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Patiño-Trives AM, Pérez-Sánchez C, Pérez-Sánchez L, Luque-Tévar M, Ábalos-Aguilera MC, Alcaide-Ruggiero L, Arias-de la Rosa I, Román-Rodríguez C, Seguí P, Espinosa M, Font P, Barbarroja N, Escudero-Contreras A, Antonio González-Reyes J, Manuel Villalba J, Collantes-Estévez E, Aguirre-Zamorano MÁ, López-Pedrera C. Anti-dsDNA Antibodies Increase the Cardiovascular Risk in Systemic Lupus Erythematosus Promoting a Distinctive Immune and Vascular Activation. Arterioscler Thromb Vasc Biol 2021; 41:2417-2430. [PMID: 34320837 DOI: 10.1161/atvbaha.121.315928] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective Systemic lupus erythematosus (SLE) is associated to boosted atherosclerosis development and a higher cardiovascular disease risk. This study aimed to delineate the role of anti-double stranded DNA (anti-dsDNA) antibodies on the molecular profile and the activity of immune and vascular cells, as well as on their enhanced cardiovascular risk. Approach and Results Eighty SLE patients were included. Extensive clinical/analytical evaluation was performed, including cardiovascular disease parameters (endothelial function, proatherogenic dyslipidemia, and carotid intima-media thickness). Gene and protein expression profiles were evaluated in monocytes from patients diagnosed positive or negative for anti-dsDNA antibodies by using NanoString and cytokine arrays, respectively. NETosis and circulating inflammatory profile was assessed in both neutrophils and plasma. Positivity and persistence of anti-dsDNA antibodies in SLE patients were associated to endothelial dysfunction, proatherogenic dyslipidemia, and accelerated atherosclerosis. In parallel, anti-dsDNA antibodies were linked to the aberrant activation of innate immune cells, so that anti-dsDNA(+) SLE monocytes showed distinctive gene and protein expression/activity profiles, and neutrophils were more prone to suffer NETosis in comparison with anti-dsDNA(−) patients. Anti-dsDNA(+) patients further displayed altered levels of numerous circulating mediators related to inflammation, NETosis, and cardiovascular risk. In vitro, Ig-dsDNA promoted NETosis on neutrophils, apoptosis on monocytes, modulated the expression of inflammation and thrombosis-related molecules, and induced endothelial activation, at least partially, by FcR (Fc receptor)-binding mechanisms. Conclusions Anti-dsDNA antibodies increase the cardiovascular risk of SLE patients by altering key molecular processes that drive a distinctive and coordinated immune and vascular activation, representing a potential tool in the management of this comorbidity.
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Affiliation(s)
- Alejandra María Patiño-Trives
- Rheumatology Service (A.M.P.-T., C.P.-S., L.P.-S., M.L.-T., M.C.A.-A., L.A.-R., I.A.-d.l.R., C.R.-R., P.F., N.B., A.E.-C., E.C.-E., M.Á.A.-Z., C.L.-P.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba/University of Cordoba, Spain
| | - Carlos Pérez-Sánchez
- Rheumatology Service (A.M.P.-T., C.P.-S., L.P.-S., M.L.-T., M.C.A.-A., L.A.-R., I.A.-d.l.R., C.R.-R., P.F., N.B., A.E.-C., E.C.-E., M.Á.A.-Z., C.L.-P.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba/University of Cordoba, Spain.,Deparment of Cell Biology, Immunology and Physiology, University of Córdoba, Campus de Excelencia Internacional Agroalimentario ceiA3, Spain (C.P.-S., J.A.G.-R., J.M.V.)
| | - Laura Pérez-Sánchez
- Rheumatology Service (A.M.P.-T., C.P.-S., L.P.-S., M.L.-T., M.C.A.-A., L.A.-R., I.A.-d.l.R., C.R.-R., P.F., N.B., A.E.-C., E.C.-E., M.Á.A.-Z., C.L.-P.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba/University of Cordoba, Spain
| | - María Luque-Tévar
- Rheumatology Service (A.M.P.-T., C.P.-S., L.P.-S., M.L.-T., M.C.A.-A., L.A.-R., I.A.-d.l.R., C.R.-R., P.F., N.B., A.E.-C., E.C.-E., M.Á.A.-Z., C.L.-P.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba/University of Cordoba, Spain
| | - M Carmen Ábalos-Aguilera
- Rheumatology Service (A.M.P.-T., C.P.-S., L.P.-S., M.L.-T., M.C.A.-A., L.A.-R., I.A.-d.l.R., C.R.-R., P.F., N.B., A.E.-C., E.C.-E., M.Á.A.-Z., C.L.-P.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba/University of Cordoba, Spain
| | - Lourdes Alcaide-Ruggiero
- Rheumatology Service (A.M.P.-T., C.P.-S., L.P.-S., M.L.-T., M.C.A.-A., L.A.-R., I.A.-d.l.R., C.R.-R., P.F., N.B., A.E.-C., E.C.-E., M.Á.A.-Z., C.L.-P.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba/University of Cordoba, Spain
| | - Iván Arias-de la Rosa
- Rheumatology Service (A.M.P.-T., C.P.-S., L.P.-S., M.L.-T., M.C.A.-A., L.A.-R., I.A.-d.l.R., C.R.-R., P.F., N.B., A.E.-C., E.C.-E., M.Á.A.-Z., C.L.-P.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba/University of Cordoba, Spain
| | - Cristóbal Román-Rodríguez
- Rheumatology Service (A.M.P.-T., C.P.-S., L.P.-S., M.L.-T., M.C.A.-A., L.A.-R., I.A.-d.l.R., C.R.-R., P.F., N.B., A.E.-C., E.C.-E., M.Á.A.-Z., C.L.-P.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba/University of Cordoba, Spain
| | - Pedro Seguí
- Radiology Service (P.S.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba/University of Cordoba, Spain
| | - Mario Espinosa
- Nephrology Service (M.E.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba/University of Cordoba, Spain
| | - Pilar Font
- Rheumatology Service (A.M.P.-T., C.P.-S., L.P.-S., M.L.-T., M.C.A.-A., L.A.-R., I.A.-d.l.R., C.R.-R., P.F., N.B., A.E.-C., E.C.-E., M.Á.A.-Z., C.L.-P.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba/University of Cordoba, Spain
| | - Nuria Barbarroja
- Rheumatology Service (A.M.P.-T., C.P.-S., L.P.-S., M.L.-T., M.C.A.-A., L.A.-R., I.A.-d.l.R., C.R.-R., P.F., N.B., A.E.-C., E.C.-E., M.Á.A.-Z., C.L.-P.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba/University of Cordoba, Spain
| | - Alejandro Escudero-Contreras
- Rheumatology Service (A.M.P.-T., C.P.-S., L.P.-S., M.L.-T., M.C.A.-A., L.A.-R., I.A.-d.l.R., C.R.-R., P.F., N.B., A.E.-C., E.C.-E., M.Á.A.-Z., C.L.-P.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba/University of Cordoba, Spain
| | - José Antonio González-Reyes
- Deparment of Cell Biology, Immunology and Physiology, University of Córdoba, Campus de Excelencia Internacional Agroalimentario ceiA3, Spain (C.P.-S., J.A.G.-R., J.M.V.)
| | - José Manuel Villalba
- Deparment of Cell Biology, Immunology and Physiology, University of Córdoba, Campus de Excelencia Internacional Agroalimentario ceiA3, Spain (C.P.-S., J.A.G.-R., J.M.V.)
| | - Eduardo Collantes-Estévez
- Rheumatology Service (A.M.P.-T., C.P.-S., L.P.-S., M.L.-T., M.C.A.-A., L.A.-R., I.A.-d.l.R., C.R.-R., P.F., N.B., A.E.-C., E.C.-E., M.Á.A.-Z., C.L.-P.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba/University of Cordoba, Spain
| | - M Ángeles Aguirre-Zamorano
- Rheumatology Service (A.M.P.-T., C.P.-S., L.P.-S., M.L.-T., M.C.A.-A., L.A.-R., I.A.-d.l.R., C.R.-R., P.F., N.B., A.E.-C., E.C.-E., M.Á.A.-Z., C.L.-P.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba/University of Cordoba, Spain
| | - Chary López-Pedrera
- Rheumatology Service (A.M.P.-T., C.P.-S., L.P.-S., M.L.-T., M.C.A.-A., L.A.-R., I.A.-d.l.R., C.R.-R., P.F., N.B., A.E.-C., E.C.-E., M.Á.A.-Z., C.L.-P.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba/University of Cordoba, Spain
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Pérez-Sánchez L, Patiño-Trives AM, Aguirre-Zamorano MÁ, Luque-Tévar M, Ábalos-Aguilera MC, Arias-de la Rosa I, Seguí P, Velasco-Gimena F, Barbarroja N, Escudero-Contreras A, Collantes-Estévez E, Pérez-Sánchez C, López-Pedrera C. Characterization of Antiphospholipid Syndrome Atherothrombotic Risk by Unsupervised Integrated Transcriptomic Analyses. Arterioscler Thromb Vasc Biol 2020; 41:865-877. [PMID: 33356391 DOI: 10.1161/atvbaha.120.315346] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Our aim was to characterize distinctive clinical antiphospholipid syndrome phenotypes and identify novel microRNA (miRNA)-mRNA-intracellular signaling regulatory networks in monocytes linked to cardiovascular disease. Approach and Results: Microarray analysis in antiphospholipid syndrome monocytes revealed 547 differentially expressed genes, mainly involved in inflammatory, cardiovascular, and reproductive disorders. Besides, this approach identified several genes related to inflammatory, renal, and dermatologic diseases. Functional analyses further demonstrated phosphorylation of intracellular kinases related to thrombosis and immune-mediated chronic inflammation. miRNA profiling showed altered expression of 22 miRNAs, enriched in pathways related to immune functions, cardiovascular disease, and autoimmune-associated pathologies. Unbiased integrated mRNA-miRNA analysis identified a signature of 9 miRNAs as potential modulators of 17 interconnected genes related to cardiovascular disease. The altered expression of that miRNA-mRNA signature was proven to be stable along time and distinctive of nonautoimmune thrombotic patients. Transfection studies and luciferase assays established the relationship between specific miRNAs and their identified target genes and proteins, along with their involvement in the regulation of monocytes procoagulant activity and cell adhesion. Correlation analyses showed relationship among altered miRNAs and their interconnected genes with aPL (antiphospholipid antibodies)-titers, along with microvascular endothelial dysfunction. In vitro studies demonstrated modulation in healthy monocytes by IgG-aPLs of several genes/miRNAs, which further intermediated downstream effects on endothelial function. The identified transcriptomic signature allowed the unsupervised division of three clusters of patients with antiphospholipid syndrome showing distinctive clinical profiles, mainly associated with their prothrombotic risk (thrombosis, autoantibody profile, cardiovascular risk factors, and atherosclerosis). CONCLUSIONS Extensive molecular profiling of monocytes in patients with primary antiphospholipid syndrome might help to identify distinctive clinical phenotypes, thus enabling new patients' tailored treatments.
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Affiliation(s)
- Laura Pérez-Sánchez
- Rheumatology Service (L.P.-S., A.M.P.-T., M.A.A.-Z., M.L.-T., M.C.A.-A., I.A.-d.l.R., N.B., A.E.-C., E.C.-E., C.L.-P.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC)/University of Cordoba, Spain
| | - Alejandra M Patiño-Trives
- Rheumatology Service (L.P.-S., A.M.P.-T., M.A.A.-Z., M.L.-T., M.C.A.-A., I.A.-d.l.R., N.B., A.E.-C., E.C.-E., C.L.-P.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC)/University of Cordoba, Spain
| | - M Ángeles Aguirre-Zamorano
- Rheumatology Service (L.P.-S., A.M.P.-T., M.A.A.-Z., M.L.-T., M.C.A.-A., I.A.-d.l.R., N.B., A.E.-C., E.C.-E., C.L.-P.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC)/University of Cordoba, Spain
| | - María Luque-Tévar
- Rheumatology Service (L.P.-S., A.M.P.-T., M.A.A.-Z., M.L.-T., M.C.A.-A., I.A.-d.l.R., N.B., A.E.-C., E.C.-E., C.L.-P.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC)/University of Cordoba, Spain
| | - M Carmen Ábalos-Aguilera
- Rheumatology Service (L.P.-S., A.M.P.-T., M.A.A.-Z., M.L.-T., M.C.A.-A., I.A.-d.l.R., N.B., A.E.-C., E.C.-E., C.L.-P.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC)/University of Cordoba, Spain
| | - Iván Arias-de la Rosa
- Rheumatology Service (L.P.-S., A.M.P.-T., M.A.A.-Z., M.L.-T., M.C.A.-A., I.A.-d.l.R., N.B., A.E.-C., E.C.-E., C.L.-P.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC)/University of Cordoba, Spain
| | - Pedro Seguí
- Radiology Service (P.S.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC)/University of Cordoba, Spain
| | - Francisco Velasco-Gimena
- Haematology Service (F.V.-G.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC)/University of Cordoba, Spain
| | - Nuria Barbarroja
- Rheumatology Service (L.P.-S., A.M.P.-T., M.A.A.-Z., M.L.-T., M.C.A.-A., I.A.-d.l.R., N.B., A.E.-C., E.C.-E., C.L.-P.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC)/University of Cordoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain (N.B.)
| | - Alejandro Escudero-Contreras
- Rheumatology Service (L.P.-S., A.M.P.-T., M.A.A.-Z., M.L.-T., M.C.A.-A., I.A.-d.l.R., N.B., A.E.-C., E.C.-E., C.L.-P.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC)/University of Cordoba, Spain
| | - Eduardo Collantes-Estévez
- Rheumatology Service (L.P.-S., A.M.P.-T., M.A.A.-Z., M.L.-T., M.C.A.-A., I.A.-d.l.R., N.B., A.E.-C., E.C.-E., C.L.-P.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC)/University of Cordoba, Spain
| | - Carlos Pérez-Sánchez
- Deparment of Medicine, University of Cambridge, School of Clinical Medicine, Addenbroke's Hospital, Cambridge Institute for Medical Research, United Kingdom (C.P.-S.)
| | - Chary López-Pedrera
- Rheumatology Service (L.P.-S., A.M.P.-T., M.A.A.-Z., M.L.-T., M.C.A.-A., I.A.-d.l.R., N.B., A.E.-C., E.C.-E., C.L.-P.), Reina Sofia Hospital/Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC)/University of Cordoba, Spain
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