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Maiorca F, Lombardi L, Marrapodi R, Pallucci D, Sabetta A, Zingaropoli MA, Perri V, Flego D, Romiti GF, Corica B, Miglionico M, Russo G, Pasculli P, Ciardi MR, Mastroianni CM, Ruberto F, Pugliese F, Pulcinelli F, Raparelli V, Cangemi R, Visentini M, Basili S, Stefanini L. Breakthrough infections after COVID-19 vaccinations do not elicit platelet hyperactivation and are associated with high platelet-lymphocyte and low platelet-neutrophil aggregates. Res Pract Thromb Haemost 2023; 7:102262. [PMID: 38193050 PMCID: PMC10772876 DOI: 10.1016/j.rpth.2023.102262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 10/25/2023] [Accepted: 10/29/2023] [Indexed: 01/10/2024] Open
Abstract
Background Severe COVID-19 is associated with an excessive immunothrombotic response and thromboinflammatory complications. Vaccinations effectively reduce the risk of severe clinical outcomes in patients with COVID-19, but their impact on platelet activation and immunothrombosis during breakthrough infections is not known. Objectives To investigate how preemptive vaccinations modify the platelet-immune crosstalk during COVID-19 infections. Methods Cross-sectional flow cytometry study of the phenotype and interactions of platelets circulating in vaccinated (n = 21) and unvaccinated patients with COVID-19, either admitted to the intensive care unit (ICU, n = 36) or not (non-ICU, n = 38), in comparison to matched SARS-CoV-2-negative patients (n = 48), was performed. Results In the circulation of unvaccinated non-ICU patients with COVID-19, we detected hyperactive and hyperresponsive platelets and platelet aggregates with adaptive and innate immune cells. In unvaccinated ICU patients with COVID-19, most of whom had severe acute respiratory distress syndrome, platelets had high P-selectin and phosphatidylserine exposure but low capacity to activate integrin αIIbβ3, dysfunctional mitochondria, and reduced surface glycoproteins. In addition, in the circulation of ICU patients, we detected microthrombi and platelet aggregates with innate, but not with adaptive, immune cells. In vaccinated patients with COVID-19, who had no acute respiratory distress syndrome, platelets had surface receptor levels comparable to those in controls and did not form microthrombi or platelet-granulocyte aggregates but aggregated avidly with adaptive immune cells. Conclusion Our study provides evidence that vaccinated patients with COVID-19 are not associated with platelet hyperactivation and are characterized by platelet-leukocyte aggregates that foster immune protection but not excessive immunothrombosis. These findings advocate for the importance of vaccination in preventing severe COVID-19.
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Affiliation(s)
- Francesca Maiorca
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Ludovica Lombardi
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Ramona Marrapodi
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Davide Pallucci
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Annamaria Sabetta
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | | | - Valentina Perri
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Davide Flego
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Giulio Francesco Romiti
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Bernadette Corica
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Marzia Miglionico
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Gianluca Russo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Patrizia Pasculli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Maria Rosa Ciardi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Claudio M. Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Franco Ruberto
- Department of Specialist Surgery and Organ Transplantation “Paride Stefanini,” Sapienza University of Rome, Rome, Italy
| | - Francesco Pugliese
- Department of Specialist Surgery and Organ Transplantation “Paride Stefanini,” Sapienza University of Rome, Rome, Italy
| | - Fabio Pulcinelli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Valeria Raparelli
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
- University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Roberto Cangemi
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Marcella Visentini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Stefania Basili
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Lucia Stefanini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
- Istituto Pasteur Italia—Fondazione Cenci Bolognetti, Rome, Italy
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Raparelli V, Romiti GF, Di Teodoro G, Seccia R, Tanzilli G, Viceconte N, Marrapodi R, Flego D, Corica B, Cangemi R, Pilote L, Basili S, Proietti M, Palagi L, Stefanini L. A machine-learning based bio-psycho-social model for the prediction of non-obstructive and obstructive coronary artery disease. Clin Res Cardiol 2023; 112:1263-1277. [PMID: 37004526 PMCID: PMC10449670 DOI: 10.1007/s00392-023-02193-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/24/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND Mechanisms of myocardial ischemia in obstructive and non-obstructive coronary artery disease (CAD), and the interplay between clinical, functional, biological and psycho-social features, are still far to be fully elucidated. OBJECTIVES To develop a machine-learning (ML) model for the supervised prediction of obstructive versus non-obstructive CAD. METHODS From the EVA study, we analysed adults hospitalized for IHD undergoing conventional coronary angiography (CCA). Non-obstructive CAD was defined by a stenosis < 50% in one or more vessels. Baseline clinical and psycho-socio-cultural characteristics were used for computing a Rockwood and Mitnitski frailty index, and a gender score according to GENESIS-PRAXY methodology. Serum concentration of inflammatory cytokines was measured with a multiplex flow cytometry assay. Through an XGBoost classifier combined with an explainable artificial intelligence tool (SHAP), we identified the most influential features in discriminating obstructive versus non-obstructive CAD. RESULTS Among the overall EVA cohort (n = 509), 311 individuals (mean age 67 ± 11 years, 38% females; 67% obstructive CAD) with complete data were analysed. The ML-based model (83% accuracy and 87% precision) showed that while obstructive CAD was associated with higher frailty index, older age and a cytokine signature characterized by IL-1β, IL-12p70 and IL-33, non-obstructive CAD was associated with a higher gender score (i.e., social characteristics traditionally ascribed to women) and with a cytokine signature characterized by IL-18, IL-8, IL-23. CONCLUSIONS Integrating clinical, biological, and psycho-social features, we have optimized a sex- and gender-unbiased model that discriminates obstructive and non-obstructive CAD. Further mechanistic studies will shed light on the biological plausibility of these associations. CLINICAL TRIAL REGISTRATION NCT02737982.
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Affiliation(s)
- Valeria Raparelli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
- Department of Translational Medicine, University of Ferrara, Via Luigi Borsari, 46, 44121, Ferrara, Italy.
- Faculty of Nursing, University of Alberta, Edmonton, Canada.
- University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy.
| | - Giulio Francesco Romiti
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Giulia Di Teodoro
- Department of Computer Control and Management Engineering Antonio Ruberti, Sapienza University of Rome, Rome, Italy
| | - Ruggiero Seccia
- Department of Computer Control and Management Engineering Antonio Ruberti, Sapienza University of Rome, Rome, Italy
| | - Gaetano Tanzilli
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Nicola Viceconte
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Ramona Marrapodi
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Davide Flego
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Bernadette Corica
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Roberto Cangemi
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Louise Pilote
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC, Canada
- Divisions of Clinical Epidemiology and General Internal Medicine, McGill University Health Centre Research Institute, Montreal, QC, Canada
| | - Stefania Basili
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Marco Proietti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK
- Division of Subacute Care, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Laura Palagi
- Department of Computer Control and Management Engineering Antonio Ruberti, Sapienza University of Rome, Rome, Italy
| | - Lucia Stefanini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
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Cangemi R, Miglionico M, D'Amico T, Fasano S, Proietti M, Romiti GF, Corica B, Stefanini L, Tanzilli G, Basili S, Raparelli V, Tarsitano MG, Eva Collaborative Group. Adherence to the Mediterranean Diet in Preventing Major Cardiovascular Events in Patients with Ischemic Heart Disease: The EVA Study. Nutrients 2023; 15:3150. [PMID: 37513570 PMCID: PMC10386039 DOI: 10.3390/nu15143150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/13/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Adherence to healthy dietary patterns, such as the Mediterranean diet (Med-diet), is recommended for the maintenance of cardiovascular health. The determinants for adherence to Med-diet and its importance in secondary cardiovascular disease prevention are still unclear. The aim of the study was to evaluate the influence of sex- and psycho-socio-cultural (i.e., gender-related) factors on Med-diet adherence and its role in preventing major cardiovascular events (MACEs) in patients with ischemic heart disease (IHD). METHODS Med-diet adherence was evaluated among 503 consecutive adults with IHD. MACEs were collected during a long-term follow-up. RESULTS Male Bem Sex-Role Inventory score (i.e., male personality traits) and physical functional capacity were associated with higher adherence, while cohabitation with a smoker and physical inactivity with poorer adherence. During a median follow-up of 22 months, 48 participants experienced MACEs (17.5%, 8.1%, and 3.9% of patients with low, medium, and high adherence, respectively; p = 0.016). At multivariate Cox--regression analysis, a greater adherence remained inversely associated with MACEs (HR: 0.49; 95% CI: 0.29-0.82; p = 0.006) after adjusting for confounding factors. CONCLUSION The study suggests that gender-related factors have a role in maintaining a healthy dietary pattern. Improving Med-diet adherence may lower the risk of recurring cardiovascular events.
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Affiliation(s)
- Roberto Cangemi
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Marzia Miglionico
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Tania D'Amico
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Salvatore Fasano
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Marco Proietti
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Division of Subacute Care, IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy
| | - Giulio Francesco Romiti
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Bernadette Corica
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Lucia Stefanini
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Gaetano Tanzilli
- Department of Internal Medicine, Anesthesiologic and Cardiovascular Sciences, University Sapienza, 00161 Rome, Italy
| | - Stefania Basili
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Valeria Raparelli
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
- University Center for Studies on Gender Medicine, University of Ferrara, 44121 Ferrara, Italy
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Maria Grazia Tarsitano
- Department of Medical and Surgical Sciences, Magna Graecia University, 88100 Catanzaro, Italy
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Lombardi L, Maiorca F, Marrapodi R, Sabetta A, Scafa N, Pallucci D, Miglionico M, Romiti GF, Corica B, Piconese S, Polimeni A, Pulcinelli F, Cangemi R, Visentini M, Basili S, Stefanini L. Distinct platelet crosstalk with adaptive and innate immune cells after adenoviral and mRNA vaccination against SARS-CoV-2. J Thromb Haemost 2023; 21:1636-1649. [PMID: 36918114 PMCID: PMC10008173 DOI: 10.1016/j.jtha.2023.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 12/11/2022] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Genetic-based COVID-19 vaccines have proved highly effective in reducing the risk of hospitalization and death. As they were first distributed on a large-scale population, adenoviral-based vaccines were linked to a very rare thrombosis with thrombocytopenia syndrome and the interplay between platelets and vaccinations increasingly gained attention. OBJECTIVE To study the crosstalk between platelets and the vaccine-induced immune response. METHODS We prospectively enrolled young healthy volunteers who received the mRNA-based vaccine, BNT162b2 (n=15), or the adenovirus-based vaccine, AZD1222 (n=25) and studied their short-term platelet and immune response before and after vaccine injections. In a separate cohort, we retrospectively analysed the effect of aspirin on the antibody response 1 and 5 months after BNT162b2 vaccination. RESULTS Here we show that a faster antibody response to either vaccine is associated to the formation of platelet aggregates with marginal zone-like B-cells, a subset geared to bridge the temporal gap between innate and adaptive immunity. However, while the mRNA-based vaccine is associated with a more gradual and tolerogenic response that fosters the crosstalk between platelets and adaptive immunity, the adenovirus-based vaccine, the less immunogenic of the two, evokes an antiviral-like response during which platelets are cleared and less likely to cooperate with B-cells. Moreover, subjects taking aspirin (n=56) display lower antibody levels after BNT162b2 vaccination compared to matched individuals. CONCLUSIONS Platelets are a component of the innate immune pathways that promote the B-cell response after vaccination. Future studies on the platelet-immune crosstalk post-immunization will improve safety, efficacy, and strategic administration of next-generation vaccines.
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Affiliation(s)
- Ludovica Lombardi
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Francesca Maiorca
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Ramona Marrapodi
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Annamaria Sabetta
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Noemi Scafa
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Davide Pallucci
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Marzia Miglionico
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Giulio F Romiti
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Bernadette Corica
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Silvia Piconese
- Department of Internal Clinical Sciences, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Antonella Polimeni
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Rome, Italy
| | - Fabio Pulcinelli
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Roberto Cangemi
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Marcella Visentini
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Stefania Basili
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Lucia Stefanini
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy; Istituto Pasteur Italia - Fondazione Cenci Bolognetti, Rome, Italy.
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Del Padre M, Marrapodi R, Minafò YA, Piano Mortari E, Radicchio G, Bocci C, Gragnani L, Camponeschi A, Colantuono S, Stefanini L, Basili S, Carsetti R, Fiorilli M, Casato M, Visentini M. Dual stimulation by autoantigen and CpG fosters the proliferation of exhausted rheumatoid factor-specific CD21 low B cells in hepatitis C virus-cured mixed cryoglobulinemia. Front Immunol 2023; 14:1094871. [PMID: 36845129 PMCID: PMC9945227 DOI: 10.3389/fimmu.2023.1094871] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/20/2023] [Indexed: 02/10/2023] Open
Abstract
Introduction Hepatitis C virus (HCV) causes mixed cryoglobulinemia (MC) by driving clonal expansion of B cells expressing B cell receptors (BCRs), often encoded by the VH1-69 variable gene, endowed with both rheumatoid factor (RF) and anti-HCV specificity. These cells display an atypical CD21low phenotype and functional exhaustion evidenced by unresponsiveness to BCR and Toll-like receptor 9 (TLR9) stimuli. Although antiviral therapy is effective on MC vasculitis, pathogenic B cell clones persist long thereafter and can cause virus-independent disease relapses. Methods Clonal B cells from patients with HCV-associated type 2 MC or healthy donors were stimulated with CpG or heath-aggregated IgG (as surrogate immune complexes) alone or in combination; proliferation and differentiation were then evaluated by flow cytometry. Phosphorylation of AKT and of the p65 NF-kB subunit were measured by flow cytometry. TLR9 was quantified by qPCR and by intracellular flow cytometry, and MyD88 isoforms were analyzed using RT-PCR. Discussion We found that dual triggering with autoantigen and CpG restored the capacity of exhausted VH1-69pos B cells to proliferate. The signaling mechanism for this BCR/TLR9 crosstalk remains elusive, since TLR9 mRNA and protein as well as MyD88 mRNA were normally expressed and CpG-induced phosphorylation of p65 NF-kB was intact in MC clonal B cells, whereas BCR-induced p65 NF-kB phosphorylation was impaired and PI3K/Akt signaling was intact. Our findings indicate that autoantigen and CpG of microbial or cellular origin may unite to foster persistence of pathogenic RF B cells in HCV-cured MC patients. BCR/TLR9 crosstalk might represent a more general mechanism enhancing systemic autoimmunity by the rescue of exhausted autoreactive CD21low B cells.
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Affiliation(s)
- Martina Del Padre
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Ramona Marrapodi
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Ylenia A. Minafò
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Eva Piano Mortari
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
- B cell unit, Immunology Research Area, IRCCS Bambino Gesù Children’s Hospital, Rome, Italy
| | - Giovanna Radicchio
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Chiara Bocci
- B cell unit, Immunology Research Area, IRCCS Bambino Gesù Children’s Hospital, Rome, Italy
| | - Laura Gragnani
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Alessandro Camponeschi
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Stefania Colantuono
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Lucia Stefanini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Stefania Basili
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Rita Carsetti
- B cell unit, Immunology Research Area, IRCCS Bambino Gesù Children’s Hospital, Rome, Italy
| | - Massimo Fiorilli
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Milvia Casato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Marcella Visentini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
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Stefanini L, Ruberto F, Curreli M, Chistolini A, Schiera E, Marrapodi R, Visentini M, Ceccarelli G, D'Ettorre G, Santoro C, Gandini O, Moro EF, Zullino V, Pugliese F, Pulcinelli FM. Increased von Willebrand Factor Platelet-Binding Capacity Is Related to Poor Prognosis in COVID-19 Patients. Thromb Haemost 2023; 123:118-122. [PMID: 36252812 PMCID: PMC9831687 DOI: 10.1055/a-1962-5447] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Lucia Stefanini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Franco Ruberto
- Department of General Surgery, Surgical Specialties and Organ Transplantation “Paride Stefanini” Sapienza University of Rome, Rome, Italy
| | | | - Antonio Chistolini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Eleonora Schiera
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Ramona Marrapodi
- Department of General Surgery, Surgical Specialties and Organ Transplantation “Paride Stefanini” Sapienza University of Rome, Rome, Italy
| | - Marcella Visentini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Gabriella D'Ettorre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Cristina Santoro
- Department of Hematology, University Hospital Policlinico Umberto I, Rome, Italy
| | - Orietta Gandini
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Emilia F. Moro
- Department of General Surgery, Surgical Specialties and Organ Transplantation “Paride Stefanini” Sapienza University of Rome, Rome, Italy
| | - Veronica Zullino
- Department of General Surgery, Surgical Specialties and Organ Transplantation “Paride Stefanini” Sapienza University of Rome, Rome, Italy
| | - Francesco Pugliese
- Department of General Surgery, Surgical Specialties and Organ Transplantation “Paride Stefanini” Sapienza University of Rome, Rome, Italy
| | - Fabio M. Pulcinelli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy,Address for correspondence Fabio M. Pulcinelli, MD Department of Experimental Medicine, Sapienza University of RomeRome 00191Italy
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7
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Degjoni A, Campolo F, Stefanini L, Venneri MA. The NO/cGMP/PKG pathway in platelets: The therapeutic potential of PDE5 inhibitors in platelet disorders. J Thromb Haemost 2022; 20:2465-2474. [PMID: 35950928 PMCID: PMC9805178 DOI: 10.1111/jth.15844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/01/2022] [Accepted: 08/08/2022] [Indexed: 01/09/2023]
Abstract
Platelets are the "guardians" of the blood circulatory system. At sites of vessel injury, they ensure hemostasis and promote immunity and vessel repair. However, their uncontrolled activation is one of the main drivers of thrombosis. To keep circulating platelets in a quiescent state, the endothelium releases platelet antagonists including nitric oxide (NO) that acts by stimulating the intracellular receptor guanylyl cyclase (GC). The latter produces the second messenger cyclic guanosine-3',5'-monophosphate (cGMP) that inhibits platelet activation by stimulating protein kinase G, which phosphorylates hundreds of intracellular targets. Intracellular cGMP pools are tightly regulated by a fine balance between GC and phosphodiesterases (PDEs) that are responsible for the hydrolysis of cyclic nucleotides. Phosphodiesterase type 5 (PDE5) is a cGMP-specific PDE, broadly expressed in most tissues in humans and rodents. In clinical practice, PDE5 inhibitors (PDE5i) are used as first-line therapy for erectile dysfunction, pulmonary artery hypertension, and lower urinary tract symptoms. However, several studies have shown that PDE5i may ameliorate the outcome of various other conditions, like heart failure and stroke. Interestingly, NO donors and cGMP analogs increase the capacity of anti-platelet drugs targeting the purinergic receptor type Y, subtype 12 (P2Y12) receptor to block platelet aggregation, and preclinical studies have shown that PDE5i inhibits platelet functions. This review summarizes the molecular mechanisms underlying the effect of PDE5i on platelet activation and aggregation focusing on the therapeutic potential of PDE5i in platelet disorders, and the outcomes of a combined therapy with PDE5i and NO donors to inhibit platelet activation.
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Affiliation(s)
- Anisa Degjoni
- Department of Experimental MedicineSapienza University of RomeRomeItaly
| | - Federica Campolo
- Department of Experimental MedicineSapienza University of RomeRomeItaly
| | - Lucia Stefanini
- Department of Translational and Precision MedicineSapienza University of RomeRomeItaly
| | - Mary Anna Venneri
- Department of Experimental MedicineSapienza University of RomeRomeItaly
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8
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Abstract
Platelets are multifunctional cells that ensure the integrity of the vascular wall and modulate the immune response at the blood/vascular interface. Their pathological activation results in both thrombosis and inflammation and implicates them in the pathogenesis of vascular disease. Vascular diseases are sexually dimorphic in terms of incidence, clinical presentation, outcome, and efficacy of anti-platelet therapy. We here provide an overview of what is known about the role of platelets in the initiation and progression of vascular diseases and summarize what is known about the sex differences in platelet reactivity and in the thromboinflammatory mechanisms that drive these diseases, with a particular focus on atherosclerosis, obstructive and non-obstructive coronary artery disease, and ischemic stroke. Understanding the sex differences at the platelet-vascular interface is clinically relevant as it will enable: (1) to design new therapeutic strategies that prevent the detrimental effects of the immune-modulatory function of platelets taking sex into account, and (2) to evaluate if sex-specific anti-platelet drug regimens should be used to reduce the risk not only of thrombosis but also of vascular disease progression.
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Affiliation(s)
- Annamaria Sabetta
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell'Università, 37, 00185, Rome, Italy
| | - Ludovica Lombardi
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell'Università, 37, 00185, Rome, Italy
| | - Lucia Stefanini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell'Università, 37, 00185, Rome, Italy.
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9
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Raparelli V, Nocella C, Proietti M, Romiti GF, Corica B, Bartimoccia S, Stefanini L, Lenzi A, Viceconte N, Tanzilli G, Cammisotto V, Pilote L, Cangemi R, Basili S, Carnevale R. Testosterone-to-estradiol ratio and platelet thromboxane release in ischemic heart disease: the EVA project. J Endocrinol Invest 2022; 45:1367-1377. [PMID: 35262860 PMCID: PMC9184432 DOI: 10.1007/s40618-022-01771-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 02/16/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Data on the interplay between sexual hormones balance, platelet function and clinical outcomes of adults with ischemic heart disease (IHD) are still lacking. OBJECTIVE To assess the association between the Testosterone (T)-to-Estradiol (E2) Ratio (T/E2) and platelet activation biomarkers in IHD and its predictive value on adverse outcomes. METHODS The EVA study is a prospective observational study of consecutive hospitalized adults with IHD undergoing coronary angiography and/or percutaneous coronary interventions. Serum T/E2 ratios E2, levels of thromboxane B2 (TxB2) and nitrates (NO), were measured at admission and major adverse events, including all-cause mortality, were collected during a long-term follow-up. RESULTS Among 509 adults with IHD (mean age 67 ± 11 years, 30% females), males were older with a more adverse cluster of cardiovascular risk factors than females. Acute coronary syndrome and non-obstructive coronary artery disease were more prevalent in females versus males. The lower sex-specific T/E2 ratios identified adults with the highest level of serum TxB2 and the lowest NO levels. During a median follow-up of 23.7 months, the lower sex-specific T/E2 was associated with higher all-cause mortality (HR 3.49; 95% CI 1.24-9.80; p = 0.018). In in vitro, platelets incubated with T/E2 ratios comparable to those measured in vivo in the lowest quartile showed increased platelet activation as indicated by higher levels of aggregation and TxB2 production. CONCLUSION Among adults with IHD, higher T/E2 ratio was associated with a lower long-term risk of fatal events. The effect of sex hormones on the platelet thromboxane release may partially explain such finding.
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Affiliation(s)
- V Raparelli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada.
- Department of Translational Medicine, University of Ferrara, via Luigi Borsari, 46, 44121, Ferrara, Italy.
- University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy.
| | - C Nocella
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - M Proietti
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK
| | - G F Romiti
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - B Corica
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - S Bartimoccia
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - L Stefanini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - A Lenzi
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - N Viceconte
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - G Tanzilli
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - V Cammisotto
- Department of General Surgery and Surgical Speciality Paride Stefanini, Sapienza University of Rome, Rome, Italy
| | - L Pilote
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC, Canada
| | - R Cangemi
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - S Basili
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - R Carnevale
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
- Mediterranea Cardiocentro-Napoli, Naples, Italy
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10
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La Gualana F, Villani F, Cusano G, Gragnani L, Stefanini L, Santini S, Basili S, Casato M, Fiorilli M, Visentini M. AB1169 IMMUNOMODULATORY EFFECTS OF SARS-CoV-2 VACCINATION: INCREASE OF REGULATORY T CELLS AFTER mRNA VACCINE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4636] [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
BackgroundBesides the ability to induce antigen-specific responses, vaccines can be endowed with immunomodulatory properties including the capacity to induce or downregulate regulatory T cells (Treg) that suppress adaptative and autoreactive immune responses (1).ObjectivesWe asked if an anti-SARS-CoV-2 mRNA vaccine could also induce an accumulation of Treg cells in patients with mixed cryoglobulinemia vasculitis (MCV), who have a deficiency of Treg cells (2) and in healthy individuals. We also investigated immunologic variables possibly associated with a low immunogenicity of SARS-CoV-2 mRNA vaccine in patients with MCV (3).MethodsWe analyzed peripheral blood lymphocyte subpopulations and anti-SARS-CoV-2 serological response in 24 patients with MCV and 9 Healthy donors (HD) before and after 2 weeks after the second dose of the Pfizer/BioNTech vaccine.ResultsAmong MCV patients we found 15 serological responders and 9 non-responders. All 5 seronegative patients treated recently with rituximab had <5 B cells/µL, whereas the absolute B cell count was increased in 2 of 4 untreated patients due to monoclonal B cell lymphocytosis, with monoclonal cells representing more than 90% of B cells, associated with non-Hodgkin lymphoma. The percentage of pathologic CD21low B cells was significantly increased in seronegative patients.Before receiving the Pfizer/BioNTech vaccine, patients with MCV had a significantly reduced frequency of Treg cells among CD4+ T cells compared to HD. After the second dose of the vaccine, there was in MCV patients a significant increase in the percent and absolute count of Treg among CD4+ T cellsConcerning the pre-vaccination distribution of T cells subpopulations, including the percentages and absolute counts of total CD3+, CD4+, CD8+, HLA-DR+ activated, Treg or CD56+ natural killer T cells, we could not reveal any pattern significantly associated with lack of serological response to vaccine.ConclusionOur findings show that lack of immunoreactivity in patients with MCV may be associated with expansion of pathologic B cells and that anti-SARS-CoV2 mRNA vaccine may induce an increase of Treg cells.References[1]Krienke C. et al. A noninflammatory mRNA vaccine for treatment of experimental autoimmune encephalomyelitis. Science. 2021 Jan 8;371(6525):145-153.[2]Boyer O. et al. CD4+CD25+ regulatory T-cell deficiency in patients with hepatitis C-mixed cryoglobulinemia vasculitis. Blood. 2004 May 1;103(9):3428-30.[3]Visentini M. et al. Flares of mixed cryoglobulinaemia vasculitis after vaccination against SARS-CoV-2. Ann Rheum Dis. 2021 Nov 24:annrheumdis-2021-221248.Disclosure of InterestsNone declared
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11
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Flego D, Cesaroni S, Romiti GF, Corica B, Marrapodi R, Scafa N, Maiorca F, Lombardi L, Pallucci D, Pulcinelli F, Raparelli V, Visentini M, Cangemi R, Piconese S, Alvaro D, Polimeni A, Basili S, Stefanini L. Platelet and immune signature associated with a rapid response to the BNT162b2 mRNA COVID-19 vaccine. J Thromb Haemost 2022; 20:961-974. [PMID: 35032087 PMCID: PMC9302646 DOI: 10.1111/jth.15648] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 01/03/2022] [Accepted: 01/07/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND A rapid immune response is critical to ensure effective protection against COVID-19. Platelets are first-line sentinels of the vascular system able to rapidly alert and stimulate the immune system. However, their role in the immune response to vaccines is not known. OBJECTIVE To identify features of the platelet-immune crosstalk that would provide an early readout of vaccine efficacy in adults who received the mRNA-based COVID-19 vaccine (BNT162b2). METHODS We prospectively enrolled 11 young healthy volunteers (54% females, median age: 28 years) who received two doses of BNT162b2, 21 days apart, and we studied their platelet and immune response before and after each dose of the vaccine (3 and 10 ± 2 days post-injection), in relation to the kinetics of the humoral response. RESULTS Participants achieving an effective level of neutralizing antibodies before the second dose of the vaccine (fast responders) had a higher leukocyte count, mounted a rapid cytokine response that incremented further after the second dose, and an elevated platelet turnover that ensured platelet count stability. Their circulating platelets were not more reactive but expressed lower surface levels of the immunoreceptor tyrosine-based inhibitory motif (ITIM)-coupled receptor CD31 (PECAM-1) compared to slow responders, and formed specific platelet-leukocyte aggregates, with B cells, just 3 days after the first dose, and with non-classical monocytes and eosinophils. CONCLUSION We identified features of the platelet-immune crosstalk that are associated with the development of a rapid humoral response to an mRNA-based vaccine (BNT162b2) and that could be exploited as early biomarkers of vaccine efficacy.
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Affiliation(s)
- Davide Flego
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Simone Cesaroni
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Giulio F Romiti
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Bernadette Corica
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Ramona Marrapodi
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Noemi Scafa
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Francesca Maiorca
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Ludovica Lombardi
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Davide Pallucci
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Fabio Pulcinelli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Valeria Raparelli
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Marcella Visentini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Roberto Cangemi
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Silvia Piconese
- Department of Internal Clinical Sciences, Anaesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Domenico Alvaro
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Antonella Polimeni
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Rome, Italy
| | - Stefania Basili
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Lucia Stefanini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
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12
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De Michele M, Piscopo P, Crestini A, Rivabene R, D'Amati G, Leopizzi M, Stefanini L, Pulcinelli F, Chistolini A, Iacobucci M, Schiavo OG, Berto I, Nicolini E, Petraglia L, Di Mascio MT, Toni D. Vaccine-induced immune thrombotic thrombocytopenia: a possible pathogenetic role of ChAdOx1 nCoV-19 vaccine encoded soluble SARS-CoV-2 spike protein. Haematologica 2022; 107:1687-1692. [PMID: 35172564 PMCID: PMC9244820 DOI: 10.3324/haematol.2021.280180] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Indexed: 11/21/2022] Open
Affiliation(s)
| | - Paola Piscopo
- Department of Neuroscience, Istituto Superiore di sanità, Viale Regina Elena, 299
| | - Alessio Crestini
- Department of Neuroscience, Istituto Superiore di sanità, Viale Regina Elena, 299
| | - Roberto Rivabene
- Department of Neuroscience, Istituto Superiore di sanità, Viale Regina Elena, 299
| | - Giulia D'Amati
- Department of Radiology, Oncology and Pathological Science, Sapienza University of Rome, Rome
| | - Martina Leopizzi
- Department of Medico-surgical sciences and Biotechnologies, Sapienza University of Rome, Latin
| | - Lucia Stefanini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome
| | - Fabio Pulcinelli
- Department of Experimental Medicine, Sapienza University of Rome, Rome
| | - Antonio Chistolini
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Rome
| | - Marta Iacobucci
- Neuroradiology Unit, Department of Human Neurosciences, Sapienza University of Rome, Rome
| | - Oscar G Schiavo
- Emergency Department, Stroke Unit, Sapienza University of Rome, Rome
| | - Irene Berto
- Department of Human Neurosciences, Sapienza University of Rome, Rome
| | - Ettore Nicolini
- Emergency Department, Stroke Unit, Sapienza University of Rome, Rome
| | - Luca Petraglia
- Emergency Department, Stroke Unit, Sapienza University of Rome, Rome
| | | | - Danilo Toni
- Department of Human Neurosciences, Sapienza University of Rome, Rome
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13
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Vinci R, Pedicino D, Bonanni A, d'Aiello A, Pisano E, Ponzo M, Severino A, Ciampi P, Canonico F, Russo G, Di Sario M, Vergallo R, Filomia S, Montone RA, Flego D, Stefanini L, Piacentini R, Conte C, Cribari F, Massetti M, Crea F, Liuzzo G. Monocyte-Platelet Aggregates Triggered by CD31 Molecule in Non-ST Elevation Myocardial Infarction: Clinical Implications in Plaque Rupture. Front Cardiovasc Med 2022; 8:741221. [PMID: 35146002 PMCID: PMC8821091 DOI: 10.3389/fcvm.2021.741221] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Abstract
Despite the recent innovations in cardiovascular care, atherothrombosis is still a major complication of acute coronary syndromes (ACS). We evaluated the involvement of the CD31 molecule in thrombotic risk through the formation of monocyte-platelet (Mo-Plt) aggregates in patients with ACS with no-ST-segment elevation myocardial infarction (NSTEMI) on top of dual anti-platelet therapy (DAPT). We enrolled 19 control (CTRL) subjects, 46 stable angina (SA), and 86 patients with NSTEMI, of which, 16 with Intact Fibrous Cap (IFC) and 19 with Ruptured Fibrous Cap (RFC) as assessed by the Optical Coherence Tomography (OCT). The expression of CD31 on monocytes and platelets was measured. Following the coronary angiography, 52 NSTEMIs were further stratified according to thrombus grade (TG) evaluation. Finally, a series of ex vivo experiments verified whether the CD31 participates in Mo-Plt aggregate formation. In patients with NSTEMI, CD31 was reduced on monocytes and was increased on platelets, especially in NSTEMI presented with RFC plaques compared to those with IFC lesions, and in patients with high TG compared to those with zero/low TG. Ex vivo experiments documented an increase in Mo-Plt aggregates among NSTEMI, which significantly decreased after the CD31 ligation, particularly in patients with RFC plaques. In NSTEMI, CD31 participates in Mo-Plt aggregate formation in spite of optimal therapy and DAPT, suggesting the existence of alternative thrombotic pathways, as predominantly displayed in patients with RFC.
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Affiliation(s)
- Ramona Vinci
- Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Daniela Pedicino
- Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- *Correspondence: Daniela Pedicino
| | - Alice Bonanni
- Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alessia d'Aiello
- Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Eugenia Pisano
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Myriana Ponzo
- Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Anna Severino
- Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Pellegrino Ciampi
- Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Canonico
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giulio Russo
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Marianna Di Sario
- Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Rocco Vergallo
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Simone Filomia
- Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Rocco Antonio Montone
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Davide Flego
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Lucia Stefanini
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Roberto Piacentini
- Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Cristina Conte
- Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Cribari
- Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Massimo Massetti
- Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Filippo Crea
- Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giovanna Liuzzo
- Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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14
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De Michele M, Lorenzano S, Piscopo P, Rivabene R, Crestini A, Chistolini A, Stefanini L, Pulcinelli FM, Berto I, Campagna R, Amisano P, Iacobucci M, Cirelli C, Falcou A, Nicolini E, Schiavo OG, Toni D. SARS-CoV-2 infection predicts larger infarct volume in patients with acute ischemic stroke. Front Cardiovasc Med 2022; 9:1097229. [PMID: 36704480 PMCID: PMC9871539 DOI: 10.3389/fcvm.2022.1097229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 12/20/2022] [Indexed: 01/11/2023] Open
Abstract
Background and purpose Acute ischemic stroke (AIS) is a fearful complication of Coronavirus Disease-2019 (COVID-19). Aims of this study were to compare clinical/radiological characteristics, endothelial and coagulation dysfunction between acute ischemic stroke (AIS) patients with and without COVID-19 and to investigate if and how the SARS-CoV-2 spike protein (SP) was implicated in triggering platelet activation. Methods We enrolled AIS patients with COVID-19 within 12 h from onset and compared them with an age- and sex-matched cohort of AIS controls without COVID-19. Neuroimaging studies were performed within 24 h. Blood samples were collected in a subset of 10 patients. Results Of 39 AIS patients, 22 had COVID-19 and 17 did not. Admission levels of Factor VIII and von Willebrand factor antigen were significantly higher in COVID-19 patients and positively correlated with the infarct volume. In multivariate linear regression analyses, COVID-19 was an independent predictor of infarct volume (B 20.318, Beta 0.576, 95%CI 6.077-34.559; p = 0.011). SP was found in serum of 2 of the 10 examined COVID-19 patients. Platelets from healthy donors showed a similar degree of procoagulant activation induced by COVID-19 and non-COVID-19 patients' sera. The anti-SP and anti-FcγRIIA blocking antibodies had no effect in modulating platelet activity in both groups. Conclusions SARS-CoV-2 infection seems to play a major role in endothelium activation and infarct volume extension during AIS.
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Affiliation(s)
- Manuela De Michele
- Emergency Department, Stroke Unit, Sapienza University of Rome, Rome, Italy
| | - Svetlana Lorenzano
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Paola Piscopo
- Department of Neuroscience, Istituto Superiore di Sanità, Rome, Italy
| | - Roberto Rivabene
- Department of Neuroscience, Istituto Superiore di Sanità, Rome, Italy
| | - Alessio Crestini
- Department of Neuroscience, Istituto Superiore di Sanità, Rome, Italy
| | - Antonio Chistolini
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Lucia Stefanini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Fabio M Pulcinelli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Irene Berto
- Emergency Department, Stroke Unit, Sapienza University of Rome, Rome, Italy
| | - Roberta Campagna
- Department of Molecular Medicine, Laboratory of Virology, Sapienza University of Rome, Rome, Italy
| | - Paolo Amisano
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Marta Iacobucci
- Neuroradiology Unit, Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Carlo Cirelli
- Neuroradiology Unit, Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Anne Falcou
- Emergency Department, Stroke Unit, Sapienza University of Rome, Rome, Italy
| | - Ettore Nicolini
- Emergency Department, Stroke Unit, Sapienza University of Rome, Rome, Italy
| | - Oscar G Schiavo
- Emergency Department, Stroke Unit, Sapienza University of Rome, Rome, Italy
| | - Danilo Toni
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
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15
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Corica B, Cacciani A, Cangemi R, Visentini M, Recchia F, Grillo R, Vano M, Sperduti N, Cincione A, Buoninfante G, Pulcinelli F, Chistolini A, De Santis A, Flego D, Romiti GF, Basili S, Stefanini L. Clinical course, management, and platelet activity assessment of splanchnic VITT: A case report. Thromb Res 2021; 208:14-17. [PMID: 34673368 PMCID: PMC8513518 DOI: 10.1016/j.thromres.2021.10.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/14/2021] [Accepted: 10/11/2021] [Indexed: 12/16/2022]
Affiliation(s)
- Bernadette Corica
- Department of Translational and Precision Medicine, Sapienza - University of Rome, Rome, Italy
| | | | - Roberto Cangemi
- Department of Translational and Precision Medicine, Sapienza - University of Rome, Rome, Italy
| | - Marcella Visentini
- Department of Translational and Precision Medicine, Sapienza - University of Rome, Rome, Italy
| | - Fabrizio Recchia
- Department of Translational and Precision Medicine, Sapienza - University of Rome, Rome, Italy
| | - Rosalba Grillo
- Department of Translational and Precision Medicine, Sapienza - University of Rome, Rome, Italy
| | - Marco Vano
- Department of Translational and Precision Medicine, Sapienza - University of Rome, Rome, Italy
| | - Nicolò Sperduti
- Department of Translational and Precision Medicine, Sapienza - University of Rome, Rome, Italy
| | - Alessandro Cincione
- Department of Translational and Precision Medicine, Sapienza - University of Rome, Rome, Italy
| | - Giovanni Buoninfante
- Department of Translational and Precision Medicine, Sapienza - University of Rome, Rome, Italy
| | - Fabio Pulcinelli
- Department of Experimental Medicine, Sapienza - University of Rome, Rome, Italy
| | - Antonio Chistolini
- Department of Translational and Precision Medicine, Sapienza - University of Rome, Rome, Italy
| | - Adriano De Santis
- Department of Translational and Precision Medicine, Sapienza - University of Rome, Rome, Italy
| | - Davide Flego
- Department of Translational and Precision Medicine, Sapienza - University of Rome, Rome, Italy
| | - Giulio Francesco Romiti
- Department of Translational and Precision Medicine, Sapienza - University of Rome, Rome, Italy
| | - Stefania Basili
- Department of Translational and Precision Medicine, Sapienza - University of Rome, Rome, Italy.
| | - Lucia Stefanini
- Department of Translational and Precision Medicine, Sapienza - University of Rome, Rome, Italy
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Baratta F, Bartimoccia S, Carnevale R, Stefanini L, Angelico F, Del Ben M. Oxidative stress mediated platelet activation in patients with congenital analbuminemia: Effect of albumin infusion. J Thromb Haemost 2021; 19:3090-3094. [PMID: 34614277 PMCID: PMC9293470 DOI: 10.1111/jth.15545] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 09/13/2021] [Accepted: 10/01/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Congenital analbuminemia is a rare autosomal recessive inherited disorder characterized by strongly decreased concentration, or complete absence, of serum albumin (SA). Several lines of evidence indicate that SA has anti-thrombotic effect. In vivo platelet function and the role of oxidative stress (OS) in platelet aggregation promotion have never been studied in analbuminaemic patients. PATIENTS AND METHODS We report two cases of congenital analbuminemia in a 38-year-old male and in a 67-year-old woman. We analyzed platelet activation (PA) and OS at baseline and 2 h after 40 g human albumin infusion. PA was evaluated as platelet aggregation, sCD40L and surface αIIbβ3 integrin and P-selectin expression. OS was evaluated measuring serum sNOX2dp, and 8-iso-PGF2α. FINDINGS Analbuminemic patients displayed higher platelet aggregation, markers of PA and of OS. Albumin infusion reduced platelet activation by reducing oxidative stress.
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Affiliation(s)
- Francesco Baratta
- Department of Clinical Internal, Anaesthesiological and Cardiovascular SciencesSapienza University of RomeRomeItaly
| | - Simona Bartimoccia
- Department of Medical‐Surgical Sciences and BiotechnologiesSapienza University of RomeLatinaItaly
| | - Roberto Carnevale
- Department of Medical‐Surgical Sciences and BiotechnologiesSapienza University of RomeLatinaItaly
- Mediterranea Cardiocentro‐NapoliNapoliItaly
| | - Lucia Stefanini
- Department of Translational and Precision MedicineSapienza University of RomeRomeItaly
| | - Francesco Angelico
- Department of Public Health and Infectious DiseasesSapienza UniversityRomeItaly
| | - Maria Del Ben
- Department of Clinical Internal, Anaesthesiological and Cardiovascular SciencesSapienza University of RomeRomeItaly
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17
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Visentini M, Gragnani L, Santini SA, Urraro T, Villa A, Monti M, Palladino A, Petraccia L, La Gualana F, Lorini S, Marri S, Madia F, Stefanini L, Basili S, Fiorilli M, Ferri C, Zignego AL, Casato M. Flares of mixed cryoglobulinaemia vasculitis after vaccination against SARS-CoV-2. Ann Rheum Dis 2021; 81:441-443. [PMID: 34819272 DOI: 10.1136/annrheumdis-2021-221248] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/09/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Marcella Visentini
- Department of Translational and Precision Medicine, University of Rome La Sapienza, Rome, Italy
| | - Laura Gragnani
- MASVE Interdepartmental Center, Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
| | - Stefano Angelo Santini
- Department of Basic, Clinical, Intensive and Perioperative Biotechnological Sciences, Catholic University School of Medicine, Rome, Italy.,Synlab Italia, Monza, Italy
| | - Teresa Urraro
- Rheumatology Unit, M Scarlato Hospital, Scafati, Italy
| | - Annalisa Villa
- Department of Translational and Precision Medicine, University of Rome La Sapienza, Rome, Italy
| | - Monica Monti
- MASVE Interdepartmental Center, Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
| | - Andrea Palladino
- Department of Translational and Precision Medicine, University of Rome La Sapienza, Rome, Italy
| | - Luisa Petraccia
- MASVE Interdepartmental Center, Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
| | - Francesca La Gualana
- Department of Translational and Precision Medicine, University of Rome La Sapienza, Rome, Italy
| | - Serena Lorini
- MASVE Interdepartmental Center, Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
| | - Silvia Marri
- MASVE Interdepartmental Center, Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
| | - Francesco Madia
- MASVE Interdepartmental Center, Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
| | - Lucia Stefanini
- Department of Translational and Precision Medicine, University of Rome La Sapienza, Rome, Italy
| | - Stefania Basili
- Department of Translational and Precision Medicine, University of Rome La Sapienza, Rome, Italy
| | - Massimo Fiorilli
- Department of Translational and Precision Medicine, University of Rome La Sapienza, Rome, Italy
| | - Clodoveo Ferri
- Rheumatology Unit, Universita degli Studi di Modena e Reggio Emilia, Modena, Italy.,Rheumatology Unit, Madonna dello Scoglio Hospital, Cotronei, Italy
| | - Anna Linda Zignego
- MASVE Interdepartmental Center, Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
| | - Milvia Casato
- Department of Translational and Precision Medicine, University of Rome La Sapienza, Rome, Italy
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18
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Raparelli V, Proietti M, Romiti GF, Seccia R, Di Teodoro G, Tanzilli G, Marrapodi R, Flego D, Corica B, Cangemi R, Palagi L, Basili S, Stefanini L. A machine-learning-based bio-psycho-social model for the prediction of non-obstructive and obstructive coronary artery disease. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3064] [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
Although cardiovascular disease is the leading cause of mortality in both females and males, women are more likely to have non-obstructive ischemic heart disease (IHD) than men. However, the underlying sex- and gender-specific mechanisms and differences in IHD manifestations are still not fully understood.
Aim
To develop an interpretable machine learning (ML) model to gain insight on the clinical, functional, biological and psychosocial features playing a major role in the supervised prediction of non-obstructive versus obstructive CAD.
Methods
From the EVA study, we analyzed a consecutive unselected cohort of adults hospitalized for IHD undergoing coronary angiography. Non-obstructive CAD was defined by a coronary stenosis at the angiogram <50%. Baseline clinical and psycho-socio-cultural characteristics were used for computing a frailty index based on Rockwood and Mitnitsky model, and gender score according to GENESIS-PRAXY methodology. The serum concentration of inflammatory cytokines was measured with a multiplex flow cytometric assay. An XGBoost classifier combined to an explainable artificial intelligence tool (SHAP) was employed to identify the most influential features in discriminating obstructive versus non-obstructive CAD.
Results
Among the overall EVA cohort (n=509), 311 individuals (mean age 67±11 years, 38% females; 67% obstructive CAD) with complete data were analyzed. The ML-based model (83% accuracy and 87% precision) revealed that while obstructive CAD associated with higher frailty index (i.e., lower physiological reserve), older age and a cytokine signature characterized by IL-1β, IL-12p70 and IL-33, non-obstructive CAD was more likely associated with higher gender score (i.e., social characteristics traditionally ascribed to women, regardless of biological sex) and with a cytokine signature characterized by IL-18, IL-8, IL-23.
Conclusions
Integrating clinical, biological and psycho-social features, we have optimized a sex- and gender-unbiased model that discriminates obstructive and non-obstructive CAD. Further mechanistic studies will shed light on the biological plausibility of the observed associations.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Italian Ministry of Education, Research and University, Scientific Independence of young Researcher (SIR)
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Affiliation(s)
- V Raparelli
- University of Ferrara, Translational Medicine, Ferrara, Italy
| | - M Proietti
- IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - G F Romiti
- Sapienza University of Rome, Translational and Precision Medicine, Rome, Italy
| | - R Seccia
- Sapienza University of Rome, Department of Computer, Control and Management Engineering, Rome, Italy
| | - G Di Teodoro
- Sapienza University of Rome, Department of Computer, Control and Management Engineering, Rome, Italy
| | - G Tanzilli
- Sapienza University of Rome, Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Rome, Italy
| | - R Marrapodi
- Sapienza University of Rome, Translational and Precision Medicine, Rome, Italy
| | - D Flego
- Sapienza University of Rome, Translational and Precision Medicine, Rome, Italy
| | - B Corica
- Sapienza University of Rome, Translational and Precision Medicine, Rome, Italy
| | - R Cangemi
- Sapienza University of Rome, Translational and Precision Medicine, Rome, Italy
| | - L Palagi
- Sapienza University of Rome, Department of Computer, Control and Management Engineering, Rome, Italy
| | - S Basili
- Sapienza University of Rome, Translational and Precision Medicine, Rome, Italy
| | - L Stefanini
- Sapienza University of Rome, Translational and Precision Medicine, Rome, Italy
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Kardous R, Joly H, Giordana B, Stefanini L, Mulliez A, Giordana C, Lemaire JJ, Fontaine D. Functional and dysfunctional impulsivities changes after subthalamic nucleus-deep brain stimulation in Parkinson disease. Neurochirurgie 2021; 67:420-426. [PMID: 33845115 DOI: 10.1016/j.neuchi.2021.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 12/07/2020] [Revised: 03/04/2021] [Accepted: 03/21/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We investigated changes of impulsivity after deep brain stimulation (DBS) of the subthalamic nucleus (STN) in Parkinson's disease (PD) patients, distinguishing functional from dysfunctional impulsivity and their contributing factors. METHODS Data of 33 PD patients treated by STN-DBS were studied before and 6 months after surgery: motor impairment, medication (dose and dopaminergic agonists), cognition, mood and occurrence of impulse control disorders. Impulsivity was assessed by the Dickman Impulsivity Inventory, which distinguishes functional impulsivity (FI), reflecting the potential for reasoning and rapid action when the situation requires it, and dysfunctional impulsivity (DI), reflecting the lack of prior reasoning, even when the situation demands it. The location of DBS leads was studied on postoperative MRI using a deformable histological atlas and by compartmentalization of the STN. RESULTS After STN-DBS, DI was significantly increased (mean pre- and postoperative DI scores 1.9±1.6 and 3.5±2.4, P<0.001) although FI was not modified (mean pre- and postoperative FI scores 6.2±2.7 and 5.8±2.6). Factors associated with a DI score's increase≥2 (multivariable logistic regression model) were: low preoperative Frontal Assessment Battery score and location of the left active contact in the ventral part of the STN. CONCLUSION Our study suggests that STN-DBS may have a different impact on both dimensions of impulsivity, worsening pathological impulsivity without altering physiological impulsivity. The increase in dysfunctional impulsivity may be favoured by the location of the electrode in the ventral part of the STN.
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Affiliation(s)
- R Kardous
- Department of Psychiatry, Université Côte d'Azur, CHU de Nice, Nice, France; Centre d'acceuil Psychiatrique, Université Côte d'Azur, CHU de Nice, Nice, France
| | - H Joly
- Department of Neurology, CRC SEP, UR2CA, URRIS, Université Côte d'Azur, CHU de Nice, Hôpital Pasteur 2, 30, avenue de la voie Romaine, 06000 Nice, France.
| | - B Giordana
- Department of Psychiatry, Université Côte d'Azur, CHU de Nice, Nice, France
| | - L Stefanini
- Department of Psychiatry, Université Côte d'Azur, CHU de Nice, Nice, France
| | - A Mulliez
- Unité de Biostatistiques (DRCI), CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - C Giordana
- Department of Neurology, Université Côte d'Azur, CHU de Nice, Nice, France
| | - J-J Lemaire
- CNRS, SIGMA Clermont, Institut Pascal, Université Clermont-Auvergne, Clermont-Ferrand, France
| | - D Fontaine
- Department of Neurosurgery, Université Côte d'Azur, CHU de Nice, Nice, France
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20
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Uitslag-Doolaard H, Stefanini L, Shams A, Blom F. Numerical prediction of a single phase Pressurized Thermal Shock scenario for crack assessment in an Reactor Pressure Vessel wall. ANN NUCL ENERGY 2020. [DOI: 10.1016/j.anucene.2020.107563] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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21
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Sarker M, Goliaei A, Golesi F, Poggi M, Cook A, Khan MAI, Temple BR, Stefanini L, Canault M, Bergmeier W, Campbell SL. Subcellular localization of Rap1 GTPase activator CalDAG-GEFI is orchestrated by interaction of its atypical C1 domain with membrane phosphoinositides. J Thromb Haemost 2020; 18:693-705. [PMID: 31758832 PMCID: PMC7050387 DOI: 10.1111/jth.14687] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 10/17/2019] [Accepted: 11/14/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND The small GTPase Rap1 and its guanine nucleotide exchange factor, CalDAG-GEFI (CDGI), are critical for platelet function and hemostatic plug formation. CDGI function is regulated by a calcium binding EF hand regulatory domain and an atypical C1 domain with unknown function. OBJECTIVE Here, we investigated whether the C1 domain controls CDGI subcellular localization, both in vitro and in vivo. METHODS CDGI interaction with phosphoinositides was studied by lipid co-sedimentation assays and molecular dynamics simulations. Cellular localization of CDGI was studied in heterologous cells by immunofluorescence and subcellular fractionation assays. RESULTS Lipid co-sedimentation studies demonstrated that the CDGI C1 domain associates with membranes through exclusive recognition of phosphoinositides, phosphatidylinositol (4,5)-biphosphate (PIP2) and phosphatidylinositol (3,4,5)-triphosphate (PIP3). Molecular dynamics simulations identified a phospholipid recognition motif consisting of residues exclusive to the CDGI C1 domain. Mutation of those residues abolished co-sedimentation of the C1 domain with lipid vesicles and impaired membrane localization of CDGI in heterologous cells. CONCLUSION Our studies identify a novel interaction between an atypical C1 domain and phosphatidylinositol (4,5)-biphosphate and phosphatidylinositol (3,4,5)-triphosphate in cellular membranes, which is critical for Rap1 signaling in health and disease.
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Affiliation(s)
- Muzaddid Sarker
- Department of Biochemistry and Biophysics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Ardeshir Goliaei
- Department of Biochemistry and Biophysics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | | | - Marjorie Poggi
- Aix Marseille University, INSERM, INRA, Marseille, France
| | - Aaron Cook
- Department of Biochemistry and Biophysics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Mohammad A. I. Khan
- Department of Biochemistry and Biophysics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Brenda R. Temple
- Department of Biochemistry and Biophysics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- RL Juliano Structural Bioinformatics Core, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Lucia Stefanini
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | | | - Wolfgang Bergmeier
- Department of Biochemistry and Biophysics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Sharon L. Campbell
- Department of Biochemistry and Biophysics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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22
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Xu W, Wittchen ES, Hoopes SL, Stefanini L, Burridge K, Caron KM. Small GTPase Rap1A/B Is Required for Lymphatic Development and Adrenomedullin-Induced Stabilization of Lymphatic Endothelial Junctions. Arterioscler Thromb Vasc Biol 2019; 38:2410-2422. [PMID: 30354217 DOI: 10.1161/atvbaha.118.311645] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 01/22/2023]
Abstract
Objective- Maintenance of lymphatic permeability is essential for normal lymphatic function during adulthood, but the precise signaling pathways that control lymphatic junctions during development are not fully elucidated. The Gs-coupled AM (adrenomedullin) signaling pathway is required for embryonic lymphangiogenesis and the maintenance of lymphatic junctions during adulthood. Thus, we sought to elucidate the downstream effectors mediating junctional stabilization in lymphatic endothelial cells. Approach and Results- We knocked-down both Rap1A and Rap1B isoforms in human neonatal dermal lymphatic cells (human lymphatic endothelial cells) and genetically deleted the mRap1 gene in lymphatic endothelial cells by producing 2 independent, conditional Rap1a/b knockout mouse lines. Rap1A/B knockdown caused disrupted junctional formation with hyperpermeability and impaired AM-induced lymphatic junctional tightening, as well as rescue of histamine-induced junctional disruption. Less than 60% of lymphatic- Rap1a/b knockout embryos survived to E13.5 exhibiting interstitial edema, blood-filled lymphatics, disrupted lymphovenous valves, and defective lymphangiogenesis. Consistently, inducible lymphatic- Rap1a/b deletion in adult animals prevented AM-rescue of histamine-induced lymphatic leakage and dilation. Conclusions- Rap1 (Ras-related protein) serves as the dominant effector downstream of AM to stabilize lymphatic junctions. Rap1 is required for maintaining lymphatic permeability and driving normal lymphatic development.
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Affiliation(s)
- Wenjing Xu
- From the Department of Cell Biology and Physiology (W.X., E.S.W., S.L.H., K.B., K.M.C.), The University of North Carolina, Chapel Hill
| | - Erika S Wittchen
- From the Department of Cell Biology and Physiology (W.X., E.S.W., S.L.H., K.B., K.M.C.), The University of North Carolina, Chapel Hill
| | - Samantha L Hoopes
- From the Department of Cell Biology and Physiology (W.X., E.S.W., S.L.H., K.B., K.M.C.), The University of North Carolina, Chapel Hill
| | - Lucia Stefanini
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy (L.S.)
| | - Keith Burridge
- From the Department of Cell Biology and Physiology (W.X., E.S.W., S.L.H., K.B., K.M.C.), The University of North Carolina, Chapel Hill.,McAllister Heart Institute (K.B.), The University of North Carolina, Chapel Hill.,Lineberger Comprehensive Cancer Center, Chapel Hill, NC (K.B.)
| | - Kathleen M Caron
- From the Department of Cell Biology and Physiology (W.X., E.S.W., S.L.H., K.B., K.M.C.), The University of North Carolina, Chapel Hill.,Department of Genetics (K.M.C.), The University of North Carolina, Chapel Hill
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23
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Barbati C, Stefanini L, Colasanti T, Cipriano E, Celia A, Gabriele G, Vomero M, Ceccarelli F, Spinelli FR, Finucci A, Speziali M, Orso G, Margiotta DPE, Conti F, Violi F, Afeltra A, Valesini G, Alessandri C. Anti-D4GDI antibodies activate platelets in vitro: a possible link with thrombocytopenia in primary antiphospholipid syndrome. Arthritis Res Ther 2019; 21:161. [PMID: 31262358 PMCID: PMC6604387 DOI: 10.1186/s13075-019-1947-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 06/17/2019] [Indexed: 11/17/2022] Open
Abstract
Background Thrombocytopenia is a manifestation associated with primary antiphospholipid syndrome (PAPS), and many studies have stressed the leading role played by platelets in the pathogenesis of antiphospholipid syndrome (APS). Platelets are highly specialized cells, and their activation involves a series of rapid rearrangements of the actin cytoskeleton. Recently, we described the presence of autoantibodies against D4GDI (Rho GDP dissociation inhibitor beta, ARHGDIB) in the serum of a large subset of SLE patients, and we observed that anti-D4GDI antibodies activated the cytoskeleton remodeling of lymphocytes by inhibiting D4GDI and allowing the upregulation of Rho GTPases, such as Rac1. Proteomic and transcriptomic studies indicate that D4GDI is very abundant in platelets, and small GTPases of the RHO family are critical regulators of actin dynamics in platelets. Methods We enrolled 38 PAPS patients, 15 patients carrying only antiphospholipid antibodies without clinical criteria of APS (aPL carriers) and 20 normal healthy subjects. Sera were stored at − 20 °C to perform an ELISA test to evaluate the presence of anti-D4GDI antibodies. Then, we purified autoantibodies anti-D4GDI from patient sera. These antibodies were used to conduct in vitro studies on platelet activation. Results We identified anti-D4GDI antibodies in sera from 18/38 (47%) patients with PAPS, in sera from 2/15(13%) aPL carriers, but in no sera from normal healthy subjects. Our in vitro results showed a significant 30% increase in the activation of integrin αIIbβ3 upon stimulation of platelets from healthy donors preincubated with the antibody anti-D4GDI purified from the serum of APS patients. Conclusions In conclusion, we show here that antibodies anti-D4GDI are present in the sera of PAPS patients and can prime platelet activation, explaining, at least in part, the pro-thrombotic state and the thrombocytopenia of PAPS patients. These findings may lead to improved diagnosis and treatment of APS.
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Affiliation(s)
- C Barbati
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Viale del Policlinico, 155, Rome, Italy.
| | - L Stefanini
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Viale del Policlinico, 155, Rome, Italy
| | - T Colasanti
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Viale del Policlinico, 155, Rome, Italy
| | - E Cipriano
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Viale del Policlinico, 155, Rome, Italy
| | - A Celia
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Viale del Policlinico, 155, Rome, Italy
| | - G Gabriele
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Viale del Policlinico, 155, Rome, Italy
| | - M Vomero
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Viale del Policlinico, 155, Rome, Italy
| | - F Ceccarelli
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Viale del Policlinico, 155, Rome, Italy
| | - F R Spinelli
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Viale del Policlinico, 155, Rome, Italy
| | - A Finucci
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Viale del Policlinico, 155, Rome, Italy
| | - M Speziali
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Viale del Policlinico, 155, Rome, Italy
| | - G Orso
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Viale del Policlinico, 155, Rome, Italy
| | - D P E Margiotta
- Department of Immuno-Rheumatology, Campus Bio-Medico, University of Rome, Rome, Italy
| | - F Conti
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Viale del Policlinico, 155, Rome, Italy
| | - F Violi
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Viale del Policlinico, 155, Rome, Italy
| | - A Afeltra
- Department of Immuno-Rheumatology, Campus Bio-Medico, University of Rome, Rome, Italy
| | - G Valesini
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Viale del Policlinico, 155, Rome, Italy
| | - C Alessandri
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Viale del Policlinico, 155, Rome, Italy
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24
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Cammisotto V, Carnevale R, Nocella C, Stefanini L, Bartimoccia S, Coluccia A, Silvestri R, Pignatelli P, Pastori D, Violi F. Nox2-mediated platelet activation by glycoprotein (GP) VI: Effect of rivaroxaban alone and in combination with aspirin. Biochem Pharmacol 2019; 163:111-118. [DOI: 10.1016/j.bcp.2019.02.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 02/12/2019] [Indexed: 01/04/2023]
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25
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Basili S, Carnevale R, Nocella C, Bartimoccia S, Raparelli V, Talerico G, Stefanini L, Romiti GF, Perticone F, Corazza GR, Piscaglia F, Pietrangelo A, Violi F. Serum Albumin Is Inversely Associated With Portal Vein Thrombosis in Cirrhosis. Hepatol Commun 2019; 3:504-512. [PMID: 30976741 PMCID: PMC6442692 DOI: 10.1002/hep4.1317] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 12/13/2018] [Indexed: 12/20/2022] Open
Abstract
We analyzed whether serum albumin is independently associated with portal vein thrombosis (PVT) in liver cirrhosis (LC) and if a biologic plausibility exists. This study was divided into three parts. In part 1 (retrospective analysis), 753 consecutive patients with LC with ultrasound-detected PVT were retrospectively analyzed. In part 2, 112 patients with LC and 56 matched controls were entered in the cross-sectional study. In part 3, 5 patients with cirrhosis were entered in the in vivo study and 4 healthy subjects (HSs) were entered in the in vitro study to explore if albumin may affect platelet activation by modulating oxidative stress. In the 753 patients with LC, the prevalence of PVT was 16.7%; logistic analysis showed that only age (odds ratio [OR], 1.024; P = 0.012) and serum albumin (OR, -0.422; P = 0.0001) significantly predicted patients with PVT. Analyzing the 112 patients with LC and controls, soluble clusters of differentiation (CD)40-ligand (P = 0.0238), soluble Nox2-derived peptide (sNox2-dp; P < 0.0001), and urinary excretion of isoprostanes (P = 0.0078) were higher in patients with LC. In LC, albumin was correlated with sCD40L (Spearman's rank correlation coefficient [rs ], -0.33; P < 0.001), sNox2-dp (rs , -0.57; P < 0.0001), and urinary excretion of isoprostanes (rs, -0.48; P < 0.0001) levels. The in vivo study showed a progressive decrease in platelet aggregation, sNox2-dp, and urinary 8-iso prostaglandin F2α-III formation 2 hours and 3 days after albumin infusion. Finally, platelet aggregation, sNox2-dp, and isoprostane formation significantly decreased in platelets from HSs incubated with scalar concentrations of albumin. Conclusion: Low serum albumin in LC is associated with PVT, suggesting that albumin could be a modulator of the hemostatic system through interference with mechanisms regulating platelet activation.
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Affiliation(s)
- Stefania Basili
- Department of Internal Medicine and Medical Specialties Sapienza University of Rome Rome Italy
| | - Roberto Carnevale
- Department of Medical-Surgical Sciences and Biotechnologies Sapienza University of Rome Latina Italy
| | | | - Simona Bartimoccia
- Department of Internal Medicine and Medical Specialties Sapienza University of Rome Rome Italy
| | - Valeria Raparelli
- Department of Experimental Medicine Sapienza University of Rome Rome Italy.,McGill University Health Center Research Institute, Center for Outcomes Research and Evaluation Montreal Canada
| | - Giovanni Talerico
- Department of Internal Medicine and Medical Specialties Sapienza University of Rome Rome Italy
| | - Lucia Stefanini
- Department of Internal Medicine and Medical Specialties Sapienza University of Rome Rome Italy
| | - Giulio F Romiti
- Department of Internal Medicine and Medical Specialties Sapienza University of Rome Rome Italy
| | - Francesco Perticone
- Department of Medical and Surgical Sciences University of Catanzaro Catanzaro Italy
| | - Gino R Corazza
- First Department of Internal Medicine Fondazione IRCCS Policlinico San Matteo, University of Pavia Italy
| | - Fabio Piscaglia
- Department of Medical and Surgical Sciences University of Bologna Bologna Italy
| | - Antonello Pietrangelo
- Unit of Internal Medicine 2, Department of Medical and Surgical Science for Children and Adults University of Modena and Reggio Emilia Modena Italy
| | - Francesco Violi
- Department of Internal Medicine and Medical Specialties Sapienza University of Rome Rome Italy
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Abstract
Review series that provides a state-of-the-art overview of the role of small GTPases in megakaryocyte and platelet biology. While the focus of the reviews is on recent advances in the area of basic science, the clinical relevance of alterations in small GTPase signaling for platelet count and function is also discussed.
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Affiliation(s)
- Lucia Stefanini
- a Department of Internal Medicine and Medical Specialties , Sapienza University of Rome , Rome , Italy
| | - Wolfgang Bergmeier
- b Department of Biochemistry and Biophysics , University of North Carolina , Chapel Hill , NC , USA.,c McAllister Heart Institute , University of North Carolina , Chapel Hill , NC , USA
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Nocella C, Cammisotto V, Fianchini L, D'Amico A, Novo M, Castellani V, Stefanini L, Violi F, Carnevale R. Extra Virgin Olive Oil and Cardiovascular Diseases: Benefits for Human Health. Endocr Metab Immune Disord Drug Targets 2018; 18:4-13. [PMID: 29141571 DOI: 10.2174/1871530317666171114121533] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [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: 06/02/2017] [Revised: 06/16/2017] [Accepted: 10/30/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVE The cardioprotective properties of Mediterranean Diet were demonstrated for the first time from the Seven Country Study. In the last few decades, numerous epidemiological studies, as well as intervention trial, confirmed this observation, pointing out the close relationship between the Mediterranean diet and cardiovascular diseases. In this context, extra virgin olive oil (EVOO), the most representative component of this diet, seems to be relevant in lowering the incidence of cardiovascular events, including myocardial infarction and stroke. From a chemical point of view, 98-99% of the total weight of EVOO is represented by fatty acids, especially monounsaturated fatty acids such as oleic acid. Tocopherols, polyphenols and other minor constituents represent the remaining 1-2%. All these components may potentially contribute to "health maintenance" with their beneficial effects by EVOOO. METHODS Studies that examined the effect of EVOO supplementation in healthy subjects and in individuals at cardiovascular risk were included. CONCLUSION The studies analyzed demonstrated the role of EVOO as anti-inflammatory, antioxidant and vasodilatory nutrient that may contribute to lower the atherosclerotic burden.
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Affiliation(s)
- Cristina Nocella
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Vittoria Cammisotto
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Luca Fianchini
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Alessandra D'Amico
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Marta Novo
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Valentina Castellani
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Lucia Stefanini
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Francesco Violi
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Roberto Carnevale
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
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Cangemi R, Carnevale R, Nocella C, Calvieri C, Cammisotto V, Novo M, Castellani V, D’Amico A, Zerbinati C, Stefanini L, Violi F. Corrigendum to “Glucocorticoids impair platelet thromboxane biosynthesis in community-acquired pneumonia” [Pharmacol. Res. 131 (2018) 66–74]. Pharmacol Res 2018; 135:268. [DOI: 10.1016/j.phrs.2018.07.008] [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: 12/01/2022]
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Abstract
Platelets are highly specialized cells that continuously patrol the vasculature to ensure its integrity (hemostasis). At sites of vascular injury, they are able to respond to trace amounts of agonists and to rapidly transition from an anti-adhesive/patrolling to an adhesive state (integrin inside-out activation) required for hemostatic plug formation. Pathological conditions that disturb the balance in the underlying signaling processes can lead to unwanted platelet activation (thrombosis) or to an increased bleeding risk. The small GTPases of the RAP subfamily, highly expressed in platelets, are critical regulators of cell adhesion, cytoskeleton remodeling, and MAP kinase signaling. Studies by our group and others demonstrate that RAP GTPases, in particular RAP1A and RAP1B, are the key molecular switches that turn on platelet activation/adhesiveness at sites of injury. In this review, we will summarize major findings on the role of RAP GTPases in platelet biology with a focus on the signaling pathways leading to the conversion of integrins to a high-affinity state.
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Affiliation(s)
- Lucia Stefanini
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Wolfgang Bergmeier
- Department of Biochemistry and Biophysics, University of North Carolina at Chapel Hill (NC), USA
- McAllister Heart Institute, University of North Carolina at Chapel Hill (NC), USA
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Carnevale R, Nocella C, Cammisotto V, Bartimoccia S, Monticolo R, D'Amico A, Stefanini L, Pagano F, Pastori D, Cangemi R, Violi F. Antioxidant activity from extra virgin olive oil via inhibition of hydrogen peroxide-mediated NADPH-oxidase 2 activation. Nutrition 2018; 55-56:36-40. [PMID: 29960154 DOI: 10.1016/j.nut.2018.03.045] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 11/28/2017] [Revised: 02/20/2018] [Accepted: 03/22/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Extra virgin olive oil (EVOO) supplementation is associated with a significant reduction in cardiovascular disease but the underlying mechanism is still unclear. METHODS In platelets that were taken from healthy subjects (n = 5), agonist-induced hydrogen peroxide (H2O2) production and NADPH oxidase 2 (NOX2) activation in the presence of or without catalase, which catabolizes H2O2, were investigated. Platelet H2O2 production, NOX2 activation, EVOO vitamin E, and total polyphenols as well as EVOO's ability to scavenge H2O2 were also measured. RESULTS Platelet NOX2 activation and H2O2 production were significantly inhibited in catalase-treated platelets and platelets that were incubated with five different EVOOs. The EVOO content of vitamin E was 53 to 223 mg/kg and total polyphenols 145 to 392 mg/L Gallic acid equivalent. EVOOs quenched in vitro H2O2 by 39 to 62%, which is an effect that is significantly correlated with vitamin E and total polyphenol concentrations (R = 0.688; P <0.001 and R = 0.541; P <0.001, respectively). CONCLUSIONS This in vitro study provides the first evidence that EVOO downregulates platelet H2O2 and in turn NOX2 activity via H2O2 scavenging.
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Affiliation(s)
- Roberto Carnevale
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.
| | - Cristina Nocella
- Department of AngioCardioNeurology, IRCCS NeuroMed, 86077, Pozzilli, IS, Italy
| | - Vittoria Cammisotto
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Simona Bartimoccia
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Roberto Monticolo
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Alessandra D'Amico
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Lucia Stefanini
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Francesca Pagano
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Daniele Pastori
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Roberto Cangemi
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Francesco Violi
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
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Cangemi R, Carnevale R, Nocella C, Calvieri C, Cammisotto V, Novo M, Castellani V, D'Amico A, Zerbinati C, Stefanini L, Violi F. Glucocorticoids impair platelet thromboxane biosynthesis in community-acquired pneumonia. Pharmacol Res 2018; 131:66-74. [PMID: 29577968 DOI: 10.1016/j.phrs.2018.03.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 01/04/2018] [Revised: 02/28/2018] [Accepted: 03/20/2018] [Indexed: 01/24/2023]
Abstract
Previous reports suggest that community-acquired pneumonia (CAP) is associated with an enhanced risk of myocardial infarction (MI) and that enhanced platelet activation may play a role. Aims of this study were to investigate if urinary excretion of 11-dehydro-thromboxane (Tx) B2, a reliable marker of platelet activation in vivo, was elevated in CAP and whether glucocorticoid administration reduced platelet activation. Three-hundred patients hospitalized for CAP were recruited and followed-up until discharge. Within the first 2 days from admission, urinary 11-dehydro-TxB2 and serum levels of methylprednisolone and betamethasone were measured. 11-Dehydro-TxB2 was also measured in a control group of 150 outpatients, matched for age, sex, and comorbidities. Finally, in-vitro studies were performed to assess if glucocorticoids affected platelet activation, at the same range of concentration found in the peripheral circulation of CAP patients treated with glucocorticoids. Compared to controls, CAP patients showed significantly higher levels of 11-dehydro-TxB2 (110 [69-151] vs. 163 [130-225] pg/mg creatinine; p < 0.001). During the in-hospital stay, 31 patients experienced MI (10%). A COX regression analysis showed that 11-dehydro-TxB2 independently predicted MI (p = .005). CAP patients treated with glucocorticoids showed significantly lower levels of 11-dehydro-TxB2 compared to untreated ones (147 [120-201] vs. 176 [143-250] pg/mg creatinine; p < 0.001). In vitro, glucocorticoids-treated platelets showed a dose-dependent decrease of ADP-induced platelet aggregation, TxB2 production, cPLA2 phosphorylation and arachidonic acid release from the platelet membrane. In conclusion, platelet TxB2 is overproduced in CAP patients and may be implicated in MI occurrence. Glucocorticoids reduce platelet release of TxB2 in vitro and urinary excretion of 11-dehydro-TxB2 in vivo and may be a novel tool to decrease platelet activation in this setting.
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Affiliation(s)
- Roberto Cangemi
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Roberto Carnevale
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Cristina Nocella
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Camilla Calvieri
- Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Vittoria Cammisotto
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Marta Novo
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Valentina Castellani
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Alessandra D'Amico
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Chiara Zerbinati
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Lucia Stefanini
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Francesco Violi
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy.
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Abstract
Platelets are small anucleated cells that constantly patrol the cardiovascular system to preserve its integrity and prevent excessive blood loss where the vessel lining is breached. Their key challenge is to form a hemostatic plug under conditions of high shear forces. To do so, platelets have evolved a molecular machinery that enables them to sense trace amounts of signals at the site of damage and to rapidly shift from a non-adhesive to a pro-adhesive state. However, this highly efficient molecular machinery can also lead to unintended platelet activation and cause clinical complications such as thrombocytopenia and thrombosis. Thus, several checkpoints are in place to tightly control platelet activation and adhesiveness in space and time. In this review, we will discuss select negative regulators of platelet activation, which are critical to maintain patrolling platelets in a quiescent, non-adhesive state and/or to limit platelet adhesion to sites of injury.
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Affiliation(s)
- L Stefanini
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - W Bergmeier
- Department of Biochemistry and Biophysics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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34
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Abstract
In this brief review paper, we will summarize the State-of-the-Art on how platelet reactivity is regulated in circulation and at sites of vascular injury. Our review discusses recent and ongoing work, presented at this year's International Society on Thrombosis and Haemostasis (ISTH) meeting, on the role of platelets in (1) classical hemostasis at sites of mechanical injury, and (2) the maintenance of vascular integrity at sites of inflammation.
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Affiliation(s)
- Wolfgang Bergmeier
- Department of Biochemistry and BiophysicsUniversity of North Carolina at Chapel HillChapel HillNCUSA
- McAllister Heart InstituteUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Lucia Stefanini
- Department of Internal Medicine and Medical SpecialtiesSapienza University of RomeRomeItaly
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35
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Abstract
Platelets are critical for hemostasis, i.e., the body's ability to prevent blood loss at sites of vascular injury. They patrol the vasculature in a quiescent, non-adhesive state for approximately 10 days, after which they are removed from circulation by phagocytic cells of the reticulo-endothelial system. At sites of vascular injury, they promptly shift to an activated, adhesive state required for the formation of a hemostatic plug. The small GTPase RAP1 is a critical regulator of platelet adhesiveness. Our recent studies demonstrate that the antagonistic balance between the RAP1 regulators, CalDAG-GEFI and RASA3, is critical for the modulation of platelet adhesiveness, both in circulation and at sites of vascular injury. The RAP1 activator CalDAG-GEFI responds to small changes in the cytoplasmic calcium concentration and thus provides sensitivity and speed to the activation response, essential for efficient platelet adhesion under conditions of hemodynamic shear stress. The RAP1 inhibitor RASA3 ensures that circulating platelets remain quiescent by restraining CalDAG-GEFI-dependent RAP1 activation. Upon cellular stimulation, it is turned off by P2Y12 signaling to enable sustained RAP1 activation, required for the formation of a stable hemostatic plug. This review will summarize important studies that elucidated the signaling pathways that control RAP1 activation in platelets.
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Affiliation(s)
- Lucia Stefanini
- Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, UK
| | - Wolfgang Bergmeier
- Department of Biochemistry and Biophysics, McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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36
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Affiliation(s)
- Wolfgang Bergmeier
- Department of Biochemistry and Biophysics, McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Stefanini L, Paul DS, Robledo RF, Chan ER, Getz TM, Campbell RA, Kechele DO, Casari C, Piatt R, Caron KM, Mackman N, Weyrich AS, Parrott MC, Boulaftali Y, Adams MD, Peters LL, Bergmeier W. RASA3 is a critical inhibitor of RAP1-dependent platelet activation. J Clin Invest 2015; 125:1419-32. [PMID: 25705885 DOI: 10.1172/jci77993] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 01/13/2015] [Indexed: 01/15/2023] Open
Abstract
The small GTPase RAP1 is critical for platelet activation and thrombus formation. RAP1 activity in platelets is controlled by the GEF CalDAG-GEFI and an unknown regulator that operates downstream of the adenosine diphosphate (ADP) receptor, P2Y12, a target of antithrombotic therapy. Here, we provide evidence that the GAP, RASA3, inhibits platelet activation and provides a link between P2Y12 and activation of the RAP1 signaling pathway. In mice, reduced expression of RASA3 led to premature platelet activation and markedly reduced the life span of circulating platelets. The increased platelet turnover and the resulting thrombocytopenia were reversed by concomitant deletion of the gene encoding CalDAG-GEFI. Rasa3 mutant platelets were hyperresponsive to agonist stimulation, both in vitro and in vivo. Moreover, activation of Rasa3 mutant platelets occurred independently of ADP feedback signaling and was insensitive to inhibitors of P2Y12 or PI3 kinase. Together, our results indicate that RASA3 ensures that circulating platelets remain quiescent by restraining CalDAG-GEFI/RAP1 signaling and suggest that P2Y12 signaling is required to inhibit RASA3 and enable sustained RAP1-dependent platelet activation and thrombus formation at sites of vascular injury. These findings provide insight into the antithrombotic effect of P2Y12 inhibitors and may lead to improved diagnosis and treatment of platelet-related disorders.
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Abstract
PURPOSE OF REVIEW G protein-coupled receptors (GPCRs) like PAR1/4 and P2Y12 have long been known for their critical role in hemostasis. In contrast, deficiency in the immunoreceptor tyrosine-based activation motif (ITAM)-coupled receptors glycoprotein (GP)VI or C-type lectin-like receptor (CLEC)-2 is associated with only a mild bleeding diathesis in humans and mice. This review summarizes recent developments on the physiological importance of platelet ITAM signaling as well as the molecular mechanisms facilitating this signaling pathway. RECENT FINDINGS Genetic experiments identified a critical role for platelet CLEC-2 signaling in the formation of lymphatic vessels during development. Similarly, signaling by both GPVI and CLEC-2, but not GPCRs, is required for the maintenance of vascular integrity at sites of inflammation in the adult. The molecular mechanisms underlying ITAM signaling in platelets continue to be refined. SUMMARY Platelet ITAM signaling plays a key role for the maintenance of vascular integrity in development and the adult. This novel form of hemostasis differs from hemostasis at sites of vascular injury in that it does not depend on major platelet adhesion receptors or GPCR signaling.
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Affiliation(s)
- Wolfgang Bergmeier
- University of North Carolina, Chapel Hill, North Carolina 27599-7035, USA.
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Calamari L, Petrera F, Stefanini L, Abeni F. Effects of different feeding time and frequency on metabolic conditions and milk production in heat-stressed dairy cows. Int J Biometeorol 2013; 57:785-796. [PMID: 23161272 DOI: 10.1007/s00484-012-0607-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Revised: 10/30/2012] [Accepted: 10/30/2012] [Indexed: 06/01/2023]
Abstract
The aim of this paper was to evaluate the effects of three different feeding management (FM) schedules on physiological markers of heat stress (HS), metabolic conditions, milk yield and quality during the hot season in dairy cows. The study involved 27 mid-lactating cows, subdivided in three homogeneous groups differing in feeding time and frequency: total mixed ration (TMR) delivered once daily in the morning (M); twice daily, half in the morning and half in the evening (ME); once daily in the evening (E). During the trial, blood samples were collected in the morning (a.m.) and in the evening (p.m.), breathing rate (BR), rectal temperature (RT), and milk yield were recorded and individual milk samples were collected. Microclimate data indicated that cows were subjected to mild-moderate HS. During the hotter days, cows receiving M treatment showed higher values of RT (38.97 °C vs 38.68 °C and 38.62 °C, in ME and E) and BR (71.44 vs 66.52 and 65.26 breaths min⁻¹, in ME and E), a.m. plasma glucose was lower in M (3.69 vs 3.83 and 3.83 mmol L⁻¹, in ME and E) and a.m. plasma urea was lower in E (4.82 vs 5.48 and 5.35 mmol L⁻¹, in M and ME). Milk yield was unaffected by FM, as well as milk composition and cheese-making properties. Only milk protein content and yield were higher in M (3.42 vs 3.36 and 3.27 g 100 mL⁻¹; and 1.11 vs 1.08 and 1.02 kg day⁻¹, for ME and E). Our results on cow physiology indicate that M seems a less suitable FM to match cow welfare during the summer season.
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Affiliation(s)
- L Calamari
- Istituto di Zootecnica, Università Cattolica del Sacro Cuore, Via Emilia Parmense, 84, 29122 Piacenza, Italy
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Wasserman M, Priest V, Alberti A, Gelera A, Stefanini L, Simmonds M. Total costs and outcomes of bare metal stent placement with intravascular ultrasound compared with angiography alone: a cost-effectiveness analysis from the perspective of the Italian health system. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht307.p266] [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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Stefanini L, Snider A, Piatt R, Petrich B, Bergmeier W. Abstract 42: A Talin Mutant that Disrupts Talin-integrin Binding in Platelets Decelerates aIIbß3 Activation Without Pathological Bleeding. Arterioscler Thromb Vasc Biol 2013. [DOI: 10.1161/atvb.33.suppl_1.a42] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Tight regulation of integrin affinity is a critical component of hemostasis. The final step of integrin inside-out activation is talin binding to two distinct sites within the integrin β cytoplasmic tail, an NPLY sequence and a membrane-proximal region (MPR). Selective deletion of talin1 from platelets (Tln1fl/flPf4-Cre+) completely prevents integrin activation and thrombus formation, and results in profound defects in hemostasis. Interestingly, platelet-specific expression of a talin1 mutant (L325R) that lacks the ability to bind the MPR, but can still bind the NPLY sequence, phenocopies talin1-knockout platelets. In this study we sought to analyze the effects on thrombosis and hemostasis of a platelet-specific talin1 mutation (W359A) that dramatically impairs binding to the NPLY sequence and does not rescue the talin1 deficiency in transfected cells.
Homozygous knock-in of talin(W359A) is embryonic lethal in mice. Thus, Tln1W359A/wt mice were crossed with Tln1fl/flPf4-Cre+ mice to generate Tln1W359A/flPf4-Cre+ (TlnWA) and Tln1wt/flPf4-Cre+ (Tlnwt) control mice. Expression of talin(W359A) in platelets partially rescued talin1 deficiency. Compared to Tlnwt controls, agonist-induced αIIbβ3 activation was reduced by ~50% and spreading on fibrinogen was only moderately impaired in TlnWA platelets. However, kinetic studies demonstrated decelerated αIIbβ3 activation in TlnWA platelets, which resulted in delayed aggregation under static conditions and reduced thrombus size at low shear rates. Interestingly, adhesion of TlnWA platelets to collagen at high shear rates was not significantly better than that of talin-deficient cells and TlnWA mice were completely protected from FeCl3-induced carotid artery occlusion. Lastly, in contrast to platelet-specific talin-knockout or TlnLR mice, TlnWA mice showed no detectable gastrointestinal bleeding and only modestly increased tail-bleeding times compared to littermate controls.
In conclusion, we demonstrate that the talin(W359A) mutation decelerates, but does not abolish, talin-dependent integrin activation in platelets. Our studies further suggest that this delay in integrin activation is protective from pathological vessel occlusion while it does not affect hemostasis in mice.
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Affiliation(s)
- Lucia Stefanini
- Biochemistry, Univ of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Adam Snider
- Medicine, Univ of California San Diego, La Jolla, CA
| | - Raymond Piatt
- Biochemistry, Univ of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Brian Petrich
- Medicine, Univ of California San Diego, La Jolla, CA
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42
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Xiang B, Zhang G, Stefanini L, Bergmeier W, Gartner TK, Whiteheart SW, Li Z. The Src family kinases and protein kinase C synergize to mediate Gq-dependent platelet activation. J Biol Chem 2012; 287:41277-87. [PMID: 23066026 DOI: 10.1074/jbc.m112.393124] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The Src family kinases (SFKs) play essential roles in collagen- and von Willebrand factor (VWF)-mediated platelet activation. However, the roles of SFKs in G protein-coupled receptor-mediated platelet activation and the molecular mechanisms whereby SFKs are activated by G protein-coupled receptor stimulation are not fully understood. Here we show that the thrombin receptor protease-activated receptor 4 agonist peptide AYPGKF elicited SFK phosphorylation in P2Y(12) deficient platelets but stimulated minimal SFK phosphorylation in platelets lacking G(q). We have previously shown that thrombin-induced SFK phosphorylation was inhibited by the calcium chelator 5,5'-dimethyl-bis-(o-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid (dimethyl-BAPTA). The calcium ionophore A23187 induced SFK phosphorylation in both wild-type and G(q) deficient platelets. Together, these results indicate that SFK phosphorylation in response to thrombin receptor stimulation is downstream from G(q)/Ca(2+) signaling. Moreover, A23187-induced thromboxane A(2) synthesis, platelet aggregation, and secretion were inhibited by preincubation of platelets with a selective SFK inhibitor, PP2. AYPGKF-induced thromboxane A(2) production in wild-type and P2Y(12) deficient platelets was abolished by PP2, and AYPGKF-mediated P-selectin expression, integrin α(IIb)β(3) activation, and aggregation of P2Y(12) deficient platelets were partially inhibited by the PKC inhibitor Ro-31-8220, PP2, dimethyl-BAPTA, or LY294002, but were abolished by Ro-31-8220 plus PP2, dimethyl-BAPTA, or LY294002. These data indicate that Ca(2+)/SFKs/PI3K and PKC represent two alternative signaling pathways mediating G(q)-dependent platelet activation.
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Affiliation(s)
- Binggang Xiang
- Saha Cardiovascular Research Center, College of Medicine, University of Kentucky, Lexington, Kentucky 40536, USA
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Stefanini L, Boulaftali Y, Ouellette TD, Holinstat M, Désiré L, Leblond B, Andre P, Conley PB, Bergmeier W. Rap1-Rac1 circuits potentiate platelet activation. Arterioscler Thromb Vasc Biol 2011; 32:434-41. [PMID: 22075250 DOI: 10.1161/atvbaha.111.239194] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The goal of this study was to investigate the potential crosstalk between Rap1 and Rac1, 2 small GTPases central to platelet activation, particularly downstream of the collagen receptor GPVI. METHODS AND RESULTS We compared the activation response of platelets with impaired Rap signaling (double knock-out; deficient in both the guanine nucleotide exchange factor, CalDAG-GEFI, and the Gi-coupled receptor for ADP, P2Y12), to that of wild-type platelets treated with a small-molecule Rac inhibitor, EHT 1864 (wild-type /EHT). We found that Rac1 is sequentially activated downstream of Rap1 on stimulation via GPVI. In return, Rac1 provides important feedback for both CalDAG-GEFI- and P2Y12-dependent activation of Rap1. When analyzing platelet responses controlled by Rac1, we observed (1) impaired lamellipodia formation, clot retraction, and granule release in both double knock-out and EHT 1864-treated wild-type platelets; and (2) reduced calcium store release in EHT 1864-treated wild-type but not double knock-out platelets. Consistent with the latter finding, we identified 2 pools of Rac1, one activated immediately downstream of GPVI and 1 activated downstream of Rap1. CONCLUSIONS We demonstrate important crosstalk between Rap1 and Rac1 downstream of GPVI. Whereas Rap1 signaling directly controls sustained Rac1 activation, Rac1 affects CalDAG-GEFI- and P2Y12-dependent Rap1 activation via its role in calcium mobilization and granule/ADP release, respectively.
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Affiliation(s)
- Lucia Stefanini
- Dept. of Biochemistry and Biophysics, University of North Carolina at Chapel Hill, 98 Manning Drive, 306a Mary Ellen Jones Building, Chapel Hill, NC 27599, USA
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Abstract
Rapid activation of platelets at sites of vascular injury is a critical event in thrombosis and hemostasis. Here, we review recent findings, which (a) identified CalDAG-GEFI (RasGRP2) at the nexus of the rapid Ca(2+)-dependent platelet activation, (b) demonstrated a complex synergy between signaling provided by CalDAG-GEFI, protein kinase C and the Gi-coupled receptor for ADP, P2Y12, and (c) suggested CalDAG-GEFI as a novel target for anti-platelet therapy.
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Affiliation(s)
- Lucia Stefanini
- Department of Medicine and Cardeza Foundation, Thomas Jefferson University, Philadelphia, PA, USA
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45
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Abstract
A rise in the intracellular calcium (Ca2+) concentration is a major component of the signaling mechanisms regulating platelet function in thrombosis and hemostasis. Previous studies, however, failed to identify many key molecules regulating Ca2+ signaling in platelets. Here, we review recent findings, which identified CalDAG-GEFI as a critical Ca2+ sensor that links increases in intracellular Ca2+ to integrin activation, TxA2 formation, and granule release in stimulated platelets. Furthermore, we summarize work that lead to the discovery of STIM1 and Orai1 as key regulators of store-operated calcium entry (SOCE) in platelets. A short discussion on the usefulness of each molecule as a potential new target for antiplatelet therapy is included.
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Affiliation(s)
- W Bergmeier
- Cardeza Foundation and Department of Medicine, Thomas Jefferson University, Philadelphia, PA, USA.
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46
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Calamari L, Petrera F, Fava A, Stefanini L. Feeding behaviour of dairy cows in forced or free cow traffic in Automatic Milking System (AMS). Italian Journal of Animal Science 2007. [DOI: 10.4081/ijas.2007.1s.410] [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] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- L. Calamari
- Istituto di Zootecnica, Università Cattolica del Sacro Cuore, Piacenza, Italy
| | - F. Petrera
- Azienda Sperimentale “V. Tadini”. Loc. Gariga, Podenzano (PC), Italy
| | - A. Fava
- Azienda Sperimentale “V. Tadini”. Loc. Gariga, Podenzano (PC), Italy
| | - L. Stefanini
- Azienda Sperimentale “V. Tadini”. Loc. Gariga, Podenzano (PC), Italy
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Canobbio I, Stefanini L, Guidetti GF, Balduini C, Torti M. A new role for FcγRIIA in the potentiation of human platelet activation induced by weak stimulation. Cell Signal 2006; 18:861-70. [PMID: 16169188 DOI: 10.1016/j.cellsig.2005.07.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2005] [Revised: 07/25/2005] [Accepted: 07/27/2005] [Indexed: 11/20/2022]
Abstract
The low affinity receptor for immunoglobulin G, FcgammaRIIA, is expressed in human platelets, mediates heparin-induced thrombocytopenia and participates to platelet activation induced by von Willebrand factor. In this work, we found that stimulation of platelets with agonists acting on G-protein-coupled receptors resulted in the tyrosine phosphorylation of FcgammaRIIA, through a mechanism involving a Src kinase. Treatment of platelets with the blocking monoclonal antibody IV.3 against FcgammaRIIA, but not with control IgG, inhibited platelet aggregation induced by TRAP1, TRAP4, the thromboxane analogue U46619, and low concentrations of thrombin. By contrast, platelet aggregation induced by high doses of thrombin was unaffected by blockade of FcgammaRIIA. We also found that the anti-FcgammaRIIA monoclonal antibody IV.3 inhibited pleckstrin phosphorylation and calcium mobilization induced by low, but not high, concentrations of thrombin. In addition, thrombin- or U46619-induced tyrosine phosphorylation of several substrates typically involved in FcgammaRIIA-mediated signalling, such as Syk and PLCgamma2, was clearly reduced by incubation with anti-FcgammaRIIA antibody IV.3. Upon stimulation with thrombin, FcgammaRIIA relocated in lipid rafts, and thrombin-induced tyrosine phosphorylation of FcgammaRIIA occurred within these membrane domains. Controlled disruption of lipid rafts by depleting membrane cholesterol prevented tyrosine phosphorylation of FcgammaRIIA and impaired platelet aggregation induced by U46619 or by low, but not high, concentrations of thrombin. These results indicate that FcgammaRIIA can be activated in human platelets downstream G-protein-coupled receptors and suggest a novel general mechanism for the reinforcement of platelet activation induced by low concentrations of agonists.
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Affiliation(s)
- Ilaria Canobbio
- Centre of Excellence for Applied Biology, Department of Biochemistry, University of Pavia, via Bassi 21, 27100 Pavia, Italy
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48
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Faggioni G, Grassi S, Fillo S, Stefanini L, Bottini E, Lista F. Rapid single tube genotyping of ACP1 by FRET based amplification and dual color melting curve analysis. Mol Cell Probes 2006; 20:27-30. [PMID: 16226867 DOI: 10.1016/j.mcp.2005.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2005] [Revised: 08/10/2005] [Accepted: 08/10/2005] [Indexed: 10/25/2022]
Abstract
Erythrocyte acid phosphatase (ACP1), also named low molecular weight phosphotyrosine phosphatase (LMW-PTP) is an enzyme involved in signal transduction pathways of tyrosine kinase receptor. The precise physiological role of ACP1 remains to be elucidated, however recent advancements suggest that it may play an important role in the control of cell proliferation. ACP1 is a highly polymorphic enzyme that has been investigated by case-control studies for decades. Initially based on protein electrophoresis, the phenotype of ACP1 is now detected by DNA-based techniques. Here, we report a new rapid single tube genotyping method for ACP1 by FRET based amplification and dual color melting curve analysis. This method does not require a post-procedure amplification process and allows unambiguous genotyping of 30 samples in less than 1 h.
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Affiliation(s)
- G Faggioni
- Laboratory of Genetics, Army Medical and Veterinary Research Center, Via S. Stefano Rotondo, 4 00184 Rome, Italy
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Bottini N, Stefanini L, Lucarelli P, Bottini E. Adaptation to past malarial endemia and susceptibility to common diseases in modern populations: a study of adenosine deaminase and MN blood group genetic polymorphisms. Am J Phys Anthropol 2005; 128:194-8. [PMID: 15761857 DOI: 10.1002/ajpa.20019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We carried out a study of adenosine deaminase (ADA) and MN blood group genetic polymorphisms in relation to past malarial morbidity in Sardinia and in relation to susceptibility to allergic asthma (a Th2 disorder) and Crohn's disease (a Th1 disorder) in the population of Rome. Eight hundred and eight schoolchildren, aged 7--14 years from 14 Sardinian villages located in the central area of the island, were considered. One hundred and twenty-two children with allergic asthma and 39 adult patients with Crohn's disease from the population of Rome were also studied. The data suggest an interaction between the two systems concerning resistance/susceptibility, both to malaria and to the diseases considered. In Sardinia, the frequency of the *L(M)/ADA*2 gametic type is negatively correlated with past malarial endemia, suggesting an increased susceptibility to malaria leading to its decrease in areas with high malarial endemia. In Rome, this gametic type is correlated negatively to allergic asthma and positively to Crohn's disease, suggesting a protective effect against allergic asthma and increased susceptibility to Crohn's disease.
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Affiliation(s)
- N Bottini
- Burnham Institute, La Jolla, California 92037, USA
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Pecci A, Canobbio I, Balduini A, Stefanini L, Cisterna B, Marseglia C, Noris P, Savoia A, Balduini CL, Torti M. Pathogenetic mechanisms of hematological abnormalities of patients with MYH9 mutations. Hum Mol Genet 2005; 14:3169-78. [PMID: 16162639 DOI: 10.1093/hmg/ddi344] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [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: 11/14/2022] Open
Abstract
Mutations of MYH9, the gene for non-muscle myosin heavy chain IIA (NMMHC-IIA), cause a complex clinical phenotype characterized by macrothrombocytopenia and granulocyte inclusion bodies, often associated with deafness, cataracts and/or glomerulonephritis. The pathogenetic mechanisms of these defects are either completely unknown or controversial. In particular, it is a matter of debate whether haploinsufficiency or a dominant-negative effect of mutant allele is responsible for hematological abnormalities. We investigated 11 patients from six pedigrees with different MYH9 mutations. We evaluated NMMHC-IIA levels in platelets and granulocytes isolated from peripheral blood and in megakaryocytes (Mks) cultured from circulating progenitors. NMMHC-IIA distribution in Mks and granulocytes was also assessed. We demonstrated that all the investigated patients had a 50% reduction of NMMHC-IIA expression in platelets and that a similar defect was present also in Mks. In subjects with R1933X and E1945X mutations, the whole NMMHC-IIA of platelets and Mks was wild-type. No NMMHC-IIA inclusions were observed at any time of Mk maturation. In granulocytes, the extent of NMMHC-IIA reduction in patients with respect to control cells was significantly greater than that measured in platelets and Mks, and we found that wild-type protein was sequestered within most of the NMMHC-IIA inclusions. Altogether these results indicate that haploinsufficiency of NMMHC-IIA in megakaryocytic lineage is the mechanism of macrothrombocytopenia consequent to MYH9 mutations, whereas in granulocytes a dominant-negative effect of mutant allele is involved in the formation of inclusion bodies. The finding that the same mutations act through different mechanisms in different cells is surprising and requires further investigation.
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