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Coagulopathy and Fibrinolytic Pathophysiology in COVID-19 and SARS-CoV-2 Vaccination. Int J Mol Sci 2022; 23:ijms23063338. [PMID: 35328761 PMCID: PMC8955234 DOI: 10.3390/ijms23063338] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/03/2022] [Accepted: 03/15/2022] [Indexed: 02/06/2023] Open
Abstract
Coronavirus Disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is frequently complicated by thrombosis. In some cases of severe COVID-19, fibrinolysis may be markedly enhanced within a few days, resulting in fatal bleeding. In the treatment of COVID-19, attention should be paid to both coagulation activation and fibrinolytic activation. Various thromboses are known to occur after vaccination with SARS-CoV-2 vaccines. Vaccine-induced immune thrombotic thrombocytopenia (VITT) can occur after adenovirus-vectored vaccination, and is characterized by the detection of anti-platelet factor 4 antibodies by enzyme-linked immunosorbent assay and thrombosis in unusual locations such as cerebral venous sinuses and visceral veins. Treatment comprises high-dose immunoglobulin, argatroban, and fondaparinux. Some VITT cases show marked decreases in fibrinogen and platelets and marked increases in D-dimer, suggesting the presence of enhanced-fibrinolytic-type disseminated intravascular coagulation with a high risk of bleeding. In the treatment of VITT, evaluation of both coagulation activation and fibrinolytic activation is important, adjusting treatments accordingly to improve outcomes.
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Mese K, Bunz O, Volkwein W, Vemulapalli SPB, Zhang W, Schellhorn S, Heenemann K, Rueckner A, Sing A, Vahlenkamp TW, Severing AL, Gao J, Aydin M, Jung D, Bachmann HS, Zänker KS, Busch U, Baiker A, Griesinger C, Ehrhardt A. Enhanced Antiviral Function of Magnesium Chloride-Modified Heparin on a Broad Spectrum of Viruses. Int J Mol Sci 2021; 22:10075. [PMID: 34576237 PMCID: PMC8466540 DOI: 10.3390/ijms221810075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/13/2021] [Accepted: 09/15/2021] [Indexed: 12/12/2022] Open
Abstract
Previous studies reported on the broad-spectrum antiviral function of heparin. Here we investigated the antiviral function of magnesium-modified heparin and found that modified heparin displayed a significantly enhanced antiviral function against human adenovirus (HAdV) in immortalized and primary cells. Nuclear magnetic resonance analyses revealed a conformational change of heparin when complexed with magnesium. To broadly explore this discovery, we tested the antiviral function of modified heparin against herpes simplex virus type 1 (HSV-1) and found that the replication of HSV-1 was even further decreased compared to aciclovir. Moreover, we investigated the antiviral effect against the new severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) and measured a 55-fold decreased viral load in the supernatant of infected cells associated with a 38-fold decrease in virus growth. The advantage of our modified heparin is an increased antiviral effect compared to regular heparin.
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Affiliation(s)
- Kemal Mese
- Virology and Microbiology, Center for Biomedical Education and Research (ZBAF), Witten/Herdecke University, 58453 Witten, Germany; (K.M.); (O.B.); (W.Z.); (S.S.); (J.G.); (A.B.)
| | - Oskar Bunz
- Virology and Microbiology, Center for Biomedical Education and Research (ZBAF), Witten/Herdecke University, 58453 Witten, Germany; (K.M.); (O.B.); (W.Z.); (S.S.); (J.G.); (A.B.)
- Department of Prosthodontics, School of Dentistry, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
| | - Wolfram Volkwein
- Bavarian Health and Food Safety Authority (LGL), 85764 Oberschleissheim, Germany; (W.V.); (A.S.); (U.B.)
| | - Sahithya P. B. Vemulapalli
- Department of NMR-Based Structural Biology, Max Planck Institute for Biophysical Chemistry, 37077 Göttingen, Germany;
| | - Wenli Zhang
- Virology and Microbiology, Center for Biomedical Education and Research (ZBAF), Witten/Herdecke University, 58453 Witten, Germany; (K.M.); (O.B.); (W.Z.); (S.S.); (J.G.); (A.B.)
| | - Sebastian Schellhorn
- Virology and Microbiology, Center for Biomedical Education and Research (ZBAF), Witten/Herdecke University, 58453 Witten, Germany; (K.M.); (O.B.); (W.Z.); (S.S.); (J.G.); (A.B.)
| | - Kristin Heenemann
- Center for Infectious Diseases, Institute of Virology, Faculty of Veterinary Medicine, University of Leipzig, 04103 Leipzig, Germany; (K.H.); (A.R.); (T.W.V.)
| | - Antje Rueckner
- Center for Infectious Diseases, Institute of Virology, Faculty of Veterinary Medicine, University of Leipzig, 04103 Leipzig, Germany; (K.H.); (A.R.); (T.W.V.)
| | - Andreas Sing
- Bavarian Health and Food Safety Authority (LGL), 85764 Oberschleissheim, Germany; (W.V.); (A.S.); (U.B.)
| | - Thomas W. Vahlenkamp
- Center for Infectious Diseases, Institute of Virology, Faculty of Veterinary Medicine, University of Leipzig, 04103 Leipzig, Germany; (K.H.); (A.R.); (T.W.V.)
| | - Anna-Lena Severing
- Centre for Biomedical Education and Research (ZBAF), Institute for Translational Wound Research, Witten/Herdecke University, 58453 Witten, Germany;
| | - Jian Gao
- Virology and Microbiology, Center for Biomedical Education and Research (ZBAF), Witten/Herdecke University, 58453 Witten, Germany; (K.M.); (O.B.); (W.Z.); (S.S.); (J.G.); (A.B.)
| | - Malik Aydin
- Center for Child and Adolescent Medicine, Center for Clinical and Translational Research (CCTR), Helios University Hospital Wuppertal, Witten/Herdecke University, 42283 Wuppertal, Germany;
| | - Dominik Jung
- Centre for Biomedical Education and Research, Institute of Pharmacology and Toxicology, Witten/Herdecke University, 58453 Witten, Germany; (D.J.); (H.S.B.)
| | - Hagen S. Bachmann
- Centre for Biomedical Education and Research, Institute of Pharmacology and Toxicology, Witten/Herdecke University, 58453 Witten, Germany; (D.J.); (H.S.B.)
| | - Kurt S. Zänker
- Center for Biomedical Education and Research (ZBAF), Institute of Immunology, Witten/Herdecke University, 58453 Witten, Germany;
| | - Ulrich Busch
- Bavarian Health and Food Safety Authority (LGL), 85764 Oberschleissheim, Germany; (W.V.); (A.S.); (U.B.)
| | - Armin Baiker
- Virology and Microbiology, Center for Biomedical Education and Research (ZBAF), Witten/Herdecke University, 58453 Witten, Germany; (K.M.); (O.B.); (W.Z.); (S.S.); (J.G.); (A.B.)
- Bavarian Health and Food Safety Authority (LGL), 85764 Oberschleissheim, Germany; (W.V.); (A.S.); (U.B.)
| | - Christian Griesinger
- Centre for Biomedical Education and Research, Institute of Pharmacology and Toxicology, Witten/Herdecke University, 58453 Witten, Germany; (D.J.); (H.S.B.)
| | - Anja Ehrhardt
- Virology and Microbiology, Center for Biomedical Education and Research (ZBAF), Witten/Herdecke University, 58453 Witten, Germany; (K.M.); (O.B.); (W.Z.); (S.S.); (J.G.); (A.B.)
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Beurskens DMH, Huckriede JP, Schrijver R, Hemker HC, Reutelingsperger CP, Nicolaes GAF. The Anticoagulant and Nonanticoagulant Properties of Heparin. Thromb Haemost 2020; 120:1371-1383. [PMID: 32820487 DOI: 10.1055/s-0040-1715460] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Heparins represent one of the most frequently used pharmacotherapeutics. Discovered around 1926, routine clinical anticoagulant use of heparin was initiated only after the publication of several seminal papers in the early 1970s by the group of Kakkar. It was shown that heparin prevents venous thromboembolism and mortality from pulmonary embolism in patients after surgery. With the subsequent development of low-molecular-weight heparins and synthetic heparin derivatives, a family of related drugs was created that continues to prove its clinical value in thromboprophylaxis and in prevention of clotting in extracorporeal devices. Fundamental and applied research has revealed a complex pharmacodynamic profile of heparins that goes beyond its anticoagulant use. Recognition of the complex multifaceted beneficial effects of heparin underscores its therapeutic potential in various clinical situations. In this review we focus on the anticoagulant and nonanticoagulant activities of heparin and, where possible, discuss the underlying molecular mechanisms that explain the diversity of heparin's biological actions.
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Affiliation(s)
- Danielle M H Beurskens
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Joram P Huckriede
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Roy Schrijver
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
| | - H Coenraad Hemker
- Synapse BV, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Chris P Reutelingsperger
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Gerry A F Nicolaes
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
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Differences in Env and Gag protein expression patterns and epitope availability in feline immunodeficiency virus infected PBMC compared to infected and transfected feline model cell lines. Virus Res 2017; 227:249-260. [PMID: 27836726 DOI: 10.1016/j.virusres.2016.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 11/05/2016] [Accepted: 11/05/2016] [Indexed: 11/21/2022]
Abstract
Env and Gag are key components of the FIV virion that are targeted to the plasma membrane for virion assembly. They are both important stimulators and targets of anti-FIV immunity. To investigate and compare the expression pattern and antigenic changes of Gag and Env in various research models, infected PBMC (the natural FIV host cells) and GFox, and transfected CrFK were stained over time with various Env and Gag specific MAbs. In FIV infected GFox and PBMC, Env showed changes in epitope availability for antibody binding during processing and trafficking, which was not seen in transfected CrFK. Interestingly, epitopes exposed on intracellular Env and Env present on the plasma membrane of CrFK and GFox seem to be hidden on plasma membrane expressed Env of FIV infected PBMC. A kinetic follow up of Gag and Env expression showed a polarization of both Gag and Env expression to specific sites at the plasma membrane of PBMC, but not in other cell lines. In conclusion, mature trimeric cell surface expressed Env might be antigenically distinct from intracellular monomeric Env in PBMC and might possibly be unrecognizable by feline humoral immunity. In addition, Env expression is restricted to a small area on the plasma membrane and co-localizes with a large moiety of Gag, which may represent a preferred FIV budding site, or initiation of virological synapses with direct cell-to-cell virus transmission.
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Li J, Das JR, Tang P, Han Z, Jaiswal JK, Ray PE. Transmembrane TNF- α Facilitates HIV-1 Infection of Podocytes Cultured from Children with HIV-Associated Nephropathy. J Am Soc Nephrol 2016; 28:862-875. [PMID: 27811066 DOI: 10.1681/asn.2016050564] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 09/02/2016] [Indexed: 12/11/2022] Open
Abstract
Studies have shown that podocytes and renal tubular epithelial cells from patients with HIV-associated nephropathy (HIVAN) express HIV-1 transcripts, suggesting that productive infection of renal epithelial cells precipitates development of HIVAN. However, podocytes and renal tubular epithelial cells do not express CD4 receptors, and it is unclear how these cells become productively infected in vivo We investigated the mechanisms underlying the infection by HIV-1 of podocytes cultured from the urine of children with HIVAN. We observed low-level productive infection on exposure of these cells to primary cell-free HIV-1 supernatants. However, envelope-defective recombinant HIV-1 did not infect the renal epithelial cell lines. Moreover, treatment of podocytes to inhibit endocytic transport or dynamin activity or remove cell surface heparan sulfate proteoglycans reduced infection efficiency. Transfection of CD4- 293T cells with a cDNA expression library developed from a podocyte cell line derived from a child with HIVAN led to the identification of TNF-α as a possible mediator of HIV-1 infection. Overexpression of transmembrane TNF-α in cultured CD4- renal tubular epithelial cells, 293T cells, and HeLa cells enabled the infection of these cells; exposure to soluble TNF-α did not. Immunohistochemistry showed TNF-α expression in podocytes of renal sections from children with HIVAN. Furthermore, we found that TNF-α enhanced NF-κB activation and integration of HIV-1 into the podocyte DNA. Finally, inhibition of dynamin activity blocked TNF-α-mediated infection. These data establish a role for transmembrane TNF-α in facilitating the viral entry and integration of HIV-1 into the DNA of renal epithelial cells.
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Affiliation(s)
- Jinliang Li
- Centers for *Genetic Medicine Research and.,Department of Pediatrics, and
| | - Jharna R Das
- Centers for *Genetic Medicine Research and.,Department of Pediatrics, and
| | - Pingtao Tang
- Centers for *Genetic Medicine Research and.,Department of Pediatrics, and
| | - Zhe Han
- Department of Pediatrics, and.,Cancer and Immunology
| | - Jyoti K Jaiswal
- Centers for *Genetic Medicine Research and.,Department of Pediatrics, and
| | - Patricio E Ray
- Centers for *Genetic Medicine Research and .,Department of Pediatrics, and.,Division of Nephrology, Children's National Health System, The George Washington University School of Medicine, Washington, DC
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