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Frustaci A, Najafian B, Donato G, Verardo R, Chimenti C, Sansone L, Belli M, Vernucci E, Russo MA. Divergent Impact of Enzyme Replacement Therapy on Human Cardiomyocytes and Enterocytes Affected by Fabry Disease: Correlation with Mannose-6-phosphate Receptor Expression. J Clin Med 2022; 11:jcm11051344. [PMID: 35268433 PMCID: PMC8911518 DOI: 10.3390/jcm11051344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/21/2022] [Accepted: 02/25/2022] [Indexed: 02/05/2023] Open
Abstract
Background: The impact of enzyme replacement therapy (ERT) on cardiomyocytes and intestinal cells, affected by Fabry disease (FD), is still unclear. Methods: Six patients with FD, including five family members with GLA mutation c.666delC and one with GLA mutation c.658C > T, manifesting cardiomyopathy and intestinal symptoms (abdominal pain, diarrhea and malabsorption) were included in the study. Clinical outcome, cardiac magnetic resonance (CMR), endomyocardial and gastro-intestinal biopsies were evaluated before and after 2 years of treatment with agalsidase-α (0.2 mg/kg every other week). Immunohistochemistry and Western blot assessments of mannose-6-phosphate receptors (IGF-II-R) on intestinal and myocardial frozen tissue were obtained at diagnosis and after 2 years of ERT. Results: After ERT left ventricular maximal wall thickness, ranging from pre (<10.5 mm) to mild (<15 mm) and moderate hypertrophy (16 mm), was not associated with significant changes at CMR. Degree of dyspnea, mean cardiomyocyte diameter and % vacuolated areas of cardiomyocytes, representing intracellular GL3, remained unmodified. In contrast, intestinal symptoms improved with disappearance of diarrhea, recovery of anemia and weight gain, correlating with near complete clearance of the enterocytes from GL3 inclusions. IGF-II-R expression was remarkably higher even at histochemistry in intestinal tissue compared with myocardium (p < 0.001) either at baseline and after ERT, thus justifying intestinal recovery. Conclusions: Human cells affected by FD may respond differently to ERT: while cardiomyocytes retain their GL3 content after 2 years of treatment, gastro-intestinal cells show GL3 removal with recovery of function. This divergent response may be related to differences in cellular turnover, as well as tissue IGF-II-R expression.
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Affiliation(s)
- Andrea Frustaci
- Department of Clinical, Internal, Anesthesiologist and Cardiovascular Sciences, La Sapienza University, 00100 Rome, Italy; (C.C.); (E.V.)
- Cellular and Molecular Cardiology Laboratory, IRCCS L. Spallanzani, 00149 Rome, Italy;
- Correspondence:
| | - Behzad Najafian
- Department of Pathology, University of Washington, Seattle, WA 98195, USA;
| | - Giuseppe Donato
- Department of Translational and Precision Medicine, La Sapienza University, 00100 Rome, Italy;
| | - Romina Verardo
- Cellular and Molecular Cardiology Laboratory, IRCCS L. Spallanzani, 00149 Rome, Italy;
| | - Cristina Chimenti
- Department of Clinical, Internal, Anesthesiologist and Cardiovascular Sciences, La Sapienza University, 00100 Rome, Italy; (C.C.); (E.V.)
- Cellular and Molecular Cardiology Laboratory, IRCCS L. Spallanzani, 00149 Rome, Italy;
| | - Luigi Sansone
- Laboratory of Molecular and Cellular Pathology, IRCCS San Raffaele Pisana, 88163 Rome, Italy; (L.S.); (M.B.)
| | - Manuel Belli
- Laboratory of Molecular and Cellular Pathology, IRCCS San Raffaele Pisana, 88163 Rome, Italy; (L.S.); (M.B.)
| | - Enza Vernucci
- Department of Clinical, Internal, Anesthesiologist and Cardiovascular Sciences, La Sapienza University, 00100 Rome, Italy; (C.C.); (E.V.)
- Laboratory of Molecular and Cellular Pathology, IRCCS San Raffaele Pisana, 88163 Rome, Italy; (L.S.); (M.B.)
| | - Matteo Antonio Russo
- MEBIC Consortium, San Raffaele Open University, 00166 Rome, Italy;
- IRCCS San Raffaele Pisana, 88163 Rome, Italy
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Foglio E, Pellegrini L, Germani A, Russo MA, Limana F. HMGB1-mediated apoptosis and autophagy in ischemic heart diseases. Vasc Biol 2019; 1:H89-H96. [PMID: 32923959 PMCID: PMC7439920 DOI: 10.1530/vb-19-0013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 08/12/2019] [Indexed: 12/17/2022]
Abstract
Acute myocardial infarction (MI) and its consequences are the most common and lethal heart syndromes worldwide and represent a significant health problem. Following MI, apoptosis has been generally seen as the major contributor of the cardiomyocyte fate and of the resultant myocardial remodeling. However, in recent years, it has been discovered that, following MI, cardiomyocytes could activate autophagy in an attempt to protect themselves against ischemic stress and to preserve cardiac function. Although initially seen as two completely separate responses, recent works have highlighted the intertwined crosstalk between apoptosis and autophagy. Numerous researches have tried to unveil the mechanisms and the molecular players involved in this phenomenon and have identified in high-mobility group box 1 (HMGB1), a highly conserved non-histone nuclear protein with important roles in the heart, one of the major regulator. Thus, the aim of this mini review is to discuss how HMGB1 regulates these two responses in ischemic heart diseases. Indeed, a detailed understanding of the crosstalk between apoptosis and autophagy in these pathologies and how HMGB1 regulates them would be of tremendous help in developing novel therapeutic approaches aimed to promote cardiomyocyte survival and to diminish tissue injury following MI.
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Affiliation(s)
- Eleonora Foglio
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Laura Pellegrini
- Institute of Oncology Research (IOR), Bellinzona, Switzerland.,Universita' della Svizzera Italiana, Lugano, Switzerland
| | - Antonia Germani
- Laboratory of Vascular Pathology, Istituto Dermopatico dell'Immacolata, IDI-IRCCS, Fondazione Luigi Maria Monti, Rome, Italy
| | - Matteo Antonio Russo
- IRCCS San Raffaele Pisana, San Raffaele Open University, Rome, Italy.,MEBIC Consortium, San Raffaele Open University, Rome, Italy
| | - Federica Limana
- Laboratory of Cellular and Molecular Pathology, IRCCS San Raffaele Pisana, Rome, Italy.,San Raffaele Open University, Rome, Italy
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Abstract
High-mobility group box 1 (HMGB1) is one of the most abundant proteins in eukaryotes and the best characterized damage-associated molecular pattern (DAMP). The biological activities of HMGB1 depend on its subcellular location, context and post-translational modifications. Inside the nucleus, HMGB1 is engaged in many DNA events such as DNA repair, transcription regulation and genome stability; in the cytoplasm, its main function is to regulate the autophagic flux while in the extracellular environment, it possesses more complicated functions and it is involved in a large variety of different processes such as inflammation, migration, invasion, proliferation, differentiation and tissue regeneration. Due to this pleiotropy, the role of HMGB1 has been vastly investigated in various pathological diseases and a large number of studies have explored its function in cardiovascular pathologies. However, in this contest, the precise mechanism of action of HMGB1 and its therapeutic potential are still very controversial since is debated whether HMGB1 is involved in tissue damage or plays a role in tissue repair and regeneration. The main focus of this review is to provide an overview of the effects of HMGB1 in different ischemic heart diseases and to discuss its functions in these pathological conditions.
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