1
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Christensen KB, Ünsal Ş, Ebbesen MF, Hemstra L, Schlosser A, Rosenstand K, Hansen PBL, Jensen BL, Bloksgaard M, Simonsen U, Sorensen GL. MFAP4-Deficiency Aggravates Age-Induced Changes in Resistance Artery Structure, While Ameliorating Hypertension. Hypertension 2024; 81:1308-1319. [PMID: 38563153 DOI: 10.1161/hypertensionaha.123.22283] [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: 10/26/2023] [Accepted: 03/15/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Abnormalities of resistance arteries may play essential roles in the pathophysiology of aging and hypertension. Deficiency of the vascular extracellular matrix protein MFAP4 (microfibrillar-associated protein 4) has previously been observed as protective against aberrant arterial remodeling. We hypothesized that MFAP4-deficiency would reduce age- and hypertension-dependent arterial changes in extracellular matrix composition and stiffening. METHODS Mesenteric arteries were isolated from old (20-23 months) littermate Mfap4+/+ and Mfap4-/- mice, and 2-photon excitation microscopy imaging was used to quantify elastin and collagen volumes and dimensions in the vascular wall. Ten-week-old littermate Mfap4+/+ and Mfap4-/- mice were subjected to 20 days of continuous Ang II (angiotensin II) infusion and hypertension was monitored using invasive blood pressure measurements. Arterial stiffness, responses to vascular constrictors, and myogenic tone were monitored using wire- or pressure-myography. Collagen contents were assessed by Western blotting. RESULTS MFAP4-deficiency significantly increased collagen volume and elastin fragmentation in aged mesenteric arteries without affecting arterial stiffness. MFAP4-deficient mice exhibited reduced diastolic pressure in Ang II-induced hypertension. There was no significant effect of MFAP4-deficiency on mesenteric artery structural remodeling or myogenic tone, although collagen content in mesenteric arteries was tendentially increased in hypertensive Mfap4+/+ mice relative to Mfap4-/- mice. Increased efficacy of vasoconstrictors (phenylephrine, thromboxane) and reduced stiffness were observed in Ang II-treated Mfap4-/- mouse mesenteric arteries in ex vivo myography recordings. CONCLUSIONS MFAP4-deficiency reduces the elastin/collagen ratio in the aging resistance artery without affecting arterial stiffness. In contrast, MFAP4-deficiency reduces the stiffness of resistance arteries and ameliorates Ang II-induced hypertension.
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Affiliation(s)
- Kimmie B Christensen
- Department of Molecular Medicine, Faculty of Health Sciences (K.B.C., Ş.Ü., L.H., A.S., K.R., P.B.L.H., B.L.J., M.B., G.L.S.), University of Southern Denmark, Odense
| | - Şeyda Ünsal
- Department of Molecular Medicine, Faculty of Health Sciences (K.B.C., Ş.Ü., L.H., A.S., K.R., P.B.L.H., B.L.J., M.B., G.L.S.), University of Southern Denmark, Odense
| | - Morten F Ebbesen
- Department of Biochemistry and Molecular Biology (M.F.E.), University of Southern Denmark, Odense
| | - Line Hemstra
- Department of Molecular Medicine, Faculty of Health Sciences (K.B.C., Ş.Ü., L.H., A.S., K.R., P.B.L.H., B.L.J., M.B., G.L.S.), University of Southern Denmark, Odense
| | - Anders Schlosser
- Department of Molecular Medicine, Faculty of Health Sciences (K.B.C., Ş.Ü., L.H., A.S., K.R., P.B.L.H., B.L.J., M.B., G.L.S.), University of Southern Denmark, Odense
| | - Kristoffer Rosenstand
- Department of Molecular Medicine, Faculty of Health Sciences (K.B.C., Ş.Ü., L.H., A.S., K.R., P.B.L.H., B.L.J., M.B., G.L.S.), University of Southern Denmark, Odense
| | - Pernille B L Hansen
- Department of Molecular Medicine, Faculty of Health Sciences (K.B.C., Ş.Ü., L.H., A.S., K.R., P.B.L.H., B.L.J., M.B., G.L.S.), University of Southern Denmark, Odense
| | - Boye L Jensen
- Department of Molecular Medicine, Faculty of Health Sciences (K.B.C., Ş.Ü., L.H., A.S., K.R., P.B.L.H., B.L.J., M.B., G.L.S.), University of Southern Denmark, Odense
| | - Maria Bloksgaard
- Department of Molecular Medicine, Faculty of Health Sciences (K.B.C., Ş.Ü., L.H., A.S., K.R., P.B.L.H., B.L.J., M.B., G.L.S.), University of Southern Denmark, Odense
| | - Ulf Simonsen
- Department of Biomedicine, Faculty of Health, Aarhus University, Denmark (U.S.)
| | - Grith L Sorensen
- Department of Molecular Medicine, Faculty of Health Sciences (K.B.C., Ş.Ü., L.H., A.S., K.R., P.B.L.H., B.L.J., M.B., G.L.S.), University of Southern Denmark, Odense
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2
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Samadzadeh S, Olesen MN, Wirenfeldt M, Möller S, Misu T, Soelberg K, Frederiksen JL, Heegaard S, Mariotto S, Fujihara K, Ruprecht K, Andersen TL, Marignier R, Lillevang ST, Flanagan EP, Pittock SJ, Kim HJ, Bennett JL, Paul F, Sorensen GL, Weinshenker BG, Lassmann H, Asgari N. Microfibrillar-associated protein 4 as a potential marker of acute relapse in inflammatory demyelinating diseases of the central nervous system: Pathological and clinical aspects. Mult Scler 2023; 29:1721-1735. [PMID: 37830484 PMCID: PMC10880047 DOI: 10.1177/13524585231200720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
BACKGROUND Microfibrillar-associated protein 4 (MFAP4) is an extracellular matrix protein not previously described in the human central nervous system (CNS). OBJECTIVES We determined MFAP4 CNS expression and measured cerebrospinal fluid (CSF) and serum levels. METHODS Tissue was sampled at autopsy from patients with acute multiple sclerosis (MS) (n = 3), progressive MS (n = 3), neuromyelitis optica spectrum disorder (NMOSD) (n = 2), and controls (n = 9), including 6 healthy controls (HC). MFAP4 levels were measured in 152 patients: 49 MS, 62 NMOSD, 22 myelin oligodendrocyte glycoprotein-associated disease (MOGAD), and 19 isolated optic neuritis (ION). RESULTS MFAP4 localized to meninges and vascular/perivascular spaces, intense in the optic nerve. At sites of active inflammation, MFAP4 reactivity was reduced in NMOSD and acute MS and less in progressive MS. CSF MFAP4 levels were reduced during relapse and at the onset of diseases (mean U/mL: MS 14.3, MOGAD 9.7, and ION 14.6 relative to HC 17.9. (p = 0.013, p = 0.000, and p = 0.019, respectively). Patients with acute ON (n = 68) had reduced CSF MFAP4 (mean U/mL: 14.5, p = 0.006). CSF MFAP4 levels correlated negatively with relapse severity (rho = -0.41, p = 0.017). CONCLUSION MFAP4 immunoreactivity was reduced at sites of active inflammation. CSF levels of MFAP4 were reduced following relapse and may reflect disease activity.
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Affiliation(s)
- Sara Samadzadeh
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- Department of Neurology, Slagelse Hospital, Slagelse, Denmark/Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Mads Nikolaj Olesen
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- Department of Neurology, Slagelse Hospital, Slagelse, Denmark/Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - Martin Wirenfeldt
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Department of Pathological Anatomy and Molecular Biology, Hospital South West Jutland, Esbjerg, Denmark
| | - Sören Möller
- Open Patient Data Explorative Network, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Tatsuro Misu
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kerstin Soelberg
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Jette Lautrup Frederiksen
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital-Rigshospitalet, Glostrup, Denmark
| | - Steffen Heegaard
- Departments of Ophthalmology and Pathology, Rigshospitalet, Glostrup, Denmark
| | - Sara Mariotto
- Neurology Unit, Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy
| | - Kazuo Fujihara
- Department of Multiple Sclerosis Therapeutics, Fukushima Medical University School of Medicine, Fukushima, Japan
- Multiple Sclerosis and Neuromyelitis Optica Center, Southern Tohoku Research Institute for Neuroscience, Koriyama, Japan
| | - Klemens Ruprecht
- Department of Neurology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Thomas Levin Andersen
- Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- Department of Pathology, Odense University Hospital, Odense, Denmark
| | - Romain Marignier
- Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| | | | - Eoin P Flanagan
- Department Neurology and Center for MS and Autoimmune Neurology, Mayo Clinic, Rochester, MN, USA
| | - Sean J Pittock
- Department Neurology and Center for MS and Autoimmune Neurology, Mayo Clinic, Rochester, MN, USA
| | - Ho Jin Kim
- Department of Neurology, Research Institute and Hospital of National Cancer Center, Goyang, Republic of Korea
| | - Jeffrey L Bennett
- Department of Neurology & Ophthalmology, Programs in Neuroscience & Immunology University of Colorado, Anschutz, CO, USA
| | - Friedemann Paul
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Grith Lykke Sorensen
- Cancer and Inflammation, Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | | | - Hans Lassmann
- Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | - Nasrin Asgari
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark Department of Neurology, Slagelse Hospital, Slagelse, Denmark
- Open Patient Data Explorative Network, Odense University Hospital, University of Southern Denmark, Odense, Denmark
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Kanaan R, Yaghi C, Saade Riachy C, Schlosser A, Hamade A, Holmskov U, Medlej‐Hashim M, Sørensen GL, Jounblat R. Serum
MFAP4
, a novel potential biomarker for liver cirrhosis screening, correlates with transient elastography in
NAFLD
patients. JGH OPEN 2023; 7:197-203. [PMID: 36968563 PMCID: PMC10037036 DOI: 10.1002/jgh3.12873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 12/20/2022] [Accepted: 01/16/2023] [Indexed: 02/25/2023]
Abstract
Background and Aim Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease in different countries. Liver fibrosis is considered as the most appropriate predictor of NAFLD-associated outcome. Microfibrillar-associated protein 4 (MFAP4) is a glycoprotein located in the extracellular matrix. Circulatory MFAP4 has been suggested as a noninvasive biomarker for the assessment of hepatitis C virus and alcoholic liver disease associated liver fibrosis. In this study, we aimed to investigate the association between serum MFAP4 and liver fibrosis severity in NAFLD patients. Methods A case-control study was conducted in which NAFLD patients (n = 25) and healthy participants (n = 12) were recruited. Liver fibrosis/cirrhosis was assessed by transient elastography (TE) and biochemical parameters were collected. Serum MFAP4 was measured by sandwich ELISA based on two monoclonal anti-MFAP4 antibodies and calibrated with a standard of recombinant MFAP4. Results Serum MFAP4 levels increased with fibrosis severity and were highly upregulated in patients with cirrhosis (F4 fibrosis stage). In addition, serum MFAP4 levels positively correlated with TE measurement and showed significant association with the severely advanced fibrotic stage in NAFLD patients, in multiple linear regression analysis following adjustment for age, gender, and body mass index. Conclusion This study suggests the use of MFAP4 as a potential diagnostic noninvasive biomarker for cirrhosis screening in NAFLD patients.
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Affiliation(s)
- Reine Kanaan
- Department of Cancer and Inflammation Research Institute of Molecular Medicine, University of Southern Denmark Odense Denmark
- Laboratory of Cellular and Molecular Physiopathologies (CAMP), Department of Life and Earth Sciences, Faculty of Sciences Lebanese University Beirut Lebanon
| | - Cesar Yaghi
- Faculty of Medicine Saint‐Joseph University Beirut Lebanon
- Hepato‐Gastroenterology Department Hôtel‐ Dieu de France University Hospital Beirut Lebanon
| | | | - Anders Schlosser
- Department of Cancer and Inflammation Research Institute of Molecular Medicine, University of Southern Denmark Odense Denmark
| | - Aline Hamade
- Laboratoire d'Innovation Thérapeutique (LIT), Departments of Life and Earth Sciences – Chemistry and Biochemistry, Faculty of Sciences Lebanese University Beirut Lebanon
| | - Uffe Holmskov
- Department of Cancer and Inflammation Research Institute of Molecular Medicine, University of Southern Denmark Odense Denmark
| | - Myrna Medlej‐Hashim
- Laboratory of Cellular and Molecular Physiopathologies (CAMP), Department of Life and Earth Sciences, Faculty of Sciences Lebanese University Beirut Lebanon
| | - Grith Lykke Sørensen
- Department of Cancer and Inflammation Research Institute of Molecular Medicine, University of Southern Denmark Odense Denmark
| | - Rania Jounblat
- Laboratory of Cellular and Molecular Physiopathologies (CAMP), Department of Life and Earth Sciences, Faculty of Sciences Lebanese University Beirut Lebanon
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4
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Han C, Peng Y, Yang X, Guo Z, Yang X, Su P, Guo S, Zhao L. Declined plasma microfibrillar-associated protein 4 levels in acute coronary syndrome. Eur J Med Res 2023; 28:32. [PMID: 36650606 PMCID: PMC9847181 DOI: 10.1186/s40001-023-01002-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 01/08/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Microfibrillar-associated protein (MFAP4), initially identified as an extracellular matrix protein, has been demonstrated in multiple human disorders, but it is yet to be discovered following acute coronary syndrome (ACS) in clinical practice. Therefore, this study aimed to investigate the relationship between circulating MFAP4 levels and coronary stenosis in ACS. METHODS We performed the study in 148 ACS subjects, including 75 ST-segment elevation myocardial infarction (STEMI), 27 non-ST-segment elevation myocardial infarction (non-STEMI) and 46 unstable angina (UA). Clinical variables were collected and Gensini and Syntax stenosis scoring systems were applied to assess the severity of coronary stenosis. Kaplan-Meier and logistic regression analysis were used to analyze the relationship between MFAP4 and the severity of coronary stenosis or ACS outcomes. Spearman analysis was used to describe the correlation between MFAP4 and clinical parameters. RESULTS Circulating MFAP4 levels were significantly decreased in the STEMI group (0.008 ng/ml) compared with the non-STEMI group (0.014 ng/ml) and UA group (0.019 ng/ml) (p < 0.001). After adjusting for confounding factors, we found that MFAP4 was an independent risk factor for STEMI (odds ratio = 0.395, 95% CI 0.174-0.895, p = 0.026). MFAP4 level was negatively correlated with Gensini score and Syntax score (r = - 0.311 and - 0.211, p < 0.001 and 0.01, respectively). Based on the MFAP4 level of 0.117 ng/ml, ACS patients were divided into two groups: the low-MFAP4 group (< 0.117 ng/ml, n = 60) and the high-MFAP4 group (≥ 0.117 ng/ml, n = 88). After the median follow-up of 165 days, Kaplan-Meier survival analysis revealed that the MACE-free rate was significantly lower in ACS patients with lower MFAP4 levels (p = 0.009). CONCLUSIONS MFAP4 has a potential as a biomarker for the degree of coronary stenosis in ACS. Confirmation of observations in larger cohorts and longer follow-up periods is warranted.
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Affiliation(s)
- Chunming Han
- grid.24696.3f0000 0004 0369 153XEmergency Medicine Clinical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XHeart Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020 China
| | - Yuanshu Peng
- grid.24696.3f0000 0004 0369 153XHeart Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020 China
| | - Xiaoyan Yang
- grid.24696.3f0000 0004 0369 153XHeart Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020 China
| | - Zongsheng Guo
- grid.24696.3f0000 0004 0369 153XHeart Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020 China
| | - Xinchun Yang
- grid.24696.3f0000 0004 0369 153XHeart Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020 China
| | - Pixiong Su
- grid.24696.3f0000 0004 0369 153XHeart Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020 China
| | - Shubin Guo
- grid.24696.3f0000 0004 0369 153XEmergency Medicine Clinical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China ,Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing, 100020 China
| | - Lei Zhao
- grid.24696.3f0000 0004 0369 153XHeart Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020 China
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5
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Sofíudóttir BK, Harders SMW, Lage-Hansen PR, Christensen R, Munk HL, Sorensen GL, Davidsen JR, Ellingsen T. Using thoracic ultrasound to detect interstitial lung disease in patients with rheumatoid arthritis: a protocol for the diagnostic test accuracy AURORA study. BMJ Open 2022; 12:e067434. [PMID: 36564119 PMCID: PMC9791457 DOI: 10.1136/bmjopen-2022-067434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Pulmonary diseases are significant contributors to morbidity and mortality in patients with rheumatoid arthritis (RA). RA-associated interstitial lung disease (RA-ILD) may be prevalent in up to 30% and clinically evident in 10% of patients with RA. Feasible methods to detect concomitant ILD in RA are warranted. Our objective is to determine the diagnostic accuracy of thoracic ultrasound (TUS) for ILD in patients with RA with respiratory symptoms, by using chest high-resolution CT (HRCT) as the reference standard. Further, we aim to evaluate the diagnostic accuracy for the promising blood biomarkers surfactant protein-D and microfibrillar-associated protein 4 in the detection of ILD in this group of patients. METHODS AND ANALYSIS By use of a standardised 14 zone protocol patients suspected of having RA-ILD will undergo TUS as index test performed by a junior resident in rheumatology (BKS), who is certified by the European Respiratory Society in performing TUS assessments. Participants form a consecutive series of up to 80 individuals in total. The anonymised TUS images will be stored and scored by the junior resident as well as two senior rheumatologists, who have received training in TUS, and a TUS-experienced pulmonologist. HRCT will be used as the gold standard for ILD diagnosis (reference standard). The two basic measures for quantifying the diagnostic test accuracy of the TUS test are the sensitivity and specificity in comparison to the HRCT. ETHICS AND DISSEMINATION Data will be collected and stored in the Research Electronic Data Capture database. The study is approved by the Committees on Health Research Ethics and the Danish Data Protection Agency. The project is registered at clinicaltrials.gov (NCT05396469, pre-results) and data will be published in peer-reviewed journals.
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Affiliation(s)
- Bjørk Khaliqi Sofíudóttir
- Department of Rheumatology, PUlmo-REuma Clinic OUH (PURE), Odense University Hospital, Odense, Syddanmark, Denmark
- Section for Biostatistics and Evidence-Based Research, Parker Instituttet, Frederiksberg, Hovedstaden, Denmark
| | - Stefan M W Harders
- Department of Radiology, Odense University Hospital, Odense, Syddanmark, Denmark
| | | | - Robin Christensen
- Section for Biostatistics and Evidence-Based Research, Parker Instituttet, Frederiksberg, Hovedstaden, Denmark
| | - Heidi Lausten Munk
- Department of Rheumatology, Odense University Hospital, Odense, Syddanmark, Denmark
| | - Grith Lykke Sorensen
- Department of Cancer and Inflammation Research, Institute for Molecular Medicine, University of Southern Denmark, Odense, Syddanmark, Denmark
| | - Jesper Rømhild Davidsen
- South Danish Center for Interstitial Lung Diseases (SCILS) and PUlmo-REuma Clinic OUH (PURE), Department of Respiratory Medicine, Odense University Hospital, Odense, Syddanmark, Denmark
| | - Torkell Ellingsen
- Department of Rheumatology, PUlmo-REuma Clinic OUH (PURE), Odense University Hospital, Odense, Syddanmark, Denmark
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6
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Kanaan R, Medlej-Hashim M, Jounblat R, Pilecki B, Sorensen GL. Microfibrillar-associated protein 4 in health and disease. Matrix Biol 2022; 111:1-25. [DOI: 10.1016/j.matbio.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/04/2022] [Accepted: 05/24/2022] [Indexed: 10/18/2022]
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7
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Torp N, Israelsen M, Madsen B, Lutz P, Jansen C, Strassburg C, Mortensen C, Knudsen AW, Sorensen GL, Holmskov U, Schlosser A, Thiele M, Trebicka J, Krag A. Corrigendum to 'Level of MFAP4 in ascites independently predicts 1-year transplant-free survival in patients with cirrhosis' [JHEP Reports 3 (2021) 100287]. JHEP Rep 2021; 3:100353. [PMID: 34693237 PMCID: PMC8514409 DOI: 10.1016/j.jhepr.2021.100353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 03/11/2021] [Accepted: 03/18/2021] [Indexed: 11/29/2022] Open
Abstract
Background & Aims Prognostic models of cirrhosis underestimate disease severity for patients with cirrhosis and ascites. Microfibrillar-associated protein 4 (MFAP4) is an extracellular matrix protein linked to hepatic neoangiogenesis and fibrogenesis. We investigated ascites MFAP4 as a predictor of transplant-free survival in patients with cirrhosis and ascites. Methods A dual-centre observational study of patients with cirrhosis and ascites recruited consecutively in relation to a paracentesis was carried out. Patients were followed up for 1 year, until death or liver transplantation (LTx). Ascites MFAP4 was tested with the model for end-stage liver disease (MELD-Na), CLIF Consortium Acute Decompensation (CLIF-C AD), and Child-Pugh score in Cox regression models. Results Ninety-three patients requiring paracentesis were included. Median ascites MFAP4 was 29.7 U/ml [22.3–41.3], and MELD-Na was 19 [16–23]. A low MELD-Na score (<20) was observed in 49 patients (53%). During follow-up, 20 patients died (22%), and 6 received LTx (6%). High ascites MFAP4 (>29.7 U/ml) was associated with 1-year transplant-free survival (p = 0.002). In Cox regression, ascites MFAP4 and MELD-Na independently predicted 1-year transplant-free survival (hazard ratio [HR] = 0.97, p = 0.03, and HR = 1.08, p = 0.01, respectively). Ascites MFAP4 and CLIF-C AD also predicted survival independently (HR = 0.96, p = 0.02, and HR = 1.05, p = 0.03, respectively), whereas only ascites MFAP4 did, controlling for the Child-Pugh score (HR = 0.97, p = 0.03, and HR = 1.18, p = 0.16, respectively). For patients with MELD-Na <20, ascites MFAP4 but not ascites protein predicted 1-year transplant-free survival (HR 0.91, p = 0.02, and HR = 0.94, p = 0.17, respectively). Conclusions Ascites MFAP4 predicts 1-year transplant-free survival in patients with cirrhosis and ascites. In patients with low MELD-Na scores, ascites MFAP4, but not total ascites protein, significantly predicted 1-year transplant-free survival. Lay summary Patients with cirrhosis who have fluid in the abdomen, ascites, are at an increased risk of death and in need for liver transplantation. Our study identified patients with ascites and a poor prognosis by measuring microfibrillar associated protein 4 (MFAP4), a protein present in the abdominal fluid. Patients with low levels of the MFAP4 protein are at particularly increased risk of death or liver transplantation, suggesting that clinical care should be intensified in this group of patients. MFAP4 is a protein linked to liver fibrosis that can be found in the ascitic fluid in patients with cirrhosis. MFAP4 in the ascitic fluid correlates with MELD-Na, Child-Pugh, and CLIF-C AD. Ascites MFAP4 independently predicts 1-year transplant-free survival in patients with cirrhosis and ascites. Ascites MFAP4 but not total ascites protein is associated with transplant-free survival in patients with MELD-Na <20. Future prognostic models in decompensated cirrhosis may be enhanced by the incorporation of ascites MFAP4.
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Key Words
- Biomarker
- CLIF-C AD, CLIF Consortium Acute Decompensation
- CPS, Child-Pugh score
- CRP, C-reactive protein
- CT, computed tomography
- Decompensated
- ECM, extracellular matrix
- Fibrosis
- GFR, glomerular filtration rate
- HR, hazard ratio
- INR, internationalised normal ratio
- LTx, liver transplantation
- Liver disease
- MELD-Na, model for end-stage liver disease
- MFAP4, microfibrillar associated protein 4
- Mortality
- NASH, non-alcoholic steatohepatitis
- Prognosis
- SBP, spontaneous bacterial peritonitis
- eGFR, estimated GFR
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Affiliation(s)
- Nikolaj Torp
- Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Mads Israelsen
- Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Bjørn Madsen
- Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Philipp Lutz
- Department of Internal Medicine I, University of Bonn, Bonn, Germany
| | - Christian Jansen
- Department of Internal Medicine I, University of Bonn, Bonn, Germany
| | | | - Christian Mortensen
- Gastro Unit, Medical Division, Copenhagen University Hospital, Hvidovre, Denmark
| | - Anne Wilkens Knudsen
- Gastro Unit, Medical Division, Copenhagen University Hospital, Hvidovre, Denmark
| | - Grith Lykke Sorensen
- Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Uffe Holmskov
- Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Anders Schlosser
- Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Maja Thiele
- Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Jonel Trebicka
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Internal Medicine I, University Hospital of Frankfurt, Frankfurt, Germany.,European Foundation for the Study of Chronic Liver Failure (EF-CLIF), Barcelona, Spain.,Institute for Bioengineering of Catalonia, Barcelona, Spain
| | - Aleksander Krag
- Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
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8
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Sækmose SG, Holst R, Lottenburger T, Ytting H, Nielsen HJ, Junker P, Schlosser A, Sorensen GL. Circadian, Week-to-Week, and Physical Exercise-Induced Variation of Serum Microfibrillar-Associated Protein 4. Biomark Insights 2021; 16:11772719211016359. [PMID: 34035648 PMCID: PMC8127734 DOI: 10.1177/11772719211016359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 04/19/2021] [Indexed: 01/06/2023] Open
Abstract
Serum microfibrillar-associated protein 4 (sMFAP4) has been investigated as a biomarker for various diseases and is demonstrated to show significant gradual increase with severity of liver fibrosis. Ideal biomarkers used for disease diagnosis or prognosis should display deviating levels in affected individuals only and be robust to factors unrelated to the disease. Here we show the impact of normal physiological variation of sMFAP4 by characterizing the circadian variation, week-to-week variation, and physical exercise-induced levels. Serum samples from 3 groups of healthy volunteers were drawn: 7 times during a 24-hour period, 5 times during a 3-week period, and before and after a standardized physical exercise challenge. sMFAP4 was determined by AlphaLISA. Statistical analysis was performed using mixed effects modeling of repeated measurements. Circadian variation of sMFAP4 was demonstrated, with time of peak and nadir values depending on age and gender. For males, the peak values were observed during nighttime whereas for females, peak values were observed in the morning. Individual sMFAP4 levels remained stable over a period of 3 weeks and physical exercise inferred a mild negative influence. In conclusion, the circadian sMFAP4 variation was significant, and the levels could be influenced by physical activity. However, these variations were of limited magnitude relative to previously observed disease-induced levels in support of the biomarker potential of sMFAP4.
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Affiliation(s)
- Susanne Gjørup Sækmose
- Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.,Department of Clinical Immunology, Naestved Hospital, Naestved, Denmark
| | - René Holst
- Oslo Centre of Biostatistics and Epidemiology, University in Oslo and Oslo University Hospital, Norway
| | | | - Henriette Ytting
- Department of Hepatology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Hans Jørgen Nielsen
- Department of Surgical Gastroenterology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - Peter Junker
- Department of Rheumatology, Odense University Hospital, University of Southern Denmark, Denmark
| | - Anders Schlosser
- Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Grith Lykke Sorensen
- Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
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9
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Torp N, Israelsen M, Madsen B, Lutz P, Jansen C, Strassburg C, Mortensen C, Knudsen AW, Sorensen GL, Holmskov U, Schlosser A, Thiele M, Trebicka J, Krag A. Level of MFAP4 in ascites independently predicts 1-year transplant-free survival in patients with cirrhosis. JHEP Rep 2021; 3:100287. [PMID: 34041469 PMCID: PMC8141937 DOI: 10.1016/j.jhepr.2021.100287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 03/11/2021] [Accepted: 03/18/2021] [Indexed: 11/28/2022] Open
Abstract
Background & Aims Prognostic models of cirrhosis underestimate disease severity for patients with cirrhosis and ascites. Microfibrillar-associated protein 4 (MFAP4) is an extracellular matrix protein linked to hepatic neoangiogenesis and fibrogenesis. We investigated ascites MFAP4 as a predictor of transplant-free survival in patients with cirrhosis and ascites. Methods A dual-centre observational study of patients with cirrhosis and ascites recruited consecutively in relation to a paracentesis was carried out. Patients were followed up for 1 year, until death or liver transplantation (LTx). Ascites MFAP4 was tested with the model for end-stage liver disease (MELD-Na), CLIF Consortium Acute Decompensation (CLIF-C AD), and Child-Pugh score in Cox regression models. Results Ninety-three patients requiring paracentesis were included. Median ascites MFAP4 was 29.7 U/L [22.3–41.3], and MELD-Na was 19 [16–23]. A low MELD-Na score (<20) was observed in 49 patients (53%). During follow-up, 20 patients died (22%), and 6 received LTx (6%). High ascites MFAP4 (>29.7 U/L) was associated with 1-year transplant-free survival (p = 0.002). In Cox regression, ascites MFAP4 and MELD-Na independently predicted 1-year transplant-free survival (hazard ratio [HR] = 0.97, p = 0.03, and HR = 1.08, p = 0.01, respectively). Ascites MFAP4 and CLIF-C AD also predicted survival independently (HR = 0.96, p = 0.02, and HR = 1.05, p = 0.03, respectively), whereas only ascites MFAP4 did, controlling for the Child-Pugh score (HR = 0.97, p = 0.03, and HR = 1.18, p = 0.16, respectively). For patients with MELD-Na <20, ascites MFAP4 but not ascites protein predicted 1-year transplant-free survival (HR 0.91, p = 0.02, and HR = 0.94, p = 0.17, respectively). Conclusions Ascites MFAP4 predicts 1-year transplant-free survival in patients with cirrhosis and ascites. In patients with low MELD-Na scores, ascites MFAP4, but not total ascites protein, significantly predicted 1-year transplant-free survival. Lay summary Patients with cirrhosis who have fluid in the abdomen, ascites, are at an increased risk of death and in need for liver transplantation. Our study identified patients with ascites and a poor prognosis by measuring microfibrillar associated protein 4 (MFAP4), a protein present in the abdominal fluid. Patients with low levels of the MFAP4 protein are at particularly increased risk of death or liver transplantation, suggesting that clinical care should be intensified in this group of patients. MFAP4 is a protein linked to liver fibrosis that can be found in the ascitic fluid in patients with cirrhosis. MFAP4 in the ascitic fluid correlates with MELD-Na, Child-Pugh, and CLIF-C AD. Ascites MFAP4 independently predicts 1-year transplant-free survival in patients with cirrhosis and ascites. Ascites MFAP4 but not total ascites protein is associated with transplant-free survival in patients with MELD-Na <20. Future prognostic models in decompensated cirrhosis may be enhanced by the incorporation of ascites MFAP4.
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Key Words
- Biomarker
- CLIF-C AD, CLIF Consortium Acute Decompensation
- CPS, Child-Pugh score
- CRP, C-reactive protein
- CT, computed tomography
- Decompensated
- ECM, extracellular matrix
- Fibrosis
- GFR, glomerular filtration rate
- HR, hazard ratio
- INR, internationalised normal ratio
- LTx, liver transplantation
- Liver disease
- MELD-Na, model for end-stage liver disease
- MFAP4, microfibrillar associated protein 4
- Mortality
- NASH, non-alcoholic steatohepatitis
- Prognosis
- SBP, spontaneous bacterial peritonitis
- eGFR, estimated GFR
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Affiliation(s)
- Nikolaj Torp
- Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Mads Israelsen
- Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Bjørn Madsen
- Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Philipp Lutz
- Department of Internal Medicine I, University of Bonn, Bonn, Germany
| | - Christian Jansen
- Department of Internal Medicine I, University of Bonn, Bonn, Germany
| | | | - Christian Mortensen
- Gastro Unit, Medical Division, Copenhagen University Hospital, Hvidovre, Denmark
| | - Anne Wilkens Knudsen
- Gastro Unit, Medical Division, Copenhagen University Hospital, Hvidovre, Denmark
| | - Grith Lykke Sorensen
- Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Uffe Holmskov
- Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Anders Schlosser
- Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Maja Thiele
- Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Jonel Trebicka
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Internal Medicine I, University Hospital of Frankfurt, Frankfurt, Germany.,European Foundation for the Study of Chronic Liver Failure (EF-CLIF), Barcelona, Spain.,Institute for Bioengineering of Catalonia, Barcelona, Spain
| | - Aleksander Krag
- Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
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10
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Madsen BS, Thiele M, Detlefsen S, Sørensen MD, Kjærgaard M, Møller LS, Rasmussen DN, Schlosser A, Holmskov U, Trebicka J, Sorensen GL, Krag A. Prediction of liver fibrosis severity in alcoholic liver disease by human microfibrillar-associated protein 4. Liver Int 2020; 40:1701-1712. [PMID: 32339377 PMCID: PMC7383987 DOI: 10.1111/liv.14491] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 03/23/2020] [Accepted: 04/18/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Alcoholic liver disease (ALD) is a public health concern that is the cause of half of all cirrhosis-related deaths. Early detection of fibrosis, ideally in the precirrhotic stage, is a key strategy for improving ALD outcomes and for preventing progression to cirrhosis. Previous studies identified the blood-borne marker human microfibrillar-associated protein 4 (MFAP4) as a biomarker for detection of hepatitis C virus (HCV)-related fibrosis. AIM To evaluate the diagnostic accuracy of MFAP4 to detect ALD-induced fibrosis. METHOD We performed a prospective, liver biopsy-controlled study involving 266 patients with prior or current alcohol overuse. Patients were split into a training and a validation cohort. RESULTS MFAP4 was present in fibrotic hepatic tissue and serum MFAP4 levels increased with fibrosis grade. The area under the receiver operating characteristic curve (AUROC) for detection of cirrhosis was 0.91 (95% CI 0.85-0.96) in the training cohort and 0.91 (95% CI 0.79-1.00) in the validation cohort. For detection of advanced fibrosis, the AUROC was 0.88 (95% CI 0.81-0.94) in the training cohort and 0.92 (95% CI 0.83-1.00) in the validation cohort. The diagnostic accuracy did not differ between MFAP4 and the enhanced liver fibrosis (ELF) test or transient elastography (TE) in an intention-to-diagnose analysis. MFAP4 did not predict hepatic decompensation in a time-to-decompensation analysis in a subgroup of patients with cirrhosis. CONCLUSION MFAP4 is a novel biomarker that can detect ALD-related fibrosis with high accuracy.
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Affiliation(s)
- Bjørn S. Madsen
- Department of Gastroenterology and HepatologyOdense University HospitalOdense CDenmark,OPEN, Odense Patient Data Exploratory NetworkOdense University HospitalOdense CDenmark
| | - Maja Thiele
- Department of Gastroenterology and HepatologyOdense University HospitalOdense CDenmark
| | - Sönke Detlefsen
- Department of PathologyOdense University HospitalOdense CDenmark,Institute of Clinical ResearchUniversity of Southern DenmarkOdense CDenmark
| | - Mia D. Sørensen
- Department of Gastroenterology and HepatologyOdense University HospitalOdense CDenmark,Department of PathologyOdense University HospitalOdense CDenmark,Institute of Clinical ResearchUniversity of Southern DenmarkOdense CDenmark
| | - Maria Kjærgaard
- Department of Gastroenterology and HepatologyOdense University HospitalOdense CDenmark
| | - Linda S. Møller
- Department of Gastroenterology and HepatologyOdense University HospitalOdense CDenmark
| | - Ditlev N. Rasmussen
- Department of Gastroenterology and HepatologyOdense University HospitalOdense CDenmark
| | - Anders Schlosser
- Institute of Molecular MedicineUniversity of Southern DenmarkOdense CDenmark
| | - Uffe Holmskov
- Institute of Molecular MedicineUniversity of Southern DenmarkOdense CDenmark
| | - Jonel Trebicka
- Institute of Clinical ResearchUniversity of Southern DenmarkOdense CDenmark,Department of Internal MedicineUniversity Clinic FrankfurtFrankfurtGermany,European Foundation for the Study of Chronic Liver Failure ‐ EF ClifBarcelonaSpain,Institute for Bioengineering of CataloniaBarcelonaSpain
| | - Grith L. Sorensen
- Institute of Molecular MedicineUniversity of Southern DenmarkOdense CDenmark
| | - Aleksander Krag
- Department of Gastroenterology and HepatologyOdense University HospitalOdense CDenmark
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11
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High plasma microfibrillar-associated protein 4 is associated with reduced surgical repair in abdominal aortic aneurysms. J Vasc Surg 2020; 71:1921-1929. [DOI: 10.1016/j.jvs.2019.08.253] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 08/15/2019] [Indexed: 12/16/2022]
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12
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Mölleken C, Ahrens M, Schlosser A, Dietz J, Eisenacher M, Meyer HE, Schmiegel W, Holmskov U, Sarrazin C, Sorensen GL, Sitek B, Bracht T. Direct-acting antivirals-based therapy decreases hepatic fibrosis serum biomarker microfibrillar-associated protein 4 in hepatitis C patients. Clin Mol Hepatol 2018; 25:42-51. [PMID: 30449076 PMCID: PMC6435967 DOI: 10.3350/cmh.2018.0029] [Citation(s) in RCA: 10] [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: 03/27/2018] [Accepted: 09/04/2018] [Indexed: 12/15/2022] Open
Abstract
Background/Aims An estimated 80 million people worldwide are infected with viremic hepatitis C virus (HCV). Even after eradication of HCV with direct acting antivirals (DAAs), hepatic fibrosis remains a risk factor for hepatocarcinogenesis. Recently, we confirmed the applicability of microfibrillar-associated protein 4 (MFAP4) as a serum biomarker for the assessment of hepatic fibrosis. The aim of the present study was to assess the usefulness of MFAP4 as a biomarker of liver fibrosis after HCV eliminating therapy with DAAs. Methods MFAP4 was measured using an immunoassay in 50 hepatitis C patients at baseline (BL), the end-of-therapy (EoT), and the 12-week follow-up (FU) visit. Changes in MFAP4 from BL to FU and their association with laboratory parameters including alanine aminotransferase (ALT), aspartate aminotransferase (AST), platelets, the AST to platelet ratio index (APRI), fibrosis-4 score (FIB-4), and albumin were analyzed. Results MFAP4 serum levels were representative of the severity of hepatic fibrosis at BL and correlated well with laboratory parameters, especially APRI (Spearman correlation, R²=0.80). Laboratory parameters decreased significantly from BL to EoT. MFAP4 serum levels were found to decrease from BL and EoT to FU with high statistical significance (Wilcoxon p<0.001 for both). Conclusions Our findings indicate that viral eradication resulted in reduced MFAP4 serum levels, presumably representing a decrease in hepatic fibrogenesis or fibrosis. Hence, MFAP4 may be a useful tool for risk assessment in hepatitis C patients with advanced fibrosis after eradication of the virus.
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Affiliation(s)
- Christian Mölleken
- Department of Gastroenterology and Hepatology, University Hospital Bergmannsheil, Bochum, Germany
| | - Maike Ahrens
- Medizinisches Proteom-Center, Ruhr University Bochum, Bochum, Germany.,Chrestos Concept GmbH & Co. KG, Essen, Germany
| | - Anders Schlosser
- Institute for Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Julia Dietz
- Medical Clinic 1, J.W. Goethe University Hospital, Frankfurt, Germany
| | - Martin Eisenacher
- Medizinisches Proteom-Center, Ruhr University Bochum, Bochum, Germany
| | - Helmut E Meyer
- Medizinisches Proteom-Center, Ruhr University Bochum, Bochum, Germany.,Leibniz-Institut für Analytische Wissenschaften - ISAS - e.V., Dortmund, Germany
| | - Wolff Schmiegel
- Department of Gastroenterology and Hepatology, University Hospital Bergmannsheil, Bochum, Germany
| | - Uffe Holmskov
- Institute for Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Christoph Sarrazin
- Medical Clinic 1, J.W. Goethe University Hospital, Frankfurt, Germany.,Medical Clinic 2, St. Josefs-Hospital, Wiesbaden, Germany
| | - Grith Lykke Sorensen
- Institute for Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Barbara Sitek
- Medizinisches Proteom-Center, Ruhr University Bochum, Bochum, Germany
| | - Thilo Bracht
- Medizinisches Proteom-Center, Ruhr University Bochum, Bochum, Germany
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13
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Blindbæk SL, Schlosser A, Green A, Holmskov U, Sorensen GL, Grauslund J. Association between microfibrillar-associated protein 4 (MFAP4) and micro- and macrovascular complications in long-term type 1 diabetes mellitus. Acta Diabetol 2017; 54:367-372. [PMID: 28039584 DOI: 10.1007/s00592-016-0953-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 12/12/2016] [Indexed: 01/26/2023]
Abstract
AIMS To evaluate microfibrillar-associated protein 4 (MFAP4) as a marker of micro- and macrovascular complications in patients with type 1 diabetes. METHODS This cross-sectional study included 203 persons with a long duration of type 1 diabetes from a population-based cohort ascertained in the former Funen County, Denmark. Detection of plasma-MFAP4 (pMFAP4) was performed by the AlphaLISA Technique. Diabetic retinopathy (DR) was graded in accordance with the Early Treatment Diabetic Retinopathy Study adaptation of the modified Airlie House classification. A monofilament test was used to test for neuropathy, and nephropathy was evaluated in a single spot urine sample. Data describing macrovascular disease were obtained from the Danish National Patient Register. RESULTS Median age and duration of diabetes were 58.7 and 43 years, respectively, and 61% were males. High levels of pMFAP4 were found in participants of old age, in women and in non-smokers (p < 0.05). In a multiple logistic regression model, patients with high levels of pMFAP4 were more likely to have diabetic neuropathy (OR 2.47 for quartile 4 versus quartile 1, 95% CI 1.01-6.03). No association was found between pMFAP4 and proliferative diabetic retinopathy, nephropathy or macrovascular disease. CONCLUSIONS No association between pMFAP4 and macrovascular vascular complications was found. However, high levels of pMFAP4 correlated independently with diabetic neuropathy. Further studies on the predictive value of increased circulating MFAP4 in diabetic neuropathy are warranted.
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Affiliation(s)
- S L Blindbæk
- Department of Ophthalmology, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark.
| | - A Schlosser
- Department of Cancer and Inflammation, Institute of Molecular Medicine, University of Southern Denmark, J.B. Winsløws Vej 21-25, 5000, Odense C, Denmark
| | - A Green
- OPEN, Odense Patient data Exploratory Network, Odense University Hospital, J.B. Winsløws Vej 9 A, 3rd floor, 5000, Odense C, Denmark
- OPEN, Odense Patient data Exploratory Network, Department of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 9 A, 3rd floor, 5000, Odense C, Denmark
| | - U Holmskov
- Department of Cancer and Inflammation, Institute of Molecular Medicine, University of Southern Denmark, J.B. Winsløws Vej 21-25, 5000, Odense C, Denmark
| | - G L Sorensen
- Department of Cancer and Inflammation, Institute of Molecular Medicine, University of Southern Denmark, J.B. Winsløws Vej 21-25, 5000, Odense C, Denmark
| | - J Grauslund
- Department of Ophthalmology, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark
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14
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Abstract
A characteristic feature of liver cirrhosis is the accumulation of large amounts of connective tissue with the prevailing content of type I collagen. Elastin is a minor connective tissue component in normal liver but it is actively synthesized by hepatic stellate cells and portal fibroblasts in diseased liver. The accumulation of elastic fibers in later stages of liver fibrosis may contribute to the decreasing reversibility of the disease with advancing time. Elastin is formed by polymerization of tropoelastin monomers. It is an amorphous protein highly resistant to the action of proteases that forms the core of elastic fibers. Microfibrils surrounding the core are composed of fibrillins that bind a number of proteins involved in fiber formation. They include microfibril-associated glycoproteins (MAGPs), microfibrillar-associated proteins (MFAPs) and fibulins. Lysyl oxidase (LOX) and lysyl oxidase-like proteins (LOXLs) are responsible for tropoelastin cross-linking and polymerization. TGF-β complexes attached to microfibrils release this cytokine and influence the behavior of the cells in the neighborhood. The role of TGF-β as the main profibrotic cytokine in the liver is well-known and the release of the cytokines of TGF-β superfamily from their storage in elastic fibers may affect the course of fibrosis. Elastic fibers are often studied in the tissues where they provide elasticity and resilience but their role is no longer viewed as purely mechanical. Tropoelastin, elastin polymer and elastin peptides resulting from partial elastin degradation influence fibroblastic and inflammatory cells as well as angiogenesis. A similar role may be performed by elastin in the liver. This article reviews the results of the research of liver elastic fibers on the background of the present knowledge of elastin biochemistry and physiology. The regulation of liver elastin synthesis and degradation may be important for the outcome of liver fibrosis.
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Affiliation(s)
- Jiří Kanta
- Department of Medical Biochemistry, Faculty of Medicine in Hradec Kralove, Charles University in Prague Hradec Kralove, Czechia
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15
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Bracht T, Mölleken C, Ahrens M, Poschmann G, Schlosser A, Eisenacher M, Stühler K, Meyer HE, Schmiegel WH, Holmskov U, Sorensen GL, Sitek B. Evaluation of the biomarker candidate MFAP4 for non-invasive assessment of hepatic fibrosis in hepatitis C patients. J Transl Med 2016; 14:201. [PMID: 27378383 PMCID: PMC4932744 DOI: 10.1186/s12967-016-0952-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 06/21/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The human microfibrillar-associated protein 4 (MFAP4) is located to extracellular matrix fibers and plays a role in disease-related tissue remodeling. Previously, we identified MFAP4 as a serum biomarker candidate for hepatic fibrosis and cirrhosis in hepatitis C patients. The aim of the present study was to elucidate the potential of MFAP4 as biomarker for hepatic fibrosis with a focus on the differentiation of no to moderate (F0-F2) and severe fibrosis stages and cirrhosis (F3 and F4, Desmet-Scheuer scoring system). METHODS MFAP4 levels were measured using an AlphaLISA immunoassay in a retrospective study including n = 542 hepatitis C patients. We applied a univariate logistic regression model based on MFAP4 serum levels and furthermore derived a multivariate model including also age and gender. Youden-optimal cutoffs for binary classification were determined for both models without restrictions and considering a lower limit of 80 % sensitivity (correct classification of F3 and F4), respectively. To assess the generalization error, leave-one-out cross validation (LOOCV) was performed. RESULTS MFAP4 levels were shown to differ between no to moderate fibrosis stages F0-F2 and severe stages (F3 and F4) with high statistical significance (t test on log scale, p value <2.2·10(-16)). In the LOOCV, the univariate classification resulted in 85.8 % sensitivity and 54.9 % specificity while the multivariate model yielded 81.3 % sensitivity and 61.5 % specificity (restricted approaches). CONCLUSIONS We confirmed the applicability of MFAP4 as a novel serum biomarker for assessment of hepatic fibrosis and identification of high-risk patients with severe fibrosis stages in hepatitis C. The combination of MFAP4 with existing tests might lead to a more accurate non-invasive diagnosis of hepatic fibrosis and allow a cost-effective disease management in the era of new direct acting antivirals.
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Affiliation(s)
- Thilo Bracht
- />Medizinisches Proteom-Center, Ruhr-Universität Bochum, 44801 Bochum, Germany
| | - Christian Mölleken
- />Department of Gastroenterology and Hepatology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bochum, Germany
| | - Maike Ahrens
- />Medizinisches Proteom-Center, Ruhr-Universität Bochum, 44801 Bochum, Germany
| | - Gereon Poschmann
- />Molecular Proteomics Laboratory (MPL), Biologisch-Medizinisches Forschungszentrum (BMFZ), Heinrich-Heine-Universität, Düsseldorf, Germany
| | - Anders Schlosser
- />Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Martin Eisenacher
- />Medizinisches Proteom-Center, Ruhr-Universität Bochum, 44801 Bochum, Germany
| | - Kai Stühler
- />Molecular Proteomics Laboratory (MPL), Biologisch-Medizinisches Forschungszentrum (BMFZ), Heinrich-Heine-Universität, Düsseldorf, Germany
| | - Helmut E. Meyer
- />Medizinisches Proteom-Center, Ruhr-Universität Bochum, 44801 Bochum, Germany
| | - Wolff H. Schmiegel
- />Department of Gastroenterology and Hepatology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bochum, Germany
| | - Uffe Holmskov
- />Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Grith L. Sorensen
- />Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Barbara Sitek
- />Medizinisches Proteom-Center, Ruhr-Universität Bochum, 44801 Bochum, Germany
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16
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Wang J, Wang S, Zhang W, Wang T, Li P, Zhao X, Niu C, Liu Y, Wang X, Ma Q. Proteomic profiling of heat acclimation in cerebrospinal fluid of rabbit. J Proteomics 2016; 144:113-22. [PMID: 27208788 DOI: 10.1016/j.jprot.2016.04.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 04/06/2016] [Accepted: 04/20/2016] [Indexed: 10/21/2022]
Abstract
UNLABELLED Heat acclimation (AC) is a phenotypic adaptation to the high ambient temperatures. So far, the physiological effects of AC have been well studied, but the molecular mechanisms underlying it, especially the proteomic studies have been rarely reported. Conducting a protein profile of cerebrospinal fluid (CSF) can facilitate the understanding of molecular pathways involved in AC and identifying stress-specific proteins as a laboratory biomarker. In this study we carried out proteomic profiling of the AC in CSF of rabbit, which would allow a deep insight into molecular signals underlying the AC. For this purpose, rabbits were subjected to AC (dry bulb temperature of (36±1)°C, wet bulb temperature of (29±0.5)°C, black-bulb temperature of (40±1.0)°C, 100min per day for 21days, untreated rabbits were used as controls. We adopted a gel-free proteomic approach (iTRAQ) method to identify protein composition in CSF of rabbits with AC. In total, 1310 proteins were identified. Among which 127 were significant up-regulated and 77 were down-regulated. According to the functions, all AC-induced proteins were classified into 8 categories, including plasma protein factors, metabolism-related proteins, energy metabolism-related proteins, cell surface/intercellular matrix proteins, stress related proteins, tumor-related proteins, as well as housekeeping proteins and putative proteins. Meanwhile, a total of 21 pathways were found involved in the developing of AC. Further analysis indicated that proteins mostly close to AC were grouped into two signal pathways, the immune-related signal pathways and the carbohydrate/lipoprotein metabolism-related signal pathways. Our study was first to carry out the whole proteomic picture of AC, and screen out the critical signaling pathways involved in this physical procedure. BIOLOGICAL SIGNIFICANCE This study reported the comparative proteomic analysis of cerebrospinal fluid of rabbits between heat acclimation and normal conditions using the gel-free proteomic mass-spectrometry approach with isotope-labeled samples (iTRAQ) techniques. Mass spectrometry analysis of the proteins from heat acclimated rabbits resulted in the identification of a total of 1310 proteins, among these, 204 proteins were related to the formation of heat acclimation. These proteins were assigned to 8 categories according to their functions. Additionally, 21 pathways involved in infectious diseases, metabolism, immunology, blood circulation, transcriptional regulation and renin-angiotensin were identified by pathway analysis in heat acclimation. This study was the first to use rabbits as a model for unraveling the molecular pathways underlying the establishment of integrative heat acclimation.
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Affiliation(s)
- Jing Wang
- Department of Tropical Medicine, Tianjin Institute of Health and Environmental Medicine, Tianjin, China
| | - Shang Wang
- Department of Tropical Medicine, Tianjin Institute of Health and Environmental Medicine, Tianjin, China
| | - Wencheng Zhang
- Department of Tropical Medicine, Tianjin Institute of Health and Environmental Medicine, Tianjin, China
| | - Tao Wang
- Department of Tropical Medicine, Tianjin Institute of Health and Environmental Medicine, Tianjin, China
| | - Peiyao Li
- Department of Tropical Medicine, Tianjin Institute of Health and Environmental Medicine, Tianjin, China
| | - Xiaoling Zhao
- Department of Tropical Medicine, Tianjin Institute of Health and Environmental Medicine, Tianjin, China
| | - Chao Niu
- Department of Tropical Medicine, Tianjin Institute of Health and Environmental Medicine, Tianjin, China
| | - Ying Liu
- Department of Tropical Medicine, Tianjin Institute of Health and Environmental Medicine, Tianjin, China
| | - Xinxing Wang
- Department of Tropical Medicine, Tianjin Institute of Health and Environmental Medicine, Tianjin, China
| | - Qiang Ma
- Department of Occupational Health, Tianjin Institute of Health and Environmental Medicine, Tianjin, China.
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17
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Milićević NM, Schmidt F, Kunz N, Kalies K, Milićević Ž, Schlosser A, Holmskov U, Sorensen GL, Westermann J. The role of microfibrillar-associated protein 4 (MFAP4) in the formation and function of splenic compartments during embryonic and adult life. Cell Tissue Res 2016; 365:135-45. [DOI: 10.1007/s00441-016-2374-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 02/01/2016] [Indexed: 11/24/2022]
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18
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Pilecki B, Holm AT, Schlosser A, Moeller JB, Wohl AP, Zuk AV, Heumüller SE, Wallis R, Moestrup SK, Sengle G, Holmskov U, Sorensen GL. Characterization of Microfibrillar-associated Protein 4 (MFAP4) as a Tropoelastin- and Fibrillin-binding Protein Involved in Elastic Fiber Formation. J Biol Chem 2015; 291:1103-14. [PMID: 26601954 DOI: 10.1074/jbc.m115.681775] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Indexed: 11/06/2022] Open
Abstract
MFAP4 (microfibrillar-associated protein 4) is an extracellular glycoprotein found in elastic fibers without a clearly defined role in elastic fiber assembly. In the present study, we characterized molecular interactions between MFAP4 and elastic fiber components. We established that MFAP4 primarily assembles into trimeric and hexameric structures of homodimers. Binding analysis revealed that MFAP4 specifically binds tropoelastin and fibrillin-1 and -2, as well as the elastin cross-linking amino acid desmosine, and that it co-localizes with fibrillin-1-positive fibers in vivo. Site-directed mutagenesis disclosed residues Phe(241) and Ser(203) in MFAP4 as being crucial for type I collagen, elastin, and tropoelastin binding. Furthermore, we found that MFAP4 actively promotes tropoelastin self-assembly. In conclusion, our data identify MFAP4 as a new ligand of microfibrils and tropoelastin involved in proper elastic fiber organization.
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Affiliation(s)
- Bartosz Pilecki
- From the Department of Cancer and Inflammation Research, Institute of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense C, Denmark
| | - Anne T Holm
- From the Department of Cancer and Inflammation Research, Institute of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense C, Denmark
| | - Anders Schlosser
- From the Department of Cancer and Inflammation Research, Institute of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense C, Denmark
| | - Jesper B Moeller
- From the Department of Cancer and Inflammation Research, Institute of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense C, Denmark
| | | | | | - Stefanie E Heumüller
- the Center for Biochemistry, Faculty of Medicine and the Center for Molecular Medicine Cologne, University of Cologne, 50931 Cologne, Germany
| | - Russell Wallis
- the Department of Infection, Immunity and Inflammation, and Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 9HN, United Kingdom, and
| | - Soren K Moestrup
- From the Department of Cancer and Inflammation Research, Institute of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense C, Denmark, the Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, 5000 Odense C, Denmark
| | - Gerhard Sengle
- the Center for Biochemistry, Faculty of Medicine and the Center for Molecular Medicine Cologne, University of Cologne, 50931 Cologne, Germany
| | - Uffe Holmskov
- From the Department of Cancer and Inflammation Research, Institute of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense C, Denmark
| | - Grith L Sorensen
- From the Department of Cancer and Inflammation Research, Institute of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense C, Denmark,
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19
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Sækmose SG, Mössner B, Christensen PB, Lindvig K, Schlosser A, Holst R, Barington T, Holmskov U, Sorensen GL. Microfibrillar-Associated Protein 4: A Potential Biomarker for Screening for Liver Fibrosis in a Mixed Patient Cohort. PLoS One 2015; 10:e0140418. [PMID: 26460565 PMCID: PMC4604125 DOI: 10.1371/journal.pone.0140418] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 09/26/2015] [Indexed: 12/11/2022] Open
Abstract
Background and Aims A method for assessment of liver fibrosis and cirrhosis without the need for a liver biopsy is desirable. Microfibrillar-associated protein 4 (MFAP4) is a suggested biomarker for identification of high-risk patients with severe fibrosis stages. This study aimed to examine associations between plasma MFAP4 (pMFAP4) and transient elastography or chronic hepatitis C virus infection in drug users and in a mixed patient cohort with increased risk of liver disease. Moreover, the study aimed to identify comorbidities that significantly influence pMFAP4. Methods pMFAP4 was measured in samples from 351 drug users attending treatment centres and from 248 acutely hospitalized medical patients with mixed diagnoses. Linear and logistic multivariate regression analyses were performed and nonparametric receiver operating characteristic-curves for cirrhosis were used to estimate cut-off points for pMFAP4. Univariate and subgroup analyses were performed using non-parametric methods. Results pMFAP4 increased significantly with liver fibrosis score. pMFAP4 was significantly associated with chronic viral infection in the drug users and with transient elastography in both cohorts. In the mixed patient cohort, pMFAP4 was significantly increased among patients with a previous diagnosis of liver disease or congestive heart failure compared to patients with other diagnoses. Conclusions pMFAP4 has the potential to be used as an outreach-screening tool for liver fibrosis in drug users and in mixed medical patients. pMFAP4 level is positively associated with transient elastography, but additional studies are warranted to validate the possible use of pMFAP4 in larger cohorts and in combination with transient elastography.
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Affiliation(s)
- Susanne Gjørup Sækmose
- Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- Department of Clinical Immunology, Naestved Hospital, Naestved, Denmark
| | - Belinda Mössner
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
| | | | - Kristoffer Lindvig
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
| | - Anders Schlosser
- Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - René Holst
- Department of Biostatistics, Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Torben Barington
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
- Odense Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Uffe Holmskov
- Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Grith Lykke Sorensen
- Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- * E-mail:
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20
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Holm AT, Wulf-Johansson H, Hvidsten S, Jorgensen PT, Schlosser A, Pilecki B, Ormhøj M, Moeller JB, Johannsen C, Baun C, Andersen T, Schneider JP, Hegermann J, Ochs M, Götz AA, Schulz H, de Angelis MH, Vestbo J, Holmskov U, Sorensen GL. Characterization of spontaneous air space enlargement in mice lacking microfibrillar-associated protein 4. Am J Physiol Lung Cell Mol Physiol 2015; 308:L1114-24. [PMID: 26033354 DOI: 10.1152/ajplung.00351.2014] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 03/25/2015] [Indexed: 11/22/2022] Open
Abstract
Microfibrillar-associated protein 4 (MFAP4) is localized to elastic fibers in blood vessels and the interalveolar septa of the lungs and is further present in bronchoalveolar lavage. Mfap4 has been previously suggested to be involved in elastogenesis in the lung. We tested this prediction and aimed to characterize the pulmonary function changes and emphysematous changes that occur in Mfap4-deficient (Mfap4(-/-)) mice. Significant changes included increases in total lung capacity and compliance, which were evident in Mfap4(-/-) mice at 6 and 8 mo but not at 3 mo of age. Using in vivo breath-hold gated microcomputed tomography (micro-CT) in 8-mo-old Mfap4(-/-) mice, we found that the mean density of the lung parenchyma was decreased, and the low-attenuation area (LAA) was significantly increased by 14% compared with Mfap4(+/+) mice. Transmission electron microscopy (TEM) did not reveal differences in the organization of elastic fibers, and there was no difference in elastin content, but a borderline significant increase in elastin mRNA expression in 3-mo-old mice. Stereological analysis showed that alveolar surface density in relation to the lung parenchyma and total alveolar surface area inside of the lung were both significantly decreased in Mfap4(-/-) mice by 25 and 15%, respectively. The data did not support an essential role of MFAP4 in pulmonary elastic fiber organization or content but indicated increased turnover in young Mfap4(-/-) mice. However, Mfap4(-/-) mice developed a spontaneous loss of lung function, which was evident at 6 mo of age, and moderate air space enlargement, with emphysema-like changes.
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Affiliation(s)
- Anne Trommelholt Holm
- Institute of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Helle Wulf-Johansson
- Institute of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Svend Hvidsten
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
| | - Patricia Troest Jorgensen
- Institute of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Anders Schlosser
- Institute of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Bartosz Pilecki
- Institute of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Maria Ormhøj
- Institute of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Jesper Bonnet Moeller
- Institute of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Claus Johannsen
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
| | - Christina Baun
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
| | - Thomas Andersen
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
| | - Jan Philipp Schneider
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany; and REBIRTH Cluster of Excellence, Hannover, Germany
| | - Jan Hegermann
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany; and REBIRTH Cluster of Excellence, Hannover, Germany
| | - Matthias Ochs
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany; and REBIRTH Cluster of Excellence, Hannover, Germany
| | - Alexander A Götz
- Institute of Neuropathology, University of Göttingen, Göttingen, Germany
| | - Holger Schulz
- Institute of Lung Biology and Disease, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; and Member of the German Center for Lung Research (DZL), Hannover, Germany; Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Martin Hrabě de Angelis
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Chair of Experimental Genetics, Center of Life and Food Sciences Weihenstephan, Technische Universität München, Freising-Weihenstephan, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany; and
| | - Jørgen Vestbo
- Department of Respiratory Medicine, Gentofte Hospital, Hellerup, Denmark
| | - Uffe Holmskov
- Institute of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Grith Lykke Sorensen
- Institute of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark;
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21
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Johansson SL, Roberts NB, Schlosser A, Andersen CB, Carlsen J, Wulf-Johansson H, Sækmose SG, Titlestad IL, Tornoe I, Miller B, Tal-Singer R, Holmskov U, Vestbo J, Sorensen GL. Microfibrillar-associated protein 4: a potential biomarker of chronic obstructive pulmonary disease. Respir Med 2014; 108:1336-44. [PMID: 25022422 DOI: 10.1016/j.rmed.2014.06.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 06/08/2014] [Accepted: 06/12/2014] [Indexed: 12/15/2022]
Abstract
BACKGROUND Microfibrillar-associated protein 4 (MFAP4) is a matricellular glycoprotein that co-localises with elastic fibres and is highly expressed in the lungs. The aim of this study was to test the hypothesis that plasma MFAP4 (pMFAP4) reflects clinical outcomes in chronic obstructive pulmonary disease (COPD). METHODS pMFAP4 was measured by an AlphaLISA immunoassay in stable COPD (n = 69) at baseline and at follow-up until 24 months after inclusion and in acute exacerbations of COPD (AECOPD) (n = 14) at baseline and until 6 months after inclusion. RESULTS The majority of patients (89%) were in GOLD II and III. Multiple linear regressions showed positive associations between pMFAP4 and the Global initiative for Obstructive Lung Disease (GOLD) grade (p = 0.01), modified Medical Research Council score (p < 0.0001) and BODE index (p = 0.04). Negative associations were found with 6-min walking distance (p = 0.04) and bronchodilator-induced reversibility (p = 0.02). The pMFAP4 levels varied less than 25% between the baseline and a 3 month follow-up in 83% of the patients. The pMFAP4 levels appeared unaffected in the acute phase of severe AECOPD but rose to an increased stable level within one month after hospitalization. CONCLUSION Increased pMFAP4 was associated to the severity in COPD and has the potential to serve as a stable disease biomarker. This observation warrants confirmation in a larger longitudinal COPD population.
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Affiliation(s)
- Sofie Lock Johansson
- Department of Cardiovascular and Renal Research, Institute of Molecular Medicine, University of Southern Denmark, JB Winsløws Vej 25.3, 5000 Odense C, Denmark
| | | | - Anders Schlosser
- Department of Cardiovascular and Renal Research, Institute of Molecular Medicine, University of Southern Denmark, JB Winsløws Vej 25.3, 5000 Odense C, Denmark
| | - Claus B Andersen
- Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Jørn Carlsen
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Helle Wulf-Johansson
- Department of Cardiovascular and Renal Research, Institute of Molecular Medicine, University of Southern Denmark, JB Winsløws Vej 25.3, 5000 Odense C, Denmark
| | - Susanne Gjørup Sækmose
- Department of Cardiovascular and Renal Research, Institute of Molecular Medicine, University of Southern Denmark, JB Winsløws Vej 25.3, 5000 Odense C, Denmark; Department of Clinical Immunology, Næstved Hospital, Ringstedgade 61, 4700 Næstved, Denmark
| | - Ingrid L Titlestad
- Department of Respiratory Medicine, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark
| | - Ida Tornoe
- Department of Cardiovascular and Renal Research, Institute of Molecular Medicine, University of Southern Denmark, JB Winsløws Vej 25.3, 5000 Odense C, Denmark
| | - Bruce Miller
- GlaxoSmithKline, 709 Swedeland Road, King of Prussia, PA 19406, USA
| | - Ruth Tal-Singer
- GlaxoSmithKline, 709 Swedeland Road, King of Prussia, PA 19406, USA
| | - Uffe Holmskov
- Department of Cardiovascular and Renal Research, Institute of Molecular Medicine, University of Southern Denmark, JB Winsløws Vej 25.3, 5000 Odense C, Denmark
| | - Jørgen Vestbo
- Department of Respiratory Medicine, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark; The University of Manchester, Manchester Academic Health Science Centre, 46 Grafton Street, M13 9NT Manchester, UK; University Hospital South Manchester NHS Foundation Trust, NIHR South Manchester Respiratory and Allergy Clinical Research Facility, Wythenshawe Hospital, Southmoor Road, Wythenshawe, Manchester, Greater Manchester M23 9LT, UK
| | - Grith Lykke Sorensen
- Department of Cardiovascular and Renal Research, Institute of Molecular Medicine, University of Southern Denmark, JB Winsløws Vej 25.3, 5000 Odense C, Denmark.
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