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Giannakopoulos B, Krilis SA. Domain 5 of Beta 2 glycoprotein I: Friend or foe in health? Context matters. Clin Immunol 2024; 265:110282. [PMID: 38917928 DOI: 10.1016/j.clim.2024.110282] [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: 06/14/2023] [Revised: 06/03/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024]
Abstract
Beta 2 glycoprotein I (β2GPI) is the major autoantigen in the antiphospholipid syndrome, an autoimmune disorder characterized by thrombotic and obstetric complications. The autoantibodies that target beta 2 glycoprotein I are pathogenic and contribute to disease pathogenesis. The β2GPI molecule is composed of 5 domains that are numbered 1 through to 5. Autoantibodies bind mainly to domain 1 whereas the majority of the biological functions of the β2GPI molecule in diverse processes such as apoptotic cell clearance, complement regulation, lipopolysaccharide clearance and anticoagulation have been localised to domain 5 and its unique biochemistry, reviewed in this article. The role of purified domain 5 peptide as a potential therapeutic agent in APS and ischemia reperfusion injury is discussed.
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Affiliation(s)
- Bill Giannakopoulos
- Faculty of Medicine and Health, University of New South Wales, St George and Sutherland Campus, Level 2, Pitney Building, Kogarah, Sydney, NSW 2217, Australia; Department of Rheumatology, St George Public Hospital, Kogarah, Sydney, 2217, Australia.
| | - Steven A Krilis
- Faculty of Medicine and Health, University of New South Wales, St George and Sutherland Campus, Level 2, Pitney Building, Kogarah, Sydney, NSW 2217, Australia; Department of Infectious Diseases, Immunology, and Sexual Health, St George Public Hospital, Kogarah, Sydney 2217, Australia.
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de Koning MSLY, Al Ali L, Bourgonje AR, Assa S, Pasch A, van Goor H, Lipsic E, van der Harst P. Associations of systemic oxidative stress with functional outcomes after ST-segment elevation myocardial infarction. Int J Cardiol 2023; 391:131214. [PMID: 37517783 DOI: 10.1016/j.ijcard.2023.131214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 07/23/2023] [Accepted: 07/24/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Ischemia-reperfusion is accompanied by oxidative stress. Serum free thiols (FTs; sulfhydryl groups) reliably reflect systemic oxidative stress. This study evaluates longitudinal changes in FTs and their associations with outcomes after ST-segment elevation myocardial infarction (STEMI). METHODS FTs were detected in archived serum samples from 378 participants of a neutral randomized trial on metformin therapy after STEMI. FT levels were determined at presentation with STEMI and at 24 h, 2 weeks, 4 months and 1 year thereafter. Outcomes included infarct size and left ventricular ejection fraction (LVEF), both determined with cardiac magnetic resonance imaging after 4 months, and 5-year major adverse cardiovascular events (MACE). RESULTS Serum FT concentrations at presentation and at 24 h were 356 ± 91 and 353 ± 76 μmol/L, respectively. The change in FTs between presentation and 24 h (ΔFTs) was associated with outcomes in age- and sex-adjusted analysis (per 100 μmol/L FT increase, β = -0.87 for infarct size, 95% confidence interval (CI): -1.75 to -0.001, P = 0.050; β = 1.31, 95% CI: 0.37 to 2.25 for LVEF, P = 0.007). Associations between ΔFTs and LVEF were markedly stronger in patients with Thrombolysis in Myocardial Infarction flow of 0 or 1 before percutaneous coronary intervention (PCI)(β = 2.73, 95% CI: 0.68 to 4.77, P = 0.009). Declining FTs during the first 24 h might be associated with higher incidence of 5-year MACE (P = 0.09). CONCLUSIONS Changes in oxidative stress early post-PCI may predict functional outcomes after STEMI. Our findings warrant validation in larger cohorts, and then may be used as rationale for development of thiol-targeted therapy in ischemic heart disease.
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Affiliation(s)
- Marie-Sophie L Y de Koning
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, the Netherlands.
| | - Lawien Al Ali
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, the Netherlands
| | - Arno R Bourgonje
- University of Groningen, University Medical Center Groningen, Department of Gastroenterology and Hepatology, Groningen, the Netherlands
| | - Solmaz Assa
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, the Netherlands
| | - Andreas Pasch
- Institute for Physiology and Pathophysiology, Johannes Kepler University, Linz 4040, Austria; Lindenhofspital, Department of Nephrology, Bern 3011, Switzerland; Nierenpraxis Bern, Bern 3011, Switzerland
| | - Harry van Goor
- University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, the Netherlands
| | - Erik Lipsic
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, the Netherlands
| | - Pim van der Harst
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, the Netherlands; Department of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands
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Tokuda K, Tanaka A, Tobe A, Shirai Y, Kurobe M, Kubota Y, Kunieda T, Miyazaki T, Mizutani K, Furusawa K, Ishii H, Murohara T. Impact of C-Reactive Protein on Long-Term Cardiac Events in Stable Coronary Artery Disease Patients with Chronic Kidney Disease. J Atheroscler Thromb 2023; 30:1635-1643. [PMID: 36908149 PMCID: PMC10627763 DOI: 10.5551/jat.64047] [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: 11/05/2022] [Accepted: 02/21/2023] [Indexed: 03/13/2023] Open
Abstract
AIM Chronic inflammation is associated with atherosclerosis development. Chronic kidney disease (CKD) is an independent risk factor for cardiovascular events and is associated with chronic inflammation. We aimed to investigate the influence of C-reactive protein (CRP), an important marker of inflammation, on the clinical outcomes of patients with CKD and stable coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). METHODS Among patients with stable CAD and CKD who underwent PCI, 516 patients whose CRP levels were available before the PCI procedure were identified. The patients were divided into two groups according to the CRP levels: those with CRP ≥ 2.0 mg/L (high-CRP group) and those with CRP <2.0 mg/L (low-CRP group). The primary endpoint of this study was the occurrence of major adverse cardiac events (MACE), defined as a composite of cardiac death, myocardial infarction, and unplanned revascularization. RESULTS Overall, the mean age of the patients was 72.5±9.7 years, and 20.7% were female. The median CRP level was 1.43 mg/L (0.6-4.9 mg/L). The median follow-up period was 3.6 years. The occurrence of MACE was significantly higher in the high-CRP group than in the low-CRP group (log-rank p<0.001). Notably, the incidence rate of cardiac death was significantly higher in the high-CRP group (log-rank p<0.001). According to the multivariable analysis, CRP level ≥ 2.0 mg/L was found to be a significant predictor of MACE (hazard ratio [HR]: 1.54, 95% confidence interval [CI]: 1.04-2.28, p=0.003), as well as estimated glomerular filtration rate (HR: 0.98, 95% CI: 0.97-0.99, p<0.01). CONCLUSION High-CRP levels adversely affect long-term cardiac events in patients with stable CAD and CKD.
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Affiliation(s)
- Kotaro Tokuda
- Department of Cardiology, Nagoya University graduate school of medicine, Nagoya, Japan
| | - Akihito Tanaka
- Department of Cardiology, Nagoya University graduate school of medicine, Nagoya, Japan
| | - Akihiro Tobe
- Department of Cardiology, Nagoya University graduate school of medicine, Nagoya, Japan
| | - Yoshinori Shirai
- Department of Cardiology, Nagoya University graduate school of medicine, Nagoya, Japan
| | - Masanari Kurobe
- Department of Cardiology, Nagoya University graduate school of medicine, Nagoya, Japan
| | - Yoshiaki Kubota
- Department of Cardiology, Nagoya University graduate school of medicine, Nagoya, Japan
| | - Takeshige Kunieda
- Department of Cardiology, Nagoya University graduate school of medicine, Nagoya, Japan
| | - Tatsuya Miyazaki
- Department of Cardiology, Nagoya University graduate school of medicine, Nagoya, Japan
| | - Koji Mizutani
- Department of Cardiology, Nagoya University graduate school of medicine, Nagoya, Japan
| | - Kenji Furusawa
- Department of Cardiology, Nagoya University graduate school of medicine, Nagoya, Japan
| | - Hideki Ishii
- Department of Cardiology, Nagoya University graduate school of medicine, Nagoya, Japan
- Department of Cardiology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University graduate school of medicine, Nagoya, Japan
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Ekhzaimy AA, Masood A, Benabdelkamel H, Elhassan T, Musambil M, Alfadda AA. Plasma proteomics reveals an improved cardio-metabolic profile in patients with type 2 diabetes post-liraglutide treatment. Diab Vasc Dis Res 2022; 19:14791641221094322. [PMID: 35616478 PMCID: PMC9152203 DOI: 10.1177/14791641221094322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Diabetes mellitus is a chronic multisystem disease with a high global prevalence, including in Saudi Arabia. The Glucagon-like Peptide (GLP-1) receptor agonist liraglutide is known to lower glucose levels, reduce weight and improve cardiovascular outcome. However, mechanisms underlying the benefits of liraglutide treatment in patients with type 2 diabetes mellitus (T2DM) remain unclear. METHODS In the present study, a 2D-DIGE MALDI-TOF mass spectrometric approach combined with bioinformatics and network pathway analysis explore the plasma proteomic profile. The study involved 20 patients with T2DM with mean age of 54.4 ± 9.5 years and Hemoglobin A1c (HbA1c) between 8% and 11% (inclusive). RESULTS A statistically significant change (p < .006) was observed in HbA1c with no significant changes in body weight, renal function, or markers of dyslipidemia post-treatment with liraglutide. 2 D-DIGE gel analysis identified significant changes (⩾1.5-fold change, Analysis of variance (ANOVA), p ⩽ 0.05) in 72 proteins, (62 down and 10 up) in liraglutide pre-treatment compared to the post-treatment state. Proteins identified in our study were found to regulate metabolic processes including acute phase response proteins, enzymes, apolipoproteins with involvement of the inflammatory signaling pathways, NF-κB, AKT, and p38 MAPK. CONCLUSION Liraglutide treatment decreased levels of acute phase response that to reduce the systemic chronic inflammatory state and oxidative stress, and eventually improve the cardio-metabolic profile in these patients.
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Affiliation(s)
- Aishah A Ekhzaimy
- Department of Medicine, College of Medicine and King Saud Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Afshan Masood
- Proteomics Resource Unit, Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Hicham Benabdelkamel
- Proteomics Resource Unit, Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Tasnem Elhassan
- Department of Medicine, College of Medicine and King Saud Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Mohthash Musambil
- Proteomics Resource Unit, Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Assim A Alfadda
- Department of Medicine, College of Medicine and King Saud Medical City, King Saud University, Riyadh, Saudi Arabia
- Proteomics Resource Unit, Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Assim A Alfadda, Department of Medicine, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia.
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Kumar S, Chinnaraj M, Planer W, Zuo X, Macor P, Tedesco F, Pozzi N. An allosteric redox switch in domain V of β 2-glycoprotein I controls membrane binding and anti-domain I autoantibody recognition. J Biol Chem 2021; 297:100890. [PMID: 34197876 PMCID: PMC8326733 DOI: 10.1016/j.jbc.2021.100890] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 06/09/2021] [Accepted: 06/16/2021] [Indexed: 01/27/2023] Open
Abstract
β2-glycoprotein I (β2GPI) is an abundant multidomain plasma protein that plays various roles in the clotting and complement cascades. It is also the main target of antiphospholipid antibodies (aPL) in the acquired coagulopathy known as antiphospholipid syndrome (APS). Previous studies have shown that β2GPI adopts two interconvertible biochemical conformations, oxidized and reduced, depending on the integrity of the disulfide bonds. However, the precise contribution of the disulfide bonds to β2GPI structure and function is unknown. Here, we substituted cysteine residues with serine to investigate how the disulfide bonds C32-C60 in domain I (DI) and C288-C326 in domain V (DV) regulate β2GPI's structure and function. Results of our biophysical and biochemical studies support the hypothesis that the C32-C60 disulfide bond plays a structural role, whereas the disulfide bond C288-C326 is allosteric. We demonstrate that absence of the C288-C326 bond, unlike absence of the C32-C60 bond, diminishes membrane binding without affecting the thermodynamic stability and overall structure of the protein, which remains elongated in solution. We also document that, while absence of the C32-C60 bond directly impairs recognition of β2GPI by pathogenic anti-DI antibodies, absence of the C288-C326 disulfide bond is sufficient to abolish complex formation in the presence of anionic phospholipids. We conclude that the disulfide bond C288-C326 operates as a molecular switch capable of regulating β2GPI's physiological functions in a redox-dependent manner. We propose that in APS patients with anti-DI antibodies, selective rupture of the C288-C326 disulfide bond may be a valid strategy to lower the pathogenic potential of aPL.
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Affiliation(s)
- Suresh Kumar
- Edward A. Doisy Department of Biochemistry and Molecular Biology, Saint Louis University School of Medicine, St Louis, Missouri, USA
| | - Mathivanan Chinnaraj
- Edward A. Doisy Department of Biochemistry and Molecular Biology, Saint Louis University School of Medicine, St Louis, Missouri, USA
| | - William Planer
- Edward A. Doisy Department of Biochemistry and Molecular Biology, Saint Louis University School of Medicine, St Louis, Missouri, USA
| | - Xiaobing Zuo
- X-Ray Science Division, Argonne National Laboratory, Lemont, Illinois, USA
| | - Paolo Macor
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Francesco Tedesco
- Istituto Auxologico Italiano, IRCCS, Laboratory of Immuno-Rheumatology, Milan, Italy
| | - Nicola Pozzi
- Edward A. Doisy Department of Biochemistry and Molecular Biology, Saint Louis University School of Medicine, St Louis, Missouri, USA.
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