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Sarrou S, Voulgaridi I, Fousika A, Dadouli K, Margaritopoulou O, Kakkas I, Hadjichristodoulou C, Kalala F, Speletas M. Heterozygous SERPINA1 Defects and Their Impact on Clinical Manifestations of Patients with Predominantly Antibody Deficiencies. Int J Mol Sci 2024; 25:5382. [PMID: 38791420 PMCID: PMC11120870 DOI: 10.3390/ijms25105382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 05/08/2024] [Accepted: 05/11/2024] [Indexed: 05/26/2024] Open
Abstract
Patients with predominantly antibody deficiencies (PADs) display hypogammaglobulinemia with a high prevalence of infections, along with autoimmune manifestations, benign and malignant lymphoproliferation and granulomatous disease. It is noteworthy that PAD patients, even those with defects in the same causative genes, display a variable clinical phenotype, suggesting that additional genetic polymorphisms, located in either immune-related or non-immune-related genes, may affect their clinical and laboratory phenotype. In this context, we analyzed 80 PAD patients, including 70 with common variable immunodeficiency (CVID) for SERPINA1 defects, in order to investigate the possible contribution to PAD clinical phenotype. Ten CVID patients carried heterozygous pathogenic SERPINA1 defects with normal alpha-1 antitrypsin levels. Interestingly, the presence of the Z allele (rs28929474), which was found in three patients, was significantly associated with liver disease; hepatic complications were also observed in patients carrying the p.Leu23Gln (rs1379209512) and the p.Phe76del (rs775982338) alleles. Conversely, no correlation of SERPINA1 defective variants with respiratory complications was observed, although patients with pathogenic variants exhibit a reduced probability of developing autoimmune diseases. Therefore, we recommend SERPINA1 genetic analysis in PAD in order to identify patients with a higher risk for liver disease.
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Affiliation(s)
- Styliani Sarrou
- Department of Immunology & Histocompatibility, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece; (S.S.); (A.F.); (O.M.); (F.K.)
| | - Ioanna Voulgaridi
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (I.V.); (K.D.); (C.H.)
| | - Athanasia Fousika
- Department of Immunology & Histocompatibility, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece; (S.S.); (A.F.); (O.M.); (F.K.)
| | - Katerina Dadouli
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (I.V.); (K.D.); (C.H.)
| | - Olympia Margaritopoulou
- Department of Immunology & Histocompatibility, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece; (S.S.); (A.F.); (O.M.); (F.K.)
| | - Ioannis Kakkas
- Department of Immunology and Histocompatibility, “Evaggelismos” General Hospital, 10676 Athens, Greece;
| | - Christos Hadjichristodoulou
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (I.V.); (K.D.); (C.H.)
| | - Fani Kalala
- Department of Immunology & Histocompatibility, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece; (S.S.); (A.F.); (O.M.); (F.K.)
| | - Matthaios Speletas
- Department of Immunology & Histocompatibility, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece; (S.S.); (A.F.); (O.M.); (F.K.)
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2
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Ferrarotti I, Wencker M, Chorostowska-Wynimko J. Rare variants in alpha 1 antitrypsin deficiency: a systematic literature review. Orphanet J Rare Dis 2024; 19:82. [PMID: 38388492 PMCID: PMC10885523 DOI: 10.1186/s13023-024-03069-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/03/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Alpha 1 Antitrypsin Deficiency (AATD) is a largely underrecognized genetic condition characterized by low Alpha 1 Antitrypsin (AAT) serum levels, resulting from variations in SERPINA1. Many individuals affected by AATD are thought to be undiagnosed, leading to poor patient outcomes. The Z (c.1096G > A; p.Glu366Lys) and S (c.863A > T; p.Glu288Val) deficiency variants are the most frequently found variants in AATD, with the Z variant present in most individuals diagnosed with AATD. However, there are many other less frequent variants known to contribute to lung and/or liver disease in AATD. To identify the most common rare variants associated with AATD, we conducted a systematic literature review with the aim of assessing AATD variation patterns across the world. METHODS A systematic literature search was performed to identify published studies reporting AATD/SERPINA1 variants. Study eligibility was assessed for the potential to contain relevant information, with quality assessment and data extraction performed on studies meeting all eligibility criteria. AATD variants were grouped by variant type and linked to the geographical region identified from the reporting article. RESULTS Of the 4945 articles identified by the search string, 864 contained useful information for this study. Most articles came from the United States, followed by the United Kingdom, Germany, Spain, and Italy. Collectively, the articles identified a total of 7631 rare variants and 216 types of rare variant across 80 counties. The F (c.739C > T; p.Arg247Cys) variant was identified 1,281 times and was the most reported known rare variant worldwide, followed by the I (c.187C > T; p.Arg63Cys) variant. Worldwide, there were 1492 Null/rare variants that were unidentified at the time of source article publication and 75 rare novel variants reported only once. CONCLUSION AATD goes far beyond the Z and S variants, suggesting there may be widespread underdiagnosis of patients with the condition. Each geographical region has its own distinctive variety of AATD variants and, therefore, comprehensive testing is needed to fully understand the true number and type of variants that exist. Comprehensive testing is also needed to ensure accurate diagnosis, optimize treatment strategies, and improve outcomes for patients with AATD.
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Affiliation(s)
- Ilaria Ferrarotti
- Centre for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, Department of Internal Medicine and Therapeutics, Pneumology Unit, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | | | - Joanna Chorostowska-Wynimko
- Department of Genetics and Clinical Immunology, National Institute of Tuberculosis and Lung Diseases, Warsaw, Poland
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Bianchera A, Vilardo V, Giaccari R, Michielon A, Bazzoli G, Buttini F, Aiello M, Chetta A, Bruno S, Bettini R. Nebulizers effectiveness on pulmonary delivery of alpha-1 antitrypsin. Drug Deliv Transl Res 2023; 13:2653-2663. [PMID: 37097606 PMCID: PMC10468431 DOI: 10.1007/s13346-023-01346-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2023] [Indexed: 04/26/2023]
Abstract
The nebulization of alpha-1 antitrypsin (AAT) for its administration to the lung could be an interesting alternative to parenteral infusion for patients suffering from AAT genetic deficiency (AATD). In the case of protein therapeutics, the effect of the nebulization mode and rate on protein conformation and activity must be carefully considered. In this paper two types of nebulizers, i.e., a jet and a mesh vibrating system, were used to nebulize a commercial preparation of AAT for infusion and compared. The aerosolization performance, in terms of mass distribution, respirable fraction, and drug delivery efficiency, as well as the activity and aggregation state of AAT upon in vitro nebulization were investigated. The two nebulizers demonstrated equivalent aerosolization performances, but the mesh nebulizer provided a higher efficiency in the delivery of the dose. The activity of the protein was acceptably preserved by both nebulizers and no aggregation or changes in its conformation were identified. This suggests that nebulization of AAT represents a suitable administration strategy ready to be translated to the clinical practice for delivering the protein directly to the lungs in AATD patients, either as a support therapy to parenteral administration or for subjects with a precocious diagnosis, to prevent the onset of pulmonary symptoms.
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Affiliation(s)
- Annalisa Bianchera
- Food and Drug Department, University of Parma, Parco Area Delle Scienze 27/a, Parma, Italy
- Interdepartmental Center Biopharmanet-Tec, University of Parma, Parco Area Delle Scienze Building 33, Parma, Italy
| | - Viviana Vilardo
- Food and Drug Department, University of Parma, Parco Area Delle Scienze 27/a, Parma, Italy
| | - Roberta Giaccari
- Food and Drug Department, University of Parma, Parco Area Delle Scienze 27/a, Parma, Italy
| | - Annalisa Michielon
- Food and Drug Department, University of Parma, Parco Area Delle Scienze 27/a, Parma, Italy
| | - Gianluca Bazzoli
- Food and Drug Department, University of Parma, Parco Area Delle Scienze 27/a, Parma, Italy
| | - Francesca Buttini
- Food and Drug Department, University of Parma, Parco Area Delle Scienze 27/a, Parma, Italy
- Interdepartmental Center Biopharmanet-Tec, University of Parma, Parco Area Delle Scienze Building 33, Parma, Italy
| | - Marina Aiello
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, Parma, Italy
| | - Alfredo Chetta
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, Parma, Italy
| | - Stefano Bruno
- Food and Drug Department, University of Parma, Parco Area Delle Scienze 27/a, Parma, Italy
- Interdepartmental Center Biopharmanet-Tec, University of Parma, Parco Area Delle Scienze Building 33, Parma, Italy
| | - Ruggero Bettini
- Food and Drug Department, University of Parma, Parco Area Delle Scienze 27/a, Parma, Italy.
- Interdepartmental Center Biopharmanet-Tec, University of Parma, Parco Area Delle Scienze Building 33, Parma, Italy.
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4
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Muacevic A, Adler JR, Kaplan AK. Comparison of COVID-19 Outcomes With Alpha-1 Antitrypsin Deficiency Prevalence in Europe: A Cross-Sectional Study. Cureus 2023; 15:e34293. [PMID: 36860224 PMCID: PMC9968998 DOI: 10.7759/cureus.34293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2023] [Indexed: 01/30/2023] Open
Abstract
Introduction We hypothesized that the geographic distributions of COVID-19 and alpha-1 antitrypsin alleles prevalence are similar. We investigate whether there is a relationship between the geographical density of the COVID-19 pandemic and the distributions of alpha-1 antitrypsin alleles. Methods This research is a cross-sectional study. Alpha-1 antitrypsin PI*MS, PI*MZ, PI*SS, PI*SZ, and PI*ZZ genotypes frequencies of European countries were compared with the case and death data related to the COVID-19 pandemic as of March 1, 2022. Results A significant relationship was found between the rates of COVID-19 cases and the rates of individuals with alpha-1 antitrypsin PI*MS, PI*MZ, PI*SS, PI*SZ, and PI*ZZ genotypes allele in European countries. Conclusions The findings showed that the prevalence distribution of the alleles of the gene defect that causes alpha-1 antitrypsin insufficiency is related to the prevalence of COVID-19 pandemic data.
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Shaik NA, Saud Al-Saud NB, Abdulhamid Aljuhani T, Jamil K, Alnuman H, Aljeaid D, Sultana N, El-Harouni AA, Awan ZA, Elango R, Banaganapalli B. Structural characterization and conformational dynamics of alpha-1 antitrypsin pathogenic variants causing alpha-1-antitrypsin deficiency. Front Mol Biosci 2022; 9:1051511. [PMID: 36504721 PMCID: PMC9730039 DOI: 10.3389/fmolb.2022.1051511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/02/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Alpha-1 antitrypsin deficiency (A1ATD) is a progressive lung disease caused by inherited pathogenic variants in the SERPINA1 gene. However, their actual role in maintenance of structural and functional characteristics of the corresponding α-1 anti-trypsin (A1AT) protein is not well characterized. Methods: The A1ATD causative SERPINA1 missense variants were initially collected from variant databases, and they were filtered based on their pathogenicity potential. Then, the tertiary protein models were constructed and the impact of individual variants on secondary structure, stability, protein-protein interactions, and molecular dynamic (MD) features of the A1AT protein was studied using diverse computational methods. Results: We identified that A1ATD linked SERPINA1 missense variants like F76S, S77F, L278P, E288V, G216C, and H358R are highly deleterious as per the consensual prediction scores of SIFT, PolyPhen, FATHMM, M-CAP and REVEL computational methods. All these variants were predicted to alter free energy dynamics and destabilize the A1AT protein. These variants were seen to cause minor structural drifts at residue level (RMSD = <2Å) of the protein. Interestingly, S77F and L278P variants subtly alter the size of secondary structural elements like beta pleated sheets and loops. The residue level fluctuations at 100 ns simulation confirm the highly damaging structural consequences of all the six missense variants on the conformation dynamics of the A1AT protein. Moreover, these variants were also predicted to cause functional deformities by negatively impacting the binding energy of A1AT protein with NE ligand molecule. Conclusion: This study adds a new computational biology dimension to interpret the genotype-protein phenotype relationship between SERPINA1 pathogenic variants with its structural plasticity and functional behavior with NE ligand molecule contributing to the Alpha-1-antitrypsin deficiency. Our results support that A1ATD complications correlates with the conformational flexibility and its propensity of A1AT protein polymerization when misfolded.
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Affiliation(s)
- Noor Ahmad Shaik
- Department of Genetic Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia,Princess Al-Jawhara Al-Brahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Najla Bint Saud Al-Saud
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Kaiser Jamil
- Department of Genetics, Bhagwan Mahavir Medical Research Centre, Hyderabad, India
| | - Huda Alnuman
- Princess Al-Jawhara Al-Brahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Deema Aljeaid
- Department of Genetic Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nasreen Sultana
- Department of Biotechnology, Acharya Nagarjuna University, Guntur, India
| | | | - Zuhier Ahmed Awan
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia,Department of Genetics, Al Borg Medical Laboratories, Jeddah, Saudi Arabia
| | - Ramu Elango
- Department of Genetic Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia,Princess Al-Jawhara Al-Brahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Babajan Banaganapalli
- Department of Genetic Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia,Princess Al-Jawhara Al-Brahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia,*Correspondence: Babajan Banaganapalli,
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6
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Pini L, Giordani J, Ciarfaglia M, Pini A, Arici M, Tantucci C. Alpha1-antitrypsin deficiency and cardiovascular disease: questions and issues of a debated relation. J Cardiovasc Med (Hagerstown) 2022; 23:637-645. [PMID: 36099070 DOI: 10.2459/jcm.0000000000001369] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Alpha1-antitrypsin (AAT) is one of the major inhibitors involved in protease/antiprotease homeostasis, and it is mainly produced by hepatocytes and pulmonary epithelial cells. Its deficiency, called alpha1-antitrypsin deficit (AATD), leads to severe hepatic and respiratory issues. Also, AAT is released into the bloodstream providing systemic anti-inflammatory effects. Apart from acting as an acute-phase anti-inflammatory protein, it can be a biomarker for monitoring disease evolution. A reduced or defective production leads to a loss of anti-inflammatory function, protease-antiprotease imbalance and cellular engorgement due to polymers deposition, with system-wide repercussions. This review aims to evaluate AATD condition in the major vessels of the head and neck, thoracic and abdominal districts. Also, a dedicated focus on autoimmune vascular diseases will be provided. A critical revision of the main literature findings starting from the 1980s until now has been performed. Studies conducted over the years have provided several contradictory pieces of evidence. Most authors acknowledge the protective and anti-inflammatory AAT role on the vascular endothelium. However, correlations between AATD and major arteries, cerebral and cardiovascular conditions, and autoimmune diseases remain unclear. Most studies recognize the role of AATD in vascular diseases but only as a cofactor inducing cellular and tissue structure impairments. However, this condition alone is not enough to determine new disease onset. Due to the opposing results reported over the years, there is still a considerable lack of knowledge on the role covered by AATD in vascular diseases. A renewed interest in this research field should be encouraged to grant new solid evidence and validate the putative role of AATD screening and replacement therapy as useful diagnostic and treatment tools.
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Affiliation(s)
- Laura Pini
- Department of Clinical and Experimental Sciences, University of Brescia, Italy.,Respiratory Medicine Unit, ASST - Spedali Civili di Brescia, Brescia, Italy
| | - Jordan Giordani
- Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Manuela Ciarfaglia
- Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Alessandro Pini
- Departement de épidemiologie d'Intervention et Formation, Epicentre, Paris, France
| | - Marianna Arici
- Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Claudio Tantucci
- Department of Clinical and Experimental Sciences, University of Brescia, Italy.,Respiratory Medicine Unit, ASST - Spedali Civili di Brescia, Brescia, Italy
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7
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Mornex JF, Balduyck M, Bouchecareilh M, Cuvelier A, Epaud R, Kerjouan M, Le Rouzic O, Pison C, Plantier L, Pujazon MC, Reynaud-Gaubert M, Toutain A, Trumbic B, Willemin MC, Zysman M, Brun O, Campana M, Chabot F, Chamouard V, Dechomet M, Fauve J, Girerd B, Gnakamene C, Lefrançois S, Lombard JN, Maitre B, Maynié-François C, Moerman A, Payancé A, Reix P, Revel D, Revel MP, Schuers M, Terrioux P, Theron D, Willersinn F, Cottin V, Mal H. [French clinical practice guidelines for the diagnosis and management of lung disease with alpha 1-antitrypsin deficiency]. Rev Mal Respir 2022; 39:633-656. [PMID: 35906149 DOI: 10.1016/j.rmr.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 05/31/2022] [Indexed: 11/18/2022]
Affiliation(s)
- J-F Mornex
- Université de Lyon, université Lyon 1, INRAE, EPHE, UMR754, IVPC, 69007 Lyon, France; Centre de référence coordonnateur des maladies pulmonaires rares, hospices civils de Lyon, hôpital Louis-Pradel, service de pneumologie, 69500 Bron, France.
| | - M Balduyck
- CHU de Lille, centre de biologie pathologie, laboratoire de biochimie et biologie moléculaire HMNO, faculté de pharmacie, EA 7364 RADEME, université de Lille, service de biochimie et biologie moléculaire, Lille, France
| | - M Bouchecareilh
- Université de Bordeaux, CNRS, Inserm U1053 BaRITon, Bordeaux, France
| | - A Cuvelier
- Service de pneumologie, oncologie thoracique et soins intensifs respiratoires, CHU de Rouen, Rouen, France; Groupe de recherche sur le handicap ventilatoire et neurologique (GRHVN), université Normandie Rouen, Rouen, France
| | - R Epaud
- Centre de références des maladies respiratoires rares, site de Créteil, Créteil, France
| | - M Kerjouan
- Service de pneumologie, CHU Pontchaillou, Rennes, France
| | - O Le Rouzic
- CHU Lille, service de pneumologie et immuno-allergologie, Lille, France; Université de Lille, CNRS, Inserm, institut Pasteur de Lille, U1019, UMR 9017, CIIL, OpInfIELD team, Lille, France
| | - C Pison
- Service de pneumologie physiologie, pôle thorax et vaisseaux, CHU de Grenoble, Grenoble, France; Université Grenoble Alpes, Saint-Martin-d'Hères, France
| | - L Plantier
- Service de pneumologie et explorations fonctionnelles respiratoires, CHRU de Tours, Tours, France; Université de Tours, CEPR, Inserm UMR1100, Tours, France
| | - M-C Pujazon
- Service de pneumologie et allergologie, pôle clinique des voies respiratoires, hôpital Larrey, Toulouse, France
| | - M Reynaud-Gaubert
- Service de pneumologie, centre de compétence pour les maladies pulmonaires rares, AP-HM, CHU Nord, Marseille, France; Aix-Marseille université, IHU-Méditerranée infection, Marseille, France
| | - A Toutain
- Service de génétique, CHU de Tours, Tours, France; UMR 1253, iBrain, université de Tours, Inserm, Tours, France
| | | | - M-C Willemin
- Service de pneumologie et oncologie thoracique, CHU d'Angers, hôpital Larrey, Angers, France
| | - M Zysman
- Service de pneumologie, CHU Haut-Lévèque, Bordeaux, France; Université de Bordeaux, centre de recherche cardiothoracique, Inserm U1045, CIC 1401, Pessac, France
| | - O Brun
- Centre de pneumologie et d'allergologie respiratoire, Perpignan, France
| | - M Campana
- Service de pneumologie, CHR d'Orléans, Orléans, France
| | - F Chabot
- Département de pneumologie, CHRU de Nancy, Vandœuvre-lès-Nancy, France; Inserm U1116, université de Lorraine, Vandœuvre-lès-Nancy, France
| | - V Chamouard
- Service pharmaceutique, hôpital cardiologique, GHE, HCL, Bron, France
| | - M Dechomet
- Service d'immunologie biologique, centre de biologie sud, centre hospitalier Lyon Sud, HCL, Pierre-Bénite, France
| | - J Fauve
- Cabinet médical, Bollène, France
| | - B Girerd
- Université Paris-Saclay, faculté de médecine, Le Kremlin-Bicêtre, France; AP-HP, centre de référence de l'hypertension pulmonaire, service de pneumologie et soins intensifs respiratoires, hôpital Bicêtre, Le Kremlin-Bicêtre, France; Inserm UMR_S 999, hôpital Marie-Lannelongue, Le Plessis-Robinson, France
| | - C Gnakamene
- Service de pneumologie, CH de Montélimar, GH Portes de Provence, Montélimar, France
| | | | | | - B Maitre
- Service de pneumologie, centre hospitalier intercommunal, Créteil, France; Inserm U952, UFR de santé, université Paris-Est Créteil, Créteil, France
| | - C Maynié-François
- Université de Lyon, collège universitaire de médecine générale, Lyon, France; Université Claude-Bernard Lyon 1, laboratoire de biométrie et biologie évolutive, UMR5558, Villeurbanne, France
| | - A Moerman
- CHRU de Lille, hôpital Jeanne-de-Flandre, Lille, France; Cabinet de médecine générale, Lille, France
| | - A Payancé
- Service d'hépatologie, CHU Beaujon, AP-HP, Clichy, France; Filière de santé maladies rares du foie de l'adulte et de l'enfant (FilFoie), CHU Saint-Antoine, Paris, France
| | - P Reix
- Service de pneumologie pédiatrique, allergologie, mucoviscidose, hôpital Femme-Mère-Enfant, HCL, Bron, France; UMR 5558 CNRS équipe EMET, université Claude-Bernard Lyon 1, Villeurbanne, France
| | - D Revel
- Université Claude-Bernard Lyon 1, Lyon, France; Hospices civils de Lyon, Lyon, France
| | - M-P Revel
- Université Paris Descartes, Paris, France; Service de radiologie, hôpital Cochin, AP-HP, Paris, France
| | - M Schuers
- Université de Rouen Normandie, département de médecine générale, Rouen, France; Sorbonne université, LIMICS U1142, Paris, France
| | | | - D Theron
- Asten santé, Isneauville, France
| | | | - V Cottin
- Université de Lyon, université Lyon 1, INRAE, EPHE, UMR754, IVPC, 69007 Lyon, France; Centre de référence coordonnateur des maladies pulmonaires rares, hospices civils de Lyon, hôpital Louis-Pradel, service de pneumologie, 69500 Bron, France
| | - H Mal
- Service de pneumologie B, hôpital Bichat-Claude-Bernard, AP-HP, Paris, France; Inserm U1152, université Paris Diderot, site Xavier Bichat, Paris, France
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8
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Koyuturk I, Kedia S, Robotham A, Star A, Brochu D, Sauvageau J, Kelly J, Gilbert M, Durocher Y. High-level production of wild-type and oxidation-resistant recombinant alpha-1-antitrypsin in glycoengineered CHO cells. Biotechnol Bioeng 2022; 119:2331-2344. [PMID: 35508753 DOI: 10.1002/bit.28129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/24/2022] [Accepted: 05/03/2022] [Indexed: 11/10/2022]
Abstract
Alpha-1-antitrypsin (A1AT) is a serine protease inhibitor which blocks the activity of serum proteases including neutrophil elastase to protect the lungs. Its deficiency is known to increase the risk of pulmonary emphysema as well as chronic obstructive pulmonary disease. Currently, the only treatment for patients with A1AT deficiency is weekly injection of plasma-purified A1AT. There is still today no commercial source of therapeutic recombinant A1AT, likely due to significant differences in expression host-specific glycosylation profile and/or high costs associated with the huge therapeutic dose needed. Accordingly, we aimed to produce high levels of recombinant wild-type A1AT, as well as a mutated protein (mutein) version for increased oxidation resistance, with N-glycans analogous to human plasma-derived A1AT. To achieve this, we disrupted two endogenous glycosyltransferase genes controlling core α-1,6-fucosylation (Fut8) and α-2,3-sialylation (ST3Gal4) in CHO cells using CRISPR/Cas9 technology, followed by overexpression of human α-2,6-sialyltransferase (ST6Gal1) using a cumate-inducible expression system. Volumetric A1AT productivity obtained from stable CHO pools was 2.5- to 6.5-fold higher with the cumate-inducible CR5 promoter compared to five strong constitutive promoters. Using the CR5 promoter, glycoengineered stable CHO pools were able to produce over 2.1 g/L and 2.8 g/L of wild-type and mutein forms of A1AT, respectively, with N-glycans analogous to the plasma-derived clinical product Prolastin-C. Supplementation of N-acetylmannosamine to the cell culture media during production increased the overall sialylation of A1AT as well as the proportion of bi-antennary and disialylated A2G2S2 N-glycans. These purified recombinant A1AT proteins showed in vitro inhibitory activity equivalent to Prolastin-C and substitution of methionine residues 351 and 358 with valines rendered A1AT significantly more resistant to oxidation. The recombinant A1AT mutein bearing an improved oxidation-resistance described in this study could represent a viable biobetter drug, offering a safe and more stable alternative for augmentation therapy. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Izel Koyuturk
- Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Université de Montréal, Qc, Canada, H3C 3J7.,Life Sciences, Human Health Therapeutics Research Centre, Building Montreal-Royalmount, National Research Council Canada, Montréal, Qc, Canada, H4P 2R2
| | - Surbhi Kedia
- Department of Parasitology, Faculty of Agricultural and Environmental Sciences, McGill University, Qc, Canada, H9X 3V9
| | - Anna Robotham
- Life Sciences, Human Health Therapeutics Research Centre, 100 Sussex Drive, National Research Council Canada, Ottawa, Ontario, Canada, K1A OR6
| | - Alexandra Star
- Life Sciences, Human Health Therapeutics Research Centre, 100 Sussex Drive, National Research Council Canada, Ottawa, Ontario, Canada, K1A OR6
| | - Denis Brochu
- Life Sciences, Human Health Therapeutics Research Centre, 100 Sussex Drive, National Research Council Canada, Ottawa, Ontario, Canada, K1A OR6
| | - Janelle Sauvageau
- Life Sciences, Human Health Therapeutics Research Centre, 100 Sussex Drive, National Research Council Canada, Ottawa, Ontario, Canada, K1A OR6
| | - John Kelly
- Life Sciences, Human Health Therapeutics Research Centre, 100 Sussex Drive, National Research Council Canada, Ottawa, Ontario, Canada, K1A OR6
| | - Michel Gilbert
- Life Sciences, Human Health Therapeutics Research Centre, 100 Sussex Drive, National Research Council Canada, Ottawa, Ontario, Canada, K1A OR6
| | - Yves Durocher
- Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Université de Montréal, Qc, Canada, H3C 3J7.,Life Sciences, Human Health Therapeutics Research Centre, Building Montreal-Royalmount, National Research Council Canada, Montréal, Qc, Canada, H4P 2R2
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9
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Grover SP, Mackman N. Anticoagulant SERPINs: Endogenous Regulators of Hemostasis and Thrombosis. Front Cardiovasc Med 2022; 9:878199. [PMID: 35592395 PMCID: PMC9110684 DOI: 10.3389/fcvm.2022.878199] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 03/29/2022] [Indexed: 12/17/2022] Open
Abstract
Appropriate activation of coagulation requires a balance between procoagulant and anticoagulant proteins in blood. Loss in this balance leads to hemorrhage and thrombosis. A number of endogenous anticoagulant proteins, such as antithrombin and heparin cofactor II, are members of the serine protease inhibitor (SERPIN) family. These SERPIN anticoagulants function by forming irreversible inhibitory complexes with target coagulation proteases. Mutations in SERPIN family members, such as antithrombin, can cause hereditary thrombophilias. In addition, low plasma levels of SERPINs have been associated with an increased risk of thrombosis. Here, we review the biological activities of the different anticoagulant SERPINs. We further consider the clinical consequences of SERPIN deficiencies and insights gained from preclinical disease models. Finally, we discuss the potential utility of engineered SERPINs as novel therapies for the treatment of thrombotic pathologies.
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10
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Dong C, Wu G, Chen C, Li X, Yuan R, Xu L, Guo H, Zhang J, Lu H, Wang F. Site‐Specific Conjugation of a Selenopolypeptide to Alpha‐1‐antitrypsin Enhances Oxidation Resistance and Pharmacological Properties. Angew Chem Int Ed Engl 2022. [DOI: 10.1002/ange.202115241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Chao Dong
- Key Laboratory of Protein and Peptide Pharmaceuticals Beijing Translational Center for Biopharmaceuticals Institute of Biophysics Chinese Academy of Sciences Beijing 100101 China
| | - Guangqi Wu
- Beijing National Laboratory for Molecular Sciences Center for Soft Matter Science and Engineering Key Laboratory of Polymer Chemistry and Physics of Ministry of Education College of Chemistry and Molecular Engineering Peking University Beijing 100871 China
| | - Chen Chen
- Key Laboratory of Protein and Peptide Pharmaceuticals Beijing Translational Center for Biopharmaceuticals Institute of Biophysics Chinese Academy of Sciences Beijing 100101 China
| | | | - Rui Yuan
- Key Laboratory of Protein and Peptide Pharmaceuticals Beijing Translational Center for Biopharmaceuticals Institute of Biophysics Chinese Academy of Sciences Beijing 100101 China
| | - Liang Xu
- Key Laboratory of Protein and Peptide Pharmaceuticals Beijing Translational Center for Biopharmaceuticals Institute of Biophysics Chinese Academy of Sciences Beijing 100101 China
| | - Hui Guo
- Key Laboratory of Protein and Peptide Pharmaceuticals Beijing Translational Center for Biopharmaceuticals Institute of Biophysics Chinese Academy of Sciences Beijing 100101 China
- Suzhou Institute for Biomedical Research Suzhou Jiangsu 215028 China
| | - Jay Zhang
- Suzhou Institute for Biomedical Research Suzhou Jiangsu 215028 China
| | - Hua Lu
- Beijing National Laboratory for Molecular Sciences Center for Soft Matter Science and Engineering Key Laboratory of Polymer Chemistry and Physics of Ministry of Education College of Chemistry and Molecular Engineering Peking University Beijing 100871 China
| | - Feng Wang
- Key Laboratory of Protein and Peptide Pharmaceuticals Beijing Translational Center for Biopharmaceuticals Institute of Biophysics Chinese Academy of Sciences Beijing 100101 China
- Suzhou Institute for Biomedical Research Suzhou Jiangsu 215028 China
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11
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He N, Liu X, Vegter AR, Evans TIA, Gray JS, Guo J, Moll SR, Guo LJ, Luo M, Ma N, Sun X, Liang B, Yan Z, Feng Z, Qi L, Joshi AS, Shahin W, Yi Y, Gibson-Corley KN, Hoffman EA, Wang K, Mueller C, Engelhardt JF, Rosen BH. Ferret models of alpha-1 antitrypsin deficiency develop lung and liver disease. JCI Insight 2022; 7:143004. [PMID: 35104244 PMCID: PMC8983124 DOI: 10.1172/jci.insight.143004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 01/28/2022] [Indexed: 11/19/2022] Open
Abstract
Alpha-1 antitrypsin deficiency (AATD) is the most common genetic cause and risk factor for chronic obstructive pulmonary disease, but the field lacks a large-animal model that allows for longitudinal assessment of pulmonary function. We hypothesized that ferrets would model human AATD-related lung and hepatic disease. AAT-knockout (AAT-KO) and PiZZ (E342K, the most common mutation in humans) ferrets were generated and compared with matched controls using custom-designed flexiVent modules to perform pulmonary function tests, quantitative computed tomography (QCT), bronchoalveolar lavage (BAL) proteomics, and alveolar morphometry. Complete loss of AAT (AAT-KO) led to increased pulmonary compliance and expiratory airflow limitation, consistent with obstructive lung disease. QCT and morphometry confirmed emphysema and airspace enlargement, respectively. Pathway analysis of BAL proteomics data revealed inflammatory lung disease and impaired cellular migration. The PiZ mutation resulted in altered AAT protein folding in the liver, hepatic injury, and reduced plasma concentrations of AAT, and PiZZ ferrets developed obstructive lung disease. In summary, AAT-KO and PiZZ ferrets model the progressive obstructive pulmonary disease seen in AAT-deficient patients and may serve as a platform for preclinical testing of therapeutics including gene therapy.
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Affiliation(s)
- Nan He
- Department of Anatomy & Cell Biology, University of Iowa Caver College of Medicine, Iowa City, United States of America
| | - Xiaoming Liu
- Department of Anatomy & Cell Biology, University of Iowa Caver College of Medicine, Iowa City, United States of America
| | - Amber R Vegter
- Department of Anatomy & Cell Biology, University of Iowa Caver College of Medicine, Iowa City, United States of America
| | - T Idil A Evans
- Department of Anatomy & Cell Biology, University of Iowa Caver College of Medicine, Iowa City, United States of America
| | - Jaimie S Gray
- Department of Anatomy & Cell Biology, University of Iowa Caver College of Medicine, Iowa City, United States of America
| | - Junfeng Guo
- Department of Radiology, University of Iowa Caver College of Medicine, Iowa City, United States of America
| | - Shashanna R Moll
- Department of Anatomy & Cell Biology, University of Iowa Caver College of Medicine, Iowa City, United States of America
| | - Lydia J Guo
- Department of Anatomy & Cell Biology, University of Iowa Caver College of Medicine, Iowa City, United States of America
| | - Meihui Luo
- Department of Anatomy & Cell Biology, University of Iowa Caver College of Medicine, Iowa City, United States of America
| | - Ningxia Ma
- Department of Anatomy & Cell Biology, University of Iowa Caver College of Medicine, Iowa City, United States of America
| | - Xingshen Sun
- Department of Anatomy & Cell Biology, University of Iowa Caver College of Medicine, Iowa City, United States of America
| | - Bo Liang
- Department of Anatomy & Cell Biology, University of Iowa Caver College of Medicine, Iowa City, United States of America
| | - Ziying Yan
- Department of Anatomy & Cell Biology, University of Iowa Caver College of Medicine, Iowa City, United States of America
| | - Zehua Feng
- Department of Anatomy & Cell Biology, University of Iowa Caver College of Medicine, Iowa City, United States of America
| | - Lisi Qi
- Department of Anatomy & Cell Biology, University of Iowa Caver College of Medicine, Iowa City, United States of America
| | - Arnav S Joshi
- Department of Surgery, University of Iowa Caver College of Medicine, Iowa City, United States of America
| | - Weam Shahin
- Department of Anatomy & Cell Biology, University of Iowa Caver College of Medicine, Iowa City, United States of America
| | - Yaling Yi
- Department of Anatomy & Cell Biology, University of Iowa Caver College of Medicine, Iowa City, United States of America
| | - Katherine N Gibson-Corley
- Department of Pathology, University of Iowa Caver College of Medicine, Iowa City, United States of America
| | - Eric A Hoffman
- Department of Radiology, University of Iowa Caver College of Medicine, Iowa City, United States of America
| | - Kai Wang
- Department of Biostatistics, University of Iowa College of Public Health, Iowa City, United States of America
| | - Christian Mueller
- Department of Pediatrics, University of Massachusetts Medical Center, Worcester, United States of America
| | - John F Engelhardt
- Department of Anatomy & Cell Biology, University of Iowa Caver College of Medicine, Iowa City, United States of America
| | - Bradley H Rosen
- Department of Anatomy & Cell Biology, University of Iowa Caver College of Medicine, Iowa City, United States of America
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12
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Forgrave LM, Wang M, Yang D, DeMarco ML. Proteoforms and their expanding role in laboratory medicine. Pract Lab Med 2022; 28:e00260. [PMID: 34950758 PMCID: PMC8672040 DOI: 10.1016/j.plabm.2021.e00260] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 10/31/2021] [Accepted: 11/22/2021] [Indexed: 12/17/2022] Open
Abstract
The term “proteoforms” describes the range of different structures of a protein product of a single gene, including variations in amino acid sequence and post-translational modifications. This diversity in protein structure contributes to the biological complexity observed in living organisms. As the concentration of a particular proteoform may increase or decrease in abnormal physiological states, proteoforms have long been used in medicine as biomarkers of health and disease. Notably, the analytical approaches used to analyze proteoforms have evolved considerably over the years. While ligand binding methods continue to play a large role in proteoform measurement in the clinical laboratory, unanticipated or unknown post-translational modifications and sequence variants can upend even extensively tested and vetted assays that have successfully made it through the medical regulatory process. As an alternate approach, mass spectrometry—with its high molecular selectivity—has become an essential tool in detection, characterization, and quantification of proteoforms in biological fluids and tissues. This review explores the analytical techniques used for proteoform detection and quantification, with an emphasis on mass spectrometry and its various applications in clinical research and patient care including, revealing new biomarker targets, helping improve the design of contemporary ligand binding in vitro diagnostics, and as mass spectrometric laboratory developed tests used in routine patient care.
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Affiliation(s)
- Lauren M. Forgrave
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Meng Wang
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - David Yang
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Mari L. DeMarco
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, St. Paul's Hospital, Providence Health Care, 1081 Burrard St, Vancouver, V6Z 1Y6, Canada
- Corresponding author. Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada.
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13
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Onur ST, Boyracı N, Akyıl FT, Sökücü SN, Kara K. Developing lung cancer in COPD: Possible role of carrying Alpha-1 antitrypsin deficiency variants. Respir Med Case Rep 2022; 38:101667. [PMID: 35646586 PMCID: PMC9136117 DOI: 10.1016/j.rmcr.2022.101667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/12/2022] [Accepted: 05/17/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation and airway inflammation, with a prevalence of 10.1%. Among the many causes of COPD, Smoking is the leading and another big cause is (AATD α1-antitrypsin deficiency)’ an inherited disorder. Prevalence of COPD patients is 1.9%. World Health Organization (WHO) advice all COPD patients’ AATD rate to be screened at least once during their life. The prevalence of AATD in the general population ranges from 1:2,000–5,000 in parts of Europe and from 1 to 5,000–10,000 in the United States and Canada. Case 1 An 81-year-old male patient with COPD. In computed tomography (CT) of the thorax, mass in the right lower lobe and a nodule in the right upper lobe were detected. The biopsy from right bronchial entrance via fiberoptic bronchoscopy (FB) yielded squamous cell carcinoma (SCC). AAT level was 169 mg/dL (ref. range: 90–200 mg/dL). M/P lowell allele was detected in genetic analysis. Case 2 A 45-year-old male patient with COPD. Conglomerated lymhadenomegaly in the paratracheal area was detected in CT. The biopsy from mucosal infiltrates initiating from the entrance of the right upper lobe to the anterior segment revealed SCC. His AAT level was 190 mg/dL (ref. range: 90–200 mg/dL) and the genetic analysis demonstrated M/I mutation. Case 3 A 64-year-old male COPD patient. In thorax CT, a 24 mm diameter parenchymal nodule in the left lower lobe was detected. Transthoracic fine needle aspiration biopsy from the left lung nodule showed SCC. His AAT level was 196 mg/dL (ref. range: 90–200 mg/dL) and M/P lowell allele was detected in the genetic analysis. Discussion AAT deficiency can cause early-onset of COPD, manifested with emphysema and chronic bronchitis. It has been suggested that AATD is associated with an increased risk of many types of cancer. Although the relationship between AATD or variant carriage and LC histopathology is not clear in the literature, it was detected as squamous cell carcinoma in our cases. We infer that unmeasurable lung damage is more prevalent in heterozygous patients and we believe that sharing our results may draw more attention in this regard.
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14
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Dong C, Wu G, Chen C, Li X, Yuan R, Xu L, Guo H, Zhang J, Lu H, Wang F. Site-Specific Conjugation of a Selenopolypeptide to Alpha-1-antitrypsin Enhances Oxidation Resistance and Pharmacological Properties. Angew Chem Int Ed Engl 2021; 61:e202115241. [PMID: 34897938 DOI: 10.1002/anie.202115241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Indexed: 01/01/2023]
Abstract
Human alpha-1-antitrypsin (A1AT), a native serine-protease inhibitor that protects tissue damage from excessive protease activities, is used as an augmentation therapy to treat A1AT-deficienct patients. However, A1AT is sensitive to oxidation-mediated deactivation and has a short circulating half-life. Currently, there is no method that can effectively protect therapeutic proteins from oxidative damage in vivo. Here we developed a novel biocompatible selenopolypeptide and site-specifically conjugated it with A1AT. The conjugated A1AT fully retained its inhibitory activity on neutrophil elastase, enhanced oxidation resistance, extended the serum half-life, and afforded long-lasting protective efficacy in a mouse model of acute lung injury. These results demonstrated that conjugating A1AT with the designed selenopolymer is a viable strategy to improve its pharmacological properties, which could potentially further be applied to a variety of oxidation sensitive biotherapeutics.
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Affiliation(s)
- Chao Dong
- Key Laboratory of Protein and Peptide Pharmaceuticals, Beijing Translational Center for Biopharmaceuticals, Institute of Biophysics, Chinese Academy of Sciences, Beijing, 100101, China
| | - Guangqi Wu
- Beijing National Laboratory for Molecular Sciences, Center for Soft Matter Science and Engineering, Key Laboratory of Polymer Chemistry and Physics of Ministry of Education, College of Chemistry and Molecular Engineering, Peking University, Beijing, 100871, China
| | - Chen Chen
- Key Laboratory of Protein and Peptide Pharmaceuticals, Beijing Translational Center for Biopharmaceuticals, Institute of Biophysics, Chinese Academy of Sciences, Beijing, 100101, China
| | | | - Rui Yuan
- Key Laboratory of Protein and Peptide Pharmaceuticals, Beijing Translational Center for Biopharmaceuticals, Institute of Biophysics, Chinese Academy of Sciences, Beijing, 100101, China
| | - Liang Xu
- Key Laboratory of Protein and Peptide Pharmaceuticals, Beijing Translational Center for Biopharmaceuticals, Institute of Biophysics, Chinese Academy of Sciences, Beijing, 100101, China
| | - Hui Guo
- Key Laboratory of Protein and Peptide Pharmaceuticals, Beijing Translational Center for Biopharmaceuticals, Institute of Biophysics, Chinese Academy of Sciences, Beijing, 100101, China.,Suzhou Institute for Biomedical Research, Suzhou, Jiangsu 215028, China
| | - Jay Zhang
- Suzhou Institute for Biomedical Research, Suzhou, Jiangsu 215028, China
| | - Hua Lu
- Beijing National Laboratory for Molecular Sciences, Center for Soft Matter Science and Engineering, Key Laboratory of Polymer Chemistry and Physics of Ministry of Education, College of Chemistry and Molecular Engineering, Peking University, Beijing, 100871, China
| | - Feng Wang
- Key Laboratory of Protein and Peptide Pharmaceuticals, Beijing Translational Center for Biopharmaceuticals, Institute of Biophysics, Chinese Academy of Sciences, Beijing, 100101, China.,Suzhou Institute for Biomedical Research, Suzhou, Jiangsu 215028, China
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15
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Bessone F, Hernández N, Tanno M, Roma MG. Drug-Induced Vanishing Bile Duct Syndrome: From Pathogenesis to Diagnosis and Therapeutics. Semin Liver Dis 2021; 41:331-348. [PMID: 34130334 DOI: 10.1055/s-0041-1729972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The most concerned issue in the context of drug/herb-induced chronic cholestasis is vanishing bile duct syndrome. The progressive destruction of intrahepatic bile ducts leading to ductopenia is usually not dose dependent, and has a delayed onset that should be suspected when abnormal serum cholestasis enzyme levels persist despite drug withdrawal. Immune-mediated cholangiocyte injury, direct cholangiocyte damage by drugs or their metabolites once in bile, and sustained exposure to toxic bile salts when biliary epithelium protective defenses are impaired are the main mechanisms of cholangiolar damage. Current therapeutic alternatives are scarce and have not shown consistent beneficial effects so far. This review will summarize the current literature on the main diagnostic tools of ductopenia and its histological features, and the differential diagnostic with other ductopenic diseases. In addition, pathomechanisms will be addressed, as well as the connection between them and the supportive and curative strategies for ductopenia management.
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Affiliation(s)
- Fernando Bessone
- Hospital Provincial del Centenario, Facultad de Ciencias Médicas, Servicio de Gastroenterología y Hepatología, Universidad Nacional de Rosario, Rosario, Argentina
| | - Nelia Hernández
- Clínica de Gastroenterología, Hospital de Clínicas y Facultad de Medicina, Universidad de la República (UdelaR), Montevideo, Uruguay
| | - Mario Tanno
- Hospital Provincial del Centenario, Facultad de Ciencias Médicas, Servicio de Gastroenterología y Hepatología, Universidad Nacional de Rosario, Rosario, Argentina
| | - Marcelo G Roma
- Instituto de Fisiología Experimental (CONICET-UNR), Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Rosario, Argentina
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16
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Herrera EM, Joseph C, Brouwer ES, Gandhi V, Czorniak M. Alpha-1 Antitrypsin Deficiency-Associated Clinical Manifestations and Healthcare Resource Use in the United States. COPD 2021; 18:315-324. [PMID: 34036848 DOI: 10.1080/15412555.2021.1917532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Pulmonary events (PEs) associated with alpha-1 antitrypsin deficiency (AATD) can have a severe clinical course and increase healthcare resource use (HRU). However, AATD-associated HRU and healthcare costs have not been extensively described. This study describes and compares real-world HRU and healthcare costs among US patients with severe (requiring hospitalization after AATD-related PE) versus nonsevere AATD clinical course. Administrative healthcare claims for patients with a second primary AATD diagnosis between 6/1/2008 and 12/31/2017 were analyzed from 2 databases (requiring continuous enrollment 6 months preceding diagnosis). Patient baseline characteristics and AATD-associated PE incidence rates, HRU, and healthcare costs during follow-up were compared in patients with severe versus nonsevere AATD. Of 5109 patients with a second AATD diagnosis, 2674 (severe, n = 711 [26.6%]; nonsevere, n = 1963 [73.4%]) had ≥1 AATD-associated PE. PE incidence per 100 person-years was higher in patients with severe versus nonsevere AATD. Annual incidences (mean ± SD) of emergency department (1.2 ± 5.7 vs. 0.4 ± 1.2), inpatient (1.3 ± 2.5 vs. 0.1 ± 0.5), and outpatient (10.3 ± 15.9 vs. 5.7 ± 13.2) visits were higher in patients with severe versus nonsevere AATD. Median (interquartile range) annual costs were also higher for patients with severe versus nonsevere AATD for emergency department ($185 [$0-$1665] vs. $0 [$0-$264]), inpatient ($16,038 [$2968-$70,941] vs. $0 [$0-$0]), and outpatient ($2663 [$412-$10,277] vs. $1114 [$134-$4195]) visits. Higher percentages of patients with severe AATD were prescribed augmentation therapy, antibiotics, or corticosteroids. These findings suggest that patients with severe AATD have higher incidence of AATD-associated PEs, as well as higher HRU and healthcare costs.
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17
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Guillaud O, Jacquemin E, Couchonnal E, Vanlemmens C, Francoz C, Chouik Y, Conti F, Duvoux C, Hilleret MN, Kamar N, Houssel-Debry P, Neau-Cransac M, Pageaux GP, Gonzales E, Ackermann O, Gugenheim J, Lachaux A, Ruiz M, Radenne S, Debray D, Lacaille F, McLin V, Duclos-Vallée JC, Samuel D, Coilly A, Dumortier J. Long term results of liver transplantation for alpha-1 antitrypsin deficiency. Dig Liver Dis 2021; 53:606-611. [PMID: 33139195 DOI: 10.1016/j.dld.2020.10.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 10/13/2020] [Accepted: 10/13/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Liver transplantation (LT) is the therapeutic option for end-stage liver disease associated with alpha1 antitrypsin (A1AT) deficiency. The aim of the present retrospective study was to report on long-term outcomes following LT for A1AT deficiency. METHODS The medical records of 90 pediatric and adult patients transplanted between 1982 and 2017 in France and Geneva (Switzerland) were reviewed. RESULTS The study population consisted of 32 adults and 58 children; median age at transplant was 13.0 years (range: 0.2-65.1), and 65 were male (72.2%). Eighty-two patients (94.8% of children and 84.4% of adults) had the PI*ZZ genotype/phenotype and eight patients (8.9%) had the Pi*SZ genotype/phenotype. Eighty-four patients (93.3%) were transplanted for end-stage liver disease and six (all Pi*ZZ adults) for HCC. Median follow-up after LT was 13.6 years (0.1-31.7). The overall cumulative patient survival rates post-transplant were 97.8% at 1 year, and 95.5%, 95.5%, 92.0%, 89.1% at 5, 10, 15, 20 years respectively. The overall cumulative graft survival rates were 92.2% at 1 year, and 89.9%, 89.9%, 84.4%, 81.5% at 5, 10, 15 and 20 years, respectively. CONCLUSIONS In a representative cohort of patients having presented with end-stage-liver disease or HCC secondary to A1AT, liver transplantation offered very good patient and graft survival rates.
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Affiliation(s)
- Olivier Guillaud
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Fédération des spécialités digestives, Lyon, France; Ramsay Générale de Santé, Clinique de la Sauvegarde, Lyon, France
| | - Emmanuel Jacquemin
- Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Hépatologie et Transplantation Hépatique Pédiatriques, Centre National de Référence de l'Atrésie des Voies Biliaires et des Cholestases Génétiques, Université Paris Saclay, Le Kremlin-Bicêtre, France; Inserm U1193, Hepatinov, Université Paris Saclay, Orsay, France
| | - Eduardo Couchonnal
- Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, Service d'Hépato-gastroentérologie et Nutrition Pédiatrique, Bron, France
| | | | - Claire Francoz
- Assistance Publique-Hôpitaux de Paris, Hôpital Beaujon, Service d'Hépatologie, Clichy, France
| | - Yasmina Chouik
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Fédération des spécialités digestives, Lyon, France
| | - Filomena Conti
- Assistance Publique-Hôpitaux de Paris, Hôpital La Pitié-Salpétrière, Service d'Hépato-gastroentérolgie, Paris, France
| | - Christophe Duvoux
- Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Service d'Hépatologie, Créteil, France
| | - Marie-Noëlle Hilleret
- CHU de Grenoble, Hôpital Michalon, Service d'Hépato-Gastroentérologie, La Tronche, France
| | - Nassim Kamar
- CHU de Toulouse, Hôpital Rangueil, Service de Néphrologie-Hypertension artérielle-Dialyse-Transplantation, Toulouse, France
| | | | - Martine Neau-Cransac
- CHU de Bordeaux, Hôpital Haut Lévêque, Service de Chirurgie Hépatobiliaire et de Transplantation Hépatique, Bordeaux, France
| | - Georges-Philippe Pageaux
- CHU de Montpellier, Hôpital Saint-Eloi, Fédération Médico-Chirurgicale des Maladies de l'Appareil Digestif, Montpellier, France
| | - Emmanuel Gonzales
- Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Hépatologie et Transplantation Hépatique Pédiatriques, Centre National de Référence de l'Atrésie des Voies Biliaires et des Cholestases Génétiques, Université Paris Saclay, Le Kremlin-Bicêtre, France; Inserm U1193, Hepatinov, Université Paris Saclay, Orsay, France
| | - Oanez Ackermann
- Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Hépatologie et Transplantation Hépatique Pédiatriques, Centre National de Référence de l'Atrésie des Voies Biliaires et des Cholestases Génétiques, Université Paris Saclay, Le Kremlin-Bicêtre, France; Inserm U1193, Hepatinov, Université Paris Saclay, Orsay, France
| | - Jean Gugenheim
- CHU de Nice, Hôpital L'Archet 2, Service de Chirurgie Digestive, Nice, France
| | - Alain Lachaux
- Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, Service d'Hépato-gastroentérologie et Nutrition Pédiatrique, Bron, France; Université de Lyon, Lyon, France
| | - Mathias Ruiz
- Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, Service d'Hépato-gastroentérologie et Nutrition Pédiatrique, Bron, France
| | - Sylvie Radenne
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service d'Hépatologie, Lyon, France
| | - Dominique Debray
- Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants malades, Unité d'Hépatologie pédiatrique, Centre de référence de l'Atrèsie des voies biliaires et cholestases génétiques, filière de santé Filfoie, Paris, France
| | - Florence Lacaille
- Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants malades, Unité d'Hépatologie pédiatrique, Centre de référence de l'Atrèsie des voies biliaires et cholestases génétiques, filière de santé Filfoie, Paris, France
| | - Valérie McLin
- Centre Suisse du Foie de l'Enfant, Hôpitaux Universitaires de Genève, Département de Pédiatrie, Gynécologie et Obstétrique, Genève, Suisse
| | - Jean-Charles Duclos-Vallée
- Inserm U1193, Hepatinov, Université Paris Saclay, Orsay, France; Assistance Publique-Hôpitaux de Paris, Hôpital Paul Brousse, Centre Hépato-Biliaire, Villejuif, France
| | - Didier Samuel
- Inserm U1193, Hepatinov, Université Paris Saclay, Orsay, France; Assistance Publique-Hôpitaux de Paris, Hôpital Paul Brousse, Centre Hépato-Biliaire, Villejuif, France
| | - Audrey Coilly
- Inserm U1193, Hepatinov, Université Paris Saclay, Orsay, France; Assistance Publique-Hôpitaux de Paris, Hôpital Paul Brousse, Centre Hépato-Biliaire, Villejuif, France
| | - Jérôme Dumortier
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Fédération des spécialités digestives, Lyon, France; Université de Lyon, Lyon, France.
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Lalonde ME, Koyuturk I, Brochu D, Jabbour J, Gilbert M, Durocher Y. Production of α2,6-sialylated and non-fucosylated recombinant alpha-1-antitrypsin in CHO cells. J Biotechnol 2020; 307:87-97. [PMID: 31697975 DOI: 10.1016/j.jbiotec.2019.10.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 10/23/2019] [Accepted: 10/29/2019] [Indexed: 01/05/2023]
Abstract
Alpha-1-antitrypsin (A1AT) is an abundant serum inhibitor of serine proteases. A1AT deficiency is a common genetic disorder which is currently treated with augmentation therapies. These treatments involve weekly injections of patients with purified plasma-derived A1AT. Such therapies can be extremely expensive and rely on plasma donors. Hence, large-scale production of recombinant A1AT (rA1AT) could greatly benefit these patients, as it could decrease the cost of treatments, reduce biosafety concerns and ensure quantitative and qualitative controls of the protein. In this report, we sought to produce α2,6-sialylated rA1AT with our cumate-inducible stable CHO pool expression system. Our different CHO pools could reach volumetric productivities of 1,2 g/L. The human α2,6-sialyltransferase was stably expressed in these cells in order to mimic elevated α2,6-sialylation levels of native A1AT protein. Sialylation of the recombinant protein was stable over the duration of the fed-batch production phase and was higher in a pool where cells were sorted and enriched by FACS based on cell-surface α2,6-sialylation. Addition of ManNAc to the cell culture media during production enhanced both α2,3 and α2,6 A1AT sialylation levels whereas addition of 2F-peracetylfucose potently inhibited fucosylation of the protein. Finally, we demonstrated that rA1AT proteins exhibited human neutrophil elastase inhibitory activities similar to the commercial human plasma-derived A1AT.
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Affiliation(s)
- Marie-Eve Lalonde
- Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Université de Montréal, Québec, H3C 3J7, Canada
| | - Izel Koyuturk
- Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Université de Montréal, Québec, H3C 3J7, Canada
| | - Denis Brochu
- Life Sciences, Human Health Therapeutics Research Centre, 100 Sussex Drive, National Research Council Canada, Ottawa, Ontario, K1A OR6, Canada
| | - Jonathan Jabbour
- Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Université de Montréal, Québec, H3C 3J7, Canada
| | - Michel Gilbert
- Life Sciences, Human Health Therapeutics Research Centre, 100 Sussex Drive, National Research Council Canada, Ottawa, Ontario, K1A OR6, Canada
| | - Yves Durocher
- Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Université de Montréal, Québec, H3C 3J7, Canada; Life Sciences, Human Health Therapeutics Research Centre, Building Montreal-Royalmount, National Research Council Canada, Montréal, Québec, H4P 2R2, Canada.
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19
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Pallister EG, Choo MSF, Tai JN, Leong DSZ, Tang WQ, Ng SK, Huang K, Marchesi A, Both P, Gray C, Rudd PM, Flitsch SL, Nguyen-Khuong T. Exploiting the Disialyl Galactose Activity of α2,6-Sialyltransferase from Photobacterium damselae To Generate a Highly Sialylated Recombinant α-1-Antitrypsin. Biochemistry 2019; 59:3123-3128. [DOI: 10.1021/acs.biochem.9b00563] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Edward G. Pallister
- Bioprocessing Technology Institute, Agency for Science Technology and Research, Singapore 138668
- School of Chemistry and Manchester Institute of Biotechnology (MIB), The University of Manchester, Manchester M1 7DN, United Kingdom
| | - Matthew S. F. Choo
- Bioprocessing Technology Institute, Agency for Science Technology and Research, Singapore 138668
| | - Jien-Nee Tai
- Bioprocessing Technology Institute, Agency for Science Technology and Research, Singapore 138668
| | - Dawn S. Z. Leong
- Bioprocessing Technology Institute, Agency for Science Technology and Research, Singapore 138668
| | - Wen-Qin Tang
- Bioprocessing Technology Institute, Agency for Science Technology and Research, Singapore 138668
| | - Say-Kong Ng
- Bioprocessing Technology Institute, Agency for Science Technology and Research, Singapore 138668
| | - Kun Huang
- School of Chemistry and Manchester Institute of Biotechnology (MIB), The University of Manchester, Manchester M1 7DN, United Kingdom
| | - Andrea Marchesi
- School of Chemistry and Manchester Institute of Biotechnology (MIB), The University of Manchester, Manchester M1 7DN, United Kingdom
| | - Peter Both
- School of Chemistry and Manchester Institute of Biotechnology (MIB), The University of Manchester, Manchester M1 7DN, United Kingdom
| | - Christopher Gray
- School of Chemistry and Manchester Institute of Biotechnology (MIB), The University of Manchester, Manchester M1 7DN, United Kingdom
| | - Pauline M. Rudd
- Bioprocessing Technology Institute, Agency for Science Technology and Research, Singapore 138668
| | - Sabine L. Flitsch
- School of Chemistry and Manchester Institute of Biotechnology (MIB), The University of Manchester, Manchester M1 7DN, United Kingdom
| | - Terry Nguyen-Khuong
- Bioprocessing Technology Institute, Agency for Science Technology and Research, Singapore 138668
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20
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Caglar FNT, Isiksacan N, Biyik I, Tureli HO, Katkat F, Karabulut D, Oztas DM, Ugurlucan M. Is there any association between rs1303 (Pi*M3) variant of alpha-1 antitrypsin gene and atrial septal aneurysm development? J Card Surg 2019; 34:1215-1219. [PMID: 31523846 DOI: 10.1111/jocs.14256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
AIM Atrial septal aneurysm (ASA) is one of the congenital heart defects. The underlying pathophysiology of ASA has not been fully understood yet. Alpha-1 antitrypsin (A1AT) is a serine protease inhibitor glycoprotein, which is held responsible from tissue wall proteolysis if it is deficient in the body. The aim of this study was to investigate A1AT serum levels and the rs1303 (Pi*M3) variant in A1AT gene in patients with ASA. MATERIAL AND METHODS Thirty patients (7 male and 23 female) with isolated ASA and 33 patients (11 male and 22 female) with normal atrial septum on echocardiography were included in this study. A1AT serum levels of study patients were measured quantitatively by the enzyme-linked immune sorbent assay (ELISA) method. The A1AT gene mutation rs1303 was analyzed by genotyping, which is performed on genomic DNA extracted from circulating mononuclear blood cells. Single-nucleotide polymorphism was evaluated on polymerase chain reaction using commercial kits. RESULTS A1AT serum levels were not statistically different among patients with and without ASA (9.52 ± 4.33 µg/mL vs 9.83 ± 5.27 µg/mL, respectively, P = .80). A1AT homozygote mutation (PiM3M3) was significantly higher in the ASA group than the control group (21 vs 11, OR (95% CI): 6.68 [2.09-21.40], P = .001). A1AT serum levels were similar among patients with normal A1AT allele (PiMM), homozygote variant (PiM3M3), and heterozygote variant (PiMM3) (P = .79). CONCLUSION This preliminary study revealed that homozygote A1AT rs1303 (PiM3M3) variant is significantly higher in patients with isolated ASA and may be associated with ASA development. Large scale comprehensive studies are needed to validate these results.
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Affiliation(s)
| | - Nilgun Isiksacan
- Department of Biochemistry, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey
| | - Ismail Biyik
- Department of Cardiology, School of Medicine, Education and Research Hospital, Usak University, Usak, Turkey
| | - Hande Oktay Tureli
- Department of Cardiology, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey
| | - Fahrettin Katkat
- Department of Cardiology, Bagcilar Education and Research Hospital, Istanbul, Turkey
| | - Dilay Karabulut
- Department of Cardiology, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey
| | - Didem Melis Oztas
- Department of Cardiovascular Surgery, Bagcilar Education and Research Hospital, Istanbul, Turkey
| | - Murat Ugurlucan
- Department of Cardiovascular Surgery, Medipol University Medical Faculty, Istanbul, Turkey
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21
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Balakrishna S, Nagarajappa C, Rangappa S. Misfolding linked mutations of SERPINA1 gene are uncommon in preeclampsia. ARCHIVES OF MEDICINE AND HEALTH SCIENCES 2019. [DOI: 10.4103/amhs.amhs_79_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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SERPINA1 mRNA as a Treatment for Alpha-1 Antitrypsin Deficiency. J Nucleic Acids 2018; 2018:8247935. [PMID: 30009048 PMCID: PMC6020464 DOI: 10.1155/2018/8247935] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 04/23/2018] [Accepted: 05/22/2018] [Indexed: 02/01/2023] Open
Abstract
Alpha-1-antitrypsin (AAT) deficiency is a genetic disorder that produces inactive/defective AAT due to mutations in the SERPINA1 gene encoding AAT. This disease is associated with decreased activity of AAT in the lungs and deposition of excessive defective AAT protein in the liver. Currently there is no specific treatment for liver disease associated with AAT deficiency. AAT lung disease is often treated with one of several serum protein replacement products; however, long-term studies of the effectiveness of SerpinA1 replacement therapy are not available, and it does not reduce liver damage in AAT deficiency. mRNA therapy could potentially target both the liver and lungs of AAT deficient patients. AAT patient fibroblasts and AAT patient fibroblast-derived hepatocytes were transfected with SERPINA1-encoding mRNA and cell culture media were tested for SerpinA1 expression. Our data demonstrates increased SerpinA1 protein in culture media from treated AAT patient fibroblasts and AAT patient fibroblast-derived hepatocytes. In vivo studies in wild type mice demonstrate SERPINA1 mRNA biodistribution in liver and lungs, as well as SerpinA1 protein expression in these two target organs which are critically affected in AAT deficiency. Taken together, our data suggests that SerpinA1 mRNA therapy has the potential to benefit patients suffering from AAT deficiency.
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23
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Bashir A, Hazari YM, Bashir S, Hilal N, Banday M, Iqbal MK, Jan TR, Farooq SS, Shah NN, Fazili KM. SERPINA1 Hepatocyte-Specific Promoter Polymorphism Associate with Chronic Obstructive Pulmonary Disease in a Study of Kashmiri Ancestry Individuals. Lung 2018; 196:447-454. [PMID: 29804144 DOI: 10.1007/s00408-018-0124-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 05/13/2018] [Indexed: 02/05/2023]
Abstract
PURPOSE Different mutations in coding and non-coding sequences of the SERPINA1 gene have been implicated in the pathogenesis of COPD. However, - 10T/C mutation in the hepatocyte-directed promoter region has not been associated with COPD pathogenesis so far. Here, we report an increased frequency of - 10C genotype that is associated with decreased levels of serum alpha1-antitrypsin (α1AT) in COPD patients. METHODS The quantification of serum α1AT was done by ELISA, the phenol-chloroform method was used for DNA extraction, PCR products were directly sequenced. The IBM SPSS Statistics v21 software was used for statistical analyses of the data. RESULTS The mean serum α1AT level was found to be 1.203+0.239 and 3.162+0.160 g/L in COPD cases and in control, respectively. The - 10C allele is associated with an increased risk of COPD [OR, 3.50 (95%CI, 1.86-6.58); p < 0.001]. The combined variant genotype (TT+CC) was significantly found associated with an increased risk of COPD [OR, 3.20 (95% CI, 1.47-6.96); p = 0.003]. A significant association of the family history with COPD (overall p value= 0.0331) suggests that genetics may play an important role in the pathogenesis of COPD. CONCLUSION The polymorphism associated with hepatocyte-specific promoter region (- 10T/C) is likely to be associated with the pathogenesis of COPD. It is quite possible that the change of the base in the hepatocyte-specific promoter of the SERPINA1 gene can modulate its strength, thereby driving the reduced expression of α1AT.
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Affiliation(s)
- Arif Bashir
- Department of Biotechnology, University of Kashmir, Srinagar, J&K, 190006, India
| | - Younis M Hazari
- Institute of Biomedical Sciences, University of Chile, 8380453, Santiago, Chile
| | - Samirul Bashir
- Department of Biotechnology, University of Kashmir, Srinagar, J&K, 190006, India
| | - Nazia Hilal
- Department of Biotechnology, University of Kashmir, Srinagar, J&K, 190006, India
| | - Mariam Banday
- Department of Biotechnology, University of Kashmir, Srinagar, J&K, 190006, India
| | - Mir Khurshid Iqbal
- Department of Biotechnology, University of Kashmir, Srinagar, J&K, 190006, India
| | - Tariq Rashid Jan
- Department of Statistics, University of Kashmir, Srinagar, J&K, 190006, India
| | - Syed Suraiya Farooq
- Department of Chest Medicine, Government Medical College, Srinagar, J&K, 190006, India
| | - Naveed Nazir Shah
- Department of Chest Medicine, Government Medical College, Srinagar, J&K, 190006, India.
| | - Khalid Majid Fazili
- Department of Biotechnology, University of Kashmir, Srinagar, J&K, 190006, India.
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24
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Dunlea DM, Fee LT, McEnery T, McElvaney NG, Reeves EP. The impact of alpha-1 antitrypsin augmentation therapy on neutrophil-driven respiratory disease in deficient individuals. J Inflamm Res 2018; 11:123-134. [PMID: 29618937 PMCID: PMC5875399 DOI: 10.2147/jir.s156405] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Alpha-1 antitrypsin (AAT) is the most abundant serine protease inhibitor circulating in the blood. AAT deficiency (AATD) is an autosomal codominant condition affecting an estimated 3.4 million individuals worldwide. The clinical disease associated with AATD can present in a number of ways including COPD, liver disease, panniculitis and antineutrophil cytoplasmic antibody vasculitis. AATD is the only proven genetic risk factor for the development of COPD, and deficient individuals who smoke are disposed to more aggressive disease. Principally, AAT is a serine protease inhibitor; however, over the past number of years, the assessment of AAT as simply an antiprotease has evolved, and it is now recognized that AAT has significant anti-inflammatory properties affecting a wide range of cells, including the circulating neutrophil.
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Affiliation(s)
- Danielle M Dunlea
- Irish Centre for Genetic Lung Disease, Department of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - Laura T Fee
- Irish Centre for Genetic Lung Disease, Department of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - Thomas McEnery
- Irish Centre for Genetic Lung Disease, Department of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - Noel G McElvaney
- Irish Centre for Genetic Lung Disease, Department of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - Emer P Reeves
- Irish Centre for Genetic Lung Disease, Department of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
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25
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Stephenson SE, Wilson CL, Crothers K, Attia EF, Wongtrakool C, Petrache I, Schnapp LM. Impact of HIV infection on α 1-antitrypsin in the lung. Am J Physiol Lung Cell Mol Physiol 2017; 314:L583-L592. [PMID: 29351445 DOI: 10.1152/ajplung.00214.2017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Emphysema is one of the most common lung diseases in HIV+ individuals. The pathogenesis of HIV-associated emphysema remains unclear; however, radiographic distribution and earlier age of presentation of emphysema in the lungs of HIV+ patients are similar to deficiency of α1-antitrypsin (A1AT), a key elastase inhibitor in the lung. Reduced levels of circulating A1AT in HIV+ patients suggest a potential mechanism for emphysema development. In the present study we asked if A1AT levels and activity in the bronchoalveolar lavage fluid (BALF) differ in HIV+ and HIV- patients with and without emphysema. A1AT levels were measured by ELISA in plasma and BALF from a cohort of 21 HIV+ and 29 HIV- patients with or without emphysematous changes on chest CT scan. To analyze A1AT function, we measured elastase activity in the BALF and assessed oxidation and polymerization of A1AT by Western blotting. Total A1AT was increased in the BALF, but not in the plasma, of HIV+ compared with HIV- patients, regardless of the presence or absence of emphysema. However, antielastase activity was decreased in BALF from HIV+ patients, suggesting impaired A1AT function. Higher levels of the oxidized form of A1AT were detected in BALF from HIV+ than HIV- patients, which may account for the decreased antielastase activity. These findings suggest that, in the lungs of HIV+ patients, posttranslational modifications of A1AT produce a "functional deficiency" of this critical elastase inhibitor, which may contribute to emphysema development.
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Affiliation(s)
- Sarah E Stephenson
- Pulmonary, Critical Care, Allergy, and Sleep Medicine, Medical University of South Carolina , Charleston, South Carolina
| | - Carole L Wilson
- Pulmonary, Critical Care, Allergy, and Sleep Medicine, Medical University of South Carolina , Charleston, South Carolina
| | - Kristina Crothers
- Pulmonary and Critical Care Medicine, University of Washington , Seattle, Washington
| | - Engi F Attia
- Pulmonary and Critical Care Medicine, University of Washington , Seattle, Washington
| | - Cherry Wongtrakool
- Pulmonary Section, Department of Veterans Affairs, Atlanta Veterans Affairs Medical Center, Decatur, Georgia.,Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine, Emory University , Atlanta, Georgia
| | - Irina Petrache
- Pulmonary, Critical Care, and Sleep Medicine, National Jewish Health, University of Colorado , Denver, Colorado
| | - Lynn M Schnapp
- Pulmonary, Critical Care, Allergy, and Sleep Medicine, Medical University of South Carolina , Charleston, South Carolina
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26
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van Witteloostuijn SB, Pedersen SL, Jensen KJ. Half-Life Extension of Biopharmaceuticals using Chemical Methods: Alternatives to PEGylation. ChemMedChem 2016; 11:2474-2495. [DOI: 10.1002/cmdc.201600374] [Citation(s) in RCA: 126] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 09/24/2016] [Indexed: 12/21/2022]
Affiliation(s)
- Søren B. van Witteloostuijn
- Department of Chemistry; University of Copenhagen; Thorvaldsensvej 40 1871 Frederiksberg C Denmark
- Gubra ApS; Hørsholm Kongevej 11B 2970 Hørsholm Denmark
| | | | - Knud J. Jensen
- Department of Chemistry; University of Copenhagen; Thorvaldsensvej 40 1871 Frederiksberg C Denmark
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27
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Historical role of alpha-1-antitrypsin deficiency in respiratory and hepatic complications. Gene 2016; 589:118-22. [DOI: 10.1016/j.gene.2016.01.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 11/11/2015] [Accepted: 01/03/2016] [Indexed: 12/14/2022]
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28
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29
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Bashir A, Shah NN, Hazari YM, Habib M, Bashir S, Hilal N, Banday M, Asrafuzzaman S, Fazili KM. Novel variants of SERPIN1A gene: Interplay between alpha1-antitrypsin deficiency and chronic obstructive pulmonary disease. Respir Med 2016; 117:139-49. [DOI: 10.1016/j.rmed.2016.06.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 04/18/2016] [Accepted: 06/06/2016] [Indexed: 12/31/2022]
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30
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Norton B, Denson J, Briggs C, Bowles M, Stell D, Aroori S. Delayed diagnosis of alpha-1-antitrypsin deficiency following post-hepatectomy liver failure: A case report. World J Gastroenterol 2016; 22:3289-3295. [PMID: 27004008 PMCID: PMC4790006 DOI: 10.3748/wjg.v22.i11.3289] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Accepted: 12/01/2015] [Indexed: 02/06/2023] Open
Abstract
Post-hepatectomy liver failure (PHLF) is a leading cause of morbidity and mortality following major liver resection. The development of PHLF is dependent on the volume of the remaining liver tissue and hepatocyte function. Without effective pre-operative assessment, patients with undiagnosed liver disease could be at increased risk of PHLF. We report a case of a 60-year-old male patient with PHLF secondary to undiagnosed alpha-1-antitrypsin deficiency (AATD) following major liver resection. He initially presented with acute large bowel obstruction secondary to a colorectal adenocarcinoma, which had metastasized to the liver. There was no significant past medical history apart from mild chronic obstructive pulmonary disease. After colonic surgery and liver directed neo-adjuvant chemotherapy, he underwent a laparoscopic partially extended right hepatectomy and radio-frequency ablation. Post-operatively he developed PHLF. The cause of PHLF remained unknown, prompting re-analysis of the histology, which showed evidence of AATD. He subsequently developed progressive liver dysfunction, portal hypertension, and eventually an extensive parastomal bleed, which led to his death; this was ultimately due to a combination of AATD and chemotherapy. This case highlights that formal testing for AATD in all patients with a known history of chronic obstructive pulmonary disease, heavy smoking, or strong family history could help prevent the development of PHLF in patients undergoing major liver resection.
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31
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Okano T, Seike M, Kuribayashi H, Soeno C, Ishii T, Kida K, Gemma A. Identification of haptoglobin peptide as a novel serum biomarker for lung squamous cell carcinoma by serum proteome and peptidome profiling. Int J Oncol 2016; 48:945-52. [PMID: 26783151 PMCID: PMC4750543 DOI: 10.3892/ijo.2016.3330] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 11/23/2015] [Indexed: 12/14/2022] Open
Abstract
To date, a number of potential biomarkers for lung squamous cell cancer (SCC) have been identified; however, sensitive biomarkers are currently lacking to detect early stage SCC due to low sensitivity and specificity. In the present study, we compared the 7 serum proteomic profiles of 11 SCC patients, 7 chronic obstructive pulmonary disease (COPD) patients and 7 healthy smokers as controls to identify potential serum biomarkers associated with SCC and COPD. Two-dimensional difference gel electrophoresis (2D-DIGE) and mass-spectrometric analysis (MS) using an affinity column revealed two candidate proteins, haptoglobin (HP) and apolipoprotein 4, as biomarkers of SCC, and α-1-antichymotrypsin as a marker of COPD. The iTRAQ technique was also used to identify SCC-specific peptides. HP protein expression was significantly higher in SCC patients than in COPD patients. Furthermore, two HP protein peptides showed significantly higher serum levels in SCC patients than in COPD patients. We established novel polyclonal antibodies for the two HP peptides and subsequently a sandwich enzyme-linked immunosorbent assay (ELISA) for the quantification of these specific peptides in patient and control sera. The sensitivity of detection by ELISA of one HP peptide (HP216) was 70% of SCC patients, 40% of COPDs patients and 13% of healthy controls. We also measured CYFRA, a cytokeratin fragment clinically used as an SCC tumor marker, in all the 28 cases and found CYFRA was detected in only seven SCC cases. However, when the measurement of HP216 was combined with that of CYFRA, 100% (10 of 10 patients) of SCC cases were detected. Our proteomic profiling demonstrates that the SCC-specific HP peptide HP216 may potentially be used as a diagnostic biomarker for SCC.
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Affiliation(s)
- Tetsuya Okano
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo 113-8603, Japan
| | - Masahiro Seike
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo 113-8603, Japan
| | - Hidehiko Kuribayashi
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo 113-8603, Japan
| | - Chie Soeno
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo 113-8603, Japan
| | - Takeo Ishii
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, The Respiratory Care Clinic, Nippon Medical School, Tokyo 113-8603, Japan
| | - Kozui Kida
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, The Respiratory Care Clinic, Nippon Medical School, Tokyo 113-8603, Japan
| | - Akihiko Gemma
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo 113-8603, Japan
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32
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Hurley K, Reeves EP, Carroll TP, McElvaney NG. Tumor necrosis factor-α driven inflammation in alpha-1 antitrypsin deficiency: a new model of pathogenesis and treatment. Expert Rev Respir Med 2015; 10:207-22. [PMID: 26634397 DOI: 10.1586/17476348.2016.1127759] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Alpha-1 antitrypsin (AAT) deficiency (AATD) has traditionally been thought of as a genetic disorder characterized by lung destruction and early emphysema in a low AAT, and high neutrophil elastase (NE) environment in the lungs of affected individuals. Recently, a growing body of evidence has emerged to support the hypothesis that tumor necrosis factor alpha (TNF-α) is essential in the pathogenesis of both genetic AATD and non-genetic chronic obstructive pulmonary disease (COPD). Reports have highlighted the importance of TNF-α driven immune cell dysfunction in the development of lung disease in AATD. The authors discuss the role of AAT as a key modulator of TNF-α signaling firstly in the setting of AATD and secondly in other conditions where AAT augmentation therapy has potential utility as a novel therapy.
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Affiliation(s)
- Killian Hurley
- a Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland Education and Research Centre , Beaumont Hospital , Dublin , Ireland
| | - Emer P Reeves
- a Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland Education and Research Centre , Beaumont Hospital , Dublin , Ireland
| | - Tomás P Carroll
- a Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland Education and Research Centre , Beaumont Hospital , Dublin , Ireland
| | - Noel G McElvaney
- a Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland Education and Research Centre , Beaumont Hospital , Dublin , Ireland
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Wozniak J, Wandtke T, Kopinski P, Chorostowska-Wynimko J. Challenges and Prospects for Alpha-1 Antitrypsin Deficiency Gene Therapy. Hum Gene Ther 2015; 26:709-18. [PMID: 26413996 PMCID: PMC4651033 DOI: 10.1089/hum.2015.044] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 08/01/2015] [Indexed: 01/06/2023] Open
Abstract
Alpha-1 antitrypsin (AAT) is a protease inhibitor belonging to the serpin family. A number of identified mutations in the SERPINA1 gene encoding this protein result in alpha-1 antitrypsin deficiency (AATD). A decrease in AAT serum concentration or reduced biological activity causes considerable risk of chronic respiratory and liver disorders. As a monogenic disease, AATD appears to be an attractive target for gene therapy, particularly for patients with pulmonary dysfunction, where augmentation of functional AAT levels in plasma might slow down respiratory disease development. The short AAT coding sequence and its activity in the extracellular matrix would enable an increase in systemic serum AAT production by cellular secretion. In vitro and in vivo experimental AAT gene transfer with gamma-retroviral, lentiviral, adenoviral, and adeno-associated viral (AAV) vectors has resulted in enhanced AAT serum levels and a promising safety profile. Human clinical trials using intramuscular viral transfer with AAV1 and AAV2 vectors of the AAT gene demonstrated its safety, but did not achieve a protective level of AAT >11 μM in serum. This review provides an in-depth critical analysis of current progress in AATD gene therapy based on viral gene transfer. The factors affecting transgene expression levels, such as site of administration, dose and type of vector, and activity of the immune system, are discussed further as crucial variables for optimizing the clinical effectiveness of gene therapy in AATD subjects.
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Affiliation(s)
- Joanna Wozniak
- Department of Gene Therapy, Faculty of Medicine, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Tomasz Wandtke
- Department of Gene Therapy, Faculty of Medicine, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Piotr Kopinski
- Department of Gene Therapy, Faculty of Medicine, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Joanna Chorostowska-Wynimko
- Department of Genetics and Clinical Immunology, National Institute of Tuberculosis and Lung Diseases, Warsaw, Poland
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Cathomas M, Schüller A, Candinas D, Inglin R. Severe postoperative wound healing disturbance in a patient with alpha-1-antitrypsin deficiency: the impact of augmentation therapy. Int Wound J 2015; 12:601-4. [PMID: 25818083 DOI: 10.1111/iwj.12419] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 12/18/2014] [Accepted: 12/23/2014] [Indexed: 11/27/2022] Open
Abstract
Wound healing disturbance is a common complication following surgery, but the underlying cause sometimes remains elusive. A 50-year-old Caucasian male developed an initially misunderstood severe wound healing disturbance following colon and abdominal wall surgery. An untreated alpha-1-antitrypsin (AAT) deficiency in the patient's medical history, known since 20 years and clinically apparent as a mild to moderate chronic obstructive pulmonary disease, was eventually found to be at its origin. Further clinical work-up showed AAT serum levels below 30% of the lower reference value; phenotype testing showed a ZZ phenotype and a biopsy taken from the wound area showed the characteristic, disease-related histological pattern of necrotising panniculitits. Augmentation therapy with plasma AAT was initiated and within a few weeks, rapid and adequate would healing was observed. AAT deficiency is an uncommon but clinically significant, possible cause of wound healing disturbances. An augmentation therapy ought to be considered in affected patients during the perioperative period.
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Affiliation(s)
- Marionna Cathomas
- Department of Visceral Surgery and Medicine, University Hospital of Bern, Bern, Switzerland
| | - Alexandra Schüller
- Department of Visceral Surgery and Medicine, University Hospital of Bern, Bern, Switzerland
| | - Daniel Candinas
- Department of Visceral Surgery and Medicine, University Hospital of Bern, Bern, Switzerland
| | - Roman Inglin
- Department of Visceral Surgery and Medicine, University Hospital of Bern, Bern, Switzerland
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Franciosi AN, McCarthy C, McElvaney NG. The efficacy and safety of inhaled human α-1 antitrypsin in people with α-1 antitrypsin deficiency-related emphysema. Expert Rev Respir Med 2015; 9:143-51. [DOI: 10.1586/17476348.2015.1002472] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Chanprasert S, Scaglia F. Adult liver disorders caused by inborn errors of metabolism: review and update. Mol Genet Metab 2015; 114:1-10. [PMID: 25467056 DOI: 10.1016/j.ymgme.2014.10.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 10/23/2014] [Accepted: 10/23/2014] [Indexed: 12/22/2022]
Abstract
Inborn errors of metabolism (IEMs) are a group of genetic diseases that have protean clinical manifestations and can involve several organ systems. The age of onset is highly variable but IEMs afflict mostly the pediatric population. However, in the past decades, the advancement in management and new therapeutic approaches have led to the improvement in IEM patient care. As a result, many patients with IEMs are surviving into adulthood and developing their own set of complications. In addition, some IEMs will present in adulthood. It is important for internists to have the knowledge and be familiar with these conditions because it is predicted that more and more adult patients with IEMs will need continuity of care in the near future. The review will focus on Wilson disease, alpha-1 antitrypsin deficiency, citrin deficiency, and HFE-associated hemochromatosis which are typically found in the adult population. Clinical manifestations and pathophysiology, particularly those that relate to hepatic disease as well as diagnosis and management will be discussed in detail.
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Affiliation(s)
- Sirisak Chanprasert
- Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA; Texas Children Hospital, Houston, TX, USA
| | - Fernando Scaglia
- Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA; Texas Children Hospital, Houston, TX, USA.
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Ferrarotti I, Carroll TP, Ottaviani S, Fra AM, O'Brien G, Molloy K, Corda L, Medicina D, Curran DR, McElvaney NG, Luisetti M. Identification and characterisation of eight novel SERPINA1 Null mutations. Orphanet J Rare Dis 2014; 9:172. [PMID: 25425243 PMCID: PMC4255440 DOI: 10.1186/s13023-014-0172-y] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 10/27/2014] [Indexed: 12/20/2022] Open
Abstract
Background Alpha-1 antitrypsin (AAT) is the most abundant circulating antiprotease and is a member of the serine protease inhibitor (SERPIN) superfamily. The gene encoding AAT is the highly polymorphic SERPINA1 gene, found at 14q32.1. Mutations in the SERPINA1 gene can lead to AAT deficiency (AATD) which is associated with a substantially increased risk of lung and liver disease. The most common pathogenic AAT variant is Z (Glu342Lys) which causes AAT to misfold and polymerise within hepatocytes and other AAT-producing cells. A group of rare mutations causing AATD, termed Null or Q0, are characterised by a complete absence of AAT in the plasma. While ultra rare, these mutations confer a particularly high risk of emphysema. Methods We performed the determination of AAT serum levels by a rate immune nephelometric method or by immune turbidimetry. The phenotype was determined by isoelectric focusing analysis on agarose gel with specific immunological detection. DNA was isolated from whole peripheral blood or dried blood spot (DBS) samples using a commercial extraction kit. The new mutations were identified by sequencing all coding exons (II-V) of the SERPINA1 gene. Results We have found eight previously unidentified SERPINA1 Null mutations, named: Q0cork, Q0perugia, Q0brescia, Q0torino, Q0cosenza, Q0pordenone, Q0lampedusa, and Q0dublin . Analysis of clinical characteristics revealed evidence of the recurrence of lung symptoms (dyspnoea, cough) and lung diseases (emphysema, asthma, chronic bronchitis) in M/Null subjects, over 45 years-old, irrespective of smoking. Conclusions We have added eight more mutations to the list of SERPINA1 Null alleles. This study underlines that the laboratory diagnosis of AATD is not just a matter of degree, because the precise determination of the deficiency and Null alleles carried by an AATD individual may help to evaluate the risk for the lung disease. Electronic supplementary material The online version of this article (doi:10.1186/s13023-014-0172-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ilaria Ferrarotti
- Centre for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, Laboratory of Biochemistry and Genetics, Institute for Respiratory Disease, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. .,Department of Molecular Medicine, University of Pavia, Pavia, Italy.
| | - Tomás P Carroll
- Respiratory Research, Department of Medicine, Royal College of Surgeons in Ireland Education and Research Centre, Beaumont Hospital, Dublin, Ireland.
| | - Stefania Ottaviani
- Centre for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, Laboratory of Biochemistry and Genetics, Institute for Respiratory Disease, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - Anna M Fra
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.
| | - Geraldine O'Brien
- Respiratory Research, Department of Medicine, Royal College of Surgeons in Ireland Education and Research Centre, Beaumont Hospital, Dublin, Ireland.
| | - Kevin Molloy
- Respiratory Research, Department of Medicine, Royal College of Surgeons in Ireland Education and Research Centre, Beaumont Hospital, Dublin, Ireland.
| | - Luciano Corda
- Department of Internal Medicine, Respiratory Disease Unit, Spedali Civili, Brescia, Italy.
| | - Daniela Medicina
- Department of Pathology, Spedali Civili of Brescia, Brescia, Italy.
| | - David R Curran
- Respiratory Department, Mercy University Hospital, Cork, Ireland.
| | - Noel G McElvaney
- Respiratory Research, Department of Medicine, Royal College of Surgeons in Ireland Education and Research Centre, Beaumont Hospital, Dublin, Ireland.
| | - Maurizio Luisetti
- Centre for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, Laboratory of Biochemistry and Genetics, Institute for Respiratory Disease, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. .,Department of Molecular Medicine, University of Pavia, Pavia, Italy.
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Balduyck M, Odou MF, Zerimech F, Porchet N, Lafitte JJ, Maitre B. Diagnosis of alpha-1 antitrypsin deficiency: modalities, indications and diagnosis strategy. Rev Mal Respir 2014; 31:729-45. [PMID: 25391508 DOI: 10.1016/j.rmr.2014.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 10/25/2013] [Indexed: 12/27/2022]
Abstract
Alpha-1 antitrypsin (α1-AT) deficiency is an autosomal recessive genetic disorder, which predisposes affected patients to development of pulmonary emphysema or liver cirrhosis. Despite the guidelines from the American Thoracic Society and the European Respiratory Society about α1-AT deficiency screening, it remains significantly under recognized. So, it seems necessary to propose an efficient and suitable biological approach to improve diagnosis and management of α1-AT deficiency. α1-AT is a 52 kDa glycoprotein predominantly produced in the liver and its physiological serum concentration for adults ranges from 0.9 to 2.0g/L (17-39 μmol/L). It is encoded by the SERPINA1 gene, which is highly pleomorphic, and to date, more than 100 alleles have been identified. α1-AT testing would initially involve quantification of serum α1-AT concentration with possible complementary measurement of the elastase inhibitory capacity of serum. If the serum α1-AT concentration is reduced below the reference value, two strategies for laboratory testing can be used: (i) serum α1-AT phenotyping by isoelectric focusing which allows identification of the most common variant designated as the PI M variant but also of various deficient variants besides the predominant PI S and PI Z ones; (ii) genotyping by allele-specific PCR methods which allows only identification of the deficient PI S and PI Z alleles. Identification of the null alleles or of other rare deficient alleles can be performed by direct sequencing of the whole SERPINA1 gene as a reflex test.
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Affiliation(s)
- M Balduyck
- Laboratoire de biochimie et biologie moléculaire (HMNO), centre de biologie pathologie, CHRU de Lille, boulevard du Pr.-J.-Leclercq, 59037 Lille cedex, France; Laboratoire de biochimie et biologie moléculaire, faculté de pharmacie, université de Lille 2, 59006 Lille, France.
| | - M-F Odou
- Laboratoire de biochimie et biologie moléculaire (HMNO), centre de biologie pathologie, CHRU de Lille, boulevard du Pr.-J.-Leclercq, 59037 Lille cedex, France; Laboratoire de bactériologie virologie, faculté de pharmacie, université de Lille 2, 59006 Lille, France
| | - F Zerimech
- Laboratoire de biochimie et biologie moléculaire (HMNO), centre de biologie pathologie, CHRU de Lille, boulevard du Pr.-J.-Leclercq, 59037 Lille cedex, France
| | - N Porchet
- Laboratoire de biochimie et biologie moléculaire (HMNO), centre de biologie pathologie, CHRU de Lille, boulevard du Pr.-J.-Leclercq, 59037 Lille cedex, France; Inserm, U837, centre de recherche Jean-Pierre-Aubert, 59045 Lille, France
| | - J-J Lafitte
- Service de pneumologie et oncologie thoracique, hôpital A.-Calmette, CHRU de Lille, 59037 Lille, France
| | - B Maitre
- Unité de pneumologie, réanimation médicale, groupe hospitalier Mondor, IMRB U955, équipe 8, université Paris Est, 94010 Créteil, France
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McCarthy C, Saldova R, Wormald MR, Rudd PM, McElvaney NG, Reeves EP. The Role and Importance of Glycosylation of Acute Phase Proteins with Focus on Alpha-1 Antitrypsin in Acute and Chronic Inflammatory Conditions. J Proteome Res 2014; 13:3131-43. [DOI: 10.1021/pr500146y] [Citation(s) in RCA: 102] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Cormac McCarthy
- Respiratory
Research Division, Royal College of Surgeons in Ireland, Beaumont
Hospital, Dublin 9, Ireland
| | - Radka Saldova
- NIBRT
GlycoScience Group, The National Institute for Bioprocessing Research
and Training, University College Dublin, Dublin 4, Ireland
| | - Mark R Wormald
- Department of Biochemistry, Oxford Glycobiology Institute, University of Oxford, Oxford OX1 3QU, U.K
| | - Pauline M. Rudd
- NIBRT
GlycoScience Group, The National Institute for Bioprocessing Research
and Training, University College Dublin, Dublin 4, Ireland
| | - Noel G. McElvaney
- Respiratory
Research Division, Royal College of Surgeons in Ireland, Beaumont
Hospital, Dublin 9, Ireland
| | - Emer P. Reeves
- Respiratory
Research Division, Royal College of Surgeons in Ireland, Beaumont
Hospital, Dublin 9, Ireland
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Molloy K, Hersh CP, Morris VB, Carroll TP, O’Connor CA, Lasky-Su JA, Greene CM, O’Neill SJ, Silverman EK, McElvaney NG. Clarification of the risk of chronic obstructive pulmonary disease in α1-antitrypsin deficiency PiMZ heterozygotes. Am J Respir Crit Care Med 2014; 189:419-27. [PMID: 24428606 PMCID: PMC5955067 DOI: 10.1164/rccm.201311-1984oc] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 01/08/2014] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Severe α1-antitrypsin deficiency (typically PiZZ homozygosity) is associated with a significantly increased risk of airflow obstruction and emphysema but the risk of chronic obstructive pulmonary disease (COPD) in PiMZ heterozygotes remains uncertain. OBJECTIVES This was a family-based study to determine the risk of COPD in PiMZ individuals. METHODS We compared 99 PiMM and 89 PiMZ nonindex subjects recruited from 51 index probands who were confirmed PiMZ heterozygotes and also had a diagnosis of COPD Global Initiative for Chronic Obstructive Lung Disease stage II-IV. The primary outcome measures of interest were quantitative variables of pre- and post-bronchodilator FEV1/FVC ratio, FEV1 (liters), FEV1 (% predicted), forced expiratory flow midexpiratory phase (FEF25-75; liters per second), FEF25-75 (% predicted), and a categorical outcome of COPD. MEASUREMENTS AND MAIN RESULTS PiMZ heterozygotes compared with PiMM individuals had a reduced median (interquartile range) post-bronchodilator FEV1 (% predicted) (92.0 [75.6-105.4] vs. 98.6 [85.5-109.7]; P = 0.04), FEV1/FVC ratio (0.75 [0.66-0.79] vs. 0.78 [0.73-0.83]; P = 0.004), and FEF25-75 (% predicted) (63.84 [38.45-84.35] vs. 72.8 [55.5-97.7]; P = 0.0013) compared with PiMM individuals. This effect was abrogated in never-smoking and accentuated in ever-smoking PiMZ individuals. PiMZ heterozygosity was associated with an adjusted odds ratio for COPD of 5.18 (95% confidence interval, 1.27-21.15; P = 0.02) and this was higher (odds ratio, 10.65; 95% confidence interval, 2.17-52.29; P = 0.004) in ever-smoking individuals. CONCLUSIONS These results indicate that PiMZ heterozygotes have significantly more airflow obstruction and COPD than PiMM individuals and cigarette smoke exposure exerts a significant modifier effect.
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Affiliation(s)
- Kevin Molloy
- Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland; and
| | - Craig P. Hersh
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Valerie B. Morris
- Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland; and
| | - Tomás P. Carroll
- Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland; and
| | - Catherine A. O’Connor
- Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland; and
| | - Jessica A. Lasky-Su
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Catherine M. Greene
- Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland; and
| | - Shane J. O’Neill
- Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland; and
| | - Edwin K. Silverman
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Noel G. McElvaney
- Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland; and
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WITHDRAWN: Diagnostic du déficit en alpha-1-antitrypsine : les moyens, les indications et la stratégie diagnostique. Rev Mal Respir 2014. [DOI: 10.1016/j.rmr.2014.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Stone H, Pye A, Stockley RA. Disease associations in alpha-1-antitrypsin deficiency. Respir Med 2013; 108:338-43. [PMID: 24176989 DOI: 10.1016/j.rmed.2013.10.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 10/04/2013] [Accepted: 10/06/2013] [Indexed: 12/17/2022]
Abstract
INTRODUCTION In addition to emphysema alpha-1-antitrypsin deficiency (AATD) has been shown to be associated with several inflammatory conditions, including bronchiectasis, vasculitis, (in particular Wegener's granulomatosis), and panniculitis, suggesting neutrophil proteinases also play a role in their pathophysiology. However, it remains unknown whether other inflammatory diseases are also more prevalent in AATD than the general population. The current study describes the prevalence of other co-morbidities in AATD with particular emphasis on inflammatory bowel disease. METHODS AND RESULTS The case notes of 651 PiZZ or PiZnull patients attending the UK national centre for AATD between 1996 and 2011 were reviewed. The prevalence of inflammatory bowel disease (1.5%) was higher than that predicted in the UK (0.4%). Ten patients had a confirmed diagnosis of ulcerative colitis, and 1 had Crohn's disease. In 2 cases there was a family history of inflammatory bowel disease and all but 1 patient were ex or never smokers. There was also a higher prevalence of hypothyroidism in this patient group than expected for the UK population - 26 cases (7.2% of females and 1.3% of males). CONCLUSIONS The current study of the UK cohort of patients with AATD confirmed a higher prevalence of ulcerative colitis than would be expected in the general population, providing further evidence of a potential link between these 2 conditions. In addition, the data suggested a potential link between hypothyroidism and AATD.
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Affiliation(s)
- H Stone
- ADAPT Project, Lung Function and Sleep Department, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK.
| | - A Pye
- ADAPT Project, Lung Function and Sleep Department, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK; University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
| | - R A Stockley
- ADAPT Project, Lung Function and Sleep Department, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK.
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Is there a therapeutic role for selenium in alpha-1 antitrypsin deficiency? Nutrients 2013; 5:758-70. [PMID: 23478569 PMCID: PMC3705318 DOI: 10.3390/nu5030758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 02/22/2013] [Accepted: 02/26/2013] [Indexed: 12/20/2022] Open
Abstract
Selenium is an essential trace mineral of fundamental importance to human health. Much of its beneficial influence is attributed to its presence within selenoproteins, a group of proteins containing the rare amino acid selenocysteine. There are 25 known human selenoproteins including glutathione peroxidases, thioredoxin reductases and selenoproteins. Selenoprotein S (SEPS1) is an endoplasmic reticulum (ER) resident selenoprotein involved in the removal of misfolded proteins from the ER. SEPS1 expression can be induced by ER stress, an event that is associated with conformational disorders and occurs due to accumulation of misfolded proteins within the ER. Alpha-1 antitrypsin (AAT) deficiency, also known as genetic emphysema, is a conformational disorder in which the roles of ER stress, SEPS1 and selenium have been investigated. SEPS1 can relieve ER stress in an in vitro model of AAT deficiency by reducing levels of active ATF6 and inhibiting grp78 promoter- and NFκB activity; some of these effects are enhanced in the presence of selenium supplementation. Other studies examining the molecular mechanisms by which selenium mediates its anti-inflammatory effects have identified a role for prostaglandin 15d-PGJ2 in targeting NFκB and PPARγ. Together these ER stress-relieving and anti-inflammatory properties suggest a therapeutic potential for selenium supplementation in genetic emphysema.
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Niklas J, Priesnitz C, Rose T, Sandig V, Heinzle E. Metabolism and metabolic burden by α1-antitrypsin production in human AGE1.HN cells. Metab Eng 2013; 16:103-14. [DOI: 10.1016/j.ymben.2013.01.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2011] [Revised: 01/04/2013] [Accepted: 01/09/2013] [Indexed: 12/16/2022]
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Bouchecareilh M, Hutt DM, Szajner P, Flotte TR, Balch WE. Histone deacetylase inhibitor (HDACi) suberoylanilide hydroxamic acid (SAHA)-mediated correction of α1-antitrypsin deficiency. J Biol Chem 2012; 287:38265-78. [PMID: 22995909 PMCID: PMC3488095 DOI: 10.1074/jbc.m112.404707] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Revised: 09/12/2012] [Indexed: 02/06/2023] Open
Abstract
α1-Antitrypsin (α1AT) deficiency (α1ATD) is a consequence of defective folding, trafficking, and secretion of α1AT in response to a defect in its interaction with the endoplasmic reticulum proteostasis machineries. The most common and severe form of α1ATD is caused by the Z-variant and is characterized by the accumulation of α1AT polymers in the endoplasmic reticulum of the liver leading to a severe reduction (>85%) of α1AT in the serum and its anti-protease activity in the lung. In this organ α1AT is critical for ensuring tissue integrity by inhibiting neutrophil elastase, a protease that degrades elastin. Given the limited therapeutic options in α1ATD, a more detailed understanding of the folding and trafficking biology governing α1AT biogenesis and its response to small molecule regulators is required. Herein we report the correction of Z-α1AT secretion in response to treatment with the histone deacetylase (HDAC) inhibitor suberoylanilide hydroxamic acid (SAHA), acting in part through HDAC7 silencing and involving a calnexin-sensitive mechanism. SAHA-mediated correction restores Z-α1AT secretion and serpin activity to a level 50% that observed for wild-type α1AT. These data suggest that HDAC activity can influence Z-α1AT protein traffic and that SAHA may represent a potential therapeutic approach for α1ATD and other protein misfolding diseases.
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Affiliation(s)
| | | | | | - Terence R. Flotte
- the Department of Pediatrics and Gene Therapy Center UMass Medical School, Worcester, Massachusetts 01655
| | - William E. Balch
- From the Department of Cell Biology
- The Skaggs Institute for Chemical Biology
- Department of Chemical Physiology, and
- the Institute for Childhood and Neglected Diseases, The Scripps Research Institute, La Jolla, California 92037 and
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Null allele alpha-1 antitrypsin deficiency: case report of the total pleural covering technique for disease-associated pneumothorax. Gen Thorac Cardiovasc Surg 2012; 60:452-5. [DOI: 10.1007/s11748-012-0015-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Accepted: 06/24/2011] [Indexed: 01/17/2023]
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Niklas J, Nonnenmacher Y, Rose T, Sandig V, Heinzle E. Quercetin treatment changes fluxes in the primary metabolism and increases culture longevity and recombinant α₁-antitrypsin production in human AGE1.HN cells. Appl Microbiol Biotechnol 2011; 94:57-67. [PMID: 22202969 DOI: 10.1007/s00253-011-3811-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Revised: 11/29/2011] [Accepted: 12/01/2011] [Indexed: 10/14/2022]
Abstract
Addition of the flavonoid quercetin to cultivations of the α(1)-antitrypsin (A1AT) producing human AGE1.HN.AAT cell line resulted in alterations of the cellular physiology and a remarkable improvement of the overall performance of these cells. In a first screening in 96-well plate format, toxicity and the effect of quercetin on the lactate/glucose ratio was analyzed. It was found that quercetin treatment reduced the lactate/glucose ratio dose dependently. An increase in culture longevity, viable cell density (160% of control), and A1AT concentration (from 0.39 g/L in the control to 0.76 g/L with quercetin, i.e., 195% of the control) was observed in batch cultivation with 10 μM quercetin compared to the control. A detailed analysis of quercetin effects on primary metabolism revealed dose-dependent alterations in metabolic fluxes. Quercetin addition resulted in an improved channeling of pyruvate into the mitochondria accompanied by reduced waste product formation and stimulation of TCA cycle activity. The observed changes in cellular physiology can be explained by different properties of quercetin and its metabolites, e.g., inhibition of specific enzymes, stimulation of oxidation of cytoplasmic, and mitochondrial NADH resulting in reduced NADH/NAD(+) ratio, and cytoprotective activity. The present study shows that the addition of specific effectors to the culture medium represents a promising strategy to improve the cellular metabolic phenotype and the production of biopharmaceuticals. The provided results contribute, additionally, to an improved understanding of quercetin action on the metabolism of human cells in a general physiological context.
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Affiliation(s)
- Jens Niklas
- Biochemical Engineering Institute, Saarland University, 66123 Saarbrücken, Germany
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Devenport NA, Reynolds JC, Parkash V, Cook J, Weston DJ, Creaser CS. Determination of free desmosine and isodesmosine as urinary biomarkers of lung disorder using ultra performance liquid chromatography–ion mobility-mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2011; 879:3797-801. [DOI: 10.1016/j.jchromb.2011.10.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Revised: 09/16/2011] [Accepted: 10/15/2011] [Indexed: 10/16/2022]
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Abstract
This article addresses the most common pulmonary issues that affect liver transplant candidates. Pretransplant diagnostic criteria of these pulmonary problems in liver transplant patients are reviewed. Successful pulmonary management schemes and caveats are described. Risks for liver transplant are emphasized.
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Affiliation(s)
- Michael J Krowka
- Division of Pulmonary and Critical Care, Mayo Clinic, Rochester, MN 55905, USA.
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Niklas J, Priesnitz C, Rose T, Sandig V, Heinzle E. Primary metabolism in the new human cell line AGE1.HN at various substrate levels: increased metabolic efficiency and α1-antitrypsin production at reduced pyruvate load. Appl Microbiol Biotechnol 2011; 93:1637-50. [PMID: 21842438 DOI: 10.1007/s00253-011-3526-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Revised: 07/20/2011] [Accepted: 08/03/2011] [Indexed: 12/15/2022]
Abstract
Metabolic responses of the new neuronal human cell line AGE1.HN to various substrate levels were analyzed in this study showing that reduced substrate and especially pyruvate load improves metabolic efficiency, leading to improved growth and α(1)-antitrypsin (A1AT) production. The adaptation of the metabolism to different pyruvate and glutamine concentrations was analyzed in detail using a full factorial design. The most important finding was an increasingly inefficient use of substrates as well as the reduction of cell proliferation with increasing pyruvate concentrations in the medium. Cultivations with different feeding profiles showed that the highest viable cell density and A1AT concentration (167% of batch) was reached in the culture with the lowest glucose level and without pyruvate feeding. Analysis of metabolic fluxes in the differently fed cultures revealed a more efficient metabolic phenotype in the cultures without pyruvate feeding. The measured in vitro enzyme activities of the selected enzymes involved in pyruvate metabolism were lower in AGE1.HN compared with CHO cells, which might explain the higher sensitivity and different adaptation of AGE1.HN to increased pyruvate concentrations. The results indicate on the one hand that increasing the connectivity between glycolysis and the TCA cycle might improve substrate use and, finally, the production of A1AT. On the other hand, a better balanced substrate uptake promises a reduction of energy spilling which is increased with increasing substrate levels in this cell line. Overall, the results of this study provide important insights into the regulation of primary metabolism and into the adaptation of AGE1.HN to different substrate levels, providing guidance for further optimization of production cell lines and applied process conditions.
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Affiliation(s)
- Jens Niklas
- Biochemical Engineering Institute, Saarland University, Saarbrücken, Germany
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