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Angeli E, Reese-Petersen A, Gonzalez A, Lopez B, Ravassa S, Genovese F, Karsdal M, Diaz J. Type III collagen formation is significantly associated with risk of outcome in HFpEF patients but loses its significant association with underlying AF. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Heart failure with preserved ejection fraction (HFpEF) is the most common type of heart failure, associated with high morbidity and mortality. Atrial fibrillation (AF) has been associated with structural remodelling and fibrosis and can coexist with HFpEF. Type III collagen is the second most abundant collagen in the heart wall and has been associated with cardiac fibrosis. It has been previously shown that type III collagen formation, measured by PRO-C3, is prognostic for all-cause mortality in HFpEF.
Purpose
In this study, we aimed at investigating if the prognostic power of PRO-C3 in relation to all-cause mortality would be affected by underlying AF in HFpEF patients.
Methods
The analysis included 166 individuals with hypertensive HFpEF. The patients were classified in three groups according to NYHA classification, 43.2% in NYHA Class II, 52.5% NYHA Class III and 2.5% NYHA Class IV. A previous history of AF was present in 53.4% of the patients. Cardiac function was assessed by echocardiography and standard clinical measures. Type III collagen formation was evaluated by means of ELISA with the biomarker PRO-C3, which targets the released N-terminal pro-peptide of type III collagen.
Results
Levels of PRO-C3 were significantly elevated in HFpEF patients with AF (p=0.0063). PRO-C3 was significantly predictive of all-cause mortality in HFpEF patients (AUC=0.643, p=0.0053), but lost its significant association when factoring in AF (AUC=0.581, p=0.235). There was an increased risk of all-cause mortality (p=0.0089) but not statistically significant differences in HFpEF patients with AF (p=0.178) with increasing tertiles of PRO-C3.
Conclusions
Type III collagen formation as measured by PRO-C3, was increased in patients with HFpEF and previously diagnosed AF. However, while PRO-C3 can be predictive of all-cause mortality in HFpEF patients, it lacks predicting ability when AF is considered. The presented data suggest a potential role of increased type III collagen formation in HFpEF patients with adverse outcomes, which is consistent with the presence of increased fibrosis, and can potentially be used as a tool of risk stratification.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Nordic Bioscience A/S
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Affiliation(s)
- E Angeli
- Nordic Bioscience A/S , Herlev , Denmark
| | | | - A Gonzalez
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA , Pamplona , Spain
| | - B Lopez
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA , Pamplona , Spain
| | - S Ravassa
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA , Pamplona , Spain
| | - F Genovese
- Nordic Bioscience A/S , Herlev , Denmark
| | - M Karsdal
- Nordic Bioscience A/S , Herlev , Denmark
| | - J Diaz
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA , Pamplona , Spain
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Reese-Petersen A, Gonzalez A, Lopez B, Ravassa S, Karsdal M, Genovese F, Diez J. Endotrophin is significantly associated with disease severity and increased risk of adverse outcome in HFpEF but not in HFrEF patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The global burden of heart failure (HF), with either reduced (HFrEF) or preserved (HFpEF) ejection fraction, has increased dramatically over the past years, and HFpEF is projected to become the dominant type of HF. Fibrogenesis, promoted by fibroblast activity, plays an important role in the pathology of HF regardless of subtype, causing impaired cardiac function. Endotrophin is a bioactive molecule released from collagen type VI during its maturation, and it is a marker of fibroblast activity. The aim of this post-hoc analysis was to confirm the previously observed prognostic potential of endotrophin (measured by PRO-C6) for adverse outcome in HFpEF and to test its prognostic abilities in HFrEF.
Methods
234 patients with hypertension and either HFrEF (30.3%) or HFpEF (69.7%) were included for analysis. 43.2% were NYHA Class II, 52.5% NYHA Class III and 2.5% NYHA Class IV. 53.4% of patients had a previous history of atrial fibrillation. The cohort did not include diabetic patients. Cardiac function was assessed by echocardiography and standard clinical measures, including left ventricle ejection fraction (EF), blood pressure (BP) and measurement of N-terminal natriuretic brain-peptide (NT-proBNP). Circulating endotrophin was quantified at baseline in serum by means of an enzyme-linked immunosorbent assay, PRO-C6.
Results
PRO-C6 levels increased significantly with disease severity in HFpEF patients (NYHA Class III vs II, p=0.0003), but not in HFrEF patients (NYHA Class III vs II, p=0.33). In HFpEF patients, PRO-C6 was able to discriminate between patients that were hospitalized for HF (AUC=0.69, p<0.001), died from cardiovascular (CV) causes (AUC=0.74, p<0.001), or by any other cause (AUC=0.73, p<0.001). PRO-C6 was not associated with none of these outcomes in HFrEF patients (AUC=0.56, p=0.42; AUC=0.53, p=0.73; AUC=0.56, p=0.53, respectively). Adding PRO-C6 to a risk prediction model containing age, sex, body mass index and systolic BP significantly increased the discriminatory power of the model for mortality (deltaAUC=0.037, p=0.04). When looking at patients stratified in PRO-C6 tertiles, patients in the upper tertile had a significantly higher risk of mortality (p<0.0001, hazard ratios 3 vs 1=4.1, 3 vs 2=3.5, respectively) and HF hospitalization (p<0.0001, hazard ratio 3 vs 1=4.4, 3 vs 2=1.6, respectively) compared to tertiles 1 and 2.
Conclusion
In this population of hypertensive HF patients, circulating endotrophin, measured by PRO-C6, was increased with increasing disease severity, and associated with a higher risk of adverse outcome in HFpEF, but not in HFrEF patients. The data presented here suggest a potential role of endotrophin in HFpEF pathophysiology and further underline the differences between HFpEF and HFrEF. These data confirm previous observations, and strengthen the usefulness of endotrophin, measured by the PRO-C6 biomarker, as a prognostic tool aiding in assessment of HFpEF patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | | | | | | | - M Karsdal
- Nordic Bioscience, Copenhagen, Denmark
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Karsdal MA, Genovese F, Rasmussen DGK, Bay-Jensen AC, Mortensen JH, Holm Nielsen S, Willumsen N, Jensen C, Manon-Jensen T, Jennings L, Reese-Petersen AL, Henriksen K, Sand JM, Bager C, Leeming DJ. Considerations for understanding protein measurements: Identification of formation, degradation and more pathological relevant epitopes. Clin Biochem 2021; 97:11-24. [PMID: 34453894 DOI: 10.1016/j.clinbiochem.2021.08.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/06/2021] [Accepted: 08/23/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVES There is a need for precision medicine and an unspoken promise of an optimal approach for identification of the right patients for value-based medicine based on big data. However, there may be a misconception that measurement of proteins is more valuable than measurement of fewer selected biomarkers. In population-based research, variation may be somewhat eliminated by quantity. However, this fascination of numbers may limit the attention to and understanding of the single. This review highlights that protein measurements (with collagens as examples) may mean different things depending on the targeted epitope - formation or degradation of tissues, and even signaling potential of proteins. DESIGN AND METHODS PubMed was searched for collagen, neo-epitope, biomarkers. RESULTS Ample examples of assays with specific epitopes, either pathological such as HbA1c, or domain specific such as pro-peptides, which total protein arrays would not have identified were evident. CONCLUSIONS We suggest that big data may be considered as the funnel of data points, in which most important parameters will be selected. If the technical precision is low or the biological accuracy is limited, and we include suboptimal quality of biomarkers, disguised as big data, we may not be able to fulfill the promise of helping patients searching for the optimal treatment. Alternatively, if the technical precision of the total protein quantification is high, but we miss the functional domains with the most considerable biological meaning, we miss the most important and valuable information of a given protein. This review highlights that measurements of the same protein in different ways may provide completely different meanings. We need to understand the pathological importance of each epitope quantified to maximize protein measurements.
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Affiliation(s)
- M A Karsdal
- Nordic Bioscience, Biomarkers & Research A/S, Herlev, Denmark.
| | - F Genovese
- Nordic Bioscience, Biomarkers & Research A/S, Herlev, Denmark
| | - D G K Rasmussen
- Nordic Bioscience, Biomarkers & Research A/S, Herlev, Denmark
| | - A C Bay-Jensen
- Nordic Bioscience, Biomarkers & Research A/S, Herlev, Denmark
| | - J H Mortensen
- Nordic Bioscience, Biomarkers & Research A/S, Herlev, Denmark
| | - S Holm Nielsen
- Nordic Bioscience, Biomarkers & Research A/S, Herlev, Denmark
| | - N Willumsen
- Nordic Bioscience, Biomarkers & Research A/S, Herlev, Denmark
| | - C Jensen
- Nordic Bioscience, Biomarkers & Research A/S, Herlev, Denmark
| | - T Manon-Jensen
- Nordic Bioscience, Biomarkers & Research A/S, Herlev, Denmark
| | | | | | - K Henriksen
- Nordic Bioscience, Biomarkers & Research A/S, Herlev, Denmark
| | - J M Sand
- Nordic Bioscience, Biomarkers & Research A/S, Herlev, Denmark
| | - C Bager
- Nordic Bioscience, Biomarkers & Research A/S, Herlev, Denmark
| | - D J Leeming
- Nordic Bioscience, Biomarkers & Research A/S, Herlev, Denmark
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Holm Nielsen S, Edsfeldt A, Tengryd C, Gustafsson H, Shore AC, Natali A, Khan F, Genovese F, Bengtsson E, Karsdal M, Leeming DJ, Nilsson J, Goncalves I. The novel collagen matrikine, endotrophin, is associated with mortality and cardiovascular events in patients with atherosclerosis. J Intern Med 2021; 290:179-189. [PMID: 33951242 PMCID: PMC8359970 DOI: 10.1111/joim.13253] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/27/2020] [Accepted: 12/08/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Rupture of atherosclerotic plaques is the major cause of acute cardiovascular events. The biomarker PRO-C6 measuring Endotrophin, a matrikine of collagen type VI, may provide valuable information detecting subjects in need of intensified strategies for secondary prevention. OBJECTIVE In this study, we evaluate endotrophin in human atherosclerotic plaques and circulating levels of PRO-C6 in patients with atherosclerosis, to determine the predictive potential of the biomarker. METHODS Sections from the stenotic human carotid plaques were stained with the PRO-C6 antibody. PRO-C6 was measured in serum of patients enrolled in the Carotid Plaque Imagining Project (CPIP) (discovery cohort, n = 577) and the innovative medicines initiative surrogate markers for micro- and macrovascular hard end-points for innovative diabetes tools (IMI-SUMMIT, validation cohort, n = 1,378). Median follow-up was 43 months. Kaplan-Meier curves and log-rank tests were performed in the discovery cohort. Cox proportional hazard regression analysis (HR with 95% CI) was used in the discovery cohort and binary logistic regression (OR with 95% CI) in the validation cohort. RESULTS PRO-C6 was localized in the core and shoulder of the atherosclerotic plaque. In the discovery cohort, PRO-C6 independently predicted future cardiovascular events (HR 1.089 [95% CI 1.019 -1.164], p = 0.01), cardiovascular death (HR 1.118 [95% CI 1.008 -1.241], p = 0.04) and all-cause death (HR 1.087 [95% CI 1.008 -1.172], p = 0.03). In the validation cohort, PRO-C6 predicted future cardiovascular events (OR 1.063 [95% CI 1.011 -1.117], p = 0.017). CONCLUSION PRO-C6 is present in the atherosclerotic plaque and associated with future cardiovascular events, cardiovascular death and all-cause mortality in two large prospective cohorts.
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Affiliation(s)
- S Holm Nielsen
- Nordic Bioscience, Herlev, Denmark.,Department of Biomedicine and Biotechnology, Technical University of Denmark, Lyngby, Denmark
| | - A Edsfeldt
- Department of Cardiology, Skåne University Hospital, Malmö, Sweden.,Department of Clinical Sciences, Lund University, Malmö, Sweden.,Wallenberg Center for Molecular Medicine, Lund University, Malmö, Sweden
| | - C Tengryd
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - H Gustafsson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - A C Shore
- Diabetes and Vascular Medicine, University of Exeter, Medical School, National Institute for Health Research Exeter Clinical Research Facility, Exeter, UK
| | - A Natali
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - F Khan
- Division of Molecular and Clinical medicine, University of Dundee, Dundee, UK
| | | | - E Bengtsson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | | | | | - J Nilsson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - I Goncalves
- Department of Cardiology, Skåne University Hospital, Malmö, Sweden.,Department of Clinical Sciences, Lund University, Malmö, Sweden
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Leeming DJ, Genovese F, Sand JMB, Rasmussen DGK, Christiansen C, Jenkins G, Maher TM, Vestbo J, Karsdal MA. Can biomarkers of extracellular matrix remodelling and wound healing be used to identify high risk patients infected with SARS-CoV-2?: lessons learned from pulmonary fibrosis. Respir Res 2021; 22:38. [PMID: 33546680 PMCID: PMC7863042 DOI: 10.1186/s12931-020-01590-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 11/29/2020] [Indexed: 02/08/2023] Open
Abstract
Pulmonary fibrosis has been identified as a main factor leading to pulmonary dysfunction and poor quality of life in post-recovery Severe Acute Respiratory Syndrome (SARS) survivor’s consequent to SARS-Cov-2 infection. Thus there is an urgent medical need for identification of readily available biomarkers that in patients with SARS-Cov-2 infection are able to; (1) identify patients in most need of medical care prior to admittance to an intensive care unit (ICU), and; (2) identify patients post-infection at risk of developing persistent fibrosis of lungs with subsequent impaired quality of life and increased morbidity and mortality. An intense amount of research have focused on wound healing and Extracellular Matrix (ECM) remodelling of the lungs related to lung function decline in pulmonary fibrosis (PF). A range of non-invasive serological biomarkers, reflecting tissue remodelling, and fibrosis have been shown to predict risk of acute exacerbations, lung function decline and mortality in PF and other interstitial lung diseases (Sand et al. in Respir Res 19:82, 2018). We suggest that lessons learned from such PF studies of the pathological processes leading to lung function decline could be used to better identify patients infected with SARS-Co-V2 at most risk of acute deterioration or persistent fibrotic damage of the lung and could consequently be used to guide treatment decisions.
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Affiliation(s)
| | | | | | | | | | - G Jenkins
- Division of Respiratory Medicine, University of Nottingham, Nottingham, UK
| | - T M Maher
- Keck School of Medicine, University of Southern California, Los Angeles, USA.,National Heart and Lung Institute, Imperial College, London, UK
| | - J Vestbo
- Division of Infection Immunity and Respiratory Medicine, The University of Manchester and Manchester University NHS Foundation Trust, Manchester, England
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Mygind N, Holm Nielsen S, Mide Michelsen M, Pena A, Bechsgaard Frestad D, Suhrs E, Bove K, Genovese F, Nielsen H, Karsdal M, Vejlstrup N, Prescott E, Kastrup J. Proteoglycan remodeling is accelerated in women with angina pectoris and diffuse myocardial fibrosis: the iPOWER Study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Women with angina and no obstructive coronary artery disease (CAD) have an unfavourable prognosis, possibly due to coronary microvascular disease and diffuse myocardial fibrosis (DMF). In DMF myocardial extracellular matrix (ECM) proteins are actively remodeled by matrix metalloproteinase (MMP).
Purpose
We investigated MMP-mediated degradation of the protegoglycans biglycan and versican in women with angina pectoris and possible DMF assessed by cardiac magnetic resonance T1 mapping.
Methods
Seventy-one women with angina pectoris and no obstructive CAD were included. Asymptomatic age-matched women served as controls (n=32). Versican and biglycan were measured in serum by specific competitive enzyme-linked immunosorbent assays. T1 mapping was performed by cardiac magnetic resonance with gadolinium measuring T1 and extracellular volume (ECV).
Results
Both biglycan and versican levels were higher in symptomatic women compared with controls; 31.4 ng/mL vs. 16.4 ng/mL (p<0.001) and 2.1 ng/mL vs. 1.8 ng/mL (p<0.001), respectively (Figure 1) and were moderately correlated to global ECV (r2=0.38, p<0.001 and r2=0.26, p=0.015 respectively).
Conclusion
Turnover of biglycan and versican was increased in symptomatic compared to asymptomatic women and associated to ECV, supporting a link between angina with no obstructive CAD and fibrotic cardiac remodeling. The examined biomarkers may prove to be suitable for monitoring active ECM remodeling.
Figure 1. Levels of BGM and VCANM
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): This work was supported by The Danish Heart Foundation, the Danish Research Fund (Den Danske Forskningsfond) and by University of Copenhagen.
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Affiliation(s)
- N.D Mygind
- Rigshospitalet, The Heart Centre, Copenhagen, Denmark
| | | | - M Mide Michelsen
- Bispebjerg Hospital of the Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - A Pena
- Gentofte University Hospital, Department of Cardiology, Copenhagen, Denmark
| | | | - E Suhrs
- Bispebjerg Hospital of the Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - K.B Bove
- Bispebjerg Hospital of the Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | | | | | | | - N Vejlstrup
- Rigshospitalet, The Heart Centre, Copenhagen, Denmark
| | - E Prescott
- Bispebjerg Hospital of the Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - J Kastrup
- Rigshospitalet, The Heart Centre, Copenhagen, Denmark
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Holm Nielsen S, Shami A, Jonasson L, Swahn E, Auf Dem Keller U, Genovese F, Karsdal M, Grufman H, Yndigegn T, Schiopu A, Nilsson J, Edsfeldt A, Alfredsson J, Goncalves I. Collagen remodeling markers show differentiated expression in patients with ST- and non-ST elevation myocardial infarction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Following acute myocardial infarction (MI), the left ventricle undergoes molecular and extracellular matrix (ECM) changes. The ECM is a dynamic structure with a potential role in cardiac remodeling post-MI. Collagens are the major components of both cardiac and arterial ECM.
Purpose
We evaluated circulating levels of type I, IV and VI collagen fragments in two cohorts of patients with acute MI to investigate collagen turnover post-MI. The cohorts were Malmö AMI in elderly (MAMI-Y) and Assessing Platelet Activity in Coronary Heart Disease (APACHE).
Methods
Serum was collected from 190 patients from the discovery cohort (MAMI-Y: mean age 74, SD 10.8) at four timepoints: admission when MI, after 3–6 days, 6 weeks, 12 months; citrate plasma was collected from 142 patients from the validation cohort (APACHE: mean age 65, SD 11.6) at four timepoints: hospitalization, 3 days, 7–9 days, 6 months. The biomarkers of matrix metalloproteinase (MMP)-mediated degradation of type I collagen (C1M), MMP-mediated degradation of type IV collagen (C4M) and formation of type VI collagen (PRO-C6) were measured at all timepoints (immunosorbent assays). Differences in the markers at the different timepoints were calculated using repeated measures ANOVA.
Results
Circulating levels of the formation biomarker PRO-C6 significantly increased from baseline and remained high at all three following timepoints in both MAMI-Y and APACHE studies (all p<0.001). In contrast, the degradation biomarkers C1M and C4M showed a similar pattern of an initial increase 3 days post-MI followed by a decrease over time, with C1M in MAMI-Y and both C1M and C4M in APACHE having returned to baseline level by the final timepoint. Circulating baseline levels of PRO-C6 correlated with age (r=0.397, p<0.0001 in MAMI-Y, r=0.427, p<0.0001 in APACHE). Categorizing the subjects into ST elevation MI (STEMI; MAMI-Y: N=67, APACHE: N=71) or non-ST elevation MI (NSTEMI; MAMI-Y: N=130, APACHE: N=52) revealed that a correlation with age remained in both subgroups (r=0.443, p<0.0001 and r=0.325, p<0.0001, respectively, in MAMI-Y, and r=0.516, p<0.0001 and r=0.316, p=0.023, respectively, in APACHE). Moreover, PRO-C6 was elevated in STEMI patients that had previously experienced an MI in both cohorts (MAMI-Y: p=0.017, APACHE: p=0.016). C1M and C4M levels were not different in patients with prior MI in any of the cohorts. No association was found between any biomarker and gender or diabetes. Echocardiography showed a correlation between baseline levels of C1M and ejection fraction (r=0.228, p=0.023) in the whole MAMI-Y cohort and among NSTEMI, but not among STEMI, subjects (r=0.337, p=0.004).
Conclusions
We observed changes in circulating fragments reflecting collagen turnover in the acute phase post-MI, more pronounced in STEMI patients. This may indicate that STEMI patients have more active collagen remodeling than NSTEMI patients and may have more altered left ventricle function and remodeling.
Funding Acknowledgement
Type of funding source: Other. Main funding source(s): This work was supported by the Danish Research Foundation “den danske forskningsfond”, the Innovation foundation (Innovationsfonden), Swedish Research Council, Swedish Heart and Lung Foundation, Swedish Society for Medical Research, Swedish Society of Medicine, the Crafoord Foundation, the Åke Wiberg foundation and the Stroke foundation.
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Affiliation(s)
- S Holm Nielsen
- Nordic Bioscience, Biomarkers and Research, Herlev, Denmark
| | - A Shami
- Lund University, Clinical Sciences Malmö, Malmö, Sweden
| | - L Jonasson
- Linkoping University, Cardiology, University Hospital and Health, Medicine and Caring Sciences, Linkoping, Sweden
| | - E Swahn
- Linkoping University, Cardiology, University Hospital and Health, Medicine and Caring Sciences, Linkoping, Sweden
| | - U Auf Dem Keller
- Technical University of Denmark, Biomedicine and Biotechnology, Lyngby, Denmark
| | - F Genovese
- Nordic Bioscience, Biomarkers and Research, Herlev, Denmark
| | - M Karsdal
- Nordic Bioscience, Biomarkers and Research, Herlev, Denmark
| | - H Grufman
- Lund University, Clinical Sciences Malmö, Malmö, Sweden
| | - T Yndigegn
- Lund University, Clinical Sciences Malmö and Department of Cardiology, Malmö, Sweden
| | - A Schiopu
- Lund University, Clinical Sciences Malmö, Malmö, Sweden
| | - J Nilsson
- Lund University, Clinical Sciences Malmö, Malmö, Sweden
| | - A Edsfeldt
- Lund University, Clinical Sciences Malmö and Department of Cardiology, Malmö, Sweden
| | - J Alfredsson
- Linkoping University, Cardiology, University Hospital and Health, Medicine and Caring Sciences, Linkoping, Sweden
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Kay SD, Genovese F, Siebuhr AS, Karsdal M, Voss A, Junker P. THU0272 BASEMENT MEMBRANE SEROLOGICAL MARKERS OF COLLAGEN TYPE IV AND LAMININ REMODELING ARE DIFFERENTIALLY EXPRESSED IN SLE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Collagen type IV and laminin are the main constituents of basement membranes (BMs). Epitopes on these molecules are targeted in various autoimmune diseases, systemic lupus erythematosus (SLE) in particular. Accelerated large vessel disease is a well-recognized cause of premature cardiovascular morbidity and mortality in SLE. Novel tools for quantification of soluble MMP-derived fragments of collagen type IV (C4M) and laminin (LG1M) have emerged as promising biomarkers for BM remodeling in atherosclerosis.Objectives:To study serum levels of collagen type IV and laminin metabolites in patients with SLE and in healthy controls. And to search for associations with disease activity, organ damage and cardiovascular comorbidity.Methods:One hundred and six SLE patients without and 20 with previous CVD events were included (1). One hundred and twenty male and female blood donors aged 20-65 years served as healthy reference. Disease activity (SLEDAI) and damage (SLICC) scores were calculated. Coronary artery calcification (CAC) was studied by CT scan and expressed as Agatston score. Carotid intima-media thickness (IMT) was measured by ultrasound (LOGIQ E9, GE Healthcare). In either subgroup atherosclerosis was defined as Agatston > 99 U and/or IMT>1 mm and/or presence of plaque. C4M and LG1M were measured by competitive ELISAs (2).Results:Patient characteristics are presented in Table 1. Overall, C4M and LG1M were significantly increased in the entire SLE cohort vs. healthy controls (35.7 ± 17.5 vs. 22.3 ± 9.4 ng/mL, p<0.0001 and 20.9 ± 21.1 vs. 9.7 ± 8.0 ng/mL, p<0.0001, respectively) (Fig 1). Highly significant positive correlations were detected between C4M and LG1M in the entire SLE cohort and in the healthy control group (Fig 2).In terms of CVD and atherosclerosis LG1M was significantly higher in SLE patients with manifest CVD vs. those without (34.47 ± 41.22 vs. 18.34 ± 13.55, p=0.0015) and in those with atherosclerosis by imaging (25.53 ± 28.12 vs 17.53 ± 13.35, p=0.036). There were no associations between C4M and CVD or atherosclerosis. There was a weak association between LG1M and SLICC (r=0.22, p=0.01), but not with SLEDAI. Details on associations with other CVD risk factors and specific organ involvement will be presented.Table 1Characteristics for SLE patients with and without CVDPatients characteristicsAll (126)SLE + CVD (20)SLE without CVD (106)pFemales, no. (%)113 (89)18 (90)95 (89)0.95Age, yrs., mean ± SD50.6± 14.454.8 ± 15.346.8± 14.10.15Disease duration, yrs., mean ± SD13.9 ± 9.319.0± 11.313.0± 11.30.007SLEDAI, median, range4 (0-14)4 (0-10)4 (0-14)0.717SLICC, median, range1 (0-11)3 (1-11)1 (0-10)0.0001Atherosclerosis, no. (%)53 (42)14 (70)39 (37)0.0006LG1M (ng/ml), mean ± SD20.9± 21.234.5± 41.218.3 ± 13.60.0015C4M (ng/ml), mean ± SD35.7 ± 17.538.1± 20.635.3± 16.90.518Conclusion:Serological levels of collagen type IV and laminin biomarkers were elevated and interrelated in an unstratified SLE population. Moreover, LG1M but not C4M was significantly elevated in SLE patients with previous CVD events and in those with atherosclerosis by imaging. These findings indicate that LG1M may serve as a serological marker for SLE-related large vessel disease. However, additional extravascular sites of increased basement membrane remodeling may contribute to the abnormal biomarker pattern.References:[1]Kay SD, Poulsen MK, Diederichsen AC, Voss A. J Rheumatol 2016;43:315–22[2]Sand JM, Larsen L, Hogaboam C et al. PLoS One 2013;8:e84934Kay SD and Genovese F contributed equally to this work.Figure 1.Levels of C4M and LG1M in serum of patients with SLE and healthy controls; graphs are presented as box and whiskers plot (in the style of Tukey). Statistical significance: ****p<0.0001.Figure 2.Correlation plots (Spearman r) of C4M and LG1M in SLE patients and healthy controls.Disclosure of Interests:Susan Due Kay: None declared, Federica Genovese Shareholder of: Own Nordic Bioscience stocks, Employee of: Nordic Bioscience, Anne Sofie Siebuhr Employee of: Nordic Bioscience, Morten Karsdal Shareholder of: Nordic Bioscience A/S., Employee of: Full time employee at Nordic Bioscience A/S., Anne Voss: None declared, Peter Junker: None declared
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Holm Nielsen S, Jonasson L, Kalogeropoulos K, Karsdal MA, Reese-Petersen AL, Auf dem Keller U, Genovese F, Nilsson J, Goncalves I. Exploring the role of extracellular matrix proteins to develop biomarkers of plaque vulnerability and outcome. J Intern Med 2020; 287:493-513. [PMID: 32012358 DOI: 10.1111/joim.13034] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 11/04/2019] [Accepted: 01/13/2020] [Indexed: 12/14/2022]
Abstract
Cardiovascular disease (CVD) is the most common cause of death in industrialized countries. One underlying cause is atherosclerosis, which is a systemic disease characterized by plaques of retained lipids, inflammatory cells, apoptotic cells, calcium and extracellular matrix (ECM) proteins in the arterial wall. The biologic composition of an atherosclerotic plaque determines whether the plaque is more or less vulnerable, that is prone to rupture or erosion. Here, the ECM and tissue repair play an important role in plaque stability, vulnerability and progression. This review will focus on ECM remodelling in atherosclerotic plaques, with focus on how ECM biomarkers might predict plaque vulnerability and outcome.
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Affiliation(s)
- S Holm Nielsen
- From the, Biomarkers and Research, Nordic Bioscience, Herlev, Denmark.,Department of Biotechnology and Biomedicine, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - L Jonasson
- Department of Medical and Health Sciences, Division of Cardiovascular Medicine, Linköping University, Linköping, Sweden
| | - K Kalogeropoulos
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - M A Karsdal
- From the, Biomarkers and Research, Nordic Bioscience, Herlev, Denmark
| | | | - U Auf dem Keller
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - F Genovese
- From the, Biomarkers and Research, Nordic Bioscience, Herlev, Denmark
| | - J Nilsson
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - I Goncalves
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Department of Cardiology, Skåne University Hospital, Malmö, Sweden
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10
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SATRAPOVA V, Hruskova Z, Sparding N, Genovese F, Bartonova L, Frausova D, Honsova E, Suchanek M, Koprivova H, Rysava R, Bednarova V, Tesar V. SUN-150 BIOMARKERS MAY PREDICT THE SEVERITY AND OUTCOME OF RENAL AAV. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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11
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SPARDING N, Møller A, G. K. Rasmussen D, Mose Nielsen P, S. Hijmans R, Asser Karsdal M, van den Born J, Nørregaard R, Genovese F. SUN-152 DIFFERENCES IN COLLAGEN TYPE III TURNOVER IN ACUTE AND CHRONIC RODENT MODELS OF KIDNEY DISEASE. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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12
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MØLLER A, Sparding N, Rasmussen D, Genovese F, Karsdal M. SAT-188 HIGHER COLLAGEN TYPE VI FORMATION IS ASSOCIATED WITH THE FIBROGENIC RESPONSE FOLLOWING KIDNEY INJURY IN RODENTS. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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13
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Leanza V, Mininni C, Di Grazia FM, Genovese F, Carbonaro A, Leanza G, Palumbo M. Minilaparotomic incision for haemorrhagic corpus luteum: a case report. G Chir 2020; 41:110-113. [PMID: 32038021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Corpus luteum cyst rupture with consequent hemoperitoneum is a common cause of admission to the emergency room. This condition is frequently misdiagnosed because of overlapping of clinical findings in acute gynecologic diseases. However, an incorrect identification may lead to delay in surgical treatment, which can Romabe a life-threatening condition. Ultrasound (US) is the first technique used for diagnosis that can confirm or dismiss the presence of intraperitoneal fluid. Secondly, the contrast-enhanced computed tomography (CT) is the quickest way to identify the site of active bleeding and to establish the correct management of the clinical condition. Herein, we report a case of a 19-years-old girl with acute abdominal pain correctly identified by diagnostic images and treated with mini-invasive surgery techniques in order to quickly act without clinic and aesthetic sequelae.
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14
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Abstract
Abstract
Background/Aim
Accumulation of extracellular matrix (ECM) proteins is the hallmark of cardiac fibrosis, causing stiffening of the ventricular wall, which can lead to heart failure and ultimately death. Many different cell types and growth factors are involved in this process but fibroblasts are the main source of ECM proteins. Here we present results from an in vitro model indicating that endotrophin (ETP), a collagen type VI fragment, activates cardiac fibroblasts and induces fibrogenesis.
Methods
The effect of ETP, transforming growth factor (TGF)-β and platelet-derived growth factor (PDGF)-DD on ECM protein synthesis was assessed in a scar-in-a-jar (SiaJ) cell model using human cardiac fibroblasts isolated from the atrium of an adult healthy donor. Cells were seeded in 48-well plates at a density of 30.000 cells/well and incubated for 24H in Dulbecco's Modified Eagle's medium (DMEM) + 10% fetal bovine serum (FBS). Serum starvation was done by seeding the cells for further 24H in DMEM + 0.4% FBS. Fresh medium was added at day 0 with 37.5/25mg/mL Ficoll 70/400 and 1% ascorbic acid, containing 11.75 nM human recombinant ETP, 0.04 nM TGF-β, 0.39 nM PDGF-DD or a vehicle control. Medium was changed and collected at day 3 and 6. Biomarkers of type I (PRO-C1), III (PRO-C3), VI (PRO-C6) collagens and fibronectin (FBN-C) formation were assessed in the medium by ELISAs developed at Nordic Bioscience.
Results
ETP induced a significant increase in PRO-C1, PRO-C3 and FBN-C (comparable to TGF-β and PDGF-DD) within the first three days of the experiment, compared to the vehicle control. The levels remained significantly increased for PRO-C3 and FBN-C throughout the experiment, and non-significantly elevated for PRO-C1, compared to the vehicle control. PDGF-DD significantly induced synthesis of type VI collagen compared to the vehicle control, while TGF-β induced a small increase in synthesis from day 0–3, after which it seemed to inhibit synthesis.
Conclusion
For the first time, a direct pro-fibrotic effect on fibroblasts induced by ETP has been shown. This novel pathway of activation could play an important role in regulating cardiac fibrosis, and thus prove to be a therapeutic target. This SiaJ model in combination with the investigated biomarkers of ECM formation could be used to further elucidate the mechanisms behind cardiac fibrosis.
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Affiliation(s)
| | - M Karsdal
- Nordic Bioscience, Copenhagen, Denmark
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15
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Goncalves I, Tengryd C, Nielsen SH, Genovese F, Bengtsson E, Karsdal M, Leeming DJ, Nilsson J, Edsfeldt A. 3046High levels of MMP-cleaved mimecan is associated to carotid plaque stability and less future cardiovascular events. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The clinical consequences of atherosclerosis, myocardial infarction and stroke are the most common causes of death globally. Mimecan, a small leucine rich-repeat proteoglycan (SLRP), is cleaved by matrix metalloproteinases (MMPs) and known to be involved in collagen fibrillogenesis and angiogenesis. Circulating levels of MMP-cleaved mimecan (cMIM) has previously been identified as a marker of extracellular matrix remodelling in ApoE−/− knockout mice. The role of mimecan and its degradation in human atherosclerotic plaques has not been explored.
Purpose
We explored whether full-length mimecan and cleaved mimecan (cMIM) are associated to plaque composition and evaluated if they can predict future cardiovascular events.
Methods
Two hundred and eighteen human atherosclerotic plaques were stained for mimecan using immunohistochemistry. cMIM was measured in 202 plaque tissue homogenates using a competitive ELISA assay. Histological components (α-actin, CD68 and glycophorin A) were assessed using immunohistochemistry, neutral lipids were measured using Oil Red O and visible areas of calcium deposits were quantified. Matrix metalloproteinases (MMP-1, -2, -3, -9, -10 and -12), tissue inhibitors of matrix metalloproteinases (TIMP-1 and -2) were analysed in plaque tissue homogenates using ELISA assays and a proximity extension assay. ECM components (glycosaminoglycans, collagen and elastin) were detected with colorimetric assays and the TGF-β1, β2 and β3 were measured by a multiplex assay. Cardiovascular events were registered using national registers, patient records and telephone calls during a follow-up period of 59 months IQR (34–73).
Results
Mimecan was expressed in human atherosclerotic plaques. The expression correlated positively with neutral lipids and intraplaque hemorrhage and inversely with α-actin. In contrast cMIM correlated with α-actin and inversely with neutral lipids. cMIM correlated also with stabilizing extracellular matrix proteins elastin, collagen as well as TGF-β1, β2 and β3. Mimecan correlated to MMP-9 and cMIM correlated to MMP-2 and TIMP-2. Patient with high levels of cMIM had a lower risk of future cardiovascular events which remained significant after adjusting for risk factors (age, gender, diabetes and symptoms) in a multivariate Cox regression
Conclusion(s)
Mimecan was associated with vulnerable plaque features, whereas cMIM was related to stable plaque features. Low levels of cMIM predicted future cardiovascular events, independently of known risk factors. Taken together this suggests a possible role for mimecan and its cleavage in atherosclerosis that needs to be further explored.
Acknowledgement/Funding
Danish Research Foundation, Swedish Research Council, Swedish Heart and Lung Foundation, Skåne University Hospital and more.
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Affiliation(s)
- I Goncalves
- Lund University, Clinical Sciences Malmö and Department of Cardiology, Malmö, Sweden
| | - C Tengryd
- Lund University, Clinical Sciences Malmö, Malmö, Sweden
| | - S H Nielsen
- Nordic Bioscience, Biomarkers & Research, Technical University Denmark, Biotechnology & Biomedicine, Herlev and Kgs. Lyngby, Denmark
| | - F Genovese
- Nordic Bioscience, Biomarkers and Research, Herlev, Denmark
| | - E Bengtsson
- Lund University, Clinical Sciences Malmö, Malmö, Sweden
| | - M Karsdal
- Nordic Bioscience, Biomarkers and Research, Herlev, Denmark
| | - D J Leeming
- Nordic Bioscience, Biomarkers and Research, Herlev, Denmark
| | - J Nilsson
- Lund University, Clinical Sciences Malmö, Malmö, Sweden
| | - A Edsfeldt
- Lund University, Clinical Sciences Malmö and Department of Cardiology, Malmö, Sweden
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Holm Nielsen S, Goncalves I, Shore A, Natali A, Khan F, Genovese F, Karsdal M, Nilsson J. 3043Endotrophin, a fragment of collagen type VI, is correlated to IMT and associated with cardiovascular events in patients with atherosclerosis and diabetes: the IMI-SUMMIT cohort. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Patients with micro- and macrovascular diseases, including atherosclerosis, have increased risk of cardiovascular events and early mortality. The atherosclerotic disease is characterised by accumulation of lipids, cells and proteins in the arterial wall, which includes remodelling of the extracellular matrix (ECM). Collagen type VI (COL6) is known to be over-expressed in patients with atherosclerosis. The biomarker PRO-C6, known as endotrophin, is a COL6 fragment that reflects formation of collagen type VI, and possess pro-inflammatory and pro-fibrotic activities.
Purpose
We explored whether increased endotrophin levels, measured by PRO-C6, were associated with intima-media thickness (IMT) and mortality in the IMI-SUMMIT cohort.
Methods
Circulating protein levels of PRO-C6 were measured in EDTA plasma from 1500 patients enrolled at four European University Hospitals, using an enzyme-linked immunosorbent assay. Follow-up data were available up to three years after sample collection. Associations between PRO-C6 and incidence of cardiovascular (CV) events and all-cause mortality were assessed by Kaplan-Meier curves and Cox proportional hazard regression analyses. Pearson correlation was performed to explore the association of PRO-C6, IMT and clinical variables. Known confounders defined by the Framingham Heart study (age, gender and diabetes) were included in the Cox proportional hazard regression analysis.
Results
Plasma PRO-C6 was significantly correlated with IMT in both the common carotid artery and the carotid bulb (r=0.09, p=0.002 and r=0.11, p=0.0003, respectively), HbA1c (r=0.11, p<0.0001) and C-reactive protein (r=0.14, p<0.0001). A total of 145 patients suffered from fatal or non-fatal cardiovascular events during the three-year follow-up period. Patients in the highest PRO-C6 tertile had a two-fold increased risk of experiencing a CV event during follow-up (p=0.002), independently of age, presence of CVD at baseline, type 2 diabetes, smoking and statin treatment in a regression model.
Conclusion
The present findings demonstrate that circulating levels of PRO-C6 are associated with atherosclerosis severity and increased incidence of cardiovascular events. Since PRO-C6 detects the signaling molecule endotrophin, the results may indicate that endotrophin is not only a biomarker of atherosclerotic disease, but may have a role in promoting disease progression.
Acknowledgement/Funding
This work was supported by the Danish Research Foundation, The Danish innovation foundation and the IMI-SUMMIT participants
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Affiliation(s)
| | - I Goncalves
- Lund University, Department of clinical Sciences, Malmo, Sweden
| | - A Shore
- University of Exeter, Diabetes and Vascular Medicine, Exeter, United Kingdom
| | - A Natali
- University of Pisa, Department of Clinical and Experimental Medicine, Pisa, Italy
| | - F Khan
- University of Dundee, Division of Systems Medicine, Dundee, United Kingdom
| | | | | | - J Nilsson
- Skane University Hospital, Department of cardiology, Malmo, Sweden
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Holm Nielsen S, Tengryd C, Edsfeldt A, Brix S, Genovese F, Bengtsson E, Karsdal M, Leeming DJ, Nilsson J, Goncalves I. A biomarker of collagen type I degradation is associated with cardiovascular events and mortality in patients with atherosclerosis. J Intern Med 2019; 285:118-123. [PMID: 30156050 DOI: 10.1111/joim.12819] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Atherosclerosis is characterized by accumulation of lipids, cells and extracellular matrix (ECM) proteins in the arterial wall. Collagen type I (COL1), a component of the arterial ECM, is cleaved by matrix metalloproteinases (MMPs) and known to be remodelled in atherosclerosis. We explored whether the MMP-mediated COL1 biomarker, C1M, was associated with cardiovascular events, cardiovascular mortality and all-cause mortality in a large prospective cohort of patients with known atherosclerosis. METHODS Serum from 787 patients who underwent a carotid endarterectomy was included. Circulating levels of C1M were measured in serum. A total of 473 patients were followed for 6 years after surgery. Associations between C1M and incidence of cardiovascular events, cardiovascular mortality and all-cause mortality were assessed by Kaplan-Meier curves and Cox regression analysis. RESULTS A total of 101 (21.4%) patients suffered from nonfatal cardiovascular events during the follow-up period, and 64 (13.5%) patients died. Of these, 39 (60.9%) died from cardiovascular diseases. Patients with C1M levels above the median were significantly associated with cardiovascular events, cardiovascular mortality and all-cause mortality (P < 0.001, P = 0.004 and P < 0.001, respectively). C1M was included in the final model for prediction of cardiovascular events (HR 2.15, 95% CI 1.40-3.32, P = 0.001), cardiovascular mortality (HR 2.20, 95% CI 1.07-4.51, P = 0.031) and all-cause mortality (HR 2.98 95% CI 1.67-5.33, P = < 0.001). CONCLUSIONS In patients with atherosclerotic carotid lesions, high levels of C1M predicted cardiovascular events, cardiovascular mortality and all-cause mortality. These findings emphasize the importance of remodelling mechanisms in atherosclerosis that are now becoming more and more explored.
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Affiliation(s)
- S Holm Nielsen
- Nordic Bioscience, Herlev, Denmark.,Technical University of Denmark, Kgs. Lyngby, Denmark
| | - C Tengryd
- Experimental Cardiovascular Research Unit, Lund University, Malmö, Sweden
| | - A Edsfeldt
- Experimental Cardiovascular Research Unit, Lund University, Malmö, Sweden.,Department of Cardiology, Skåne University Hospital, Malmö, Sweden
| | - S Brix
- Technical University of Denmark, Kgs. Lyngby, Denmark
| | | | - E Bengtsson
- Experimental Cardiovascular Research Unit, Lund University, Malmö, Sweden
| | | | | | - J Nilsson
- Experimental Cardiovascular Research Unit, Lund University, Malmö, Sweden
| | - I Goncalves
- Experimental Cardiovascular Research Unit, Lund University, Malmö, Sweden.,Department of Cardiology, Skåne University Hospital, Malmö, Sweden
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Goncalves I, Holm Nielsen S, Tengryd C, Brix S, Edsfeldt A, Genovese F, Bengtsson E, Karsdal M, Julie Leeming D, Nilsson J. 4982Markers of basement membrane remodelling are associated with higher mortality in patients with advanced carotid atherosclerosis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.4982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- I Goncalves
- Lund University, Clinical Sciences Malmö and Department of Cardiology, Malmö, Sweden
| | - S Holm Nielsen
- Technical University of Denmark / Nordic Bioscience, Disease Systems Immunology, Department of Biotechnology and Biomedicine / Biomarkers and Research, Kgs. Lyngby/Herlev, Denmark
| | - C Tengryd
- Lund University, Clinical Sciences Malmö, Malmö, Sweden
| | - S Brix
- Technical University of Denmark, Disease Systems Immunology, Department of Biotechnology and Biomedicine, Kgs. Lyngby, Denmark
| | - A Edsfeldt
- Lund University, Clinical Sciences Malmö and Department of Cardiology, Malmö, Sweden
| | - F Genovese
- Nordic Bioscience, Biomarkers and Research, Herlev, Denmark
| | - E Bengtsson
- Lund University, Clinical Sciences Malmö, Malmö, Sweden
| | - M Karsdal
- Nordic Bioscience, Biomarkers and Research, Herlev, Denmark
| | | | - J Nilsson
- Lund University, Clinical Sciences Malmö, Malmö, Sweden
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Holm Nielsen S, Tengryd C, Brix S, Genovese F, Bengtsson E, Karsdal M, Lynge Reese-Pedersen A, Leeming DJ, Edsfeldt A, Nilsson J, Goncalves I. 4984A marker of collagen type I degradation is associated with cardiovascular events and mortality in patients with known atherosclerosis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.4984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - C Tengryd
- Lund University, Department of clinical Sciences, Malmo, Sweden
| | - S Brix
- Technical University of Denmark, Department of Biotechnology and Biomedicine, Kgs. Lyngby, Denmark
| | | | - E Bengtsson
- Lund University, Department of clinical Sciences, Malmo, Sweden
| | | | | | | | - A Edsfeldt
- Lund University, Department of clinical Sciences, Malmo, Sweden
| | - J Nilsson
- Lund University, Department of clinical Sciences, Malmo, Sweden
| | - I Goncalves
- Skane University Hospital, Department of cardiology, Malmo, Sweden
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Luetkens J, Wolpers C, Beiert T, Meendermann H, Daye N, Knappe V, Stoeckigt F, Karsdal M, Nielsen S, Genovese F, Dabir D, Linhart M, Nickenig G, Schrickel J, Andrie R. P5222Cardiac magnetic resonance using late gadolinium enhancement imaging and T1 mapping predicts poor outcome in patients with atrial fibrillation after catheter ablation therapy. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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21
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Genovese F, Marilli I, Benintende G, Privitera A, Gulino FA, Iozza I, Cimino C, Palumbo MA. Diagnosis and management of fetal ductus arteriosus constriction-closure. J Neonatal Perinatal Med 2015; 8:324352M572245181. [PMID: 25758002 DOI: 10.3233/npm-15814031] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Pathognomonic features of in utero premature restriction/closure of the ductus arteriosus (DA) are increased right ventricular afterload, impaired right ventricular function, and consequently tricuspid regurgitation and right heart dilation. The most common reason for constriction-closure of DA is maternal administration of non-steroidal anti-inflammatory drugs (NSAIDs) during the 3rd trimester of gestation. The idiopathic form is a rare event and, maybe, an underestimated abnormality that, if it is not promptly recognized, may result in severe fetal-neonatal compromise. We describe a case of a 38-year-old woman presenting at 34+0 weeks of gestation with a normally grown male fetus whose fetal echocardiography had shown right ventricular hypertrophy, a tortuous S-shaped DA and a significant pulmonary hyperflow. All signs were consistent of an idiopathic severe constriction of DA with a significant fetal cardiac involvement. The patient was admitted to a tertiary care center equipped with Neonatal Intensive Care Unit (NICU), and delivered by cesarean section at 34+4 weeks with a good maternal and neonatal outcome. Based on our experience and a review of the Literature we propose a management algorithm to use when dealing with preterm or early term pregnancy complicated by this fetal hemodynamic malfunction.
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Affiliation(s)
- F Genovese
- Institute of Obstetric and Gynecologic Pathology, Department of Surgery, Division of Obstetrics and Gynecology, S. Bambino Hospital, University of Catania, Catania, Italy
| | - I Marilli
- Institute of Obstetric and Gynecologic Pathology, Department of Surgery, Division of Obstetrics and Gynecology, S. Bambino Hospital, University of Catania, Catania, Italy
| | - G Benintende
- Complex Operative Unit of Prenatal Diagnosis and Medical Genetics, University Hospital Vittorio Emanuele, Catania, Italy
| | - A Privitera
- Department of Paediatric Cardiology, S. Bambino Hospital, University of Catania, Catania, Italy
| | - F A Gulino
- Institute of Obstetric and Gynecologic Pathology, Department of Surgery, Division of Obstetrics and Gynecology, S. Bambino Hospital, University of Catania, Catania, Italy
| | - I Iozza
- Institute of Obstetric and Gynecologic Pathology, Department of Surgery, Division of Obstetrics and Gynecology, S. Bambino Hospital, University of Catania, Catania, Italy
| | - C Cimino
- Department of Pediatrics, University of Catania, Catania, Italy
| | - M A Palumbo
- Institute of Obstetric and Gynecologic Pathology, Department of Surgery, Division of Obstetrics and Gynecology, S. Bambino Hospital, University of Catania, Catania, Italy
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Kurnatowska I, Grzelak P, Masajtis-Zagajewska A, Kaczmarska M, Stefa czyk L, Vermeer C, Maresz K, Nowicki M, Patel L, Bernard LM, Elder GJ, Leonardis D, Mallamaci F, Tripepi G, D'Arrigo G, Postorino M, Enia G, Caridi G, Marino F, Parlongo G, Zoccali C, Genovese F, Boor P, Papasotiriou M, Leeming DJ, Karsdal MA, Floege J, Delmas-Frenette C, Troyanov S, Awadalla P, Devuyst O, Madore F, Jensen JM, Mose FH, Kulik AEO, Bech JN, Fenton RA, Pedersen EB, Lucisano S, Villari A, Benedetto F, Pettinato G, Cernaro V, Lupica R, Trimboli D, Costantino G, Santoro D, Buemi M, Carmone C, Robben JH, Hadchouel J, Rongen G, Deinum J, Navis GJ, Wetzels JF, Deen PM, Block G, Fishbane S, Shemesh S, Sharma A, Wolf M, Chertow G, Gracia M, Arroyo D, Betriu A, Valdivielso JM, Fernandez E, Cantaluppi V, Medica D, Quercia AD, Dellepiane S, Gai M, Leonardi G, Guarena C, Migliori M, Panichi V, Biancone L, Camussi G, Covic A, Ketteler M, Rastogi A, Spinowitz B, Sprague SM, Botha J, Rakov V, Floege J, Floege J, Ketteler M, Rastogi A, Spinowitz B, Sprague SM, Botha J, Braunhofer P, Covic A, Kaku Y, Ookawara S, Miyazawa H, Ito K, Ueda Y, Hirai K, Hoshino T, Mori H, Nabata A, Yoshida I, Tabei K, El-Shahawy M, Cotton J, Kaupke J, Wooldridge TD, Weiswasser M, Smith WT, Covic A, Ketteler M, Rastogi A, Spinowitz B, Sprague SM, Botha J, Braunhofer P, Floege J, Hanowski T, Jager K, Rong S, Lesch T, Knofel F, Kielstein H, McQuarrie EP, Mark PB, Freel EM, Taylor A, Jardine AG, Wang CL, Du Y, Nan L, :Hess K, Savvaidis A, Lysaja K, Dimkovic N, Floege J, Marx N, Schlieper G, Skrunes R, Larsen KK, Svarstad E, Tondel C, Singh B, Ash SR, Lavin PT, Yang A, Rasmussen HS, Block GA, Egbuna O, Zeig S, Pergola PE, Singh B, Braun A, Yu Y, Sohn W, Padhi D, Block G, Chertow G, Fishbane S, Rodriguez M, Chen M, Shemesh S, Sharma A, Wolf M, Delgado G, Kleber ME, Grammer TB, Kraemer BK, Maerz W, Scharnagl H, Ichii M, Ishimura E, Shima H, Ohno Y, Tsuda A, Nakatani S, Ochi A, Mori K, Inaba M, Filiopoulos V, Manolios N, Hadjiyannakos D, Arvanitis D, Karatzas I, Vlassopoulos D, Floege J, Botha J, Chong E, Sprague SM, Cosmai L, Porta C, Foramitti M, Masini C, Sabbatini R, Malberti F, Elewa U, Nastou D, Fernandez B, Egido J, Ortiz A, Hara S, Tanaka K, Kushiyama A, Sakai K, Sawa N, Hoshino J, Ubara Y, Takaichi K, Bouquegneau A, Vidal-Petiot E, Vrtovsnik F, Cavalier E, Krzesinski JM, Flamant M, Delanaye P, Kilis-Pstrusinska K, Prus-Wojtowicz E, Szepietowski JC, Raj DS, Amdur R, Yamamoto J, Mori M, Sugiyama N, Inaguma D, Youssef DM, Alshal AA, Elbehidy RM, Bolignano D, Palmer S, Navaneethan S, Strippoli G, Kim YN, Park K, Gwoo S, Shin HS, Jung YS, Rim H, Rhew HY, Tekce H, Kin Tekce B, Aktas G, Schiepe F, Draz Y, Rakov V, Yilmaz MI, Siriopol D, Saglam M, Kurt YG, Unal H, Eyileten T, Gok M, Cetinkaya H, Oguz Y, Sari S, Vural A, Mititiuc I, Covic A, Kanbay M, Filiopoulos V, Manolios N, Hadjiyannakos D, Arvanitis D, Karatzas I, Vlassopoulos D, Okarska-Napierala M, Ziolkowska H, Pietrzak R, Skrzypczyk P, Jankowska K, Werner B, Roszkowska-Blaim M, Cernaro V, Trifiro G, Lorenzano G, Lucisano S, Buemi M, Santoro D, Krause R, Fuhrmann I, Degenhardt S, Daul AE, Sallee M, Dou L, Cerini C, Poitevin S, Gondouin B, Jourde-Chiche N, Brunet P, Dignat-George F, Burtey S, Massimetti C, Achilli P, Madonna MPP, Muratore MTT, Fabbri GDD, Brescia F, Feriozzi S, Unal HU, Kurt YG, Gok M, Cetinkaya H, Karaman M, Eyileten T, Vural A, Oguz Y, Y lmaz MI, Sugahara M, Sugimoto I, Aoe M, Chikamori M, Honda T, Miura R, Tsuchiya A, Hamada K, Ishizawa K, Saito K, Sakurai Y, Mise N, Gama-Axelsson T, Quiroga B, Axelsson J, Lindholm B, Qureshi AR, Carrero JJ, Pechter U, Raag M, Ots-Rosenberg M, Vande Walle J, Greenbaum LA, Bedrosian CL, Ogawa M, Kincaid JF, Loirat C, Liborio A, Leite TT, Neves FMDO, Torres De Melo CB, Leitao RDA, Cunha L, Filho R, Sheerin N, Loirat C, Greenbaum L, Furman R, Cohen D, Delmas Y, Bedrosian CL, Legendre C, Koibuchi K, Aoki T, Miyagi M, Sakai K, Aikawa A, Pozna Ski P, Sojka M, Kusztal M, Klinger M, Fakhouri F, Bedrosian CL, Ogawa M, Kincaid JF, Loirat C, Heleniak Z, Aleksandrowicz E, Wierblewska E, Kunicka K, Bieniaszewski L, Zdrojewski Z, Rutkowski B. CKD PATHOPHYSIOLOGY AND CLINICAL STUDIES. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Willumsen N, Genovese F, Hogaboam C, Sand J, Martinez F, Han M, Skjot-Arkil H, Karsdal M, Bay-Jensen A, Leeming D. Serological Detection of Matrix Metalloproteinase Generated Fragments of Elastin and Type IV Collagen may be Biomarkers of Lung Metastatic Breast Cancer. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt084.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Teodoro MC, Genovese F, Rubbino G, Palumbo M, Zarbo G. [Chronic pelvic pain in patients with endometriosis: results of laparoscopic treatment]. Minerva Ginecol 2012; 64:9-14. [PMID: 22334226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIM The chronic pelvic pain (CPP) linked to endometriosis, relatively frequent condition in women of reproductive age, often represents the main complaint for which the patient seeks medical advice. The purpose of this prospective study was to evaluate if and to which extent systematic ablation of endometriotic lesions causes an improvement and/or disappearance of pain in patients with ascertained endometriosis and in whom the main preoperative symptom is chronic pelvic pain. METHODS This study examined 109 patients, affected by chronic pelvic pain secondary to endometriosis, underwent laparoscopic treatment. All patients in the preoperative phase and only the 92 coming back for follow up, were asked both to fill out an anonymous questionnaire about their quality of life and to indicate on a numeric visual analogue scale (VAS) the intensity of the perceived pain. RESULTS Overall the median of the VAS score for pain decreased from 7.5 before surgery to 2.5 at one-year postoperative-follow up, which was consistent (Wilcoxon test) with a statistically significant regression (P<0.0001) of the intensity of perceived pain (disappearance or marked reduction) in the operated patients, independently from the stage of the disease and the type of pain; also data on quality of life during work and social activity indicated a relevant improvement respectively in 82% and in 83% of patients following the laparoscopic procedure. CONCLUSION For this reason and as suggested by the present international guidelines, when the medical therapy against pain fails and/or in the presence of an adnexal mass (chocolate cyst) or deep endometriotic lesion, it is generally correct to rely on surgical ablation of the lesions preferably by laparoscopy.
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Mangiapane E, Lamberti C, Genovese F, Pessione A, Mazzoli R, Giunta C, Pessione E. A 2-DE proteomic study to detect selenium-induced proteins in a probiotic Lactobacillus buchneri strain. J Biotechnol 2010. [DOI: 10.1016/j.jbiotec.2010.09.304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lacerenza D, Genovese F, Profiti M, Nucera D, Rosati S. Characterization of an immunodominant epitope of small ruminant lentivirus (SRLV) nucleoprotein. Vet Immunol Immunopathol 2008; 125:361-7. [DOI: 10.1016/j.vetimm.2008.05.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2008] [Revised: 05/13/2008] [Accepted: 05/19/2008] [Indexed: 11/27/2022]
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Tralongo V, Becchina G, Genovese F, Nagar C, Ottoveggio G, Pinto G. Polymorphous low-grade adenocarcinoma of the salivary glands: clinicopathological and immunohistochemical study of a case. Anticancer Res 2002; 22:1347-52. [PMID: 12168949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
Polymorphous low-grade adenocarcinoma (PLGA) is a distinctive salivary gland neoplasm with a predilection for intraoral sites. Histological and immunohistochemical analyses were used to study a case involving the minor salivary glands of the buccal mucosa in a 68-year-old woman. Histologically, the tumor was characterized by unenca-psulated, progressing and focally-infiltrative borders and showed variable growth patterns including solid, tubular, microcystic and cribriform; papillary and papillary-cystic areas of more than focal extent were present. Cytologically the neoplasm was composed of uniform, round to cuboidal cells with bland, round to oval nuclei. Immunohistochemical analysis showed that the tumor cells were positive for cytokeratin, S-100 protein, vimentin, focally-positive for EMA and actin and negative for CEA. The significance of the papillary component and the possible relationship to other salivary gland tumors is discussed.
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Affiliation(s)
- V Tralongo
- Servizio di Anatomia ed Istologia Patologica e Citopatologia, Presidio Ospedaliero G.F. Ingrassia-Azienda, Palermo, Italy.
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Cuzzola M, Mancuso G, Beninati C, Biondo C, Genovese F, Tomasello F, Flo TH, Espevik T, Teti G. Beta 2 integrins are involved in cytokine responses to whole Gram-positive bacteria. J Immunol 2000; 164:5871-6. [PMID: 10820267 DOI: 10.4049/jimmunol.164.11.5871] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Proinflammatory cytokines have an important pathophysiologic role in septic shock. CD14 is involved in cytokine responses to a number of purified bacterial products, including LPS. However, little is known of monocyte receptors involved in cytokine responses to whole bacteria. To identify these receptors, human monocytes were pretreated with different mAbs and TNF-alpha was measured in culture supernatants after stimulation with whole heat-killed bacteria. Human serum and anti-CD14 Abs significantly increased and decreased, respectively, TNF-alpha responses to the Gram-negative Escherichia coli. However, neither treatment influenced responses to any of the Gram-positive bacteria tested, including group A and B streptococci, Listeria monocytogenes, and Staphylococcus aureus. Complement receptor type III (CR3 or CD18/CD11b) Abs prevented TNF-alpha release induced by heat-killed group A or B streptococci. In contrast, the same Abs had no effects when monocytes were stimulated with L. monocytogenes or S. aureus. Using either of the latter bacteria, significant inhibition of TNF-alpha release was produced by Abs to CD11c, one of the subunits of CR4. To confirm these blocking Ab data, IL-6 release was measured in CR3-, CR4-, or CD14-transfected Chinese hamster ovary cells after bacterial stimulation. Accordingly, streptococci triggered moderate IL-6 production (p < 0.05) in CR3 but not CD14 or CR4 transfectants. In contrast, L. monocytogenes and S. aureus induced IL-6 release in CR4 but not CR3 or CD14 transfectants. Collectively our data indicate that beta 2 integrins, such as CR3 and CR4, may be involved in cytokine responses to Gram-positive bacteria. Moreover, CD14 may play a more important role in responses to whole Gram-negative bacteria relative to Gram-positive ones.
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Affiliation(s)
- M Cuzzola
- Istituto di Microbiologia, Facoltà di Medicina e Chirurgia, Università degli Studi di Messina, Messina, Italy
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Calabri GB, Santini MG, Genovese F, Bambi F, Salvi G, Calabri G. [Prevalence of anti-HAV antibodies (hepatitis A virus) in 18-year-old males from the Florence area]. Pediatr Med Chir 1999; 21:219-20. [PMID: 10963011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
In 1998 sera from 430 18 year old male subjects living in "Florentina area" have been tested for anti-hepatitis A virus (HAV) antibodies. 27 out of 430, (6.2%), study samples were found to be positive. Our results confirm the low circulation rate of HAV in Florence area.
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Affiliation(s)
- G B Calabri
- Dipartimento di Pediatria, Università degli Studi, Azienda Ospedaliera A. Meyer di Firenze, Italia
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Genovese F, Mancuso G, Cuzzola M, Biondo C, Beninati C, Delfino D, Teti G. Role of IL-10 in a neonatal mouse listeriosis model. J Immunol 1999; 163:2777-82. [PMID: 10453021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
This study was undertaken to test the hypothesis that altered IL-10 production plays a role in the increased susceptibility of neonates to listeriosis. Plasma IL-10 levels were measured in neonatal and adult mice at various times after infection with Listeria monocytogenes. Relative to adults, neonatal mice had markedly increased IL-10 levels early in the course of infection with Listeria using a 90% lethal dose. Higher neonatal IL-10 responses were also observed after injecting adults and pups with equal doses of killed organisms. Splenic macrophages from neonates produced higher IL-10 levels than those of adults after in vitro stimulation with killed bacteria, confirming in vivo observations. Moreover, IL-10 blockade had differential effects in neonates and adults infected with live Listeria. In adult mice, anti-IL-10 Abs decreased bacterial burden early in the course of infection, but were no longer effective at 6 days or later after challenge. In the pups, however, the same treatment had beneficial effects both early and late during infection and resulted in increased survival. Collectively, our data suggest that an overproduction of IL-10 by macrophages may at least partially explain the increased susceptibility of neonates to listeriosis, and provide further evidence that cytokine production is different in adults and neonates.
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Affiliation(s)
- F Genovese
- Istituto di Microbiologia, Università di Messina, Facoltà di Medicina e Chirurgia, Italy
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Abstract
Previous studies have shown an increased mortality in response to endotoxin in 24-hr-old neonatal rats compared with older neonates and adults. This increased susceptibility may be related to increased nitric oxide (NO) and thromboxane (TxB2) production. Twenty-four-hour-old neonatal rat pups were given either N(G)-nitro-L-arginine methyl ester (L-NAME; a nonspecific NO synthase inhibitor), S-methylthioisourea (SMT; a specific NO synthase inhibitor), or molsidomine (a NO donor) subcutaneously prior to or after an LD50 of intracardiac endotoxin. Mortality was followed for 72 hr. There was no statistically significant difference in mortality between control animals and those pretreated with L-NAME, SMT, or molsidomine. A trend toward increased mortality with nonspecific NO synthase inhibition and decreased mortality with the NO donor was noted. Splenic cells were obtained for in vitro cytokine stimulation studies. In vitro adherent splenic cell stimulation studies confirmed an increase in NO production with NO donor pretreatment and decreased production of NO with NO synthase inhibition pretreatment. There was no difference in TxB2 production with either the NO synthase inhibitor or the NO donor. In conclusion, at the several doses employed, neither nonselective or selective NO synthase inhibitors nor NO donors prevented endotoxin-induced mortality in rat neonatal shock. Although these findings do not preclude possible involvement of NO in neonatal pathophysiology, increased NO production thus does not appear to be the primary determinant of the increased susceptibility of the neonatal rat to endotoxic shock.
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Affiliation(s)
- J B Cochran
- Department of Pediatrics, Medical University of South Carolina, Charleston 29425, USA
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Ogura S, Umegaki O, Genovese F, Fernando LP, Cochran JB, Romeo CM, Cook JA. Protective effect of tyrphostin AG-556 on shock induced by endotoxin or gram positive bacteria. Shock 1999; 12:105-10. [PMID: 10446890 DOI: 10.1097/00024382-199908000-00003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The effects of tyrphostin AG-556 (TYR), a tyrosine kinase inhibitor, were evaluated on shock induced by lipopolysaccharide (LPS) or group B streptococcus (GBS) in rats. Mortality and mean survival time were monitored. Plasma 6-keto prostaglandin F1alpha (6-keto PGF1alpha) was also measured at four hours after LPS injection. The effects of TYR on the production of 6-keto PGF1alpha thromboxane B2(TXB2) and nitrite (NO) from LPS or GBS stimulated in vitro peritoneal rat macrophage were also examined. Salmonella enteritidis LPS (12 mg/kg, i.v. ) (n=6) produced severe shock (100% mortality). Simultaneous treatment with TYR (n=6) significantly (p < 0.01) extended mean survival time and 33% of rats survived. Plasma 6-keto PGF1alpha concentrations were increased in LPS controls, whereas TYR (5 mg/kg) significantly (p < 0.05) decreased the production. Animals treated with GBS/D-galactosamine (n=9) also exhibited shock with 100% lethality and TYR again prolonged survival time (p < 0.05) with 55% of the animals surviving. To evaluate direct effects of TYR on mediator production induced by LPS or GBS, rat macrophages were stimulated with heat-killed GBS or LPS with or without TYR. Supernatants were collected at 24 h for determination of TXB2, 6-keto PGF1alpha and NO. All mediators measured were significantly increased (p < 0.05) with LPS or GBS. TYR inhibited (p < 0.05) the production of all mediators from macrophages induced by LPS or GBS. The decrease in eicosanoids was associated with a reduction of the content of cyclooxygenase-2 (COX-2) as determined by western blotting. Collectively, these results suggest that TYR ameliorates toxic shock induced by LPS or gram positive bacteria. This protection is associated with suppression of macrophage mediator production.
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Affiliation(s)
- S Ogura
- Dept. of Anesthesiology and Emergency Medicine, Kagawa Medical University, Kita, Japan
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Cochran JB, Genovese F, Romeo C, Guyton K, Teti G, Cook JA. The effect of a tyrosine kinase inhibitor on endotoxin mortality and splenocyte mediator production in the neonatal rat. Shock 1999; 11:35-8. [PMID: 9921714 DOI: 10.1097/00024382-199901000-00005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Tyrosine kinases mediate cellular signal transduction to endotoxin. A class of tyrosine kinase inhibitors, the tyrphostins, have been shown to protect mice from endotoxin-induced lethality. Neonatal rats and mice have been shown to be uniquely susceptible to lethal endotoxic shock. In our study, the effect of a lipophilic tyrphostin, AG 556, on endotoxin-induced neonatal and adult mortality and in vitro neonatal splenic cell thromboxane (TxB2), tumor necrosis factor-alpha (TNF-alpha), and nitric oxide (NO) production were examined. Neonatal rats (<24 h old) were administered tyrphostin (100 microg subcutaneous) 2 h before an approximate LD50 dose of Salmonella enteritidis endotoxin (.024 mg/kg/intracardiac). There was a significant decrease in mortality in the animals pretreated with 100 microg of tyrphostin (29% mortality in the treated group, n = 41 versus 53% in the vehicle control group, n = 40; p < .05). Also in adult rats tyrphostin (5 mg/kg intraperitoneal) 2 h before endotoxin (10 mg/kg intravenous) significantly improved survival (50% drug treated versus 84% in control, n = 12/group; p < .05). Adherent neonatal splenic cell mediator production of TxB2, TNF-alpha, and NO (measured by nitrite) in tyrphostin pretreated splenic cells were compared with endotoxin-stimulated splenic cells in vitro. The studies (n = 4) demonstrate an increase (p < .05) in the production of TxB2, TNF-alpha, and NO in the endotoxin- (10 microg/mL) stimulated adherent splenic cells compared with basal. Tyrphostin pretreatment (10, 20, 50 microM) produced a dose-dependent decrease (p < .05) in endotoxin-stimulated TxB2 and TNF-alpha production. NO production was not significantly reduced. In conclusion, tryphostin appears to have a protective effect on mortality in both adult and neonatal rat endotoxic shock. Tyrphostin decreased specific mediator production in stimulated neonatal cells. Thus, inhibition of signal transduction pathways of endotoxin activation by tyrosine kinase inhibition may provide an effective approach to treat endotoxic shock in the neonate.
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Affiliation(s)
- J B Cochran
- Department of Pediatrics, Medical University of South Carolina, Charleston 29425, USA
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Faulkner LB, Tucci F, Tamburini A, Tintori V, Lippi AA, Bambi F, Malentacca F, Azzari C, Gelli AM, Genovese F, Bernini G. G-CSF serum pharmacokinetics during peripheral blood progenitor cell mobilization: neutrophil count-adjusted dosage might potentially improve mobilization and be more cost-effective. Bone Marrow Transplant 1998; 21:1091-5. [PMID: 9645570 DOI: 10.1038/sj.bmt.1701241] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The optimal dosing schedule of G-CSF for peripheral blood progenitor cell (PBPC) mobilization is still under investigation although many centers use 10 microg/kg/day in a single subcutaneous dose. However, G-CSF clearance increases with increasing absolute neutrophil count (ANC). Hence a G-CSF dosage adjusted to ANC might be a reasonable approach. We measured G-CSF trough serum levels by sandwich ELISA assay at different ANCs in eight patients undergoing treatment with filgrastim at 10 microg/kg/day in a single subcutaneous dose. A total of 26 samples were analyzed, and a strong correlation between increasing ANC and decreasing G-CSF levels was found by linear regression analysis (P < 0.0003, r2 = 0.4199). For ANC values above 5000/microl the trough serum levels, ie 24 h after administration, were consistently below the level that provides maximal clonogenic precursor stimulation in vitro (10 ng/ml). Serial serum G-CSF measurements performed in three patients at 0, 3, 6, 9 and 24 h after G-CSF administration, showed a reduction of the area under the curve (AUC) with increasing ANC. For an ANC of 20000/microl or greater, the G-CSF serum level fell under the maximal in vitro stimulation threshold of 10 ng/ml within 12 h. This preliminary pharmacokinetic data seems to suggest that an ANC-adjusted G-CSF dosing schedule might improve the design of PBPC mobilization regimens.
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Affiliation(s)
- L B Faulkner
- Department of Pediatrics, University of Florence, Ospedale Pediatrico A Meyer, Italy
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Bambi F, Faulkner LB, Azzari C, Gelli AM, Tamburini A, Tintori V, Lippi AA, Tucci F, Bernini G, Genovese F. Pediatric peripheral blood progenitor cell collection: haemonetics MCS 3P versus COBE Spectra versus Fresenius AS104. Transfusion 1998; 38:70-4. [PMID: 9482397 DOI: 10.1046/j.1537-2995.1998.38198141501.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND An increasing number of apheresis machines are becoming available for peripheral blood progenitor cell (PBPC) collection in children. STUDY DESIGN AND METHODS At the Children's Hospital of Florence (Italy), three apheresis machines were evaluated: MCS 3P (Haemonetics) (10 procedures in 4 patients, aged 10-12 years, weight 23.5-64 kg), Spectra, (COBE) (8 procedures in 3 patients, aged 4-17 years, weight 19-59 kg), and AS104 (Fresenius) (24 procedures in 9 patients, aged 2-16 years, weight 13.6-60 kg). For PBPC quantitative analysis, CD34 cytofluorimetry was employed. Relevant variables analyzed included efficiency of CD34+ cell extraction and enrichment, mononuclear cell purity and red cell contamination of the apheresis components, and platelet count decreases after leukapheresis. RESULTS No significant differences in CD34+ cell-extraction abilities were found. However, the AS104 provided consistently purer leukapheresis components in terms of mononuclear cell and CD34+ cell enrichment (441 +/- 59%, vs. 240 +/- 35% and 290 +/- 42% for MCS 3P and Spectra, respectively). Postapheresis platelet counts dropped the least with the AS104. The smallest patient who underwent apheresis with MCS 3P (the only machine working on discontinuous flow and hence with greater volume shifts) weighed 23.5 kg and tolerated the procedure well, with no signs of hemodynamic instability. No significant complications were observed. CONCLUSION All machines seem to have comparable PBPC extraction efficiency, but the AS104 seems to give the component with the greatest PBPC enrichment. This feature might be relevant for further ex vivo cell processing (CD34+ cell selection, expansion, and so on).
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Affiliation(s)
- F Bambi
- Department of Pediatrics, University of Florence Azienda Ospedale A. Meyer, Italy
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Mancuso G, Cusumano V, Genovese F, Gambuzza M, Beninati C, Teti G. Role of interleukin 12 in experimental neonatal sepsis caused by group B streptococci. Infect Immun 1997; 65:3731-5. [PMID: 9284145 PMCID: PMC175532 DOI: 10.1128/iai.65.9.3731-3735.1997] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Cytokines are suspected to play an important role in systemic infections by group B streptococci (GBS), an important cause of neonatal sepsis. This work was undertaken to determine if interleukin 12 (IL-12) is produced in mouse pups infected with GBS and has a role in this sepsis model. IL-12 elevations were measured by both an enzyme-linked immunosorbent assay and a bioassay in plasma samples obtained from 12 to 72 h after GBS challenge. Pretreatment with neutralizing anti-IL-12 antibodies significantly increased lethality and blood CFU (P < 0.05). Conversely, either prophylactically or therapeutically administered recombinant IL-12 (rIL-12) significantly improved survival time and decreased blood CFU. Since these beneficial effects were associated with increased spleen gamma interferon (IFN-gamma) production, we examined whether the latter cytokine mediated the observed rIL-12 effects. Pretreatment with neutralizing anti-IFN-gamma monoclonal antibodies significantly counteracted the beneficial effects of rIL-12 on lethality. Our data indicate that rIL-12 is a possible candidate for treatment of GBS sepsis and that its activities in this model are at least partially mediated by IFN-gamma.
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Affiliation(s)
- G Mancuso
- Istituto di Microbiologia, Facoltà di Medicina e Chirurgia, Università degli Studi di Messina, Italy
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Cusumano V, Mancuso G, Genovese F, Cuzzola M, Carbone M, Cook JA, Cochran JB, Teti G. Neonatal hypersusceptibility to endotoxin correlates with increased tumor necrosis factor production in mice. J Infect Dis 1997; 176:168-76. [PMID: 9207363 DOI: 10.1086/514019] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Septic shock is a major cause of mortality in neonates. The hypothesis was tested that neonatal age is associated with altered sensitivity to shock-inducing bacterial products or proinflammatory cytokines (or both). Mice of different ages were inoculated with various doses of lipopolysaccharide (LPS), superantigenic staphylococcal enterotoxin B (SEB), or recombinant tumor necrosis factor-alpha (rTNF-alpha), alone or in combination with the sensitizing agent D-galactosamine. Neonatal mice were markedly more susceptible to LPS-induced lethality but more resistant to SEB than were adults (P < .05). Mice of different ages did not differ, however, in their sensitivity to lethal activities of rTNF-alpha. Neonatal susceptibility to LPS and SEB correlated directly with plasma TNF-alpha but not IFN-gamma levels, which was confirmed by TNF-alpha and IFN-gamma blockade experiments. These data document marked age-related differences in the pathophysiology of septic shock and suggest that IFN-gamma is not an obligatory mediator of either LPS- or SEB-induced lethality in neonates.
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Affiliation(s)
- V Cusumano
- Istituto di Microbiologia, Facoltà di Medicina e Chirurgia dell'Universita di Messina, Italy
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Cusumano V, Mancuso G, Genovese F, Delfino D, Beninati C, Losi E, Teti G. Role of gamma interferon in a neonatal mouse model of group B streptococcal disease. Infect Immun 1996; 64:2941-4. [PMID: 8757817 PMCID: PMC174171 DOI: 10.1128/iai.64.8.2941-2944.1996] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The aim of this study was to assess the role of gamma interferon (IFN-gamma) in a neonatal mouse model of group B streptococcal (GBS) sepsis. IFN-gamma was produced by spleen cells at 24, 48, and 72 h after GBS challenge. Treatment with anti-IFN-gamma at 6 h before challenge totally abrogated the IFN-gamma response but did not affect survival. Subcutaneous administration of recombinant IFN-gamma (2,500 IU per pup) at 18 h after challenge resulted in increased survival time and reduced blood colony counts at 48 and 72 h. In vitro preincubation of neonatal whole blood with IFN-gamma before the addition of GBS resulted in significant restriction of bacterial growth. These data indicate that administration of recombinant IFN-gamma can partially restore impaired host defenses against GBS in neonatal mice. This cytokine may be useful for the treatment of neonatal infections.
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Affiliation(s)
- V Cusumano
- Instituto di Microbiologia, Facoltà di Medicina e Chirugia, Universitadegli Studi di Messina, Italy
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Abstract
We investigated the role of interleukin-10 (IL-10) in a neonatal mouse model of lethal group B streptococci (GBS) sepsis. Plasma IL-10 levels significantly increased at 24 and 48 h after GBS inoculation. Neutralization of IL-10 with specific antibodies had no effect on lethality. Administration of recombinant IL-10 at 20 or 4 h before challenge, but not at later times, resulted in decreased tumor necrosis factor alpha levels and improved survival. IL-10 could be potentially useful for the treatment of GBS sepsis.
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Affiliation(s)
- V Cusumano
- Istituto di Microbiologia, Facolta di Medicina e Chirurgia, Universita degli Studi di Messina, Italy
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Genovese F, Mancuso G, Cuzzola M, Cusumano V, Nicoletti F, Bendtzen K, Teti G. Improved survival and antagonistic effect of sodium fusidate on tumor necrosis factor alpha in a neonatal mouse model of endotoxin shock. Antimicrob Agents Chemother 1996; 40:1733-5. [PMID: 8807074 PMCID: PMC163407 DOI: 10.1128/aac.40.7.1733] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Unlike the antibiotics erythromycin and penicillin G, sodium fusidate (fusidin) pretreatment (80 mg/kg of body weight) increased the survival rate of neonatal BALB/c mice challenged with Salmonella enteritidis lipopolysaccharide. Fusidin also significantly reduced the plasma tumor necrosis factor alpha levels. Hence, fusidin may prove useful in the management of bacterial sepsis in humans.
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Affiliation(s)
- F Genovese
- Institute of Microbiology, University of Messina, Italy
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Mancuso G, Blandino G, Gambuzza M, Genovese F, Migliardo M, Carbone M, Fera MT, Cusumano V. Beneficial effects of pentoxifylline in neonatal rats infected with group B streptococci. J Chemother 1995; 7:417-9. [PMID: 8596123 DOI: 10.1179/joc.1995.7.5.417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Previous studies have indicated that tumor necrosis factor-alpha (TNF-alpha) may play a pathophysiologic role in experimental sepsis by group B streptococci (GBS). We tested the efficacy of some TNF-alpha and eicosanoid inhibitors in a neonatal rat model of GBS disease. The drugs tested included cloricromene, SKF86002, pentoxifylline, CGS8515, ibuprofen and LY203647. None of these compounds were protective against GBS infection, with the exception of pentoxifylline, that produced a moderate enhancement of survival time. Further studies are needed to ascertain if specific inhibitors of TNF-alpha, alone or in conjunction with antibiotics, may be effective as therapeutic agents in neonatal GBS sepsis.
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Affiliation(s)
- G Mancuso
- Institute of Microbiology, University of Messina, Italy
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Genovese F, Mancuso G, Cusumano V, Cook JA, Cochran J, Teti G. EFFECTS OF RECOMBINANT IL-10 IN A NEONATAL MOUSE MODEL OF GROUP B STREPTOCOCCAL SEPSIS. Shock 1995. [DOI: 10.1097/00024382-199506000-00201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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