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da Fonseca FG, Conran N. Introduction to the thematic issue on infectious diseases: Highlights of the Brazilian virology conference 2022 and International Experimental Biology and Medicine Conference (IEBMC), Brazil 2022. Exp Biol Med (Maywood) 2023; 248:1613-1615. [PMID: 38058116 PMCID: PMC10723025 DOI: 10.1177/15353702231216529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023] Open
Affiliation(s)
- Flávio G da Fonseca
- Microbiology Department, Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte 31270-901, Brazil
- Vaccine Technology Center (CT Vacinas), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte 31310-260, Brazil
| | - Nicola Conran
- Hematology and Transfusion Center (Hemocentro), University of Campinas (UNICAMP), Campinas 13083-878, Brazil
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2
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Piel FB, Rees DC, DeBaun MR, Nnodu O, Ranque B, Thompson AA, Ware RE, Abboud MR, Abraham A, Ambrose EE, Andemariam B, Colah R, Colombatti R, Conran N, Costa FF, Cronin RM, de Montalembert M, Elion J, Esrick E, Greenway AL, Idris IM, Issom DZ, Jain D, Jordan LC, Kaplan ZS, King AA, Lloyd-Puryear M, Oppong SA, Sharma A, Sung L, Tshilolo L, Wilkie DJ, Ohene-Frempong K. Defining global strategies to improve outcomes in sickle cell disease: a Lancet Haematology Commission. Lancet Haematol 2023; 10:e633-e686. [PMID: 37451304 DOI: 10.1016/s2352-3026(23)00096-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/31/2023] [Accepted: 04/12/2023] [Indexed: 07/18/2023]
Affiliation(s)
- Frédéric B Piel
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
| | - David C Rees
- Department of Paediatric Haematology, King's College London, King's College Hospital, London, UK
| | - Michael R DeBaun
- Department of Pediatrics, Vanderbilt-Meharry Center of Excellence for Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Obiageli Nnodu
- Department of Haematology and Blood Transfusion, College of Health Sciences and Centre of Excellence for Sickle Cell Disease Research and Training, University of Abuja, Abuja, Nigeria
| | - Brigitte Ranque
- Department of Internal Medicine, Georges Pompidou European Hospital, Assistance Publique-Hopitaux de Paris Centre, University of Paris Cité, Paris, France
| | - Alexis A Thompson
- Division of Hematology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Russell E Ware
- Division of Hematology and Global Health Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Miguel R Abboud
- Department of Pediatrics and Adolescent Medicine, and Sickle Cell Program, American University of Beirut, Beirut, Lebanon
| | - Allistair Abraham
- Division of Blood and Marrow Transplantation, Children's National Hospital, Washington, DC, USA
| | - Emmanuela E Ambrose
- Department of Paediatrics and Child Health, Bugando Medical Centre, Mwanza, Tanzania
| | - Biree Andemariam
- New England Sickle Cell Institute, University of Connecticut Health, Connecticut, USA
| | - Roshan Colah
- Department of Haematogenetics, Indian Council of Medical Research National Institute of Immunohaematology, Mumbai, India
| | - Raffaella Colombatti
- Pediatric Oncology Hematology Unit, Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Nicola Conran
- Department of Clinical Medicine, School of Medical Sciences, Center of Hematology and Hemotherapy (Hemocentro), University of Campinas-UNICAMP, Campinas, Brazil
| | - Fernando F Costa
- Department of Clinical Medicine, School of Medical Sciences, Center of Hematology and Hemotherapy (Hemocentro), University of Campinas-UNICAMP, Campinas, Brazil
| | - Robert M Cronin
- Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Mariane de Montalembert
- Department of Pediatrics, Necker-Enfants Malades Hospital, Assistance Publique-Hopitaux de Paris Centre, Paris, France
| | - Jacques Elion
- Paris Cité University and University of the Antilles, Inserm, BIGR, Paris, France
| | - Erica Esrick
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
| | - Anthea L Greenway
- Department Clinical Haematology, Royal Children's Hospital, Parkville and Department Haematology, Monash Health, Clayton, VIC, Australia
| | - Ibrahim M Idris
- Department of Hematology, Aminu Kano Teaching Hospital/Bayero University Kano, Kano, Nigeria
| | - David-Zacharie Issom
- Department of Business Information Systems, School of Management, HES-SO University of Applied Sciences and Arts of Western Switzerland, Geneva, Switzerland
| | - Dipty Jain
- Department of Paediatrics, Government Medical College, Nagpur, India
| | - Lori C Jordan
- Department of Pediatrics, Division of Pediatric Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Zane S Kaplan
- Department of Clinical Haematology, Monash Health and Monash University, Melbourne, VIC, Australia
| | - Allison A King
- Departments of Pediatrics and Internal Medicine, Divisions of Pediatric Hematology and Oncology and Hematology, Washington University School of Medicine, St Louis, MO, USA
| | - Michele Lloyd-Puryear
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Samuel A Oppong
- Department of Obstetrics and Gynecology, University of Ghana Medical School, Accra, Ghana
| | - Akshay Sharma
- Department of Bone Marrow Transplantation and Cellular Therapy, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Lillian Sung
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Leon Tshilolo
- Institute of Biomedical Research/CEFA Monkole Hospital Centre and Official University of Mbuji-Mayi, Mbuji-Mayi, Democratic Republic of the Congo
| | - Diana J Wilkie
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, USA
| | - Kwaku Ohene-Frempong
- Division of Hematology, Children's Hospital of Philadelphia, Pennsylvania, USA; Sickle Cell Foundation of Ghana, Kumasi, Ghana
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Gotardo ÉMF, Brito PL, Gushiken LFS, Chweih H, Leonardo FC, Costa FF, Conran N. Molecular and cellular effects of in vivo chronic intravascular hemolysis and anti-inflammatory therapeutic approaches. Vascul Pharmacol 2023; 150:107176. [PMID: 37116732 DOI: 10.1016/j.vph.2023.107176] [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: 01/24/2023] [Revised: 04/11/2023] [Accepted: 04/25/2023] [Indexed: 04/30/2023]
Abstract
Intravascular hemolysis (IVH) occurs in numerous inherited and acquired disorders, including sickle cell disease (SCD), malaria and sepsis. These diseases display unique symptoms, but often share complications, such as vasomotor dysfunction and pulmonary hypertension. Consequently, in vivo models are needed to study the effects of continuous intravascular hemolytic processes, independently of the molecular or extrinsic alteration that leads to erythrocyte destruction. We gave twice-weekly low-dose phenylhydrazine (LDPHZ) to C57BL/6 J mice for 4 weeks, and measured parameters indicative of anemia, hemoglobin-clearance pathways, inflammation and iron turnover, comparing these to those of a murine model of SCD, which displays associated IVH. LDPHZ administration provoked discreet anemia in mice and significant reticulocytosis, in association with hemoglobin/heme-clearance pathway protein depletion. Mice subjected to chronic hemolysis displayed elevated leukocyte counts and plasma levels of interleukin (IL)-1β, TNF-α, IL-6, soluble ICAM-1, endothelin-1 and anti-inflammatory IL-10, closely emulating alterations indicative of systemic inflammatory and endothelial activation in SCD, and confirming chronic IVH in itself as a serious complication. Discreet accelerations in hepatic and splenic iron turnover also occurred in LDPHZ mice, without alterations in liver damage markers. Examining the effects of two therapies on hemolysis-induced inflammation, the administration of hydroxyurea (and to a lesser extent, l-glutamine) significantly abrogated hemolytic inflammation in mice, without apparent inhibition of hemolysis. In conclusion, the isolation of chronic IVH, a common disease mechanism, using this model, may allow the study of hemolysis-specific sequelae at the cellular and systemic level, and the investigation of candidate agents that could potentially counter hemolytic inflammation.
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Affiliation(s)
- Érica M F Gotardo
- Hematology and Transfusion Center, University of Campinas - UNICAMP, Campinas, SP, Brazil.
| | - Pâmela L Brito
- Hematology and Transfusion Center, University of Campinas - UNICAMP, Campinas, SP, Brazil
| | - Lucas F S Gushiken
- Hematology and Transfusion Center, University of Campinas - UNICAMP, Campinas, SP, Brazil
| | - Hanan Chweih
- Hematology and Transfusion Center, University of Campinas - UNICAMP, Campinas, SP, Brazil
| | - Flavia C Leonardo
- Hematology and Transfusion Center, University of Campinas - UNICAMP, Campinas, SP, Brazil
| | - Fernando F Costa
- Hematology and Transfusion Center, University of Campinas - UNICAMP, Campinas, SP, Brazil
| | - Nicola Conran
- Hematology and Transfusion Center, University of Campinas - UNICAMP, Campinas, SP, Brazil.
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4
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Nader E, Conran N, Leonardo FC, Hatem A, Boisson C, Carin R, Renoux C, Costa FF, Joly P, Brito PL, Esperti S, Bernard J, Gauthier A, Poutrel S, Bertrand Y, Garcia C, Saad STO, Egée S, Connes P. Piezo1 activation augments sickling propensity and the adhesive properties of sickle red blood cells in a calcium-dependent manner. Br J Haematol 2023. [PMID: 37011913 DOI: 10.1111/bjh.18799] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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: 01/03/2023] [Revised: 03/07/2023] [Accepted: 03/28/2023] [Indexed: 04/05/2023]
Abstract
Haemoglobin S polymerization in the red blood cells (RBCs) of individuals with sickle cell anaemia (SCA) can cause RBC sickling and cellular alterations. Piezo1 is a mechanosensitive protein that modulates intracellular calcium (Ca2+ ) influx, and its activation has been associated with increased RBC surface membrane phosphatidylserine (PS) exposure. Hypothesizing that Piezo1 activation, and ensuing Gárdos channel activity, alter sickle RBC properties, RBCs from patients with SCA were incubated with the Piezo1 agonist, Yoda1 (0.1-10 μM). Oxygen-gradient ektacytometry and membrane potential measurement showed that Piezo1 activation significantly decreased sickle RBC deformability, augmented sickling propensity, and triggered pronounced membrane hyperpolarization, in association with Gárdos channel activation and Ca2+ influx. Yoda1 induced Ca2+ -dependent adhesion of sickle RBCs to laminin, in microfluidic assays, mediated by increased BCAM binding affinity. Furthermore, RBCs from SCA patients that were homo-/heterozygous for the rs59446030 gain-of-function Piezo1 variant demonstrated enhanced sickling under deoxygenation and increased PS exposure. Thus, Piezo1 stimulation decreases sickle RBC deformability, and increases the propensities of these cells to sickle upon deoxygenation and adhere to laminin. Results support a role of Piezo1 in some of the RBC properties that contribute to SCA vaso-occlusion, indicating that Piezo1 may represent a potential therapeutic target molecule for this disease.
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Affiliation(s)
- Elie Nader
- Laboratory LIBM EA7424, Vascular Biology and Red Blood Cell Team, University of Lyon, Lyon, France
| | - Nicola Conran
- Hematology and Transfusion Center, University of Campinas, Campinas, Brazil
| | - Flavia C Leonardo
- Hematology and Transfusion Center, University of Campinas, Campinas, Brazil
| | - Aline Hatem
- Sorbonne Université, CNRS, UMR 8227 LBI2M, Station Biologique de Roscoff SBR, Roscoff, France
| | - Camille Boisson
- Laboratory LIBM EA7424, Vascular Biology and Red Blood Cell Team, University of Lyon, Lyon, France
- Service de Biochimie et Biologie Moléculaire, Laboratoire de Biologie Médicale Multi-site, Hospices Civils de Lyon, Lyon, France
| | - Romain Carin
- Laboratory LIBM EA7424, Vascular Biology and Red Blood Cell Team, University of Lyon, Lyon, France
| | - Céline Renoux
- Laboratory LIBM EA7424, Vascular Biology and Red Blood Cell Team, University of Lyon, Lyon, France
- Service de Biochimie et Biologie Moléculaire, Laboratoire de Biologie Médicale Multi-site, Hospices Civils de Lyon, Lyon, France
| | - Fernando F Costa
- Hematology and Transfusion Center, University of Campinas, Campinas, Brazil
| | - Philippe Joly
- Laboratory LIBM EA7424, Vascular Biology and Red Blood Cell Team, University of Lyon, Lyon, France
- Service de Biochimie et Biologie Moléculaire, Laboratoire de Biologie Médicale Multi-site, Hospices Civils de Lyon, Lyon, France
| | - Pamela L Brito
- Hematology and Transfusion Center, University of Campinas, Campinas, Brazil
| | - Sofia Esperti
- Laboratory LIBM EA7424, Vascular Biology and Red Blood Cell Team, University of Lyon, Lyon, France
- Erytech Pharma, Lyon, France
| | - Joelle Bernard
- Service de Biochimie et Biologie Moléculaire, Laboratoire de Biologie Médicale Multi-site, Hospices Civils de Lyon, Lyon, France
| | - Alexandra Gauthier
- Laboratory LIBM EA7424, Vascular Biology and Red Blood Cell Team, University of Lyon, Lyon, France
- Institut d'Hématologique et d'Oncologique Pédiatrique, Hospices Civils de Lyon, Lyon, France
| | - Solene Poutrel
- Laboratory LIBM EA7424, Vascular Biology and Red Blood Cell Team, University of Lyon, Lyon, France
- Service de Médecine Interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Yves Bertrand
- Institut d'Hématologique et d'Oncologique Pédiatrique, Hospices Civils de Lyon, Lyon, France
| | - Caroline Garcia
- Service de Biochimie et Biologie Moléculaire, Laboratoire de Biologie Médicale Multi-site, Hospices Civils de Lyon, Lyon, France
| | - Sara T O Saad
- Hematology and Transfusion Center, University of Campinas, Campinas, Brazil
| | - Stéphane Egée
- Sorbonne Université, CNRS, UMR 8227 LBI2M, Station Biologique de Roscoff SBR, Roscoff, France
| | - Philippe Connes
- Laboratory LIBM EA7424, Vascular Biology and Red Blood Cell Team, University of Lyon, Lyon, France
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Sesti-Costa R, Costa FF, Conran N. Role of Macrophages in Sickle Cell Disease Erythrophagocytosis and Erythropoiesis. Int J Mol Sci 2023; 24:ijms24076333. [PMID: 37047304 PMCID: PMC10094208 DOI: 10.3390/ijms24076333] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
Sickle cell disease (SCD) is an inherited blood disorder caused by a β-globin gene point mutation that results in the production of sickle hemoglobin that polymerizes upon deoxygenation, causing the sickling of red blood cells (RBCs). RBC deformation initiates a sequence of events leading to multiple complications, such as hemolytic anemia, vaso-occlusion, chronic inflammation, and tissue damage. Macrophages participate in extravascular hemolysis by removing damaged RBCs, hence preventing the release of free hemoglobin and heme, and triggering inflammation. Upon erythrophagocytosis, macrophages metabolize RBC-derived hemoglobin, activating mechanisms responsible for recycling iron, which is then used for the generation of new RBCs to try to compensate for anemia. In the bone marrow, macrophages can create specialized niches, known as erythroblastic islands (EBIs), which regulate erythropoiesis. Anemia and inflammation present in SCD may trigger mechanisms of stress erythropoiesis, intensifying RBC generation by expanding the number of EBIs in the bone marrow and creating new ones in extramedullary sites. In the current review, we discuss the distinct mechanisms that could induce stress erythropoiesis in SCD, potentially shifting the macrophage phenotype to an inflammatory profile, and changing their supporting role necessary for the proliferation and differentiation of erythroid cells in the disease. The knowledge of the soluble factors, cell surface and intracellular molecules expressed by EBI macrophages that contribute to begin and end the RBC’s lifespan, as well as the understanding of their signaling pathways in SCD, may reveal potential targets to control the pathophysiology of the disease.
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6
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Conran N. Pain mechanisms in sickle cell disease. Are we closer to a breakthrough? Haematologica 2023; 108:663-664. [PMID: 35615934 PMCID: PMC9973463 DOI: 10.3324/haematol.2022.281200] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Indexed: 11/09/2022] Open
Abstract
Not available.
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Affiliation(s)
- Nicola Conran
- Hematology and Transfusion Center, University of Campinas-UNICAMP, Campinas, Sao Paulo, Brazil.
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Conran N, Lambert M, Turner ND. Introduction to the thematic issue: Recognition of women leaders in Science. Exp Biol Med (Maywood) 2022; 247:2173-2175. [PMID: 36703493 PMCID: PMC9899982 DOI: 10.1177/15353702231151240] [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] [Indexed: 01/28/2023] Open
Abstract
This thematic issue of Experimental Biology and Medicine is dedicated to the incredibly important contributions made by women leaders in the biomedical sciences throughout recent history. Scientists from many disciplines have contributed papers, both original research and state of the art reviews, to demonstrate the type of work being performed every day by women leaders committed to advancing scientific knowledge in their respective fields of specialization. In this introduction, we provide readers with a brief highlight of the information to be found in the invited papers.
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Affiliation(s)
- Nicola Conran
- Hematology and Transfusion Center
(Hemocentro), University of Campinas (UNICAMP), Campinas 13083-878, Brazil,Nicola Conran.
| | - Muriel Lambert
- Department of Pathology, Immunology and
Laboratory Medicine, New Jersey Medical School, Rutgers University, Newark, NJ 07103,
USA
| | - Nancy D Turner
- Department of Food Science and Human
Nutrition, Michigan State University, East Lansing, MI 48824-1312, USA
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Conran N, de Alvarenga Maximo C, Oliveira T, Fertrin KY, Lobo C, Costa FF. Safe use of hydroxycarbamide in sickle cell disease patients hospitalized for painful vaso-occlusive episodes during the randomized, open-label HELPS study. Br J Haematol 2022; 199:153-157. [PMID: 35834407 DOI: 10.1111/bjh.18349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/22/2022] [Accepted: 06/25/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Nicola Conran
- Hematology Center, University of Campinas-UNICAMP, Campinas, SP, Brazil
| | - Claudia de Alvarenga Maximo
- Divisão de Hematologia, Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti (Hemorio), Rio de Janeiro, Brazil
| | - Thais Oliveira
- Research Department, Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti (Hemorio), Rio de Janeiro, Brazil
| | - Kleber Y Fertrin
- Hematology Center, University of Campinas-UNICAMP, Campinas, SP, Brazil.,Division of Hematology, University of Washington, Seattle, Washington, USA
| | - Clarisse Lobo
- Research Department, Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti (Hemorio), Rio de Janeiro, Brazil
| | - Fernando F Costa
- Hematology Center, University of Campinas-UNICAMP, Campinas, SP, Brazil
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Conran N, Costa FF. Sickle Cell Disease and Oxidative Stress: Implications for a Role of Diminished Endothelial SOD2 in Pulmonary Complications. Function (Oxf) 2022; 3:zqac021. [PMID: 36156896 PMCID: PMC9492249 DOI: 10.1093/function/zqac021] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 01/07/2023]
Affiliation(s)
| | - Fernando F Costa
- Hematology and Transfusion Center, University of Campinas – UNICAMP, Campinas, São Paulo 13083-878, Brazil
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Sesti-Costa R, Silva-Filho JL, Barcellini W, Le Van Kim C, Conran N. Editorial: Inflammatory Mechanisms of Hemolytic Diseases. Front Immunol 2022; 12:834527. [PMID: 35095935 PMCID: PMC8791393 DOI: 10.3389/fimmu.2021.834527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 12/23/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Renata Sesti-Costa
- Hematology and Hemotherapy Center, University of Campinas (UNICAMP), Campinas, Brazil
| | - João Luiz Silva-Filho
- Wellcome Centre for Molecular Parasitology, Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, United Kingdom
| | - Wilma Barcellini
- Hematology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico Hospital, Milan, Italy
| | - Caroline Le Van Kim
- Université de Paris and Université des Antilles, INSERM, BIGR, Paris, France
| | - Nicola Conran
- Hematology and Hemotherapy Center, University of Campinas (UNICAMP), Campinas, Brazil
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11
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Torres LS, Teles LIM, Shaul ME, Fridlender ZG, Santos I, Leonardo FC, de Melo Campos P, Benites BD, Olalla Saad ST, Costa FF, Conran N. Accelerated low-density neutrophil transition in sickle cell anaemia may contribute to disease pathophysiology. Br J Haematol 2021; 197:232-235. [PMID: 34954828 DOI: 10.1111/bjh.18009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/08/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Lidiane S Torres
- Hematology and Transfusion Centre, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil.,Albert Einstein College of Medicine, Bronx, NY, USA
| | - Lediana I M Teles
- Hematology and Transfusion Centre, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Merav E Shaul
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Institute of Pulmonary Medicine, Hadassah-Hebrew University Medical Centre, Jerusalem, Israel
| | - Zvi G Fridlender
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Institute of Pulmonary Medicine, Hadassah-Hebrew University Medical Centre, Jerusalem, Israel
| | - Irene Santos
- Hematology and Transfusion Centre, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Flávia C Leonardo
- Hematology and Transfusion Centre, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Paula de Melo Campos
- Hematology and Transfusion Centre, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Bruno D Benites
- Hematology and Transfusion Centre, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Sara T Olalla Saad
- Hematology and Transfusion Centre, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Fernando F Costa
- Hematology and Transfusion Centre, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Nicola Conran
- Hematology and Transfusion Centre, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
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12
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Abstract
The pathophysiology of sickle cell anemia, a hereditary hemoglobinopathy, has fascinated clinicians and scientists alike since its description over 100 years ago. A single gene mutation in the HBB gene results in the production of abnormal hemoglobin (Hb) S, whose polymerization when deoxygenated alters the physiochemical properties of red blood cells, in turn triggering pan-cellular activation and pathological mechanisms that include hemolysis, vaso-occlusion, and ischemia-reperfusion to result in the varied and severe complications of the disease. Now widely regarded as an inflammatory disease, in recent years attention has included the role of leukocytes in vaso-occlusive processes in view of the part that these cells play in innate immune processes, their inherent ability to adhere to the endothelium when activated, and their sheer physical and potentially obstructive size. Here, we consider the role of sickle red blood cell populations in elucidating the importance of adhesion vis-a-vis polymerization in vaso-occlusion, review the direct adhesion of sickle red cells to the endothelium in vaso-occlusive processes, and discuss how red cell- and leukocyte-centered mechanisms are not mutually exclusive. Given the initial clinical success of crizanlizumab, a specific anti-P selectin therapy, we suggest that it is appropriate to take a holistic approach to understanding and exploring the complexity of vaso-occlusive mechanisms and the adhesive roles of the varied cell types, including endothelial cells, platelets, leukocytes, and red blood cells.
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Affiliation(s)
- Nicola Conran
- Hematology Center, University of Campinas-UNICAMP, Barão Geraldo 13083-8, Campinas, SP, Brazil
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13
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Nader E, Conran N, Romana M, Connes P. Vasculopathy in Sickle Cell Disease: From Red Blood Cell Sickling to Vascular Dysfunction. Compr Physiol 2021; 11:1785-1803. [PMID: 33792905 DOI: 10.1002/cphy.c200024] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Sickle cell disease (SCD) is a hereditary disorder that leads to the production of an abnormal hemoglobin, hemoglobin S (HbS). HbS polymerizes in deoxygenated conditions, which can prompt red blood cell (RBC) sickling and leaves the RBCs more rigid, fragile, and prone to hemolysis. SCD patients suffer from a plethora of complications, ranging from acute complications, such as characteristic, frequent, and debilitating vaso-occlusive episodes to chronic organ damage. While RBC sickling is the primary event at the origin of vaso-occlusive processes, other factors that can further increase RBC transit times in the microcirculation may also be required to precipitate vaso-occlusive processes. The adhesion of RBC and leukocytes to activated endothelium and the formation of heterocellular aggregates, as well as increased blood viscosity, are among the mechanisms involved in slowing the progress of RBCs in deoxygenated vascular areas, favoring RBC sickling and promoting vascular occlusion. Chronic inflammatory processes and oxidative stress, which are perpetuated by hemolytic events and ischemia-reperfusion injury, result in this pan cellular activation and some acute events, such as stroke and acute chest syndrome, as well as chronic end-organ damage. Furthermore, impaired vasodilation and vasomotor hyperresponsiveness in SCD also contribute to vaso-occlusive processes. Treating SCD as a vascular disease in addition to its hematological perspective, the present article looks at the interplay between abnormal RBC physiology/integrity, vascular dysfunction and clinical severity in SCD, and discusses existing therapies and novel drugs in development that may ameliorate vascular complications in the disease. © 2021 American Physiological Society. Compr Physiol 11:1785-1803, 2021.
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Affiliation(s)
- Elie Nader
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - Nicola Conran
- Hematology Center, University of Campinas - UNICAMP, Cidade Universitária, Campinas-SP, Brazil
| | - Marc Romana
- Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Université des Antilles, UMR_S1134, BIGR, Pointe-à-Pitre, France.,Université de Paris, UMR_S1134, BIGR, INSERM, Paris, France
| | - Philippe Connes
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team Vascular Biology and Red Blood Cell, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
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Conran N, De Paula EV. Thromboinflammatory mechanisms in sickle cell disease - challenging the hemostatic balance. Haematologica 2020; 105:2380-2390. [PMID: 33054078 PMCID: PMC7556678 DOI: 10.3324/haematol.2019.239343] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 04/19/2020] [Indexed: 11/11/2022] Open
Abstract
Sickle cell disease (SCD) is an inherited hemoglobinopathy that is caused by the presence of abnormal hemoglobin S (HbS) in red blood cells, leading to alterations in red cell properties and shape, as the result of HbS dexoygenation and subsequent polymerization. SCD pathophysiology is characterized by chronic inflammatory processes, triggered by hemolytic and vaso-occlusive events, which lead to the varied complications, organ damage and elevated mortality seen in individuals with the disease. In association with activation of the endothelium and leukocytes, hemostatic alterations and thrombotic events are well-documented in SCD. Here we discuss the role for inflammatory pathways in modulating coagulation and inducing platelet activation in SCD, due to tissue factor activation, adhesion molecule expression, inflammatory mediator production and the induction of innate immune responses, amongst other mechanisms. Thromboinflammatory pathways may play a significant role in some of the major complications of SCD, such as stroke, venous thromboembolism and possibly acute chest syndrome, besides exacerbating the chronic inflammation and cellular interactions that trigger vaso-occlusion, ischemia-reperfusion processes, and eventually organ damage.
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Affiliation(s)
- Nicola Conran
- Hematology Center, University of Campinas, UNICAMP, Cidade Universitária, Campinas-SP, Brazil
| | - Erich V. De Paula
- Hematology Center, University of Campinas, UNICAMP, Cidade Universitária, Campinas-SP, Brazil
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15
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Ferreira WA, Chweih H, Lanaro C, Almeida CB, Brito PL, Gotardo EMF, Torres L, Miguel LI, Franco-Penteado CF, Leonardo FC, Garcia F, Saad STO, Frenette PS, Brockschnieder D, Costa FF, Stasch JP, Sandner P, Conran N. Beneficial Effects of Soluble Guanylyl Cyclase Stimulation and Activation in Sickle Cell Disease Are Amplified by Hydroxyurea: In Vitro and In Vivo Studies. J Pharmacol Exp Ther 2020; 374:469-478. [PMID: 32631869 PMCID: PMC7445859 DOI: 10.1124/jpet.119.264606] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 12/13/2019] [Accepted: 06/26/2020] [Indexed: 12/13/2022] Open
Abstract
The complex pathophysiology of sickle cell anemia (SCA) involves intravascular hemolytic processes and recurrent vaso-occlusion, driven by chronic vascular inflammation, which result in the disease’s severe clinical complications, including recurrent painful vaso-occlusive episodes. Hydroxyurea, the only drug frequently used for SCA therapy, is a cytostatic agent, although it appears to exert nitric oxide/soluble guanylyl cyclase (sGC) modulating activity. As new drugs that can complement or replace the use of hydroxyurea are sought to further reduce vaso-occlusive episode frequency in SCA, we investigated the effects of the sGC agonists BAY 60-2770 (sGC activator) and BAY 41-2272 (sGC stimulator) in the presence or absence of hydroxyurea on SCA vaso-occlusive mechanisms and cell recruitment both ex vivo and in vivo. These agents significantly reduced stimulated human SCA neutrophil adhesive properties ex vivo in association with the inhibition of surface β2-integrin activation. A single administration of BAY 60-2770 or BAY 41-2272 decreased tumor necrosis factor cytokine–induced leukocyte recruitment in a mouse model of SCA vaso-occlusion. Importantly, the in vivo actions of both agonists were significantly potentiated by the coadministration of hydroxyurea. Erythroid cell fetal hemoglobin (HbF) elevation is also a major goal for SCA therapy. BAY 41-2272 but not BAY 60-2770 at the concentrations employed significantly induced γ-globin gene transcription in association with HbF production in cultured erythroleukemic cells. In conclusion, sGC agonist drugs could represent a promising approach as therapy for SCA, for use either as stand-alone treatments or in combination with hydroxyurea.
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Affiliation(s)
- W A Ferreira
- Hematology Center, School of Medical Sciences, University of Campinas (UNICAMP), Brazil (W.A.F., H.C., C.L., C.B.A., P.L.B., E.M.F.G., L.T., L.I.M., C.F.F.-P., F.C.L., F.G., S.S.T.O., F.F.C., N.C.); Bayer AG, Pharmaceuticals - Drug Discovery, Wuppertal, Germany (D.B., J.P.S., P.S.); Ruth L. and David S Gottesman Institute for Stem Cell and Regenerative Medicine Research, Albert Einstein College of Medicine, Bronx, New York (P.S.F.); and Hannover Medical School, Institute of Pharmacology, Hannover, Germany (P.S.)
| | - H Chweih
- Hematology Center, School of Medical Sciences, University of Campinas (UNICAMP), Brazil (W.A.F., H.C., C.L., C.B.A., P.L.B., E.M.F.G., L.T., L.I.M., C.F.F.-P., F.C.L., F.G., S.S.T.O., F.F.C., N.C.); Bayer AG, Pharmaceuticals - Drug Discovery, Wuppertal, Germany (D.B., J.P.S., P.S.); Ruth L. and David S Gottesman Institute for Stem Cell and Regenerative Medicine Research, Albert Einstein College of Medicine, Bronx, New York (P.S.F.); and Hannover Medical School, Institute of Pharmacology, Hannover, Germany (P.S.)
| | - C Lanaro
- Hematology Center, School of Medical Sciences, University of Campinas (UNICAMP), Brazil (W.A.F., H.C., C.L., C.B.A., P.L.B., E.M.F.G., L.T., L.I.M., C.F.F.-P., F.C.L., F.G., S.S.T.O., F.F.C., N.C.); Bayer AG, Pharmaceuticals - Drug Discovery, Wuppertal, Germany (D.B., J.P.S., P.S.); Ruth L. and David S Gottesman Institute for Stem Cell and Regenerative Medicine Research, Albert Einstein College of Medicine, Bronx, New York (P.S.F.); and Hannover Medical School, Institute of Pharmacology, Hannover, Germany (P.S.)
| | - C B Almeida
- Hematology Center, School of Medical Sciences, University of Campinas (UNICAMP), Brazil (W.A.F., H.C., C.L., C.B.A., P.L.B., E.M.F.G., L.T., L.I.M., C.F.F.-P., F.C.L., F.G., S.S.T.O., F.F.C., N.C.); Bayer AG, Pharmaceuticals - Drug Discovery, Wuppertal, Germany (D.B., J.P.S., P.S.); Ruth L. and David S Gottesman Institute for Stem Cell and Regenerative Medicine Research, Albert Einstein College of Medicine, Bronx, New York (P.S.F.); and Hannover Medical School, Institute of Pharmacology, Hannover, Germany (P.S.)
| | - P L Brito
- Hematology Center, School of Medical Sciences, University of Campinas (UNICAMP), Brazil (W.A.F., H.C., C.L., C.B.A., P.L.B., E.M.F.G., L.T., L.I.M., C.F.F.-P., F.C.L., F.G., S.S.T.O., F.F.C., N.C.); Bayer AG, Pharmaceuticals - Drug Discovery, Wuppertal, Germany (D.B., J.P.S., P.S.); Ruth L. and David S Gottesman Institute for Stem Cell and Regenerative Medicine Research, Albert Einstein College of Medicine, Bronx, New York (P.S.F.); and Hannover Medical School, Institute of Pharmacology, Hannover, Germany (P.S.)
| | - E M F Gotardo
- Hematology Center, School of Medical Sciences, University of Campinas (UNICAMP), Brazil (W.A.F., H.C., C.L., C.B.A., P.L.B., E.M.F.G., L.T., L.I.M., C.F.F.-P., F.C.L., F.G., S.S.T.O., F.F.C., N.C.); Bayer AG, Pharmaceuticals - Drug Discovery, Wuppertal, Germany (D.B., J.P.S., P.S.); Ruth L. and David S Gottesman Institute for Stem Cell and Regenerative Medicine Research, Albert Einstein College of Medicine, Bronx, New York (P.S.F.); and Hannover Medical School, Institute of Pharmacology, Hannover, Germany (P.S.)
| | - L Torres
- Hematology Center, School of Medical Sciences, University of Campinas (UNICAMP), Brazil (W.A.F., H.C., C.L., C.B.A., P.L.B., E.M.F.G., L.T., L.I.M., C.F.F.-P., F.C.L., F.G., S.S.T.O., F.F.C., N.C.); Bayer AG, Pharmaceuticals - Drug Discovery, Wuppertal, Germany (D.B., J.P.S., P.S.); Ruth L. and David S Gottesman Institute for Stem Cell and Regenerative Medicine Research, Albert Einstein College of Medicine, Bronx, New York (P.S.F.); and Hannover Medical School, Institute of Pharmacology, Hannover, Germany (P.S.)
| | - L I Miguel
- Hematology Center, School of Medical Sciences, University of Campinas (UNICAMP), Brazil (W.A.F., H.C., C.L., C.B.A., P.L.B., E.M.F.G., L.T., L.I.M., C.F.F.-P., F.C.L., F.G., S.S.T.O., F.F.C., N.C.); Bayer AG, Pharmaceuticals - Drug Discovery, Wuppertal, Germany (D.B., J.P.S., P.S.); Ruth L. and David S Gottesman Institute for Stem Cell and Regenerative Medicine Research, Albert Einstein College of Medicine, Bronx, New York (P.S.F.); and Hannover Medical School, Institute of Pharmacology, Hannover, Germany (P.S.)
| | - C F Franco-Penteado
- Hematology Center, School of Medical Sciences, University of Campinas (UNICAMP), Brazil (W.A.F., H.C., C.L., C.B.A., P.L.B., E.M.F.G., L.T., L.I.M., C.F.F.-P., F.C.L., F.G., S.S.T.O., F.F.C., N.C.); Bayer AG, Pharmaceuticals - Drug Discovery, Wuppertal, Germany (D.B., J.P.S., P.S.); Ruth L. and David S Gottesman Institute for Stem Cell and Regenerative Medicine Research, Albert Einstein College of Medicine, Bronx, New York (P.S.F.); and Hannover Medical School, Institute of Pharmacology, Hannover, Germany (P.S.)
| | - F C Leonardo
- Hematology Center, School of Medical Sciences, University of Campinas (UNICAMP), Brazil (W.A.F., H.C., C.L., C.B.A., P.L.B., E.M.F.G., L.T., L.I.M., C.F.F.-P., F.C.L., F.G., S.S.T.O., F.F.C., N.C.); Bayer AG, Pharmaceuticals - Drug Discovery, Wuppertal, Germany (D.B., J.P.S., P.S.); Ruth L. and David S Gottesman Institute for Stem Cell and Regenerative Medicine Research, Albert Einstein College of Medicine, Bronx, New York (P.S.F.); and Hannover Medical School, Institute of Pharmacology, Hannover, Germany (P.S.)
| | - F Garcia
- Hematology Center, School of Medical Sciences, University of Campinas (UNICAMP), Brazil (W.A.F., H.C., C.L., C.B.A., P.L.B., E.M.F.G., L.T., L.I.M., C.F.F.-P., F.C.L., F.G., S.S.T.O., F.F.C., N.C.); Bayer AG, Pharmaceuticals - Drug Discovery, Wuppertal, Germany (D.B., J.P.S., P.S.); Ruth L. and David S Gottesman Institute for Stem Cell and Regenerative Medicine Research, Albert Einstein College of Medicine, Bronx, New York (P.S.F.); and Hannover Medical School, Institute of Pharmacology, Hannover, Germany (P.S.)
| | - S T O Saad
- Hematology Center, School of Medical Sciences, University of Campinas (UNICAMP), Brazil (W.A.F., H.C., C.L., C.B.A., P.L.B., E.M.F.G., L.T., L.I.M., C.F.F.-P., F.C.L., F.G., S.S.T.O., F.F.C., N.C.); Bayer AG, Pharmaceuticals - Drug Discovery, Wuppertal, Germany (D.B., J.P.S., P.S.); Ruth L. and David S Gottesman Institute for Stem Cell and Regenerative Medicine Research, Albert Einstein College of Medicine, Bronx, New York (P.S.F.); and Hannover Medical School, Institute of Pharmacology, Hannover, Germany (P.S.)
| | - P S Frenette
- Hematology Center, School of Medical Sciences, University of Campinas (UNICAMP), Brazil (W.A.F., H.C., C.L., C.B.A., P.L.B., E.M.F.G., L.T., L.I.M., C.F.F.-P., F.C.L., F.G., S.S.T.O., F.F.C., N.C.); Bayer AG, Pharmaceuticals - Drug Discovery, Wuppertal, Germany (D.B., J.P.S., P.S.); Ruth L. and David S Gottesman Institute for Stem Cell and Regenerative Medicine Research, Albert Einstein College of Medicine, Bronx, New York (P.S.F.); and Hannover Medical School, Institute of Pharmacology, Hannover, Germany (P.S.)
| | - D Brockschnieder
- Hematology Center, School of Medical Sciences, University of Campinas (UNICAMP), Brazil (W.A.F., H.C., C.L., C.B.A., P.L.B., E.M.F.G., L.T., L.I.M., C.F.F.-P., F.C.L., F.G., S.S.T.O., F.F.C., N.C.); Bayer AG, Pharmaceuticals - Drug Discovery, Wuppertal, Germany (D.B., J.P.S., P.S.); Ruth L. and David S Gottesman Institute for Stem Cell and Regenerative Medicine Research, Albert Einstein College of Medicine, Bronx, New York (P.S.F.); and Hannover Medical School, Institute of Pharmacology, Hannover, Germany (P.S.)
| | - F F Costa
- Hematology Center, School of Medical Sciences, University of Campinas (UNICAMP), Brazil (W.A.F., H.C., C.L., C.B.A., P.L.B., E.M.F.G., L.T., L.I.M., C.F.F.-P., F.C.L., F.G., S.S.T.O., F.F.C., N.C.); Bayer AG, Pharmaceuticals - Drug Discovery, Wuppertal, Germany (D.B., J.P.S., P.S.); Ruth L. and David S Gottesman Institute for Stem Cell and Regenerative Medicine Research, Albert Einstein College of Medicine, Bronx, New York (P.S.F.); and Hannover Medical School, Institute of Pharmacology, Hannover, Germany (P.S.)
| | - J P Stasch
- Hematology Center, School of Medical Sciences, University of Campinas (UNICAMP), Brazil (W.A.F., H.C., C.L., C.B.A., P.L.B., E.M.F.G., L.T., L.I.M., C.F.F.-P., F.C.L., F.G., S.S.T.O., F.F.C., N.C.); Bayer AG, Pharmaceuticals - Drug Discovery, Wuppertal, Germany (D.B., J.P.S., P.S.); Ruth L. and David S Gottesman Institute for Stem Cell and Regenerative Medicine Research, Albert Einstein College of Medicine, Bronx, New York (P.S.F.); and Hannover Medical School, Institute of Pharmacology, Hannover, Germany (P.S.)
| | - P Sandner
- Hematology Center, School of Medical Sciences, University of Campinas (UNICAMP), Brazil (W.A.F., H.C., C.L., C.B.A., P.L.B., E.M.F.G., L.T., L.I.M., C.F.F.-P., F.C.L., F.G., S.S.T.O., F.F.C., N.C.); Bayer AG, Pharmaceuticals - Drug Discovery, Wuppertal, Germany (D.B., J.P.S., P.S.); Ruth L. and David S Gottesman Institute for Stem Cell and Regenerative Medicine Research, Albert Einstein College of Medicine, Bronx, New York (P.S.F.); and Hannover Medical School, Institute of Pharmacology, Hannover, Germany (P.S.)
| | - N Conran
- Hematology Center, School of Medical Sciences, University of Campinas (UNICAMP), Brazil (W.A.F., H.C., C.L., C.B.A., P.L.B., E.M.F.G., L.T., L.I.M., C.F.F.-P., F.C.L., F.G., S.S.T.O., F.F.C., N.C.); Bayer AG, Pharmaceuticals - Drug Discovery, Wuppertal, Germany (D.B., J.P.S., P.S.); Ruth L. and David S Gottesman Institute for Stem Cell and Regenerative Medicine Research, Albert Einstein College of Medicine, Bronx, New York (P.S.F.); and Hannover Medical School, Institute of Pharmacology, Hannover, Germany (P.S.)
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Koks S, Williams RW, Quinn J, Farzaneh F, Conran N, Tsai SJ, Awandare G, Goodman SR. COVID-19: Time for precision epidemiology. Exp Biol Med (Maywood) 2020; 245:677-679. [PMID: 32301338 DOI: 10.1177/1535370220919349] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
- Sulev Koks
- The Perron Institute for Neurological and Translational Science, Murdoch University, Australia
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17
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Silva JAF, Gotardo ÉMF, Chweih H, Miguel LI, Ferreira WA, Hedlund B, Elford HL, Leonardo FC, Costa FF, Conran N. Didox (3,4-dihydroxybenzohydroxamic acid) reduces the vascular inflammation induced by acute intravascular hemolysis. Blood Cells Mol Dis 2020; 81:102404. [PMID: 31972517 DOI: 10.1016/j.bcmd.2020.102404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 01/10/2020] [Accepted: 01/10/2020] [Indexed: 11/24/2022]
Affiliation(s)
| | | | - Hanan Chweih
- Hematology Center, University of Campinas-UNICAMP, Brazil
| | | | | | - Bo Hedlund
- Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota Medical School, MN, USA
| | - Howard L Elford
- Molecules for Health, Inc., 800 East Leigh Street, Suite 206-4, Richmond, VA 23219, USA
| | | | | | - Nicola Conran
- Hematology Center, University of Campinas-UNICAMP, Brazil.
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Silveira AAA, Mahon OR, Cunningham CC, Corr EM, Mendonça R, Saad STO, Costa FF, Dunne A, Conran N. S100A8 acts as an autocrine priming signal for heme-induced human Mϕ pro-inflammatory responses in hemolytic inflammation. J Leukoc Biol 2019; 106:35-43. [PMID: 31091351 DOI: 10.1002/jlb.3mia1118-418rr] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 11/01/2018] [Revised: 04/10/2019] [Accepted: 05/02/2019] [Indexed: 12/28/2022] Open
Abstract
Intravascular hemolysis, in addition to reducing red cell counts, incurs extensive vascular inflammation and oxidative stress. One product of hemolysis, heme, is a potent danger associated molecular pattern (DAMP), activating leukocytes and inducing cytokine expression and processing, among other pro-inflammatory effects. We explored pathways by which heme-induced inflammation may be amplified under sterile conditions. Incubation of human Mϕs, differentiated from CD14+ cells, with heme induced time- and concentration-dependent gene and protein expression of S100A8, a myeloid cell-derived alarmin. Human Mϕ stimulation with recombinant S100A8, in turn, induced robust pro-IL-1β expression that was dependent upon NF-κB activation, gene transcription, and partially dependent upon TLR4-mediated signaling. Moreover, heme itself stimulated significant Mϕ pro-IL-1β gene and protein expression via an S100A8-mediated mechanism and greatly amplified S100A8-driven NLRP3 inflammasome-mediated IL-1β secretion. In vivo, induction of acute intravascular hemolysis in mice induced a rapid elevation of plasma S100A8 that could be abolished by hemopexin, a heme scavenger. Finally, plasma S100A8 levels were found to be significantly elevated in patients with the inherited hemolytic anemia, sickle cell anemia, when compared with levels in healthy individuals. In conclusion, we demonstrate that hemolytic processes are associated with S100A8 generation and that some of the inflammatory effects of heme may be amplified by autocrine S100A8 production. Findings suggest a mechanism by which hemolytic inflammation could be propagated via leukocyte priming by endogenous proteins, even in sterile inflammatory environments such as those that occur in the hemolytic diseases. S100A8 may represent a therapeutic target for reducing inflammation in hemolytic disorders.
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Affiliation(s)
| | - Olwyn R Mahon
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Clare C Cunningham
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Emma M Corr
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Rafaela Mendonça
- Hematology Center, University of Campinas-UNICAMP, Campinas, São Paulo, Brazil
| | - Sara T O Saad
- Hematology Center, University of Campinas-UNICAMP, Campinas, São Paulo, Brazil
| | - Fernando F Costa
- Hematology Center, University of Campinas-UNICAMP, Campinas, São Paulo, Brazil
| | - Aisling Dunne
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Nicola Conran
- Hematology Center, University of Campinas-UNICAMP, Campinas, São Paulo, Brazil
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Abstract
IMPACT STATEMENT Sickle cell disease (SCD) is one of the most common inherited diseases and is associated with a reduced life expectancy and acute and chronic complications, including frequent painful vaso-occlusive episodes that often require hospitalization. At present, treatment of SCD is limited to hematopoietic stem cell transplant, transfusion, and limited options for pharmacotherapy, based principally on hydroxyurea therapy. This review highlights the importance of intracellular cGMP-dependent signaling pathways in SCD pathophysiology; modulation of these pathways with soluble guanylate cyclase (sGC) stimulators or phosphodiesterase (PDE) inhibitors could potentially provide vasorelaxation and anti-inflammatory effects, as well as elevate levels of anti-sickling fetal hemoglobin.
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Affiliation(s)
- Nicola Conran
- Hematology Center, University of Campinas – UNICAMP,
Cidade Universitária, Campinas-SP 13083-878-SP, Brazil
| | - Lidiane Torres
- Hematology Center, University of Campinas – UNICAMP,
Cidade Universitária, Campinas-SP 13083-878-SP, Brazil
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20
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Affiliation(s)
- Lidiane Torres
- Hematology Center, University of Campinas – UNICAMP, Campinas, Brazil
| | - Nicola Conran
- Hematology Center, University of Campinas – UNICAMP, Campinas, Brazil
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21
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Conran N, Goodman SR, Stambrook P. Inaugurating Our Latin American EBM/SEBM Office in Campinas Brazil: Three Perspectives. Exp Biol Med (Maywood) 2018; 243:879-881. [PMID: 30105953 DOI: 10.1177/1535370218788259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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22
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Abstract
The primary β-globin gene mutation that causes sickle cell disease (SCD) has significant pathophysiological consequences that result in hemolytic events and the induction of the inflammatory processes that ultimately lead to vaso-occlusion. In addition to their role in the initiation of the acute painful vaso-occlusive episodes that are characteristic of SCD, inflammatory processes are also key components of many of the complications of the disease including autosplenectomy, acute chest syndrome, pulmonary hypertension, leg ulcers, nephropathy and stroke. We, herein, discuss the events that trigger inflammation in the disease, as well as the mechanisms, inflammatory molecules and cells that propagate these inflammatory processes. Given the central role that inflammation plays in SCD pathophysiology, many of the therapeutic approaches currently under pre-clinical and clinical development for the treatment of SCD endeavor to counter aspects or specific molecules of these inflammatory processes and it is possible that, in the future, we will see anti-inflammatory drugs being used either together with, or in place of, hydroxyurea in those SCD patients for whom hematopoietic stem cell transplants and evolving gene therapies are not a viable option.
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Affiliation(s)
- Nicola Conran
- Hematology Center, University of Campinas - UNICAMP, Cidade Universitária, Campinas-SP, Brazil
| | - John D Belcher
- Department of Medicine, Division of Hematology, Oncology and Transplantation, Vascular Biology Center, University of Minnesota, Minneapolis, MN, USA
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Franco‐Penteado CF, Moraes AR, Chweih H, Conran N, Claudino MA, Costa FF. Fasudil, a ROCK inhibitor, attenuates endotelial‐leukocyte interaction in sickle cell transgenic mice. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.lb621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - Hanan Chweih
- Hematology and Hemotherapy Center, UNICAMPCampinasBrazil
| | - Nicola Conran
- Hematology and Hemotherapy Center, UNICAMPCampinasBrazil
| | - Mário A Claudino
- Laboratory of Multidisciplinary ResearchSão Francisco University Medical SchoolBragança PaulistaBrazil
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Antoniellis Silveira AA, Dominical VM, Morelli Vital D, Alves Ferreira W, Trindade Maranhão Costa F, Werneck CC, Ferreira Costa F, Conran N. Attenuation of TNF-induced neutrophil adhesion by simvastatin is associated with the inhibition of Rho-GTPase activity, p50 activity and morphological changes. Int Immunopharmacol 2018; 58:160-165. [PMID: 29604489 DOI: 10.1016/j.intimp.2018.03.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 03/22/2018] [Accepted: 03/24/2018] [Indexed: 12/19/2022]
Abstract
Neutrophil adhesion to the vasculature in response to potent inflammatory stimuli, such as TNF-α (TNF), can contribute to atheroprogression amongst other pathophysiological mechanisms. Previous studies have shown that simvastatin, a statin with known pleiotropic anti-inflammatory properties, can partially abrogate the effects of TNF-induced neutrophil adhesion, in association with the modulation of β2-integrin expression. We aimed to further characterize the effects of this statin on neutrophil and leukocyte adhesive mechanisms in vitro and in vivo. A microfluidic assay confirmed the ability of simvastatin to inhibit TNF-induced human neutrophil adhesion to fibronectin ligand under conditions of shear stress, while intravital imaging microscopy demonstrated an abrogation of leukocyte recruitment by simvastatin in the microvasculature of mice that had received a TNF stimulus. This inhibition of neutrophil adhesion was accompanied by the inhibition of TNF-induced RhoA activity in human neutrophils, and alterations in cell morphology and β2-integrin activity. Additionally, TNF augmented the activity of the p50 NFκB subunit in human neutrophils and TNF-induced neutrophil adhesion and β2-integrin activity could be abolished using pharmacological inhibitors of NFκB translocation, BAY11-7082 and SC514. Accordingly, the TNF-induced elevation of neutrophil p50 activity was abolished by simvastatin. In conclusion, our data provide further evidence of the ability of simvastatin to inhibit neutrophil adhesive interactions in response to inflammatory stimuli, both in vivo and in vitro. Simvastatin appears to inhibit neutrophil adhesion by interfering in TNF-induced cytoskeletal rearrangements, in association with the inhibition of Rho A activity, NFκB translocation and, consequently, β2-integrin activity.
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Affiliation(s)
| | - Venina Marcela Dominical
- Hematology and Hemotherapy Center, School of Medicine, University of Campinas-UNICAMP, Campinas, Sao Paulo, Brazil
| | - Daiana Morelli Vital
- Hematology and Hemotherapy Center, School of Medicine, University of Campinas-UNICAMP, Campinas, Sao Paulo, Brazil
| | - Wilson Alves Ferreira
- Hematology and Hemotherapy Center, School of Medicine, University of Campinas-UNICAMP, Campinas, Sao Paulo, Brazil
| | - Fabio Trindade Maranhão Costa
- Laboratory of Tropical Diseases - Prof. Dr. Luiz Jacintho da Silva, Department of Genetics, Evolution and Bioagents, Institute of Biology (IB), University of Campinas-UNICAMP, Brazil
| | - Claudio C Werneck
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas-UNICAMP, Campinas, Brazil
| | - Fernando Ferreira Costa
- Hematology and Hemotherapy Center, School of Medicine, University of Campinas-UNICAMP, Campinas, Sao Paulo, Brazil
| | - Nicola Conran
- Hematology and Hemotherapy Center, School of Medicine, University of Campinas-UNICAMP, Campinas, Sao Paulo, Brazil.
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Todd Milne G, Sandner P, Lincoln KA, Harrison PC, Chen H, Wang H, Clifford H, Qian HS, Wong D, Sarko C, Fryer R, Richman J, Reinhart GA, Boustany CM, Pullen SS, Andresen H, Moltzau LR, Cataliotti A, Levy FO, Lukowski R, Frankenreiter S, Friebe A, Calamaras T, Baumgartner R, McLaughlin A, Aronovitz M, Baur W, Wang GR, Kapur N, Karas R, Blanton R, Hell S, Waldman SA, Lin JE, Colon-Gonzalez F, Kim GW, Blomain ES, Merlino D, Snook A, Erdmann J, Wobst J, Kessler T, Schunkert H, Walter U, Pagel O, Walter E, Gambaryan S, Smolenski A, Jurk K, Zahedi R, Klinger JR, Benza RL, Corris PA, Langleben D, Naeije R, Simonneau G, Meier C, Colorado P, Chang MK, Busse D, Hoeper MM, Masferrer JL, Jacobson S, Liu G, Sarno R, Bernier S, Zhang P, Todd Milne G, Flores-Costa R, Currie M, Hall K, Möhrle D, Reimann K, Wolter S, Wolters M, Mergia E, Eichert N, Geisler HS, Ruth P, Friebe A, Feil R, Zimmermann U, Koesling D, Knipper M, Rüttiger L, Tanaka Y, Okamoto A, Nojiri T, Kumazoe M, Tokudome T, Miura K, Hino J, Hosoda H, Miyazato M, Kangawa K, Kapil V, Ahluwalia A, Paolocci N, Eaton P, Campbell JC, Henning P, Franz E, Sankaran B, Herberg FW, Kim C, Wittwer M, Luo Q, Kaila V, Dames SA, Tobin A, Alam M, Rudyk O, Krasemann S, Hartmann K, Prysyazhna O, Zhang M, Zhao L, Weiss A, Schermuly R, Eaton P, Moyes AJ, Chu SM, Baliga RS, Hobbs AJ, Michalakis S, Mühlfriedel R, Schön C, Fischer DM, Wilhelm B, Zobor D, Kohl S, Peters T, Zrenner E, Bartz-Schmidt KU, Ueffing M, Wissinger B, Seeliger M, Biel M, Ranek MJ, Kokkonen KM, Lee DI, Holewinski RJ, Agrawal V, Virus C, Stevens DA, Sasaki M, Zhang H, Mannion MM, Rainer PP, Page RC, Schisler JC, Van Eyk JE, Willis MS, Kass DA, Zaccolo M, Russwurm M, Giesen J, Russwurm C, Füchtbauer EM, Koesling D, Bork NI, Nikolaev VO, Agulló L, Floor M, Villà-Freixa J, Manfra O, Calamera G, Surdo NC, Meier S, Froese A, Nikolaev VO, Zaccolo M, Levy FO, Andressen KW, Aue A, Schwiering F, Groneberg D, Friebe A, Bajraktari G, Burhenne J, Haefeli WE, Weiss J, Beck K, Voussen B, Vincent A, Parsons SP, Huizinga JD, Friebe A, Mónica FZ, Seto E, Murad F, Bian K, Burgoyne JR, Prysyazhna O, Richards D, Eaton P, Calamera G, Bjørnerem M, Ulsund AH, Kim JJ, Kim C, Levy FO, Andressen KW, Donzelli S, Goetz M, Schmidt K, Wolters M, Stathopoulou K, Prysyazhna O, Scotcher J, Dees C, Subramanian H, Butt E, Kamynina A, Bruce King S, Nikolaev VO, de Witt C, Leichert LI, Feil R, Eaton P, Cuello F, Dobrowinski H, Lehners M, Schmidt MPH, Feil R, Feil S, Wen L, Wolters M, Thunemann M, Schmidt K, Olbrich M, Langer H, Gawaz M, Friebe A, de Wit C, Feil R, Franz E, Kim JJ, Bertinetti D, Kim C, Herberg FW, Ghofrani HA, Grimminger F, Grünig E, Huang Y, Jansa P, Jing ZC, Kilpatrick D, Langleben D, Rosenkranz S, Menezes F, Fritsch A, Nikkho S, Frey R, Humbert M, Groneberg D, Aue A, Schwiering F, Friebe A, Harloff M, Reinders J, Schlossmann J, Jung J, Wales JA, Chen CY, Breci L, Weichsel A, Bernier SG, Solinga R, Sheppeck JE, Renhowe PA, Montfort WR, Qin L, Sung YJ, Casteel D, Kim C, Kollau A, Neubauer A, Schrammel A, Russwurm M, Koesling D, Mayer B, Kumazoe M, Takai M, Takeuchi C, Kadomatsu M, Hiroi S, Takamatsu K, Nojiri T, Kangawa K, Tachibana H, Opelt M, Eroglu E, Waldeck-Weiermair M, Russwurm M, Koesling D, Malli R, Graier WF, Fassett JT, Schrammel A, Mayer B, Sollie SJ, Moltzau LR, Hernandez-Valladares M, Berven F, Levy FO, Andressen KW, Nojiri T, Tokudome T, Kumazoe M, Arai M, Suzuki Y, Miura K, Hino J, Hosoda H, Miyazato M, Okumura M, Kawaoka S, Kangawa K, Peters S, Schmidt H, Selin Kenet B, Nies SH, Frank K, Wen L, Rathjen FG, Feil R, Petrova ON, Lamarre I, Négrerie M, Robinson JW, Egbert JR, Davydova J, Jaffe LA, Potter LR, Robinson JW, Blixt N, Shuhaibar LC, Warren GL, Mansky KC, Jaffe LA, Potter LR, Romoli S, Bauch T, Dröbner K, Eitner F, Ruppert M, Radovits T, Korkmaz-Icöz S, Li S, Hegedűs P, Loganathan S, Németh BT, Oláh A, Mátyás C, Benke K, Merkely B, Karck M, Szabó G, Scheib U, Broser M, Mukherjee S, Stehfest K, Gee CE, Körschen HG, Oertner TG, Hegemann P, Schmidt H, Dickey DM, Dumoulin A, Kühn R, Jaffe L, Potter LR, Rathjen FG, Schobesberger S, Wright P, Poulet C, Mansfield C, Friebe A, Harding SE, Nikolaev VO, Gorelik J, Kollau A, Opelt M, Wölkart G, Gorren ACF, Russwurm M, Koesling D, Schrammel A, Mayer B, Schwaerzer GK, Casteel DE, Dalton ND, Gu Y, Zhuang S, Milewicz DM, Peterson KL, Pilz R, Schwiering F, Aue A, Groneberg D, Friebe A, Argyriou AI, Makrynitsa G, Alexandropoulos II, Stamopoulou A, Bantzi M, Giannis A, Topouzis S, Papapetropoulos A, Spyroulias GA, Stuehr DJ, Ghosh A, Dai Y, Misra S, Tchernychev B, Jung J, Liu G, Silos-Santiago I, Hannig G, Dao VTV, Deile M, Nedvetsky PI, Güldner A, Ibarra-Alvarado C, Gödecke A, Schmidt HHHW, Vachaviolos A, Gerling A, Thunemann M, Lutz SZ, Häring HU, Krüger MA, Pichler BJ, Shipston MJ, Feil S, Feil R, Vandenwijngaert S, Ledsky CD, Agha O, Hu D, Domian IJ, Buys ES, Newton-Cheh C, Bloch DB, Voussen B, Beck K, Mauro N, Keppler J, Friebe A, Ferreira WA, Chweih H, Brito PL, Almeida CB, Penteado CFF, Saad SSO, Costa FF, Frenette PS, Brockschnieder D, Stasch JP, Sandner P, Conran N, Zimmer DP, Tobin J, Shea C, Sarno R, Long K, Jacobson S, Tang K, Germano P, Wakefield J, Banijamali A, Im GYJ, Sheppeck JE, Profy AT, Todd Milne G, Currie MG, Masferrer JL. Abstracts from the 8th International Conference on cGMP Generators, Effectors and Therapeutic Implications : Bamberg, Germany. 23-25 June, 2017. BMC Pharmacol Toxicol 2017; 18:64. [PMID: 29035170 PMCID: PMC5667593 DOI: 10.1186/s40360-017-0170-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Silveira AAA, Dominical VM, Almeida CB, Chweih H, Ferreira WA, Vicente CP, Costa FTM, Werneck CC, Costa FF, Conran N. TNF induces neutrophil adhesion via formin-dependent cytoskeletal reorganization and activation of β-integrin function. J Leukoc Biol 2017; 103:87-98. [DOI: 10.1189/jlb.3a0916-388rr] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 07/04/2017] [Accepted: 07/05/2017] [Indexed: 11/24/2022] Open
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Abstract
INTRODUCTION Therapeutic options for sickle cell disease (SCD) are limited and, currently, only one drug (hydroxyurea) has FDA approval for the treatment of adult SCD. While this genetic disease is caused by hemoglobin polymerization, subsequent downstream events trigger platelet activation, vaso-occlusion and the disease's complex pathophysiology. Areas covered: The oral thienopyridine, prasugrel hydrochloride, irreversibly inhibits the P2Y12 receptors, inhibiting ADP-dependent platelet activation. We discuss recent clinical trials evaluating the pharmokinetics of prasugrel and its potential for use in SCD. Expert opinion: Prasugrel administration in SCD appears to be well tolerated and safe. However, although this drug modestly inhibits platelet activity in these patients, administration of prasugrel to a large group of children and adolescents for up to 24 months failed to convincingly reduce vaso-occlusive complications. Speculatively, prasugrel may be of occasional use for off-license purposes in patients unable or unwilling to take hydroxyurea (particularly in 12-17-year olds). Although there is currently no prospect of prasugrel being licensed for use in SCD, the success of on-going trials of other antiplatelet agents in SCD might lead to further trials of prasugrel in SCD.
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Affiliation(s)
- Nicola Conran
- a Hematology Center , University of Campinas - UNICAMP, Cidade Universitaria , Campinas-SP , Brazil
| | - David C Rees
- b Department of Paediatric Haematology , King's College Hospital , London , UK
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Garrido VT, Sonzogni L, Mtatiro SN, Costa FF, Conran N, Thein SL. Association of plasma CD40L with acute chest syndrome in sickle cell anemia. Cytokine 2017; 97:104-107. [PMID: 28609750 DOI: 10.1016/j.cyto.2017.05.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 05/17/2017] [Accepted: 05/20/2017] [Indexed: 12/11/2022]
Abstract
Platelet activation and platelet-derived cytokines contribute to the vascular inflammation and increased thrombotic activity known to occur in patients with sickle cell anemia (SCA). CD40 ligand (CD40L), a platelet-associated pro-inflammatory molecule that promotes endothelial cell activation, is elevated in the circulation of SCA patients. We sought to evaluate the association of CD40L and inflammation with sickle-related clinical complications and laboratory variables in SCA patients. Soluble CD40L, thrombospondin (TSP)-1 and tumor necrosis factor (TNF)-α were determined in the platelet-poor plasma of healthy individuals and steady-state SCA patients by ELISA. Lifetime clinical complications were verified by detailed review of patients' medical records. We found that plasma CD40L was associated with acute chest syndrome (ACS), and that SCA patients with a lifetime history of ACS (ACS+) presented significantly higher plasma CD40L and TSP-1 than patients who had never experienced ACS (ACS-). In the ACS+ group, both platelet-derived proteins (CD40L and TSP-1) correlated with mean corpuscular volume, mean corpuscular hemoglobin and reticulocyte hemoglobin, while in the ACS- group, CD40L correlated with low red blood cell counts, hemoglobin, hematocrit and lactate dehydrogenase, and TSP-1 correlated with reticulocyte percentage and white blood cell count. As expected, CD40L and TSP-1 correlated with platelet counts in both groups. These data highlight the possible role of platelet activation in ACS and suggest that plasma sCD40L, together with TSP-1, may represent a potential marker of susceptibility to ACS in SCA.
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Affiliation(s)
| | - Laura Sonzogni
- King's College London Faculty of Life Sciences & Medicine, Department of Molecular Haematology, Division of Cancer Studies, UK
| | - Siana Nkya Mtatiro
- King's College London Faculty of Life Sciences & Medicine, Department of Molecular Haematology, Division of Cancer Studies, UK
| | - Fernando F Costa
- Hematology Centre, School of Medicine, University of Campinas - UNICAMP, Brazil
| | - Nicola Conran
- Hematology Centre, School of Medicine, University of Campinas - UNICAMP, Brazil
| | - Swee Lay Thein
- King's College London Faculty of Life Sciences & Medicine, Department of Molecular Haematology, Division of Cancer Studies, UK
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Colella MP, Santana BA, Conran N, Tomazini V, Costa FF, Calado RT, Saad STO. Telomere length correlates with disease severity and inflammation in sickle cell disease. Rev Bras Hematol Hemoter 2017; 39:140-145. [PMID: 28577651 PMCID: PMC5457472 DOI: 10.1016/j.bjhh.2017.02.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 02/14/2017] [Accepted: 02/15/2017] [Indexed: 12/26/2022] Open
Abstract
Background Telomeres, the ends of linear chromosomes, shorten during mitotic cell division and erosion may be aggravated by inflammation or proliferative and oxidative stress. As the bone marrow is under hyperproliferative pressure in sickle cell disease and several tissues are submitted to chronic inflammation, this study sought to determine the telomere length of patients with sickle cell disease. Methods The mean telomere length was measured in peripheral blood leukocytes by quantitative polymerase chain reaction. The age-adjusted telomere to single copy gene ratio was compared between 91 adult sickle cell disease patients and 188 controls. Results Sickle cell disease patients had significantly shorter telomeres than the controls (p-value < 0.0001). Moreover, among sickle cell disease genotypes, Hb SS patients had significantly shorter telomeres compared to Hb SC and Hb Sβ patients (p-value < 0.0001). Patients on hydroxyurea also had shorter telomeres in comparison to those off the drug (p-value = 0.02). A positive correlation was observed between telomere length and hemoglobin level (r = 0.3; p-value = 0.004), whereas negative correlations were detected between telomere length and lymphocyte count (r = −0.3; p-value = 0.005) and interleukin-8 serum levels (r = −0.4; p-value = 0.02). Conclusions The findings of this study indicate that telomeres are short in sickle cell disease patients and that telomere erosion directly correlates with disease genotype, inflammation markers, and the use of hydroxyurea.
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Affiliation(s)
| | - Barbara A Santana
- Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil; Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), Ribeirão Preto, São Paulo, SP, Brazil
| | - Nicola Conran
- Universidade Estadual de Campinas/Hemocentro (UNICAMP), Campinas, SP, Brazil
| | - Vinicius Tomazini
- Universidade Estadual de Campinas/Hemocentro (UNICAMP), Campinas, SP, Brazil
| | - Fernando F Costa
- Universidade Estadual de Campinas/Hemocentro (UNICAMP), Campinas, SP, Brazil
| | - Rodrigo T Calado
- Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil; Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), Ribeirão Preto, São Paulo, SP, Brazil
| | - Sara T Olalla Saad
- Universidade Estadual de Campinas/Hemocentro (UNICAMP), Campinas, SP, Brazil.
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Abstract
Intravascular hemolysis, or the destruction of red blood cells in the circulation, can occur in numerous diseases, including the acquired hemolytic anemias, sickle cell disease and β-thalassemia, as well as during some transfusion reactions, preeclampsia and infections, such as those caused by malaria or Clostridium perfringens. Hemolysis results in the release of large quantities of red cell damage-associated molecular patterns (DAMPs) into the circulation, which, if not neutralized by innate protective mechanisms, have the potential to activate multiple inflammatory pathways. One of the major red cell DAMPs, heme, is able to activate converging inflammatory pathways, such as toll-like receptor signaling, neutrophil extracellular trap formation and inflammasome formation, suggesting that this DAMP both activates and amplifies inflammation. Other potent DAMPs that may be released by the erythrocytes upon their rupture include heat shock proteins (Hsp), such as Hsp70, interleukin-33 and Adenosine 5' triphosphate. As such, hemolysis represents a major inflammatory mechanism that potentially contributes to the clinical manifestations that have been associated with the hemolytic diseases, such as pulmonary hypertension and leg ulcers, and likely plays a role in specific complications of sickle cell disease such as endothelial activation, vaso-occlusive processes and tissue injury.
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Affiliation(s)
- Rafaela Mendonça
- Hematology Center, School of Medicine, University of Campinas-UNICAMP, Barão Geraldo, Campinas, Sao Paulo, 13083-970, Brazil
| | - Angélica A A Silveira
- Hematology Center, School of Medicine, University of Campinas-UNICAMP, Barão Geraldo, Campinas, Sao Paulo, 13083-970, Brazil
| | - Nicola Conran
- Hematology Center, School of Medicine, University of Campinas-UNICAMP, Barão Geraldo, Campinas, Sao Paulo, 13083-970, Brazil.
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Leonardo FC, Brugnerotto AF, Domingos IF, Fertrin KY, de Albuquerque DM, Bezerra MAC, Araújo AS, Saad STO, Costa FF, Menzel S, Conran N, Thein SL. Reduced rate of sickle-related complications in Brazilian patients carrying HbF-promoting alleles at the BCL11A and HMIP-2 loci. Br J Haematol 2016; 173:456-60. [PMID: 26888013 DOI: 10.1111/bjh.13961] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [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: 10/06/2015] [Accepted: 12/08/2015] [Indexed: 11/28/2022]
Abstract
The presence of high levels of fetal haemoglobin (HbF) provides well-validated clinical benefits to patients with sickle cell anaemia (SCA). Nevertheless it has been difficult to show clear direct effects of the known genetic HbF modifiers, such as the enhancer polymorphisms for haematopoietic transcription factors BCL11A and MYB, on SCA severity. Investigating SCA patients from Brazil, with a high degree of European genetic admixture, we have detected strong effects of these variants on HbF levels. Critically, we have shown, for the first time, that the presence of such HbF-promoting variants leads to a reduced rate of SCA complications, especially stroke.
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Affiliation(s)
- Flávia C Leonardo
- Haematology Centre, School of Medicine, University of Campinas- UNICAMP, Campinas, Brazil
| | - Ana F Brugnerotto
- Haematology Centre, School of Medicine, University of Campinas- UNICAMP, Campinas, Brazil
| | - Igor F Domingos
- Department of Genetics, Federal University of Pernambuco, Recife, Brazil
| | - Kleber Y Fertrin
- Haematology Centre, School of Medicine, University of Campinas- UNICAMP, Campinas, Brazil
| | | | - Marcos A C Bezerra
- Department of Genetics, Federal University of Pernambuco, Recife, Brazil
| | - Aderson S Araújo
- Haematology and Haemotherapy Foundation of Pernambuco (HEMOPE), Recife, Brazil
| | - Sara T O Saad
- Haematology Centre, School of Medicine, University of Campinas- UNICAMP, Campinas, Brazil
| | - Fernando F Costa
- Haematology Centre, School of Medicine, University of Campinas- UNICAMP, Campinas, Brazil
| | - Stephan Menzel
- Department of Molecular Haematology, Division of Cancer Studies, King's College London Faculty of Life Sciences & Medicine, London, UK
| | - Nicola Conran
- Haematology Centre, School of Medicine, University of Campinas- UNICAMP, Campinas, Brazil
| | - Swee Lay Thein
- Department of Molecular Haematology, Division of Cancer Studies, King's College London Faculty of Life Sciences & Medicine, London, UK.,Sickle Cell Branch, National Heart, Lung and Blood Institute, NIH, Bethesda, MD, USA
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Affiliation(s)
- Nicola Conran
- Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
| | - Camila Bononi Almeida
- Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE), São Paulo, SP, Brazil
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Dominical VM, Vital DM, Garrido VT, Silveira AAA, Olalla-Saad ST, Costa FF, Conran N. Interactions of sickle red blood cells with neutrophils are stabilized on endothelial cell layers. Blood Cells Mol Dis 2015; 56:38-40. [PMID: 26603722 DOI: 10.1016/j.bcmd.2015.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 10/26/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Venina Marcela Dominical
- Hematology Center, School of Medicine, University of Campinas - UNICAMP, Campinas, Sao Paulo, Brazil
| | - Daiana Morelli Vital
- Hematology Center, School of Medicine, University of Campinas - UNICAMP, Campinas, Sao Paulo, Brazil
| | - Vanessa Tonin Garrido
- Hematology Center, School of Medicine, University of Campinas - UNICAMP, Campinas, Sao Paulo, Brazil
| | | | - Sara T Olalla-Saad
- Hematology Center, School of Medicine, University of Campinas - UNICAMP, Campinas, Sao Paulo, Brazil
| | - Fernando Ferreira Costa
- Hematology Center, School of Medicine, University of Campinas - UNICAMP, Campinas, Sao Paulo, Brazil
| | - Nicola Conran
- Hematology Center, School of Medicine, University of Campinas - UNICAMP, Campinas, Sao Paulo, Brazil.
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Dominical VM, Samsel L, Nichols JS, Costa FF, McCoy JP, Conran N, Kato GJ. Prominent role of platelets in the formation of circulating neutrophil-red cell heterocellular aggregates in sickle cell anemia. Haematologica 2015; 99:e214-7. [PMID: 25420284 DOI: 10.3324/haematol.2014.108555] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Venina M Dominical
- INCT de Sangue, Hematology and Hemotherapy Center, University of Campinas - UNICAMP, Campinas, SP, Brazil
| | - Leigh Samsel
- Flow Cytometry Core, Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - James S Nichols
- Sickle Cell Vascular Disease Section, Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Fernando F Costa
- INCT de Sangue, Hematology and Hemotherapy Center, University of Campinas - UNICAMP, Campinas, SP, Brazil
| | - J Phillip McCoy
- Flow Cytometry Core, Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Nicola Conran
- INCT de Sangue, Hematology and Hemotherapy Center, University of Campinas - UNICAMP, Campinas, SP, Brazil
| | - Gregory J Kato
- Sickle Cell Vascular Disease Section, Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
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Lopes FCM, Traina F, Almeida CB, Leonardo FC, Franco-Penteado CF, Garrido VT, Colella MP, Soares R, Olalla-Saad ST, Costa FF, Conran N. Key endothelial cell angiogenic mechanisms are stimulated by the circulating milieu in sickle cell disease and attenuated by hydroxyurea. Haematologica 2015; 100:730-9. [PMID: 25769545 DOI: 10.3324/haematol.2014.119727] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 03/05/2015] [Indexed: 01/05/2023] Open
Abstract
As hypoxia-induced inflammatory angiogenesis may contribute to the manifestations of sickle cell disease, we compared the angiogenic molecular profiles of plasma from sickle cell disease individuals and correlated these with in vitro endothelial cell-mediated angiogenesis-stimulating activity and in vivo neovascularization. Bioplex demonstrated that plasma from patients with steady-state sickle cell anemia contained elevated concentrations of pro-angiogenic factors (angiopoietin-1, basic fibroblast growth factor, vascular endothelial growth factor, vascular endothelial growth factor-D and placental growth factor) and displayed potent pro-angiogenic activity, significantly increasing endothelial cell proliferation, migration and capillary-like structure formation. In vivo neovascularization of Matrigel plugs was significantly greater in sickle cell disease mice than in non-sickle cell disease mice, consistent with an up-regulation of angiogenesis in the disease. In plasma from patients with hemoglobin SC disease without proliferative retinopathy, anti-angiogenic endostatin and thrombospondin-2 were significantly elevated. In contrast, plasma from hemoglobin SC individuals with proliferative retinopathy had a pro-angiogenic profile and more significant effects on endothelial cell proliferation and capillary formation than plasma from patients without retinopathy. Hydroxyurea therapy was associated with significant reductions in plasma angiogenic factors and inhibition of endothelial cell-mediated angiogenic mechanisms and neovascularization. Thus, individuals with sickle cell anemia or hemoglobin SC disease with retinopathy present a highly angiogenic circulating milieu, capable of stimulating key endothelial cell-mediated angiogenic mechanisms. Combination anti-angiogenic therapy to prevent the progression of unregulated neovascularization and associated manifestations in sickle cell disease, such as pulmonary hypertension, may be indicated; furthermore, the benefits and drawbacks of the potent anti-angiogenic effects of hydroxyurea should be clarified.
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Affiliation(s)
- Flavia C M Lopes
- INCT de Sangue, Hematology Center, School of Medical Science, University of Campinas - UNICAMP, São Paulo, Brazil
| | - Fabiola Traina
- INCT de Sangue, Hematology Center, School of Medical Science, University of Campinas - UNICAMP, São Paulo, Brazil Department of Internal Medicine, University of São Paulo at Riberão Preto Medical School, Riberão Preto, Brazil
| | - Camila B Almeida
- INCT de Sangue, Hematology Center, School of Medical Science, University of Campinas - UNICAMP, São Paulo, Brazil
| | - Flavia C Leonardo
- INCT de Sangue, Hematology Center, School of Medical Science, University of Campinas - UNICAMP, São Paulo, Brazil
| | - Carla F Franco-Penteado
- INCT de Sangue, Hematology Center, School of Medical Science, University of Campinas - UNICAMP, São Paulo, Brazil
| | - Vanessa T Garrido
- INCT de Sangue, Hematology Center, School of Medical Science, University of Campinas - UNICAMP, São Paulo, Brazil
| | - Marina P Colella
- INCT de Sangue, Hematology Center, School of Medical Science, University of Campinas - UNICAMP, São Paulo, Brazil
| | - Raquel Soares
- Department of Biochemistry (I3S), Faculty of Medicine, University of Porto, Portugal
| | - Sara T Olalla-Saad
- INCT de Sangue, Hematology Center, School of Medical Science, University of Campinas - UNICAMP, São Paulo, Brazil
| | - Fernando F Costa
- INCT de Sangue, Hematology Center, School of Medical Science, University of Campinas - UNICAMP, São Paulo, Brazil
| | - Nicola Conran
- INCT de Sangue, Hematology Center, School of Medical Science, University of Campinas - UNICAMP, São Paulo, Brazil
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Colella MP, de Paula EV, Machado-Neto JA, Conran N, Annichino-Bizzacchi JM, Costa FF, Olalla Saad ST, Traina F. Elevated hypercoagulability markers in hemoglobin SC disease. Haematologica 2015; 100:466-71. [PMID: 25596272 DOI: 10.3324/haematol.2014.114587] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Hemoglobin SC disease is a very prevalent hemoglobinopathy; however, very little is known about this condition specifically. There appears to be an increased risk of thromboembolic events in hemoglobin SC disease, but studies evaluating the hemostatic alterations are lacking. We describe the findings of a cross-sectional observational study evaluating coagulation activation markers in adult patients with hemoglobin SC, comparing them with those in sickle cell anemia patients and healthy controls. A total of 56 hemoglobin SC and 39 sickle cell anemia patients were included in the study, all in steady state, and 27 healthy controls. None of the patients was taking hydroxyurea. Hemoglobin SC patients had a significantly up-regulated relative expression of tissue factor, as well as elevations in thrombin-antithrombin complex and D-dimer, in comparison to controls (P<0.01). Hemoglobin SC patients had lower tissue factor expression, and thrombin-antithrombin complex and D-dimer levels when compared to sickle cell anemia patients (P<0.05). Markers of endothelial activation (soluble thrombomodulin and soluble vascular cell adhesion molecule-1) and inflammation (tumor necrosis factor-alpha) were both significantly elevated in hemoglobin SC patients when compared to controls, being as high as the levels seen in patients with sickle cell anemia. Overall, in hemoglobin SC patients, higher hemolytic activity and inflammation were associated with a more intense activation of coagulation, and hemostatic activation was associated with two very prevalent chronic complications seen in hemoglobin SC disease: retinopathy and osteonecrosis. In summary, our results demonstrate that hemoglobin SC patients have a hypercoagulable state, although this manifestation was not as intense as that seen in sickle cell anemia.
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Affiliation(s)
- Marina P Colella
- Hematology and Hemotherapy Center - University of Campinas/Hemocentro UNICAMP, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas
| | - Erich V de Paula
- Hematology and Hemotherapy Center - University of Campinas/Hemocentro UNICAMP, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas
| | - João A Machado-Neto
- Hematology and Hemotherapy Center - University of Campinas/Hemocentro UNICAMP, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas
| | - Nicola Conran
- Hematology and Hemotherapy Center - University of Campinas/Hemocentro UNICAMP, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas
| | - Joyce M Annichino-Bizzacchi
- Hematology and Hemotherapy Center - University of Campinas/Hemocentro UNICAMP, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas
| | - Fernando F Costa
- Hematology and Hemotherapy Center - University of Campinas/Hemocentro UNICAMP, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas
| | - Sara T Olalla Saad
- Hematology and Hemotherapy Center - University of Campinas/Hemocentro UNICAMP, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas
| | - Fabiola Traina
- Hematology and Hemotherapy Center - University of Campinas/Hemocentro UNICAMP, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas Currently at the Department of Internal Medicine, University of São Paulo at Ribeirão Preto Medical School, São Paulo, Brazil
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Affiliation(s)
- Nicola Conran
- INCT de Sangue, Hematology Center, School of Medicine, University of Campinas - UNICAMP, Campinas, Sao Paulo, Brazil
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Dominical VM, Vital DM, O'Dowd F, Saad STO, Costa FF, Conran N. In vitro microfluidic model for the study of vaso-occlusive processes. Exp Hematol 2014; 43:223-8. [PMID: 25461252 DOI: 10.1016/j.exphem.2014.10.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 10/17/2014] [Accepted: 10/30/2014] [Indexed: 12/25/2022]
Abstract
Vaso-occlusion, responsible for much of the morbidity of sickle-cell disease, is a complex multicellular process, apparently triggered by leukocyte adhesion to the vessel wall. The microcirculation represents a major site of leukocyte-endothelial interactions and vaso-occlusive processes. We have developed a biochip with subdividing interconnecting microchannels that decrease in size (40 μm to 10 μm in width), for use in conjunction with a precise microfluidic device, to mimic cell flow and adhesion through channels of sizes that approach those of the microcirculation. The biochips were utilized to observe the dynamics of the passage of neutrophils and red blood cells, isolated from healthy and sickle-cell anemia (SCA) individuals, through laminin or endothelial adhesion molecule-coated microchannels at physiologically relevant rates of flow and shear stress. Obstruction of E-selectin/intercellular adhesion molecule 1-coated biochip microchannels by SCA neutrophils was significantly greater than that observed for healthy neutrophils, particularly in the microchannels of 40-15 μm in width. Whereas SCA red blood cells alone did not significantly adhere to, or obstruct, microchannels, mixed suspensions of SCA neutrophils and red blood cells significantly adhered to and obstructed laminin-coated channels. Results from this in vitro microfluidic model support a primary role for leukocytes in the initiation of SCA occlusive processes in the microcirculation. This assay represents an easy-to-use and reproducible in vitro technique for understanding molecular mechanisms and cellular interactions occurring in subdividing microchannels of widths approaching those observed in the microvasculature. The assay could hold potential for testing drugs developed to inhibit occlusive mechanisms such as those observed in SCA and thrombotic diseases.
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Affiliation(s)
- Venina M Dominical
- INCT de Sangue, Hematology and Hemotherapy Center, School of Medicine, University of Campinas, Campinas, São Paulo, Brazil
| | - Daiana M Vital
- INCT de Sangue, Hematology and Hemotherapy Center, School of Medicine, University of Campinas, Campinas, São Paulo, Brazil
| | | | - Sara T O Saad
- INCT de Sangue, Hematology and Hemotherapy Center, School of Medicine, University of Campinas, Campinas, São Paulo, Brazil
| | - Fernando F Costa
- INCT de Sangue, Hematology and Hemotherapy Center, School of Medicine, University of Campinas, Campinas, São Paulo, Brazil
| | - Nicola Conran
- INCT de Sangue, Hematology and Hemotherapy Center, School of Medicine, University of Campinas, Campinas, São Paulo, Brazil.
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dos Santos AF, Almeida CB, Brugnerotto AF, Roversi FM, Pallis FR, Franco-Penteado CF, Lanaro C, Albuquerque DM, Leonardo FC, Costa FF, Conran N. Reduced plasma angiotensin II levels are reversed by hydroxyurea treatment in mice with sickle cell disease. Life Sci 2014; 117:7-12. [PMID: 25219880 DOI: 10.1016/j.lfs.2014.08.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 08/20/2014] [Accepted: 08/26/2014] [Indexed: 01/01/2023]
Abstract
AIMS Sickle cell disease (SCD) pathogenesis leads to recurrent vaso-occlusive and hemolytic processes, causing numerous clinical complications including renal damage. As vasoconstrictive mechanisms may be enhanced in SCD, due to endothelial dysfunction and vasoactive protein production, we aimed to determine whether the expression of proteins of the renin-angiotensin system (RAS) may be altered in an animal model of SCD. MAIN METHODS Plasma angiotensin II (Ang II) was measured in C57BL/6 (WT) mice and mice with SCD by ELISA, while quantitative PCR was used to compare the expressions of the genes encoding the angiotensin-II-receptors 1 and 2 (AT1R and AT2R) and the angiotensin-converting enzymes (ACE1 and ACE2) in the kidneys, hearts, livers and brains of mice. The effects of hydroxyurea (HU; 50-75mg/kg/day, 4weeks) treatment on these parameters were also determined. KEY FINDINGS Plasma Ang II was significantly diminished in SCD mice, compared with WT mice, in association with decreased AT1R and ACE1 expressions in SCD mice kidneys. Treatment of SCD mice with HU reduced leukocyte and platelet counts and increased plasma Ang II to levels similar to those of WT mice. HU also increased AT1R and ACE2 gene expression in the kidney and heart. SIGNIFICANCE Results indicate an imbalanced RAS in an SCD mouse model; HU therapy may be able to restore some RAS parameters in these mice. Further investigations regarding Ang II production and the RAS in human SCD may be warranted, as such changes may reflect or contribute to renal damage and alterations in blood pressure.
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Affiliation(s)
- Alisson F dos Santos
- INCT de Sangue, Hematology and Hemotherapy Center, School of Medicine, University of Campinas -UNICAMP, Campinas, Sao Paulo, Brazil
| | - Camila B Almeida
- INCT de Sangue, Hematology and Hemotherapy Center, School of Medicine, University of Campinas -UNICAMP, Campinas, Sao Paulo, Brazil
| | - Ana F Brugnerotto
- INCT de Sangue, Hematology and Hemotherapy Center, School of Medicine, University of Campinas -UNICAMP, Campinas, Sao Paulo, Brazil
| | - Fernanda M Roversi
- INCT de Sangue, Hematology and Hemotherapy Center, School of Medicine, University of Campinas -UNICAMP, Campinas, Sao Paulo, Brazil
| | - Flávia R Pallis
- INCT de Sangue, Hematology and Hemotherapy Center, School of Medicine, University of Campinas -UNICAMP, Campinas, Sao Paulo, Brazil
| | - Carla F Franco-Penteado
- INCT de Sangue, Hematology and Hemotherapy Center, School of Medicine, University of Campinas -UNICAMP, Campinas, Sao Paulo, Brazil
| | - Carolina Lanaro
- INCT de Sangue, Hematology and Hemotherapy Center, School of Medicine, University of Campinas -UNICAMP, Campinas, Sao Paulo, Brazil
| | - Dulcinéia M Albuquerque
- INCT de Sangue, Hematology and Hemotherapy Center, School of Medicine, University of Campinas -UNICAMP, Campinas, Sao Paulo, Brazil
| | - Flávia C Leonardo
- INCT de Sangue, Hematology and Hemotherapy Center, School of Medicine, University of Campinas -UNICAMP, Campinas, Sao Paulo, Brazil
| | - Fernando F Costa
- INCT de Sangue, Hematology and Hemotherapy Center, School of Medicine, University of Campinas -UNICAMP, Campinas, Sao Paulo, Brazil
| | - Nicola Conran
- INCT de Sangue, Hematology and Hemotherapy Center, School of Medicine, University of Campinas -UNICAMP, Campinas, Sao Paulo, Brazil.
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Lopes FCM, Ferreira R, Albuquerque DM, Silveira AAA, Costa R, Soares R, Costa FF, Conran N. In vitro and in vivo anti-angiogenic effects of hydroxyurea. Microvasc Res 2014; 94:106-13. [DOI: 10.1016/j.mvr.2014.05.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 05/29/2014] [Accepted: 05/30/2014] [Indexed: 11/25/2022]
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Affiliation(s)
- Nicola Conran
- INCT do Sangue, Hematology and Hemotherapy Center, School of Medicine, University of Campinas, UNICAMP, Campinas, Brazil
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Zapponi KCS, Mazetto BM, Bittar LF, Barnabé A, Santiago-Bassora FD, De Paula EV, Orsi FA, Franco-Penteado CF, Conran N, Annichino-Bizzacchi JM. Increased adhesive properties of neutrophils and inflammatory markers in venous thromboembolism patients with residual vein occlusion and high D-dimer levels. Thromb Res 2014; 133:736-42. [PMID: 24560897 DOI: 10.1016/j.thromres.2014.01.035] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 12/12/2013] [Accepted: 01/28/2014] [Indexed: 01/20/2023]
Abstract
BACKGROUND Venous thromboembolism (VTE) develops via a multicellular process on the endothelial surface. Although widely recognized, the relationship between inflammation and thrombosis, this relationship has been mostly explored in clinical studies by measuring circulating levels of inflammatory cytokines. However, the role of inflammatory cells, such as neutrophils, in the pathogenesis of VTE is not clear in humans. AIMS To evaluate the adhesive properties of neutrophils, erythrocytes and platelets in VTE patients and to correlate findings with inflammatory and hypercoagulability marker levels. METHODS Study group consisted of twenty-nine VTE patients and controls matched according to age, gender and ethnic background. Adhesive properties of neutrophils, erythrocytes and platelets were determined using a static adhesion assay. Neutrophil adhesion molecules expressions were evaluated by flow cytometry. Inflammatory and hypercoagulability marker levels were evaluated by standard methods. Residual vein occlusion (RVO) was evaluated by Doppler ultrasound. RESULTS No significant difference could be observed in platelet and erythrocyte adhesion between VTE patients and controls. Interestingly, VTE patients with high levels of D-dimer and RVO, demonstrated a significant increase in neutrophil adhesion, compared to controls and remaining patients. Inflammatory markers (IL-6, IL-8, TNF-α) were also significantly elevated in this subgroup, compared to other VTE patients. Adhesive properties of neutrophils correlated with IL-6 and D-dimer levels. Neutrophils adhesion molecules (CD11a, CD11b and CD18) were not altered in any of the groups. CONCLUSION These findings not only support the hypothesis of an association between inflammation and hypercoagulability, but more importantly, highlight the role of neutrophils in this process.
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Affiliation(s)
- Kiara C S Zapponi
- Hematology and Hemotherapy Center, University of Campinas - UNICAMP, São Paulo, Brazil.
| | - Bruna M Mazetto
- Hematology and Hemotherapy Center, University of Campinas - UNICAMP, São Paulo, Brazil
| | - Luis F Bittar
- Hematology and Hemotherapy Center, University of Campinas - UNICAMP, São Paulo, Brazil
| | - Aline Barnabé
- Hematology and Hemotherapy Center, University of Campinas - UNICAMP, São Paulo, Brazil
| | | | - Erich V De Paula
- Department of Clinical Pathology, University of Campinas - UNICAMP, São Paulo, Brazil
| | - Fernanda A Orsi
- Hematology and Hemotherapy Center, University of Campinas - UNICAMP, São Paulo, Brazil
| | | | - Nicola Conran
- Hematology and Hemotherapy Center, University of Campinas - UNICAMP, São Paulo, Brazil
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Pallis FR, Conran N, Fertrin KY, Olalla Saad ST, Costa FF, Franco-Penteado CF. Hydroxycarbamide reduces eosinophil adhesion and degranulation in sickle cell anaemia patients. Br J Haematol 2013; 164:286-95. [PMID: 24383847 DOI: 10.1111/bjh.12628] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [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: 05/29/2013] [Accepted: 09/18/2013] [Indexed: 01/21/2023]
Abstract
Inflammation, leucocyte and red cell adhesion to the endothelium contribute to the pathogenesis of sickle cell anaemia. Neutrophils appear to be important for vaso-occlusion, however, eosinophils may also participate in this phenomenon. The role of eosinophils in the pathophysiology of sickle cell anaemia (SCA) and the effect of hydroxycarbamide (HC) therapy on the functional properties of these cells are not understood. Patients with SCA and those on HC therapy (SCAHC) were included in the study. SCAHC individuals presented significantly lower absolute numbers of eosinophils than SCA. Furthermore, SCAHC eosinophils demonstrated significantly lower adhesive properties, compared to SCA eosinophils. SCA and SCAHC eosinophils presented greater spontaneous migration when compared with control eosinophils. Baseline eosinophil peroxidase and reactive oxygen species release was higher for SCA individuals than for control individuals, as were plasma levels of eosinophil derived neurotoxin. SCAHC eosinophil degranulation was lower than that of SCA eosinophil degranulation. Eotaxin-1 and RANTES levels were higher in the plasma of SCA and SCAHC individuals, when compared with controls. These data suggest that eosinophils exist in an activated state in SCA and indicate that these cells play a role in the vaso-occlusive process. The exact mechanism by which HC may alter SCA eosinophil properties is not clear.
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Affiliation(s)
- Flavia Rubia Pallis
- Haematology and Haemotherapy Centre - Instituto Nacional de Ciência e Tecnologia do Sangue (INCTS), UNICAMP, Campinas, São Paulo, Brazil
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Sakamoto TM, Lanaro C, Ozelo MC, Garrido VT, Olalla-Saad ST, Conran N, Costa FF. Increased adhesive and inflammatory properties in blood outgrowth endothelial cells from sickle cell anemia patients. Microvasc Res 2013; 90:173-9. [PMID: 24144783 DOI: 10.1016/j.mvr.2013.10.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 10/08/2013] [Accepted: 10/10/2013] [Indexed: 12/23/2022]
Abstract
The endothelium plays an important role in sickle cell anemia (SCA) pathophysiology, interacting with red cells, leukocytes and platelets during the vaso-occlusive process and undergoing activation and dysfunction as a result of intravascular hemolysis and chronic inflammation. Blood outgrowth endothelial cells (BOECs) can be isolated from adult peripheral blood and have been used in diverse studies, since they have a high proliferative capacity and a stable phenotype during in vitro culture. This study aimed to establish BOEC cultures for use as an in vitro study model for endothelial function in sickle cell anemia. Once established, BOECs from steady-state SCA individuals (SCA BOECs) were characterized for their adhesive and inflammatory properties, in comparison to BOECs from healthy control individuals (CON BOECs). Cell adhesion assays demonstrated that control individual red cells adhered significantly more to SCA BOEC than to CON BOEC. Despite these increased adhesive properties, SCA BOECs did not demonstrate significant differences in their expression of major endothelial adhesion molecules, compared to CON BOECs. SCA BOECs were also found to be pro-inflammatory, producing a significantly higher quantity of the cytokine, IL-8, than CON BOECs. From the results obtained, we suggest that BOEC may be a good model for the in vitro study of SCA. Data indicate that endothelial cells of sickle cell anemia patients may have abnormal inflammatory and adhesive properties even outside of the chronic inflammatory and vaso-occlusive environment of patients.
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Affiliation(s)
- Tatiana Mary Sakamoto
- INCT de Sangue, Hematology and Hemotherapy Centre, School of Medicine, University of Campinas - UNICAMP, Brazil
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Sakamoto TM, Canalli AA, Traina F, Franco-Penteado CF, Gambero S, Saad STO, Conran N, Costa FF. Altered red cell and platelet adhesion in hemolytic diseases: Hereditary spherocytosis, paroxysmal nocturnal hemoglobinuria and sickle cell disease. Clin Biochem 2013; 46:1798-803. [PMID: 24060729 DOI: 10.1016/j.clinbiochem.2013.09.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 09/10/2013] [Accepted: 09/13/2013] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Intravascular hemolysis may have important pathophysiological consequences, such as the induction of cellular adhesion and vasculopathy. We compared the adhesive properties of red cells (RBC) and platelets in hereditary spherocytosis (HS), paroxysmal nocturnal hemoglobinuria (PNH) and sickle cell disease (SCD) patients. DESIGN AND METHODS The adhesion of RBC and platelets, from patients and healthy subjects, was determined using static adhesion assays. RBC surface markers were characterized by flow cytometry and lactate dehydrogenase (LDH), plasma hemoglobin (pHb) and TNF-α were assayed in serum/plasma samples. RESULTS pHb levels were elevated in all three hemolytic diseases, indicating the incidence of intravascular hemolysis. RBC adhesion and TNF-α were augmented in HS and SCD, but not in PNH. Reticulocyte counts were raised in the three diseases, but were higher in HS and SCD than in PNH; high expressions of CD71, CD36 and CD49d were observed on SCD RBC, while CD71 alone was increased on HS and PNH RBC. Splenectomy was associated with reversals of increased pHb, RBC adhesion, reticulocytes, RBC marker expression and inflammation in HS. In contrast, platelet adhesion was elevated in SCD and PNH, but not HS. Platelet adhesion correlated significantly with serum LDH, but not pHb, in the hemolytic disease cohort; interestingly, LDH did not correlate with reticulocytes or pHb levels. CONCLUSIONS Results indicate that extravascular, rather than intravascular, hemolysis (and ensuing RBC production) may contribute to elevations in RBC adhesive properties in HS and SCD, while mechanisms peculiar to each disease may augment platelet adhesion in SCD and PNH.
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Affiliation(s)
- Tatiana M Sakamoto
- INCT de Sangue, Haematology and Haemotherapy Centre, School of Medicine, University of Campinas - UNICAMP, Campinas, Sao Paulo, Brazil
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Silveira AAA, Dominical VM, Lazarini M, Costa FF, Conran N. Simvastatin abrogates inflamed neutrophil adhesive properties, in association with the inhibition of Mac-1 integrin expression and modulation of Rho kinase activity. Inflamm Res 2012; 62:127-32. [PMID: 23250325 DOI: 10.1007/s00011-012-0579-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 10/22/2012] [Accepted: 11/26/2012] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Leukocytes play a primary role in vascular inflammation, and thus an understanding of the pathways involved in the activation of these cells and means to inhibit their consequent adhesion to the vessel wall is of significant interest. This study aimed to determine whether statins have a direct effect upon neutrophil adhesive properties under inflammatory conditions. METHODS Neutrophils from healthy individuals were subjected to adhesion assays (with fibronectin as ligand) and flow cytometry. RESULTS In the presence of a TNF-α inflammatory stimulus, neutrophils displayed a rapid and substantial enhancement in their adhesive properties that was abrogated by preincubation of cells with simvastatin. Neutrophil surface expression of the Mac-1 integrin subunit, CD11b, was augmented by TNF-α, and this increased expression was also inhibited by simvastatin. TNF-α also induced neutrophil LFA-1 and Mac-1 activation, but this activation was not blocked by simvastatin. Interestingly, while addition of the isoprenoids, geranygerayl pyrophosphate and farnesyl pyrophosphate, to cells did not alter the effect of simvastatin on TNF-α-stimulated adhesion, concurrent incubation of cells with the Rho kinase (ROCK) inhibitor reversed the effects of simvastatin on neutrophil adhesion and CD11b expression. CONCLUSION Simvastatin appears to have direct anti-inflammatory effects in neutrophils that may be mediated by modulation of ROCK activity.
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Colella MP, De Paula EV, Conran N, Machado-Neto JA, Annicchino-Bizzacchi JM, Costa FF, Saad STO, Traina F. Hydroxyurea is associated with reductions in hypercoagulability markers in sickle cell anemia. J Thromb Haemost 2012; 10:1967-70. [PMID: 22817333 DOI: 10.1111/j.1538-7836.2012.04861.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Garrido VT, Proença-Ferreira R, Dominical VM, Traina F, Bezerra MAC, Mello MRB, Colella MP, Araújo AS, Saad STO, Costa FF, Conran N. Elevated plasma levels and platelet-associated expression of the pro-thrombotic and pro-inflammatory protein, TNFSF14 (LIGHT), in sickle cell disease. Br J Haematol 2012; 158:788-97. [DOI: 10.1111/j.1365-2141.2012.09218.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 05/28/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Vanessa T. Garrido
- INCT de Sangue, Haematology and Haemotherapy Centre; School of Medicine; University of Campinas -UNICAMP; Campinas; SP; Brazil
| | - Renata Proença-Ferreira
- INCT de Sangue, Haematology and Haemotherapy Centre; School of Medicine; University of Campinas -UNICAMP; Campinas; SP; Brazil
| | - Venina M. Dominical
- INCT de Sangue, Haematology and Haemotherapy Centre; School of Medicine; University of Campinas -UNICAMP; Campinas; SP; Brazil
| | - Fabiola Traina
- INCT de Sangue, Haematology and Haemotherapy Centre; School of Medicine; University of Campinas -UNICAMP; Campinas; SP; Brazil
| | - Marcos A. C. Bezerra
- Centro de Ciências Biológicas; Universidade Federal de Pernambuco; Recife; PE; PE; Brazil
| | - Mariana R. B. Mello
- INCT de Sangue, Haematology and Haemotherapy Centre; School of Medicine; University of Campinas -UNICAMP; Campinas; SP; Brazil
| | - Marina P. Colella
- INCT de Sangue, Haematology and Haemotherapy Centre; School of Medicine; University of Campinas -UNICAMP; Campinas; SP; Brazil
| | - Aderson S. Araújo
- Haematology and Haemotherapy Foundation of Pernambuco (HEMOPE); Recife; PE; Brazil
| | - Sara T. O. Saad
- INCT de Sangue, Haematology and Haemotherapy Centre; School of Medicine; University of Campinas -UNICAMP; Campinas; SP; Brazil
| | - Fernando F. Costa
- INCT de Sangue, Haematology and Haemotherapy Centre; School of Medicine; University of Campinas -UNICAMP; Campinas; SP; Brazil
| | - Nicola Conran
- INCT de Sangue, Haematology and Haemotherapy Centre; School of Medicine; University of Campinas -UNICAMP; Campinas; SP; Brazil
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Almeida CB, Favero ME, Pereira-Cunha FG, Lorand-Metze I, Saad STO, Costa FF, Conran N. Alterations in cell maturity and serum survival factors may modulate neutrophil numbers in sickle cell disease. Exp Biol Med (Maywood) 2011; 236:1239-46. [PMID: 21998130 DOI: 10.1258/ebm.2011.011130] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Leukocytes are known to exacerbate inflammatory and vaso-occlusive processes in sickle cell disease (SCD). The aim of this study was to determine whether alterations in neutrophil maturity and/or cell-death modulating factors in the circulation contribute to the increased leukocyte counts and leukocyte survival observed in SCD. The maturity of circulating neutrophils from healthy control individuals (CON), SCD and SCD patients on hydroxyurea therapy (SCDHU) was determined immunophenotypically. Serum factors affecting neutrophil apoptosis (determined by annexin V-binding) were analyzed by culturing control neutrophils (CON neutrophils) with pooled serum from CON, SCD and SCDHU individuals. Immunophenotypic characterization of neutrophils suggested a slight, but significant, increase in the circulation of immature neutrophils in SCD. While SCD neutrophils cultured in the presence of CON serum presented delayed apoptosis, unexpectedly, the culture of CON neutrophils with SCD serum significantly augmented apoptosis and caspase-9 activity. Inhibition of the activity of serum interleukin-8, a neutrophil-apoptosis-inhibiting cytokine, significantly increased SCD serum-induced CON neutrophil apoptosis, indicating that SCD serum may have both apoptotic and antiapoptotic properties. The decreased maturity of SCD neutrophils observed is suggestive of an accelerated immigration of leukocytes from the bone marrow to the circulating pool that may contribute to an increase in cell survival, subject to modulation by a complex balance of both anti- and proapoptotic factors contained in the circulation of SCD individuals.
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Affiliation(s)
- Camila Bononi Almeida
- Hematology and Hemotherapy Center, Instituto Nacional de Ciência e Tecnologia do Sangue, UNICAMP, Campinas, São Paulo, 13083-970, Brazil
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