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Krilis M, Qi M, Ioannou Y, Zhang JY, Ahmadi Z, Wong JWH, Vlachoyiannopoulos PG, Moutsopoulos HM, Koike T, Sturgess AD, Chong BH, Krilis SA, Giannakopoulos B. Clinical relevance of nitrated beta 2-glycoprotein I in antiphospholipid syndrome: Implications for thrombosis risk. J Autoimmun 2021; 122:102675. [PMID: 34098405 DOI: 10.1016/j.jaut.2021.102675] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 05/26/2021] [Accepted: 05/29/2021] [Indexed: 02/03/2023]
Abstract
Β2-Glycoprotein I (β2GPI) is an important anti-thrombotic protein and is the major auto-antigen in the antiphospholipid syndrome (APS). The clinical relevance of nitrosative stress in post translational modification of β2GPI was examined.The effects of nitrated (n)β2GPI on its anti-thrombotic properties and its plasma levels in primary and secondary APS were determined with appropriate clinical control groups. β2-glycoprotein I was nitrated at tyrosines 218, 275 and 309. β2-glycoprotein I binds to lipid peroxidation modified products through Domains IV and V. Nitrated β2GPI loses this binding (p < 0.05) and had diminished activity in inhibiting platelet adhesion to vWF under high shear flow (p < 0.01). Levels of nβ2GPI were increased in patients with primary APS compared to patients with either secondary APS (p < 0.05), autoimmune disease without APS (p < 0.05) or non-autoimmune patients with arterial thrombosis (p < 0.01) and healthy individuals (p < 0.05).In conclusion tyrosine nitration of plasma β2GPI is demonstrated and has important implications with regards to the pathophysiology of platelet mediated thrombosis in APS. Elevated plasma levels of nβ2GPI in primary APS may be a risk factor for thrombosis warranting further investigation.
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Affiliation(s)
- M Krilis
- Department of Infectious Disease, Immunology and Sexual Health, St George Hospital and Department of Medicine, St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia.
| | - M Qi
- Department of Infectious Disease, Immunology and Sexual Health, St George Hospital and Department of Medicine, St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia.
| | - Y Ioannou
- Department of Infectious Disease, Immunology and Sexual Health, St George Hospital and Department of Medicine, St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia; Division of Medicine, Centre for Rheumatology Research, University College London, London, UK.
| | - J Y Zhang
- Department of Infectious Disease, Immunology and Sexual Health, St George Hospital and Department of Medicine, St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia.
| | - Z Ahmadi
- Haematology Research Unit, St George and Sutherland Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
| | - J W H Wong
- Prince of Wales Clinical School and Lowy Cancer Research Centre, University of New South Wales, Sydney, NSW, Australia.
| | - P G Vlachoyiannopoulos
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
| | - H M Moutsopoulos
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
| | - T Koike
- Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University School of Medicine, Sapporo, Japan.
| | - A D Sturgess
- Department of Rheumatology, St George Hospital, University of New South Wales, Sydney, NSW, Australia.
| | - B H Chong
- Haematology Research Unit, St George and Sutherland Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
| | - S A Krilis
- Department of Infectious Disease, Immunology and Sexual Health, St George Hospital and Department of Medicine, St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia.
| | - B Giannakopoulos
- Department of Infectious Disease, Immunology and Sexual Health, St George Hospital and Department of Medicine, St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia; Department of Rheumatology, St George Hospital, University of New South Wales, Sydney, NSW, Australia.
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GRIKA ELEFTHERIAP, ZIAKAS PANAYIOTISD, ZINTZARAS ELIAS, MOUTSOPOULOS HARALAMPOSM, VLACHOYIANNOPOULOS PANAYIOTISG. Morbidity, Mortality, and Organ Damage in Patients with Antiphospholipid Syndrome. J Rheumatol 2012; 39:516-23. [DOI: 10.3899/jrheum.110800] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective.To describe morbidity, organ damage, mortality, and cause of death in patients with antiphospholipid syndrome (APS).Methods.Descriptive analysis of 135 patients. Patients were clustered according to initial event: arterial thrombosis including stroke (AT; n = 46), venous thrombosis including pulmonary emboli (VT; n = 53), or pregnancy morbidity (PM; n = 36). Disease progression according to initial event and prevalence of organ damage was observed.Results.APS occurs among young individuals (mean age 33.3 ± 11.9 yrs). One-third of the patients have APS secondary to systemic lupus erythematosus (SLE) or SLE-like disease. A broad spectrum of clinical manifestations mark the disease onset even before diagnosis. The pattern of initial presentation is preserved with regard to second event; VT is followed by VT (84%), AT is followed by AT (95%), and PM is followed by PM (88.9%). The highest morbidity is attributed to neurologic damage. PM is more likely to be followed by a second event, yet is associated with less organ damage than AT and VT. After a mean followup of 7.55 years, 29% of patients experienced organ damage and 5 died, with Systemic Lupus International Collaborating Clinics score associated with increased mortality (HR 1.31, 95% CI 1.07–1.60, p = 0.01, per 1-unit increase); hematological malignancies occurred in 2 patients after a cumulative followup of 1020 person-years. Coexistent SLE adds significant damage in patients with APS.Conclusion.APS is a disease of young individuals, who experience increased morbidity. Neurologic damage is the most common cause of morbidity. AT at presentation as well as coexistent SLE are associated with poor outcome.
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Tew JG, El Shikh ME, El Sayed RM, Schenkein HA. Dendritic cells, antibodies reactive with oxLDL, and inflammation. J Dent Res 2011; 91:8-16. [PMID: 21531918 DOI: 10.1177/0022034511407338] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Periodontitis appears to promote chronic inflammatory diseases, including atherosclerosis, but relevant mechanisms need clarification. Oral bacteria induce antibodies that bind not only bacteria, but also oxLDL. Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans induce remarkable IgG responses that are dominated by IgG2, and IgG2 is IFN-γ-dependent and is promoted by dendritic cells (DCs). LDL-reactive antibodies induced by P. gingivalis and A. actinomycetemcomitans include anti-phosphorylcholine (α-PC) and β2-glycoprotein-1-dependent anticardiolipin (α-CL), and these antibodies may link chronic inflammatory diseases at a mechanistic level. Antibody-mediated uptake of oxLDL or bacteria dramatically enhances DC-IL-12, and DC-IL-12 induces NK-cell-IFN-γ responses that promote Th-1 responses and sustained inflammation. DCs may be derived from monocytes, and this is striking in cultures of aggressive periodontitis (AgP) monocytes, where DC numbers are about double control levels. Moreover, serum α-CL levels in individuals with AgP are frequently elevated, and these antibodies promote atherosclerosis in persons with antiphospholipid syndrome. Elevated serum levels of soluble-intercellular adhesion molecule, soluble-vascular cell adhesion molecule, and soluble-E-selectin are atherosclerosis-associated indicators of vascular inflammation, and these markers are elevated in the subset of AgP patients with high α-CL. We reason that periodontitis patients with elevated antibodies reactive with oxLDL could be a subgroup at high risk for cardiovascular sequelae.
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Affiliation(s)
- J G Tew
- Clinical Research Center for Periodontal Diseases, School of Dentistry, VCU, Richmond, VA 23298-0556, USA.
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