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Baillie K, Davies HE, Keat SBK, Ladell K, Miners KL, Jones SA, Mellou E, Toonen EJM, Price DA, Morgan BP, Zelek WM. Complement dysregulation is a prevalent and therapeutically amenable feature of long COVID. Med 2024; 5:239-253.e5. [PMID: 38359836 DOI: 10.1016/j.medj.2024.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 11/09/2023] [Accepted: 01/22/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Long COVID encompasses a heterogeneous set of ongoing symptoms that affect many individuals after recovery from infection with SARS-CoV-2. The underlying biological mechanisms nonetheless remain obscure, precluding accurate diagnosis and effective intervention. Complement dysregulation is a hallmark of acute COVID-19 but has not been investigated as a potential determinant of long COVID. METHODS We quantified a series of complement proteins, including markers of activation and regulation, in plasma samples from healthy convalescent individuals with a confirmed history of infection with SARS-CoV-2 and age/ethnicity/sex/infection/vaccine-matched patients with long COVID. FINDINGS Markers of classical (C1s-C1INH complex), alternative (Ba, iC3b), and terminal pathway (C5a, TCC) activation were significantly elevated in patients with long COVID. These markers in combination had a receiver operating characteristic predictive power of 0.794. Other complement proteins and regulators were also quantitatively different between healthy convalescent individuals and patients with long COVID. Generalized linear modeling further revealed that a clinically tractable combination of just four of these markers, namely the activation fragments iC3b, TCC, Ba, and C5a, had a predictive power of 0.785. CONCLUSIONS These findings suggest that complement biomarkers could facilitate the diagnosis of long COVID and further suggest that currently available inhibitors of complement activation could be used to treat long COVID. FUNDING This work was funded by the National Institute for Health Research (COV-LT2-0041), the PolyBio Research Foundation, and the UK Dementia Research Institute.
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Affiliation(s)
- Kirsten Baillie
- Division of Infection and Immunity, Cardiff University School of Medicine, University Hospital of Wales, Heath Park, Cardiff CF14 4XN, UK
| | - Helen E Davies
- Department of Respiratory Medicine, University Hospital of Wales, Llandough, Penarth CF64 2XX, UK
| | - Samuel B K Keat
- Division of Infection and Immunity, Cardiff University School of Medicine, University Hospital of Wales, Heath Park, Cardiff CF14 4XN, UK
| | - Kristin Ladell
- Division of Infection and Immunity, Cardiff University School of Medicine, University Hospital of Wales, Heath Park, Cardiff CF14 4XN, UK
| | - Kelly L Miners
- Division of Infection and Immunity, Cardiff University School of Medicine, University Hospital of Wales, Heath Park, Cardiff CF14 4XN, UK
| | - Samantha A Jones
- Department of Respiratory Medicine, University Hospital of Wales, Llandough, Penarth CF64 2XX, UK
| | - Ermioni Mellou
- Division of Infection and Immunity, Cardiff University School of Medicine, University Hospital of Wales, Heath Park, Cardiff CF14 4XN, UK
| | - Erik J M Toonen
- R&D Department, Hycult Biotechnology, Frontstraat 2A, 5405 PB Uden, the Netherlands
| | - David A Price
- Division of Infection and Immunity, Cardiff University School of Medicine, University Hospital of Wales, Heath Park, Cardiff CF14 4XN, UK; Systems Immunity Research Institute, Cardiff University School of Medicine, University Hospital of Wales, Heath Park, Cardiff CF14 4XN, UK
| | - B Paul Morgan
- Division of Infection and Immunity, Cardiff University School of Medicine, University Hospital of Wales, Heath Park, Cardiff CF14 4XN, UK; Systems Immunity Research Institute, Cardiff University School of Medicine, University Hospital of Wales, Heath Park, Cardiff CF14 4XN, UK.
| | - Wioleta M Zelek
- Division of Infection and Immunity, Cardiff University School of Medicine, University Hospital of Wales, Heath Park, Cardiff CF14 4XN, UK; Systems Immunity Research Institute, Cardiff University School of Medicine, University Hospital of Wales, Heath Park, Cardiff CF14 4XN, UK
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Kamegai N, Kim H, Suzuki Y, Fukui S, Kojima H, Maruyama S, Morgan BP, Zelek WM, Mizuno M. Complement terminal pathway inhibition reduces peritoneal injuries in a rat peritonitis model. Clin Exp Immunol 2023; 214:209-218. [PMID: 37549240 PMCID: PMC10714190 DOI: 10.1093/cei/uxad088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 06/07/2023] [Accepted: 08/07/2023] [Indexed: 08/09/2023] Open
Abstract
Peritonitis and the resulting peritoneal injuries are common problems that prevent long-term peritoneal dialysis (PD) therapy in patients with end-stage kidney diseases. Previously, we have analyzed the relationship between the complement system and progression of peritoneal injuries associated with PD, particularly focusing on the early activation pathways and effects of the anaphylatoxins. We here utilized a novel mAb 2H2 that blocks assembly of the membrane attack complex (MAC) to investigate roles of the complement terminal pathway in PD-associated peritoneal injury. We intraperitoneally injected mAb 2H2 anti-C5b-7 (2.5 or 5 mg/rat) once or twice over the five-day course of the experiment to investigate the effects of inhibiting formation of MAC in a fungal rat peritonitis model caused by repeated intraperitoneal administration of zymosan after methylglyoxal pretreatment (Zy/MGO model). Rats were sacrificed on day 5 and macroscopic changes in both parietal and visceral peritoneum evaluated. Peritoneal thickness, the abundance of fibrinogen and complement C3 and MAC deposition in tissue and accumulation of inflammatory cells were pathologically assessed. The results showed that mAb 2H2, but not isotype control mAb, reduced peritoneal thickness and accumulation of inflammatory cells in a dose and frequency-dependent manner in the Zy/MGO model. These effects were accompanied by decreased C3, MAC, and fibrinogen deposition in peritoneum. In conclusion, in the rat Zy/MGO model, complement terminal pathway activation and MAC formation substantially contributed to development of peritoneal injuries, suggesting that MAC-targeted therapies might be effective in preventing development of peritoneal injuries in humans.
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Affiliation(s)
- Naoki Kamegai
- Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hangsoo Kim
- Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuhiro Suzuki
- Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sosuke Fukui
- Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroshi Kojima
- Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shoichi Maruyama
- Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - B Paul Morgan
- Division of Infection and Immunity, and Dementia Research Institute, School of Medicine, Cardiff University, Cardiff, UK
| | - Wioleta Milena Zelek
- Division of Infection and Immunity, and Dementia Research Institute, School of Medicine, Cardiff University, Cardiff, UK
| | - Masashi Mizuno
- Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Bowen EE, Hurcombe JA, Barrington F, Keir LS, Farmer LK, Wherlock MD, Ortiz-Sandoval CG, Bruno V, Bohorquez-Hernandez A, Diatlov D, Rostam-Shirazi N, Wells S, Stewart M, Teboul L, Lay AC, Butler MJ, Pope RJP, Larkai EMS, Morgan BP, Moppett J, Satchell SC, Welsh GI, Walker PD, Licht C, Saleem MA, Coward RJM. Shiga toxin targets the podocyte causing hemolytic uremic syndrome through endothelial complement activation. Med 2023; 4:761-777.e8. [PMID: 37863058 DOI: 10.1016/j.medj.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 07/18/2023] [Accepted: 09/18/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Shiga toxin (Stx)-producing Escherichia coli hemolytic uremic syndrome (STEC-HUS) is the leading cause of acute kidney injury in children, with an associated mortality of up to 5%. The mechanisms underlying STEC-HUS and why the glomerular microvasculature is so susceptible to injury following systemic Stx infection are unclear. METHODS Transgenic mice were engineered to express the Stx receptor (Gb3) exclusively in their kidney podocytes (Pod-Gb3) and challenged with systemic Stx. Human glomerular cell models and kidney biopsies from patients with STEC-HUS were also studied. FINDINGS Stx-challenged Pod-Gb3 mice developed STEC-HUS. This was mediated by a reduction in podocyte vascular endothelial growth factor A (VEGF-A), which led to loss of glomerular endothelial cell (GEnC) glycocalyx, a reduction in GEnC inhibitory complement factor H binding, and local activation of the complement pathway. Early therapeutic inhibition of the terminal complement pathway with a C5 inhibitor rescued this podocyte-driven, Stx-induced HUS phenotype. CONCLUSIONS This study potentially explains why systemic Stx exposure targets the glomerulus and supports the early use of terminal complement pathway inhibition in this devastating disease. FUNDING This work was supported by the UK Medical Research Council (MRC) (grant nos. G0901987 and MR/K010492/1) and Kidney Research UK (grant nos. TF_007_20151127, RP42/2012, and SP/FSGS1/2013). The Mary Lyon Center is part of the MRC Harwell Institute and is funded by the MRC (A410).
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Affiliation(s)
- Emily E Bowen
- Bristol Renal, Bristol Medical School, University of Bristol, Bristol BS1 3NY, UK; The Hospital for Sick Children, Toronto, ON MG5 1X8, Canada; University of Manchester, Manchester M13 9PT, UK.
| | - Jennifer A Hurcombe
- Bristol Renal, Bristol Medical School, University of Bristol, Bristol BS1 3NY, UK
| | - Fern Barrington
- Bristol Renal, Bristol Medical School, University of Bristol, Bristol BS1 3NY, UK
| | - Lindsay S Keir
- Bristol Renal, Bristol Medical School, University of Bristol, Bristol BS1 3NY, UK
| | - Louise K Farmer
- Bristol Renal, Bristol Medical School, University of Bristol, Bristol BS1 3NY, UK
| | - Matthew D Wherlock
- Bristol Renal, Bristol Medical School, University of Bristol, Bristol BS1 3NY, UK
| | | | | | | | - Daniel Diatlov
- The Hospital for Sick Children, Toronto, ON MG5 1X8, Canada
| | | | - Sara Wells
- MRC Harwell Institute, Mary Lyon Centre, Harwell Campus, Oxfordshire OX11 0RD, UK
| | - Michelle Stewart
- MRC Harwell Institute, Mary Lyon Centre, Harwell Campus, Oxfordshire OX11 0RD, UK
| | - Lydia Teboul
- MRC Harwell Institute, Mary Lyon Centre, Harwell Campus, Oxfordshire OX11 0RD, UK
| | - Abigail C Lay
- Bristol Renal, Bristol Medical School, University of Bristol, Bristol BS1 3NY, UK; University of Manchester, Manchester M13 9PT, UK
| | - Matthew J Butler
- Bristol Renal, Bristol Medical School, University of Bristol, Bristol BS1 3NY, UK
| | - Robert J P Pope
- Bristol Renal, Bristol Medical School, University of Bristol, Bristol BS1 3NY, UK
| | - Eva M S Larkai
- Bristol Renal, Bristol Medical School, University of Bristol, Bristol BS1 3NY, UK
| | - B Paul Morgan
- UK Dementia Research Institute Cardiff and Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff CF144XN. UK
| | - John Moppett
- Bristol Royal Hospital for Sick Children, Bristol BS2 8BJ, UK
| | - Simon C Satchell
- Bristol Renal, Bristol Medical School, University of Bristol, Bristol BS1 3NY, UK
| | - Gavin I Welsh
- Bristol Renal, Bristol Medical School, University of Bristol, Bristol BS1 3NY, UK
| | | | | | - Moin A Saleem
- Bristol Renal, Bristol Medical School, University of Bristol, Bristol BS1 3NY, UK; Bristol Royal Hospital for Sick Children, Bristol BS2 8BJ, UK
| | - Richard J M Coward
- Bristol Renal, Bristol Medical School, University of Bristol, Bristol BS1 3NY, UK; Bristol Royal Hospital for Sick Children, Bristol BS2 8BJ, UK.
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Karbian N, Eshed-Eisenbach Y, Zeibak M, Tabib A, Sukhanov N, Vainshtein A, Morgan BP, Fellig Y, Peles E, Mevorach D. Complement-membrane regulatory proteins are absent from the nodes of Ranvier in the peripheral nervous system. J Neuroinflammation 2023; 20:245. [PMID: 37875972 PMCID: PMC10594684 DOI: 10.1186/s12974-023-02920-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 10/02/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Homozygous CD59-deficient patients manifest with recurrent peripheral neuropathy resembling Guillain-Barré syndrome (GBS), hemolytic anemia and recurrent strokes. Variable mutations in CD59 leading to loss of function have been described and, overall, 17/18 of patients with any mutation presented with recurrent GBS. Here we determine the localization and possible role of membrane-bound complement regulators, including CD59, in the peripheral nervous systems (PNS) of mice and humans. METHODS We examined the localization of membrane-bound complement regulators in the peripheral nerves of healthy humans and a CD59-deficient patient, as well as in wild-type (WT) and CD59a-deficient mice. Cross sections of teased sciatic nerves and myelinating dorsal root ganglia (DRG) neuron/Schwann cell cultures were examined by confocal and electron microscopy. RESULTS We demonstrate that CD59a-deficient mice display normal peripheral nerve morphology but develop myelin abnormalities in older age. They normally express myelin protein zero (P0), ankyrin G (AnkG), Caspr, dystroglycan, and neurofascin. Immunolabeling of WT nerves using antibodies to CD59 and myelin basic protein (MBP), P0, and AnkG revealed that CD59 was localized along the internode but was absent from the nodes of Ranvier. CD59 was also detected in blood vessels within the nerve. Finally, we show that the nodes of Ranvier lack other complement-membrane regulatory proteins, including CD46, CD55, CD35, and CR1-related gene-y (Crry), rendering this area highly exposed to complement attack. CONCLUSION The Nodes of Ranvier lack CD59 and are hence not protected from complement terminal attack. The myelin unit in human PNS is protected by CD59 and CD55, but not by CD46 or CD35. This renders the nodes and myelin in the PNS vulnerable to complement attack and demyelination in autoinflammatory Guillain-Barré syndrome, as seen in CD59 deficiency.
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Affiliation(s)
- Netanel Karbian
- Rheumatology and Rare Disease Research Center, The Wohl Institute for Translational Medicine, Hadassah-Hebrew University Medical Center and School of Medicine, Jerusalem, Israel
| | - Yael Eshed-Eisenbach
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
- Department of Molecular Neuroscience, Weizmann Institute of Science, Rehovot, Israel
| | - Marian Zeibak
- Rheumatology and Rare Disease Research Center, The Wohl Institute for Translational Medicine, Hadassah-Hebrew University Medical Center and School of Medicine, Jerusalem, Israel
| | - Adi Tabib
- Rheumatology and Rare Disease Research Center, The Wohl Institute for Translational Medicine, Hadassah-Hebrew University Medical Center and School of Medicine, Jerusalem, Israel
| | - Natasha Sukhanov
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
- Department of Molecular Neuroscience, Weizmann Institute of Science, Rehovot, Israel
| | - Anya Vainshtein
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
- Department of Molecular Neuroscience, Weizmann Institute of Science, Rehovot, Israel
| | - B. Paul Morgan
- Systems Immunity Research Institute, Cardiff University, Cardiff, Wales UK
| | - Yakov Fellig
- Department of Pathology, School of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Elior Peles
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
- Department of Molecular Neuroscience, Weizmann Institute of Science, Rehovot, Israel
| | - Dror Mevorach
- Rheumatology and Rare Disease Research Center, The Wohl Institute for Translational Medicine, Hadassah-Hebrew University Medical Center and School of Medicine, Jerusalem, Israel
- The Institute of Rheumatology-Immunology-Allergology, The Wohl Institute for Translational Medicine, Department of Medicine, Hadassah-Hebrew University Medical Center and School of Medicine, POB 12000, 91120 Jerusalem, Israel
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5
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Daskoulidou N, Shaw B, Torvell M, Watkins L, Cope EL, Carpanini SM, Allen ND, Morgan BP. Complement receptor 1 is expressed on brain cells and in the human brain. Glia 2023; 71:1522-1535. [PMID: 36825534 PMCID: PMC10953339 DOI: 10.1002/glia.24355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 02/05/2023] [Accepted: 02/09/2023] [Indexed: 02/25/2023]
Abstract
Genome wide association studies (GWAS) have highlighted the importance of the complement cascade in pathogenesis of Alzheimer's disease (AD). Complement receptor 1 (CR1; CD35) is among the top GWAS hits. The long variant of CR1 is associated with increased risk for AD; however, roles of CR1 in brain health and disease are poorly understood. A critical confounder is that brain expression of CR1 is controversial; failure to demonstrate brain expression has provoked the suggestion that peripherally expressed CR1 influences AD risk. We took a multi-pronged approach to establish whether CR1 is expressed in brain. Expression of CR1 at the protein and mRNA level was assessed in human microglial lines, induced pluripotent stem cell (iPSC)-derived microglia from two sources and brain tissue from AD and control donors. CR1 protein was detected in microglial lines and iPSC-derived microglia expressing different CR1 variants when immunostained with a validated panel of CR1-specific antibodies; cell extracts were positive for CR1 protein and mRNA. CR1 protein was detected in control and AD brains, co-localizing with astrocytes and microglia, and expression was significantly increased in AD compared to controls. CR1 mRNA expression was detected in all AD and control brain samples tested; expression was significantly increased in AD. The data unequivocally demonstrate that the CR1 transcript and protein are expressed in human microglia ex vivo and on microglia and astrocytes in situ in the human brain; the findings support the hypothesis that CR1 variants affect AD risk by directly impacting glial functions.
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Affiliation(s)
| | - Bethany Shaw
- UK Dementia Research Institute, Cardiff UniversityCardiffUK
| | - Megan Torvell
- UK Dementia Research Institute, Cardiff UniversityCardiffUK
| | - Lewis Watkins
- UK Dementia Research Institute, Cardiff UniversityCardiffUK
| | - Emma L. Cope
- School of Biosciences, Cardiff UniversityCardiffUK
| | | | - Nicholas D. Allen
- UK Dementia Research Institute, Cardiff UniversityCardiffUK
- School of Biosciences, Cardiff UniversityCardiffUK
| | - B. Paul Morgan
- UK Dementia Research Institute, Cardiff UniversityCardiffUK
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Goff LM, Davies K, Zelek WM, Kodosaki E, Hakim O, Lockhart S, O’Rahilly S, Morgan BP. Ethnic differences in complement system biomarkers and their association with metabolic health in men of Black African and White European ethnicity. Clin Exp Immunol 2023; 212:52-60. [PMID: 36722378 PMCID: PMC10081104 DOI: 10.1093/cei/uxad011] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 12/18/2022] [Accepted: 01/31/2023] [Indexed: 02/02/2023] Open
Abstract
Inflammation plays a fundamental role in the development of several metabolic diseases, including obesity and type 2 diabetes (T2D); the complement system has been implicated in their development. People of Black African (BA) ethnicity are disproportionately affected by T2D and other metabolic diseases but the impact of ethnicity on the complement system has not been explored. We investigated ethnic differences in complement biomarkers and activation status between men of BA and White European (WE) ethnicity and explored their association with parameters of metabolic health. We measured a panel of 15 complement components, regulators, and activation products in fasting plasma from 89 BA and 96 WE men. Ethnic differences were statistically validated. Association of complement biomarkers with metabolic health indices (BMI, waist circumference, insulin resistance, and HbA1c) were assessed in the groups. Plasma levels of the key complement components C3 and C4, the regulators clusterin and properdin and the activation marker iC3b were significantly higher in BA compared to WE men after age adjustment, while FD levels were significantly lower. C3 and C4 levels positively correlated with some or all markers of metabolic dysfunction in both ethnic groups while FD was inversely associated with HbA1c in both groups, and clusterin and properdin were inversely associated with some markers of metabolic dysfunction only in the WE group. Our findings of increased levels of complement components and activation products in BA compared to WE men suggest differences in complement regulation that may impact susceptibility to poor metabolic health.
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Affiliation(s)
- L M Goff
- Department of Nutritional Sciences, School of Population & Life Course Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK
| | - K Davies
- Dementia Research Institute Cardiff, School of Medicine, Cardiff University, Cardiff, UK
| | - W M Zelek
- Dementia Research Institute Cardiff, School of Medicine, Cardiff University, Cardiff, UK
| | - E Kodosaki
- Dementia Research Institute Cardiff, School of Medicine, Cardiff University, Cardiff, UK
| | - O Hakim
- Department of Nutritional Sciences, School of Population & Life Course Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK
- School of Life & Health Sciences, University of Roehampton, London, UK
| | - S Lockhart
- MRC Metabolic Diseases Unit & Wellcome-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - S O’Rahilly
- MRC Metabolic Diseases Unit & Wellcome-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - B P Morgan
- Dementia Research Institute Cardiff, School of Medicine, Cardiff University, Cardiff, UK
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Veteleanu A, Pape S, Davies K, Kodosaki E, Hye A, Zelek WM, Strydom A, Morgan BP. Complement dysregulation and Alzheimer's disease in Down syndrome. Alzheimers Dement 2023; 19:1383-1392. [PMID: 36149090 PMCID: PMC10798358 DOI: 10.1002/alz.12799] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/03/2022] [Accepted: 08/24/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Down syndrome (DS) is associated with immune dysregulation and a high risk of early onset Alzheimer's disease (AD). Complement is a key part of innate immunity and driver of pathological inflammation, including neuroinflammation in AD. Complement dysregulation has been reported in DS; however, the pattern of dysregulation and its relationship to AD risk is unclear. METHODS Plasma levels of 14 complement biomarkers were measured in 71 adults with DS and 46 controls to identify DS-associated dysregulation; impact of apolipoprotein E (APOE) ε4 genotype, single nucleotide polymorphisms (SNPs) in CLU and CR1, and dementia on complement biomarkers was assessed. RESULTS Plasma levels of complement activation products (TCC, iC3b), proteins (C1q, C3, C9), and regulators (C1 inhibitor, factor H, FHR4, clusterin) were significantly elevated in DS versus controls while FI and sCR1 were significantly lower. In DS with AD (n = 13), C3 and FI were significantly decreased compared to non-AD DS (n = 58). Neither APOE genotype nor CLU SNPs impacted complement levels, while rs6656401 in CR1 significantly impacted plasma sCR1 levels. CONCLUSIONS Complement is dysregulated in DS, likely reflecting the generalized immune dysregulation state; measurement may help identify inflammatory events in individuals with DS. Complement biomarkers differed in DS with and without AD and may aid diagnosis and/or prediction. HIGHLIGHTS Complement is significantly dysregulated in plasma of people with DS who show changes in levels of multiple complement proteins compared to controls. People with DS and dementia show evidence of additional complement dysregulation with significantly lower levels of C3 and factor I compared to those without dementia. rs6656401 in CR1 was associated with significantly elevated sCR1 plasma levels in DS.
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Affiliation(s)
- Aurora Veteleanu
- School of MedicineUK Dementia Research InstituteCardiff UniversityCardiffUK
| | - Sarah Pape
- Department of Forensic and Neurodevelopmental ScienceInstitute of PsychiatryPsychology and NeuroscienceKing's CollegeLondonUK
| | - Kate Davies
- School of Medicine, Division of Infection and ImmunityCardiff UniversityCardiffUK
| | - Eleftheria Kodosaki
- School of Medicine, Division of Infection and ImmunityCardiff UniversityCardiffUK
| | - Abdul Hye
- Department of Forensic and Neurodevelopmental ScienceInstitute of PsychiatryPsychology and NeuroscienceKing's CollegeLondonUK
| | - Wioleta M. Zelek
- School of MedicineUK Dementia Research InstituteCardiff UniversityCardiffUK
- School of Medicine, Division of Infection and ImmunityCardiff UniversityCardiffUK
| | - Andre Strydom
- Department of Forensic and Neurodevelopmental ScienceInstitute of PsychiatryPsychology and NeuroscienceKing's CollegeLondonUK
| | - B. Paul Morgan
- School of MedicineUK Dementia Research InstituteCardiff UniversityCardiffUK
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Chen DW, Kang T, Xu XZ, Xia WJ, Ye X, Wu YB, Xu YR, Liu J, Ren H, Deng J, Chen YK, Ding HQ, Aslam M, Zelek WM, Morgan BP, Kapur R, Santoso S, Fu YS. Mechanism and intervention of murine transfusion-related acute lung injury caused by anti-CD36 antibodies. JCI Insight 2023; 8:165142. [PMID: 36809299 PMCID: PMC10070104 DOI: 10.1172/jci.insight.165142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/15/2023] [Indexed: 02/23/2023] Open
Abstract
Anti-CD36 Abs have been suggested to induce transfusion-related acute lung injury (TRALI) upon blood transfusion, particularly in Asian populations. However, little is known about the pathological mechanism of anti-CD36 Ab-mediated TRALI, and potential therapies have not yet been identified. Here, we developed a murine model of anti-CD36 Ab-mediated TRALI to address these questions. Administration of mouse mAb against CD36 (mAb GZ1) or human anti-CD36 IgG, but not GZ1 F(ab')2 fragments, induced severe TRALI in Cd36+/+ male mice. Predepletion of recipient monocytes or complement, but not neutrophils or platelets, prevented the development of murine TRALI. Moreover, plasma C5a levels after TRALI induction by anti-CD36 Abs increased more than 3-fold, implying a critical role of complement C5 activation in the mechanism of Fc-dependent anti-CD36-mediated TRALI. Administration of GZ1 F(ab')2, antioxidant (N-acetyl cysteine, NAC), or C5 blocker (mAb BB5.1) before TRALI induction completely protected mice from anti-CD36-mediated TRALI. Although no significant amelioration in TRALI was observed when mice were injected with GZ1 F(ab')2 after TRALI induction, significant improvement was achieved when mice were treated postinduction with NAC or anti-C5. Importantly, anti-C5 treatment completely rescued mice from TRALI, suggesting the potential role of existing anti-C5 drugs in the treatment of patients with TRALI caused by anti-CD36.
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Affiliation(s)
- Da-Wei Chen
- Institute of Blood Transfusion, Guangzhou Blood Centre, Guangzhou, Guangdong, China
- Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen, Germany
| | - Tian Kang
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiu-Zhang Xu
- Institute of Blood Transfusion, Guangzhou Blood Centre, Guangzhou, Guangdong, China
| | - Wen-Jie Xia
- Institute of Blood Transfusion, Guangzhou Blood Centre, Guangzhou, Guangdong, China
| | - Xin Ye
- Institute of Blood Transfusion, Guangzhou Blood Centre, Guangzhou, Guangdong, China
| | - Yong-Bin Wu
- The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yao-Ri Xu
- Institute of Blood Transfusion, Guangzhou Blood Centre, Guangzhou, Guangdong, China
| | - Jing Liu
- Institute of Blood Transfusion, Guangzhou Blood Centre, Guangzhou, Guangdong, China
| | - Hui Ren
- Institute of Blood Transfusion, Guangzhou Blood Centre, Guangzhou, Guangdong, China
| | - Jing Deng
- Institute of Blood Transfusion, Guangzhou Blood Centre, Guangzhou, Guangdong, China
| | - Yang-Kai Chen
- Institute of Blood Transfusion, Guangzhou Blood Centre, Guangzhou, Guangdong, China
| | - Hao-Qiang Ding
- Institute of Blood Transfusion, Guangzhou Blood Centre, Guangzhou, Guangdong, China
| | - Muhammad Aslam
- Department of Cardiology and Angiology, Justus Liebig University, Giessen, Germany
| | - Wioleta M Zelek
- Dementia Research Institute, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - B Paul Morgan
- Dementia Research Institute, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Rick Kapur
- Department of Experimental Immunohematology, Sanquin Research and Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Sentot Santoso
- Institute of Blood Transfusion, Guangzhou Blood Centre, Guangzhou, Guangdong, China
- Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen, Germany
| | - Yong-Shui Fu
- Institute of Blood Transfusion, Guangzhou Blood Centre, Guangzhou, Guangdong, China
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, Guangdong, China
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9
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Evans R, Watkins LM, Hawkins K, Santiago G, Demetriou C, Naughton M, Dittmer M, Rees MI, Fitzgerald D, Morgan BP, Neal JW, Howell OW. Complement activation and increased anaphylatoxin receptor expression are associated with cortical grey matter lesions and the compartmentalised inflammatory response of multiple sclerosis. Front Cell Neurosci 2023; 17:1094106. [PMID: 37032838 PMCID: PMC10073739 DOI: 10.3389/fncel.2023.1094106] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/07/2023] [Indexed: 04/11/2023] Open
Abstract
Background The extent of cortical pathology is an important determinant of multiple sclerosis (MS) severity. Cortical demyelination and neurodegeneration are related to inflammation of the overlying leptomeninges, a more inflammatory CSF milieu and with parenchymal microglia and astroglia activation. These are all components of the compartmentalised inflammatory response. Compartmentalised inflammation is a feature of progressive MS, which is not targeted by disease modifying therapies. Complement is differentially expressed in the MS CSF and complement, and complement receptors, are associated with demyelination and neurodegeneration. Methods To better understand if complement activation in the leptomeninges is associated with underlying cortical demyelination, inflammation, and microglial activation, we performed a neuropathological study of progressive MS (n = 22, 14 females), neuroinflammatory (n = 8), and non-neurological disease controls (n = 10). We then quantified the relative extent of demyelination, connective tissue inflammation, complement, and complement receptor positive microglia/macrophages. Results Complement was elevated at the leptomeninges, subpial, and within and around vessels of the cortical grey matter. The extent of complement C1q immunoreactivity correlated with connective tissue infiltrates, whilst activation products C4d, Bb, and C3b associated with grey matter demyelination, and C3a receptor 1+ and C5a receptor 1+ microglia/macrophages closely apposed C3b labelled cells. The density of C3a receptor 1+ and C5a receptor 1+ cells was increased at the expanding edge of subpial and leukocortical lesions. C5a receptor 1+ cells expressed TNFα, iNOS and contained puncta immunoreactive for proteolipid protein, neurofilament and synaptophysin, suggesting their involvement in grey matter lesion expansion. Interpretation The presence of products of complement activation at the brain surfaces, their association with the extent of underlying pathology and increased complement anaphylatoxin receptor positive microglia/macrophages at expanding cortical grey matter lesions, could represent a target to modify compartmentalised inflammation and cortical demyelination.
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Affiliation(s)
- Rhian Evans
- Faculty of Medicine, Health and Life Sciences, Swansea University Medical School, Swansea, United Kingdom
| | - Lewis M. Watkins
- Faculty of Medicine, Health and Life Sciences, Swansea University Medical School, Swansea, United Kingdom
| | - Kristen Hawkins
- Faculty of Medicine, Health and Life Sciences, Swansea University Medical School, Swansea, United Kingdom
| | - Gabriella Santiago
- Faculty of Medicine, Health and Life Sciences, Swansea University Medical School, Swansea, United Kingdom
| | - Constantinos Demetriou
- Faculty of Medicine, Health and Life Sciences, Swansea University Medical School, Swansea, United Kingdom
| | - Michelle Naughton
- The Wellcome-Wolfson Institute for Experimental Medicine, Queen’s University Belfast, Belfast, United Kingdom
| | - Marie Dittmer
- Centre for Experimental Medicine, Queen’s University Belfast, Belfast, United Kingdom
| | - Mark I. Rees
- Faculty of Medicine and Health, The University of Sydney, Darlington, NSW, Australia
| | - Denise Fitzgerald
- The Wellcome-Wolfson Institute for Experimental Medicine, Queen’s University Belfast, Belfast, United Kingdom
| | - B. Paul Morgan
- School of Medicine, UK Dementia Research Institute Cardiff and Systems Immunity Research Institute, Cardiff University, Cardiff, United Kingdom
| | - James W. Neal
- Faculty of Medicine, Health and Life Sciences, Swansea University Medical School, Swansea, United Kingdom
| | - Owain W. Howell
- Faculty of Medicine, Health and Life Sciences, Swansea University Medical School, Swansea, United Kingdom
- *Correspondence: Owain W. Howell,
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10
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Seidel F, Kleemann R, van Duyvenvoorde W, van Trigt N, Keijzer N, van der Kooij S, van Kooten C, Verschuren L, Menke A, Kiliaan AJ, Winter J, Hughes TR, Morgan BP, Baas F, Fluiter K, Morrison MC. Therapeutic Intervention with Anti-Complement Component 5 Antibody Does Not Reduce NASH but Does Attenuate Atherosclerosis and MIF Concentrations in Ldlr-/-.Leiden Mice. Int J Mol Sci 2022; 23:ijms231810736. [PMID: 36142647 PMCID: PMC9506266 DOI: 10.3390/ijms231810736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/07/2022] [Accepted: 09/10/2022] [Indexed: 11/30/2022] Open
Abstract
Background: Chronic inflammation is an important driver in the progression of non-alcoholic steatohepatitis (NASH) and atherosclerosis. The complement system, one of the first lines of defense in innate immunity, has been implicated in both diseases. However, the potential therapeutic value of complement inhibition in the ongoing disease remains unclear. Methods: After 20 weeks of high-fat diet (HFD) feeding, obese Ldlr-/-.Leiden mice were treated twice a week with an established anti-C5 antibody (BB5.1) or vehicle control. A separate group of mice was kept on a chow diet as a healthy reference. After 12 weeks of treatment, NASH was analyzed histopathologically, and genome-wide hepatic gene expression was analyzed by next-generation sequencing and pathway analysis. Atherosclerotic lesion area and severity were quantified histopathologically in the aortic roots. Results: Anti-C5 treatment considerably reduced complement system activity in plasma and MAC deposition in the liver but did not affect NASH. Anti-C5 did, however, reduce the development of atherosclerosis, limiting the total lesion size and severity independently of an effect on plasma cholesterol but with reductions in oxidized LDL (oxLDL) and macrophage migration inhibitory factor (MIF). Conclusion: We show, for the first time, that treatment with an anti-C5 antibody in advanced stages of NASH is not sufficient to reduce the disease, while therapeutic intervention against established atherosclerosis is beneficial to limit further progression.
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Affiliation(s)
- Florine Seidel
- Department of Metabolic Health Research, Netherlands Organisation for Applied Scientific Research (TNO), 2333 CK Leiden, The Netherlands
- Department Medical Imaging, Anatomy, Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, 6525 EZ Nijmegen, The Netherlands
- Correspondence:
| | - Robert Kleemann
- Department of Metabolic Health Research, Netherlands Organisation for Applied Scientific Research (TNO), 2333 CK Leiden, The Netherlands
| | - Wim van Duyvenvoorde
- Department of Metabolic Health Research, Netherlands Organisation for Applied Scientific Research (TNO), 2333 CK Leiden, The Netherlands
| | - Nikki van Trigt
- Department of Metabolic Health Research, Netherlands Organisation for Applied Scientific Research (TNO), 2333 CK Leiden, The Netherlands
| | - Nanda Keijzer
- Department of Metabolic Health Research, Netherlands Organisation for Applied Scientific Research (TNO), 2333 CK Leiden, The Netherlands
| | - Sandra van der Kooij
- Department of Internal Medicine (Nephrology) and Transplant Center, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Cees van Kooten
- Department of Internal Medicine (Nephrology) and Transplant Center, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Lars Verschuren
- Department of Microbiology and Systems Biology, Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands
| | - Aswin Menke
- Department of Metabolic Health Research, Netherlands Organisation for Applied Scientific Research (TNO), 2333 CK Leiden, The Netherlands
| | - Amanda J. Kiliaan
- Department Medical Imaging, Anatomy, Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, 6525 EZ Nijmegen, The Netherlands
| | - Johnathan Winter
- Complement Biology Group, Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff CF14 4XN, UK
- UK Dementia Research Institute Cardiff, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK
| | - Timothy R. Hughes
- Complement Biology Group, Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff CF14 4XN, UK
- UK Dementia Research Institute Cardiff, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK
| | - B. Paul Morgan
- Complement Biology Group, Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff CF14 4XN, UK
- UK Dementia Research Institute Cardiff, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK
| | - Frank Baas
- Department of Clinical Genetics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Kees Fluiter
- Department of Clinical Genetics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Martine C. Morrison
- Department of Metabolic Health Research, Netherlands Organisation for Applied Scientific Research (TNO), 2333 CK Leiden, The Netherlands
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11
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Lekova E, Zelek WM, Gower D, Spitzfaden C, Osuch IH, John-Morris E, Stach L, Gormley D, Sanderson A, Bridges A, Wear ER, Petit-Frere S, Burden MN, Priest R, Wattam T, Kitchen SJ, Feeney M, Davis S, Morgan BP, Nichols EM. Discovery of functionally distinct anti-C7 monoclonal antibodies and stratification of anti-nicotinic AChR positive Myasthenia Gravis patients. Front Immunol 2022; 13:968206. [PMID: 36148231 PMCID: PMC9486540 DOI: 10.3389/fimmu.2022.968206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
Myasthenia Gravis (MG) is mediated by autoantibodies against acetylcholine receptors that cause loss of the receptors in the neuromuscular junction. Eculizumab, a C5-inhibitor, is the only approved treatment for MG that mechanistically addresses complement-mediated loss of nicotinic acetylcholine receptors. It is an expensive drug and was approved despite missing the primary efficacy endpoint in the Phase 3 REGAIN study. There are two observations to highlight. Firstly, further C5 inhibitors are in clinical development, but other terminal pathway proteins, such as C7, have been relatively understudied as therapeutic targets, despite the potential for lower and less frequent dosing. Secondly, given the known heterogenous mechanisms of action of autoantibodies in MG, effective patient stratification in the REGAIN trial may have provided more favorable efficacy readouts. We investigated C7 as a target and assessed the in vitro function, binding epitopes and mechanism of action of three mAbs against C7. We found the mAbs were human, cynomolgus monkey and/or rat cross-reactive and each had a distinct, novel mechanism of C7 inhibition. TPP1820 was effective in preventing experimental MG in rats in both prophylactic and therapeutic dosing regimens. To enable identification of MG patients that are likely to respond to C7 inhibition, we developed a patient stratification assay and showed in a small cohort of MG patients (n=19) that 63% had significant complement activation and C7-dependent loss of AChRs in this in vitro set up. This study provides validation of C7 as a target for treatment of MG and provides a means of identifying patients likely to respond to anti-C7 therapy based on complement-activating properties of patient autoantibodies.
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Affiliation(s)
- Eleonora Lekova
- Immunology Research Unit, GlaxoSmithKline Research & Development (GSK R&D), Stevenage, United Kingdom
| | - Wioleta M. Zelek
- Division of Infection and Immunity and Dementia Research Institute, Systems Immunity Research Institute, School of Medicine, Cardiff University, Wales, United Kingdom
| | - David Gower
- Medicinal Science and Technology, Biopharm Discovery, GlaxoSmithKline Research & Development (GSK R&D), Stevenage, United Kingdom
| | - Claus Spitzfaden
- Medicines, Science and Technology, Protein Cellular and Structural Sciences (PCSS) Structural and Biophysical Sciences, GlaxoSmithKline Research & Development (GSK R&D), Stevenage, United Kingdom
| | - Isabelle H. Osuch
- Immunology Research Unit, GlaxoSmithKline Research & Development (GSK R&D), Stevenage, United Kingdom
| | - Elen John-Morris
- Immunology Research Unit, GlaxoSmithKline Research & Development (GSK R&D), Stevenage, United Kingdom
| | - Lasse Stach
- Medicinal Science and Technology, Biopharm Discovery, GlaxoSmithKline Research & Development (GSK R&D), Stevenage, United Kingdom
| | - Darren Gormley
- Immunology Research Unit, GlaxoSmithKline Research & Development (GSK R&D), Stevenage, United Kingdom
| | - Andrew Sanderson
- Medicines, Science and Technology, Protein Cellular and Structural Sciences (PCSS) Protein and Cellular Sciences, GlaxoSmithKline Research & Development (GSK R&D), Stevenage, United Kingdom
| | - Angela Bridges
- Medicines, Science and Technology, Protein Cellular and Structural Sciences (PCSS) Protein and Cellular Sciences, GlaxoSmithKline Research & Development (GSK R&D), Stevenage, United Kingdom
| | - Elizabeth R. Wear
- Immunology Research Unit, GlaxoSmithKline Research & Development (GSK R&D), Stevenage, United Kingdom
| | - Sebastien Petit-Frere
- Immunology Research Unit, GlaxoSmithKline Research & Development (GSK R&D), Stevenage, United Kingdom
| | - Michael N. Burden
- Medicinal Science and Technology, Biopharm Discovery, GlaxoSmithKline Research & Development (GSK R&D), Stevenage, United Kingdom
| | - Richard Priest
- Medicinal Science and Technology, Biopharm Discovery, GlaxoSmithKline Research & Development (GSK R&D), Stevenage, United Kingdom
| | - Trevor Wattam
- Medicinal Science and Technology, Biopharm Discovery, GlaxoSmithKline Research & Development (GSK R&D), Stevenage, United Kingdom
| | - Semra J. Kitchen
- Immunology Research Unit, GlaxoSmithKline Research & Development (GSK R&D), Stevenage, United Kingdom
| | - Maria Feeney
- Immunology Research Unit, GlaxoSmithKline Research & Development (GSK R&D), Stevenage, United Kingdom
| | - Susannah Davis
- Medicinal Science and Technology, Biopharm Discovery, GlaxoSmithKline Research & Development (GSK R&D), Stevenage, United Kingdom
| | - B. Paul Morgan
- Division of Infection and Immunity and Dementia Research Institute, Systems Immunity Research Institute, School of Medicine, Cardiff University, Wales, United Kingdom
| | - Eva-Maria Nichols
- Immunology Research Unit, GlaxoSmithKline Research & Development (GSK R&D), Stevenage, United Kingdom
- *Correspondence: Eva-Maria Nichols,
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12
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Banda NK, Deane KD, Bemis EA, Strickland C, Seifert J, Jordan K, Goldman K, Morgan BP, Moreland LW, Lewis MJ, Pitzalis C, Holers VM. Analysis of Complement Gene Expression, Clinical Associations, and Biodistribution of Complement Proteins in the Synovium of Early Rheumatoid Arthritis Patients Reveals Unique Pathophysiologic Features. J Immunol 2022; 208:2482-2496. [PMID: 35500934 PMCID: PMC9133225 DOI: 10.4049/jimmunol.2101170] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/17/2022] [Indexed: 01/31/2023]
Abstract
Rheumatoid arthritis (RA) is an autoimmune disease characterized by synovial hyperplasia and inflammation. The finding of autoantibodies in seropositive RA suggests that complement system activation might play a pathophysiologic role due to the local presence of immune complexes in the joints. Our first objective was to explore the Pathobiology of Early Arthritis Cohort (PEAC) mRNA sequencing data for correlations between clinical disease severity as measured by DAS28-ESR (disease activity score in 28 joints for erythrocyte sedimentation rate) and complement system gene expression, both in the synovium and in blood. Our second objective was to determine the biodistribution using multiplex immunohistochemical staining of specific complement activation proteins and inhibitors from subjects in the Accelerating Medicines Partnership (AMP) RA/SLE study. In the PEAC study, there were significant positive correlations between specific complement gene mRNA expression levels in the synovium and DAS28-ESR for the following complement genes: C2, FCN1, FCN3, CFB, CFP, C3AR1, C5AR1, and CR1 Additionally, there were significant negative correlations between DAS28-ESR and Colec12, C5, C6, MASP-1, CFH, and MCP In the synovium there were also significant positive correlations between DAS28-ESR and FcγR1A, FcγR1B, FcγR2A, and FcγR3A Notably, CFHR4 synovial expression was positively correlated following treatment with the DAS28-ESR at 6 mo, suggesting a role in worse therapeutic responses. The inverse correlation of C5 RNA expression in the synovium may underlie the failure of significant benefit from C5/C5aR inhibitors in clinical trials performed in patients with RA. Multiplex immunohistochemical analyses of early RA synovium reveal significant evidence of regional alterations of activation and inhibitory factors that likely promote local complement activation.
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Affiliation(s)
- Nirmal K Banda
- Division of Rheumatology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO;
| | - Kevin D Deane
- Division of Rheumatology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Elizabeth A Bemis
- Division of Rheumatology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Colin Strickland
- Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, CO
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Jennifer Seifert
- Division of Rheumatology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Kimberly Jordan
- Human Immune Monitoring Shared Resource, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Katriona Goldman
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, U.K.; and
| | - B Paul Morgan
- Systems Immunity URI, Division of Infection and Immunity, and UK Dementia Research Institute Cardiff, School of Medicine, Cardiff University, Cardiff, U.K
| | - Larry W Moreland
- Division of Rheumatology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Myles J Lewis
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, U.K.; and
| | - Costantino Pitzalis
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, U.K.; and
| | - V Michael Holers
- Division of Rheumatology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
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13
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Gytz Olesen H, Michailidou I, Zelek WM, Vreijling J, Ruizendaal P, de Klein F, Marquart JA, Kuipers TB, Mei H, Zhang Y, Ahasan M, Johnson KK, Wang Y, Morgan BP, van Dijk M, Fluiter K, Andersen GR, Baas F. Development, Characterization, and in vivo Validation of a Humanized C6 Monoclonal Antibody that Inhibits the Membrane Attack Complex. J Innate Immun 2022; 15:16-36. [PMID: 35551129 PMCID: PMC10643903 DOI: 10.1159/000524587] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/08/2022] [Indexed: 11/19/2022] Open
Abstract
Damage and disease of nerves activates the complement system. We demonstrated that activation of the terminal pathway of the complement system leads to the formation of the membrane attack complex (MAC) and delays regeneration in the peripheral nervous system. Animals deficient in the complement component C6 showed improved recovery after neuronal trauma. Thus, inhibitors of the MAC might be of therapeutic use in neurological disease. Here, we describe the development, structure, mode of action, and properties of a novel therapeutic monoclonal antibody, CP010, against C6 that prevents formation of the MAC in vivo. The monoclonal antibody is humanized and specific for C6 and binds to an epitope in the FIM1-2 domain of human and primate C6 with sub-nanomolar affinity. Using biophysical and structural studies, we show that the anti-C6 antibody prevents the interaction between C6 and C5/C5b by blocking the C6 FIM1-2:C5 C345c axis. Systemic administration of the anti-C6 mAb caused complete depletion of free C6 in circulation in transgenic rats expressing human C6 and thereby inhibited MAC formation. The antibody prevented disease in experimental autoimmune myasthenia gravis and ameliorated relapse in chronic relapsing experimental autoimmune encephalomyelitis in human C6 transgenic rats. CP010 is a promising complement C6 inhibitor that prevents MAC formation. Systemic administration of this C6 monoclonal antibody has therapeutic potential in the treatment of neuronal disease.
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Affiliation(s)
- Heidi Gytz Olesen
- Department of Molecular Biology and Genetics - Protein Science, Aarhus University, Aarhus, Denmark
| | | | - Wioleta M Zelek
- Division of Infection and Immunity and Dementia Research Institute, Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff, UK
| | | | | | - Ferry de Klein
- Core Facility Genomics, Amsterdam UMC, Amsterdam, The Netherlands
| | | | - Thomas B Kuipers
- Sequencing Analysis Support Core, Department of Biomedical Data Sciences, LUMC, Leiden, The Netherlands
| | - Hailiang Mei
- Sequencing Analysis Support Core, Department of Biomedical Data Sciences, LUMC, Leiden, The Netherlands
| | - Yuchun Zhang
- Alexion, AstraZeneca Rare Disease, New Haven, Connecticut, USA
| | - Muhammad Ahasan
- Alexion, AstraZeneca Rare Disease, New Haven, Connecticut, USA
| | | | - Yi Wang
- Alexion, AstraZeneca Rare Disease, New Haven, Connecticut, USA
| | - B Paul Morgan
- Division of Infection and Immunity and Dementia Research Institute, Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff, UK
| | | | - Kees Fluiter
- Department of Clinical Genetics, LUMC, Leiden, The Netherlands,
| | - Gregers Rom Andersen
- Department of Molecular Biology and Genetics - Protein Science, Aarhus University, Aarhus, Denmark
| | - Frank Baas
- Department of Clinical Genetics, LUMC, Leiden, The Netherlands
- Complement Pharma BV, Amsterdam, The Netherlands
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14
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Kolka CM, Webster J, Lepletier A, Winterford C, Brown I, Richards RS, Zelek WM, Cao Y, Khamis R, Shanmugasundaram KB, Wuethrich A, Trau M, Brosda S, Barbour A, Shah AK, Eslick GD, Clemons NJ, Morgan BP, Hill MM. C5b-9 Membrane Attack Complex Formation and Extracellular Vesicle Shedding in Barrett's Esophagus and Esophageal Adenocarcinoma. Front Immunol 2022; 13:842023. [PMID: 35345676 PMCID: PMC8957096 DOI: 10.3389/fimmu.2022.842023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 02/10/2022] [Indexed: 02/05/2023] Open
Abstract
The early complement components have emerged as mediators of pro-oncogenic inflammation, classically inferred to cause terminal complement activation, but there are limited data on the activity of terminal complement in cancer. We previously reported elevated serum and tissue C9, the terminal complement component, in esophageal adenocarcinoma (EAC) compared to the precursor condition Barrett’s Esophagus (BE) and healthy controls. Here, we investigate the level and cellular fates of the terminal complement complex C5b-9, also known as the membrane attack complex. Punctate C5b-9 staining and diffuse C9 staining was detected in BE and EAC by multiplex immunohistofluorescence without corresponding increase of C9 mRNA transcript. Increased C9 and C5b-9 staining were observed in the sequence normal squamous epithelium, BE, low- and high-grade dysplasia, EAC. C5b-9 positive esophageal cells were morphologically intact, indicative of sublytic or complement-evasion mechanisms. To investigate this at a cellular level, we exposed non-dysplastic BE (BAR-T and CP-A), high-grade dysplastic BE (CP-B and CP-D) and EAC (FLO-1 and OE-33) cell lines to the same sublytic dose of immunopurified human C9 (3 µg/ml) in the presence of C9-depleted human serum. Cellular C5b-9 was visualized by immunofluorescence confocal microscopy. Shed C5b-9 in the form of extracellular vesicles (EV) was measured in collected conditioned medium using recently described microfluidic immunoassay with capture by a mixture of three tetraspanin antibodies (CD9/CD63/CD81) and detection by surface-enhanced Raman scattering (SERS) after EV labelling with C5b-9 or C9 antibody conjugated SERS nanotags. Following C9 exposure, all examined cell lines formed C5b-9, internalized C5b-9, and shed C5b-9+ and C9+ EVs, albeit at varying levels despite receiving the same C9 dose. In conclusion, these results confirm increased esophageal C5b-9 formation during EAC development and demonstrate capability and heterogeneity in C5b-9 formation and shedding in BE and EAC cell lines following sublytic C9 exposure. Future work may explore the molecular mechanisms and pathogenic implications of the shed C5b-9+ EV.
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Affiliation(s)
- Cathryn M Kolka
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Julie Webster
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Ailin Lepletier
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Clay Winterford
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Ian Brown
- Envoi Pathology, Herston, QLD, Australia
| | - Renee S Richards
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Wioleta M Zelek
- Division of Infection & Immunity, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Yilang Cao
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Ramlah Khamis
- Centre for Personalised Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, St Lucia, QLD, Australia
| | - Karthik B Shanmugasundaram
- Centre for Personalised Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, St Lucia, QLD, Australia
| | - Alain Wuethrich
- Centre for Personalised Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, St Lucia, QLD, Australia
| | - Matt Trau
- Centre for Personalised Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, St Lucia, QLD, Australia.,School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD, Australia
| | - Sandra Brosda
- University of Queensland Diamantina Institute, Faculty of Medicine, The University of Queensland, St Lucia, QLD, Australia
| | - Andrew Barbour
- University of Queensland Diamantina Institute, Faculty of Medicine, The University of Queensland, St Lucia, QLD, Australia
| | - Alok K Shah
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Guy D Eslick
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Digestive Health, Hunter Medical Research Institute, The University of Newcastle, Newcastle, NSW, Australia
| | - Nicholas J Clemons
- Cancer Research Division, Peter MaCallum Cancer Centre, Melbourne VIC, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - B Paul Morgan
- Division of Infection & Immunity, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Michelle M Hill
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia.,University of Queensland Diamantina Institute, Faculty of Medicine, The University of Queensland, St Lucia, QLD, Australia
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15
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Banda NK, Deane KD, Seifert J, Strickland C, Bemis E, Jordan K, Goldmann K, Morgan BP, Lewis MJ, Pitzalis C, Moreland LW, Holers VM. A Snap Shot of Complement Gene Expression and Presence of Complement Proteins in Synovial Biopsies from Early Rheumatoid Arthritis Patients. The Journal of Immunology 2022. [DOI: 10.4049/jimmunol.208.supp.108.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Abstract
The etiology of rheumatoid arthritis (RA) is unknown. Previous studies of mouse models of RA have strongly implicated the alternative and lectin pathways of the complement system in disease pathogenesis. Here we explored the Pathobiology of Early Arthritis Cohort (PEAC) tissue RNA sequencing (RNA-seq) database and identify correlations among complement gene expression, Fc receptor expression and clinical severity, measured as disease activity score 28 - erythrocyte sendimentation rate (DAS28-ESR), in both blood and synovium. We also evaluated the biodistribution of complement activation pathway proteins and inhibitors using Multispectral ImmunoHistoChemical (MIHC) staining. Ultrasound guided synovial biopsies (n = 23), obtained from Accelerating Medicines Partnership (AMP) studies, were subjected to MIHC for various complement proteins. Our analyses revealed that in the synovium, but not in blood, significant positive correlations existed between complement gene expression and DAS28-ESR for C2, CFB, FCN1, C3AR1, C5AR1, and CR1. Surprisingly, levels of MASP1, Colec12, C5 and C6 RNA inversely correlated with baseline DAS28-ESR. After 6 months therapy, baseline CFHR4 positively correlated with delta DAS28-ESR. In the synovium, there were also significant positive correlations between DAS28-ESR and FcγR1A, FcγR1B, FcγR2A and FcγR3A. In early RA (ERA) synovium, a significantly (p < 0.05) higher levels of cells expressed CFH compared with CFB and CFHR4. We also found regional imbalance between C3 and CFH in ERA synovial biopsies. ERA synovial biopsies implicate the complement system in early disease and reveal intriguing differences among factors in clinical relevance, outcome and localized tissue dysregulation.
Supported by R01AR51749-16
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Affiliation(s)
- Nirmal K Banda
- 1Division of Rheumatology, Univ. of Colorado Anschutz Med. Campus
| | | | | | - Colin Strickland
- 3School of Medicine, Department of Radiology, Univ. of Colorado Anschutz Med. Campus
| | | | | | - Kationa Goldmann
- 4Ctr. for Exptl. Med. & Rheumatology, William Harvey Res. Inst., Barts & The London Sch. of Med. & Dent., Queen Mary Univ. of London, London, UK, United Kingdom
| | - B. Paul Morgan
- 5Syst. Immunity URI, and UK DRI Cardiff, Sch. of Med., Cardiff Univ., Cardiff UK, United Kingdom
| | - Myles J Lewis
- 4Ctr. for Exptl. Med. & Rheumatology, William Harvey Res. Inst., Barts & The London Sch. of Med. & Dent., Queen Mary Univ. of London, London, UK, United Kingdom
| | - Costantino Pitzalis
- 4Ctr. for Exptl. Med. & Rheumatology, William Harvey Res. Inst., Barts & The London Sch. of Med. & Dent., Queen Mary Univ. of London, London, UK, United Kingdom
| | - Larry W Moreland
- 6School of Medicine, Division of Rheumatology, Univ. of Colorado Anschutz Med. Campus
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16
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Zelek WM, Morgan BP. Targeting complement in neurodegeneration: challenges, risks, and strategies. Trends Pharmacol Sci 2022; 43:615-628. [DOI: 10.1016/j.tips.2022.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 12/13/2022]
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17
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Cooze BJ, Dickerson M, Loganathan R, Watkins LM, Grounds E, Pearson BR, Bevan RJ, Morgan BP, Magliozzi R, Reynolds R, Neal JW, Howell OW. The association between neurodegeneration and local complement activation in the thalamus to progressive multiple sclerosis outcome. Brain Pathol 2022; 32:e13054. [PMID: 35132719 PMCID: PMC9425007 DOI: 10.1111/bpa.13054] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/17/2021] [Accepted: 01/17/2022] [Indexed: 01/22/2023] Open
Abstract
The extent of grey matter demyelination and neurodegeneration in the progressive multiple sclerosis (PMS) brains at post‐mortem associates with more severe disease. Regional tissue atrophy, especially affecting the cortical and deep grey matter, including the thalamus, is prognostic for poor outcomes. Microglial and complement activation are important in the pathogenesis and contribute to damaging processes that underlie tissue atrophy in PMS. We investigated the extent of pathology and innate immune activation in the thalamus in comparison to cortical grey and white matter in blocks from 21 cases of PMS and 10 matched controls. Using a digital pathology workflow, we show that the thalamus is invariably affected by demyelination and had a far higher proportion of active inflammatory lesions than forebrain cortical tissue blocks from the same cases. Lesions were larger and more frequent in the medial nuclei near the ventricular margin, whilst neuronal loss was greatest in the lateral thalamic nuclei. The extent of thalamic neuron loss was not associated with thalamic demyelination but correlated with the burden of white matter pathology in other forebrain areas (Spearman r = 0.79, p < 0.0001). Only thalamic neuronal loss, and not that seen in other forebrain cortical areas, correlated with disease duration (Spearman r = −0.58, p = 0.009) and age of death (Spearman r = −0.47, p = 0.045). Immunoreactivity for the complement pattern recognition molecule C1q, and products of complement activation (C4d, Bb and C3b) were elevated in thalamic lesions with an active inflammatory pathology. Complement regulatory protein, C1 inhibitor, was unchanged in expression. We conclude that active inflammatory demyelination, neuronal loss and local complement synthesis and activation in the thalamus, are important to the pathological and clinical disease outcomes of PMS.
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Affiliation(s)
- Benjamin J Cooze
- Faculty of Medical, Health and Life Sciences, Swansea University, Swansea, UK
| | - Matthew Dickerson
- Faculty of Medical, Health and Life Sciences, Swansea University, Swansea, UK
| | | | - Lewis M Watkins
- Faculty of Medical, Health and Life Sciences, Swansea University, Swansea, UK
| | - Ethan Grounds
- Faculty of Medical, Health and Life Sciences, Swansea University, Swansea, UK
| | - Ben R Pearson
- Faculty of Medical, Health and Life Sciences, Swansea University, Swansea, UK
| | - Ryan Jack Bevan
- UK Dementia Research Institute at Cardiff University, Cardiff, UK
| | - B Paul Morgan
- UK Dementia Research Institute at Cardiff University, Cardiff, UK
| | - Roberta Magliozzi
- Department of Neurological and Movement Sciences, University of Verona, Italy
| | | | - James W Neal
- Faculty of Medical, Health and Life Sciences, Swansea University, Swansea, UK
| | - Owain W Howell
- Faculty of Medical, Health and Life Sciences, Swansea University, Swansea, UK
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18
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Scurr MJ, Zelek WM, Lippiatt G, Somerville M, Burnell SEA, Capitani L, Davies K, Lawton H, Tozer T, Rees T, Roberts K, Evans M, Jackson A, Young C, Fairclough L, Tighe P, Wills M, Westwell AD, Morgan BP, Gallimore A, Godkin A. Whole blood-based measurement of SARS-CoV-2-specific T cells reveals asymptomatic infection and vaccine immunogenicity in healthy subjects and patients with solid-organ cancers. Immunology 2022; 165:250-259. [PMID: 34775604 PMCID: PMC8653009 DOI: 10.1111/imm.13433] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/05/2021] [Accepted: 11/03/2021] [Indexed: 12/23/2022] Open
Abstract
Accurate assessment of SARS-CoV-2 immunity is critical in evaluating vaccine efficacy and devising public health policies. Whilst the exact nature of effective immunity remains incompletely defined, SARS-CoV-2-specific T-cell responses are a critical feature that will likely form a key correlate of protection against COVID-19. Here, we developed and optimized a high-throughput whole blood-based assay to determine the T-cell response associated with prior SARS-CoV-2 infection and/or vaccination amongst 231 healthy donors and 68 cancer patients. Following overnight in vitro stimulation with SARS-CoV-2-specific peptides, blood plasma samples were analysed for TH 1-type cytokines. Highly significant differential IFN-γ+ /IL-2+ SARS-CoV-2-specific T-cell responses were seen amongst previously infected COVID-19-positive healthy donors in comparison with unknown / naïve individuals (p < 0·0001). IFN-γ production was more effective at identifying asymptomatic donors, demonstrating higher sensitivity (96·0% vs. 83·3%) but lower specificity (84·4% vs. 92·5%) than measurement of IL-2. A single COVID-19 vaccine dose induced IFN-γ and/or IL-2 SARS-CoV-2-specific T-cell responses in 116 of 128 (90·6%) healthy donors, reducing significantly to 27 of 56 (48·2%) when measured in cancer patients (p < 0·0001). A second dose was sufficient to boost T-cell responses in the majority (90·6%) of cancer patients, albeit IFN-γ+ responses were still significantly lower overall than those induced in healthy donors (p = 0·034). Three-month post-vaccination T-cell responses also declined at a faster rate in cancer patients. Overall, this cost-effective standardizable test ensures accurate and comparable assessments of SARS-CoV-2-specific T-cell responses amenable to widespread population immunity testing, and identifies individuals at greater need of booster vaccinations.
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Affiliation(s)
- Martin J. Scurr
- Division of Infection & ImmunitySchool of MedicineCardiff UniversityCardiffUK
- ImmunoServ LtdCardiffUK
| | - Wioleta M. Zelek
- School of MedicineSystems Immunity University Research InstituteCardiff UniversityCardiffUK
- UK Dementia Research Institute CardiffCardiff UniversityCardiffUK
| | | | - Michelle Somerville
- Division of Infection & ImmunitySchool of MedicineCardiff UniversityCardiffUK
| | | | - Lorenzo Capitani
- Division of Infection & ImmunitySchool of MedicineCardiff UniversityCardiffUK
| | | | | | - Thomas Tozer
- Department of Gastroenterology & HepatologyUniversity Hospital of WalesCardiffUK
| | - Tara Rees
- Department of Gastroenterology & HepatologyUniversity Hospital of WalesCardiffUK
| | - Kerry Roberts
- Department of Gastroenterology & HepatologyUniversity Hospital of WalesCardiffUK
| | | | | | | | | | - Paddy Tighe
- School of Life SciencesUniversity of NottinghamNottinghamUK
| | - Mark Wills
- Department of MedicineAddenbrooke’s HospitalUniversity of CambridgeCambridgeUK
| | - Andrew D. Westwell
- School of Pharmacy and Pharmaceutical SciencesCardiff UniversityCardiffUK
| | - B. Paul Morgan
- School of MedicineSystems Immunity University Research InstituteCardiff UniversityCardiffUK
- UK Dementia Research Institute CardiffCardiff UniversityCardiffUK
| | - Awen Gallimore
- Division of Infection & ImmunitySchool of MedicineCardiff UniversityCardiffUK
- School of MedicineSystems Immunity University Research InstituteCardiff UniversityCardiffUK
| | - Andrew Godkin
- Division of Infection & ImmunitySchool of MedicineCardiff UniversityCardiffUK
- School of MedicineSystems Immunity University Research InstituteCardiff UniversityCardiffUK
- Department of Gastroenterology & HepatologyUniversity Hospital of WalesCardiffUK
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19
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Westacott LJ, Humby T, Haan N, Brain SA, Bush EL, Toneva M, Baloc AI, Moon AL, Reddaway J, Owen MJ, Hall J, Hughes TR, Morgan BP, Gray WP, Wilkinson LS. Complement C3 and C3aR mediate different aspects of emotional behaviours; relevance to risk for psychiatric disorder. Brain Behav Immun 2022; 99:70-82. [PMID: 34543680 DOI: 10.1016/j.bbi.2021.09.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/03/2021] [Accepted: 09/13/2021] [Indexed: 12/18/2022] Open
Abstract
Complement is a key component of the immune system with roles in inflammation and host-defence. Here we reveal novel functions of complement pathways impacting on emotional reactivity of potential relevance to the emerging links between complement and risk for psychiatric disorder. We used mouse models to assess the effects of manipulating components of the complement system on emotionality. Mice lacking the complement C3a Receptor (C3aR-/-) demonstrated a selective increase in unconditioned (innate) anxiety whilst mice deficient in the central complement component C3 (C3-/-) showed a selective increase in conditioned (learned) fear. The dissociable behavioural phenotypes were linked to different signalling mechanisms. Effects on innate anxiety were independent of C3a, the canonical ligand for C3aR, consistent with the existence of an alternative ligand mediating innate anxiety, whereas effects on learned fear were due to loss of iC3b/CR3 signalling. Our findings show that specific elements of the complement system and associated signalling pathways contribute differentially to heightened states of anxiety and fear commonly seen in psychopathology.
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Affiliation(s)
- Laura J Westacott
- Neuroscience and Mental Health Research Institute, MRC Centre for Neuropsychiatric Genetic and Genomics, School of Medicine, Hadyn Ellis Building, Cardiff University, Cardiff CF24 4HQ, UK; Hodge Centre for Neuropsychiatric Immunology, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK
| | - Trevor Humby
- Neuroscience and Mental Health Research Institute, MRC Centre for Neuropsychiatric Genetic and Genomics, School of Medicine, Hadyn Ellis Building, Cardiff University, Cardiff CF24 4HQ, UK; Behavioural Genetics Group, Schools of Psychology and Medicine, Cardiff University, Cardiff CF10 3AT, UK
| | - Niels Haan
- Neuroscience and Mental Health Research Institute, MRC Centre for Neuropsychiatric Genetic and Genomics, School of Medicine, Hadyn Ellis Building, Cardiff University, Cardiff CF24 4HQ, UK
| | - Sophie A Brain
- Behavioural Genetics Group, Schools of Psychology and Medicine, Cardiff University, Cardiff CF10 3AT, UK
| | - Emma-Louise Bush
- Behavioural Genetics Group, Schools of Psychology and Medicine, Cardiff University, Cardiff CF10 3AT, UK
| | - Margarita Toneva
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Andreea-Ingrid Baloc
- Behavioural Genetics Group, Schools of Psychology and Medicine, Cardiff University, Cardiff CF10 3AT, UK
| | - Anna L Moon
- Neuroscience and Mental Health Research Institute, MRC Centre for Neuropsychiatric Genetic and Genomics, School of Medicine, Hadyn Ellis Building, Cardiff University, Cardiff CF24 4HQ, UK
| | - Jack Reddaway
- Neuroscience and Mental Health Research Institute, MRC Centre for Neuropsychiatric Genetic and Genomics, School of Medicine, Hadyn Ellis Building, Cardiff University, Cardiff CF24 4HQ, UK; Hodge Centre for Neuropsychiatric Immunology, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK
| | - Michael J Owen
- Neuroscience and Mental Health Research Institute, MRC Centre for Neuropsychiatric Genetic and Genomics, School of Medicine, Hadyn Ellis Building, Cardiff University, Cardiff CF24 4HQ, UK
| | - Jeremy Hall
- Neuroscience and Mental Health Research Institute, MRC Centre for Neuropsychiatric Genetic and Genomics, School of Medicine, Hadyn Ellis Building, Cardiff University, Cardiff CF24 4HQ, UK; Hodge Centre for Neuropsychiatric Immunology, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK
| | - Timothy R Hughes
- Complement Biology Group, Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff CF14 4XW, UK; Hodge Centre for Neuropsychiatric Immunology, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK
| | - B Paul Morgan
- Complement Biology Group, Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff CF14 4XW, UK; Hodge Centre for Neuropsychiatric Immunology, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK; UK Dementia Research Institute, Cardiff University, Cardiff CF24 4HQ, UK
| | - William P Gray
- Neuroscience and Mental Health Research Institute, MRC Centre for Neuropsychiatric Genetic and Genomics, School of Medicine, Hadyn Ellis Building, Cardiff University, Cardiff CF24 4HQ, UK; Hodge Centre for Neuropsychiatric Immunology, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK; Brain Repair and Intracranial Therapeutics (BRAIN) Unit, School of Medicine, Cardiff University, CF24 4HQ, UK
| | - Lawrence S Wilkinson
- Neuroscience and Mental Health Research Institute, MRC Centre for Neuropsychiatric Genetic and Genomics, School of Medicine, Hadyn Ellis Building, Cardiff University, Cardiff CF24 4HQ, UK; Behavioural Genetics Group, Schools of Psychology and Medicine, Cardiff University, Cardiff CF10 3AT, UK; Hodge Centre for Neuropsychiatric Immunology, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK.
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20
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Lewis LA, Gulati S, Zelek WM, Morgan BP, Song WC, Zheng B, Nowak N, DeOliveira RB, Sanchez B, DeSouza Silva L, Schuurman J, Beurskens F, Ram S, Rice PA. Efficacy of an Experimental Gonococcal Lipooligosaccharide Mimitope Vaccine Requires Terminal Complement. J Infect Dis 2021; 225:1861-1864. [PMID: 34971376 PMCID: PMC9113499 DOI: 10.1093/infdis/jiab630] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 12/30/2021] [Indexed: 01/02/2023] Open
Abstract
A safe and effective vaccine against multidrug-resistant gonorrhea is urgently needed. An experimental peptide vaccine called TMCP2 that mimics an oligosaccharide epitope in gonococcal lipooligosaccharide, when adjuvanted with glucopyranosyl lipid adjuvant-stable emulsion, elicits bactericidal immunoglobulin G and hastens clearance of gonococci in the mouse vaginal colonization model. In this study, we show that efficacy of TMCP2 requires an intact terminal complement pathway, evidenced by loss of activity in C9-/- mice or when C7 function was blocked. In conclusion, TMCP2 vaccine efficacy in the mouse vagina requires membrane attack complex. Serum bactericidal activity may serve as a correlate of protection for TMCP2.
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Affiliation(s)
- Lisa A Lewis
- Division of Infectious Diseases and Immunology, University of Massachusetts Medical School, Worcester, Massachusetts, USA,Correspondence: Lisa A. Lewis, Division of Infectious Diseases and Immunology, University of Massachusetts Medical School, Lazare Research Bldg, Room 214, 364 Plantation St, Worcester MA 01605 ()
| | - Sunita Gulati
- Division of Infectious Diseases and Immunology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Wioleta M Zelek
- Systems Immunity Research Institute and Dementia Research Institute, Henry Wellcome Building for Biomedical Research, Cardiff University, Heath Park, Cardiff, United Kingdom
| | - B Paul Morgan
- Systems Immunity Research Institute and Dementia Research Institute, Henry Wellcome Building for Biomedical Research, Cardiff University, Heath Park, Cardiff, United Kingdom
| | - Wen-Chao Song
- Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Bo Zheng
- Division of Infectious Diseases and Immunology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Nancy Nowak
- Division of Infectious Diseases and Immunology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Rosane B DeOliveira
- Division of Infectious Diseases and Immunology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Bryan Sanchez
- Division of Infectious Diseases and Immunology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Leandro DeSouza Silva
- Division of Infectious Diseases and Immunology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | | | | | - Sanjay Ram
- Division of Infectious Diseases and Immunology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Peter A Rice
- Division of Infectious Diseases and Immunology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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21
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Chakraborty M, Rodrigues PRS, Watkins WJ, Hayward A, Sharma A, Hayward R, Smit E, Jones R, Goel N, Asokkumar A, Calvert J, Odd D, Morris I, Doherty C, Elliott S, Strang A, Andrews R, Zaher S, Sharma S, Bell S, Oruganti S, Smith C, Orme J, Edkins S, Craigon M, White D, Dantoft W, Davies LC, Moet L, McLaren JE, Clarkstone S, Watson GL, Hood K, Kotecha S, Morgan BP, O'Donnell VB, Ghazal P. nSeP: immune and metabolic biomarkers for early detection of neonatal sepsis-protocol for a prospective multicohort study. BMJ Open 2021; 11:e050100. [PMID: 37010923 PMCID: PMC8718461 DOI: 10.1136/bmjopen-2021-050100] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Diagnosing neonatal sepsis is heavily dependent on clinical phenotyping as culture-positive body fluid has poor sensitivity, and existing blood biomarkers have poor specificity.A combination of machine learning, statistical and deep pathway biology analyses led to the identification of a tripartite panel of biologically connected immune and metabolic markers that showed greater than 99% accuracy for detecting bacterial infection with 100% sensitivity. The cohort study described here is designed as a large-scale clinical validation of this previous work. METHODS AND ANALYSIS This multicentre observational study will prospectively recruit a total of 1445 newborn infants (all gestations)-1084 with suspected early-or late-onset sepsis, and 361 controls-over 4 years. A small volume of whole blood will be collected from infants with suspected sepsis at the time of presentation. This sample will be used for integrated transcriptomic, lipidomic and targeted proteomics profiling. In addition, a subset of samples will be subjected to cellular phenotype and proteomic analyses. A second sample from the same patient will be collected at 24 hours, with an opportunistic sampling for stool culture. For control infants, only one set of blood and stool sample will be collected to coincide with clinical blood sampling. Along with detailed clinical information, blood and stool samples will be analysed and the information will be used to identify and validate the efficacy of immune-metabolic networks in the diagnosis of bacterial neonatal sepsis and to identify new host biomarkers for viral sepsis. ETHICS AND DISSEMINATION The study has received research ethics committee approval from the Wales Research Ethics Committee 2 (reference 19/WA/0008) and operational approval from Health and Care Research Wales. Submission of study results for publication will involve making available all anonymised primary and processed data on public repository sites. TRIAL REGISTRATION NUMBER NCT03777670.
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Affiliation(s)
- Mallinath Chakraborty
- Regional Neonatal Intensive Care Unit, University Hospital of Wales, Cardiff, UK
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | | | - W John Watkins
- Department of Statistics, Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Angela Hayward
- Regional Neonatal Intensive Care Unit, University Hospital of Wales, Cardiff, UK
| | - Alok Sharma
- Regional Neonatal Intensive Care Unit, University Hospital of Wales, Cardiff, UK
| | - Rachel Hayward
- Regional Neonatal Intensive Care Unit, University Hospital of Wales, Cardiff, UK
| | - Elisa Smit
- Regional Neonatal Intensive Care Unit, University Hospital of Wales, Cardiff, UK
| | - Rebekka Jones
- Regional Neonatal Intensive Care Unit, University Hospital of Wales, Cardiff, UK
| | - Nitin Goel
- Regional Neonatal Intensive Care Unit, University Hospital of Wales, Cardiff, UK
| | - Amar Asokkumar
- Regional Neonatal Intensive Care Unit, University Hospital of Wales, Cardiff, UK
| | - Jennifer Calvert
- Regional Neonatal Intensive Care Unit, University Hospital of Wales, Cardiff, UK
| | - David Odd
- Regional Neonatal Intensive Care Unit, University Hospital of Wales, Cardiff, UK
| | - Ian Morris
- Regional Neonatal Intensive Care Unit, University Hospital of Wales, Cardiff, UK
| | - Cora Doherty
- Regional Neonatal Intensive Care Unit, University Hospital of Wales, Cardiff, UK
| | - Sian Elliott
- Regional Neonatal Intensive Care Unit, University Hospital of Wales, Cardiff, UK
| | - Angela Strang
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Robert Andrews
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Summia Zaher
- Department of Obstetrics and Gynaecology, University Hospital of Wales, Cardiff, UK
| | - Simran Sharma
- Infection and Immunity, Cardiff University, Cardiff, UK
- Women's unit, Cardiff and Vale NHS Trust, Cardiff, UK
| | - Sarah Bell
- Department of Anaesthetics, University Hospital of Wales, Cardiff, UK
| | - Siva Oruganti
- Regional Neonatal Intensive Care Unit, University Hospital of Wales, Cardiff, UK
| | - Claire Smith
- Simpsons Special Cary Baby Unit, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Judith Orme
- Simpsons Special Cary Baby Unit, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Sarah Edkins
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Marie Craigon
- Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, The University of Edinburgh, Edinburgh, UK
| | - Daniel White
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Widad Dantoft
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Luke C Davies
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Linda Moet
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - James E McLaren
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Samantha Clarkstone
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Gareth L Watson
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Kerenza Hood
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Sailesh Kotecha
- Department of Child Health, Institute of Molecular & Experimental Medicine, Cardiff University School of Medicine, Cardiff, UK
| | - B Paul Morgan
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Valerie B O'Donnell
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Peter Ghazal
- Department of Systems Medicine, Medical School, Cardiff University, Cardiff, UK
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22
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Torvell M, Carpanini SM, Daskoulidou N, Byrne RAJ, Sims R, Morgan BP. Genetic Insights into the Impact of Complement in Alzheimer's Disease. Genes (Basel) 2021; 12:1990. [PMID: 34946939 PMCID: PMC8702080 DOI: 10.3390/genes12121990] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/12/2021] [Accepted: 12/13/2021] [Indexed: 01/18/2023] Open
Abstract
The presence of complement activation products at sites of pathology in post-mortem Alzheimer's disease (AD) brains is well known. Recent evidence from genome-wide association studies (GWAS), combined with the demonstration that complement activation is pivotal in synapse loss in AD, strongly implicates complement in disease aetiology. Genetic variations in complement genes are widespread. While most variants individually have only minor effects on complement homeostasis, the combined effects of variants in multiple complement genes, referred to as the "complotype", can have major effects. In some diseases, the complotype highlights specific parts of the complement pathway involved in disease, thereby pointing towards a mechanism; however, this is not the case with AD. Here we review the complement GWAS hits; CR1 encoding complement receptor 1 (CR1), CLU encoding clusterin, and a suggestive association of C1S encoding the enzyme C1s, and discuss difficulties in attributing the AD association in these genes to complement function. A better understanding of complement genetics in AD might facilitate predictive genetic screening tests and enable the development of simple diagnostic tools and guide the future use of anti-complement drugs, of which several are currently in development for central nervous system disorders.
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Affiliation(s)
- Megan Torvell
- UK Dementia Research Institute Cardiff, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK; (M.T.); (S.M.C.); (N.D.); (R.A.J.B.)
- Division of Infection and Immunity, Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff CF14 4XN, UK
| | - Sarah M. Carpanini
- UK Dementia Research Institute Cardiff, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK; (M.T.); (S.M.C.); (N.D.); (R.A.J.B.)
- Division of Infection and Immunity, Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff CF14 4XN, UK
| | - Nikoleta Daskoulidou
- UK Dementia Research Institute Cardiff, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK; (M.T.); (S.M.C.); (N.D.); (R.A.J.B.)
- Division of Infection and Immunity, Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff CF14 4XN, UK
| | - Robert A. J. Byrne
- UK Dementia Research Institute Cardiff, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK; (M.T.); (S.M.C.); (N.D.); (R.A.J.B.)
- Division of Infection and Immunity, Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff CF14 4XN, UK
| | - Rebecca Sims
- Division of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK;
| | - B. Paul Morgan
- UK Dementia Research Institute Cardiff, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK; (M.T.); (S.M.C.); (N.D.); (R.A.J.B.)
- Division of Infection and Immunity, Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff CF14 4XN, UK
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Chamberlain JL, Huda S, Whittam DH, Matiello M, Morgan BP, Jacob A. Correction to: Role of complement and potential of complement inhibitors in myasthenia gravis and neuromyelitis optica spectrum disorders: a brief review. J Neurol 2021; 269:539. [PMID: 34779891 DOI: 10.1007/s00415-021-10896-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Saif Huda
- Department of Neurology, The Walton Centre, Lower Lane, Liverpool, L9 7LJ, UK
| | | | - Marcelo Matiello
- Department of Neurology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - B Paul Morgan
- School of Medicine, Henry Wellcome Building for Biomedical Research, University Hospital of Wales, Heath Park, Cardiff, CF14 4XN, UK
| | - Anu Jacob
- Department of Neurology, The Walton Centre, Lower Lane, Liverpool, L9 7LJ, UK.,University of Liverpool, Liverpool, UK
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24
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Wong EK, Marchbank KJ, Lomax-Browne H, Pappworth IY, Denton H, Cooke K, Ward S, McLoughlin AC, Richardson G, Wilson V, Harris CL, Morgan BP, Hakobyan S, McAlinden P, Gale DP, Maxwell H, Christian M, Malcomson R, Goodship TH, Marks SD, Pickering MC, Kavanagh D, Cook HT, Johnson SA. C3 Glomerulopathy and Related Disorders in Children: Etiology-Phenotype Correlation and Outcomes. Clin J Am Soc Nephrol 2021; 16:1639-1651. [PMID: 34551983 PMCID: PMC8729419 DOI: 10.2215/cjn.00320121] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 09/17/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND OBJECTIVES Membranoproliferative GN and C3 glomerulopathy are rare and overlapping disorders associated with dysregulation of the alternative complement pathway. Specific etiologic data for pediatric membranoproliferative GN/C3 glomerulopathy are lacking, and outcome data are based on retrospective studies without etiologic data. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS A total of 80 prevalent pediatric patients with membranoproliferative GN/C3 glomerulopathy underwent detailed phenotyping and long-term follow-up within the National Registry of Rare Kidney Diseases (RaDaR). Risk factors for kidney survival were determined using a Cox proportional hazards model. Kidney and transplant graft survival was determined using the Kaplan-Meier method. RESULTS Central histology review determined 39 patients with C3 glomerulopathy, 31 with immune-complex membranoproliferative GN, and ten with immune-complex GN. Patients were aged 2-15 (median, 9; interquartile range, 7-11) years. Median complement C3 and C4 levels were 0.31 g/L and 0.14 g/L, respectively; acquired (anticomplement autoantibodies) or genetic alternative pathway abnormalities were detected in 46% and 9% of patients, respectively, across all groups, including those with immune-complex GN. Median follow-up was 5.18 (interquartile range, 2.13-8.08) years. Eleven patients (14%) progressed to kidney failure, with nine transplants performed in eight patients, two of which failed due to recurrent disease. Presence of >50% crescents on the initial biopsy specimen was the sole variable associated with kidney failure in multivariable analysis (hazard ratio, 6.2; 95% confidence interval, 1.05 to 36.6; P<0.05). Three distinct C3 glomerulopathy prognostic groups were identified according to presenting eGFR and >50% crescents on the initial biopsy specimen. CONCLUSIONS Crescentic disease was a key risk factor associated with kidney failure in a national cohort of pediatric patients with membranoproliferative GN/C3 glomerulopathy and immune-complex GN. Presenting eGFR and crescentic disease help define prognostic groups in pediatric C3 glomerulopathy. Acquired abnormalities of the alternative pathway were commonly identified but not a risk factor for kidney failure.
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Affiliation(s)
- Edwin K.S. Wong
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- Department of Renal Medicine, Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - Kevin J. Marchbank
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Hannah Lomax-Browne
- Department of Immunology and Inflammation, Imperial College, London, United Kingdom
| | - Isabel Y. Pappworth
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Harriet Denton
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Katie Cooke
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Sophie Ward
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Amy-Claire McLoughlin
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Grant Richardson
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Valerie Wilson
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - Claire L. Harris
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - B. Paul Morgan
- Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Svetlana Hakobyan
- Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Paul McAlinden
- Research and Development Department, Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Daniel P. Gale
- Department of Renal Medicine, University College London, London, United Kingdom
| | | | - Martin Christian
- Nottingham Children’s Hospital, Queens Medical Centre, Nottingham, United Kingdom
| | - Roger Malcomson
- Histopathology Department, Leicester Royal Infirmary, Leicester, United Kingdom
| | - Timothy H.J. Goodship
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - Stephen D. Marks
- Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
- National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre, University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Matthew C. Pickering
- Department of Immunology and Inflammation, Imperial College, London, United Kingdom
| | - David Kavanagh
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- Department of Renal Medicine, Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - H. Terence Cook
- Department of Immunology and Inflammation, Imperial College, London, United Kingdom
| | - Sally A. Johnson
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- Department of Paediatric Nephrology, Great North Children’s Hospital, Newcastle upon Tyne, United Kingdom
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25
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Westacott LJ, Haan N, Evison C, Marei O, Hall J, Hughes TR, Zaben M, Morgan BP, Humby T, Wilkinson LS, Gray WP. Dissociable effects of complement C3 and C3aR on survival and morphology of adult born hippocampal neurons, pattern separation, and cognitive flexibility in male mice. Brain Behav Immun 2021; 98:136-150. [PMID: 34403734 DOI: 10.1016/j.bbi.2021.08.215] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/15/2021] [Accepted: 08/09/2021] [Indexed: 12/14/2022] Open
Abstract
Adult hippocampal neurogenesis (AHN) is a form of ongoing plasticity in the brain that supports specific aspects of cognition. Disruptions in AHN have been observed in neuropsychiatric conditions presenting with inflammatory components and are associated with impairments in cognition and mood. Recent evidence highlights important roles of the complement system in synaptic plasticity and neurogenesis during neurodevelopment and in acute learning and memory processes. In this work we investigated the impact of the complement C3/C3aR pathway on AHN and its functional implications for AHN-related behaviours. In C3-/- mice, we found increased numbers and accelerated migration of adult born granule cells, indicating that absence of C3 leads to abnormal survival and distribution of adult born neurons. Loss of either C3 or C3aR affected the morphology of immature neurons, reducing morphological complexity, though these effects were more pronounced in the absence of C3aR. We assessed functional impacts of the cellular phenotypes in an operant spatial discrimination task that assayed AHN sensitive behaviours. Again, we observed differences in the effects of manipulating C3 or C3aR, in that whilst C3aR-/- mice showed evidence of enhanced pattern separation abilities, C3-/- mice instead demonstrated impaired behavioural flexibility. Our findings show that C3 and C3aR manipulation have distinct effects on AHN that impact at different stages in the development and maturation of newly born neurons, and that the dissociable cellular phenotypes are associated with specific alterations in AHN-related behaviours.
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Affiliation(s)
- Laura J Westacott
- Neuroscience and Mental Health Research Institute, MRC Centre for Neuropsychiatric Genetic and Genomics, School of Medicine, Cardiff University, Hadyn Ellis Building, Cardiff CF24 4HQ, UK; Hodge Centre for Neuropsychiatric Immunology, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK
| | - Niels Haan
- Neuroscience and Mental Health Research Institute, MRC Centre for Neuropsychiatric Genetic and Genomics, School of Medicine, Cardiff University, Hadyn Ellis Building, Cardiff CF24 4HQ, UK; Hodge Centre for Neuropsychiatric Immunology, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK
| | - Claudia Evison
- National Centre for Mental Health, Cardiff University, Hadyn Ellis Building, Cardiff CF24 4HQ, UK
| | - Omar Marei
- Neuroscience and Mental Health Research Institute, MRC Centre for Neuropsychiatric Genetic and Genomics, School of Medicine, Cardiff University, Hadyn Ellis Building, Cardiff CF24 4HQ, UK
| | - Jeremy Hall
- Neuroscience and Mental Health Research Institute, MRC Centre for Neuropsychiatric Genetic and Genomics, School of Medicine, Cardiff University, Hadyn Ellis Building, Cardiff CF24 4HQ, UK; Hodge Centre for Neuropsychiatric Immunology, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK
| | - Timothy R Hughes
- Complement Biology Group, Systems Immunity Research Institute, School of Medicine, Cardiff University, CF14 4XW Cardiff, UK
| | - Malik Zaben
- Neuroscience and Mental Health Research Institute, MRC Centre for Neuropsychiatric Genetic and Genomics, School of Medicine, Cardiff University, Hadyn Ellis Building, Cardiff CF24 4HQ, UK; Brain Repair and Intracranial Neurotherapeutics (BRAIN), Biomedical Research Unit, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, CF24 4HQ, UK
| | - B Paul Morgan
- Complement Biology Group, Systems Immunity Research Institute, School of Medicine, Cardiff University, CF14 4XW Cardiff, UK; Hodge Centre for Neuropsychiatric Immunology, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK; UK Dementia Research Institute, Cardiff University, Cardiff CF24 4HQ, UK
| | - Trevor Humby
- Neuroscience and Mental Health Research Institute, MRC Centre for Neuropsychiatric Genetic and Genomics, School of Medicine, Cardiff University, Hadyn Ellis Building, Cardiff CF24 4HQ, UK; Behavioural Genetics Group, Schools of Psychology and Medicine, Cardiff University, Cardiff CF10 3AT, UK; Hodge Centre for Neuropsychiatric Immunology, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK
| | - Lawrence S Wilkinson
- Neuroscience and Mental Health Research Institute, MRC Centre for Neuropsychiatric Genetic and Genomics, School of Medicine, Cardiff University, Hadyn Ellis Building, Cardiff CF24 4HQ, UK; Behavioural Genetics Group, Schools of Psychology and Medicine, Cardiff University, Cardiff CF10 3AT, UK; Hodge Centre for Neuropsychiatric Immunology, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK
| | - William P Gray
- Neuroscience and Mental Health Research Institute, MRC Centre for Neuropsychiatric Genetic and Genomics, School of Medicine, Cardiff University, Hadyn Ellis Building, Cardiff CF24 4HQ, UK; Hodge Centre for Neuropsychiatric Immunology, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK; Brain Repair and Intracranial Neurotherapeutics (BRAIN), Biomedical Research Unit, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, CF24 4HQ, UK.
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26
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McMahon O, Hallam TM, Patel S, Harris CL, Menny A, Zelek WM, Widjajahakim R, Java A, Cox TE, Tzoumas N, Steel DHW, Shuttleworth VG, Smith-Jackson K, Brocklebank V, Griffiths H, Cree AJ, Atkinson JP, Lotery AJ, Bubeck D, Morgan BP, Marchbank KJ, Seddon JM, Kavanagh D. The rare C9 P167S risk variant for age-related macular degeneration increases polymerization of the terminal component of the complement cascade. Hum Mol Genet 2021; 30:1188-1199. [PMID: 33783477 PMCID: PMC8212764 DOI: 10.1093/hmg/ddab086] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 03/21/2021] [Accepted: 03/22/2021] [Indexed: 12/25/2022] Open
Abstract
Age-related macular degeneration (AMD) is a complex neurodegenerative eye disease with behavioral and genetic etiology and is the leading cause of irreversible vision loss among elderly Caucasians. Functionally significant genetic variants in the alternative pathway of complement have been strongly linked to disease. More recently, a rare variant in the terminal pathway of complement has been associated with increased risk, Complement component 9 (C9) P167S. To assess the functional consequence of this variant, C9 levels were measured in two independent cohorts of AMD patients. In both cohorts, it was demonstrated that the P167S variant was associated with low C9 plasma levels. Further analysis showed that patients with advanced AMD had elevated sC5b-9 compared to those with non-advanced AMD, although this was not associated with the P167S polymorphism. Electron microscopy of membrane attack complexes (MACs) generated using recombinantly produced wild type or P167S C9 demonstrated identical MAC ring structures. In functional assays, the P167S variant displayed a higher propensity to polymerize and a small increase in its ability to induce hemolysis of sheep erythrocytes when added to C9-depleted serum. The demonstration that this C9 P167S AMD risk polymorphism displays increased polymerization and functional activity provides a rationale for the gene therapy trials of sCD59 to inhibit the terminal pathway of complement in AMD that are underway.
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Affiliation(s)
- O McMahon
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - T M Hallam
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - S Patel
- Department of Ophthalmology and Visual Sciences, University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - C L Harris
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - A Menny
- Department of Life Sciences, Sir Ernst Chain Building, Imperial College London, London SW7 2AZ, UK
| | - W M Zelek
- Division of Infection and Immunity, School of Medicine, Systems Immunity Research Institute, Cardiff University, Heath Park, Cardiff CF14 4XN, UK
| | - R Widjajahakim
- Department of Ophthalmology and Visual Sciences, University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - A Java
- Divisions of Nephrology and Rheumatology, Department of Medicine, Washington University, St Louis, MO 63110, USA
| | - T E Cox
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - N Tzoumas
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, NE1 3BZ, UK
| | - D H W Steel
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, NE1 3BZ, UK
| | - V G Shuttleworth
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - K Smith-Jackson
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - V Brocklebank
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - H Griffiths
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - A J Cree
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - J P Atkinson
- Divisions of Nephrology and Rheumatology, Department of Medicine, Washington University, St Louis, MO 63110, USA
| | - A J Lotery
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - D Bubeck
- Department of Life Sciences, Sir Ernst Chain Building, Imperial College London, London SW7 2AZ, UK
| | - B P Morgan
- Division of Infection and Immunity, School of Medicine, Systems Immunity Research Institute, Cardiff University, Heath Park, Cardiff CF14 4XN, UK
| | - K J Marchbank
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - J M Seddon
- Department of Ophthalmology and Visual Sciences, University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - D Kavanagh
- Complement Therapeutics Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- National Renal Complement Therapeutics Centre, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
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27
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Webster JA, Wuethrich A, Shanmugasundaram KB, Richards RS, Zelek WM, Shah AK, Gordon LG, Kendall BJ, Hartel G, Morgan BP, Trau M, Hill MM. Development of EndoScreen Chip, a Microfluidic Pre-Endoscopy Triage Test for Esophageal Adenocarcinoma. Cancers (Basel) 2021; 13:2865. [PMID: 34201241 PMCID: PMC8229863 DOI: 10.3390/cancers13122865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/03/2021] [Accepted: 06/03/2021] [Indexed: 12/11/2022] Open
Abstract
The current endoscopy and biopsy diagnosis of esophageal adenocarcinoma (EAC) and its premalignant condition Barrett's esophagus (BE) is not cost-effective. To enable EAC screening and patient triaging for endoscopy, we developed a microfluidic lectin immunoassay, the EndoScreen Chip, which allows sensitive multiplex serum biomarker measurements. Here, we report the proof-of-concept deployment for the EAC biomarker Jacalin lectin binding complement C9 (JAC-C9), which we previously discovered and validated by mass spectrometry. A monoclonal C9 antibody (m26 3C9) was generated and validated in microplate ELISA, and then deployed for JAC-C9 measurement on EndoScreen Chip. Cohort evaluation (n = 46) confirmed the expected elevation of serum JAC-C9 in EAC, along with elevated total serum C9 level. Next, we asked if the small panel of serum biomarkers improves detection of EAC in this cohort when used in conjunction with patient risk factors (age, body mass index and heartburn history). Using logistic regression modeling, we found that serum C9 and JAC-C9 significantly improved EAC prediction from AUROC of 0.838 to 0.931, with JAC-C9 strongly predictive of EAC (vs. BE OR = 4.6, 95% CI: 1.6-15.6, p = 0.014; vs. Healthy OR = 4.1, 95% CI: 1.2-13.7, p = 0.024). This proof-of-concept study confirms the microfluidic EndoScreen Chip technology and supports the potential utility of blood biomarkers in improving triaging for diagnostic endoscopy. Future work will expand the number of markers on EndoScreen Chip from our list of validated EAC biomarkers.
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Affiliation(s)
- Julie A. Webster
- QIMR Berghofer Medical Research Institute, Herston, QLD 4006, Australia; (J.A.W.); (R.S.R.); (A.K.S.); (L.G.G.); (B.J.K.); (G.H.)
| | - Alain Wuethrich
- Centre for Personalised Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Brisbane City, QLD 4072, Australia; (A.W.); (K.B.S.); (M.T.)
| | - Karthik B. Shanmugasundaram
- Centre for Personalised Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Brisbane City, QLD 4072, Australia; (A.W.); (K.B.S.); (M.T.)
| | - Renee S. Richards
- QIMR Berghofer Medical Research Institute, Herston, QLD 4006, Australia; (J.A.W.); (R.S.R.); (A.K.S.); (L.G.G.); (B.J.K.); (G.H.)
| | - Wioleta M. Zelek
- Division of Infection and Immunity, Cardiff University, Heath Park, Cardiff CF10 3AX, UK; (W.M.Z.); (B.P.M.)
| | - Alok K. Shah
- QIMR Berghofer Medical Research Institute, Herston, QLD 4006, Australia; (J.A.W.); (R.S.R.); (A.K.S.); (L.G.G.); (B.J.K.); (G.H.)
| | - Louisa G. Gordon
- QIMR Berghofer Medical Research Institute, Herston, QLD 4006, Australia; (J.A.W.); (R.S.R.); (A.K.S.); (L.G.G.); (B.J.K.); (G.H.)
| | - Bradley J. Kendall
- QIMR Berghofer Medical Research Institute, Herston, QLD 4006, Australia; (J.A.W.); (R.S.R.); (A.K.S.); (L.G.G.); (B.J.K.); (G.H.)
- Faculty of Medicine, The University of Queensland, Herston, Brisbane, QLD 4102, Australia
- Department of Gastroenterolgy and Hepatology, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia
| | - Gunter Hartel
- QIMR Berghofer Medical Research Institute, Herston, QLD 4006, Australia; (J.A.W.); (R.S.R.); (A.K.S.); (L.G.G.); (B.J.K.); (G.H.)
| | - B. Paul Morgan
- Division of Infection and Immunity, Cardiff University, Heath Park, Cardiff CF10 3AX, UK; (W.M.Z.); (B.P.M.)
| | - Matt Trau
- Centre for Personalised Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Brisbane City, QLD 4072, Australia; (A.W.); (K.B.S.); (M.T.)
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD 4072, Australia
| | - Michelle M. Hill
- QIMR Berghofer Medical Research Institute, Herston, QLD 4006, Australia; (J.A.W.); (R.S.R.); (A.K.S.); (L.G.G.); (B.J.K.); (G.H.)
- Faculty of Medicine, The University of Queensland, Herston, Brisbane, QLD 4102, Australia
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28
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Byrne RAJ, Torvell M, Daskoulidou N, Fathalla D, Kokkali E, Carpanini SM, Morgan BP. Novel Monoclonal Antibodies Against Mouse C1q: Characterisation and Development of a Quantitative ELISA for Mouse C1q. Mol Neurobiol 2021; 58:4323-4336. [PMID: 34002346 PMCID: PMC8487419 DOI: 10.1007/s12035-021-02419-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 04/30/2021] [Indexed: 12/20/2022]
Abstract
Recent studies have identified roles for complement in synaptic pruning, both physiological during development and pathological in Alzheimer's disease (AD). These reports suggest that C1q initiates complement activation on synapses and C3 fragments then tag them for removal by microglia. There is an urgent need to characterise these processes in rodent AD models; this requires the development of reagents and methods for detection and quantification of rodent C1q in fluids and pathological tissues. These will enable better evaluation of the role of C1q in disease and its value as disease biomarker. We describe the generation in C1q-deficient mice of novel monoclonal antibodies against mouse and rat C1q that enabled development of a sensitive, specific, and quantitative ELISA for mouse and rat C1q capable of measuring C1q in biological fluids and tissue extracts. Serum C1q levels were measured in wild-type (WT), C1q knockout (KO), C3 KO, C7 KO, Crry KO, and 3xTg and APPNL-G-F AD model mice through ageing. C1q levels significantly decreased in WT, APPNL-G-F, and C7 KO mice with ageing. C1q levels were reduced in APPNL-G-F compared to WT at all ages and in 3xTg at 12 months; C3 KO and C7 KO, but not Crry KO mice, also demonstrated significantly lower C1q levels compared to matched WT. In brain homogenates, C1q levels increased with age in both WT and APPNL-G-F mice. This robust and adaptable assay for quantification of mouse and rat C1q provides a vital tool for investigating the expression of C1q in rodent models of AD and other complement-driven pathologies.
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Affiliation(s)
- Robert A J Byrne
- UK Dementia Research Institute Cardiff, Hadyn Ellis Building, Cardiff University, Maindy Road, Cardiff, CF244HQ, UK.,Division of Infection and Immunity and Systems Immunity Research Institute, School of Medicine, Cardiff University, Hadyn Ellis Building, Heath Park, Cardiff, CF144XN, UK
| | - Megan Torvell
- UK Dementia Research Institute Cardiff, Hadyn Ellis Building, Cardiff University, Maindy Road, Cardiff, CF244HQ, UK.,Division of Infection and Immunity and Systems Immunity Research Institute, School of Medicine, Cardiff University, Hadyn Ellis Building, Heath Park, Cardiff, CF144XN, UK
| | - Nikoleta Daskoulidou
- UK Dementia Research Institute Cardiff, Hadyn Ellis Building, Cardiff University, Maindy Road, Cardiff, CF244HQ, UK.,Division of Infection and Immunity and Systems Immunity Research Institute, School of Medicine, Cardiff University, Hadyn Ellis Building, Heath Park, Cardiff, CF144XN, UK
| | - Dina Fathalla
- UK Dementia Research Institute Cardiff, Hadyn Ellis Building, Cardiff University, Maindy Road, Cardiff, CF244HQ, UK.,Division of Infection and Immunity and Systems Immunity Research Institute, School of Medicine, Cardiff University, Hadyn Ellis Building, Heath Park, Cardiff, CF144XN, UK
| | - Eirini Kokkali
- School of Optometry and Visual Sciences, Cardiff University, Maindy Road, Cardiff, CF244HQ, UK
| | - Sarah M Carpanini
- UK Dementia Research Institute Cardiff, Hadyn Ellis Building, Cardiff University, Maindy Road, Cardiff, CF244HQ, UK.,Division of Infection and Immunity and Systems Immunity Research Institute, School of Medicine, Cardiff University, Hadyn Ellis Building, Heath Park, Cardiff, CF144XN, UK
| | - B Paul Morgan
- UK Dementia Research Institute Cardiff, Hadyn Ellis Building, Cardiff University, Maindy Road, Cardiff, CF244HQ, UK. .,Division of Infection and Immunity and Systems Immunity Research Institute, School of Medicine, Cardiff University, Hadyn Ellis Building, Heath Park, Cardiff, CF144XN, UK.
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Enache D, Nikkheslat N, Fathalla D, Morgan BP, Lewis S, Drake R, Deakin B, Walters J, Lawrie SM, Egerton A, MacCabe JH, Mondelli V. Peripheral immune markers and antipsychotic non-response in psychosis. Schizophr Res 2021; 230:1-8. [PMID: 33667853 PMCID: PMC8224180 DOI: 10.1016/j.schres.2020.12.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 12/19/2020] [Accepted: 12/30/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Peripheral immune markers have previously been linked to a poor response to antipsychotic medication and more severe negative symptoms at the onset of psychosis. The present study investigated the association of blood cytokines and complement markers with the presence of antipsychotic non-response and symptom severity in patients with psychosis. METHODS This cross-sectional study recruited 94 patients with schizophrenia and other psychoses, of whom 47 were defined as antipsychotic responders and 47 as antipsychotic non-responders. In all subjects we measured plasma levels of cytokines (IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-13, TNF-α, and IFN-γ), complement markers (C1-inhibitor, C3, C4, C3a, C3b, Bb, factor D, C5a, terminal complement complex) and high sensitivity C-reactive protein (hsCRP). Symptom severity was recorded using the Positive and Negative Syndrome scale for Schizophrenia (PANSS). Binary logistic regression tested each immune marker as predictor of response status while covarying for relevant socio-demographic variables. Correlation analyses tested the association between immune markers and the severity of symptoms. RESULTS Interleukin (IL)-8 significantly predicted antipsychotic non-response (OR=24.70, 95% CI, 1.35-453.23, p = 0.03). Other immune markers were not associated with antipsychotic response. IL-6, IL-8, IL-10 and TNF-α significantly positively correlated with negative psychotic symptoms. CONCLUSIONS Higher levels of IL-8 are associated with a poor response to antipsychotic treatment. Increased cytokines levels are specifically associated with more severe negative symptoms in patients with schizophrenia and other psychoses.
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Affiliation(s)
- Daniela Enache
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London, UK; Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Naghmeh Nikkheslat
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London, UK
| | - Dina Fathalla
- Dementia Research Institute, Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - B Paul Morgan
- Dementia Research Institute, Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Shôn Lewis
- Department of Psychiatry, University of Manchester, Manchester, UK
| | - Richard Drake
- Department of Psychiatry, University of Manchester, Manchester, UK
| | - Bill Deakin
- Department of Psychiatry, University of Manchester, Manchester, UK
| | - James Walters
- MRC Centre for Neuropsychiatric Genetics, Cardiff University, Cardiff, UK
| | - Stephen M Lawrie
- Department of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Alice Egerton
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, UK
| | - James H MacCabe
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, UK
| | - Valeria Mondelli
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, UK.
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30
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Carpanini SM, Harwood JC, Baker E, Torvell M, Sims R, Williams J, Morgan BP. The Impact of Complement Genes on the Risk of Late-Onset Alzheimer's Disease. Genes (Basel) 2021; 12:443. [PMID: 33804666 PMCID: PMC8003605 DOI: 10.3390/genes12030443] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/13/2021] [Accepted: 03/16/2021] [Indexed: 12/27/2022] Open
Abstract
Late-onset Alzheimer's disease (LOAD), the most common cause of dementia, and a huge global health challenge, is a neurodegenerative disease of uncertain aetiology. To deliver effective diagnostics and therapeutics, understanding the molecular basis of the disease is essential. Contemporary large genome-wide association studies (GWAS) have identified over seventy novel genetic susceptibility loci for LOAD. Most are implicated in microglial or inflammatory pathways, bringing inflammation to the fore as a candidate pathological pathway. Among the most significant GWAS hits are three complement genes: CLU, encoding the fluid-phase complement inhibitor clusterin; CR1 encoding complement receptor 1 (CR1); and recently, C1S encoding the complement enzyme C1s. Complement activation is a critical driver of inflammation; changes in complement genes may impact risk by altering the inflammatory status in the brain. To assess complement gene association with LOAD risk, we manually created a comprehensive complement gene list and tested these in gene-set analysis with LOAD summary statistics. We confirmed associations of CLU and CR1 genes with LOAD but showed no significant associations for the complement gene-set when excluding CLU and CR1. No significant association with other complement genes, including C1S, was seen in the IGAP dataset; however, these may emerge from larger datasets.
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Affiliation(s)
- Sarah M. Carpanini
- UK Dementia Research Institute at Cardiff University, School of Medicine, Cardiff, CF24 4HQ, UK; (S.M.C.); (E.B.); (M.T.); (J.W.)
- Division of Infection and Immunity, School of Medicine, Systems Immunity Research Institute, Cardiff University, Cardiff, CF14 4XN, UK
| | - Janet C. Harwood
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, CF24 4HQ, UK; (J.C.H.); (R.S.)
| | - Emily Baker
- UK Dementia Research Institute at Cardiff University, School of Medicine, Cardiff, CF24 4HQ, UK; (S.M.C.); (E.B.); (M.T.); (J.W.)
| | - Megan Torvell
- UK Dementia Research Institute at Cardiff University, School of Medicine, Cardiff, CF24 4HQ, UK; (S.M.C.); (E.B.); (M.T.); (J.W.)
- Division of Infection and Immunity, School of Medicine, Systems Immunity Research Institute, Cardiff University, Cardiff, CF14 4XN, UK
| | | | - Rebecca Sims
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, CF24 4HQ, UK; (J.C.H.); (R.S.)
| | - Julie Williams
- UK Dementia Research Institute at Cardiff University, School of Medicine, Cardiff, CF24 4HQ, UK; (S.M.C.); (E.B.); (M.T.); (J.W.)
| | - B. Paul Morgan
- UK Dementia Research Institute at Cardiff University, School of Medicine, Cardiff, CF24 4HQ, UK; (S.M.C.); (E.B.); (M.T.); (J.W.)
- Division of Infection and Immunity, School of Medicine, Systems Immunity Research Institute, Cardiff University, Cardiff, CF14 4XN, UK
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31
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Moat SJ, Zelek WM, Carne E, Ponsford MJ, Bramhall K, Jones S, El-Shanawany T, Wise MP, Thomas A, George C, Fegan C, Steven R, Webb R, Weeks I, Morgan BP, Jolles S. Development of a high-throughput SARS-CoV-2 antibody testing pathway using dried blood spot specimens. Ann Clin Biochem 2021; 58:123-131. [PMID: 33269949 PMCID: PMC7844389 DOI: 10.1177/0004563220981106] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Serological assays for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) have roles in seroepidemiology, convalescent plasma-testing, antibody durability and vaccine studies. Currently, SARS-CoV-2 serology is performed using serum/plasma collected by venepuncture. Dried blood spot (DBS) testing offers significant advantages as it is minimally invasive, avoids venepuncture with specimens being mailed to the laboratory. METHODS A pathway utilizing a newborn screening laboratory infrastructure was developed using an enzyme-linked immunosorbent assay to detect IgG antibodies against the receptor-binding domain of the SARS-CoV-2 spike protein in DBS specimens. Paired plasma and DBS specimens from SARS-CoV-2 antibody-positive and -negative subjects and polymerase chain reaction positive subjects were tested. DBS specimen stability, effect of blood volume and punch location were also evaluated. RESULTS DBS specimens from antibody-negative (n = 85) and -positive (n = 35) subjects and polymerase chain reaction positive subjects (n = 11) had a mean (SD; range) optical density (OD) of 0.14 (0.046; 0.03-0.27), 0.98 (0.41; 0.31-1.64) and 1.12 (0.37; 0.49-1.54), respectively. An action value OD >0.28 correctly assigned all cases. The weighted Deming regression for comparison of the DBS and the plasma assay yielded: y = 0.004041 + 1.005x, r = 0.991, Sy/x 0.171, n = 82. Extraction efficiency of antibodies from DBS specimens was >99%. DBS specimens were stable for at least 28 days at ambient room temperature and humidity. CONCLUSIONS SARS-CoV-2 IgG receptor-binding domain antibodies can be reliably detected in DBS specimens. DBS serological testing offers lower costs than either point of care or serum/plasma assays that require patient travel, phlebotomy and hospital/clinic resources; the development of a DBS assay may be particularly important for resource poor settings.
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Affiliation(s)
- Stuart J Moat
- Wales Newborn Screening Laboratory, Department of Medical Biochemistry, Immunology and Toxicology, University Hospital of Wales, Cardiff, Wales, UK
- School of Medicine, Cardiff University, Cardiff, Wales, UK
| | - Wioleta M Zelek
- Systems Immunity University Research Institute and Dementia Research Institute, Cardiff University, Cardiff, UK
| | - Emily Carne
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK
| | - Mark J Ponsford
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK
- Division of Infection, Inflammation and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Kathryn Bramhall
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK
| | - Sara Jones
- Weqas, Cardiff and Vale University Health Board, Cardiff, UK
| | - Tariq El-Shanawany
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK
| | - Matt P Wise
- Adult Critical Care, University Hospital of Wales, Cardiff, UK
| | - Annette Thomas
- Weqas, Cardiff and Vale University Health Board, Cardiff, UK
| | - Chloe George
- Welsh Blood Service, Ely Valley Road, Talbot Green, Pontyclun, UK
| | - Christopher Fegan
- Department of Haematology, University Hospital of Wales, Cardiff, Wales, UK
| | - Rachael Steven
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK
| | - Russell Webb
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK
| | - Ian Weeks
- College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - B Paul Morgan
- Systems Immunity University Research Institute and Dementia Research Institute, Cardiff University, Cardiff, UK
| | - Stephen Jolles
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK
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32
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Murrell I, Forde D, Zelek W, Tyson L, Chichester L, Palmer N, Jones R, Morgan BP, Moore C. Temporal development and neutralising potential of antibodies against SARS-CoV-2 in hospitalised COVID-19 patients: An observational cohort study. PLoS One 2021; 16:e0245382. [PMID: 33497420 PMCID: PMC7837461 DOI: 10.1371/journal.pone.0245382] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 12/29/2020] [Indexed: 12/17/2022] Open
Abstract
Antibody responses are important in the control of viral respiratory infection in the human host. What is not clear for SARS-CoV-2 is how rapidly this response occurs, or when antibodies with protective capability evolve. Hence, defining the events of SARS-CoV-2 seroconversion and the time frame for the development of antibodies with protective potential may help to explain the different clinical presentations of COVID-19. Furthermore, accurate descriptions of seroconversion are needed to inform the best use of serological assays for diagnostic testing and serosurveillance studies. Here, we describe the humoral responses in a cohort of hospitalised COVID-19 patients (n = 19) shortly following the onset of symptoms. Commercial and 'in-house' serological assays were used to measure IgG antibodies against different SARS-CoV-2 structural antigens-Spike (S) S1 sub-unit and Nucleocapsid protein (NP)-and to assess the potential for virus neutralisation mediated specifically by inhibition of binding between the viral attachment protein (S protein) and cognate receptor (ACE-2). Antibody response kinetics varied amongst the cohort, with patients seroconverting within 1 week, between 1-2 weeks, or after 2 weeks, following symptom onset. Anti-NP IgG responses were generally detected earlier, but reached maximum levels slower, than anti-S1 IgG responses. The earliest IgG antibodies produced by all patients included those that recognised the S protein receptor-binding domain (RBD) and were capable of inhibiting binding to ACE-2. These data revealed events and patterns of SARS-CoV-2 seroconversion that may be important predictors of the outcome of infection and guide the delivery of clinical services in the COVID-19 response.
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Affiliation(s)
- Isa Murrell
- Wales Specialist Virology Centre, Public Health Wales Microbiology, University Hospital of Wales, Cardiff, Wales, United Kingdom
| | - Donall Forde
- Wales Specialist Virology Centre, Public Health Wales Microbiology, University Hospital of Wales, Cardiff, Wales, United Kingdom
| | - Wioleta Zelek
- Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff, Wales, United Kingdom
| | - Linda Tyson
- Wales Specialist Virology Centre, Public Health Wales Microbiology, University Hospital of Wales, Cardiff, Wales, United Kingdom
| | - Lisa Chichester
- Wales Specialist Virology Centre, Public Health Wales Microbiology, University Hospital of Wales, Cardiff, Wales, United Kingdom
| | - Nicki Palmer
- Wales Specialist Virology Centre, Public Health Wales Microbiology, University Hospital of Wales, Cardiff, Wales, United Kingdom
| | - Rachel Jones
- Wales Specialist Virology Centre, Public Health Wales Microbiology, University Hospital of Wales, Cardiff, Wales, United Kingdom
| | - B. Paul Morgan
- Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff, Wales, United Kingdom
| | - Catherine Moore
- Wales Specialist Virology Centre, Public Health Wales Microbiology, University Hospital of Wales, Cardiff, Wales, United Kingdom
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Morgan BP, Gommerman JL, Ramaglia V. An "Outside-In" and "Inside-Out" Consideration of Complement in the Multiple Sclerosis Brain: Lessons From Development and Neurodegenerative Diseases. Front Cell Neurosci 2021; 14:600656. [PMID: 33488361 PMCID: PMC7817777 DOI: 10.3389/fncel.2020.600656] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 11/24/2020] [Indexed: 12/14/2022] Open
Abstract
The last 15 years have seen an explosion of new findings on the role of complement, a major arm of the immune system, in the central nervous system (CNS) compartment including contributions to cell migration, elimination of synapse during development, aberrant synapse pruning in neurologic disorders, damage to nerve cells in autoimmune diseases, and traumatic injury. Activation of the complement system in multiple sclerosis (MS) is typically thought to occur as part of a primary (auto)immune response from the periphery (the outside) against CNS antigens (the inside). However, evidence of local complement production from CNS-resident cells, intracellular complement functions, and the more recently discovered role of early complement components in shaping synaptic circuits in the absence of inflammation opens up the possibility that complement-related sequelae may start and finish within the brain itself. In this review, the complement system will be introduced, followed by evidence that implicates complement in shaping the developing, adult, and normal aging CNS as well as its contribution to pathology in neurodegenerative conditions. Discussion of data supporting "outside-in" vs. "inside-out" roles of complement in MS will be presented, concluded by thoughts on potential approaches to therapies targeting specific elements of the complement system.
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Affiliation(s)
- B. Paul Morgan
- UK Dementia Research Institute at Cardiff, Cardiff University, Cardiff, United Kingdom
| | | | - Valeria Ramaglia
- Department of Immunology, University of Toronto, Toronto, ON, Canada
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MacKenzie G, Subramaniam S, Caldwell LJ, Fitzgerald D, Harrison NA, Hong S, Irani SR, Khandaker GM, Liston A, Miron VE, Mondelli V, Morgan BP, Pariante C, Shah DK, Taams LS, Teeling JL, Upthegrove R. Research priorities for neuroimmunology: identifying the key research questions to be addressed by 2030. Wellcome Open Res 2021; 6:194. [PMID: 34778569 PMCID: PMC8558843 DOI: 10.12688/wellcomeopenres.16997.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2021] [Indexed: 01/05/2023] Open
Abstract
Neuroimmunology in the broadest sense is the study of interactions between the nervous and the immune systems. These interactions play important roles in health from supporting neural development, homeostasis and plasticity to modifying behaviour. Neuroimmunology is increasingly recognised as a field with the potential to deliver a significant positive impact on human health and treatment for neurological and psychiatric disorders. Yet, translation to the clinic is hindered by fundamental knowledge gaps on the underlying mechanisms of action or the optimal timing of an intervention, and a lack of appropriate tools to visualise and modulate both systems. Here we propose ten key disease-agnostic research questions that, if addressed, could lead to significant progress within neuroimmunology in the short to medium term. We also discuss four cross-cutting themes to be considered when addressing each question: i) bi-directionality of neuroimmune interactions; ii) the biological context in which the questions are addressed (e.g. health vs disease vs across the lifespan); iii) tools and technologies required to fully answer the questions; and iv) translation into the clinic. We acknowledge that these ten questions cannot represent the full breadth of gaps in our understanding; rather they focus on areas which, if addressed, may have the most broad and immediate impacts. By defining these neuroimmunology priorities, we hope to unite existing and future research teams, who can make meaningful progress through a collaborative and cross-disciplinary effort.
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Affiliation(s)
| | | | - Lindsey J Caldwell
- Wellcome Trust, London, NW1 2BE, UK
- UK Dementia Research Institute Headquarters, London, UK
| | - Denise Fitzgerald
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK
| | - Neil A Harrison
- Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK
- Division of Psychological Medicine and Clinical Neuroscience, Cardiff University, Cardiff, UK
| | - Soyon Hong
- UK Dementia Research Institute, Institute of Neurology, University College London, London, UK
| | - Sarosh R Irani
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- Department of Neurology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Golam M Khandaker
- MRC integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Adrian Liston
- Laboratory of Lymphocyte Signalling and Development, The Babraham Institute, Cambridge, UK
| | - Veronique E Miron
- UK Dementia Research Institute at The University of Edinburgh, Centre for Discovery Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Valeria Mondelli
- National Institute for Health Research, Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - B Paul Morgan
- UK Dementia Research Institute, Cardiff University, Cardiff, UK
- Systems Immunity Research Institute, Cardiff University, Cardiff, UK
| | - Carmine Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Leonie S Taams
- Centre for Inflammation Biology & Cancer Immunology, Department of Inflammation Biology, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Jessica L Teeling
- Biological Sciences, Faculty of Natural and Environmental Sciences, University of Southampton, Southampton, UK
| | - Rachel Upthegrove
- Early Intervention Service, Birmingham Womens and Children’s NHS Foundation Trust, Birmingham, UK
- Institute for Mental Health, University of Birmingham, Birmingham, UK
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35
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Buckland MS, Galloway JB, Fhogartaigh CN, Meredith L, Provine NM, Bloor S, Ogbe A, Zelek WM, Smielewska A, Yakovleva A, Mann T, Bergamaschi L, Turner L, Mescia F, Toonen EJM, Hackstein CP, Akther HD, Vieira VA, Ceron-Gutierrez L, Periselneris J, Kiani-Alikhan S, Grigoriadou S, Vaghela D, Lear SE, Török ME, Hamilton WL, Stockton J, Quick J, Nelson P, Hunter M, Coulter TI, Devlin L, Bradley JR, Smith KGC, Ouwehand WH, Estcourt L, Harvala H, Roberts DJ, Wilkinson IB, Screaton N, Loman N, Doffinger R, Lyons PA, Morgan BP, Goodfellow IG, Klenerman P, Lehner PJ, Matheson NJ, Thaventhiran JED. Treatment of COVID-19 with remdesivir in the absence of humoral immunity: a case report. Nat Commun 2020; 11:6385. [PMID: 33318491 PMCID: PMC7736571 DOI: 10.1038/s41467-020-19761-2] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/27/2020] [Indexed: 12/18/2022] Open
Abstract
The response to the coronavirus disease 2019 (COVID-19) pandemic has been hampered by lack of an effective severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antiviral therapy. Here we report the use of remdesivir in a patient with COVID-19 and the prototypic genetic antibody deficiency X-linked agammaglobulinaemia (XLA). Despite evidence of complement activation and a robust T cell response, the patient developed persistent SARS-CoV-2 pneumonitis, without progressing to multi-organ involvement. This unusual clinical course is consistent with a contribution of antibodies to both viral clearance and progression to severe disease. In the absence of these confounders, we take an experimental medicine approach to examine the in vivo utility of remdesivir. Over two independent courses of treatment, we observe a temporally correlated clinical and virological response, leading to clinical resolution and viral clearance, with no evidence of acquired drug resistance. We therefore provide evidence for the antiviral efficacy of remdesivir in vivo, and its potential benefit in selected patients.
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Affiliation(s)
- Matthew S Buckland
- Department of Clinical Immunology, Barts Health, London, UK.
- UCL GOSH Institute of Child Health Division of Infection and Immunity, Section of Cellular and Molecular Immunology, London, UK.
| | - James B Galloway
- Centre for Rheumatic Diseases, King's College London, London, UK
| | | | - Luke Meredith
- Department of Pathology, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Nicholas M Provine
- Peter Medawar Building for Pathogen Research, South Parks Rd, Oxford, OX1 3SY, UK
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Stuart Bloor
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge Biomedical Campus, Cambridge, UK
- Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
| | - Ane Ogbe
- Peter Medawar Building for Pathogen Research, South Parks Rd, Oxford, OX1 3SY, UK
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Wioleta M Zelek
- Systems Immunity Institute and Dementia Research Institute, Cardiff University, Cardiff, UK
| | - Anna Smielewska
- Division of Virology, Department of Pathology, University of Cambridge, Addenbrookes Hospital, Cambridge, UK
- PHE - Public Health England Laboratory, Cambridge. Box 236, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, UK
| | - Anna Yakovleva
- Department of Pathology, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Tiffeney Mann
- Medical Research Council Toxicology Unit, University of Cambridge, Gleeson Building, Tennis Court Road, Cambridge, CB2 1QW, UK
| | - Laura Bergamaschi
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge Biomedical Campus, Cambridge, UK
- Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
| | - Lorinda Turner
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge Biomedical Campus, Cambridge, UK
- Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
| | - Frederica Mescia
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge Biomedical Campus, Cambridge, UK
- Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
| | - Erik J M Toonen
- R&D Department, Hycult Biotechnology, Frontstraat 2A, 5405 PB, Uden, The Netherlands
| | - Carl-Philipp Hackstein
- Peter Medawar Building for Pathogen Research, South Parks Rd, Oxford, OX1 3SY, UK
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Hossain Delowar Akther
- Peter Medawar Building for Pathogen Research, South Parks Rd, Oxford, OX1 3SY, UK
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Vinicius Adriano Vieira
- Peter Medawar Building for Pathogen Research, South Parks Rd, Oxford, OX1 3SY, UK
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | | | - Jimstan Periselneris
- Respiratory Department, King's College Hospital NHS Foundation Trust, UK. Department of Clinical Virology, Addenbrookes, UK
| | | | | | - Devan Vaghela
- Department of Infectious Diseases, Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - Sara E Lear
- Department of Immunology, Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - M Estée Török
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge Biomedical Campus, Cambridge, UK
- Cambridge University Hospitals NHS Foundation Trust, Department of Microbiology, Cambridge, UK
| | - William L Hamilton
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge Biomedical Campus, Cambridge, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Joanne Stockton
- Institute of Microbiology and Infection, University of Birmingham, Birmingham, UK
| | - Josh Quick
- Institute of Microbiology and Infection, University of Birmingham, Birmingham, UK
| | - Peter Nelson
- Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
| | - Michael Hunter
- Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
| | - Tanya I Coulter
- Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
- Regional Immunology Service, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
| | - Lisa Devlin
- Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
- Regional Immunology Service, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
| | - John R Bradley
- NIHR BioResource and NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK
| | - Kenneth G C Smith
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge Biomedical Campus, Cambridge, UK
- Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
| | - Willem H Ouwehand
- Department of Haematology, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
- NHS Blood and Transplant, Cambridge Biomedical Campus, Cambridge, UK
| | | | | | - David J Roberts
- NHS Blood and Transplant, Oxford, UK
- Radcliffe Department of Medicine and BRC Haematology Theme, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Ian B Wilkinson
- Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
| | | | - Nicholas Loman
- Institute of Microbiology and Infection, University of Birmingham, Birmingham, UK
| | - Rainer Doffinger
- Respiratory Department, King's College Hospital NHS Foundation Trust, UK. Department of Clinical Virology, Addenbrookes, UK
| | - Paul A Lyons
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge Biomedical Campus, Cambridge, UK
- Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
| | - B Paul Morgan
- Systems Immunity Institute and Dementia Research Institute, Cardiff University, Cardiff, UK
| | - Ian G Goodfellow
- Department of Pathology, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Paul Klenerman
- Peter Medawar Building for Pathogen Research, South Parks Rd, Oxford, OX1 3SY, UK
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Paul J Lehner
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge Biomedical Campus, Cambridge, UK
- Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
- Department of Infectious Diseases, Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - Nicholas J Matheson
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge Biomedical Campus, Cambridge, UK.
- Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK.
- Department of Infectious Diseases, Cambridge University Hospitals NHS Trust, Cambridge, UK.
- NHS Blood and Transplant, Cambridge Biomedical Campus, Cambridge, UK.
| | - James E D Thaventhiran
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge Biomedical Campus, Cambridge, UK.
- Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK.
- Medical Research Council Toxicology Unit, University of Cambridge, Gleeson Building, Tennis Court Road, Cambridge, CB2 1QW, UK.
- Cancer Research UK Cambridge Institute, Cambridge Biomedical Campus, Cambridge, UK.
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Rodrigues PRS, Picco N, Morgan BP, Ghazal P. Sepsis target validation for repurposing and combining complement and immune checkpoint inhibition therapeutics. Expert Opin Drug Discov 2020; 16:537-551. [PMID: 33206027 DOI: 10.1080/17460441.2021.1851186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Introduction: Sepsis is a disease that occurs due to an adverse immune response to infection by bacteria, viruses and fungi and is the leading pathway to death by infection. The hallmarks for maladapted immune reactions in severe sepsis, which contribute to multiple organ failure and death, are bookended by the exacerbated activation of the complement system to protracted T-cell dysfunction states orchestrated by immune checkpoint control. Despite major advances in our understanding of the condition, there remains to be either a definitive test or an effective therapeutic intervention.Areas covered: The authors consider a combinational drug therapy approach using new biologics, and mathematical modeling for predicting patient responses, in targeting innate and adaptive immune mediators underlying sepsis. Special consideration is given for emerging complement and immune checkpoint inhibitors that may be repurposed for sepsis treatment.Expert opinion: In order to overcome the challenges inherent to finding new therapies for the complex dysregulated host response to infection that drives sepsis, it is necessary to move away from monotherapy and promote precision for personalized combinatory therapies. Notably, combinatory therapy should be guided by predictive systems models of the immune-metabolic characteristics of an individual's disease progression.
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Affiliation(s)
- Patrícia R S Rodrigues
- School of Medicine, Systems Immunity Research Institute, Cardiff University, Cardiff, UK
| | - Noemi Picco
- Department of Mathematics, Swansea University, Swansea, UK
| | - B Paul Morgan
- School of Medicine, Systems Immunity Research Institute, Cardiff University, Cardiff, UK
| | - Peter Ghazal
- School of Medicine, Systems Immunity Research Institute, Cardiff University, Cardiff, UK
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Zelek WM, Morgan BP. Monoclonal Antibodies Capable of Inhibiting Complement Downstream of C5 in Multiple Species. Front Immunol 2020; 11:612402. [PMID: 33424866 PMCID: PMC7793867 DOI: 10.3389/fimmu.2020.612402] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/09/2020] [Indexed: 12/20/2022] Open
Abstract
Better understanding of roles of complement in pathology has fuelled an explosion of interest in complement-targeted therapeutics. The C5-blocking monoclonal antibody (mAb) eculizumab, the first of the new wave of complement blocking drugs, was FDA approved for treatment of Paroxysmal Nocturnal Hemoglobinuria in 2007; its expansion into other diseases has been slow and remains restricted to rare and ultra-rare diseases such as atypical hemolytic uremic syndrome. The success of eculizumab has provoked other Pharma to follow this well-trodden track and made C5 blockade the busiest area of complement drug development. C5 blockade inhibits generation of C5a and C5b, the former an anaphylatoxin, the latter the nidus for formation of the pro-inflammatory membrane attack complex. In order to use anti-complement drugs in common complement-driven diseases, more affordable and equally effective therapeutics are needed. To address this, we explored complement inhibition downstream of C5. Novel blocking mAbs targeting C7 and/or the C5b-7 complex were generated, identified using high throughput functional assays and specificity confirmed by immunochemical assays and surface plasmon resonance (SPR). Selected mAbs were tested in rodents to characterize pharmacokinetics, and therapeutic capacity. Administration of a mouse C7-selective mAb to wildtype mice, or a human C7 specific mAb to C7-deficient mice reconstituted with human C7, completely inhibited serum lytic activity for >48 h. The C5b-7 complex selective mAb 2H2, most active in rat serum, efficiently inhibited serum lytic activity in vivo for over a week from a single low dose (10 mg/kg); this mAb effectively blocked disease and protected muscle endplates from destruction in a rat myasthenia model. Targeting C7 and C7-containing terminal pathway intermediates is an innovative therapeutic approach, allowing lower drug dose and lower product cost, that will facilitate the expansion of complement therapeutics to common diseases.
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Affiliation(s)
- Wioleta M Zelek
- Systems Immunity Research Institute, Division of Infection and Immunity and Dementia Research Institute, School of Medicine, Cardiff University, Wales, United Kingdom
| | - B Paul Morgan
- Systems Immunity Research Institute, Division of Infection and Immunity and Dementia Research Institute, School of Medicine, Cardiff University, Wales, United Kingdom
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Bevan RJ, Hughes TR, Williams PA, Good MA, Morgan BP, Morgan JE. Retinal ganglion cell degeneration correlates with hippocampal spine loss in experimental Alzheimer's disease. Acta Neuropathol Commun 2020; 8:216. [PMID: 33287900 PMCID: PMC7720390 DOI: 10.1186/s40478-020-01094-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 11/23/2020] [Indexed: 02/06/2023] Open
Abstract
Neuronal dendritic and synaptic pruning are early features of neurodegenerative diseases, including Alzheimer’s disease. In addition to brain pathology, amyloid plaque deposition, microglial activation, and cell loss occur in the retinas of human patients and animal models of Alzheimer’s disease. Retinal ganglion cells, the output neurons of the retina, are vulnerable to damage in neurodegenerative diseases and are a potential opportunity for non-invasive clinical diagnosis and monitoring of Alzheimer’s progression. However, the extent of retinal involvement in Alzheimer’s models and how well this reflects brain pathology is unclear. Here we have quantified changes in retinal ganglion cells dendritic structure and hippocampal dendritic spines in three well-studied Alzheimer’s mouse models, Tg2576, 3xTg-AD and APPNL-G-F. Dendritic complexity of DiOlistically labelled retinal ganglion cells from retinal explants was reduced in all three models in an age-, gender-, and receptive field-dependent manner. DiOlistically labelled hippocampal slices showed spine loss in CA1 apical dendrites in all three Alzheimer’s models, mirroring the early stages of neurodegeneration as seen in the retina. Morphological classification showed that loss of thin spines predominated in all. The demonstration that retinal ganglion cells dendritic field reduction occurs in parallel with hippocampal dendritic spine loss in all three Alzheimer’s models provide compelling support for the use of retinal neurodegeneration. As retinal dendritic changes are within the optical range of current clinical imaging systems (for example optical coherence tomography), our study makes a case for imaging the retina as a non-invasive way to diagnose disease and monitor progression in Alzheimer’s disease.
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Zelek WM, Cole J, Ponsford MJ, Harrison RA, Schroeder BE, Webb N, Jolles S, Fegan C, Morgan M, Wise MP, Morgan BP. Complement Inhibition with the C5 Blocker LFG316 in Severe COVID-19. Am J Respir Crit Care Med 2020; 202:1304-1308. [PMID: 32897730 PMCID: PMC7605181 DOI: 10.1164/rccm.202007-2778le] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
| | - Jade Cole
- University Hospital of Wales, Cardiff, United Kingdom and
| | - Mark J Ponsford
- Cardiff University, Cardiff, United Kingdom.,University Hospital of Wales, Cardiff, United Kingdom and
| | | | | | - Nicholas Webb
- Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - Stephen Jolles
- University Hospital of Wales, Cardiff, United Kingdom and
| | | | - Matt Morgan
- Cardiff University, Cardiff, United Kingdom.,University Hospital of Wales, Cardiff, United Kingdom and
| | - Matt P Wise
- Cardiff University, Cardiff, United Kingdom.,University Hospital of Wales, Cardiff, United Kingdom and
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O'Connor DB, Aggleton JP, Chakrabarti B, Cooper CL, Creswell C, Dunsmuir S, Fiske ST, Gathercole S, Gough B, Ireland JL, Jones MV, Jowett A, Kagan C, Karanika‐Murray M, Kaye LK, Kumari V, Lewandowsky S, Lightman S, Malpass D, Meins E, Morgan BP, Morrison Coulthard LJ, Reicher SD, Schacter DL, Sherman SM, Simms V, Williams A, Wykes T, Armitage CJ. Research priorities for the COVID-19 pandemic and beyond: A call to action for psychological science. Br J Psychol 2020; 111:603-629. [PMID: 32683689 PMCID: PMC7404603 DOI: 10.1111/bjop.12468] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/23/2020] [Indexed: 12/22/2022]
Abstract
The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that has caused the coronavirus disease 2019 (COVID-19) pandemic represents the greatest international biopsychosocial emergency the world has faced for a century, and psychological science has an integral role to offer in helping societies recover. The aim of this paper is to set out the shorter- and longer-term priorities for research in psychological science that will (a) frame the breadth and scope of potential contributions from across the discipline; (b) enable researchers to focus their resources on gaps in knowledge; and (c) help funders and policymakers make informed decisions about future research priorities in order to best meet the needs of societies as they emerge from the acute phase of the pandemic. The research priorities were informed by an expert panel convened by the British Psychological Society that reflects the breadth of the discipline; a wider advisory panel with international input; and a survey of 539 psychological scientists conducted early in May 2020. The most pressing need is to research the negative biopsychosocial impacts of the COVID-19 pandemic to facilitate immediate and longer-term recovery, not only in relation to mental health, but also in relation to behaviour change and adherence, work, education, children and families, physical health and the brain, and social cohesion and connectedness. We call on psychological scientists to work collaboratively with other scientists and stakeholders, establish consortia, and develop innovative research methods while maintaining high-quality, open, and rigorous research standards.
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Affiliation(s)
| | | | | | - Cary L. Cooper
- Alliance Manchester Business SchoolUniversity of ManchesterUK
| | - Cathy Creswell
- Departments of Experimental Psychology and PsychiatryUniversity of OxfordUK
| | - Sandra Dunsmuir
- Educational Psychology GroupDivision of Psychology and Language SciencesUniversity College LondonUK
| | - Susan T. Fiske
- Department of Psychology and School of International and Public AffairsPrinceton UniversityNew JerseyUSA
| | | | - Brendan Gough
- Leeds School of Social SciencesLeeds Beckett UniversityUK
| | - Jane L. Ireland
- School of PsychologyUniversity of Central LancashirePrestonUK
- Mersey Care NHS Foundation TrustLiverpoolUK
| | - Marc V. Jones
- Department of PsychologyManchester Metropolitan UniversityUK
| | - Adam Jowett
- School of PsychologicalSocial & Behavioural SciencesCoventry UniversityUK
| | - Carolyn Kagan
- School of PsychologyManchester Metropolitan UniversityUK
| | | | | | - Veena Kumari
- Centre for Cognitive NeuroscienceCollege of Health and Life SciencesBrunel University LondonUK
| | | | - Stafford Lightman
- Translational Health Sciences, Bristol Medical SchoolUniversity of BristolUK
| | | | | | - B. Paul Morgan
- Systems Immunity URI CardiffSchool of MedicineCardiff UniversityUK
| | | | | | | | | | | | | | - Til Wykes
- Institute of Psychiatry, Psychology and Neuroscience, King's College LondonUK
- South London and Maudsley NHS Foundation TrustUK
| | - Christopher J. Armitage
- Manchester Centre for Health PsychologySchool of Health SciencesUniversity of ManchesterUK
- Manchester University NHS Foundation TrustManchester Academic Health Science CentreUK
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Jackson HM, Foley KE, O'Rourke R, Stearns TM, Fathalla D, Morgan BP, Howell GR. A novel mouse model expressing human forms for complement receptors CR1 and CR2. BMC Genet 2020; 21:101. [PMID: 32907542 PMCID: PMC7487969 DOI: 10.1186/s12863-020-00893-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 07/21/2020] [Indexed: 12/20/2022] Open
Abstract
Background The complement cascade is increasingly implicated in development of a variety of diseases with strong immune contributions such as Alzheimer’s disease and Systemic Lupus Erythematosus. Mouse models have been used to determine function of central components of the complement cascade such as C1q and C3. However, species differences in their gene structures mean that mice do not adequately replicate human complement regulators, including CR1 and CR2. Genetic variation in CR1 and CR2 have been implicated in modifying disease states but the mechanisms are not known. Results To decipher the roles of human CR1 and CR2 in health and disease, we engineered C57BL/6J (B6) mice to replace endogenous murine Cr2 with human complement receptors, CR1 and CR2 (B6.CR2CR1). CR1 has an array of allotypes in human populations and using traditional recombination methods (Flp-frt and Cre-loxP) two of the most common alleles (referred to here as CR1long and CR1short) can be replicated within this mouse model, along with a CR1 knockout allele (CR1KO). Transcriptional profiling of spleens and brains identified genes and pathways differentially expressed between mice homozygous for either CR1long, CR1short or CR1KO. Gene set enrichment analysis predicts hematopoietic cell number and cell infiltration are modulated by CR1long, but not CR1short or CR1KO. Conclusion The B6.CR2CR1 mouse model provides a novel tool for determining the relationship between human-relevant CR1 alleles and disease.
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Affiliation(s)
- Harriet M Jackson
- The Jackson Laboratory, 600 Main Street, Bar Harbor, ME, USA.,Dementia Research Institute Cardiff and Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff, Wales, UK
| | - Kate E Foley
- The Jackson Laboratory, 600 Main Street, Bar Harbor, ME, USA.,Graduate School of Biomedical Sciences, Tufts University School of Medicine, Boston, MA, USA
| | - Rita O'Rourke
- The Jackson Laboratory, 600 Main Street, Bar Harbor, ME, USA
| | | | - Dina Fathalla
- Dementia Research Institute Cardiff and Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff, Wales, UK
| | - B Paul Morgan
- Dementia Research Institute Cardiff and Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff, Wales, UK
| | - Gareth R Howell
- The Jackson Laboratory, 600 Main Street, Bar Harbor, ME, USA. .,Graduate School of Biomedical Sciences, Tufts University School of Medicine, Boston, MA, USA. .,Graduate School of Biomedical Sciences and Engineering, University of Maine, Orono, ME, USA.
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Altmann T, Torvell M, Owens S, Mitra D, Sheerin NS, Morgan BP, Kavanagh D, Forsyth R. Complement factor I deficiency: A potentially treatable cause of fulminant cerebral inflammation. Neurol Neuroimmunol Neuroinflamm 2020; 7:7/3/e689. [PMID: 32098865 PMCID: PMC7051217 DOI: 10.1212/nxi.0000000000000689] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 01/21/2020] [Indexed: 11/15/2022]
Abstract
Objective To raise awareness of complement factor I (CFI) deficiency as a potentially treatable cause of severe cerebral inflammation. Methods Case report with neuroradiology, neuropathology, and functional data describing the mutation with review of literature. Results We present a case of acute, fulminant, destructive cerebral edema in a previously well 11-year-old, demonstrating massive activation of complement pathways on neuropathology and compound heterozygote status for 2 pathogenic mutations in CFI which result in normal levels but completely abrogate function. Conclusions Our case adds to a very small number of extant reports of this phenomenon associated with a spectrum of inflammatory histopathologies including hemorrhagic leukoencephalopathy and clinical presentations resembling severe acute disseminated encephalomyelitis. CFI deficiency can result in uncontrolled activation of the complement pathways in the brain resulting in devastating cerebral inflammation. The deficit is latent, but the catastrophic dysregulation of the complement system may be the result of a C3 acute phase response. Diagnoses to date have been retrospective. Diagnosis requires a high index of suspicion and clinician awareness of the limitations of first-line clinical tests of complement activity and activation. Simple measurement of circulating CFI levels, as here, may fail to diagnose functional deficiency with absent CFI activity. These diagnostic challenges may mean that the CFI deficiency is being systematically under-recognized as a cause of fulminant cerebral inflammation. Complement inhibitory therapies (such as eculizumab) offer new potential treatment, underlining the importance of prompt recognition, and real-time whole exome sequencing may play an important future role.
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Affiliation(s)
- Tom Altmann
- From the Department of Paediatric Infectious Disease (T.A, S.O.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Division of Infection and Immunity and Dementia Research Institute (M.T., B.P.M.), School of Medicine, Cardiff University; Department of Neuroradiology (D.M.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Department of National Renal Complement Therapeutics Centre (N.S.S., D.K.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Complement Therapeutics Research (N.S.S., D.K.), Translational and Clinical Research Institute, Newcastle University; Department of Paediatric Neurology (R.F.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Neuroscience, Neurodisability and Neurological Disorders Groups (R.F.), Translational and Clinical Research Institute, Newcastle University, United Kingdom
| | - Megan Torvell
- From the Department of Paediatric Infectious Disease (T.A, S.O.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Division of Infection and Immunity and Dementia Research Institute (M.T., B.P.M.), School of Medicine, Cardiff University; Department of Neuroradiology (D.M.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Department of National Renal Complement Therapeutics Centre (N.S.S., D.K.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Complement Therapeutics Research (N.S.S., D.K.), Translational and Clinical Research Institute, Newcastle University; Department of Paediatric Neurology (R.F.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Neuroscience, Neurodisability and Neurological Disorders Groups (R.F.), Translational and Clinical Research Institute, Newcastle University, United Kingdom
| | - Stephen Owens
- From the Department of Paediatric Infectious Disease (T.A, S.O.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Division of Infection and Immunity and Dementia Research Institute (M.T., B.P.M.), School of Medicine, Cardiff University; Department of Neuroradiology (D.M.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Department of National Renal Complement Therapeutics Centre (N.S.S., D.K.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Complement Therapeutics Research (N.S.S., D.K.), Translational and Clinical Research Institute, Newcastle University; Department of Paediatric Neurology (R.F.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Neuroscience, Neurodisability and Neurological Disorders Groups (R.F.), Translational and Clinical Research Institute, Newcastle University, United Kingdom
| | - Dipayan Mitra
- From the Department of Paediatric Infectious Disease (T.A, S.O.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Division of Infection and Immunity and Dementia Research Institute (M.T., B.P.M.), School of Medicine, Cardiff University; Department of Neuroradiology (D.M.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Department of National Renal Complement Therapeutics Centre (N.S.S., D.K.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Complement Therapeutics Research (N.S.S., D.K.), Translational and Clinical Research Institute, Newcastle University; Department of Paediatric Neurology (R.F.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Neuroscience, Neurodisability and Neurological Disorders Groups (R.F.), Translational and Clinical Research Institute, Newcastle University, United Kingdom
| | - Neil S Sheerin
- From the Department of Paediatric Infectious Disease (T.A, S.O.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Division of Infection and Immunity and Dementia Research Institute (M.T., B.P.M.), School of Medicine, Cardiff University; Department of Neuroradiology (D.M.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Department of National Renal Complement Therapeutics Centre (N.S.S., D.K.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Complement Therapeutics Research (N.S.S., D.K.), Translational and Clinical Research Institute, Newcastle University; Department of Paediatric Neurology (R.F.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Neuroscience, Neurodisability and Neurological Disorders Groups (R.F.), Translational and Clinical Research Institute, Newcastle University, United Kingdom
| | - B Paul Morgan
- From the Department of Paediatric Infectious Disease (T.A, S.O.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Division of Infection and Immunity and Dementia Research Institute (M.T., B.P.M.), School of Medicine, Cardiff University; Department of Neuroradiology (D.M.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Department of National Renal Complement Therapeutics Centre (N.S.S., D.K.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Complement Therapeutics Research (N.S.S., D.K.), Translational and Clinical Research Institute, Newcastle University; Department of Paediatric Neurology (R.F.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Neuroscience, Neurodisability and Neurological Disorders Groups (R.F.), Translational and Clinical Research Institute, Newcastle University, United Kingdom
| | - David Kavanagh
- From the Department of Paediatric Infectious Disease (T.A, S.O.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Division of Infection and Immunity and Dementia Research Institute (M.T., B.P.M.), School of Medicine, Cardiff University; Department of Neuroradiology (D.M.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Department of National Renal Complement Therapeutics Centre (N.S.S., D.K.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Complement Therapeutics Research (N.S.S., D.K.), Translational and Clinical Research Institute, Newcastle University; Department of Paediatric Neurology (R.F.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Neuroscience, Neurodisability and Neurological Disorders Groups (R.F.), Translational and Clinical Research Institute, Newcastle University, United Kingdom
| | - Rob Forsyth
- From the Department of Paediatric Infectious Disease (T.A, S.O.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Division of Infection and Immunity and Dementia Research Institute (M.T., B.P.M.), School of Medicine, Cardiff University; Department of Neuroradiology (D.M.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Department of National Renal Complement Therapeutics Centre (N.S.S., D.K.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Complement Therapeutics Research (N.S.S., D.K.), Translational and Clinical Research Institute, Newcastle University; Department of Paediatric Neurology (R.F.), Newcastle upon Tyne Hospitals NHS Foundation Trust; Neuroscience, Neurodisability and Neurological Disorders Groups (R.F.), Translational and Clinical Research Institute, Newcastle University, United Kingdom
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Cipriani V, Lorés-Motta L, He F, Fathalla D, Tilakaratna V, McHarg S, Bayatti N, Acar İE, Hoyng CB, Fauser S, Moore AT, Yates JRW, de Jong EK, Morgan BP, den Hollander AI, Bishop PN, Clark SJ. Increased circulating levels of Factor H-Related Protein 4 are strongly associated with age-related macular degeneration. Nat Commun 2020; 11:778. [PMID: 32034129 PMCID: PMC7005798 DOI: 10.1038/s41467-020-14499-3] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 01/10/2020] [Indexed: 12/21/2022] Open
Abstract
Age-related macular degeneration (AMD) is a leading cause of blindness. Genetic variants at the chromosome 1q31.3 encompassing the complement factor H (CFH, FH) and CFH related genes (CFHR1-5) are major determinants of AMD susceptibility, but their molecular consequences remain unclear. Here we demonstrate that FHR-4 plays a prominent role in AMD pathogenesis. We show that systemic FHR-4 levels are elevated in AMD (P-value = 7.1 × 10-6), whereas no difference is seen for FH. Furthermore, FHR-4 accumulates in the choriocapillaris, Bruch's membrane and drusen, and can compete with FH/FHL-1 for C3b binding, preventing FI-mediated C3b cleavage. Critically, the protective allele of the strongest AMD-associated CFH locus variant rs10922109 has the highest association with reduced FHR-4 levels (P-value = 2.2 × 10-56), independently of the AMD-protective CFHR1-3 deletion, and even in those individuals that carry the high-risk allele of rs1061170 (Y402H). Our findings identify FHR-4 as a key molecular player contributing to complement dysregulation in AMD.
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Affiliation(s)
- Valentina Cipriani
- William Harvey Research Institute, Clinical Pharmacology, Queen Mary University of London, London, EC1M 6BQ, UK.
- UCL Institute of Ophthalmology, University College London, London, EC1V 9EL, UK.
- Moorfields Eye Hospital NHS Foundation Trust, London, EC1V 2PD, UK.
- UCL Genetics Institute, University College London, London, WC1E 6BT, UK.
| | - Laura Lorés-Motta
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, 6525 GA, The Netherlands
| | - Fan He
- Division of Evolution and Genomic Sciences, Faculty of Biology Medicine and Health, School of Biological Sciences, University of Manchester, Oxford Road, Manchester, M13 9PT, UK
| | - Dina Fathalla
- Systems Immunity URI, Division of Infection and Immunity, and UK DRI Cardiff, School of Medicine, Cardiff University, Cardiff, CF14 4XN, UK
| | - Viranga Tilakaratna
- Division of Evolution and Genomic Sciences, Faculty of Biology Medicine and Health, School of Biological Sciences, University of Manchester, Oxford Road, Manchester, M13 9PT, UK
| | - Selina McHarg
- Division of Evolution and Genomic Sciences, Faculty of Biology Medicine and Health, School of Biological Sciences, University of Manchester, Oxford Road, Manchester, M13 9PT, UK
| | - Nadhim Bayatti
- Division of Evolution and Genomic Sciences, Faculty of Biology Medicine and Health, School of Biological Sciences, University of Manchester, Oxford Road, Manchester, M13 9PT, UK
| | - İlhan E Acar
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, 6525 GA, The Netherlands
| | - Carel B Hoyng
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, 6525 GA, The Netherlands
| | - Sascha Fauser
- Department of Ophthalmology, University Hospital of Cologne, Cologne, 50924, Germany
- Roche Pharma Research and Early Development, F. Hoffmann-La Roche Ltd, Basel, 4070, Switzerland
| | - Anthony T Moore
- UCL Institute of Ophthalmology, University College London, London, EC1V 9EL, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, EC1V 2PD, UK
- Ophthalmology Department, University of California San Francisco, San Francisco, CA, USA
| | - John R W Yates
- UCL Institute of Ophthalmology, University College London, London, EC1V 9EL, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, EC1V 2PD, UK
- Department of Medical Genetics, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Eiko K de Jong
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, 6525 GA, The Netherlands
| | - B Paul Morgan
- Systems Immunity URI, Division of Infection and Immunity, and UK DRI Cardiff, School of Medicine, Cardiff University, Cardiff, CF14 4XN, UK
| | - Anneke I den Hollander
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, 6525 GA, The Netherlands
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, 6525 HR, The Netherlands
| | - Paul N Bishop
- Division of Evolution and Genomic Sciences, Faculty of Biology Medicine and Health, School of Biological Sciences, University of Manchester, Oxford Road, Manchester, M13 9PT, UK
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK
| | - Simon J Clark
- Division of Evolution and Genomic Sciences, Faculty of Biology Medicine and Health, School of Biological Sciences, University of Manchester, Oxford Road, Manchester, M13 9PT, UK.
- The Lydia Becker Institute of Immunology and Inflammation, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
- Department of Ophthalmology, Research Institute of Ophthalmology, Eberhard Karls University of Tübingen, 72076, Tübingen, Germany.
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Shi L, Winchester LM, Liu BY, Killick R, Ribe EM, Westwood S, Baird AL, Buckley NJ, Hong S, Dobricic V, Kilpert F, Franke A, Kiddle S, Sattlecker M, Dobson R, Cuadrado A, Hye A, Ashton NJ, Morgan AR, Bos I, Vos SJ, ten Kate M, Scheltens P, Vandenberghe R, Gabel S, Meersmans K, Engelborghs S, De Roeck EE, Sleegers K, Frisoni GB, Blin O, Richardson JC, Bordet R, Molinuevo JL, Rami L, Wallin A, Kettunen P, Tsolaki M, Verhey F, Lleó A, Alcolea D, Popp J, Peyratout G, Martinez-Lage P, Tainta M, Johannsen P, Teunissen CE, Freund-Levi Y, Frölich L, Legido-Quigley C, Barkhof F, Blennow K, Rasmussen KL, Nordestgaard BG, Frikke-Schmidt R, Nielsen SF, Soininen H, Vellas B, Kloszewska I, Mecocci P, Zetterberg H, Morgan BP, Streffer J, Visser PJ, Bertram L, Nevado-Holgado AJ, Lovestone S. Dickkopf-1 Overexpression in vitro Nominates Candidate Blood Biomarkers Relating to Alzheimer's Disease Pathology. J Alzheimers Dis 2020; 77:1353-1368. [PMID: 32831200 PMCID: PMC7683080 DOI: 10.3233/jad-200208] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Previous studies suggest that Dickkopf-1 (DKK1), an inhibitor of Wnt signaling, plays a role in amyloid-induced toxicity and hence Alzheimer's disease (AD). However, the effect of DKK1 expression on protein expression, and whether such proteins are altered in disease, is unknown. OBJECTIVE We aim to test whether DKK1 induced protein signature obtained in vitro were associated with markers of AD pathology as used in the amyloid/tau/neurodegeneration (ATN) framework as well as with clinical outcomes. METHODS We first overexpressed DKK1 in HEK293A cells and quantified 1,128 proteins in cell lysates using aptamer capture arrays (SomaScan) to obtain a protein signature induced by DKK1. We then used the same assay to measure the DKK1-signature proteins in human plasma in two large cohorts, EMIF (n = 785) and ANM (n = 677). RESULTS We identified a 100-protein signature induced by DKK1 in vitro. Subsets of proteins, along with age and apolipoprotein E ɛ4 genotype distinguished amyloid pathology (A + T-N-, A+T+N-, A+T-N+, and A+T+N+) from no AD pathology (A-T-N-) with an area under the curve of 0.72, 0.81, 0.88, and 0.85, respectively. Furthermore, we found that some signature proteins (e.g., Complement C3 and albumin) were associated with cognitive score and AD diagnosis in both cohorts. CONCLUSIONS Our results add further evidence for a role of DKK regulation of Wnt signaling in AD and suggest that DKK1 induced signature proteins obtained in vitro could reflect theATNframework as well as predict disease severity and progression in vivo.
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Affiliation(s)
- Liu Shi
- Department of Psychiatry, University of Oxford, UK
| | | | | | - Richard Killick
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Institute Clinical Neuroscience Institute, London, UK
| | | | | | | | | | - Shengjun Hong
- Lübeck Interdisciplinary Platform for Genome Analytics, Institutes of Neurogenetics and Cardiogenetics, University of Lübeck, Lübeck, Germany
| | - Valerija Dobricic
- Lübeck Interdisciplinary Platform for Genome Analytics, Institutes of Neurogenetics and Cardiogenetics, University of Lübeck, Lübeck, Germany
| | - Fabian Kilpert
- Lübeck Interdisciplinary Platform for Genome Analytics, Institutes of Neurogenetics and Cardiogenetics, University of Lübeck, Lübeck, Germany
| | - Andre Franke
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Steven Kiddle
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Institute Clinical Neuroscience Institute, London, UK
- MRC Social, Genetic and Developmental Psychiatry Centre, King’s College London, UK
| | - Martina Sattlecker
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Institute Clinical Neuroscience Institute, London, UK
- MRC Social, Genetic and Developmental Psychiatry Centre, King’s College London, UK
| | - Richard Dobson
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Institute of Health Informatics, University College London, London, UK
| | - Antonio Cuadrado
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Investigación Sanitaria La Paz (IdiPaz), Instituto de Investigaciones Biomédicas Alberto Sols UAM-CSIC, and Department of Biochemistry, Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
- ”Victor Babes” National Institute of Pathology, Bucharest, Romania
| | - Abdul Hye
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Institute Clinical Neuroscience Institute, London, UK
| | - Nicholas J. Ashton
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Institute Clinical Neuroscience Institute, London, UK
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, London, UK
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
| | | | - Isabelle Bos
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centrum Limburg, Maastricht University, Maastricht, the Netherlands
- Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands
| | - Stephanie J.B. Vos
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centrum Limburg, Maastricht University, Maastricht, the Netherlands
| | - Mara ten Kate
- Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands
| | - Philip Scheltens
- Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands
| | | | - Silvy Gabel
- University Hospital Leuven, Leuven, Belgium
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Belgium
| | - Karen Meersmans
- University Hospital Leuven, Leuven, Belgium
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Belgium
| | - Sebastiaan Engelborghs
- Center for Neurosciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
- Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
- Department of Neurology, UZ Brussel, Brussels, Belgium
| | - Ellen E. De Roeck
- Center for Neurosciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
- Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Kristel Sleegers
- Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
- Neurodegenerative Brain Diseases Group, Center for Molecular Neurology, VIB, Belgium
| | - Giovanni B. Frisoni
- University of Geneva, Geneva, Switzerland
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Olivier Blin
- AIX Marseille University, INS, Ap-hm, Marseille, France
| | | | | | - José L. Molinuevo
- Alzheimer’s disease & other cognitive disorders unit, Hospital Clínic, Barcelona, Spain
- BarcelonaBeta Brain Research Center, Universitat Pompeu Fabra, Barcelona, Spain
| | - Lorena Rami
- BarcelonaBeta Brain Research Center, Universitat Pompeu Fabra, Barcelona, Spain
| | - Anders Wallin
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Memory Clinic at Department of Neuropsychiatry, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Petronella Kettunen
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Magda Tsolaki
- 1st Department of Neurology, AHEPA University Hospital, school of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Makedonia, Greece
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centrum Limburg, Maastricht University, Maastricht, the Netherlands
| | - Alberto Lleó
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Daniel Alcolea
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Julius Popp
- Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
- Geriatric Psychiatry, Department of Psychiatry, Geneva University Hospitals, and University of Geneva, Geneva, Switzerland
| | - Gwendoline Peyratout
- Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
| | | | - Mikel Tainta
- CITA-Alzheimer Foundation, San Sebastian, Spain
- Organización Sanitaria Integrada Goierri – Alto Urola, Osakidetza, Spain
| | - Peter Johannsen
- Danish Dementia Research Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Charlotte E. Teunissen
- Neurochemistry Laboratory, dept of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands
| | - Yvonne Freund-Levi
- School of Medical Sciences, Örebro University, Örebro, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institute, Stockholm, Sweden
- Department of Old Age Psychiatry, Psychology and Neuroscience, King’s College London, UK
- Department of Psychiatry, Örebro Universitetssjukhus, Örebro, Sweden
| | - Lutz Frölich
- Department of Geriatric Psychiatry, Zentralinstitut für Seelische Gesundheit, University of Heidelberg, Mannheim, Germany
| | - Cristina Legido-Quigley
- Kings College London, London, UK
- The Systems Medicine Group, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherland
- UCL Institutes of Neurology and Healthcare Engineering, London, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Katrine Laura Rasmussen
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Børge Grønne Nordestgaard
- The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, Denmark
| | - Ruth Frikke-Schmidt
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sune Fallgaard Nielsen
- The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Hilkka Soininen
- Neurology / Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Bruno Vellas
- Toulouse Gerontopole University Hospital, Univeriste Paul Sabatier, INSERM U 558, France
| | | | - Patrizia Mecocci
- Section of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- UK Dementia Research Institute at UCL, London, United Kingdom
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, United Kingdom
| | - B. Paul Morgan
- Dementia Research Institute Cardiff, Cardiff University, Cardiff, UK
| | - Johannes Streffer
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
- UCB, Braine-l’Alleud, Belgium, formerly Janssen R&D, LLC. Beerse, Belgium at the time of study conduct
| | - Pieter Jelle Visser
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centrum Limburg, Maastricht University, Maastricht, the Netherlands
- Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Lars Bertram
- Lübeck Interdisciplinary Platform for Genome Analytics, Institutes of Neurogenetics and Cardiogenetics, University of Lübeck, Lübeck, Germany
- Department of Psychology, University of Oslo, Oslo, Norway
| | | | - Simon Lovestone
- Department of Psychiatry, University of Oxford, UK
- Currently at Janssen-Cilag UK, formerly at Department of Psychiatry, University of Oxford, UK at the time of the study conduct
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45
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Westwood S, Baird AL, Anand SN, Nevado-Holgado AJ, Kormilitzin A, Shi L, Hye A, Ashton NJ, Morgan AR, Bos I, Vos SJ, Baker S, Buckley NJ, Ten Kate M, Scheltens P, Teunissen CE, Vandenberghe R, Gabel S, Meersmans K, Engelborghs S, De Roeck EE, Sleegers K, Frisoni GB, Blin O, Richardson JC, Bordet R, Molinuevo JL, Rami L, Wallin A, Kettunen P, Tsolaki M, Verhey F, Lléo A, Sala I, Popp J, Peyratout G, Martinez-Lage P, Tainta M, Johannsen P, Freund-Levi Y, Frölich L, Dobricic V, Legido-Quigley C, Bertram L, Barkhof F, Zetterberg H, Morgan BP, Streffer J, Visser PJ, Lovestone S. Validation of Plasma Proteomic Biomarkers Relating to Brain Amyloid Burden in the EMIF-Alzheimer's Disease Multimodal Biomarker Discovery Cohort. J Alzheimers Dis 2020; 74:213-225. [PMID: 31985466 PMCID: PMC7175945 DOI: 10.3233/jad-190434] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
We have previously investigated, discovered, and replicated plasma protein biomarkers for use to triage potential trials participants for PET or cerebrospinal fluid measures of Alzheimer's disease (AD) pathology. This study sought to undertake validation of these candidate plasma biomarkers in a large, multi-center sample collection. Targeted plasma analyses of 34 proteins with prior evidence for prediction of in vivo pathology were conducted in up to 1,000 samples from cognitively healthy elderly individuals, people with mild cognitive impairment, and in patients with AD-type dementia, selected from the EMIF-AD catalogue. Proteins were measured using Luminex xMAP, ELISA, and Meso Scale Discovery assays. Seven proteins replicated in their ability to predict in vivo amyloid pathology. These proteins form a biomarker panel that, along with age, could significantly discriminate between individuals with high and low amyloid pathology with an area under the curve of 0.74. The performance of this biomarker panel remained consistent when tested in apolipoprotein E ɛ4 non-carrier individuals only. This blood-based panel is biologically relevant, measurable using practical immunocapture arrays, and could significantly reduce the cost incurred to clinical trials through screen failure.
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Affiliation(s)
| | | | | | | | | | - Liu Shi
- Department of Psychiatry, University of Oxford, UK
| | - Abdul Hye
- Maurice Wohl Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Nicholas J. Ashton
- Maurice Wohl Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Mölndal, Sweden
- Wallenberg Centre for Molecular & Translational Medicine, University of Gothenburg, Gothenburg, Sweden
| | | | - Isabelle Bos
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centrum Limburg, Maastricht University, Maastricht, the Netherlands
| | - Stephanie J.B. Vos
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centrum Limburg, Maastricht University, Maastricht, the Netherlands
| | | | | | - Mara Ten Kate
- Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands
| | - Philip Scheltens
- Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands
| | | | | | - Silvy Gabel
- University Hospital Leuven, Leuven, Belgium
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Belgium
| | - Karen Meersmans
- University Hospital Leuven, Leuven, Belgium
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Belgium
| | - Sebastiaan Engelborghs
- Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, University of Antwerp, Antwerp, Belgium
- Center for Neurosciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Ellen E. De Roeck
- Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, University of Antwerp, Antwerp, Belgium
- Center for Neurosciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Kristel Sleegers
- Center for Neurosciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Neurodegenerative Brain Diseases Group, Center for Molecular Neurology, VIB, Belgium
| | - Giovanni B. Frisoni
- University of Geneva, Geneva, Switzerland
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Olivier Blin
- AIX Marseille University, INS, Ap-Hm, Marseille, France
| | | | | | - José L. Molinuevo
- Alzheimer’s Disease & Other Cognitive Disorders Unit, Hopsital Clínic-IDIBAPS, Barcelona, Spain
- Barcelona Beta Brain Research Center, Unversitat Pompeu Fabra, Barcelona, Spain
| | - Lorena Rami
- Barcelona Beta Brain Research Center, Unversitat Pompeu Fabra, Barcelona, Spain
| | - Anders Wallin
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Petronella Kettunen
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Magda Tsolaki
- 1st Department of Neurology, AHEPA University Hospital, Makedonia, Thessaloniki, Greece
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centrum Limburg, Maastricht University, Maastricht, the Netherlands
| | - Alberto Lléo
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Isabel Sala
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Julius Popp
- University Hospital of Lausanne, Lausanne, Switzerland
- Geriatric Psychiatry, Department of Mental Health and Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | | | - Pablo Martinez-Lage
- Geriatric Psychiatry, Department of Mental Health and Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | | | - Peter Johannsen
- Danish Dementia Research Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Yvonne Freund-Levi
- Maurice Wohl Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
- Department of Neurobiology, Caring Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, and Department of Geriatric Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Lutz Frölich
- Department of Geriatric Psychiatry, Zentralinstitut für Seelische Gesundheit, University of Heidelberg, Mannheim, Germany
| | - Valerija Dobricic
- Lübeck Interdisciplinary Platform for Genome Analytics, Institutes of Neurogenetics and Cardiogenetics, University of Lübeck, Lübeck, Germany
| | - Cristina Legido-Quigley
- Kings College London, London, UK
- The Systems Medicine Group, Steno Diabetes Center, Gentofte, Denmark
| | - Lars Bertram
- Lübeck Interdisciplinary Platform for Genome Analytics, Institutes of Neurogenetics and Cardiogenetics, University of Lübeck, Lübeck, Germany
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherland
- UCL Institutes of Neurology and Healthcare Engineering, London, UK
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- UK Dementia Research Institute at UCL, London, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - B. Paul Morgan
- Dementia Research Institute Cardiff, Cardiff University, Cardiff, UK
| | - Johannes Streffer
- Center for Neurosciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- UCB, Braine-l’Alleud, Belgium, formerly Janssen R&D, LLC. Beerse, Belgium at the Time of Study Conduct
| | - Pieter Jelle Visser
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centrum Limburg, Maastricht University, Maastricht, the Netherlands
- Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands
| | - Simon Lovestone
- Department of Psychiatry, University of Oxford, UK
- Janssen R&D, UK formerly affiliation (1) at the Time of the Study Conduct
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46
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Ghias MH, Hyde MJ, Tomalin LE, Morgan BP, Alavi A, Lowes MA, Piguet V. Role of the Complement Pathway in Inflammatory Skin Diseases: A Focus on Hidradenitis Suppurativa. J Invest Dermatol 2019; 140:531-536.e1. [PMID: 31870626 DOI: 10.1016/j.jid.2019.09.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 09/05/2019] [Accepted: 09/19/2019] [Indexed: 12/12/2022]
Abstract
Although the role of immune dysregulation in hidradenitis suppurativa (HS) has yet to be elucidated, recent studies identified several complement abnormalities in patients with HS. The complement system serves a critical role in the modulation of immune response and regulation of cutaneous commensal bacteria. Complement is implicated in several inflammatory skin diseases including systemic lupus erythematosus, angioedema, pemphigus, bullous pemphigoid, and HS. A model of HS pathogenesis is proposed, integrating the role of commensal bacteria, cutaneous immune responses, and complement dysregulation. The role of complement in disease pathogenesis has led to the development of novel anticomplement agents and clinical trials investigating the efficacy of such treatments in HS.
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Affiliation(s)
| | | | - Lewis E Tomalin
- Icahn School of Medicine at Mt. Sinai Department of Population Health, New York, New York
| | - B Paul Morgan
- School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Afsaneh Alavi
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada
| | | | - Vincent Piguet
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada.
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47
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van Dijk BJ, Meijers JCM, Kloek AT, Knaup VL, Rinkel GJE, Morgan BP, van der Kamp MJ, Osuka K, Aronica E, Ruigrok YM, van de Beek D, Brouwer M, Pekna M, Hol EM, Vergouwen MDI. Complement C5 Contributes to Brain Injury After Subarachnoid Hemorrhage. Transl Stroke Res 2019; 11:678-688. [PMID: 31811640 PMCID: PMC7340633 DOI: 10.1007/s12975-019-00757-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 10/29/2019] [Accepted: 11/19/2019] [Indexed: 12/13/2022]
Abstract
Previous studies showed that complement activation is associated with poor functional outcome after aneurysmal subarachnoid hemorrhage (SAH). We investigated whether complement activation is underlying brain injury after aneurysmal SAH (n = 7) and if it is an appropriate treatment target. We investigated complement expression in brain tissue of aneurysmal SAH patients (n = 930) and studied the role of common genetic variants in C3 and C5 genes in outcome. We analyzed plasma levels (n = 229) to identify the functionality of a single nucleotide polymorphism (SNP) associated with outcome. The time course of C5a levels was measured in plasma (n = 31) and CSF (n = 10). In an SAH mouse model, we studied the extent of microglia activation and cell death in wild-type mice, mice lacking the C5a receptor, and in mice treated with C5-specific antibodies (n = 15 per group). Brain sections from aneurysmal SAH patients showed increased presence of complement components C1q and C3/C3b/iC3B compared to controls. The complement component 5 (C5) SNP correlated with C5a plasma levels and poor disease outcome. Serial measurements in CSF revealed that C5a was > 1400-fold increased 1 day after aneurysmal SAH and then gradually decreased. C5a in plasma was 2-fold increased at days 3–10 after aneurysmal SAH. In the SAH mouse model, we observed a ≈ 40% reduction in both microglia activation and cell death in mice lacking the C5a receptor, and in mice treated with C5-specific antibodies. These data show that C5 contributes to brain injury after experimental SAH, and support further study of C5-specific antibodies as novel treatment option to reduce brain injury and improve prognosis after aneurysmal SAH.
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Affiliation(s)
- Bart J van Dijk
- UMC Utrecht Brain Center, Department of Translational Neurosciences, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Utrecht, The Netherlands.,UMC Utrecht Brain Center, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Utrecht, The Netherlands
| | - Joost C M Meijers
- Department of Experimental Vascular Medicine, Academic Medical Center, Meibergdreef 9, Amsterdam, The Netherlands.,Department of Plasma Proteins, Sanquin Research, Plesmanlaan 125, Amsterdam, The Netherlands
| | - Anne T Kloek
- Department of Neurology, Amsterdam Neuroscience, Academic Medical Center, Meibergdreef 9, Amsterdam, The Netherlands
| | - Veronique L Knaup
- Department of Experimental Vascular Medicine, Academic Medical Center, Meibergdreef 9, Amsterdam, The Netherlands
| | - Gabriel J E Rinkel
- UMC Utrecht Brain Center, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Utrecht, The Netherlands
| | - B Paul Morgan
- Systems Immunity Research Institute, Cardiff University, Heath Park, Cardiff, UK
| | - Marije J van der Kamp
- UMC Utrecht Brain Center, Department of Translational Neurosciences, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Utrecht, The Netherlands
| | - Koji Osuka
- Department of Neurological Surgery, Aichi Medical University, 1-1 Karimatayazako, Aichi, Japan
| | - Eleonora Aronica
- Department of Neuropathology, Academic Medical Center, Meibergdreef 9, Amsterdam, The Netherlands
| | - Ynte M Ruigrok
- UMC Utrecht Brain Center, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Utrecht, The Netherlands
| | - Diederik van de Beek
- Department of Neurology, Amsterdam Neuroscience, Academic Medical Center, Meibergdreef 9, Amsterdam, The Netherlands
| | - Matthijs Brouwer
- Department of Neurology, Amsterdam Neuroscience, Academic Medical Center, Meibergdreef 9, Amsterdam, The Netherlands
| | - Marcela Pekna
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Medicinaregatan 9A, Gothenburg, Sweden
| | - Elly M Hol
- UMC Utrecht Brain Center, Department of Translational Neurosciences, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Utrecht, The Netherlands.,Netherlands Institute for Neuroscience, Institute of the Royal Netherlands Academy of Arts and Sciences, Meibergdreef 47, Amsterdam, The Netherlands
| | - Mervyn D I Vergouwen
- UMC Utrecht Brain Center, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Utrecht, The Netherlands.
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Zelek WM, Fathalla D, Morgan A, Touchard S, Loveless S, Tallantyre E, Robertson NP, Morgan BP. Cerebrospinal fluid complement system biomarkers in demyelinating disease. Mult Scler 2019; 26:1929-1937. [PMID: 31701790 DOI: 10.1177/1352458519887905] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) can be difficult to differentiate from other demyelinating diseases, notably neuromyelitis optica spectrum disorder (NMOSD). We previously showed that NMOSD is distinguished from MS by plasma complement biomarkers. OBJECTIVE Here, we measure cerebrospinal fluid (CSF) complement proteins in MS, NMOSD and clinically isolated syndrome (CIS), a neurological episode that may presage MS, to test whether these distinguish NMOSD from MS and CIS. MATERIALS AND METHODS CSF (53 MS, 17 CIS, 11 NMOSD, 35 controls) was obtained; complement proteins (C4, C3, C5, C9, C1, C1q, Factor B (FB)), regulators (Factor I (FI), Factor H (FH), FH-Related Proteins 1, 2 and 5 (FHR125), C1 Inhibitor (C1INH), Properdin) and activation products (terminal complement complex (TCC), iC3b) were quantified by ELISA and results expressed relative to CSF total protein (μg/mg). RESULTS Compared to control CSF, (1) levels of C4, C1INH and Properdin were elevated in MS; (2) TCC, iC3b, FI and FHR125 were increased in CIS; and (3) all complement biomarkers except TCC, FHR125, Properdin and C5 were higher in NMOSD CSF. A statistical model comprising six analytes (C3, C9, FB, C1q, FI, Properdin) plus age/gender optimally differentiated MS from NMOSD.
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Affiliation(s)
| | - Dina Fathalla
- Systems Immunity University Research Institute, Cardiff University, Cardiff, UK
| | - Angharad Morgan
- Systems Immunity University Research Institute, Cardiff University, Cardiff, UK
| | - Samuel Touchard
- Systems Immunity University Research Institute, Cardiff University, Cardiff, UK
| | - Samantha Loveless
- Division of Psychological Medicine and Clinical Neurology, School of Medicine, Cardiff University, Cardiff, UK
| | - Emma Tallantyre
- Division of Psychological Medicine and Clinical Neurology, School of Medicine, Cardiff University, Cardiff, UK
| | - Neil P Robertson
- Division of Psychological Medicine and Clinical Neurology, School of Medicine, Cardiff University, Cardiff, UK
| | - B Paul Morgan
- Systems Immunity University Research Institute, Cardiff University, Cardiff, UK
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Shi L, Westwood S, Baird AL, Winchester L, Dobricic V, Kilpert F, Hong S, Franke A, Hye A, Ashton NJ, Morgan AR, Bos I, Vos SJB, Buckley NJ, Kate MT, Scheltens P, Vandenberghe R, Gabel S, Meersmans K, Engelborghs S, De Roeck EE, Sleegers K, Frisoni GB, Blin O, Richardson JC, Bordet R, Molinuevo JL, Rami L, Wallin A, Kettunen P, Tsolaki M, Verhey F, Lleó A, Alcolea D, Popp J, Peyratout G, Martinez-Lage P, Tainta M, Johannsen P, Teunissen CE, Freund-Levi Y, Frölich L, Legido-Quigley C, Barkhof F, Blennow K, Zetterberg H, Baker S, Morgan BP, Streffer J, Visser PJ, Bertram L, Lovestone S, Nevado-Holgado AJ. Discovery and validation of plasma proteomic biomarkers relating to brain amyloid burden by SOMAscan assay. Alzheimers Dement 2019; 15:1478-1488. [PMID: 31495601 PMCID: PMC6880298 DOI: 10.1016/j.jalz.2019.06.4951] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 06/11/2019] [Accepted: 06/23/2019] [Indexed: 11/09/2022]
Abstract
Introduction Plasma proteins have been widely studied as candidate biomarkers to predict brain amyloid deposition to increase recruitment efficiency in secondary prevention clinical trials for Alzheimer's disease. Most such biomarker studies are targeted to specific proteins or are biased toward high abundant proteins. Methods 4001 plasma proteins were measured in two groups of participants (discovery group = 516, replication group = 365) selected from the European Medical Information Framework for Alzheimer's disease Multimodal Biomarker Discovery study, all of whom had measures of amyloid. Results A panel of proteins (n = 44), along with age and apolipoprotein E (APOE) ε4, predicted brain amyloid deposition with good performance in both the discovery group (area under the curve = 0.78) and the replication group (area under the curve = 0.68). Furthermore, a causal relationship between amyloid and tau was confirmed by Mendelian randomization. Discussion The results suggest that high-dimensional plasma protein testing could be a useful and reproducible approach for measuring brain amyloid deposition.
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Affiliation(s)
- Liu Shi
- Department of Psychiatry, University of Oxford, Oxford, UK.
| | - Sarah Westwood
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Alison L Baird
- Department of Psychiatry, University of Oxford, Oxford, UK
| | | | - Valerija Dobricic
- Lübeck Interdisciplinary Platform for Genome Analytics, Institutes of Neurogenetics and Cardiogenetics, University of Lübeck, Lübeck, Germany
| | - Fabian Kilpert
- Lübeck Interdisciplinary Platform for Genome Analytics, Institutes of Neurogenetics and Cardiogenetics, University of Lübeck, Lübeck, Germany
| | - Shengjun Hong
- Lübeck Interdisciplinary Platform for Genome Analytics, Institutes of Neurogenetics and Cardiogenetics, University of Lübeck, Lübeck, Germany
| | - Andre Franke
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Abdul Hye
- Maurice Wohl Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Nicholas J Ashton
- Maurice Wohl Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK; Department of Psychiatry and Neurochemistry, University of Gothenburg, Mölndal, Sweden; Wallenberg Centre for Molecular & Translational Medicine, University of Gothenburg, Gothenburg, Sweden; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, London, UK
| | - Angharad R Morgan
- Dementia Research Institute Cardiff, Cardiff University, Cardiff, UK
| | - Isabelle Bos
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centrum Limburg, Maastricht University, Maastricht, the Netherlands
| | - Stephanie J B Vos
- Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands
| | - Noel J Buckley
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Mara Ten Kate
- Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands
| | - Philip Scheltens
- Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands
| | | | - Silvy Gabel
- University Hospital Leuven, Leuven, Belgium; Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Belgium
| | - Karen Meersmans
- University Hospital Leuven, Leuven, Belgium; Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Belgium
| | - Sebastiaan Engelborghs
- Center for Neurosciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium; Institute Born-Bunge, University of Antwerp, Antwerp, Belgium; Department of Neurology, VUB University Hospital Brussels (UZ Brussel), Brussels, Belgium
| | - Ellen E De Roeck
- Center for Neurosciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium; Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Kristel Sleegers
- Institute Born-Bunge, University of Antwerp, Antwerp, Belgium; Neurodegenerative Brain Diseases Group, Center for Molecular Neurology, VIB, Edegem, Belgium
| | - Giovanni B Frisoni
- University of Geneva, Geneva, Switzerland; IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Olivier Blin
- AIX Marseille University, INS, Ap-hm, Marseille, France
| | | | - Régis Bordet
- University of Lille, Inserm, CHU Lille, Lille, France
| | - José L Molinuevo
- Alzheimer's disease & other cognitive disorders unit, Hopsital Clínic-IDIBAPS, Barcelona, Spain; Barcelona Beta Brain Research Center, Universitat Pompeu Fabra, Barcelona, Spain
| | - Lorena Rami
- Barcelona Beta Brain Research Center, Universitat Pompeu Fabra, Barcelona, Spain
| | - Anders Wallin
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Petronella Kettunen
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Magda Tsolaki
- 1st Department of Neurology, AHEPA University Hospital, Makedonia, Thessaloniki, Greece
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centrum Limburg, Maastricht University, Maastricht, the Netherlands
| | - Alberto Lleó
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Daniel Alcolea
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Julius Popp
- University Hospital of Lausanne, Lausanne, Switzerland; Geriatric Psychiatry, Department of Mental Health and Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | | | | | | | - Peter Johannsen
- Danish Dementia Research Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Yvonne Freund-Levi
- Department of Neurobiology, Caring Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, and Department of Geriatric Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden; Department of Psychiatry in Region Örebro County and School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Department of Old Age Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Lutz Frölich
- Department of Geriatric Psychiatry, Zentralinstitut für Seelische Gesundheit, University of Heidelberg, Mannheim, Germany
| | - Cristina Legido-Quigley
- Kings College London, London, UK; The Systems Medicine Group, Steno Diabetes Center, Gentofte, Denmark
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherland; UCL Institutes of Neurology and Healthcare Engineering, London, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL, London, UK; Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | | | - B Paul Morgan
- Dementia Research Institute Cardiff, Cardiff University, Cardiff, UK
| | - Johannes Streffer
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium; Janssen R&D, LLC, Beerse, Belgium
| | - Pieter Jelle Visser
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centrum Limburg, Maastricht University, Maastricht, the Netherlands; Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands; Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Lars Bertram
- Lübeck Interdisciplinary Platform for Genome Analytics, Institutes of Neurogenetics and Cardiogenetics, University of Lübeck, Lübeck, Germany; Department of Psychology, University of Oslo, Oslo, Norway
| | - Simon Lovestone
- Department of Psychiatry, University of Oxford, Oxford, UK; Janssen-Cilag UK, formerly Department of Psychiatry, University of Oxford, Oxford, UK
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Chamberlain JL, Huda S, Whittam DH, Matiello M, Morgan BP, Jacob A. Role of complement and potential of complement inhibitors in myasthenia gravis and neuromyelitis optica spectrum disorders: a brief review. J Neurol 2019; 268:1643-1664. [PMID: 31482201 DOI: 10.1007/s00415-019-09498-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/02/2019] [Accepted: 08/05/2019] [Indexed: 02/08/2023]
Abstract
The complement system is a powerful member of the innate immune system. It is highly adept at protecting against pathogens, but exists in a delicate balance between its protective functions and overactivity, which can result in autoimmune disease. A cascade of complement proteins that requires sequential activation, and numerous complement regulators, exists to regulate a proportionate response to pathogens. In spite of these mechanisms there is significant evidence for involvement of the complement system in driving the pathogenesis of variety of diseases including neuromyelitis optica spectrum disorders (NMOSD) and myasthenia gravis (MG). As an amplification cascade, there are an abundance of molecular targets that could be utilized for therapeutic intervention. Clinical trials assessing complement pathway inhibition in both these conditions have recently been completed and include the first randomized placebo-controlled trial in NMOSD showing positive results. This review aims to review and update the reader on the complement system and the evolution of complement-based therapeutics in these two disorders.
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Affiliation(s)
| | - Saif Huda
- Department of Neurology, The Walton Centre, Lower Lane, Liverpool, L9 7LJ, UK
| | - Daniel H Whittam
- Department of Neurology, The Walton Centre, Lower Lane, Liverpool, L9 7LJ, UK
| | - Marcelo Matiello
- Department of Neurology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - B Paul Morgan
- School of Medicine, Henry Wellcome Building for Biomedical Research, University Hospital of Wales, Heath Park, Cardiff, CF14 4XN, UK
| | - Anu Jacob
- Department of Neurology, The Walton Centre, Lower Lane, Liverpool, L9 7LJ, UK.,University of Liverpool, Liverpool, UK
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