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Ledinek Ž, Sobočan M, Sisinger D, Hojnik M, Büdefeld T, Potočnik U, Knez J. The association of Wnt-signalling and EMT markers with clinical characteristics in women with endometrial cancer. Front Oncol 2023; 13:1013463. [PMID: 36969079 PMCID: PMC10031053 DOI: 10.3389/fonc.2023.1013463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 02/20/2023] [Indexed: 03/11/2023] Open
Abstract
Endometrial cancer is the most common gynecologic malignancy in the developed world. Risk stratification and treatment approaches are changing due to better understanding of tumor biology. Upregulated Wnt signaling plays an important role in cancer initiation and progression with promising potential for development of specific Wnt inhibitor therapy. One of the ways in which Wnt signaling contributes to progression of cancer, is by activating epithelial-to-mesenchymal transition (EMT) in tumor cells, causing the expression of mesenchymal markers, and enabling tumor cells to dissociate and migrate. This study analyzed the expression of Wnt signaling and EMT markers in endometrial cancer. Wnt signaling and EMT markers were significantly correlated with hormone receptors status in EC, but not with other clinico-pathological characteristics. Expression of Wnt antagonist, Dkk1 was significantly different between the ESGO-ESTRO-ESP patient risk assessment categories using integrated molecular risk assessment.
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Affiliation(s)
- Živa Ledinek
- Department of Pathology, University Medical Centre Maribor, Maribor, Slovenia
| | - Monika Sobočan
- Divison for Gynaecology and Perinatology, University Medical Centre Maribor, Maribor, Slovenia
- Department of Gynaecology and Obstetrics, Faculty of Medicine University of Maribor, Maribor, Slovenia
| | - Damjan Sisinger
- Department of Pathology, University Medical Centre Maribor, Maribor, Slovenia
| | - Marko Hojnik
- Department of Pathology, University Medical Centre Maribor, Maribor, Slovenia
| | - Tomaž Büdefeld
- Center for Human Molecular Genetics and Pharmacogenomics, Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - Uroš Potočnik
- Center for Human Molecular Genetics and Pharmacogenomics, Faculty of Medicine, University of Maribor, Maribor, Slovenia
- Laboratory for Biochemistry, Molecular Biology and Genomics, University of Maribor, Maribor, Slovenia
- Department for Science and Research, University Medical Centre Maribor, Maribor, Slovenia
| | - Jure Knez
- Divison for Gynaecology and Perinatology, University Medical Centre Maribor, Maribor, Slovenia
- Department of Gynaecology and Obstetrics, Faculty of Medicine University of Maribor, Maribor, Slovenia
- *Correspondence: Jure Knez,
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Maksymowych WP, Baraliakos X, Lambert RG, Landewé RBM, Sandoval D, Carlier H, Lisse J, LI X, Hojnik M, Østergaard M. POS0301 STRUCTURAL OUTCOMES IN THE SACROILIAC JOINT AFTER IXEKIZUMAB TREATMENT FOR 16 WEEKS IN PATIENTS WITH ACTIVE NON‑RADIOGRAPHIC AXIAL SPONDYLOARTHRITIS STRATIFIED BY GENDER, HLA-B27, AND BASELINE MRI INFLAMMATION. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundIxekizumab (IXE) has demonstrated clinical efficacy in patients with active non-radiographic axial spondyloarthritis (nr-axSpA) together with significant repair of structural lesions in the sacroiliac joint (SIJ) on MRI. There is, however, a paucity of data as to which patients may be most responsive.ObjectivesWe aimed to evaluate whether patients’ gender, HLA-B27 status, and presence of MRI inflammation impacted the effect of treatment with IXE versus placebo (PBO) on MRI structural lesions in the SIJ in patients with nr-axSpA.MethodsPatients with active nr-axSpA, biologic-naïve (COAST-X, NCT02757352) were randomized 1:1:1 to ixekizumab 80 mg every 4 (Q4W) or 2 weeks (Q2W) or PBO. Structural lesions on SIJ MRI were assessed by the Spondyloarthritis Research Consortium of Canada (SPARCC) MRI SIJ structural score (SSS). Treatment comparisons used analysis of covariance based on observed cases. SPARCC SSS subgroup analyses were performed according to baseline gender, HLA-B27 status, and SPARCC MRI SIJ bone marrow oedema (BME) <4 and ≥4 subgroups, which reflects a definite MRI for inflammation in the SIJ typical of axSpA.ResultsOf 303 randomized patients, 266 patients (Q4W: n=85, Q2W: n=91, PBO: n=90) had an MRI scan at baseline and week 16. At baseline, SPARCC scores were consistently higher in males, and mostly higher in HLA-B27 and BME≥4 positive subgroups. Significant differences between patients treated with IXE versus PBO were observed for male patients, HLA-B27 positives, and those with baseline SPARCC BME ≥4. Numerically similar changes were observed in female patients, patients with negative HLA-B27, and patients with SPARCC BME<4, though not statistically significant.ConclusionEffects of IXE on structural repair are most evident in males, HLA-B27 positives, and patients with definite MRI inflammation at baseline.Table 1.MRI SIJ Structural Lesion Outcomes.LesionAnalysisPBOIXE Q4WIXE Q2WMale (n=39)Female (n=51)Male (n=44)Female (n=41)Male (n=43)Female (n=48)ErosionBL mean5·1671·9803·5452·8173·5232·594LS mean CFB (SE)0·51 (0·20)-0·11 (0·17)-0·63 (0·18)-0·11 (0·19)-0·51 (0·18)-0·32 (0·17)P value vs PBONANAp<0·001p>0·99p<0·001p=0·37FatBL mean2·0510·9122·0911·2931·4650·677LS mean CFB (SE)-0·02 (0·09)-0·03 (0·08)0·29 (0·08)0·03 (0·08)0·21 (0·08)0·04 (0·08)P value vs PBONANAp=0·01p=0·65p=0·062p=0·51BackfillBL mean1·1540·1670·6630·4150·7910·323LS mean CFB (SE)-0·20 (0·13)0·01 (0·11)0·39 (0·12)0·01 (0·12)0·34 (0·12)0·14 (0·11)P value vs PBONANAp<0·001p>0·99p=0·002p=0·38LesionAnalysisHLA-B27+HLA-B27-HLA-B27+HLA-B27-HLA-B27+HLA-B27-(n=64)(n=25)(n=61)(n=23)(n=65)(n=26)ErosionBL mean3·8202·1003·4672·5433·5151·827LS mean CFB (SE)0·27 (0·15)-0·10 (0·24)-0·49 (0·15)-0·01 (0·25)-0·50 (0·15)-0·17 (0·24)P value vs PBONANAp<0·001p=0·79p<0·001p=0·84FatBL mean1·5781·0201·3282·7831·2850·462LS mean CFB (SE)-0·06 (0·06)-0·06 (0·10)0·22 (0·06)0·01 (0·10)0·13 (0·06)0·10 (0·10)P value vs PBONANAp=0·002p=0·65p=0·027p=0·25BackfillBL mean0·7420·2400·5420·5650·7620LS mean CFB (SE)-0·12 (0·10)0·01 (0·16)0·28 (0·10)0 (0·17)0·27 (0·10)0·16 (0·16)P value vs PBONANAp=0·005p=0·96p=0·005p=0·52LesionAnalysisBME ≥4BME <4BME ≥4BME <4BME ≥4BME <4(n=40)(n=50)(n=27)(n=58)(n=38)(n=53)ErosionBL mean4·8632·1605·3522·1905·2761·425LS mean CFB (SE)0·42 (0·19)-0·06 (0·17)-0·70 (0·23)-0·23 (0·16)-0·71 (0·20)-0·19 (0·17)P value vs PBONANAp<0·001p=0·47p<0·001p=0·57FatBL mean0·7751·9101·9261·6031·6710·604LS mean CFB (SE)-0·02 (0·08)-0·02 (0·07)0·54 (0·10)-0·01 (0·07)0·28 (0·08)0·01 (0·07)P value vs PBONANAp<0·001p=0·90p=0·013p=0·74BackfillBL mean0·7500·4701·0190·3280·7630·387LS mean CFB (SE)-0·21 (0·12)0·01 (0·11)0·41 (0·15)0·11 (0·10)0·49 (0·13)0·05 (0·11)P value vs PBONANAp=0·002p=0·52p<0·001p=0·80CFB=change from BL. BL=baseline, LS=least squares.AcknowledgementsStudy was sponsored by Eli Lilly and CompanyDisclosure of InterestsWalter P Maksymowych Speakers bureau: AbbVie, Janssen, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Boehringer Ingelheim, Celgene, Eli Lilly and Company, Galapagos, Janssen, Novartis, Pfizer, and UCB and is Chief Medical Officer of CARE Arthritis Ltd, Grant/research support from: AbbVie, Novartis, Pfizer, and UCB, Xenofon Baraliakos Grant/research support from: Abbvie, Amgen, BMS, Chugai, Galapagos, Gilead, Eli Lilly and Company, MSD, Novartis, Pfizer, Roche, Sandoz, and UCB, Robert G Lambert Consultant of: CARE Arthritis, Image Analysis Group, Parexel, and Pfizer, Robert B.M. Landewé Consultant of: AbbVie, Astra-Zeneca, Bristol Myers Squibb, Celgene, Eli Lilly and Company, Janssen, Gilead, Galapagos, Glaxo-Smith-Kline, Novartis, Pfizer, UCB, Grant/research support from: AbbVie, Novartis, Pfizer, and UCB; and is director of Imaging Rheumatology BV, which is a registered company under Dutch Law, David Sandoval Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Hilde Carlier Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Jeffrey Lisse Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Xiaoqi Li Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Maja Hojnik Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Mikkel Østergaard Speakers bureau: AbbVie, BMS, Boehringer-Ingelheim, Celgene, Eli Lilly and Company, Hospira, Janssen, Merck, Novartis, Novo, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB, Consultant of: AbbVie, BMS, Boehringer-Ingelheim, Celgene, Eli Lilly and Company, Hospira, Janssen, Merck, Novartis, Novo, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB, Grant/research support from: AbbVie, BMS, Merck, Celgene, and Novartis
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Hojnik M, Kenda Šuster N, Smrkolj Š, Frković Grazio S, Verdenik I, Rižner TL. AKR1C3 Is Associated with Better Survival of Patients with Endometrial Carcinomas. J Clin Med 2020; 9:jcm9124105. [PMID: 33352741 PMCID: PMC7766127 DOI: 10.3390/jcm9124105] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/13/2020] [Accepted: 12/16/2020] [Indexed: 12/19/2022] Open
Abstract
The aldo-keto reductase (AKR) superfamily is gaining attention in cancer research. AKRs are involved in important biochemical processes and have crucial roles in carcinogenesis and chemoresistance. The enzyme AKR1C3 has many functions, which include production of prostaglandins, androgens and estrogens, and metabolism of different chemotherapeutics; AKR1C3 is thus implicated in the pathophysiology of different cancers. Endometrial and ovarian cancers represent the majority of gynecological malignancies in developed countries. Personalized treatments for these cancers depend on identification of prognostic and predictive biomarkers that allow stratification of patients. In this study, we evaluated the immunohistochemical (IHC) staining of AKR1C3 in 123 paraffin-embedded samples of endometrial cancer and 99 samples of ovarian cancer, and examined possible correlations between expression of AKR1C3 and other clinicopathological data. The IHC expression of AKR1C3 was higher in endometrial cancer compared to ovarian cancer. In endometrioid endometrial carcinoma, high AKR1C3 IHC expression correlated with better overall survival (hazard ratio, 0.19; 95% confidence interval, 0.06−0.65, p = 0.008) and with disease-free survival (hazard ratio, 0.328; 95% confidence interval, 0.12–0.88, p = 0.027). In patients with ovarian cancer, there was no correlation between AKR1C3 IHC expression and overall and disease-free survival or response to chemotherapy. These results demonstrate that AKR1C3 is a potential prognostic biomarker for endometrioid endometrial cancer.
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Affiliation(s)
- Marko Hojnik
- Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Nataša Kenda Šuster
- Division of Gynecology, Department of Obstetrics and Gynecology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (N.K.Š.); (Š.S.); (I.V.)
- Medical Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Špela Smrkolj
- Division of Gynecology, Department of Obstetrics and Gynecology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (N.K.Š.); (Š.S.); (I.V.)
- Medical Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Snježana Frković Grazio
- Division of Gynecology, Department of Pathology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia;
| | - Ivan Verdenik
- Division of Gynecology, Department of Obstetrics and Gynecology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (N.K.Š.); (Š.S.); (I.V.)
| | - Tea Lanišnik Rižner
- Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia;
- Correspondence: ; Tel.: +386-1-5437657; Fax: +386-1-5437641
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Boehncke WH, Horváth R, Dalkiliç E, Lima SAL, Okada M, Hojnik M, Ganz F, Lubrano E. Association between clinical specialty setting and disease management in patients with psoriatic arthritis: results from LOOP, a cross-sectional, multi-country, observational study. J Eur Acad Dermatol Venereol 2020; 34:2035-2043. [PMID: 32003056 DOI: 10.1111/jdv.16251] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 12/30/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Psoriatic arthritis (PsA) is a chronic and debilitating disease that can be managed by different clinical specialists. OBJECTIVES The objective of the LOOP study was to evaluate the impact of clinical specialty setting on the time to diagnosis and treatment of patients with PsA. Clinical disease activity and disease burden were also compared between clinical settings. METHODS LOOP was a cross-sectional, multicentre, observational study conducted in 17 countries in Western and Eastern Europe, the Middle East, Latin America and Asia. Adult patients (≥18 years) with a suspected or established diagnosis of PsA who were routinely visiting a rheumatologist, dermatologist or non-rheumatology/non-dermatology physician were enrolled. All patients were assessed by both a rheumatologist and a dermatologist. RESULTS Of 1483 enrolled patients, a total of 1273 had a confirmed diagnosis of PsA. There was no significant difference in the median time from onset of inflammatory musculoskeletal symptoms to PsA diagnosis between patients enrolled by rheumatologists and dermatologists (6.0 vs. 3.9 months). However, the median time from diagnosis to first treatment with a conventional synthetic disease-modifying anti-rheumatic drug (csDMARD) was significantly shorter in the rheumatology setting compared with the dermatology setting (0 vs. 2.0 months; P < 0.001). In addition, disease activity was significantly higher in the dermatology setting compared with the rheumatology setting. CONCLUSIONS Differences in the management and clinical status of patients with PsA were observed between the rheumatology and dermatology settings. Importantly, median time from diagnosis to first csDMARD was significantly shorter in the rheumatology setting, and patients in the dermatology setting had higher disease activity. These data show the importance of improved collaboration between rheumatologists and dermatologists.
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Affiliation(s)
- W H Boehncke
- Division of Dermatology and Venereology, Geneva University Hospitals, Geneva, Switzerland.,Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - R Horváth
- Department of Paediatric and Adult Rheumatology, University Hospital Motol, Prague, Czech Republic
| | - E Dalkiliç
- Department of Rheumatology, Uludağ University School of Medicine, Gorukle, Bursa, Turkey
| | - S A L Lima
- Department of Clinical Medicine, Rheumatology, ABC Medical School, Santo André, Brazil
| | - M Okada
- Immuno-Rheumatology Center, St. Luke's International Hospital, Tokyo, Japan
| | - M Hojnik
- Formerly AbbVie, Ljubljana, Slovenia
| | - F Ganz
- AbbVie AG, Baar, Switzerland
| | - E Lubrano
- Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy
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Dobovišek L, Hojnik M, Ferk P. Overlapping molecular pathways between cannabinoid receptors type 1 and 2 and estrogens/androgens on the periphery and their involvement in the pathogenesis of common diseases (Review). Int J Mol Med 2016; 38:1642-1651. [PMID: 27779654 DOI: 10.3892/ijmm.2016.2779] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Accepted: 10/12/2016] [Indexed: 11/06/2022] Open
Abstract
The physiological and pathophysiological roles of sex hormones have been well documented and the modulation of their effects is applicable in many current treatments. On the other hand, the physiological role of endocannabinoids is not yet clearly understood and the endocannabinoid system is considered a relatively new therapeutic target. The physiological association between sex hormones and cannabinoids has been investigated in several studies; however, its involvement in the pathophysiology of common human diseases has been studied separately. Herein, we present the first systematic review of molecular pathways that are influenced by both the cannabinoids and sex hormones, including adenylate cyclase and protein kinase A, epidermal growth factor receptor, cyclic adenosine monophosphate response element-binding protein, vascular endothelial growth factor, proto-oncogene serine/threonine-protein kinase, mitogen-activated protein kinase, phosphatidylinositol-4,5-bisphosphate 3-kinase, C-Jun N-terminal kinase and extracellular-signal-regulated kinases 1/2. Most of these influence cell proliferative activity. Better insight into this association may prove to be beneficial for the development of novel pharmacological treatment strategies for many common diseases, including breast cancer, endometrial cancer, prostate cancer, osteoporosis and atherosclerosis. The associations between cannabinoids, estrogens and androgens under these conditions are also presented and the molecular interactions are highlighted.
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Affiliation(s)
- Luka Dobovišek
- Department of Pharmacology and Experimental Toxicology, Faculty of Medicine, University of Maribor, SI-2000 Maribor, Slovenia
| | - Marko Hojnik
- Department of Pharmacology and Experimental Toxicology, Faculty of Medicine, University of Maribor, SI-2000 Maribor, Slovenia
| | - Polonca Ferk
- Department of Pharmacology and Experimental Toxicology, Faculty of Medicine, University of Maribor, SI-2000 Maribor, Slovenia
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Inman R, Sieper J, Poddubnyy D, Akar S, Munoz-Fernandez S, Hojnik M. THU0407 Baseline Results from Proof – A 5-Year Observational Study of Long-Term Disease Outcome in Axial Spondyloarthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Boehncke WH, Piercy J, Chen S, Hojnik M, Ganz F. AB0749 Impact of Patient Perception of Psoriasis and Psoriatic Arthritis Severity on Patient-Reported Outcomes: An Analysis from The Adelphi Database. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Mease P, Kavanaugh A, Coates L, McInnes I, Hojnik M, Zhang Y, Anderson J, Dorr A, Gladman D. THU0431 The Prediction and Benefits of Minimal Disease Activity in Patients with Psoriatic Arthritis in the Adept Trial. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gladman D, Mease P, Smolen J, Weinman J, Kalus S, Dorr A, Hojnik M, Nurwakagari P, Selenko-Gebauer N. SAT0566 Impact of Disease Management by Rheumatologists and Dermatologists on Patients' Attitude Toward Medication in Psoriatic Arthritis: Results from the Global Align Study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Smolen J, Gladman D, McNeil H, Weinman J, Kalus S, Dorr A, Hojnik M, Nurwakagari P, Selenko-Gebauer N. FRI0353 Association of Attitudes Toward Conventional Synthetic Disease-Modifying Anti-Rheumatic Drugs and Tumor Necrosis Factor Inhibitors and Treatment Adherence in Rheumatoid Arthritis, Ankylosing Spondylitis, and Psoriatic Arthritis: Results from the Global Align Study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Hojnik M, Dobovišek L, Knez Ž, Ferk P. A synergistic interaction of 17-β-estradiol with specific cannabinoid receptor type 2 antagonist/inverse agonist on proliferation activity in primary human osteoblasts. Biomed Rep 2015; 3:554-558. [PMID: 26171165 DOI: 10.3892/br.2015.469] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 09/15/2014] [Accepted: 03/02/2015] [Indexed: 12/19/2022] Open
Abstract
The bone remodeling process is influenced by various factors, including estrogens and transmitters of the endocannabinoid system. In osteoblasts, cannabinoid receptors 2 (CB-2) are expressed at a much higher level compared to CB-1 receptors. Previous studies have shown that estrogens could influence CB-2 receptor expression. In the present study, the possible interactions of a specific CB-2 agonist and a specific CB-2 antagonist/inverse agonist with 17-β-estradiol were investigated in primary human osteoblasts (HOB). HOB cells were cultured in phenol red-free osteoblast growth medium (37°C, 5% CO2). In their 5th passage, HOB were exposed to different concentrations of i) 17-β-estradiol (1, 10 and 100 nM); ii) a specific CB-2 agonist (R,S)-AM1241 (1 and 7.5 µM); and iii) a specific CB-2 antagonist/inverse agonist AM630 (10 µM) and to selected combinations of the substances. After 24 and 48 h of incubation, HOB proliferation activity was measured using a WST-8 assay. Alkaline phosphatase activity was also evaluated using spectrophotometry. Concomitant exposure of HOB to 17-β-estradiol (10 nM) and to specific CB-2 antagonist/inverse agonist (10 µM) showed similar HOB proliferation activity to HOB incubated with 17-β-estradiol only at a 100 nM concentration. By contrast, concomitant incubation of HOB with 17-β-estradiol (10 nM) and specific CB-2 agonist (7.5 µM) resulted in decreased HOB proliferation activity as compared to HOB incubated with 17-β-estradiol only (10 nM). Similar findings were observed after 24 and 48 h of incubation. In all the experiments, HOB successfully passed the alkaline phosphatase differentiation test. In conclusion, for the first time a synergistic interaction between 17-β-estradiol and specific CB-2 antagonist/inverse agonist was observed in HOB. Understanding the molecular pathways of this interaction would be of great importance in developing more efficient and safer drugs for treating or preventing bone diseases.
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Affiliation(s)
- Marko Hojnik
- Department of Pharmacology and Experimental Toxicology, Faculty of Medicine, University of Maribor, Maribor SI-2000, Slovenia
| | - Luka Dobovišek
- Department of Pharmacology and Experimental Toxicology, Faculty of Medicine, University of Maribor, Maribor SI-2000, Slovenia
| | - Željko Knez
- Faculty of Chemistry and Chemical Engineering, University of Maribor, Maribor SI-2000, Slovenia
| | - Polonca Ferk
- Department of Pharmacology and Experimental Toxicology, Faculty of Medicine, University of Maribor, Maribor SI-2000, Slovenia
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Nagy O, Poόr G, Géher P, Killinger Z, Ter-Vartanyan S, Hojnik M. AB0384 Effectiveness and Adherence to Adalimumab Treatment in Patients with RA in Eastern Europe: Results of the Eviraeast Observational Study. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mease P, Karunaratne P, Kupper H, Hojnik M, Dorr A, McInnes I. AB0757 Achievement of A Combined Clinical and Radiographic Endpoint in Patients with Psoriatic Arthritis in the ADEPT Trial. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
In the past sicca syndromes were attributed to destruction of glandular tissue. It is now thought that cytokines, autoantibodies, and parasympathetic nervous system dysfunction all have an important role in the xerostomia and xerophthalmia in Sjögren's syndrome.
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Affiliation(s)
- A Hocevar
- Department of Rheumatology, Medical Centre Ljubljana, SI 1000 Ljubljana, Slovenia
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Sipek-Dolnicar A, Hojnik M, Rozman B. Bleeding tendency and relapsing small vessel thromboses in a patient with secondary antiphospholipid syndrome. Clin Exp Rheumatol 2003; 21:412-3. [PMID: 12846077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
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Sipek-Dolnicar A, Hojnik M, Bozic B, Vizjak A, Rozman B, Ferluga D. Clinical presentations and vascular histopathology in autopsied patients with systemic lupus erythematosus and anticardiolipin antibodies. Clin Exp Rheumatol 2002; 20:335-42. [PMID: 12102469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
OBJECTIVE To examine histomorphological and immunohistological changes in an autopsy series of systemic lupus erythematosus (SLE) patients with or without anticardiolipin antibodies (aCL). METHODS Fourteen SLE patients who died at our department from 1988 to 1996 were included. The patients' medical files were reviewed for the clinical history and the presence of IgG and IgM aCL. Autopsy samples of various organs, including regularly the kidneys, heart, brain and skin, were studied by standard histological methods and the direct immunofluorescence technique. RESULTS Thirteen of 14 (93%) autopsied SLE patients were persistently positive for IgG aCL and had common overt thrombotic complications and/or other clinical features related to the antiphospholipid syndrome. Their autopsy tissue samples showed frequent occlusive vascular changes such as bland thromboses, thrombotic microangiopathy (TMA) related changes and arterial intimalfibrous hyperplasia. The immune complex related vascular changes were mostly unremarkable and present mainly in low aCL positive patients, who also had more aggressive types of lupus glomerulonephritis (GN). CONCLUSION Increased IgG aCL were found in 13 out of 14 autopsied SLE patients who had predominant occlusive vascular histopathologic changes. The coincidence of bland thromboses with a characteristic TMA histopathology suggested two pathogenetic mechanisms associated with the presence of aCL, one related to abnormal coagulation and the other to endothelial cell injury. The extent of granular vascular immune deposits, typical of SLE, and the severity of lupus GN were inversely related to the aCL level.
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Affiliation(s)
- A Sipek-Dolnicar
- Department of Rheumatology, University Medical Centre, Ljubljana, Slovenia
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18
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Affiliation(s)
- A Ambrozic
- Department of Rheumatology, University Medical Centre Ljubljana, Slovenia.
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Logar D, Vidan-Jeras B, Ambrozic A, Dolzan V, Hojnik M, Bozic B, Rozman B. The association of HLA-DR/DQ coding and QBP promoter allelic polymorphism with antiphospholipid antibody response in SLE. Arthritis Res 2002. [PMCID: PMC3273069 DOI: 10.1186/ar463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- D Logar
- University Medical Centre, Ljubljana, Slovenia
| | | | - A Ambrozic
- University Medical Centre, Ljubljana, Slovenia
| | - V Dolzan
- Faculty of Medicine, Ljubljana, Slovenia
| | - M Hojnik
- University Medical Centre, Ljubljana, Slovenia
| | - B Bozic
- University Medical Centre, Ljubljana, Slovenia
| | - B Rozman
- University Medical Centre, Ljubljana, Slovenia
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Ambrozic A, Bozic B, Hojnik M, Kveder T. Improving an anti-beta2 GPI ELISA by reducing the influence of a blocking agent. Arthritis Res Ther 2001. [PMCID: PMC3273245 DOI: 10.1186/ar249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Cucnik S, Kveder T, Hojnik M, Bozic B. Isolation of β2GPI by perchloric acid yields three proteins having different antigenic properties. Arthritis Res Ther 2001. [PMCID: PMC3273236 DOI: 10.1186/ar252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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22
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Sipek-Dolnicar A, Hojnik M, Rozman B, Vizjak A, Ferluga D. Small vessel thrombosis without major thrombotic events in systemic lupus erythematosus patients with antiphospholipid syndrome. Wien Klin Wochenschr 2000; 112:707-10. [PMID: 11020961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Antiphospholipid syndrome has been defined by the presence of antiphospholipid antibodies or lupus anticoagulant in association with certain clinical events, including recurrent arterial or venous thromboses and recurrent fetal loss. It comprises two separate clinical entities: simple, characterized by large vessel occlusions, and catastrophic, with multiple occlusive events predominantly affecting small vessels. Three patients with systemic lupus erythematosus and permanently increased IgG anticardiolipin antibody levels are being described. Only postmortem histopathological examination revealed microangiopathic thrombotic changes in different organs, which were clinically silent in early stages of the disease and misinterpreted later in its course because of a peculiar clinical picture. All patients presented features of catastrophic antiphospholipid syndrome in the final stage of the disease.
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Affiliation(s)
- A Sipek-Dolnicar
- Department of Rheumatology, University Medical Center, Ljubljana, Slovenia
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George J, Gilburd B, Hojnik M, Levy Y, Langevitz P, Matsuura E, Koike T, Shoenfeld Y. Target recognition of beta2-glycoprotein I (beta2GPI)-dependent anticardiolipin antibodies: evidence for involvement of the fourth domain of beta2GPI in antibody binding. J Immunol 1998; 160:3917-23. [PMID: 9558098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Beta2-glycoprotein I (beta2GPI) is an absolute requirement for the binding of autoimmune anticardiolipin Abs (aCL) to cardiolipin (CL). We evaluated the target recognition of human beta2GPI by IgG derived from two patients with primary and two with secondary antiphospholipid syndrome. The total IgG serum fractions and beta2GPI affinity-purified IgGs were assessed by using various domain-deleted mutants (DM) of human beta2GPI (DMs: I-III, I-IV, II-V, III-V, IV-V, and V) and mouse mAbs against individual beta2GPI domains. The four IgGs bound slightly to CL in the absence of beta2GPI and showed increased binding in the beta2GPI presence. Following affinity purification of the IgGs on a beta2GPI column, reactivity toward CL was absent. DMs containing domain V inhibited the binding of biotinylated beta2GPI to CL. The addition to CL-coated plates of DM V, but not the other DMs, reduced the binding of all four IgGs. The anti-beta2GPI IgGs bound only to complete beta2GPI and DM I-IV coated on the plates. The binding to plate-adsorbed beta2GPI could be inhibited by complete beta2GPI and DM I-IV, the latter being a more efficient inhibitor. Further, the human anti-beta2GPI IgGs could compete with the binding to beta2GPI of Cof-21 mouse mAb (directed at domain IV), but not with the two other mouse mAbs. The results suggest that some "autoimmune:" beta2GPI-dependent anticardiolipin Abs recognize a beta2GPI target that is distinct from the CL-binding site in domain V. The target site for some antiphospholipid syndrome IgGs appear to reside in domain IV of beta2GPI.
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Affiliation(s)
- J George
- Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel
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George J, Blank M, Gilburd B, Hojnik M, Shenkman B, Tamarin I, Varon D, Matsuura E, Koike T, Shoenfeld Y. Immunologic characterization and functional properties of murine antibodies raised against deleted mutants of human beta 2-glycoprotein I. Int Immunol 1997; 9:913-21. [PMID: 9199975 DOI: 10.1093/intimm/9.6.913] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
beta 2-Glycoprotein I (beta 2GPI) is a 50 kDa molecule proposed as a principal target of 'autoimmune' antiphospholipid antibodies (aPL). We have used deleted mutants (DM) representing different domains of beta 2GPI (I-IV, IV-V and V) for immunization of naive mice and studied the characteristics of the respective murine IgG preparations in comparison with affinity-purified IgG from two patients with primary antiphospholipid syndrome. Immunization with beta 2GPI and with the DM produced anti-beta 2GPI antibodies, part of which reacted with negatively charged phospholipids (PL), whereas reactivity with cardiolipin was evident only in the IgG from mice immunized with beta 2GPI. These results are consistent with the presumption that aPL are induced following the in vivo association of beta 2GPI (used for immunization) with resident negatively charged PL. Accordingly, DM which either lack the PL binding site or aPL attachment locus did not elicit, upon immunization, antibodies reactive with PL. Further, murine anti-beta 2GPI IgG and human 'autoimmune' aPL were similar, albeit not identical, in terms of DM requirement for PL binding and charge dependency. Murine antibodies and human aPL, regardless of their binding characteristics, were found to bind significantly to platelets upon their activation with thrombin and to promote platelet activation. The results of the current study emphasize the dissimilarities between human 'autoimmune' aPL and murine anti-beta 2GPI. Thus, anti-beta 2GPI antibodies to different DM as well as human aPL are capable of binding and activating human platelets provided beta 2GPI is present.
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Affiliation(s)
- J George
- Department of Medicine B, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Israel
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George J, Blank M, Hojnik M, Bar-Meir E, Koike T, Matsuura E, Lorber M, Aviram M, Shoenfeld Y. Oxidized low-density lipoprotein (Ox-LDL) but not LDL aggravates the manifestations of experimental antiphospholipid syndrome (APS). Clin Exp Immunol 1997; 108:227-33. [PMID: 9158090 PMCID: PMC1904658 DOI: 10.1046/j.1365-2249.1997.d01-1019.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [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] [Indexed: 02/04/2023] Open
Abstract
Ox-LDL is thought to play a major role in atherogenesis. The mechanisms mediating the deleterious influences of Ox-LDL include foam cell formation and cell cytotoxicity. The production of anti-Ox-LDL antibodies results in the formation of immune complexes which are taken up at enhanced rate by macrophages, leading to foam cell formation. APS is characterized by repeated venous and arterial thromboembolic phenomena, recurrent fetal loss and thrombocytopenia, associated with the presence of antibodies to negatively charged phospholipids (aPL) (i.e. cardiolipin, phosphatidylserine). Phospholipids bear structural resemblance to LDL, and several studies have indeed proved that aPL display cross-reactivity with anti-Ox-LDL antibodies. In this study we assessed the capacity of oxidized and native forms of LDL to aggravate the clinical picture of experimentally induced APS in naive mice. Mice were actively immunized intradermally with anticardiolipin antibodies and developed a clinical picture resembling APS in humans. Subsequently, the mice were infused with either Ox-LDL, native LDL or PBS, and similar regimens were applied to controls. APS mice infused with Ox-LDL were found to exhibit a significantly more severe form of the disease in comparison with native LDL- and PBS-infused mice, expressed by lower platelet counts (261,000/mm3, 535,000/mm3 and 455,000/mm3, respectively), longer activated partial thromboplastin time (aPTT) (99 +/- 12 s, 63 +/- 8 s and 74 +/- 8 s, respectively) and higher fetal resorption rates (72.7%, 34.4% and 32.6%, respectively). The results of this study show that Ox-LDL, compared with native LDL, aggravates the clinical manifestations of experimental APS and suggest that cross-reactivity of Ox-LDL with phospholipids may provide a pathogenic explanation for this effect.
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Affiliation(s)
- J George
- Department of Medicine B, Sheba Medical Centre, Tel Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Israel
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Ziporen L, Goldberg I, Arad M, Hojnik M, Ordi-Ros J, Afek A, Blank M, Sandbank Y, Vilardell-Tarres M, de Torres I, Weinberger A, Asherson RA, Kopolovic Y, Shoenfeld Y. Libman-Sacks endocarditis in the antiphospholipid syndrome: immunopathologic findings in deformed heart valves. Lupus 1996; 5:196-205. [PMID: 8803890 DOI: 10.1177/096120339600500306] [Citation(s) in RCA: 98] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine the potential immunologic mechanism and involvement of antiphospholipid antibodies in the pathogenesis of heart valve lesions in patients with the antiphospholipid syndrome (APS). METHODS Immunoperoxidase and immunofluorescence staining methods were used to evaluate 13 heart valve specimens derived from eight patients with the APS, either primary or secondary to systemic lupus erythematosus. Primary antibodies to human immunoglobulins, complement components, serum albumin and a monoclonal anti-idiotypic antibody to human anticardiolipin antibodies (aCL) were employed. Various tissue specimens from a patient with the APS as well as deformed and normal valves from subjects without the APS were used as controls. RESULTS Linear subendothelial deposition consisting of immunoglobulins with complement components but not of a non-specific serum protein was found in deformed valves from patients with the APS. None of the control valves or tissues disclosed similar deposition. The same pattern and location of staining was obtained by the anti-idiotypic antibody to aCL. A significant amount of IgG immunoglobulins that bound to cardiolipin was eluted from a valve of a patient with secondary APS. CONCLUSION Deposits of immunoglobulins including aCL, and of complement components, are common in affected valves of patients with primary and secondary APS. Such deposits may be involved in the pathogenesis of valvular lesions.
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Affiliation(s)
- L Ziporen
- Research Unit of Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
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Abstract
The antiphospholipid syndrome (APS) is defined by the presence of anti-phospholipid antibodies (aPLs) and venous or arterial thrombosis, recurrent pregnancy loss, or thrombocytopenia. The syndrome can be either primary or secondary to an underlying condition, most commonly systemic lupus erythematosus (SLE). Echocardiographic studies have disclosed heart valve abnormalities in about a third of patients with primary APS. SLE patients with aPLs have a higher prevalence of valvular involvement than those without these antibodies. Valvular lesions associated with aPLs occur as valve masses (nonbacterial vegetations) or thickening. These two morphological alterations can be combined and are thought to reflect the same pathological process. Both can be associated with valve dysfunction, although such association is much more common with the latter alteration. The predominant functional abnormality is regurgitation; stenosis is rare. The mitral valve is mainly affected, followed by the aortic valve. Valvular involvement usually does not cause clinical valvular disease. The presence of aPLs seems to further increase the risk for thromboembolic complications, mainly cerebrovascular, posed by valve lesions. Superadded bacterial endocarditis is rare but may be difficult to distinguish from pseudoinfective endocarditis. The current therapeutic guidelines are those for APS in general. Secondary antithrombotic prevention with long-term, high-intensity oral anticoagulation is advised. The efficacy of aspirin, either alone or in combination, is yet to be assessed. Corticosteroids are not beneficial and may even facilitate valve damage. Immunosuppressive agents should only be used for the treatment of an underlying condition. Current data suggest a role for aPLs in the pathogenesis of valvular lesions. aPLs may promote the formation of valve thrombi. These antibodies may also act by another mechanism, as indicated by the finding of subendothelial deposits of immunoglobulins, including anticardiolipin antibodies, and of colocalized complement components in deformed valves from patients with APS.
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Affiliation(s)
- M Hojnik
- Department of Medicine "B", Sheba Medical Center, Tel-Aviv University, Tel-Hashomer, Israel
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Hojnik M, Gilburd B, Ziporen L, Blank M, Tomer Y, Scheinberg MA, Tincani A, Rozman B, Shoenfeld Y. Anticardiolipin antibodies in infections are heterogenous in their dependency on beta 2-glycoprotein I: analysis of anticardiolipin antibodies in leprosy. Lupus 1994; 3:515-21. [PMID: 7704010 DOI: 10.1177/096120339400300615] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We studied the effect of beta 2-GPI on binding of antibodies in sera from patients with leprosy and patients with the antiphospholipid syndrome (APS) to CL in enzyme-linked immunosorbent assays (ELISAs). Increased levels of IgG aCL were detected in 59 of 61 leprosy patients' sera by the standard aCL-ELISA in the presence of bovine beta 2-GPI and in 60 of the 61 leprosy patients' sera by the modified aCL-ELISA without beta 2-GPI. When tested by both aCL-ELISAs on the same plate, 10/31 leprosy sera and 9/10 APS sera bound better in the standard aCL-ELISA, 16/31 leprosy sera bound better in the modified aCL-ELISA and in five leprosy and one APS sera the difference was not significant. A dose-dependent enhancing effect of beta 2-GPI on the leprosy and APS sera binding to CL was confirmed using purified human beta 2-GPI. Enhanced binding was seen if beta 2-GPI was added either before or together with the test serum. In 11/61 leprosy sera increased levels of IgG antibodies against beta 2-GPI were found by ELISA. Leprosy anti-beta 2-GPI antibodies appear to be a separate antibody population recognizing only beta 2-GPI adsorbed on the ELISA plate. These results demonstrate heterogeneity of leprosy aCL with respect to their beta 2-GPI requirement for binding to CL.
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Affiliation(s)
- M Hojnik
- Research Unit of Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
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