Extracellular vesicle protein CD14 relates to common carotid intima-media thickness in eight-year-old children

Plasma CD16+ Extracellular Vesicles Associate with Carotid Artery Intima-Media Thickness in HIV+ Adults on Combination Antiretroviral Therapy

HIV-infected individuals have increased risk for cardiovascular disease (CVD) despite suppressive antiretroviral therapy (ART). This is likely a result of persistent immune activation and systemic inflammation. Extracellular vesicles (EVs) have emerged as critical mediators of intercellular communication and may drive inflammation contributing to CVD. EVs were characterized in plasma from 74 HIV-infected individuals on combination antiretroviral therapy (cART) and 64 HIV-uninfected controls with paired carotid intima-media thickness (cIMT) assessment. EVs were profiled with markers reflecting lymphoid, myeloid, and endothelial origin. Seventeen plasma inflammatory biomarkers were also assessed. Human umbilical vein endothelial cell (HUVEC) apoptosis was quantified after EV exposure. A significant correlation was observed in HIV-infected participants between cIMT and EVs expressing CD16, and the monocyte-related markers CD4, CD14, and CX3CR1 showed a similar but nonsignificant association with cIMT. No significant correlation between cIMT measurements from HIV-uninfected individuals and EVs was observed. Levels of serum amyloid A, C-reactive protein, and myeloperoxidase significantly correlated with CD14⁺, CD16⁺, and CX3CR1⁺ EVs. No correlation was noted between cIMT and soluble inflammatory markers. HUVECs showed increased necrosis after exposure to the EV-containing fraction of plasma derived from HIV-infected individuals compared to uninfected controls. Our study reveals that EVs expressing monocyte markers correlated with cIMT in HIV-infected individuals on cART. Moreover, EV fractions derived from HIV-infected individuals lead to greater endothelial cell death via necrotic pathways. Collectively, EVs have potential as biomarkers of and therapeutic targets in the pathogenesis of CVD in the setting of treated HIV disease. IMPORTANCE HIV-infected individuals have a 2-fold-increased risk of cardiovascular disease compared with the general population, yet the mechanisms underlying this comorbidity are unclear. Extracellular vesicles have emerged as important mediators in cell-cell communication and, given what we know of their biology, may drive inflammation contributing to cardiovascular disease in this vulnerable population.

Exploring New Kingdoms: The Role of Extracellular Vesicles in Oxi-Inflamm-Aging Related to Cardiorenal Syndrome

The incidence of age associated chronic diseases has increased in recent years. Although several diverse causes produce these phenomena, abundant evidence shows that oxidative stress plays a central role. In recent years, numerous studies have focused on elucidating the role of oxidative stress in the development and progression of both aging and chronic diseases, opening the door to the discovery of new underlying mechanisms and signaling pathways. Among them, senolytics and senomorphics, and extracellular vesicles offer new therapeutic strategies to slow the development of aging and its associated chronic diseases by decreasing oxidative stress. In this review, we aim to discuss the role of extracellular vesicles in human cardiorenal syndrome development and their possible role as biomarkers, targets, or vehicles of drugs to treat this syndrome.

Inflammation, Senescence and MicroRNAs in Chronic Kidney Disease

Background

Patients with chronic kidney disease (CKD) show a chronic microinflammatory state that promotes premature aging of the vascular system. Currently, there is a growth interest in the search of novel biomarkers related to vascular aging to identify CKD patients at risk to develop cardiovascular complications.

Methods

Forty-five CKD patients were divided into three groups according to CKD-stages [predialysis (CKD4-5), hemodialysis (HD) and kidney transplantation (KT)]. In all these patients, we evaluated the quantitative changes in microRNAs (miRNAs), CD14+C16++ monocytes number, and microvesicles (MV) concentration [both total MV, and monocytes derived MV (CD14+Annexin V+CD16+)]. To understand the molecular mechanism involved in senescence and osteogenic transdifferentation of vascular smooth muscle cells (VSMC), these cells were stimulated with MV isolated from THP-1 monocytes treated with uremic toxins (txMV).

Results

A miRNA array was used to investigate serum miRNAs profile in CKD patients. Reduced expression levels of miRNAs-126-3p, -191-5p and -223-3p were observed in CKD4-5 and HD patients as compared to KT. This down-regulation disappeared after KT, even when lower glomerular filtration rates (eGFR) persisted. Moreover, HD patients had higher percentage of proinflammatory monocytes (CD14+CD16++) and MV derived of proinflammatory monocytes (CD14+Annexin V+CD16+) than the other groups. In vitro studies showed increased expression of osteogenic markers (BMP2 and miRNA-223-3p), expression of cyclin D1, β-galactosidase activity and VSMC size in those cells treated with txMV.

Conclusion

CKD patients present a specific circulating miRNAs expression profile associated with the microinflammatory state. Furthermore, microvesicles generated by monocytes treated with uremic toxins induce early senescence and osteogenic markers (BMP2 and miRNA-223-3p) in VSMC.

Extracellular Vesicles as Messengers in Atherosclerosis

Atherosclerosis is a major cause of cardiovascular diseases. Most cells involved in atherosclerosis can shed extracellular vesicles (EVs). Both atherogenic factors, such as hypoxia and oxidative stress, and atheroprotective factors, such as laminar blood flow, can influence the production of EV shedding. EVs can carry protein, DNA, mRNA, and noncoding RNA and act as mediators or messengers for cell-to-cell communications. EVs have been proven to promote or inhibit atherogenesis under particular circumstances. Therefore, EVs might be targeted for preventing or treating atherosclerotic diseases. The level of circulating EVs has been associated with the presence, progressiveness, or severity of atherosclerosis. Therefore, EVs may be utilized as indexes for diagnosing and grading atherosclerosis. Here, we reviewed the progress concerning the involvements of EVs in atherogenesis and atheroprotection. We also discussed the potential applications of EVs in managing atherosclerotic diseases.

Monocyte-derived circulating microparticles (CD14+, CD14+/CD11b+ and CD14+/CD142+) are related to long-term prognosis for cardiovascular mortality in STEMI patients

BACKGROUND

Circulating microparticles (cMPs) have been proposed as novel biomarkers of cardiovascular disease (CVD). We aimed to investigate the prognostic relevance of cMPs for future major adverse cardiovascular events (MACE) in STEMI patients.

METHODS

We included 200 STEMI patients treated with percutaneous coronary intervention (PCI). One hundred patients with a primary composite end point (recurrent nonfatal acute MI, rehospitalization for heart failure, unscheduled PCI or death because of CV causes) were case-matched for sex, age, and CVD risk factors to 100 patients without a primary endpoint at the end of study follow-up (4.4 (1.4) years). cMPs from vascular cells were measured by flow cytometer at a mean of 28h after onset of symptoms.

RESULTS

No differences were observed in MP shedding between patients with or without a MACE at the end of the study follow-up. However, compared to patients who survived during follow-up, patients who died because of CV causes (n=24) presented with increased total cMPs (Annexin V-AV-⁺), cMPs carrying tissue factor, and increased MP shedding from platelets, lymphocytes, monocytes, and activated leukocytes, and ~10% lower left ventricular ejection fraction (LVEF). ROC-curve analyses showed that monocyte-derived cMPs (CD14⁺/AV⁺, CD11b⁺/CD14⁺/AV⁺ and CD142⁺/CD14⁺/AV⁺) considered together with LVEF best predicted cardiovascular mortality.

CONCLUSIONS

Monocyte-derived cMPs assessed in the acute phase relate to the prognosis of CV death at the long term. These findings may be of clinical interest in the risk assessment of STEMI patients.

Biomarker Profiles in Women with PCOS and PCOS Offspring; A Pilot Study

Objective

To study metabolic/inflammatory biomarker risk profiles in women with PCOS and PCOS offspring.

Design

Cross-sectional comparison of serum biomarkers.

Setting

University Medical Center Utrecht.

Patients

Hyperandrogenic PCOS women (HA-PCOS, n = 34), normoandrogenic PCOS women (NA-PCOS, n = 34), non-PCOS reference population (n = 32), PCOS offspring (n = 14, age 6–8 years), and a paedriatic reference population (n = 30).

Main Outcome Measure(s)

Clustering profile of adipocytokines (IL-1b, IL-6, IL-13, IL-17, IL-18, TNF-α, adiponectin, adipsin, leptin, chemerin, resistin, RBP4, DPP-IV/sCD26, CCL2/MCP-1), growth factors (PIGF, VEGF, sVEGF-R1), soluble cell adhesion molecules (sICAM-1/sCD54, sVCAM-1/sCD106), and other inflammatory related proteases (MMP-9, S100A8, Cathepsin S). Differences in median biomarker concentrations between groups, and associations with the free androgen index (FAI; Testosterone/SHBG x100).

Results

The cluster analysis identified leptin, RBP-4, DPP-IV and adiponectin as potential discriminative markers for HA-PCOS with a specifically strong correlation in cases with increased BMI. Leptin (R² = 0.219) and adiponectin (R² = 0.182) showed the strongest correlation with the FAI. When comparing median protein concentrations adult PCOS women with or without hyperandrogenemia, the most profound differences were observed for leptin (P < 0.001), DPP-IV (P = 0.005), and adiponectin (P < 0.001). Adjusting for age, BMI and multiple testing attenuated all differences. In PCOS offspring, MMP-9 (P = 0.001) and S100A8 (P < 0.001) concentrations were significantly higher compared to a healthy matched reference population, even after correcting for age and BMI and adjustment for multiple testing.

Conclusion

In this preliminary investigation we observed significant differences in adipocytokines between women with or without hyperandrogenic PCOS and non-PCOS controls, mostly influenced by BMI. Leptin and adiponectin showed the strongest correlation with the FAI in adult women with PCOS. In PCOS offspring other inflammatory biomarkers (MMP-9, S100A8) were increased, suggesting that these children may exhibit increased chronic low-grade inflammation. Additional research is required to confirm results of the current exploratory investigation.