slices and glycoproteomic analysis was performed using mass spectrometry. Finally, cardiac and lung tissue content of immunoreactive ET-1 was determined. PMI caused 60% mortality in WT mice, due to left ventricular wall rupture, and 7% in mMCP-4 KO mice. Cardiac PET analysis revealed a significant reduction in left ventricular volume (systolic and diastolic) and preserved the ejection fraction in mMCP-4 KO compared to WT animals. The infarcted area, apoptotic signaling and wall remodeling were significantly decreased in mMCP-4 KO mice compared to their WT congeners, while collagen deposition was increased. Glycoproteomic analysis showed an increase in apolipoprotein A1, an established chymase substrate in mMCP-4 KO mice compared to WT mice post-PMI. ET-1 levels were increased in the lungs of WT, but not mMCP-4 KO mice, 24 h post-PMI. Thus, the genetic deletion of mMCP-4 improved survival and heart function post-PMI.
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Affiliation(s)
- Martin Houde
- Department of Pharmacology-Physiology, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, QC, Canada.,Division of BioTherapeutics, Leiden Academic Centre for Drug Research, Universiteit Leiden, Leiden, Netherlands
| | - Adel Schwertani
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - Hanène Touil
- Department of Pharmacology-Physiology, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Louisane Desbiens
- Department of Pharmacology-Physiology, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Otman Sarrhini
- Department of Nuclear Medicine and Radiobiology, Sherbrooke Molecular Imaging Center, CRCHUS, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Roger Lecomte
- Department of Nuclear Medicine and Radiobiology, Sherbrooke Molecular Imaging Center, CRCHUS, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Martin Lepage
- Department of Nuclear Medicine and Radiobiology, Sherbrooke Molecular Imaging Center, CRCHUS, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Hugo Gagnon
- PhenoSwitch Bioscience Inc., Sherbrooke, QC, Canada
| | - Shinji Takai
- Department of Innovative Medicine, Osaka Medical College, Osaka, Japan
| | - Gunnar Pejler
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden.,Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Danielle Jacques
- Department of Anatomy and Cell Biology, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Fernand Gobeil
- Department of Pharmacology-Physiology, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Robert Day
- Department of Surgery, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Pedro D'Orléans-Juste
- Department of Pharmacology-Physiology, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, QC, Canada
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20
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Kareinen I, Baumann M, Nguyen SD, Maaninka K, Anisimov A, Tozuka M, Jauhiainen M, Lee-Rueckert M, Kovanen PT. Chymase released from hypoxia-activated cardiac mast cells cleaves human apoA-I at Tyr 192 and compromises its cardioprotective activity. J Lipid Res 2018; 59:945-957. [PMID: 29581158 DOI: 10.1194/jlr.m077503] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 03/22/2018] [Indexed: 01/05/2023] Open
Abstract
ApoA-I, the main structural and functional protein of HDL particles, is cardioprotective, but also highly sensitive to proteolytic cleavage. Here, we investigated the effect of cardiac mast cell activation and ensuing chymase secretion on apoA-I degradation using isolated rat hearts in the Langendorff perfusion system. Cardiac mast cells were activated by injection of compound 48/80 into the coronary circulation or by low-flow myocardial ischemia, after which lipid-free apoA-I was injected and collected in the coronary effluent for cleavage analysis. Mast cell activation by 48/80 resulted in apoA-I cleavage at sites Tyr192 and Phe229, but hypoxic activation at Tyr192 only. In vitro, the proteolytic end-product of apoA-I with either rat or human chymase was the Tyr192-truncated fragment. This fragment, when compared with intact apoA-I, showed reduced ability to promote migration of cultured human coronary artery endothelial cells in a wound-healing assay. We propose that C-terminal truncation of apoA-I by chymase released from cardiac mast cells during ischemia impairs the ability of apoA-I to heal damaged endothelium in the ischemic myocardium.
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Affiliation(s)
- Ilona Kareinen
- Wihuri Research Institute, Helsinki, Finland; Department of Veterinary Biosciences, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Marc Baumann
- Protein Chemistry Unit, Institute of Biomedicine/Anatomy, University of Helsinki, Helsinki, Finland
| | | | | | - Andrey Anisimov
- Wihuri Research Institute, Helsinki, Finland; Translational Cancer Biology Program, University of Helsinki, Helsinki, Finland
| | - Minoru Tozuka
- Analytical Laboratory Chemistry, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Matti Jauhiainen
- Minerva Foundation Institute for Medical Research, Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland
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21
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Indhirajanti S, van Daele PL, Bos S, Mulder MT, Bot I, Roeters van Lennep JE. Systemic mastocytosis associates with cardiovascular events despite lower plasma lipid levels. Atherosclerosis 2018; 268:152-156. [DOI: 10.1016/j.atherosclerosis.2017.11.030] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 10/05/2017] [Accepted: 11/30/2017] [Indexed: 11/29/2022]
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22
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Kovanen PT, Bot I. Mast cells in atherosclerotic cardiovascular disease – Activators and actions. Eur J Pharmacol 2017; 816:37-46. [DOI: 10.1016/j.ejphar.2017.10.013] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 10/06/2017] [Accepted: 10/09/2017] [Indexed: 12/19/2022]
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23
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Peng M, Zhang Q, Cheng Y, Fu S, Yang H, Guo X, Zhang J, Wang L, Zhang L, Xue Z, Li Y, Da Y, Yao Z, Qiao L, Zhang R. Apolipoprotein A-I mimetic peptide 4F suppresses tumor-associated macrophages and pancreatic cancer progression. Oncotarget 2017; 8:99693-99706. [PMID: 29245934 PMCID: PMC5725125 DOI: 10.18632/oncotarget.21157] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 09/08/2017] [Indexed: 01/07/2023] Open
Abstract
Pancreatic cancer is an aggressive malignancy that is unresponsive to conventional radiation and chemotherapy. Therefore, development of novel immune therapeutic strategies is urgently needed. L-4F, an Apolipoprotein A-I (ApoA-I) mimetic peptide, is engineered to mimic the anti-inflammatory and anti-oxidative functionalities of ApoA-I. In this work, H7 cells were orthotopically implanted in C57BL/6 mice and treated with L-4F. Then, pancreatic cancer progression and the inflammatory microenvironment were investigated in vivo. The cytotoxicity of L-4F toward H7 cells was assessed in vitro. Furthermore, we investigated the effects of L-4F on macrophage polarization by analyzing the polarization and genes of mouse bone marrow-derived macrophages in vitro. The results show that L-4F substantially reduced the tumorigenicity of H7 cells. L-4F inhibited inflammation by reducing the accumulation of inflammatory cells, such as IL-17A-, IL-4-, GM-CSF-, IL-1β-, and IL-6-producing cells and Th1 and Th17. Notably, L-4F also decreased the percentage of macrophages in tumor tissues, especially M2 macrophages (CD11b+F4/80+CD206+), which was also confirmed in vitro. Additionally, the expression of the M2 marker genes Arg1, MRC1, and CCL22 and the inflammatory genes IL-6, iNOS, and IL-12 was decreased by L-4F, indicating that L-4F prevents M2 type macrophage polarization. However, L-4F could not directly attenuate H7 cell invasion or proliferation and did not induce apoptosis. In addition, L-4F potently down-regulated STAT3, JNK and ERK signaling pathways but not affects the phosphorylation of p38 in RAW 264.7 cells. These results suggest that L-4F exhibits an effective therapeutic effect on pancreatic cancer progression by inhibiting tumor-associated macrophages and inflammation.
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Affiliation(s)
- Meiyu Peng
- Department of Immunology, School of Clinical Medicine, Weifang Medical University, Weifang, China.,Laboratory of Immunology and Inflammation, Department of Immunology, Key Laboratory of Immune Microenvironment and Diseases of Educational Ministry of China, Tianjin Key Laboratory of Molecular and Cellular Immunology, Tianjin Medical University, Tianjin, China
| | - Qi Zhang
- Institute of Integrative Medicines for Acute Abdominal Diseases, Nankai Hospital, Tianjin, China.,Laboratory of Immunology and Inflammation, Department of Immunology, Key Laboratory of Immune Microenvironment and Diseases of Educational Ministry of China, Tianjin Key Laboratory of Molecular and Cellular Immunology, Tianjin Medical University, Tianjin, China
| | - Yingnan Cheng
- Laboratory of Immunology and Inflammation, Department of Immunology, Key Laboratory of Immune Microenvironment and Diseases of Educational Ministry of China, Tianjin Key Laboratory of Molecular and Cellular Immunology, Tianjin Medical University, Tianjin, China
| | - Shuyu Fu
- Laboratory of Immunology and Inflammation, Department of Immunology, Key Laboratory of Immune Microenvironment and Diseases of Educational Ministry of China, Tianjin Key Laboratory of Molecular and Cellular Immunology, Tianjin Medical University, Tianjin, China.,Institute of Human Virology, Sun Yat-Sen University, Guangzhou, China
| | - Huipeng Yang
- Laboratory of Immunology and Inflammation, Department of Immunology, Key Laboratory of Immune Microenvironment and Diseases of Educational Ministry of China, Tianjin Key Laboratory of Molecular and Cellular Immunology, Tianjin Medical University, Tianjin, China
| | - Xiangdong Guo
- Laboratory of Immunology and Inflammation, Department of Immunology, Key Laboratory of Immune Microenvironment and Diseases of Educational Ministry of China, Tianjin Key Laboratory of Molecular and Cellular Immunology, Tianjin Medical University, Tianjin, China
| | - Jieyou Zhang
- Laboratory of Immunology and Inflammation, Department of Immunology, Key Laboratory of Immune Microenvironment and Diseases of Educational Ministry of China, Tianjin Key Laboratory of Molecular and Cellular Immunology, Tianjin Medical University, Tianjin, China
| | - Lina Wang
- Department of Immunology, School of Clinical Medicine, Weifang Medical University, Weifang, China
| | - Lijuan Zhang
- Laboratory of Immunology and Inflammation, Department of Immunology, Key Laboratory of Immune Microenvironment and Diseases of Educational Ministry of China, Tianjin Key Laboratory of Molecular and Cellular Immunology, Tianjin Medical University, Tianjin, China
| | - Zhenyi Xue
- Laboratory of Immunology and Inflammation, Department of Immunology, Key Laboratory of Immune Microenvironment and Diseases of Educational Ministry of China, Tianjin Key Laboratory of Molecular and Cellular Immunology, Tianjin Medical University, Tianjin, China
| | - Yan Li
- Laboratory of Immunology and Inflammation, Department of Immunology, Key Laboratory of Immune Microenvironment and Diseases of Educational Ministry of China, Tianjin Key Laboratory of Molecular and Cellular Immunology, Tianjin Medical University, Tianjin, China
| | - Yurong Da
- Laboratory of Immunology and Inflammation, Department of Immunology, Key Laboratory of Immune Microenvironment and Diseases of Educational Ministry of China, Tianjin Key Laboratory of Molecular and Cellular Immunology, Tianjin Medical University, Tianjin, China
| | - Zhi Yao
- Laboratory of Immunology and Inflammation, Department of Immunology, Key Laboratory of Immune Microenvironment and Diseases of Educational Ministry of China, Tianjin Key Laboratory of Molecular and Cellular Immunology, Tianjin Medical University, Tianjin, China
| | - Liang Qiao
- Storr Liver Unit, Westmead Institute for Medical Research, the University of Sydney and Westmead Hospital, Westmead, New South Wales, Australia
| | - Rongxin Zhang
- Laboratory of Immunology and Inflammation, Department of Immunology, Key Laboratory of Immune Microenvironment and Diseases of Educational Ministry of China, Tianjin Key Laboratory of Molecular and Cellular Immunology, Tianjin Medical University, Tianjin, China.,Laboratory of Immunology and Inflammation, School of Life Science and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, China
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Li L, Huang B, Song S, Sohun H, Rao Z, Tao L, Jin Q, Zeng J, Wu R, Ji K, Lin J, Wu L, Chu M. A20 functions as mediator in TNFα-induced injury of human umbilical vein endothelial cells through TAK1-dependent MAPK/eNOS pathway. Oncotarget 2017; 8:65230-65239. [PMID: 29029426 PMCID: PMC5630326 DOI: 10.18632/oncotarget.18191] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 04/27/2017] [Indexed: 12/15/2022] Open
Abstract
A20, a negative regulator of nuclear factor κB signaling, has been shown to attenuate atherosclerotic events. Transforming growth factor beta-activated kinase 1 (TAK1) plays a critical role in TNFα-induced atherosclerosis via endothelial nitric oxide (NO) synthase (eNOS) uncoupling and NO reduction. In the study, we investigated the hypothesis that A20 protected endothelial cell injury induced by TNFα through modulating eNOS activity and TAK1 signalling. Human umbilical vein endothelial cells (HUVECs) were stimulated by TNFα. The impact of A20 on cell apoptosis, eNOS expression and NO production and related TAK1 pathway were detected. Both eNOS and NO production were remarkably reduced. TAK1, p38 MAPK phosphorylation and HUVECs apoptosis were enhanced after TNFα stimulation for 2 hrs. Inhibition of A20 significantly activated TAK1, p38 MAPK phosphorylation, and cell apoptosis, but blocked eNOS expression and NO production. Furthermore, p38 MAPK expression was suppressed by A20 over-expression, but re-enhanced by inhibiting A20 or activation of TAK1. Furtherly, TNFα-induced suppression of eNOS and NO production were largely prevented by silencing p38 MAPK. Collectively, our results suggested that A20-mediated TAK1 inactivation suppresses p38 MAPK and regulated MAPK/eNOS pathway, which contributes to endothelial cell survival and function preservation.
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Affiliation(s)
- Lei Li
- Institute of Cardiovascular Development and Translational Medicine, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | | | - Shiyang Song
- Institute of Cardiovascular Development and Translational Medicine, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Hareshwaree Sohun
- Institute of Cardiovascular Development and Translational Medicine, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Zhiheng Rao
- Institute of Cardiovascular Development and Translational Medicine, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Luyuan Tao
- Institute of Cardiovascular Development and Translational Medicine, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Qike Jin
- Institute of Cardiovascular Development and Translational Medicine, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Jingjing Zeng
- Institute of Cardiovascular Development and Translational Medicine, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Rongzhou Wu
- Institute of Cardiovascular Development and Translational Medicine, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Kangting Ji
- Institute of Cardiovascular Development and Translational Medicine, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Jiafeng Lin
- Institute of Cardiovascular Development and Translational Medicine, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Lianpin Wu
- Institute of Cardiovascular Development and Translational Medicine, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Maoping Chu
- Institute of Cardiovascular Development and Translational Medicine, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325027, China
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25
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Maafi F, Li B, Gebhard C, Brodeur MR, Nachar W, Villeneuve L, Lesage F, Rhainds D, Rhéaume E, Tardif JC. Development of a new bioactivatable fluorescent probe for quantification of apolipoprotein A-I proteolytic degradation in vitro and in vivo. Atherosclerosis 2017; 258:8-19. [PMID: 28167355 DOI: 10.1016/j.atherosclerosis.2017.01.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 01/04/2017] [Accepted: 01/19/2017] [Indexed: 01/20/2023]
Abstract
BACKGROUND AND AIMS The potential benefits of high-density lipoproteins (HDL) against atherosclerosis are attributed to its major protein component, apolipoprotein A-I (apoA-I). Most of the apoA-I in the vascular wall appears to be in its lipid-poor form. The latter, however, is subjected to degradation by proteases localized in atherosclerotic plaques, which, in turn, has been shown to negatively impact its atheroprotective functions. Here, we report the development and in vivo use of a bioactivatable near-infrared full-length apoA-I-Cy5.5 fluorescent probe for the assessment of apoA-I-degrading proteolytic activities. METHODS Fluorescence quenching was obtained by saturation of Cy5.5 fluorophore molecules on apoA-I protein. ApoA-I cleavage led to near-infrared fluorescence enhancement. In vitro proteolysis of the apoA-I probe by a variety of proteases including serine, cysteine, and metalloproteases resulted in an up to 11-fold increase in fluorescence (n = 5, p ≤ 0.05). RESULTS We detected activation of the probe in atherosclerotic mice aorta sections using in situ zymography and showed that broad-spectrum protease inhibitors protected the probe from degradation, resulting in decreased fluorescence (-54%, n = 6 per group, p ≤ 0.0001). In vivo, the injected probe showed stronger fluorescence emission in the aorta of human apoB transgenic Ldlr-/- atherosclerotic mice (ATX) as compared to wild-type mice. In vivo observations were confirmed by ex vivo aorta imaging quantification where a 10-fold increase in fluorescent signal in ATX mice (p ≤ 0.05 vs. control mice) was observed. CONCLUSIONS The use of this probe in different applications may help to assess new molecular mechanisms of atherosclerosis and may improve current HDL-based therapies by enhancing apoA-I functionality.
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Affiliation(s)
- Foued Maafi
- Montreal Heart Institute and Université de Montréal, Quebec, Canada
| | - Baoqiang Li
- Montreal Heart Institute and Université de Montréal, Quebec, Canada; Institute of Biomedical Engineering, École Polytechnique de Montréal, Montreal, Quebec, Canada
| | | | | | - Walid Nachar
- Montreal Heart Institute and Université de Montréal, Quebec, Canada
| | - Louis Villeneuve
- Montreal Heart Institute and Université de Montréal, Quebec, Canada
| | - Frédéric Lesage
- Montreal Heart Institute and Université de Montréal, Quebec, Canada; Institute of Biomedical Engineering, École Polytechnique de Montréal, Montreal, Quebec, Canada
| | - David Rhainds
- Montreal Heart Institute and Université de Montréal, Quebec, Canada
| | - Eric Rhéaume
- Montreal Heart Institute and Université de Montréal, Quebec, Canada
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Dinnes DLM, White MY, Kockx M, Traini M, Hsieh V, Kim M, Hou L, Jessup W, Rye K, Thaysen‐Andersen M, Cordwell SJ, Kritharides L. Human macrophage cathepsin β‐mediated C‐terminal cleavage of apolipoprotein α‐I at Ser
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severely impairs antiatherogenic capacity. FASEB J 2016; 30:4239-4255. [DOI: 10.1096/fj.201600508r] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 09/01/2016] [Indexed: 11/11/2022]
Affiliation(s)
| | - Melanie Y. White
- School of Molecular BioscienceDiscipline of Pathology School of Medical Sciences and Charles Perkins Centre University of Sydney Sydney New South Wales Australia
| | - Maaike Kockx
- Atherosclerosis LaboratoryANZAC Research Institute
| | | | - Victar Hsieh
- Department of CardiologySt. George Hospital Sydney New South Wales Australia
| | - Mi‐Jurng Kim
- School of Medical Sciences Sydney New South Wales Australia
| | - Liming Hou
- Lipid Research GroupSchool of Medical Sciences University of New South Wales Sydney New South Wales Australia
| | - Wendy Jessup
- Atherosclerosis LaboratoryANZAC Research Institute
| | - Kerry‐Anne Rye
- Lipid Research GroupSchool of Medical Sciences University of New South Wales Sydney New South Wales Australia
| | - Morten Thaysen‐Andersen
- Department of Chemistry and Biomolecular SciencesFaculty of Science and Engineering Macquarie University Sydney New South Wales Australia
| | - Stuart J. Cordwell
- School of Molecular BioscienceDiscipline of Pathology School of Medical Sciences and Charles Perkins Centre University of Sydney Sydney New South Wales Australia
| | - Leonard Kritharides
- Atherosclerosis LaboratoryANZAC Research Institute
- Department of CardiologyConcord Repatriation General Hospital Sydney New South Wales Australia
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Ollikainen E, Tulamo R, Lehti S, Lee-Rueckert M, Hernesniemi J, Niemelä M, Ylä-Herttuala S, Kovanen PT, Frösen J. Smooth Muscle Cell Foam Cell Formation, Apolipoproteins, and ABCA1 in Intracranial Aneurysms: Implications for Lipid Accumulation as a Promoter of Aneurysm Wall Rupture. J Neuropathol Exp Neurol 2016; 75:689-99. [PMID: 27283327 DOI: 10.1093/jnen/nlw041] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Saccular intracranial aneurysm (sIA) aneurysm causes intracranial hemorrhages that are associated with high mortality. Lipid accumulation and chronic inflammation occur in the sIA wall. A major mechanism for lipid clearance from arteries is adenosine triphosphate-binding cassette A1 (ABCA1)-mediated lipid efflux from foam cells to apolipoprotein A-I (apoA-I). We investigated the association of wall degeneration, inflammation, and lipid-related parameters in tissue samples of 16 unruptured and 20 ruptured sIAs using histology and immunohistochemistry. Intracellular lipid accumulation was associated with wall remodeling (p = 0.005) and rupture (p = 0.020). Foam cell formation was observed in smooth muscle cells, in addition to CD68- and CD163-positive macrophages. Macrophage infiltration correlated with intracellular lipid accumulation and apolipoproteins, including apoA-I. ApoA-I correlated with markers of lipid accumulation and wall degeneration (p = 0.01). ApoA-I-positive staining colocalized with ABCA1-positive cells particularly in sIAs with high number of smooth muscle cells (p = 0.003); absence of such colocalization was associated with wall degeneration (p = 0.017). Known clinical risk factors for sIA rupture correlated inversely with apoA-I. We conclude that lipid accumulation associates with sIA wall degeneration and risk of rupture, possibly via formation of foam cells and subsequent loss of mural cells. Reduced removal of lipids from the sIA wall via ABCA1-apoA-I pathway may contribute to this process.
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Affiliation(s)
- Eliisa Ollikainen
- From the Biomedicum, Neurosurgery Research Group, Helsinki, Finland (EO, RT, JH, MN, JF); Biomedicum, Wihuri Research Institute, Helsinki, Finland (EO, SL, ML-R, PTK); Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland (RT); Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland (JH, MN); Department of Molecular Medicine, AIV-Institute, Kuopio, Finland, University of Eastern Finland (SY-H); Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland (JF); and Hemorrhagic Brain Pathology Research Group, Kuopio University Hospital, Kuopio, Finland (JF)
| | - Riikka Tulamo
- From the Biomedicum, Neurosurgery Research Group, Helsinki, Finland (EO, RT, JH, MN, JF); Biomedicum, Wihuri Research Institute, Helsinki, Finland (EO, SL, ML-R, PTK); Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland (RT); Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland (JH, MN); Department of Molecular Medicine, AIV-Institute, Kuopio, Finland, University of Eastern Finland (SY-H); Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland (JF); and Hemorrhagic Brain Pathology Research Group, Kuopio University Hospital, Kuopio, Finland (JF)
| | - Satu Lehti
- From the Biomedicum, Neurosurgery Research Group, Helsinki, Finland (EO, RT, JH, MN, JF); Biomedicum, Wihuri Research Institute, Helsinki, Finland (EO, SL, ML-R, PTK); Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland (RT); Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland (JH, MN); Department of Molecular Medicine, AIV-Institute, Kuopio, Finland, University of Eastern Finland (SY-H); Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland (JF); and Hemorrhagic Brain Pathology Research Group, Kuopio University Hospital, Kuopio, Finland (JF)
| | - Miriam Lee-Rueckert
- From the Biomedicum, Neurosurgery Research Group, Helsinki, Finland (EO, RT, JH, MN, JF); Biomedicum, Wihuri Research Institute, Helsinki, Finland (EO, SL, ML-R, PTK); Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland (RT); Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland (JH, MN); Department of Molecular Medicine, AIV-Institute, Kuopio, Finland, University of Eastern Finland (SY-H); Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland (JF); and Hemorrhagic Brain Pathology Research Group, Kuopio University Hospital, Kuopio, Finland (JF)
| | - Juha Hernesniemi
- From the Biomedicum, Neurosurgery Research Group, Helsinki, Finland (EO, RT, JH, MN, JF); Biomedicum, Wihuri Research Institute, Helsinki, Finland (EO, SL, ML-R, PTK); Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland (RT); Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland (JH, MN); Department of Molecular Medicine, AIV-Institute, Kuopio, Finland, University of Eastern Finland (SY-H); Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland (JF); and Hemorrhagic Brain Pathology Research Group, Kuopio University Hospital, Kuopio, Finland (JF)
| | - Mika Niemelä
- From the Biomedicum, Neurosurgery Research Group, Helsinki, Finland (EO, RT, JH, MN, JF); Biomedicum, Wihuri Research Institute, Helsinki, Finland (EO, SL, ML-R, PTK); Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland (RT); Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland (JH, MN); Department of Molecular Medicine, AIV-Institute, Kuopio, Finland, University of Eastern Finland (SY-H); Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland (JF); and Hemorrhagic Brain Pathology Research Group, Kuopio University Hospital, Kuopio, Finland (JF)
| | - Seppo Ylä-Herttuala
- From the Biomedicum, Neurosurgery Research Group, Helsinki, Finland (EO, RT, JH, MN, JF); Biomedicum, Wihuri Research Institute, Helsinki, Finland (EO, SL, ML-R, PTK); Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland (RT); Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland (JH, MN); Department of Molecular Medicine, AIV-Institute, Kuopio, Finland, University of Eastern Finland (SY-H); Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland (JF); and Hemorrhagic Brain Pathology Research Group, Kuopio University Hospital, Kuopio, Finland (JF)
| | - Petri T Kovanen
- From the Biomedicum, Neurosurgery Research Group, Helsinki, Finland (EO, RT, JH, MN, JF); Biomedicum, Wihuri Research Institute, Helsinki, Finland (EO, SL, ML-R, PTK); Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland (RT); Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland (JH, MN); Department of Molecular Medicine, AIV-Institute, Kuopio, Finland, University of Eastern Finland (SY-H); Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland (JF); and Hemorrhagic Brain Pathology Research Group, Kuopio University Hospital, Kuopio, Finland (JF)
| | - Juhana Frösen
- From the Biomedicum, Neurosurgery Research Group, Helsinki, Finland (EO, RT, JH, MN, JF); Biomedicum, Wihuri Research Institute, Helsinki, Finland (EO, SL, ML-R, PTK); Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland (RT); Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland (JH, MN); Department of Molecular Medicine, AIV-Institute, Kuopio, Finland, University of Eastern Finland (SY-H); Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland (JF); and Hemorrhagic Brain Pathology Research Group, Kuopio University Hospital, Kuopio, Finland (JF)
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