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Kellermair L, Höfer C, Zeller MWG, Kubasta C, Bandke D, Weis S, Kellermair J, Forstner T, Helbok R, Vosko MR. Endothelial receptor proteins in acute venous thrombosis and delayed thrombus resolution in cerebral sinus vein thrombosis. J Neurol 2024:10.1007/s00415-024-12225-3. [PMID: 38578497 DOI: 10.1007/s00415-024-12225-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND AND PURPOSE Cerebral sinus venous thrombosis (CSVT) is a rare but life-threatening disease and its diagnosis remains challenging. Blood biomarkers, including D-Dimer are currently not recommended in guidelines. Soluble endothelial receptor proteins (sICAM-1, sPECAM-1 and sVCAM-1) have been shown to be promising diagnostic biomarkers in deep vein thrombosis (DVT) and pulmonary embolism (PE). Therefore, we examined endothelial receptor proteins as potential biomarkers for detecting CSVT. METHODS In this bi-centre, prospective study, we quantified D-Dimer as well as sICAM-1, sPECAM-1 and sVCAM-1 in plasma of patients with clinically suspected CSVT managed in the neurological emergency department (ED) of a tertiary care hospital. All patients underwent cerebral magnetic resonance imaging (MRI) and were followed up after 3, 6 and 12 months to detect thrombus resolution. RESULTS Twenty-four out of 75 (32%) patients with clinically suspected CSVT presenting with headache to the ED were diagnosed with acute CSVT. These patients had a mean age of 45 ± 16 years and 78% were female. In patients with CSVT, mean baseline D-dimer (p < 0.001) and sPECAM-1 (p < 0.001) were significantly higher compared to patients without CSVT. The combination of D-Dimer and sPECAM-1 yielded the best ROC-AUC (0.994; < 0.001) with a negative predictive value of 95.7% and a positive predictive value of 95.5%. In addition, higher baseline sPECAM-1 levels (> 198 ng/ml) on admission were associated with delayed venous thrombus resolution at 3 months (AUC = 0.83). CONCLUSION sPECAM-1 in combination with D-Dimer should be used to improve the diagnostic accuracy of acute CSVT and sPECAM-1 may predict long-term outcome of CSVT. Confirmatory results are needed in other settings in order to show their value in the management concept of CSVT patients.
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Affiliation(s)
- Lukas Kellermair
- Department of Neurology, Kepler University Hospital GmbH, Johannes Kepler University Linz, Krankenhausstr. 9, 4021, Linz, Austria
| | - Christoph Höfer
- Department of Neurology, The Hospital of the Brothers of Saint John of God, Linz, Austria
| | - Matthias W G Zeller
- Department of Neurology, Kepler University Hospital GmbH, Johannes Kepler University Linz, Krankenhausstr. 9, 4021, Linz, Austria
| | - Christa Kubasta
- Department of Laboratory Medicine, Kepler University Hospital, Linz, Austria
- Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Dave Bandke
- Division of Neuropathology, Department of Pathology and Molecular Pathology, Kepler University Hospital, Neuromed Campus, Linz, Austria
- Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Serge Weis
- Division of Neuropathology, Department of Pathology and Molecular Pathology, Kepler University Hospital, Neuromed Campus, Linz, Austria
- Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Jörg Kellermair
- Medical Faculty, Johannes Kepler University, Linz, Austria
- Department of Cardiology, Kepler University Hospital, Med Campus III, Linz, Austria
| | - Thomas Forstner
- Department of Applied Systems Research and Statistics, Johannes Kepler University Linz, Linz, Austria
| | - Raimund Helbok
- Department of Neurology, Kepler University Hospital GmbH, Johannes Kepler University Linz, Krankenhausstr. 9, 4021, Linz, Austria
| | - Milan R Vosko
- Department of Neurology, Kepler University Hospital GmbH, Johannes Kepler University Linz, Krankenhausstr. 9, 4021, Linz, Austria.
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Wang C, Keliher E, Zeller MWG, Wojtkiewicz GR, Aguirre AD, Buckbinder L, Kim HY, Chen J, Maresca K, Ahmed MS, Motlagh NJ, Nahrendorf M, Chen JW. An activatable PET imaging radioprobe is a dynamic reporter of myeloperoxidase activity in vivo. Proc Natl Acad Sci U S A 2019; 116:11966-11971. [PMID: 31123149 PMCID: PMC6575581 DOI: 10.1073/pnas.1818434116] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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] [Indexed: 01/11/2023] Open
Abstract
Myeloperoxidase (MPO) is a critical proinflammatory enzyme implicated in cardiovascular, neurological, and rheumatological diseases. Emerging therapies targeting inflammation have raised interest in tracking MPO activity in patients. We describe 18F-MAPP, an activatable MPO activity radioprobe for positron emission tomography (PET) imaging. The activated radioprobe binds to proteins and accumulates at sites of MPO activity. The radioprobe 18F-MAPP has a short blood half-life, remains stable in plasma, does not demonstrate cytotoxicity, and crosses the intact blood-brain barrier. The 18F-MAPP imaging detected sites of elevated MPO activity in living mice embedded with human MPO and in mice induced with chemical inflammation or myocardial infarction. The 18F-MAPP PET imaging noninvasively differentiated varying amounts of MPO activity, competitive inhibition, and MPO deficiency in living animals, confirming specificity and showing that the radioprobe can quantify changes in in vivo MPO activity. The radiosynthesis has been optimized and automated, an important step in translation. These data indicate that 18F-MAPP is a promising translational candidate to noninvasively monitor MPO activity and inflammation in patients.
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Affiliation(s)
- Cuihua Wang
- Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114
| | - Edmund Keliher
- Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114
| | - Matthias W G Zeller
- Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114
| | - Gregory R Wojtkiewicz
- Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114
| | - Aaron D Aguirre
- Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114
- Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114
| | | | - Hye-Yeong Kim
- Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114
| | - Jianqing Chen
- Pfizer World Wide Research and Development, Cambridge, MA 02139
| | - Kevin Maresca
- Pfizer World Wide Research and Development, Cambridge, MA 02139
| | - Maaz S Ahmed
- Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114
| | - Negin Jalali Motlagh
- Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114
| | - Matthias Nahrendorf
- Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114
| | - John W Chen
- Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114;
- Institute for Innovation in Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA 02114
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Linnoila J, Pulli B, Armangué T, Planagumà J, Narsimhan R, Schob S, Zeller MWG, Dalmau J, Chen J. Mouse model of anti-NMDA receptor post-herpes simplex encephalitis. Neurol Neuroimmunol Neuroinflamm 2019; 6:e529. [PMID: 30697582 PMCID: PMC6340334 DOI: 10.1212/nxi.0000000000000529] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 10/16/2018] [Indexed: 11/17/2022]
Abstract
Objective To develop an endogenous rodent model of postinfectious anti-NMDA receptor (NMDAR) encephalitis. Methods Six mice were inoculated intranasally with herpes simplex virus (HSV) 1 and subsequently treated with acyclovir for 2 weeks. Serum was collected at 3, 6, and 8 weeks postinoculation and tested for NMDAR antibodies through a cell-based assay. Eight weeks postinoculation, mice were killed and their brains were sectioned and immunostained with antibodies to postsynaptic density (PSD)-95 and NMDARs. Colocalization of hippocampal PSD-95 and NMDAR clusters, representing postsynaptic membrane NMDARs, was quantified via confocal imaging. Hippocampi were additionally analyzed for NMDAR and PSD-95 protein using Western blot analysis. Results Four of 6 mice (67%) developed serum antibodies to NMDARs: 1 at 3 weeks, 1 at 6 weeks, and 2 at 8 weeks postinoculation. As compared to inoculated mice that did not develop NMDAR antibodies, immunofluorescence staining revealed decreased hippocampal postsynaptic membrane NMDARs in mice with serum antibodies at 8 weeks postinoculation. Western blot analysis showed that mice that had NMDAR antibodies at 8 weeks had decreased total NMDAR but not PSD-95 protein in hippocampal extracts (p < 0.05). Conclusions Mice inoculated intranasally with HSV-1 developed serum NMDAR antibodies. These antibodies were associated with reduced hippocampal NMDARs, as has been shown in previous models where antibodies from patients with anti-NMDAR encephalitis were infused into mice, paving the way for future studies into the pathophysiology of autoimmune encephalitides.
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Affiliation(s)
- Jenny Linnoila
- Center for Systems Biology (CSB), Department of Neurology (J.L., R.N.), Massachusetts General Hospital (MGH); CSB, Department of Radiology (B.P., S.S., M.Z.), MGH, Boston; Neuroimmunology Program (T.A.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona; Pediatric Neuroimmunology Unit (T.A.), Neurology Department, Sant Joan de Déu Children's Hospital, University of Barcelona; Neuroimmunology Program (J.P., J.D.), IDIBAPS, Barcelona, Spain; Department of Neurology (J.D.), University of Pennsylvania, PA; Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain; and Institute for Innovation in Imaging (J.C.), Department of Radiology, MGH, Boston
| | - Benjamin Pulli
- Center for Systems Biology (CSB), Department of Neurology (J.L., R.N.), Massachusetts General Hospital (MGH); CSB, Department of Radiology (B.P., S.S., M.Z.), MGH, Boston; Neuroimmunology Program (T.A.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona; Pediatric Neuroimmunology Unit (T.A.), Neurology Department, Sant Joan de Déu Children's Hospital, University of Barcelona; Neuroimmunology Program (J.P., J.D.), IDIBAPS, Barcelona, Spain; Department of Neurology (J.D.), University of Pennsylvania, PA; Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain; and Institute for Innovation in Imaging (J.C.), Department of Radiology, MGH, Boston
| | - Thaís Armangué
- Center for Systems Biology (CSB), Department of Neurology (J.L., R.N.), Massachusetts General Hospital (MGH); CSB, Department of Radiology (B.P., S.S., M.Z.), MGH, Boston; Neuroimmunology Program (T.A.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona; Pediatric Neuroimmunology Unit (T.A.), Neurology Department, Sant Joan de Déu Children's Hospital, University of Barcelona; Neuroimmunology Program (J.P., J.D.), IDIBAPS, Barcelona, Spain; Department of Neurology (J.D.), University of Pennsylvania, PA; Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain; and Institute for Innovation in Imaging (J.C.), Department of Radiology, MGH, Boston
| | - Jesús Planagumà
- Center for Systems Biology (CSB), Department of Neurology (J.L., R.N.), Massachusetts General Hospital (MGH); CSB, Department of Radiology (B.P., S.S., M.Z.), MGH, Boston; Neuroimmunology Program (T.A.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona; Pediatric Neuroimmunology Unit (T.A.), Neurology Department, Sant Joan de Déu Children's Hospital, University of Barcelona; Neuroimmunology Program (J.P., J.D.), IDIBAPS, Barcelona, Spain; Department of Neurology (J.D.), University of Pennsylvania, PA; Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain; and Institute for Innovation in Imaging (J.C.), Department of Radiology, MGH, Boston
| | - Radha Narsimhan
- Center for Systems Biology (CSB), Department of Neurology (J.L., R.N.), Massachusetts General Hospital (MGH); CSB, Department of Radiology (B.P., S.S., M.Z.), MGH, Boston; Neuroimmunology Program (T.A.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona; Pediatric Neuroimmunology Unit (T.A.), Neurology Department, Sant Joan de Déu Children's Hospital, University of Barcelona; Neuroimmunology Program (J.P., J.D.), IDIBAPS, Barcelona, Spain; Department of Neurology (J.D.), University of Pennsylvania, PA; Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain; and Institute for Innovation in Imaging (J.C.), Department of Radiology, MGH, Boston
| | - Stefan Schob
- Center for Systems Biology (CSB), Department of Neurology (J.L., R.N.), Massachusetts General Hospital (MGH); CSB, Department of Radiology (B.P., S.S., M.Z.), MGH, Boston; Neuroimmunology Program (T.A.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona; Pediatric Neuroimmunology Unit (T.A.), Neurology Department, Sant Joan de Déu Children's Hospital, University of Barcelona; Neuroimmunology Program (J.P., J.D.), IDIBAPS, Barcelona, Spain; Department of Neurology (J.D.), University of Pennsylvania, PA; Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain; and Institute for Innovation in Imaging (J.C.), Department of Radiology, MGH, Boston
| | - Matthias W G Zeller
- Center for Systems Biology (CSB), Department of Neurology (J.L., R.N.), Massachusetts General Hospital (MGH); CSB, Department of Radiology (B.P., S.S., M.Z.), MGH, Boston; Neuroimmunology Program (T.A.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona; Pediatric Neuroimmunology Unit (T.A.), Neurology Department, Sant Joan de Déu Children's Hospital, University of Barcelona; Neuroimmunology Program (J.P., J.D.), IDIBAPS, Barcelona, Spain; Department of Neurology (J.D.), University of Pennsylvania, PA; Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain; and Institute for Innovation in Imaging (J.C.), Department of Radiology, MGH, Boston
| | - Josep Dalmau
- Center for Systems Biology (CSB), Department of Neurology (J.L., R.N.), Massachusetts General Hospital (MGH); CSB, Department of Radiology (B.P., S.S., M.Z.), MGH, Boston; Neuroimmunology Program (T.A.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona; Pediatric Neuroimmunology Unit (T.A.), Neurology Department, Sant Joan de Déu Children's Hospital, University of Barcelona; Neuroimmunology Program (J.P., J.D.), IDIBAPS, Barcelona, Spain; Department of Neurology (J.D.), University of Pennsylvania, PA; Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain; and Institute for Innovation in Imaging (J.C.), Department of Radiology, MGH, Boston
| | - John Chen
- Center for Systems Biology (CSB), Department of Neurology (J.L., R.N.), Massachusetts General Hospital (MGH); CSB, Department of Radiology (B.P., S.S., M.Z.), MGH, Boston; Neuroimmunology Program (T.A.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona; Pediatric Neuroimmunology Unit (T.A.), Neurology Department, Sant Joan de Déu Children's Hospital, University of Barcelona; Neuroimmunology Program (J.P., J.D.), IDIBAPS, Barcelona, Spain; Department of Neurology (J.D.), University of Pennsylvania, PA; Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain; and Institute for Innovation in Imaging (J.C.), Department of Radiology, MGH, Boston
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Pulli B, Ali M, Iwamoto Y, Zeller MWG, Schob S, Linnoila JJ, Chen JW. Myeloperoxidase-Hepatocyte-Stellate Cell Cross Talk Promotes Hepatocyte Injury and Fibrosis in Experimental Nonalcoholic Steatohepatitis. Antioxid Redox Signal 2015; 23:1255-69. [PMID: 26058518 PMCID: PMC4677570 DOI: 10.1089/ars.2014.6108] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [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: 01/18/2023]
Abstract
AIMS Myeloperoxidase (MPO), a highly oxidative enzyme secreted by leukocytes has been implicated in human and experimental nonalcoholic steatohepatitis (NASH), but the underlying mechanisms remain unknown. In this study, we investigated how MPO contributes to progression from steatosis to NASH. RESULTS In C57Bl/6J mice fed a diet deficient in methionine and choline to induce NASH, neutrophils and to a lesser extent inflammatory monocytes are markedly increased compared with sham mice and secrete abundant amounts of MPO. Through generation of HOCl, MPO directly causes hepatocyte death in vivo. In vitro experiments demonstrate mitochondrial permeability transition pore induction via activation of SAPK/JNK and PARP. MPO also contributes to activation of hepatic stellate cells (HSCs), the most important source of collagen in the liver. In vitro MPO-activated HSCs have an activation signature (MAPK and PI3K-AKT phosphorylation) and upregulate COL1A1, α-SMA, and CXCL1. MPO-derived oxidative stress also activates transforming growth factor β (TGF-β) in vitro, and TGF-β signaling inhibition with SB-431542 decreased steatosis and fibrosis in vivo. Conversely, congenital absence of MPO results in reduced hepatocyte injury, decreased levels of TGF-β, fewer activated HSCs, and less severe fibrosis in vivo. INNOVATION AND CONCLUSION Cumulatively, these findings demonstrate important cross talk between inflammatory myeloid cells, hepatocytes, and HSCs via MPO and establish MPO as part of a proapoptotic and profibrotic pathway of progression in NASH, as well as a potential therapeutic target to ameliorate this disease.
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Affiliation(s)
- Benjamin Pulli
- 1 Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School , Boston, Massachusetts.,2 Department of Radiology, Massachusetts General Hospital , Boston, Massachusetts
| | - Muhammad Ali
- 1 Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School , Boston, Massachusetts
| | - Yoshiko Iwamoto
- 1 Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School , Boston, Massachusetts
| | - Matthias W G Zeller
- 1 Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School , Boston, Massachusetts
| | - Stefan Schob
- 1 Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School , Boston, Massachusetts
| | - Jenny J Linnoila
- 1 Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School , Boston, Massachusetts
| | - John W Chen
- 1 Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School , Boston, Massachusetts.,2 Department of Radiology, Massachusetts General Hospital , Boston, Massachusetts
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