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Semeraro F, Ammollo CT, Semeraro N, Colucci M. Extracellular histones promote fibrinolysis by single-chain urokinase-type plasminogen activator in a factor seven activating protease-dependent way. Thromb Res 2020; 196:193-199. [PMID: 32891905 DOI: 10.1016/j.thromres.2020.08.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 08/11/2020] [Accepted: 08/21/2020] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Extracellular histones inhibit tissue plasminogen activator (t-PA)-mediated fibrinolysis by modifying fibrin structure and rheological properties. However, other plasminogen activators involved in intravascular and extravascular fibrinolysis have not been considered yet. OBJECTIVES We investigated the effect of histones on fibrinolysis driven by different plasminogen activators. METHODS Clot lysis induced by t-PA, urokinase (u-PA) and its single chain precursor (scu-PA) was evaluated by turbidimetry. Conversion of scu-PA to u-PA and activation of factor seven activating protease (FSAP) were assessed by fluorogenic and chromogenic assays, respectively. RESULTS Histones delayed t-PA- and u-PA-mediated fibrinolysis but strongly accelerated scu-PA-driven clot lysis through the enhancement of scu-PA to u-PA conversion. This effect required a plasma factor identified as FSAP by the following findings: 1) histones enhanced neither scu-PA activation nor scu-PA-mediated clot lysis under purified conditions; 2) in plasma, the enhancement of fibrinolytic activity by histones was abolished by a neutralizing anti-FSAP antibody; and 3) histones promoted the activation of plasma FSAP. The effect of the natural mixture of histones on scu-PA-driven fibrinolysis was differentially recapitulated by the individual recombinant histones, H4 displaying the strongest activity. When complexed to DNA, histones still accelerated scu-PA-mediated fibrinolysis but with a lesser efficiency due to a reduced FSAP activation. Finally, preincubation of histones with heparin or activated protein C, two known inhibitors of histones, further amplified histone-mediated boost of scu-PA-driven fibrinolysis. CONCLUSIONS Enhancement of FSAP-mediated scu-PA activity by histones may play yet unforeseen roles in intravascular fibrinolysis and contribute to extravascular proteolysis and tissue damage.
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Affiliation(s)
- Fabrizio Semeraro
- Dipartimento di Scienze Biomediche e Oncologia Umana, Università degli Studi di Bari Aldo Moro, Bari, Italy.
| | - Concetta T Ammollo
- Dipartimento di Scienze Biomediche e Oncologia Umana, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - Nicola Semeraro
- Dipartimento di Scienze Biomediche e Oncologia Umana, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - Mario Colucci
- Dipartimento di Scienze Biomediche e Oncologia Umana, Università degli Studi di Bari Aldo Moro, Bari, Italy
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Levi M, Cohn DM. The Role of Complement in Hereditary Angioedema. Transfus Med Rev 2019; 33:243-247. [DOI: 10.1016/j.tmrv.2019.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 08/15/2019] [Accepted: 08/16/2019] [Indexed: 11/28/2022]
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Gu M, Wang M, Cai B, Cheng X, Li Z, Sun B, Wang F, Shi Y, Zhang Z, Liu X. Chromosome 10q25 polymorphism is associated with susceptibility to large artery atherosclerotic stroke. Gene 2019; 691:18-23. [PMID: 30580071 DOI: 10.1016/j.gene.2018.12.026] [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: 08/14/2018] [Revised: 11/07/2018] [Accepted: 12/07/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIMS A recent genome-wide association study (GWAS) reported an association between a single nucleotide polymorphism (SNP) rs11196288 and risk of early-onset large artery atherosclerotic (LAA) stroke in European population. The interaction between genetic and environmental factors such as age has also received increasing attention. We performed this study to investigate the association between the rs11196288A > G polymorphism and LAA stroke risk in the Chinese Han population and test whether age interacts rs11196288 to influence LAA stroke risk. METHODS Genotyping of rs11196288 was performed in 1066 LAA stroke patients and 1167 healthy controls. Multivariate logistic regression analyses were applied to assess the effect of the rs11196288A > G polymorphism on susceptibility and short-term outcome of LAA stroke. Nomograms were performed to estimate probability of risk for an individual patient. RESULTS A significant decrement of LAA stroke risk was found in co-dominant (AG vs. AA, OR = 0.76, 95% CI = 0.64-0.91, P = 0.003; GG vs. AA, OR = 0.65, 95% CI = 0.50-0.85, P = 0.002), dominant (AG/GG vs. AA, OR = 0.74, 95% CI = 0.62-0.87, P < 0.001) and recessive models (GG vs. AA/AG, OR = 0.76, 95% CI = 0.59-0.97, P = 0.028) of rs11196288. However, the interaction between age and genotypes of rs11196288 was not statistically significant, and no significant association was observed between the rs11196288A > G polymorphism and short-term outcome of LAA stroke (P > 0.05). CONCLUSIONS In the southeastern Chinese population, the rs11196288A > G polymorphism is associated with decreased risk of LAA stroke.
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Affiliation(s)
- Mengmeng Gu
- Department of Neurology, Jinling Clinical College of Nanjing Medical University, Nanjing 210002, Jiangsu, China
| | - Mengmeng Wang
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu, China
| | - Biyang Cai
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu, China
| | - Xi Cheng
- Department of Neurology, Jinling Clinical College of Nanjing Medical University, Nanjing 210002, Jiangsu, China
| | - Zibao Li
- Department of Neurology, Jinling Clinical College of Nanjing Medical University, Nanjing 210002, Jiangsu, China
| | - Bo Sun
- Department of Neurology, Jinling Clinical College of Nanjing Medical University, Nanjing 210002, Jiangsu, China
| | - Fang Wang
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu, China
| | - Yonghui Shi
- Department of Clinical Laboratory, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu, China
| | - Zhizhong Zhang
- Department of Neurology, Jinling Clinical College of Nanjing Medical University, Nanjing 210002, Jiangsu, China; Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu, China.
| | - Xinfeng Liu
- Department of Neurology, Jinling Clinical College of Nanjing Medical University, Nanjing 210002, Jiangsu, China; Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu, China.
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Levi M, Cohn DM, Zeerleder S. Hereditary angioedema: Linking complement regulation to the coagulation system. Res Pract Thromb Haemost 2019; 3:38-43. [PMID: 30656274 PMCID: PMC6332742 DOI: 10.1002/rth2.12175] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 11/12/2018] [Indexed: 12/20/2022] Open
Abstract
Congenital deficiency of C1 inhibitor, the main inhibitor of the classic complement system pathway, leads to paroxysmal angioedema (hereditary angioedema) that can be debilitating or life-threatening for affected patients. In the past few years many new insights on the pathogenesis of angioedema formation in the presence of low levels of C1 inhibitor has been accumulated. There is a central role for bradykinin that is released upon activation of the kallikrein-kinin system that is insufficiently controlled by adequate levels of C1 inhibitor. As C1 inhibitor also possesses a central regulatory role of other plasma systems, including the contact activation system of coagulation and the plasminogen-plasmin system that governs endogenous fibrinolysis, it is interesting to observe the effects of C1 inhibitor deficiency on activation of these systems and relevance for hemostasis in vivo and thrombo-embolic disease. Interestingly, and despite significant activation of these pathways, C1 inhibitor deficiency is not at all associated with a hemorrhagic tendency or prothrombotic state. New therapeutic options for treatment of C1 inhibitor efficiency have become available in recent years, including various forms of C1 inhibitor concentrate. Restoration of C1 inhibitor levels in patients with hereditary angioedema has not resulted in thrombotic complications or any other relevant disorder associated with the hemostatic system.
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Affiliation(s)
- Marcel Levi
- Department of MedicineUniversity College London HospitalsNHS Foundation TrustLondonUK
- Cardiometabolic ProgrammeUniversity College London HospitalsNHS Foundation TrustLondonUK
- Department of Vascular MedicineAmsterdam Universities Medical CenterAmsterdamThe Netherlands
| | - Danny M. Cohn
- Department of Vascular MedicineAmsterdam Universities Medical CenterAmsterdamThe Netherlands
| | - Sacha Zeerleder
- Department of Molecular Cell BiologySanquin Research & Landsteiner LaboratoryAmsterdamThe Netherlands
- Department of Hematology and Central Hematology LaboratoryInselspitalBern University HospitalBernSwitzerland
- Department for BioMedical ResearchBern University HospitalBernSwitzerland
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van der Meer AJ, Zeerleder S, Blok DC, Kager LM, Lede IO, Rahman W, Afroz R, Ghose A, Visser CE, Zahed ASM, Husain MA, Alam KM, Barua PC, Hassan M, Tayab MA, Dondorp AM, van der Poll T. Neutrophil extracellular traps in patients with pulmonary tuberculosis. Respir Res 2017; 18:181. [PMID: 29084563 PMCID: PMC5663039 DOI: 10.1186/s12931-017-0663-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 10/12/2017] [Indexed: 01/19/2023] Open
Abstract
Tuberculosis is a devastating infectious disease causing many deaths worldwide. Recent investigations have implicated neutrophil extracellular traps (NETs) in the host response to tuberculosis. The aim of the current study was to obtain evidence for NETs release in the circulation during human tuberculosis. For this we measured the plasma concentrations of nucleosomes in conjunction with neutrophil elastase, in 64 patients with active pulmonary tuberculosis and 32 healthy controls. Patients with active tuberculosis had elevated plasma levels of nucleosomes and elastase when compared with local healthy blood donors. Furthermore nucleosome and elastase levels showed a positive correlation. These findings provide the first evidence for the release of NETs in the circulation of patients with active pulmonary tuberculosis.
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Affiliation(s)
- Anne Jan van der Meer
- Centre for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Room G2-130, 1105, AZ, Amsterdam, The Netherlands.
| | - Sacha Zeerleder
- Department of Haematology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Department of Immunopathology, Chittagong Medical College & Hospital (CMCH), Chittagong, Bangladesh
| | - Dana C Blok
- Centre for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Room G2-130, 1105, AZ, Amsterdam, The Netherlands
| | - Liesbeth M Kager
- Centre for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Room G2-130, 1105, AZ, Amsterdam, The Netherlands
| | - Ivar O Lede
- Department of Microbiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Wahid Rahman
- Department of Internal Medicine, Chittagong Medical College & Hospital (CMCH), Chittagong, Bangladesh
| | - Rumana Afroz
- Department of Internal Medicine, Chittagong Medical College & Hospital (CMCH), Chittagong, Bangladesh
| | - Aniruddha Ghose
- Department of Internal Medicine, Chittagong Medical College & Hospital (CMCH), Chittagong, Bangladesh
| | - Caroline E Visser
- Department of Microbiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Abu Shahed Md Zahed
- Department of Internal Medicine, Chittagong Medical College & Hospital (CMCH), Chittagong, Bangladesh
| | - Md Anwar Husain
- Department of Microbiology, Chittagong Medical College & Hospital (CMCH), Chittagong, Bangladesh
| | - Khan Mashrequl Alam
- Department of Microbiology, Chittagong Medical College & Hospital (CMCH), Chittagong, Bangladesh
| | | | - Mahtabuddin Hassan
- Department of Internal Medicine, Chittagong Medical College & Hospital (CMCH), Chittagong, Bangladesh
| | - Md Abu Tayab
- Chittagong General Hospital, Chittagong, Bangladesh
| | - Arjen M Dondorp
- Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
| | - Tom van der Poll
- Centre for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Room G2-130, 1105, AZ, Amsterdam, The Netherlands.,Division of Infectious Diseases, Sanquin Blood Supply and Landsteiner Laboratory of the Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Ramanathan R, Gram JB, Sand NPR, Nørgaard BL, Diederichsen AC, Vitzthum F, Schwarz H, Sidelmann JJ. Factor VII-activating protease. Blood Coagul Fibrinolysis 2017; 28:558-563. [DOI: 10.1097/mbc.0000000000000640] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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8
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DeAguero JL, McKown EN, Zhang L, Keirsey J, Fischer EG, Samedi VG, Canan BD, Kilic A, Janssen PML, Delfín DA. Altered protein levels in the isolated extracellular matrix of failing human hearts with dilated cardiomyopathy. Cardiovasc Pathol 2016; 26:12-20. [PMID: 27837684 DOI: 10.1016/j.carpath.2016.10.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 09/23/2016] [Accepted: 10/10/2016] [Indexed: 01/09/2023] Open
Abstract
Dilated cardiomyopathy (DCM) is associated with extensive pathological cardiac remodeling and involves numerous changes in the protein expression profile of the extracellular matrix of the heart. We obtained seven human, end-stage, failing hearts with DCM (DCM-failing) and nine human, nonfailing donor hearts and compared their extracellular matrix protein profiles. We first showed that the DCM-failing hearts had indeed undergone extensive remodeling of the left ventricle myocardium relative to nonfailing hearts. We then isolated the extracellular matrix from a subset of these hearts and performed a proteomic analysis on the isolated matrices. We found that the levels of 26 structural proteins were altered in the DCM-failing isolated cardiac extracellular matrix compared to nonfailing isolated cardiac extracellular matrix. Overall, most of the extracellular matrix proteins showed reduced levels in the DCM-failing hearts, while all of the contractile proteins showed increased levels. There was a mixture of increased and decreased levels of cytoskeletal and nuclear transport proteins. Using immunoprobing, we verified that collagen IV (α2 and α6 isoforms), zyxin, and myomesin protein levels were reduced in the DCM-failing hearts. We expect that these data will add to the understanding of the pathology associated with heart failure with DCM.
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Affiliation(s)
- Joshua L DeAguero
- The University of New Mexico College of Pharmacy, Department of Pharmaceutical Sciences, MSC09 5360, 1 University of New Mexico, Albuquerque, NM 87131, USA.
| | - Elizabeth N McKown
- The University of New Mexico College of Pharmacy, Department of Pharmaceutical Sciences, MSC09 5360, 1 University of New Mexico, Albuquerque, NM 87131, USA.
| | - Liwen Zhang
- The Ohio State University Mass Spectrometry and Proteomics Facility, Campus Chemical Instrument Center, 460 W. 12th Ave., Room 250 Biomedical Research Tower, Columbus, OH 43210, USA.
| | - Jeremy Keirsey
- The Ohio State University Mass Spectrometry and Proteomics Facility, Campus Chemical Instrument Center, 460 W. 12th Ave., Room 250 Biomedical Research Tower, Columbus, OH 43210, USA.
| | - Edgar G Fischer
- The University of New Mexico School of Medicine, Department of Pathology, MSC08 4640, 1 University of New Mexico, Albuquerque, NM 87131, USA.
| | - Von G Samedi
- The University of New Mexico School of Medicine, Department of Pathology, MSC08 4640, 1 University of New Mexico, Albuquerque, NM 87131, USA.
| | - Benjamin D Canan
- The Ohio State University College of Medicine, Department of Physiology and Cell Biology and the Davis Heart Lung Research Institute, 200 Hamilton Hall, 1645 Neil Avenue, Columbus, OH 43210.
| | - Ahmet Kilic
- The Ohio State University College of Medicine, Department of Surgery and the Davis Heart Lung Research Institute, Richard M. Ross Heart Hospital, 452 West 10th Ave., Columbus, OH 43210.
| | - Paul M L Janssen
- The Ohio State University College of Medicine, Department of Physiology and Cell Biology and the Davis Heart Lung Research Institute, 200 Hamilton Hall, 1645 Neil Avenue, Columbus, OH 43210.
| | - Dawn A Delfín
- The University of New Mexico College of Pharmacy, Department of Pharmaceutical Sciences, MSC09 5360, 1 University of New Mexico, Albuquerque, NM 87131, USA.
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Increased Nucleosomes and Neutrophil Activation Link to Disease Progression in Patients with Scrub Typhus but Not Murine Typhus in Laos. PLoS Negl Trop Dis 2015; 9:e0003990. [PMID: 26317419 PMCID: PMC4552835 DOI: 10.1371/journal.pntd.0003990] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Accepted: 07/15/2015] [Indexed: 11/19/2022] Open
Abstract
Cell-mediated immunity is essential in protection against rickettsial illnesses, but the role of neutrophils in these intracellular vasculotropic infections remains unclear. This study analyzed the plasma levels of nucleosomes, FSAP-activation (nucleosome-releasing factor), and neutrophil activation, as evidenced by neutrophil-elastase (ELA) complexes, in sympatric Lao patients with scrub typhus and murine typhus. In acute scrub typhus elevated nucleosome levels correlated with lower GCS scores, raised respiratory rate, jaundice and impaired liver function, whereas neutrophil activation correlated with fibrinolysis and high IL-8 plasma levels, a recently identified predictor of severe disease and mortality. Nucleosome and ELA complex levels were associated with a 4.8-fold and 4-fold increased risk of developing severe scrub typhus, beyond cut off values of 1,040 U/ml for nucleosomes and 275 U/ml for ELA complexes respectively. In murine typhus, nucleosome levels associated with pro-inflammatory cytokines and the duration of illness, while ELA complexes correlated strongly with inflammation markers, jaundice and increased respiratory rates. This study found strong correlations between circulating nucleosomes and neutrophil activation in patients with scrub typhus, but not murine typhus, providing indirect evidence that nucleosomes could originate from neutrophil extracellular trap (NET) degradation. High circulating plasma nucleosomes and ELA complexes represent independent risk factors for developing severe complications in scrub typhus. As nucleosomes and histones exposed on NETs are highly cytotoxic to endothelial cells and are strongly pro-coagulant, neutrophil-derived nucleosomes could contribute to vascular damage, the pro-coagulant state and exacerbation of disease in scrub typhus, thus indicating a detrimental role of neutrophil activation. The data suggest that increased neutrophil activation relates to disease progression and severe complications, and increased plasma levels of nucleosomes and ELA complexes represent independent risk factors for developing severe scrub typhus. Tropical rickettsial illnesses, especially scrub typhus and murine typhus, are increasingly recognized as a leading cause of treatable undifferentiated febrile illness in Asia, but remain severely neglected and under appreciated diseases in many areas. In this study we investigated the relationship of markers of neutrophil activation and cell death with disease severity in patients with acute scrub typhus and murine typhus in Laos. These easily measurable circulating markers were associated with a 4 to 5-fold increased risk of developing severe clinical disease manifestations in scrub typhus and represent independent predictors of severe disease, and possibly death. We also found strong correlations between circulating markers of cell death and neutrophil activation in patients with scrub typhus, but not murine typhus, providing indirect evidence that neutrophil extracellular traps could contribute to the vascular damage and pro-coagulant state leading to exacerbation of disease in scrub typhus, thus indicating a detrimental role of neutrophil activation. The data suggest that increased neutrophil activation relates to disease progression and severe complications, and increased plasma levels of nucleosomes and ELA complexes represent independent risk factors for developing severe scrub typhus.
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Zhou P, Wu E, Alam HB, Li Y. Histone cleavage as a mechanism for epigenetic regulation: current insights and perspectives. Curr Mol Med 2015; 14:1164-72. [PMID: 25323999 DOI: 10.2174/1566524014666141015155630] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 07/28/2014] [Accepted: 07/29/2014] [Indexed: 11/22/2022]
Abstract
Discovered over a century ago, histones constitute one of the oldest families of proteins and have been remarkably conserved throughout eukaryotic evolution. However, only for the past 30 years have histones demonstrated that their influence extends far beyond packaging DNA. To create the various chromatin structures that are necessary for DNA function in higher eukaryotes, histones undergo posttranslational modifications. While many such modifications are well documented, others, such as histone tail cleavage are less understood. Recent studies have discovered several proteases that cleave histones and have suggested roles for clipped histones in stem cell differentiation and aging in addition to infection and inflammation; the underlying mechanisms, however, are uncertain. One histone class in particular, histone H3, has received outstanding interest due to its numerous N-terminal modification sites and prevalence in regulating homeostatic processes. Here, with special consideration of H3, we will discuss the novel findings regarding histone proteolytic cleavage as well as their significance in the studies of immunology and epigenetics.
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Affiliation(s)
| | | | | | - Y Li
- University of Michigan Medical School, Section of General Surgery, University of Michigan Hospital, Ann Arbor, MI 48109, USA.
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A Nationwide Study of Norwegian Patients with Hereditary Angioedema with C1 Inhibitor Deficiency Identified Six Novel Mutations in SERPING1. PLoS One 2015; 10:e0131637. [PMID: 26154504 PMCID: PMC4496036 DOI: 10.1371/journal.pone.0131637] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 06/05/2015] [Indexed: 11/24/2022] Open
Abstract
Hereditary angioedema with C1 inhibitor deficiency (C1-INH-HAE) is characterized by relapsing, non-pruritic swelling in skin and submucosal tissue. Symptoms can appear in early infancy when diagnosis is more difficult. In the absence of a correct diagnosis, treatment of abdominal attacks often lead to unnecessary surgery, and laryngeal edema can cause asphyxiation. A cohort study of 52 patients from 25 unrelated families in Norway was studied. Diagnosis of C1-INH-HAE was based on international consensus criteria including low functional and/or antigenic C1-INH values and antigenic C4. As SERPING1 mutations in Norwegian patients with C1-INH-HAE are largely undescribed and could help in diagnosis, we aimed to find and describe these mutations. Mutation analysis of the SERPING1 gene was performed by Sanger sequencing of all protein coding exons and exon-intron boundaries. Samples without detected mutation were further analyzed by multiplex ligation-dependent probe amplification to detect deletions and duplications. Novel mutations suspected to lead to splice defects were analyzed on the mRNA level. Fifty-two patients from 25 families were included. Forty-four (84,6%) suffered from C1-INH-HAE type I and eight (15,4%) suffered from C1-INH-HAE type II. Pathogenic or likely pathogenic mutations were found in 22/25 families (88%). Thirteen unique mutations were detected, including six previously undescribed. There were three missense mutations including one mutation affecting the reactive center loop at codon 466, three nonsense mutations, three small deletions/duplications, three gross deletions, and one splice mutation.
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Parahuleva MS, Kanse S, Hölschermann H, Zheleva K, Zandt D, Worsch M, Parviz B, Güttler N, Tillmanns H, Böning A, Erdogan A. Association of circulating factor seven activating protease (FSAP) and of oral Omega-3 fatty acids supplements with clinical outcome in patients with atrial fibrillation: the OMEGA-AF study. J Thromb Thrombolysis 2015; 37:317-25. [PMID: 23575879 DOI: 10.1007/s11239-013-0921-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Factor VII Activating Protease (FSAP) activates factor VII (FVII) as well as pro-urokinase (uPA). Our goal was to evaluate the relation between plasma levels of FSAP and clinical instability in atrial fibrillation (AF) and possible effects of oral omega-3 fatty acids (FA) supplements. 101 patients with persistent AF were analyzed in the OMEGA-AF Study. Plasma FSAP levels were measured at baseline and after 12 weeks of treatment with omega-3 FA. The median FSAP antigen concentration, in contrast to FSAP activity, was higher in patients with persistent AF. The maintenance of SR after successful cardioversion (CV) did not lead to a normalization of FSAP concentration. Supplementation with omega-3 FA but not placebo significantly reduced elevated FSAP concentration. Furthermore, elevated FSAP levels did not indicate a significantly increased risk of recurrence of AF after electrical CV or cardiovascular clinical events during 1 year of follow-up. Plasma FSAP concentration was increased in patients with AF and may be involved in the pathogenesis of this condition. The possible effects of omega-3 FA on clinical AF potential could be linked with modulation of circulating FSAP levels.
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Affiliation(s)
- Mariana S Parahuleva
- Internal Medicine I/Cardiology and Angiology, University Hospital of Giessen and Marburg, Klinikstr. 36, 35392, Giessen, Germany,
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Parahuleva MS, Maj R, Hölschermann H, Parviz B, Abdallah Y, Erdogan A, Tillmanns H, Kanse SM. Regulation of monocyte/macrophage function by factor VII activating protease (FSAP). Atherosclerosis 2013; 230:365-72. [PMID: 24075769 DOI: 10.1016/j.atherosclerosis.2013.08.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 06/29/2013] [Accepted: 08/06/2013] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Factor VII activating protease (FSAP) is a novel regulator of vascular inflammation and hemostasis. However, the molecular mechanism by which circulating FSAP influences inflammatory events and progression of atherosclerosis is not yet entirely understood. Here we have investigated the influence of FSAP on monocyte/macrophage functions. METHODS We stimulated human monocyte-derived macrophages with FSAP and analyzed their cellular responses. RESULTS FSAP induced IκB-dependent NF-κB activation in a time- and concentration-dependent fashion. FSAP also activated the phosphorylation and proteolytic degradation of the inhibitor protein IκBα. The phosphorylation of the p65 subunit of NF-κB was induced by FSAP, which is known to contribute to the enhancement of DNA-binding activity of NF-κB. Concomitantly, FSAP up-regulated the expression of pro-inflammatory cytokines, matrix metalloproteinases, cell adhesion molecules and tissue factor. In the presence of FSAP there was increased monocytes adhesion and transendothelial migration in a beta2 integrin dependent manner. CONCLUSIONS Our findings suggest that FSAP activates the NF-κB pathway and the associated downstream pro-inflammatory factors in monocytic cells. This adds to a spectrum of FSAP effects on the vascular system that may explain its association with cardiovascular diseases.
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Affiliation(s)
- Mariana S Parahuleva
- Internal Medicine I/Cardiology and Angiology, Innere Medizin I - Kardiologie, Bad Homburg, Germany.
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