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Patiño-Martinez E, Nakabo S, Jiang K, Carmona- Rivera C, Tsai WL, Claybaugh D, Yu ZX, Romero A, Bohrnsen E, Schwarz B, Solís-Barbosa MA, Blanco LP, Naqi M, Temesgen-Oyelakim Y, Davis M, Manna Z, Mehta N, Naz F, Brooks S, dell’Orso S, Hasni S, Kaplan MJ. The aconitate decarboxylase 1/itaconate pathway modulates immune dysregulation and associates with cardiovascular disease markers in SLE. medRxiv 2024:2024.02.20.24303097. [PMID: 38605883 PMCID: PMC11007756 DOI: 10.1101/2024.02.20.24303097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Objective The Krebs cycle enzyme Aconitate Decarboxylase 1 (ACOD1) mediates itaconate synthesis in myeloid cells.. Previously, we reported that administration of 4-octyl itaconate abrogated lupus phenotype in mice. Here, we explore the role of the endogenous ACOD1/itaconate pathway in the development of murine lupus as well as their relevance in premature cardiovascular damage in SLE. Methods We characterized Acod1 protein expression in bone marrow-derived macrophages and human monocyte-derived macrophages, following a TLR7 agonist (imiquimod, IMQ). Wild type and Acod1-/- mice were exposed to topical IMQ for 5 weeks to induce an SLE phenotype and immune dysregulation was quantified. Itaconate serum levels were quantified in SLE patients and associated to cardiometabolic parameters and disease activity. Results ACOD1 was induced in mouse bone marrow-derived macrophages (BMDM) and human monocyte-derived macrophages following in vitro TLR7 stimulation. This induction was partially dependent on type I Interferon receptor signaling and specific intracellular pathways. In the IMQ-induced mouse model of lupus, ACOD1 knockout (Acod1-/-) displayed disruptions of the splenic architecture, increased serum anti-dsDNA and proinflammatory cytokine levels, enhanced kidney immune complex deposition and proteinuria, when compared to the IMQ-treated WT mice. Consistent with these results, Acod1-/- BMDM exposed to IMQ showed higher proinflammatory features in vitro. Itaconate levels were decreased in SLE serum compared to healthy control sera, in association with specific perturbed cardiometabolic parameters and subclinical vascular disease. Conclusion These findings suggest that the ACOD1/itaconate pathway plays important immunomodulatory and vasculoprotective roles in SLE, supporting the potential therapeutic role of itaconate analogs in autoimmune diseases.
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Affiliation(s)
- Eduardo Patiño-Martinez
- Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, Maryland, USA
| | - Shuichiro Nakabo
- Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, Maryland, USA
| | - Kan Jiang
- Biodata Mining and Discovery Section, NIAMS/NIH
| | - Carmelo Carmona- Rivera
- Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, Maryland, USA
| | | | - Dillon Claybaugh
- Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, Maryland, USA
| | - Zu-Xi Yu
- National Heart, Lung, and Blood Institute (NHLBI), NIH
| | - Aracely Romero
- Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, Maryland, USA
| | - Eric Bohrnsen
- Protein & Chemistry Section, Research Technologies Branch, National Institute of Allergy and Infectious Diseases (NIAID), NIH, Hamilton, MT, USA
| | - Benjamin Schwarz
- Protein & Chemistry Section, Research Technologies Branch, National Institute of Allergy and Infectious Diseases (NIAID), NIH, Hamilton, MT, USA
| | - Miguel A. Solís-Barbosa
- Department of Molecular Biomedicine, Centro de Investigación y de Estudios Avanzados del I.P.N, 07360 Mexico City, Mexico
| | - Luz P. Blanco
- Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, Maryland, USA
| | | | | | | | | | - Nehal Mehta
- National Heart, Lung, and Blood Institute (NHLBI), NIH
| | - Faiza Naz
- Office of Science and Technology, NIAMS/NIH
| | | | | | | | - Mariana J. Kaplan
- Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, Maryland, USA
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Rivera-Alsina ME, Rivera CC, Rollene N, Kirby RS, Ayres A, McNamara M. Voluntary screening program for HIV in pregnancy. Cost effectiveness. J Reprod Med 2001; 46:243-8. [PMID: 11304866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
OBJECTIVE To determine the effectiveness of a voluntary human immunodeficiency virus (HIV) screening program in pregnancy. STUDY DESIGN Using a business decision theory analysis model, we estimated the outcomes and costs of the two possible decisions by our patients (test/no test). Patients with a positive HIV screen would undergo evaluation and possible prophylactic antiviral therapy. The model was utilized to evaluate the Naval Medical Center San Diego Program from 1995-1997. RESULTS Prevalence of HIV in active duty Navy personnel during the years evaluated were 1995, 0.024%; 1996, 0.028%; and 1997, 0.022%. Patients screened for HIV during these years were 1995, 3,874; 1996, 3,924; and 1997, 4,127 (n = 11,925). Incidence of HIV seroprevalence in patients screened during the study period was zero. The number of patients declining HIV screening was: 1995, 10; 1996, 8; and 1997, 5. During the same period, reported HIV seroprevalence among pregnant patients in the United States was 1.5/1,000. CONCLUSION HIV seroprevalence in our pregnant population (zero) was lower than expected, considering the national pregnancy prevalence and Navy prevalence. The expected number of cases of positive HIV screens was 17.8. The cost of the program for the study period was $103,748. The cost of care for one positive neonate ranges between $100,000 and $200,000.
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Affiliation(s)
- M E Rivera-Alsina
- Department of Obstetrics and Gynecology, Naval Medical Center, San Diego, California, USA
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