1
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Vogel F, Ars S, Wunch D, Lavoie J, Gillespie L, Maazallahi H, Röckmann T, Nęcki J, Bartyzel J, Jagoda P, Lowry D, France J, Fernandez J, Bakkaloglu S, Fisher R, Lanoiselle M, Chen H, Oudshoorn M, Yver-Kwok C, Defratyka S, Morgui JA, Estruch C, Curcoll R, Grossi C, Chen J, Dietrich F, Forstmaier A, Denier van der Gon HAC, Dellaert SNC, Salo J, Corbu M, Iancu SS, Tudor AS, Scarlat AI, Calcan A. Ground-Based Mobile Measurements to Track Urban Methane Emissions from Natural Gas in 12 Cities across Eight Countries. Environ Sci Technol 2024; 58:2271-2281. [PMID: 38270974 PMCID: PMC10851421 DOI: 10.1021/acs.est.3c03160] [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] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 01/02/2024] [Accepted: 01/03/2024] [Indexed: 01/26/2024]
Abstract
To mitigate methane emission from urban natural gas distribution systems, it is crucial to understand local leak rates and occurrence rates. To explore urban methane emissions in cities outside the U.S., where significant emissions were found previously, mobile measurements were performed in 12 cities across eight countries. The surveyed cities range from medium size, like Groningen, NL, to large size, like Toronto, CA, and London, UK. Furthermore, this survey spanned across European regions from Barcelona, ES, to Bucharest, RO. The joint analysis of all data allows us to focus on general emission behavior for cities with different infrastructure and environmental conditions. We find that all cities have a spectrum of small, medium, and large methane sources in their domain. The emission rates found follow a heavy-tailed distribution, and the top 10% of emitters account for 60-80% of total emissions, which implies that strategic repair planning could help reduce emissions quickly. Furthermore, we compare our findings with inventory estimates for urban natural gas-related methane emissions from this sector in Europe. While cities with larger reported emissions were found to generally also have larger observed emissions, we find clear discrepancies between observation-based and inventory-based emission estimates for our 12 cities.
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Affiliation(s)
- F. Vogel
- Climate
Research Division, Environment and Climate
Change Canada, Toronto M3H 5T4, Canada
| | - S. Ars
- Climate
Research Division, Environment and Climate
Change Canada, Toronto M3H 5T4, Canada
| | - D. Wunch
- Department
of Physics, University of Toronto, Toronto M5S 1A7, Canada
| | - J. Lavoie
- Department
of Physics, University of Toronto, Toronto M5S 1A7, Canada
| | - L. Gillespie
- Climate
Research Division, Environment and Climate
Change Canada, Toronto M3H 5T4, Canada
- Department
of Physics, University of Toronto, Toronto M5S 1A7, Canada
| | - H. Maazallahi
- Institute
for Marine and Atmospheric Research Utrecht, Utrecht University, Utrecht 3584 CC, The Netherlands
| | - T. Röckmann
- Institute
for Marine and Atmospheric Research Utrecht, Utrecht University, Utrecht 3584 CC, The Netherlands
| | - J. Nęcki
- AGH, University of Kraków, Kraków 30-059, Poland
| | - J. Bartyzel
- AGH, University of Kraków, Kraków 30-059, Poland
| | - P. Jagoda
- AGH, University of Kraków, Kraków 30-059, Poland
| | - D. Lowry
- Department
of Earth Sciences, Royal Holloway University
of London, Egham, Surrey TW20 0EX, U.K.
| | - J. France
- Department
of Earth Sciences, Royal Holloway University
of London, Egham, Surrey TW20 0EX, U.K.
| | - J. Fernandez
- Department
of Earth Sciences, Royal Holloway University
of London, Egham, Surrey TW20 0EX, U.K.
| | - S. Bakkaloglu
- Department
of Earth Sciences, Royal Holloway University
of London, Egham, Surrey TW20 0EX, U.K.
| | - R. Fisher
- Department
of Earth Sciences, Royal Holloway University
of London, Egham, Surrey TW20 0EX, U.K.
| | - M. Lanoiselle
- Department
of Earth Sciences, Royal Holloway University
of London, Egham, Surrey TW20 0EX, U.K.
| | - H. Chen
- Centre for
Isotope Research, Energy and Sustainability Research Institute, University of Groningen, Groningen 9747 AG, Netherlands
| | - M. Oudshoorn
- Centre for
Isotope Research, Energy and Sustainability Research Institute, University of Groningen, Groningen 9747 AG, Netherlands
| | - C. Yver-Kwok
- LSCE,
CEA-CNRS-UVSQ, University Paris-Saclay, Gif-sur-Yvette 91191, France
| | - S. Defratyka
- LSCE,
CEA-CNRS-UVSQ, University Paris-Saclay, Gif-sur-Yvette 91191, France
| | - J. A. Morgui
- ICTA, Autonomous University of Barcelona, Barcelona 08193, Spain
| | - C. Estruch
- Eurecat, Centre
Tecnològic de Catalunya, Barcelona 08290, Spain
| | - R. Curcoll
- ICTA, Autonomous University of Barcelona, Barcelona 08193, Spain
- INTE, Universitat
Politècnica de Catalunya, Barcelona 08028, Spain
| | - C. Grossi
- INTE, Universitat
Politècnica de Catalunya, Barcelona 08028, Spain
| | - J. Chen
- Environmental Sensing and Modelling, Technical
University of Munich, Munich 80333, Germany
| | - F. Dietrich
- Environmental Sensing and Modelling, Technical
University of Munich, Munich 80333, Germany
| | - A. Forstmaier
- Environmental Sensing and Modelling, Technical
University of Munich, Munich 80333, Germany
| | | | - S. N. C. Dellaert
- Netherlands Organisation for Applied Scientific Research—TNO, Utrecht 3584CB, The Netherlands
| | - J. Salo
- Geography and
GIS, University of Northern
Colorado, Greeley, Colorado 80639, United States
| | - M. Corbu
- Faculty
of Physics, University of Bucharest, Bucharest 050663, Romania
- INCAS, National Institute for Aerospace
Research “Elie Carafoli”, Bucharest 061126, Romania
| | - S. S. Iancu
- Faculty
of Physics, University of Bucharest, Bucharest 050663, Romania
- INCAS, National Institute for Aerospace
Research “Elie Carafoli”, Bucharest 061126, Romania
| | - A. S. Tudor
- Faculty
of Physics, University of Bucharest, Bucharest 050663, Romania
- INCAS, National Institute for Aerospace
Research “Elie Carafoli”, Bucharest 061126, Romania
| | - A. I. Scarlat
- Faculty
of Physics, University of Bucharest, Bucharest 050663, Romania
- INCAS, National Institute for Aerospace
Research “Elie Carafoli”, Bucharest 061126, Romania
| | - A. Calcan
- INCAS, National Institute for Aerospace
Research “Elie Carafoli”, Bucharest 061126, Romania
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2
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Savino S, Nicola B, Luigi MP, Dimitrios B, Borghi MO, Xavier B, Grossi C, Tornai D, Papp M, Shoenfeld Y, Ielo D, Fritzler MJ. Autoantibodies testing in autoimmunity: Diagnostic, prognostic and classification value. Autoimmun Rev 2023; 22:103356. [PMID: 37150488 DOI: 10.1016/j.autrev.2023.103356] [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: 04/25/2023] [Accepted: 05/04/2023] [Indexed: 05/09/2023]
Abstract
Diagnosis of autoimmune diseases is in most cases challenging for clinicians as there is not a single specific laboratory or histological marker to diagnose or exclude the presence of the conditions. This review focused on the current knowledge of the role of autoantibodies' testing in various diseases, such as systemic lupus erythematosus, rheumatoid arthritis, antiphospholipid syndrome, undifferentiated connective tissues disease, primary biliary cirrhosis and primary sclerosing cholangitis. Similarly, the prognostic and diagnostic values of autoantibodies testing in patients with interstitial lung disease have been reviewed. In-depth research on the molecular action of these autoantibodies on immune regulation and diseases pathogenesis has been explored beyond their correlation with disease phenotypes, highlighting the impact of autoantibodies targeting on disease outcomes and etiopathogenesis.
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Affiliation(s)
- Sciascia Savino
- University Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases (ERK-net, ERN-Reconnect and RITA-ERN Member) with Nephrology and Dialysis Unit and Center of Immuno-Rheumatology and Rare Diseases, Coordinating Center of the Interregional Network for Rare Diseases of Piedmont and Aosta Valley, San Giovanni Bosco Hub Hospital, Turin, Italy
| | - Bizzaro Nicola
- Laboratory of Clinical Pathology, Azienda Sanitaria Universitaria Integrata di Udine, Tolmezzo, Italy
| | - Meroni Pier Luigi
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Laboratory of Immuno-Rheumatology, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - Bogdanos Dimitrios
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - M O Borghi
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Laboratory of Immuno-Rheumatology, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - Bossuyt Xavier
- Clinical and diagnostic immunology, Department of Microbiology, Immunology and transplantation, KU Leuven, Leuven, Belgium; Department of laboratory medicine, UZ Leuven, Leuven, Belgium
| | - C Grossi
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Laboratory of Immuno-Rheumatology, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - Dávid Tornai
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, European Reference Network on Hepatological Diseases, ERN RARE-LIVER, Hungary
| | - Maria Papp
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, European Reference Network on Hepatological Diseases, ERN RARE-LIVER, Hungary
| | - Yehuda Shoenfeld
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, Israel
| | | | - Marvin J Fritzler
- Department of Medicine, Cumming School of Medicine, Calgary, Alberta, Canada
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3
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Grossi C, Capitani N, Benagiano M, Baldari CT, Della Bella C, Macor P, Tedesco F, Borghi MO, Maugeri N, D’Elios MM, Meroni PL. Beta 2 glycoprotein I and neutrophil extracellular traps: Potential bridge between innate and adaptive immunity in anti-phospholipid syndrome. Front Immunol 2023; 13:1076167. [PMID: 36700193 PMCID: PMC9868732 DOI: 10.3389/fimmu.2022.1076167] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/20/2022] [Indexed: 01/10/2023] Open
Abstract
Antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by recurrent vascular thrombosis and miscarriages in the absence of known causes. Antibodies against phospholipid-binding proteins (aPL) are pathogenic players in both clotting and pregnancy APS manifestations. There is sound evidence that antibodies specific for beta2 glycoprotein I (β2GPI) trigger thrombotic and pregnancy complications by interacting with the molecule on the membranes of different cell types of the coagulation cascade, and in placenta tissues. In addition to the humoral response against β2GPI, both peripheral and tissue CD4+ β2GPI-specific T cells have been reported in primary APS as well as in systemic lupus erythematosus (SLE)-associated APS. While adaptive immunity plays a clear role in APS, it is still debated whether innate immunity is involved as well. Acute systemic inflammation does not seem to be present in the syndrome, however, there is sound evidence that complement activation is crucial in animal models and can be found also in patients. Furthermore, neutrophil extracellular traps (NETs) have been documented in arterial and venous thrombi with different etiology, including clots in APS models. Keeping in mind that β2GPI is a pleiotropic glycoprotein, acting as scavenger molecule for infectious agents and apoptotic/damaged body constituents and that self-molecules externalized through NETs formation may become immunogenic autoantigens, we demonstrated β2GPI on NETs, and its ability to stimulate CD4+β2GPI-specific T cells. The aim of this review is to elucidate the role of β2GPI in the cross-talk between the innate and adaptive immunity in APS.
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Affiliation(s)
- Claudia Grossi
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Laboratory of Immuno-Rheumatology, Milan, Italy
| | - Nagaja Capitani
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy,Department of Life Sciences, University of Siena, Siena, Italy
| | - Marisa Benagiano
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Chiara Della Bella
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Paolo Macor
- Department of Life Science, University of Trieste, Trieste, Italy
| | - Francesco Tedesco
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Laboratory of Immuno-Rheumatology, Milan, Italy
| | - Maria Orietta Borghi
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Laboratory of Immuno-Rheumatology, Milan, Italy,Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Norma Maugeri
- Autoimmunity and Vascular Inflammation Unit, Division of Immunology, Transplantation & Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Institute, Milan, Italy
| | - Mario Milco D’Elios
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy,*Correspondence: Pier Luigi Meroni, ; ; Mario Milco D’Elios,
| | - Pier Luigi Meroni
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Laboratory of Immuno-Rheumatology, Milan, Italy,*Correspondence: Pier Luigi Meroni, ; ; Mario Milco D’Elios,
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4
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Otahal PPS, Fialova E, Vosahlik J, Wiedner H, Grossi C, Vargas A, Michielsen N, Turtiainen T, Luca A, Wołoszczuk K, Beck TR. Low-Level Radon Activity Concentration-A MetroRADON International Intercomparison. Int J Environ Res Public Health 2022; 19:ijerph19105810. [PMID: 35627347 PMCID: PMC9141648 DOI: 10.3390/ijerph19105810] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/28/2022] [Accepted: 04/01/2022] [Indexed: 11/16/2022]
Abstract
An international comparison of continuous monitors measuring radon activity concentration was performed to validate the traceability of the European radon calibration facilities. It was carried out by comparing the secondary standards used by these previous facilities, ranging from 100 Bq·m-3 to 300 Bq·m-3. Secondary standards were individually compared to a secondary reference device previously calibrated in a reference radon atmosphere traceable to a primary standard. The intercomparison was organized by the National Institute for Nuclear, Chemical, and Biological Protection (SUJCHBO) in the period from October 2019 to April 2020 within the European Metrology Program for Innovation and Research (EMPIR), JRP-Contract 16ENV10 MetroRADON. Eight European laboratories participated in this study. The results of the experiment are presented and discussed.
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Affiliation(s)
- Petr P. S. Otahal
- Nuclear Protection Department, National Institute for Nuclear, Chemical & Biological Protection, 26231 Milin, Czech Republic; (E.F.); (J.V.)
- Correspondence:
| | - Eliska Fialova
- Nuclear Protection Department, National Institute for Nuclear, Chemical & Biological Protection, 26231 Milin, Czech Republic; (E.F.); (J.V.)
- Department of Geological Sciences, Faculty of Science, Masaryk University, 60200 Brno, Czech Republic
| | - Josef Vosahlik
- Nuclear Protection Department, National Institute for Nuclear, Chemical & Biological Protection, 26231 Milin, Czech Republic; (E.F.); (J.V.)
| | - Hannah Wiedner
- Physikalisch-Technischer Prüfdienst, Bundesamt für Eich- und Vermessungswesen, 1160 Wien, Austria;
| | - Claudia Grossi
- Institut de Tècniques Energètiques, Universitat Politècnica de Catalunya, 08028 Barcelona, Spain; (C.G.); (A.V.)
| | - Arturo Vargas
- Institut de Tècniques Energètiques, Universitat Politècnica de Catalunya, 08028 Barcelona, Spain; (C.G.); (A.V.)
| | - Nathalie Michielsen
- Institut de Radioprotection et de Sûreté Nucléaire, CEDEX, 92262 Fontenay-aux-Roses, France;
| | - Tuukka Turtiainen
- Radiation and Nuclear Safety Authority (STUK), Environmental Radiation Surveillance, 00811 Helsinki, Finland;
| | - Aurelian Luca
- Institutul National de Cercetare-Dezvoltare Pentru Fizica si Inginerie Nucleara “Horia Hulubei”, RO-077125 Magurele, Romania;
| | | | - Thomas R. Beck
- Federal Office for Radiation Protection, 10318 Berlin, Germany;
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5
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Cerrato M, Badellino S, Menegatti F, Bonavero I, Grossi C, Lo Zito B, Orlandi E, Gastino A, Cuffini E, Blasi L, Mantovani C, Parise R, Ricardi U, Levis M. PD-0672 Cardiac toxicity predicts mortality in NSCLC patients: interim analysis of the LUNG-HEART Study. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02919-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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6
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Rábago D, Quindós L, Vargas A, Sainz C, Radulescu I, Ioan MR, Cardellini F, Capogni M, Rizzo A, Celaya S, Fuente I, Fuente M, Rodriguez M, Grossi C. Intercomparison of Radon Flux Monitors at Low and at High Radium Content Areas under Field Conditions. Int J Environ Res Public Health 2022; 19:ijerph19074213. [PMID: 35409895 PMCID: PMC8998188 DOI: 10.3390/ijerph19074213] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 12/10/2022]
Abstract
Interlaboratory exercises are a good tool to compare the response of different systems to the same quantity and to identify possible inconsistencies between them. One of the main goals of the EMPIR 19ENV01 traceRadon project is to harmonize radon flux measurements based on different systems and methodologies. In the framework of the traceRadon Project, two radon flux intercomparison campaigns were carried out in October 2021 at high and at low radon source areas. Four institutions participated in the field intercomparison exercises with their own systems. Every system was based on a specific radon monitor (diffusion or pump mode) and an accumulation chamber (with manual or automatic opening). Radon fluxes were calculated by each participant using both exponential and linear fittings of the radon activity concentration measured over time within the accumulation chambers. The results of this study show mainly: (i) the exponential approach is not advisable due to the variability of the radon flux and the leakage of the systems during long-time measurements; (ii) the linear approach should be applied to minimize the measurement period in agreement with the time response and sensitivity of the monitors; (iii) radon flux measured at high radon source areas (radium content of about 800 Bq kg-1) risks being underestimated because of the influence of advective effects; (iv) radon flux measured at low radon source areas (radium content of about 30 Bq kg-1) may present large uncertainties if sensitive radon monitors with pump mode are not used.
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Affiliation(s)
- Daniel Rábago
- Radon Group, University of Cantabria, 39011 Santander, Spain; (D.R.); (C.S.); (S.C.); (I.F.)
| | - Luis Quindós
- Radon Group, University of Cantabria, 39011 Santander, Spain; (D.R.); (C.S.); (S.C.); (I.F.)
- Correspondence:
| | - Arturo Vargas
- Laboratory of 222Rn Studies, Institut de Tècniques Energètiques, Universitat Politècnica de Catalunya, 08028 Barcelona, Spain; (A.V.); (M.R.); (C.G.)
| | - Carlos Sainz
- Radon Group, University of Cantabria, 39011 Santander, Spain; (D.R.); (C.S.); (S.C.); (I.F.)
| | - Ileana Radulescu
- Horia Hulubei National Institute for R&D in Physics and Nuclear Engineering, 077125 Magurele, Romania; (I.R.); (M.-R.I.)
| | - Mihail-Razvan Ioan
- Horia Hulubei National Institute for R&D in Physics and Nuclear Engineering, 077125 Magurele, Romania; (I.R.); (M.-R.I.)
| | - Francesco Cardellini
- National Institute of Ionizing Radiation Metrology (INMRI)—Italian National Agency for New Technologies, Energy and Sustainable Economic Development (ENEA), Via Anguillarese 301, 00123 Rome, Italy; (F.C.); (M.C.)
| | - Marco Capogni
- National Institute of Ionizing Radiation Metrology (INMRI)—Italian National Agency for New Technologies, Energy and Sustainable Economic Development (ENEA), Via Anguillarese 301, 00123 Rome, Italy; (F.C.); (M.C.)
| | - Alessandro Rizzo
- Radiation Protection Institute (IRP)—Italian National Agency for New Technologies, Energy and Sustainable Economic Development (ENEA), Via Anguillarese 301, 00123 Rome, Italy;
| | - Santiago Celaya
- Radon Group, University of Cantabria, 39011 Santander, Spain; (D.R.); (C.S.); (S.C.); (I.F.)
| | - Ismael Fuente
- Radon Group, University of Cantabria, 39011 Santander, Spain; (D.R.); (C.S.); (S.C.); (I.F.)
| | - Marta Fuente
- Laboratoire des Sciences du Climat et de l’Environnement, (LSCE-IPSL), CEA-CNRS-UVSQ, Université Paris-Saclay, 91191 Gif-sur-Yvette, France;
| | - Maria Rodriguez
- Laboratory of 222Rn Studies, Institut de Tècniques Energètiques, Universitat Politècnica de Catalunya, 08028 Barcelona, Spain; (A.V.); (M.R.); (C.G.)
| | - Claudia Grossi
- Laboratory of 222Rn Studies, Institut de Tècniques Energètiques, Universitat Politècnica de Catalunya, 08028 Barcelona, Spain; (A.V.); (M.R.); (C.G.)
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7
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Grossi C, Artusi C, Meroni P, Borghi MO, Neglia L, Lonati PA, Oggioni M, Tedesco F, De Simoni MG, Fumagalli S. β2 glycoprotein I participates in phagocytosis of apoptotic neurons and in vascular injury in experimental brain stroke. J Cereb Blood Flow Metab 2021; 41:2038-2053. [PMID: 33444093 PMCID: PMC8323337 DOI: 10.1177/0271678x20984551] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Beta-2 Glycoprotein I (β2-GPI) is the main target of anti-phospholipid antibodies (aPL) in the autoimmune anti-phospholipid syndrome, characterized by increased risk of stroke. We here investigated the antibody independent role of β2-GPI after ischemia/reperfusion, modeled in vivo by transient middle cerebral artery occlusion (tMCAo) in male C57Bl/6J mice; in vitro by subjecting immortalized human brain microvascular endothelial cells (ihBMEC) to 16 h hypoxia and 4 h re-oxygenation. ApoH (coding for β2-GPI) was upregulated selectively in the liver at 48 h after tMCAo. At the same time β2-GPI circulating levels increased. β2-GPI was detectable in brain parenchyma and endothelium at all time points after tMCAo. Parenchymal β2-GPI recognized apoptotic neurons (positive for annexin V, C3 and TUNEL) cleared by CD68+ brain macrophages. Hypoxic ihBMEC showed increased release of IL-6, over-expression of thrombomodulin and IL-1α after re-oxygenation with β2-GPI alone. β2-GPI interacted with mannose-binding lectin in mouse plasma and ihBMEC medium, potentially involved in formation of thrombi. We show for the first time that brain ischemia triggers the hepatic production of β2-GPI. β2-GPI is present in the ischemic endothelium, enhancing vascular inflammation, and extravasates binding stressed neurons before their clearance by phagocytosis. Thus β2-GPI may be a new mediator of brain injury following ischemic stroke.
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Affiliation(s)
- Claudia Grossi
- Istituto Auxologico Italiano, IRCCS, Laboratory of Immuno-Rheumatology, Milan, Italy
| | - Carolina Artusi
- Rheumatology Department, ASST Gaetano Pini-CTO, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - PierLuigi Meroni
- Istituto Auxologico Italiano, IRCCS, Laboratory of Immuno-Rheumatology, Milan, Italy
| | - Maria Orietta Borghi
- Istituto Auxologico Italiano, IRCCS, Laboratory of Immuno-Rheumatology, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Laura Neglia
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Department of Neuroscience, Milan, Italy
| | - Paola Adele Lonati
- Istituto Auxologico Italiano, IRCCS, Laboratory of Immuno-Rheumatology, Milan, Italy
| | - Marco Oggioni
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Department of Neuroscience, Milan, Italy
| | - Francesco Tedesco
- Istituto Auxologico Italiano, IRCCS, Laboratory of Immuno-Rheumatology, Milan, Italy
| | - Maria-Grazia De Simoni
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Department of Neuroscience, Milan, Italy
| | - Stefano Fumagalli
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Department of Neuroscience, Milan, Italy
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8
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Barili F, D'Errigo P, Rosato S, Grossi C, D'Ovidio M, Pagano E, Seccareccia F. Long-term outcomes following coronary artery bypass grafting: the role of off-pump strategy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2674] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The debate on the advantages and limitations of off-pump (OPCAB) on long-term outcomes has not still arrived to a conclusion. This study was designed to compare the impact of OPCAB vs on-pump coronary artery bypass grafting (CABG) on long-term mortality and major adverse cardiac events (MACEs).
Methods
The PRIORITY project was designed to evaluate the long-term outcomes of 2 large prospective multicenter cohort studies on CABG conducted between 2002–2004 and 2007–2008. Data on isolated CABG were linked to 2 administrative datasets. Time-to-event methods were employed to analyze outcomes.
Results
The population consisted of 11021 patients who underwent isolated CABG (27.2% OPCAB) that were divided into development and validation datasets. The median follow-up time was 8 years (interquartile range 7.6–10 years) and was 100% complete. Unadjusted long-term survival was significantly worst for OPCAB, nonetheless the adjustment did not confirm OPCAB as a risk factor for mortality (HR 0.94, 95% CI 0.85–1.03, p=0.19). OPCAB was associated to an increased risk of MACE at 10 years (adjusted HR 1.14, 95% CI 1.06–1.23, p=0.001). Inside the MACEs, OPCAB was significantly related to increased incidence of rehospitalization for percutaneous cardiac intervention (PCI), (adjusted HR 1.33, 95% CI 1.16–1.53, p<0.001), demonstrating to be an independent risk factor for PCI with an hazard that is 33% higher than on-pump CABG.
Conclusions
OPCAB did not affect long-term mortality but is associated with an increased long-term risk of repeat PCI. These findings may have important implications towards health resources allocation, particularly in a climate of cost containment of healthcare expenditures.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Italian Minister of Health
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Affiliation(s)
- F Barili
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - P D'Errigo
- National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Rome, Italy
| | - S Rosato
- National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Rome, Italy
| | - C Grossi
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - M D'Ovidio
- Health Authority Roma E, Lazio Regional Health Service, Rome, Italy
| | - E Pagano
- Centre for Epidemiology and Prevention of Cancer (CPO-Piemonte), Turin, Italy
| | - F Seccareccia
- National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Rome, Italy
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9
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Borghi MO, Beltagy A, Garrafa E, Curreli D, Cecchini G, Bodio C, Grossi C, Blengino S, Tincani A, Franceschini F, Andreoli L, Lazzaroni MG, Piantoni S, Masneri S, Crisafulli F, Brugnoni D, Muiesan ML, Salvetti M, Parati G, Torresani E, Mahler M, Heilbron F, Pregnolato F, Pengo M, Tedesco F, Pozzi N, Meroni PL. Anti-Phospholipid Antibodies in COVID-19 Are Different From Those Detectable in the Anti-Phospholipid Syndrome. Front Immunol 2020; 11:584241. [PMID: 33178218 PMCID: PMC7593765 DOI: 10.3389/fimmu.2020.584241] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [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: 07/16/2020] [Accepted: 09/25/2020] [Indexed: 12/14/2022] Open
Abstract
Background Critically ill patients with coronavirus disease 2019 (COVID-19) have a profound hypercoagulable state and often develop coagulopathy which leads to organ failure and death. Because of a prolonged activated partial-thromboplastin time (aPTT), a relationship with anti-phospholipid antibodies (aPLs) has been proposed, but results are controversial. Functional assays for aPL (i.e., lupus anticoagulant) can be influenced by concomitant anticoagulation and/or high levels of C reactive protein. The presence of anti-cardiolipin (aCL), anti-beta2-glycoprotein I (anti-β2GPI), and anti-phosphatidylserine/prothrombin (aPS/PT) antibodies was not investigated systematically. Epitope specificity of anti-β2GPI antibodies was not reported. Objective To evaluate the prevalence and the clinical association of aPL in a large cohort of COVID-19 patients, and to characterize the epitope specificity of anti-β2GPI antibodies. Methods ELISA and chemiluminescence assays were used to test 122 sera of patients suffering from severe COVID-19. Of them, 16 displayed major thrombotic events. Results Anti-β2GPI IgG/IgA/IgM was the most frequent in 15.6/6.6/9.0% of patients, while aCL IgG/IgM was detected in 5.7/6.6% by ELISA. Comparable values were found by chemiluminescence. aPS/PT IgG/IgM were detectable in 2.5 and 9.8% by ELISA. No association between thrombosis and aPL was found. Reactivity against domain 1 and 4-5 of β2GPI was limited to 3/58 (5.2%) tested sera for each domain and did not correlate with aCL/anti-β2GPI nor with thrombosis. Conclusions aPL show a low prevalence in COVID-19 patients and are not associated with major thrombotic events. aPL in COVID-19 patients are mainly directed against β2GPI but display an epitope specificity different from antibodies in antiphospholipid syndrome.
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Affiliation(s)
- Maria Orietta Borghi
- Immunorheumatology Research Laboratory, Istituto Auxologico Italiano, Istituto di Ricovero Cura a Carattere Scientifico (IRCCS), Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Asmaa Beltagy
- Immunorheumatology Research Laboratory, Istituto Auxologico Italiano, Istituto di Ricovero Cura a Carattere Scientifico (IRCCS), Milan, Italy
- Rheumatology and Clinical Immunology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Emirena Garrafa
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- Department of Laboratory Diagnostics, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili, Brescia, Italy
| | - Daniele Curreli
- Immunorheumatology Research Laboratory, Istituto Auxologico Italiano, Istituto di Ricovero Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Germana Cecchini
- Department of Chemical Chemistry, Istituto Auxologico Italiano, Istituto di Ricovero Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Caterina Bodio
- Immunorheumatology Research Laboratory, Istituto Auxologico Italiano, Istituto di Ricovero Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Claudia Grossi
- Immunorheumatology Research Laboratory, Istituto Auxologico Italiano, Istituto di Ricovero Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Simonetta Blengino
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, Istituto di Ricovero Cura a Carattere Scientifico (IRCCS), San Luca Hospital, Milan, Italy
| | - Angela Tincani
- Rheumatology and Clinical Immunology Unit, Department of Clinical and Experimental Sciences, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Franco Franceschini
- Rheumatology and Clinical Immunology Unit, Department of Clinical and Experimental Sciences, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Laura Andreoli
- Rheumatology and Clinical Immunology Unit, Department of Clinical and Experimental Sciences, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Maria Grazia Lazzaroni
- Rheumatology and Clinical Immunology Unit, Department of Clinical and Experimental Sciences, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Silvia Piantoni
- Rheumatology and Clinical Immunology Unit, Department of Clinical and Experimental Sciences, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Stefania Masneri
- Rheumatology and Clinical Immunology Unit, Department of Clinical and Experimental Sciences, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Francesca Crisafulli
- Rheumatology and Clinical Immunology Unit, Department of Clinical and Experimental Sciences, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Duilio Brugnoni
- Department of Laboratory Diagnostics, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili, Brescia, Italy
| | - Maria Lorenza Muiesan
- Unità Operativa Complessa (UOC) 2° Medicina, Department of Clinical and Experimental Sciences, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Massimo Salvetti
- Unità Operativa Complessa (UOC) 2° Medicina, Department of Clinical and Experimental Sciences, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Gianfranco Parati
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, Istituto di Ricovero Cura a Carattere Scientifico (IRCCS), San Luca Hospital, Milan, Italy
| | - Erminio Torresani
- Department of Chemical Chemistry, Istituto Auxologico Italiano, Istituto di Ricovero Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Michael Mahler
- Research and Development, Inova Diagnostics, Inc., San Diego, CA, United States
| | - Francesca Heilbron
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, Istituto di Ricovero Cura a Carattere Scientifico (IRCCS), San Luca Hospital, Milan, Italy
| | - Francesca Pregnolato
- Immunorheumatology Research Laboratory, Istituto Auxologico Italiano, Istituto di Ricovero Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Martino Pengo
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, Istituto di Ricovero Cura a Carattere Scientifico (IRCCS), San Luca Hospital, Milan, Italy
| | - Francesco Tedesco
- Immunorheumatology Research Laboratory, Istituto Auxologico Italiano, Istituto di Ricovero Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Nicola Pozzi
- Department of Biochemistry and Molecular Biology, Saint Louis University School of Medicine, St. Louis, MO, United States
| | - Pier Luigi Meroni
- Immunorheumatology Research Laboratory, Istituto Auxologico Italiano, Istituto di Ricovero Cura a Carattere Scientifico (IRCCS), Milan, Italy
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10
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Durigutto P, Macor P, Pozzi N, Agostinis C, Bossi F, Meroni PL, Grossi C, Borghi MO, Planer W, Garred P, Tedesco F. Complement Activation and Thrombin Generation by MBL Bound to β2-Glycoprotein I. J Immunol 2020; 205:1385-1392. [PMID: 32759297 DOI: 10.4049/jimmunol.2000570] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 07/04/2020] [Indexed: 01/23/2023]
Abstract
β2-Glycoprotein I (β2-GPI) is an abundant plasma glycoprotein with unknown physiological function and is currently recognized as the main target of antiphospholipid Abs responsible for complement activation and vascular thrombosis in patients with antiphospholipid syndrome (APS). In this study, we provide evidence that mannose-binding lectin (MBL) binds to β2-GPI in Ca++ and a dose-dependent manner and that this interaction activates complement and promotes complement-dependent thrombin generation. Surprisingly, a significant binding was observed between MBL and isolated domains II and IV of β2-GPI, whereas the carbohydrate chains, domain I and domain V, were not involved in the interaction, documenting a noncanonical binding mode between MBL and β2-GPI. Importantly, this interaction may occur on endothelial cells because binding of MBL to β2-GPI was detected on the surface of HUVECs, and colocalization of MBL with β2-GPI was observed on the endothelium of a biopsy specimen of a femoral artery from an APS patient. Because β2-GPI-mediated MBL-dependent thrombin generation was increased after priming the endothelium with TNF-α, our data suggests that this mechanism could play an important yet unrecognized role under physiological conditions and may be upregulated in pathological situations. Moreover, the complement activation and the procoagulant effects of the β2-GPI/MBL complex may contribute to amplify similar activities of anti-β2-GPI Abs in APS and possibly act independently of Abs, raising the issue of developing appropriate therapies to avoid recurrences and disability in patients at risk for these clinical conditions.
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Affiliation(s)
- Paolo Durigutto
- Laboratorio di Immuno-Reumatologia, Istituto Auxologico Italiano, Istituto di Ricerca e Cura a Carattere Scientifico, Cusano Milanino, 20095 Milan, Italy
| | - Paolo Macor
- Department of Life Sciences, University of Trieste, 34127 Trieste, Italy
| | - Nicola Pozzi
- Edward A. Doisy Department of Biochemistry and Molecular Biology, Saint Louis University School of Medicine, St. Louis, MO 63104
| | - Chiara Agostinis
- Istituto Materno-Infantile, Istituto di Ricerca e Cura a Carattere Scientifico, Burlo Garofolo, 34137 Trieste, Italy
| | - Fleur Bossi
- Istituto Materno-Infantile, Istituto di Ricerca e Cura a Carattere Scientifico, Burlo Garofolo, 34137 Trieste, Italy
| | - Pier Luigi Meroni
- Laboratorio di Immuno-Reumatologia, Istituto Auxologico Italiano, Istituto di Ricerca e Cura a Carattere Scientifico, Cusano Milanino, 20095 Milan, Italy
| | - Claudia Grossi
- Laboratorio di Immuno-Reumatologia, Istituto Auxologico Italiano, Istituto di Ricerca e Cura a Carattere Scientifico, Cusano Milanino, 20095 Milan, Italy
| | - Maria O Borghi
- Laboratorio di Immuno-Reumatologia, Istituto Auxologico Italiano, Istituto di Ricerca e Cura a Carattere Scientifico, Cusano Milanino, 20095 Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; and
| | - William Planer
- Edward A. Doisy Department of Biochemistry and Molecular Biology, Saint Louis University School of Medicine, St. Louis, MO 63104
| | - Peter Garred
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Rigshospitalet, Faculty of Health and Medical Sciences, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Francesco Tedesco
- Laboratorio di Immuno-Reumatologia, Istituto Auxologico Italiano, Istituto di Ricerca e Cura a Carattere Scientifico, Cusano Milanino, 20095 Milan, Italy;
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11
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Borghi MO, Beltagy A, Garrafa E, Curreli D, Cecchini G, Bodio C, Grossi C, Blengino S, Tincani A, Franceschini F, Andreoli L, Lazzaroni MG, Piantoni S, Masneri S, Crisafulli F, Brugnoni D, Muiesan ML, Salvetti M, Parati G, Torresani E, Mahler M, Heilbron F, Pregnolato F, Pengo M, Tedesco F, Pozzi N, Meroni PL. Anti-phospholipid antibodies in COVID-19 are different from those detectable in the anti-phospholipid syndrome. medRxiv 2020. [PMID: 32588001 DOI: 10.1101/2020.06.17.20134114] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Critically ill patients with coronavirus disease 2019 (COVID-19) have a profound hypercoagulable state and often develop coagulopathy which leads to organ failure and death. Because of a prolonged activated partial-thromboplastin time (aPTT), a relationship with anti-phospholipid antibodies (aPL) has been proposed, but results are controversial. Functional assays for aPL (i.e., lupus anticoagulant) can be influenced by concomitant anticoagulation and/or high levels of C reactive protein. The presence of anti-cardiolipin (aCL), anti-beta2-glycoprotein I (anti-β2GPI) and anti-phosphatidylserine/prothrombin (aPS/PT) antibodies was not investigated systematically. Epitope specificity of anti-β2GPI antibodies was not reported. OBJECTIVE To evaluate the prevalence and the clinical association of aPL in a large cohort of COVID-19 patients, and to characterize the epitope specificity of anti-β2GPI antibodies. METHODS ELISA and chemiluminescence assays were used to test 122 sera of patients suffering from severe COVID-19. Of them, 16 displayed major thrombotic events. RESULTS Anti-β2GPI IgG/IgA/IgM were the most frequent in 15.6/6.6/9.0% of patients, while aCL IgG/IgM were detected in 5.7/6.6% by ELISA. Comparable values were found by chemiluminescence. aPS/PT IgG/IgM were detectable in 2.5 and 9.8% by ELISA. No association between thrombosis and aPL was found. Reactivity against domain 1 and 4-5 of β2GPI was limited to 3/58 (5.2%) tested sera for each domain and did not correlate with aCL/anti-β2GPI nor with thrombosis. CONCLUSIONS aPL show a low prevalence in COVID-19 patients and are not associated with major thrombotic events. aPL in COVID-19 patients are mainly directed against β2GPI but display an epitope specificity different from antibodies in antiphospholipid syndrome.
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12
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Bodio C, Grossi C, Pregnolato F, Favalli EG, Biggioggero M, Marchesoni A, Murgo A, Filippini M, Migliorini P, Caporali R, Pellerito R, Ciccia F, Sarzi-Puttini P, Perosa F, Paolazzi G, Hollan I, Bendtzen K, Meroni PL, Borghi MO. Personalized medicine in rheumatoid arthritis: How immunogenicity impacts use of TNF inhibitors. Autoimmun Rev 2020; 19:102509. [DOI: 10.1016/j.autrev.2020.102509] [Citation(s) in RCA: 8] [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: 11/19/2019] [Accepted: 11/22/2019] [Indexed: 01/30/2023]
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13
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Gutiérrez-Álvarez I, Martín J, Adame J, Grossi C, Vargas A, Bolívar J. Applicability of the closed-circuit accumulation chamber technique to measure radon surface exhalation rate under laboratory conditions. RADIAT MEAS 2020. [DOI: 10.1016/j.radmeas.2020.106284] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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Andrisani G, Soriani P, Manno M, Pizzicannella M, Pugliese F, Mutignani M, Naspetti R, Petruzziello L, Iacopini F, Grossi C, Lagoussis P, Vavassori S, Coppola F, La Terra A, Ghersi S, Cecinato P, De Nucci G, Salerno R, Pandolfi M, Costamagna G, Di Matteo FM. Colo-rectal endoscopic full-thickness resection (EFTR) with the over-the-scope device (FTRD ®): A multicenter Italian experience. Dig Liver Dis 2019; 51:375-381. [PMID: 30377063 DOI: 10.1016/j.dld.2018.09.030] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/15/2018] [Accepted: 09/27/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIM Endoscopic full-thickness resection(EFTR) with FTRD® in colo-rectum may be useful for several indications.The aim was to assess its efficacy and safety. MATERIAL AND METHODS In this retrospective multicenter study 114 patients were screened; 110 (61M/49F, mean age 68 ± 11 years, range 20-90) underwent EFTR using FTRD®. Indications were:residual/recurrent adenoma (39), incomplete resection at histology (R1 resection) (26), non-lifting lesion (12), adenoma involving the appendix (2) or diverticulum (2), subepithelial lesions(10), suspected T1 carcinoma (16), diagnostic resection (3). Technical success (TS: lesion reached and resected), R0 resection (negative lateral and deep margins),EFTR rate(all layers documented in the specimen) and safety have been evaluated. RESULTS TS was achieved in 94.4% of cases. EFTR was achieved in 91% with lateral and deep R0 resection in 90% and 92%. Mean size of specimens was 20 mm (range 6-42). In residual/recurrent adenomas, final analysis revealed: low-risk T1 (11), adenoma with low-grade dysplasia (LGD) (24) and high-grade dysplasia (HGD) (3), scar tissue (1). Histology reports of R1 resections were: adenoma with LGD (6), with HGD (1), low-risk (6) and high-risk (1) T1, scar tissue (12). Non-lifting lesions were diagnosed as: adenoma with HGD (3), low-risk (7) and high risk (2) T1. Adverse clinical events occurred in 12 patients (11%),while adverse technical events in11%. Three-months follow-up was available in 100 cases and residual disease was evident in only seven patients. CONCLUSIONS EFTR using FTRD® seems to be a feasible, effective and safe technique for treating selected colo-rectal lesions. Comparative prospective studies are needed to confirm these promising results.
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Affiliation(s)
- G Andrisani
- Digestive Endoscopy Unit, Campus Bio-Medico, Rome, Italy.
| | - P Soriani
- Digestive Endoscopy Unit, Ramazzini Hospital, Carpi, Modena, Italy
| | - M Manno
- Digestive Endoscopy Unit, Ramazzini Hospital, Carpi, Modena, Italy
| | | | - F Pugliese
- Diagnostic and Interventional Digestive Endoscopy, Niguarda Ca-Granda Hospital, Milan, Italy
| | - M Mutignani
- Diagnostic and Interventional Digestive Endoscopy, Niguarda Ca-Granda Hospital, Milan, Italy
| | - R Naspetti
- Surgical Endoscopy Unit, Careggi Hospital, Florence, Italy
| | - L Petruzziello
- Digestive Endoscopy Unit, Gemelli University Hospital, Rome, Italy
| | - F Iacopini
- Gastroenterology Endoscopy Unit, S.Giuseppe Hospital, Albano Laziale, Rome,Italy
| | - C Grossi
- Gastroenterology Endoscopy Unit, S.Giuseppe Hospital, Albano Laziale, Rome,Italy
| | - P Lagoussis
- Division Of General Surgery I, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - S Vavassori
- Division Of General Surgery I, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - F Coppola
- Department Gastroenterology, San Giovanni Bosco Hospital, Torino, Italy
| | - A La Terra
- Department Gastroenterology, San Giovanni Bosco Hospital, Torino, Italy
| | - S Ghersi
- Gastroenterology and Digestive Endoscopy Unit, AUSL Bologna, Bologna, Italy
| | - P Cecinato
- Unit of Gastroenterology and Digestive Endoscopy, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - G De Nucci
- Gastroenterology and Digestive Endoscopy Unit, A.O. Salvini, Garbagnate Milanese, Italy
| | - R Salerno
- Endoscopy Unit, ASST Fatebenefratelli Sacco, Milan, Italy
| | - M Pandolfi
- Digestive Endoscopy Unit, Campus Bio-Medico, Rome, Italy
| | - G Costamagna
- Digestive Endoscopy Unit, Gemelli University Hospital, Rome, Italy
| | - F M Di Matteo
- Digestive Endoscopy Unit, Campus Bio-Medico, Rome, Italy
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15
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Durigutto P, Grossi C, Borghi MO, Macor P, Pregnolato F, Raschi E, Myers MP, de Groot PG, Meroni PL, Tedesco F. New insight into antiphospholipid syndrome: antibodies to β2glycoprotein I-domain 5 fail to induce thrombi in rats. Haematologica 2018; 104:819-826. [PMID: 30442725 PMCID: PMC6442945 DOI: 10.3324/haematol.2018.198119] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 11/14/2018] [Indexed: 11/09/2022] Open
Abstract
Clinical studies have reported different diagnostic/predictive values of antibodies to domain 1 or 4/5 of β2glycoproteinI in terms of risk of thrombosis and pregnancy complications in patients with antiphospholipid syndrome. To obtain direct evidence for the pathogenic role of anti-domain 1 or anti-domain 4/5 antibodies, we analyzed the in vivo pro-coagulant effect of two groups of 5 sera IgG each reacting selectively with domain 1 or domain 5 in lipopolysaccharide (LPS)-treated rats. Antibody-induced thrombus formation in mesenteric vessels was followed by intravital microscopy, and vascular deposition of β2glycoproteinI, human IgG and C3 was analyzed by immunofluorescence. Five serum IgG with undetectable anti-β2glycoproteinI antibodies served as controls. All the anti-domain 1-positive IgG exhibited potent pro-coagulant activity while the anti-domain 5-positive and the negative control IgG failed to promote blood clot and vessel occlusion. A stronger granular deposit of IgG/C3 was found on the mesenteric endothelium of rats treated with anti-domain 1 antibodies, as opposed to a mild linear IgG staining and absence of C3 observed in rats receiving anti-domain 5 antibodies. Purified anti-domain 5 IgG, unlike anti-domain 1 IgG, did not recognize cardiolipin-bound β2glycoproteinI while being able to interact with fluid-phase β2glycoproteinI. These findings may explain the failure of anti-domain 5 antibodies to exhibit a thrombogenic effect in vivo, and the interaction of these antibodies with circulating β2glycoproteinI suggests their potential competitive role with the pro-coagulant activity of anti-domain 1 antibodies. These data aim at better defining “really at risk” patients for more appropriate treatments to avoid recurrences and disability.
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Affiliation(s)
| | - Claudia Grossi
- Istituto Auxologico Italiano, IRCCS, Laboratory of Immuno-Rheumatology, Milan, Italy
| | - Maria Orietta Borghi
- Istituto Auxologico Italiano, IRCCS, Laboratory of Immuno-Rheumatology, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - Paolo Macor
- Department of Life Sciences, University of Trieste, Italy
| | - Francesca Pregnolato
- Istituto Auxologico Italiano, IRCCS, Laboratory of Immuno-Rheumatology, Milan, Italy
| | - Elena Raschi
- Istituto Auxologico Italiano, IRCCS, Laboratory of Immuno-Rheumatology, Milan, Italy
| | - Michael P Myers
- International Centre for Genetic Engineering and Biotechnology, Trieste, Italy
| | - Philip G de Groot
- Department of Clinical Chemistry and Haematology, University of Utrecht, University Medical Center Utrecht, the Netherlands
| | - Pier Luigi Meroni
- Istituto Auxologico Italiano, IRCCS, Laboratory of Immuno-Rheumatology, Milan, Italy
| | - Francesco Tedesco
- Istituto Auxologico Italiano, IRCCS, Laboratory of Immuno-Rheumatology, Milan, Italy
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16
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Ripoll VM, Pregnolato F, Mazza S, Bodio C, Grossi C, McDonnell T, Pericleous C, Meroni PL, Isenberg DA, Rahman A, Giles IP. Gene expression profiling identifies distinct molecular signatures in thrombotic and obstetric antiphospholipid syndrome. J Autoimmun 2018; 93:114-123. [PMID: 30033000 PMCID: PMC6123515 DOI: 10.1016/j.jaut.2018.07.002] [Citation(s) in RCA: 14] [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] [Received: 05/29/2018] [Accepted: 07/01/2018] [Indexed: 02/07/2023]
Abstract
Antiphospholipid antibodies (aPL) cause vascular thrombosis (VT) and/or pregnancy morbidity (PM). Differential mechanisms however, underlying the pathogenesis of these different manifestations of antiphospholipid syndrome (APS) are not fully understood. Therefore, we compared the effects of aPL from patients with thrombotic or obstetric APS on monocytes to identify different molecular pathways involved in the pathogenesis of APS subtypes. VT or PM IgG induced similar numbers of differentially expressed (DE) genes in monocytes. However, gene ontology (GO) analysis of DE genes revealed disease-specific genome signatures. Compared to PM, VT-IgG showed specific up regulation of genes associated with cell response to stress, regulation of MAPK signalling pathway and cell communication. In contrast, PM-IgG regulated genes involved in cell adhesion, extracellular matrix and embryonic and skeletal development. A novel gene expression analysis based on differential variability (DV) was also applied. This analysis identified similar GO categories compared to DE analysis but also uncovered novel pathways modulated solely by PM or VT-IgG. Gene expression analysis distinguished a differential effect of VT or PM-IgG upon monocytes supporting the hypothesis that they trigger distinctive physiological mechanisms. This finding contributes to our understanding of the pathology of APS and may lead to the development of different targeted therapies for VT or PM APS.
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Affiliation(s)
- Vera M Ripoll
- Centre for Rheumatology Research, Division of Medicine, University College London, Department of Medicine, Rayne Institute, 5 University Street, London, UK, WC1E 6JF, UK.
| | - Francesca Pregnolato
- Immunology Research Laboratory, IRCCS Istituto Auxologico Italiano, Via Zucchi, 18, 20095 Cusano milanino MI, Italy
| | - Simona Mazza
- Centre for Rheumatology Research, Division of Medicine, University College London, Department of Medicine, Rayne Institute, 5 University Street, London, UK, WC1E 6JF, UK
| | - Caterina Bodio
- Immunology Research Laboratory, IRCCS Istituto Auxologico Italiano, Via Zucchi, 18, 20095 Cusano milanino MI, Italy
| | - Claudia Grossi
- Immunology Research Laboratory, IRCCS Istituto Auxologico Italiano, Via Zucchi, 18, 20095 Cusano milanino MI, Italy
| | - Thomas McDonnell
- Centre for Rheumatology Research, Division of Medicine, University College London, Department of Medicine, Rayne Institute, 5 University Street, London, UK, WC1E 6JF, UK
| | - Charis Pericleous
- Centre for Rheumatology Research, Division of Medicine, University College London, Department of Medicine, Rayne Institute, 5 University Street, London, UK, WC1E 6JF, UK
| | - Pier Luigi Meroni
- Immunology Research Laboratory, IRCCS Istituto Auxologico Italiano, Via Zucchi, 18, 20095 Cusano milanino MI, Italy
| | - David A Isenberg
- Centre for Rheumatology Research, Division of Medicine, University College London, Department of Medicine, Rayne Institute, 5 University Street, London, UK, WC1E 6JF, UK
| | - Anisur Rahman
- Centre for Rheumatology Research, Division of Medicine, University College London, Department of Medicine, Rayne Institute, 5 University Street, London, UK, WC1E 6JF, UK
| | - Ian P Giles
- Centre for Rheumatology Research, Division of Medicine, University College London, Department of Medicine, Rayne Institute, 5 University Street, London, UK, WC1E 6JF, UK
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17
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Chighizola CB, Pregnolato F, Andreoli L, Bodio C, Cesana L, Comerio C, Gerosa M, Grossi C, Kumar R, Lazzaroni MG, Mahler M, Mattia E, Nalli C, Norman GL, Raimondo MG, Ruffatti A, Tonello M, Trespidi L, Tincani A, Borghi MO, Meroni PL. Beyond thrombosis: Anti-β2GPI domain 1 antibodies identify late pregnancy morbidity in anti-phospholipid syndrome. J Autoimmun 2018; 90:76-83. [PMID: 29454510 DOI: 10.1016/j.jaut.2018.02.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [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: 10/22/2017] [Revised: 02/02/2018] [Accepted: 02/05/2018] [Indexed: 12/22/2022]
Abstract
Antibodies against β2 glycoprotein I (anti-β2GPI) have been identified as the main pathogenic autoantibody subset in anti-phospholipid syndrome (APS); the most relevant epitope is a cryptic and conformation-dependent structure on β2GPI domain (D) 1. Anti-β2GPI domain profiling has been investigated in thrombotic APS, leading to the identification of antibodies targeting D1 as the main subpopulation. In contrast, scarce attention has been paid to obstetric APS, hence this study aimed at characterizing the domain reactivity with regards to pregnancy morbidity (PM). To this end, 135 women with persistently positive, medium/high titre anti-β2GPI IgG, without any associated systemic autoimmune diseases and at least one previous pregnancy were included: 27 asymptomatic carriers; 53 women with obstetric APS; 20 women with thrombotic APS; and 35 women with both thrombotic and obstetric complications. Anti-D1 and anti-D4/5 antibodies were tested using a chemiluminescent immunoassay and a research ELISA assay, respectively (QUANTA Flash® β2GPI Domain 1 IgG and QUANTA Lite® β2GPI D4/5 IgG, Inova Diagnostics). Positivity for anti-D1 antibodies, but not anti-D4/5 antibodies, was differently distributed across the 4 subgroups of patients (p < 0.0001) and significantly correlated with thrombosis (χ2 = 17.28, p < 0.0001) and PM (χ2 = 4.28, p = 0.039). Patients with triple positivity for anti-phospholipid antibodies displayed higher anti-D1 titres and lower anti-D4/5 titres compared to women with one or two positive tests (p < 0.0001 and p = 0.005, respectively). Reactivity against D1 was identified as a predictor for PM (OR 2.4, 95% confidence interval [CI] 1.2-5.0, p = 0.017); in particular, anti-D1 antibodies were predictive of late PM, conveying an odds ratio of 7.3 (95% CI 2.1-25.5, p = 0.022). Positivity for anti-D1 antibodies was not associated with early pregnancy loss. Anti-D4/5 antibodies were not associated with clinical APS manifestations. As a whole, our data suggest that anti-D1 antibodies are significantly associated not only with thrombosis, but also with late PM, while positive anti-D4/5 antibodies are not predictive of thrombosis or PM.
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Affiliation(s)
- Cecilia Beatrice Chighizola
- Department of Clinical Sciences and Community Health, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy; Experimental Laboratory of Immunological and Rheumatologic Researches, IRCCS Istituto Auxologico Italiano, Via Zucchi 18, 20095 Cusano Milanino, Milan, Italy
| | - Francesca Pregnolato
- Experimental Laboratory of Immunological and Rheumatologic Researches, IRCCS Istituto Auxologico Italiano, Via Zucchi 18, 20095 Cusano Milanino, Milan, Italy
| | - Laura Andreoli
- Rheumatology and Clinical Immunology, Spedali Civili of Brescia, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Caterina Bodio
- Department of Clinical Sciences and Community Health, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy; Experimental Laboratory of Immunological and Rheumatologic Researches, IRCCS Istituto Auxologico Italiano, Via Zucchi 18, 20095 Cusano Milanino, Milan, Italy
| | - Laura Cesana
- Experimental Laboratory of Immunological and Rheumatologic Researches, IRCCS Istituto Auxologico Italiano, Via Zucchi 18, 20095 Cusano Milanino, Milan, Italy
| | - Chiara Comerio
- Department of Obstetrics and Gynaecology, Fondazione Cà Granda, Ospedale Maggiore Policlinico, Via della Commenda 12, 20122 Milan, Italy
| | - Maria Gerosa
- Department of Clinical Sciences and Community Health, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy; Department of Rheumatology, ASST Istituto Gaetano Pini & CTO, Piazza Cardinal Ferrari, 1 20122 Milan, Italy
| | - Claudia Grossi
- Experimental Laboratory of Immunological and Rheumatologic Researches, IRCCS Istituto Auxologico Italiano, Via Zucchi 18, 20095 Cusano Milanino, Milan, Italy
| | - Rajesh Kumar
- Rheumatology and Clinical Immunology, Spedali Civili of Brescia, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Maria Grazia Lazzaroni
- Rheumatology and Clinical Immunology, Spedali Civili of Brescia, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Michael Mahler
- INOVA Diagnostics, 9900 Old Grove Road, San Diego, CA 92131-1638, USA
| | - Elena Mattia
- Rheumatology Unit, Department of Medicine, University of Padua, via Giustiniani 2, 35128 Padua, Italy
| | - Cecilia Nalli
- Rheumatology and Clinical Immunology, Spedali Civili of Brescia, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Gary L Norman
- INOVA Diagnostics, 9900 Old Grove Road, San Diego, CA 92131-1638, USA
| | - Maria Gabriella Raimondo
- Department of Clinical Sciences and Community Health, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy; Department of Rheumatology, ASST Istituto Gaetano Pini & CTO, Piazza Cardinal Ferrari, 1 20122 Milan, Italy
| | - Amelia Ruffatti
- Rheumatology Unit, Department of Medicine, University of Padua, via Giustiniani 2, 35128 Padua, Italy
| | - Marta Tonello
- Rheumatology Unit, Department of Medicine, University of Padua, via Giustiniani 2, 35128 Padua, Italy
| | - Laura Trespidi
- Department of Obstetrics and Gynaecology, Fondazione Cà Granda, Ospedale Maggiore Policlinico, Via della Commenda 12, 20122 Milan, Italy
| | - Angela Tincani
- Rheumatology and Clinical Immunology, Spedali Civili of Brescia, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Maria Orietta Borghi
- Department of Clinical Sciences and Community Health, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy; Experimental Laboratory of Immunological and Rheumatologic Researches, IRCCS Istituto Auxologico Italiano, Via Zucchi 18, 20095 Cusano Milanino, Milan, Italy
| | - Pier Luigi Meroni
- Department of Clinical Sciences and Community Health, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy; Experimental Laboratory of Immunological and Rheumatologic Researches, IRCCS Istituto Auxologico Italiano, Via Zucchi 18, 20095 Cusano Milanino, Milan, Italy; Department of Rheumatology, ASST Istituto Gaetano Pini & CTO, Piazza Cardinal Ferrari, 1 20122 Milan, Italy.
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18
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Pengo V, Tonello M, Noventa F, Grossi C, Borghi MO, Moerloose PD, Reber G, Ruffatti A, Cavazzana A. Anti-β2-glycoprotein I ELISA assay: The influence of different antigen preparations. Thromb Haemost 2017. [DOI: 10.1160/th08-02-0082] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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19
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Grossi C, Ballester J, Serrano I, Galmarini S, Camacho A, Curcoll R, Morguí JA, Rodò X, Duch MA. Influence of long-range atmospheric transport pathways and climate teleconnection patterns on the variability of surface 210Pb and 7Be concentrations in southwestern Europe. J Environ Radioact 2016; 165:103-114. [PMID: 27676361 DOI: 10.1016/j.jenvrad.2016.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 09/14/2016] [Accepted: 09/17/2016] [Indexed: 06/06/2023]
Abstract
The variability of the atmospheric concentration of the 7Be and 210Pb radionuclides is strongly linked to the origin of air masses, the strength of their sources and the processes of wet and dry deposition. It has been shown how these processes and their variability are strongly affected by climate change. Thus, a deeper knowledge of the relationship between the atmospheric radionuclides variability measured close to the ground and these atmospheric processes could help in the analysis of climate scenarios. In the present study, we analyze the atmospheric variability of a 14-year time series of 7Be and 210Pb in a Mediterranean coastal city using a synergy of different indicators and tools such as: the local meteorological conditions, global and regional climate indexes and a lagrangian atmospheric transport model. We particularly focus on the relationships between the main pathways of air masses and sun spots occurrence, the variability of the local relative humidity and temperature conditions, and the main modes of regional climate variability, such as the North Atlantic Oscillation (NAO) and the Western Mediterranean Oscillation (WeMO). The variability of the observed atmospheric concentrations of both 7Be and 210Pb radionuclides was found to be mainly positively associated to the local climate conditions of temperature and to the pathways of air masses arriving at the station. Measured radionuclide concentrations significantly increase when air masses travel at low tropospheric levels from central Europe and the western part of the Iberian Peninsula, while low concentrations are associated with westerly air masses. We found a significant negative correlation between the WeMO index and the atmospheric variability of both radionuclides and no significant association was observed for the NAO index.
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Affiliation(s)
- C Grossi
- Institut Català de Cienciès del Clima (IC3), Barcelona, Spain.
| | - J Ballester
- Institut Català de Cienciès del Clima (IC3), Barcelona, Spain
| | - I Serrano
- Institut de Tècniques Energètiques (INTE), Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
| | - S Galmarini
- European Commission, Joint Research Centre, Institute for Environment and Sustainability, Ispra, Italy
| | - A Camacho
- Institut de Tècniques Energètiques (INTE), Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
| | - R Curcoll
- Institut Català de Cienciès del Clima (IC3), Barcelona, Spain
| | - J A Morguí
- Institut Català de Cienciès del Clima (IC3), Barcelona, Spain; Departament d'Ecologia, Universitat de Barcelona (UB), Barcelona, Spain
| | - X Rodò
- Institut Català de Cienciès del Clima (IC3), Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - M A Duch
- Institut de Tècniques Energètiques (INTE), Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
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Moroni G, Doria A, Giglio E, Imbasciati E, Tani C, Zen M, Strigini F, Zaina B, Tincani A, Gatto M, de Liso F, Grossi C, Meroni PL, Cabiddu G, Messa P, Ravani P, Mosca M. Maternal outcome in pregnant women with lupus nephritis. A prospective multicenter study. J Autoimmun 2016; 74:194-200. [DOI: 10.1016/j.jaut.2016.06.012] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 06/17/2016] [Accepted: 06/21/2016] [Indexed: 01/31/2023]
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21
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Moroni G, Doria A, Giglio E, Tani C, Zen M, Strigini F, Zaina B, Tincani A, de Liso F, Matinato C, Grossi C, Gatto M, Castellana P, Limardo M, Meroni PL, Messa P, Ravani P, Mosca M. Fetal outcome and recommendations of pregnancies in lupus nephritis in the 21st century. A prospective multicenter study. J Autoimmun 2016; 74:6-12. [PMID: 27496151 DOI: 10.1016/j.jaut.2016.07.010] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 07/24/2016] [Accepted: 07/25/2016] [Indexed: 01/12/2023]
Abstract
The aim of this multicenter study was to assess the present risk of fetal complications and the inherent risk factors in pregnant women with lupus nephritis. Seventy-one pregnancies in 61women (59 Caucasians and 2 Asians) with lupus nephritis were prospectively followed between October 2006 and December 2013. All patients received a counselling visit within 3 months before the beginning of pregnancy and were followed by a multidisciplinary team. At baseline mild active nephritis was present in 15 cases (21.1%). Six pregnancies (8.4%) resulted in fetal loss. Arterial hypertension at baseline (P = 0.003), positivity for lupus anticoagulant (P = 0.001), anticardiolipin IgG antibodies (P = 0.007), antibeta2 IgG (P = 0.018) and the triple positivity for antiphospholipid antibodies (P = 0.004) predicted fetal loss. Twenty pregnancies (28.2%) ended pre-term and 12 newborns (16.4%) were small for gestational age. Among the characteristics at baseline, high SLE disease activity index (SLEDAI) score (P = 0.027), proteinuria (P = 0.045), history of renal flares (P = 0.004), arterial hypertension (P = 0.009) and active lupus nephritis (P = 0.000) increased the probability of preterm delivery. Odds for preterm delivery increased by 60% for each quarterly unit increase in SLEDAI and by 15% for each quarterly increase in proteinuria by 1 g per day. The probability of having a small for gestational age baby was reduced by 85% in women who received hydroxychloroquine therapy (P = 0.023). In this study, the rate of fetal loss was low and mainly associated with the presence of antiphospholipid antibodies. Preterm delivery remains a frequent complication of pregnancies in lupus. SLE and lupus nephritis activity are the main risk factors for premature birth. Arterial hypertension predicted both fetal loss and preterm delivery. Based on our results the key for a successful pregnancy in lupus nephritis is a multidisciplinary approach with close medical, obstetric and neonatal monitoring. This entails: a) a preconception evaluation to establish and inform women about pregnancy risks; b) planning pregnancy during inactive lupus nephritis, maintained inactive with the lowest possible dosage of allowed drugs; c) adequate treatment of known risk factors (arterial hypertension, antiphospholipid and antibodies); d) close monitoring during and after pregnancy to rapidly identify and treat SLE flares and obstetric complications.
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Affiliation(s)
- Gabriella Moroni
- Nephrological Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Andrea Doria
- Department of Medicine-DIMED, Division of Rheumatology, University of Padova, Italy
| | - Elisa Giglio
- Nephrological Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Tani
- Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Italy
| | - Margherita Zen
- Department of Medicine-DIMED, Division of Rheumatology, University of Padova, Italy
| | - Francesca Strigini
- Department of Reproductive Medicine and Child Development Division of Obstetrics and Gynecology, University of Pisa, Italy
| | - Barbara Zaina
- Department of Obstetrics and Gynecology Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Angela Tincani
- Rheumatology and Clinical Immunology Unit, Spedali Civili of Brescia, Italy
| | - Federica de Liso
- Laboratory of Clinical Chemistry and Microbiology, Fondazione IRCCS Ca' Granda Ospedale, Maggiore Policlinico, Milan, Italy
| | - Caterina Matinato
- Laboratory of Clinical Chemistry and Microbiology, Fondazione IRCCS Ca' Granda Ospedale, Maggiore Policlinico, Milan, Italy
| | - Claudia Grossi
- Experimental Laboratory of Immunological and Rheumatologic Researches, IRCCS Istituto, Auxologico Italiano, Milan, Italy
| | - Mariele Gatto
- Department of Medicine-DIMED, Division of Rheumatology, University of Padova, Italy
| | - Paola Castellana
- Dipartimento di Scienze della Salute, Azienda Ospedaliera San Paolo, Milan, Italy
| | - Monica Limardo
- Nephrology, Azienda Ospedaliera della Provincia di Lecco, Lecco, Italy
| | - Pier Luigi Meroni
- Experimental Laboratory of Immunological and Rheumatologic Researches, IRCCS Istituto, Auxologico Italiano, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Piergiorgio Messa
- Nephrological Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Pietro Ravani
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada; Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Marta Mosca
- Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Italy
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22
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Artusi C, Fumagalli S, Oggioni M, Borghi M, Grossi C, Meroni P, Tedesco F, De Simoni M. AB0131 Tissue Beta 2 glycoprotein I in Brain Ischemic Injury. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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23
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Roggenbuck D, Borghi MO, Somma V, Büttner T, Schierack P, Hanack K, Grossi C, Bodio C, Macor P, von Landenberg P, Boccellato F, Mahler M, Meroni PL. Antiphospholipid antibodies detected by line immunoassay differentiate among patients with antiphospholipid syndrome, with infections and asymptomatic carriers. Arthritis Res Ther 2016; 18:111. [PMID: 27209064 PMCID: PMC4875598 DOI: 10.1186/s13075-016-1018-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [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: 12/23/2015] [Accepted: 05/11/2016] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Antiphospholipid antibodies (aPL) can be detected in asymptomatic carriers and infectious patients. The aim was to investigate whether a novel line immunoassay (LIA) differentiates between antiphospholipid syndrome (APS) and asymptomatic aPL+ carriers or patients with infectious diseases (infectious diseases controls (IDC)). METHODS Sixty-one patients with APS (56 primary, 22/56 with obstetric events only, and 5 secondary), 146 controls including 24 aPL+ asymptomatic carriers and 73 IDC were tested on a novel hydrophobic solid phase coated with cardiolipin (CL), phosphatic acid, phosphatidylcholine, phosphatidylethanolamine, phosphatidylglycerol, phosphatidylinositol, phosphatidylserine, beta2-glycoprotein I (β2GPI), prothrombin, and annexin V. Samples were also tested by anti-CL and anti-β2GPI ELISAs and for lupus anticoagulant activity. Human monoclonal antibodies (humoAbs) against human β2GPI or PL alone were tested on the same LIA substrates in the absence or presence of human serum, purified human β2GPI or after CL-micelle absorption. RESULTS Comparison of LIA with the aPL-classification assays revealed good agreement for IgG/IgM aß2GPI and aCL. Anti-CL and anti-ß2GPI IgG/IgM reactivity assessed by LIA was significantly higher in patients with APS versus healthy controls and IDCs, as detected by ELISA. IgG binding to CL and ß2GPI in the LIA was significantly lower in aPL+ carriers and Venereal Disease Research Laboratory test (VDRL) + samples than in patients with APS. HumoAb against domain 1 recognized β2GPI bound to the LIA-matrix and in anionic phospholipid (PL) complexes. Absorption with CL micelles abolished the reactivity of a PL-specific humoAb but did not affect the binding of anti-β2GPI humoAbs. CONCLUSIONS The LIA and ELISA have good agreement in detecting aPL in APS, but the LIA differentiates patients with APS from infectious patients and asymptomatic carriers, likely through the exposure of domain 1.
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Affiliation(s)
- Dirk Roggenbuck
- Institute of Biotechnology, Faculty 2, Brandenburg University of Technology Cottbus-Senftenberg, Großenhainer Str. 57, 01968, Senftenberg, Germany. .,Research and Development Department, Medipan GmbH, Dahlewitz/Berlin, Germany.
| | - Maria Orietta Borghi
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy.,Istituto Auxologico Italiano, Laboratory of Immunorheumatology, Cusano Milanino, Italy
| | - Valentina Somma
- Research and Development Department, Medipan GmbH, Dahlewitz/Berlin, Germany
| | - Thomas Büttner
- Research and Development Department, GA Generic Assays GmbH, Dahlewitz/Berlin, Germany
| | - Peter Schierack
- Research and Development Department, Medipan GmbH, Dahlewitz/Berlin, Germany
| | - Katja Hanack
- Chair Immuntechnology, Department of Biochemistry and Biology, University of Potsdam, Potsdam, Germany
| | - Claudia Grossi
- Istituto Auxologico Italiano, Laboratory of Immunorheumatology, Cusano Milanino, Italy
| | - Caterina Bodio
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Paolo Macor
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | | | | | | | - Pier Luigi Meroni
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy.,Istituto Auxologico Italiano, Laboratory of Immunorheumatology, Cusano Milanino, Italy
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24
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Chighizola CB, Pregnolato F, Raschi E, Grossi C, Gentilini D, Borghi MO, Chen P, Meroni PL. Antiphospholipid Antibodies and Infertility: A Gene Expression Study in Decidual Stromal Cells. Isr Med Assoc J 2016; 18:146-149. [PMID: 27228630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Antiphospholipid antibodies (aPL) have been advocated as potential mediators of unexplained female infertility, but no evidence has yet been raised to support such an association. OBJECTIVES To test the hypothesis that aPL might interfere with uterine decidualization, a gene expression study was performed on decidual stromal cells treated with different aPL preparations. METHODS Decidual stromal cells were isolated from first-trimester deciduas obtained from two women undergoing elective abortion, and treated with: (i) a β2GPI-dependent aPL monoclonal antibody (IS3); (ii) IS3 plus TIFI, a synthetic peptide mimicking PL-binding region of β2GPI; and (iii) IgG from healthy subjects (NHS). Gene expression data were acquired using human HT-12 v3 beadchip arrays (Illumina). Differential expression analysis was performed by fitting a gene-wise linear model using the treatment group and decidual source as covariates. RESULTS In the comparison of IS3 versus IgG NHS-treated decidual cells, gene ontology (GO) enrichment was expressed in terms relating to well-characterized aPL-mediated cellular effects: "inflammatory response," "immune response," "response to stress," "oxydoreductase activity," "metalloendopeptidase activity," and "cytokine/chemokine activity." As expected, almost all genes were up-regulated by IS3 treatment. The same GO categories appeared to be differentially expressed when IS3 treatment was compared to IS3 + TIFI, but with most genes being down-regulated. CONCLUSIONS Given the inflammatory response evinced on gene expression analysis of decidual stromal cells treated with a β2GPI -dependent aPL monoclonal antibody, it is feasible that aPL might interfere with uterine decidualization, affecting the early stages of implantation and ultimately resulting in female infertility.
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25
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Bucci L, Ostan R, Giampieri E, Cevenini E, Pini E, Scurti M, Vescovini R, Sansoni P, Caruso C, Mari D, Ronchetti F, Borghi M, Ogliari G, Grossi C, Capri M, Salvioli S, Castellani G, Franceschi C, Monti D. Corrigendum to “Immune parameters identify Italian centenarians with a longer five-year survival independent of their health and functional status” [Exp. Gerontol. 54C (2014) 14–20]. Exp Gerontol 2016. [DOI: 10.1016/j.exger.2015.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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26
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Andreoli L, Chighizola CB, Nalli C, Gerosa M, Borghi MO, Pregnolato F, Grossi C, Zanola A, Allegri F, Norman GL, Mahler M, Meroni PL, Tincani A. Clinical characterization of antiphospholipid syndrome by detection of IgG antibodies against β2 -glycoprotein i domain 1 and domain 4/5: ratio of anti-domain 1 to anti-domain 4/5 as a useful new biomarker for antiphospholipid syndrome. Arthritis Rheumatol 2015; 67:2196-204. [PMID: 25939498 DOI: 10.1002/art.39187] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 04/30/2015] [Indexed: 11/12/2022]
Abstract
OBJECTIVE It has been suggested that only antibodies against domain 1 (D1) of β2 -glycoprotein I (β2 GPI) are pathogenic and diagnostic. The role of antibodies against other β2 GPI domains is still debated. This study was undertaken to evaluate the clinical relevance of domain specificity profiling of anti-β2 GPI IgG antibodies in antiphospholipid syndrome (APS) patients and in control groups of patients with systemic autoimmune rheumatic diseases and in asymptomatic antiphospholipid antibody (aPL) carriers. METHODS We evaluated 159 subjects with persistently positive, medium or high-titer anti-β2 GPI IgG, including 56 patients with thrombotic (obstetric or nonobstetric) primary APS, 31 women with obstetric primary APS, 42 aPL-positive patients with systemic autoimmune rheumatic diseases, and 30 asymptomatic aPL carriers. One hundred healthy donors were included. Anti-β2 GPI D1 and D4/5 IgG were tested on research enzyme-linked immunosorbent assays containing recombinant β2 GPI domains. RESULTS As compared to other groups, aPL carriers displayed higher frequency/titer of anti-D4/5 IgG. Unlike anti-D4/5, anti-D1 IgG antibodies were more frequent and at higher titer in triple than in single or double aPL-positive subjects. An anti-D1 to anti-D4/5 ratio of ≥1.5 was predictive of systemic autoimmunity (odds ratio 3.25 [95% confidence interval 1.45-7.49], P = 0.005). Neither anti-D1 nor anti-D4/5 antibodies were associated with APS clinical criteria. CONCLUSION Anti-D1 IgG is the preferential specificity not only in vascular and obstetric primary APS, but also in patients with systemic autoimmune rheumatic disease with no clinical features of APS. Conversely, aPL carriers do not have a polarized profile toward D1. Combined testing for anti-β2 GPI IgG with different domain specificity allows a more accurate aPL profiling, with polarization toward anti-D1 IgG as a possible fingerprint of systemic autoimmunity.
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Affiliation(s)
| | | | | | - Maria Gerosa
- University of Milan and Istituto G. Pini, Milan, Italy
| | - M Orietta Borghi
- University of Milan and IRCCS Istituto Auxologico Italiano, Milan, Italy
| | | | | | | | | | | | | | - Pier Luigi Meroni
- University of Milan and IRCCS Istituto Auxologico Italiano, Milan, Italy
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Willis R, Grossi C, Orietta Borghi M, Martos-Sevilla G, Zegers I, Sheldon J, Meroni PL. International standards for IgG and IgM anti-β2glycoprotein antibody measurement. Lupus 2015; 23:1317-9. [PMID: 25228737 DOI: 10.1177/0961203314544535] [Citation(s) in RCA: 9] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
International standards for anti-beta2 glycoprotein I (anti-β2GPI) testing are needed. We evaluated the suitability of polyclonal/monoclonal candidate reference materials (RM) for the assay. IgG/IgM anti-β2GPI were affinity-purified (AP) from high-positive antiphospholipid syndrome sera and IgG from HCAL clone supernatant. Igs were tested for purity by SDS-PAGE, pooled, concentrated, sterile-filtered and the protein concentration determined. One unit was defined as the binding activity of 1 µg/ml of AP anti-β2GPI Ig. IgG/IgM RM were each assigned a unit value using the respective AP material as a calibrator. Polyclonal/monoclonal RM and 30 samples were evaluated for linearity, unit equivalency and commutability. Polyclonal AP material was assigned a value of 100 U IgG and 15 U IgM anti-β2GPI, respectively. IgG-RM had a value of 270 IgG and the IgM-RM of 220.3 IgM anti-β2GPI U. The linearity (R (2)) of each RM curve for the various assays ranged from 0.96 to 0.99. Commutability samples fit very well within 95% prediction intervals and had excellent correlation when comparing assays. IgG and IgM polyclonal and IgG monoclonal RM displayed excellent linearity and commutability, being good candidates for better standardization of anti-β2GPI immunoassays.
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Affiliation(s)
- R Willis
- Rheumatology and Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - C Grossi
- Experimental Laboratory of Immunological and Rheumatologic Researches, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - M Orietta Borghi
- Experimental Laboratory of Immunological and Rheumatologic Researches, IRCCS Istituto Auxologico Italiano, Milan, Italy Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - G Martos-Sevilla
- European Commission Joint Research Centre, Institute for Reference Materials and Measurements (IRMM), Geel, Belgium
| | - I Zegers
- European Commission Joint Research Centre, Institute for Reference Materials and Measurements (IRMM), Geel, Belgium
| | - J Sheldon
- Protein Reference Unit, St George's Hospital, London, UK
| | - P L Meroni
- Experimental Laboratory of Immunological and Rheumatologic Researches, IRCCS Istituto Auxologico Italiano, Milan, Italy Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Zaninoni A, Vercellati C, Imperiali FG, Marcello AP, Fattizzo B, Fermo E, Bianchi P, Grossi C, Cattaneo A, Cortelezzi A, Zanella A, Barcellini W. Detection of red blood cell antibodies in mitogen-stimulated cultures from patients with hereditary spherocytosis. Transfusion 2015; 55:2930-8. [PMID: 26259504 DOI: 10.1111/trf.13257] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 05/27/2015] [Accepted: 06/22/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND Hereditary spherocytosis (HS) is a congenital hemolytic anemia caused by defects in red blood cell (RBC) membrane proteins leading to premature RBC clearance in the spleen. The presence of RBC autoantibodies has never been extensively investigated in HS. STUDY DESIGN AND METHODS RBC antibody-bound immunoglobulin (Ig)G was investigated in 91 consecutive HS patients by mitogen-stimulated direct antiglobulin test (MS-DAT), a sensitive method able to magnify latent RBC antibody autoimmunity and related with hemolytic variables, previous splenectomy, and type of membrane defect. RESULTS A total of 61% of HS cases had RBC antibodies by MS-DAT (29 Band 3, 17 spectrin deficiency, and nine no defined defect). The amount of RBC-bound IgG was greater in HS compared with controls (236 ± 192 ng/mL vs. 52 ± 29 ng/mL, p < 0.0001), although lower than that observed in autoimmune hemolytic anemia (AIHA; 634 ± 371 ng/mL vs. 236 ± 192 ng/mL, p < 0.0001). Western blot experiments showed that purified IgG fraction from MS-DAT-positive patients bind to α- and β-spectrin, Band 3, and Band 4.9. Positive cases displayed increased reticulocytosis and slightly reduced hemoglobin (Hb) values compared to negative ones. Patients displaying RBC-bound IgG of more than 250 ng/mL (the positive threshold of AIHA) showed increased number of spherocytes and mainly had spectrin deficiency. RBC-bound IgG and free Hb increased over time after storage at 4°C, a surrogate of ex vivo aging, more evidently in HS than controls, and particularly in Band 3 deficiency. CONCLUSION RBC autoantibodies were detected by MS-DAT in more than a half of HS patients. Positive cases showed a more evident hemolytic pattern suggesting a pathogenic role of these autoantibodies in RBC opsonization and splenic removal.
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Affiliation(s)
| | | | | | | | | | - Elisa Fermo
- UO Oncoematologia, UOS Fisiopatologia delle Anemie
| | | | - Claudia Grossi
- Experimental Laboratory of Immunological and Rheumatologic Researches, IRCCS Istituto Auxologico Italiano
| | - Alessandra Cattaneo
- UO Laboratorio Centrale di Analisi Chimico Cliniche e Microbiologiche Dipartimento Dei Servizi, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
| | - Agostino Cortelezzi
- UO Oncoematologia, UOS Fisiopatologia delle Anemie.,Università Degli Studi di Milano, Milan, Italy
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Gualtierotti R, Ingegnoli F, Orenti A, Boracchi P, Schioppo T, Borghi O, Castelnuovo L, Galbiati V, Grossi C, Lubatti C, Mastaglio C, Zeni S, Meroni P. AB1085 Empirical Approach to Investigate Raynaud's Phenomenon: The Pearl Study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Vargas A, Arnold D, Adame JA, Grossi C, Hernández-Ceballos MA, Bolivar JP. Analysis of the vertical radon structure at the Spanish "El Arenosillo" tower station. J Environ Radioact 2015; 139:1-17. [PMID: 25464036 DOI: 10.1016/j.jenvrad.2014.09.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 09/23/2014] [Accepted: 09/28/2014] [Indexed: 06/04/2023]
Abstract
This paper presents an analysis of one year of hourly radon and meteorological measurements at 10 m and 100 m a.g.l. at El Arenosillo tall-tower station, in the south-west of the Iberian Peninsula. Whole-year and seasonal composites of the diurnal radon cycle show the expected behaviour, with larger concentrations at 10 m than at 100 m during the night, due to poor vertical mixing, and similar concentrations at both heights during the daylight hours. Wind speed and wind direction analyses by sector show the prevailing contributions for each season. Sectors with air which has spent a longer period over the ocean and high wind speeds will lead to low concentrations at both levels, whereas inland sectors show a clear increase of the concentrations with similar overall averages for the two levels. The Sierra Morena, Guadalquivir and Bethics System sectors (continental pathways) are the sectors that show higher concentrations for mild to large wind speeds. The daily evolution of radon concentration differences at both heights has been grouped into four clusters by using a K-means algorithm method. The four clusters have been selected so that they sufficiently describe different characteristics in terms of stability. The temporal evolution of the mixing height (MH) and of the bulk diffusivity parameter (Kb) during the nocturnal period has been calculated by using the temporal variation of (222)Rn concentration at 10 m and the concentration gradient with height, respectively.
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Affiliation(s)
- A Vargas
- Institute of Energy Technologies (INTE), Technical University of Catalonia, Barcelona, Spain.
| | - D Arnold
- Central Institute for Meteorology and Geodynamics (ZAMG), Vienna, Austria
| | - J A Adame
- Atmospheric Sounding Station, El Arenosillo. National Institute for Aerospace Technology (INTA), Mazagón-Huelva, Spain
| | - C Grossi
- Catalan Institute of Climate Science (IC3), Barcelona, Spain
| | - M A Hernández-Ceballos
- European Commission, Joint Research Centre (JRC), Institute for Transuranium Elements (ITU), Nuclear Security Unit, Karlsruhe, Germany
| | - J P Bolivar
- Department of Applied Physics, University of Huelva, Huelva, Spain
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Moreno V, Font L, Baixeras C, Garcia-Orellana J, Bach J, Grossi C, Vargas A. Effectiveness Analysis of Filters Used with Radon Detectors under Extreme Environmental Conditions for Long-term Exposures. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.phpro.2015.11.067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by thrombotic events and/or pregnancy morbidity in the persistent presence of antiphospholipid antibodies (aPL). aPL targeting β2 glycoprotein I (anti-β2GPI Abs) provide the main pathogenic autoantibody subset. In monocytes, platelets and endothelial cells (ECs), the interaction of circulating aPL with membrane-bound β2GPI results in cell activation, and EC perturbation provides an important player in clotting. Several receptors have been suggested to mediate β2GPI/EC binding. AnnexinA2 provides a high-affinity binding site for β2GPI but, since it does not span the cell membrane, an adaptor protein is required to trigger signal. Consistent evidence supports the role of Toll-like receptor (TLR) 4 as co-receptor for β2GPI on ECs. β2GPI was recently reported to behave as lipopolysaccharide (LPS) scavenger. In monocytes, TLR4 activation was shown to be apparent, due to LPS/β2GPI complexes. Conversely, our findings in ECs demonstrate that β2GPI interacts directly with TLR4, and that such interaction may contribute to β2GPI-dependent aPL-mediated EC activation. LPS enhanced anti-β2GPI Ab binding to EC only at cell-activating concentrations, able to up-regulate TLR4. This in vitro model may explain why LPS behaves as a second hit increasing the expression of β2GPI in vascular tissues and triggering aPL-mediated thrombosis in vivo.
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Affiliation(s)
- MO Borghi
- Experimental Laboratory of Immunological and Rheumatologic Researches, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - E Raschi
- Experimental Laboratory of Immunological and Rheumatologic Researches, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - C Grossi
- Experimental Laboratory of Immunological and Rheumatologic Researches, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - CB Chighizola
- Experimental Laboratory of Immunological and Rheumatologic Researches, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - PL Meroni
- Experimental Laboratory of Immunological and Rheumatologic Researches, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Abstract
The ACT STATIS method, a multi-table comparison, was applied to 62 Rosa species to be clustered into four sections (Carolinae, Cinnamomeae, Pimpinellifoliae and Synstylae); the data sets were dealing with morphology (15 criteria), anthocyanin pattern (10 compounds), flavonol heteroside pattern (26 compounds) and superoxide dismutase isozyme (SOD) polymorphism (11 bands). This method appeared very powerful to recognize the rose sections and to set up a marker hierarchy which places at the first level the flavonol hetero side pattern, then the morphological data, the SOD isozyme data and finally the anthocyanin pattern. The correlation studies between the markers underlined the relatively common view by means of flavonol patterns and the morphological features
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Affiliation(s)
- C. Grossi
- GROSSI Cédric, Laboratoire de Biologie Micromoléculaire et Phytochimie, Université Claude Bernard Lyon I, 43, bd du 11 novembre 1918, 69622 Villeurbanne Cedex, France
| | - O. Raymond
- GROSSI Cédric, Laboratoire de Biologie Micromoléculaire et Phytochimie, Université Claude Bernard Lyon I, 43, bd du 11 novembre 1918, 69622 Villeurbanne Cedex, France
| | - C. Sanlaville-Boisson
- GROSSI Cédric, Laboratoire de Biologie Micromoléculaire et Phytochimie, Université Claude Bernard Lyon I, 43, bd du 11 novembre 1918, 69622 Villeurbanne Cedex, France
| | - M. Jay
- GROSSI Cédric, Laboratoire de Biologie Micromoléculaire et Phytochimie, Université Claude Bernard Lyon I, 43, bd du 11 novembre 1918, 69622 Villeurbanne Cedex, France
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Gualtierotti R, Ingegnoli F, Schioppo T, Lubatti C, Zeni S, Mastaglio C, Galbiati V, Grossi C, Borghi M, Castelnovo L, Meroni P. AB1013 Systemic Sclerosis and Myositis Extractable Nuclear Antigen (ENA) Analysis: Profile of A Cohort of Subjects with Isolated Raynaud's Phenomenon. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Raschi E, Chighizola CB, Grossi C, Ronda N, Gatti R, Meroni PL, Borghi MO. β2-glycoprotein I, lipopolysaccharide and endothelial TLR4: three players in the two hit theory for anti-phospholipid-mediated thrombosis. J Autoimmun 2014; 55:42-50. [PMID: 24685231 DOI: 10.1016/j.jaut.2014.03.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 01/31/2014] [Accepted: 03/05/2014] [Indexed: 10/25/2022]
Abstract
The thrombogenic effect of β2-glycoprotein I (β2GPI)-dependent anti-phospholipid antibodies (aPL) in animal models was found to be LPS dependent. Since β2GPI behaves as LPS scavenger, LPS/β2GPI complex was suggested to account for in vitro cell activation through LPS/TLR4 involvement being LPS the actual bridge ligand between β2GPI and TLR4 at least in monocytes/macrophages. However, no definite information is available on the interaction among β2GPI, LPS and endothelial TLR4 in spite of the main role of endothelial cells (EC) in clotting. To analyse at the endothelial level the need of LPS, we investigated the in vitro interaction of β2GPI with endothelial TLR4 and we assessed the role of LPS in such an interaction. To do this, we evaluated the direct binding and internalization of β2GPI by confocal microscopy in living TLR4-MD2 transfected CHO cells (CHO/TLR4-MD2) and β2GPI binding to CHO/TLR4-MD2 cells and human umbilical cord vein EC (HUVEC) by flow cytometry and cell-ELISA using anti-β2GPI monoclonal antibodies in the absence or presence of various concentrations of exogenous LPS. To further investigate the role of TLR4, we performed anti-β2GPI antibody binding and adhesion molecule up-regulation in TLR4-silenced HUVEC. Confocal microscopy studies show that β2GPI does interact with TLR4 at the cell membrane and is internalized in cytoplasmic granules in CHO/TLR4-MD2 cells. β2GPI binding to CHO/TLR4-MD2 cells and HUVEC is also confirmed by flow cytometry and cell-ELISA, respectively. The interaction between β2GPI and TLR4 is confirmed by the reduction of anti-β2GPI antibody binding and by the up-regulation of E-selectin or ICAM-1 by TLR4 silencing in HUVEC. β2GPI binding is not affected by LPS at concentrations comparable to those found in both β2GPI and antibody preparations. Only higher amount of LPS that can activate EC and up-regulate TLR4 expression are found to increase the binding. Our findings demonstrate that β2GPI interacts directly with TLR4 expressed on EC, and that such interaction may contribute to β2GPI-dependent aPL-mediated EC activation. At variance of monocytic cells, we also showed a threshold effect for the action of LPS, that is able to enhance anti-β2GPI antibody EC binding only at cell activating concentrations, shown to increase TLR4 expression. This in vitro model may explain why LPS behaves as a second hit increasing the expression of β2GPI in vascular tissues and triggering aPL-mediated thrombosis in experimental animals.
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Affiliation(s)
- Elena Raschi
- Immunology Research Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Cecilia B Chighizola
- Immunology Research Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Claudia Grossi
- Immunology Research Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Nicoletta Ronda
- Department of Applied Pharmacological, Biological and Chemical Sciences, University of Parma, Parma, Italy
| | - Rita Gatti
- Department of Experimental Medicine, University of Parma, Parma, Italy
| | - Pier Luigi Meroni
- Immunology Research Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - M Orietta Borghi
- Immunology Research Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Bucci L, Ostan R, Giampieri E, Cevenini E, Pini E, Scurti M, Vescovini R, Sansoni P, Caruso C, Mari D, Ronchetti F, Borghi MO, Ogliari G, Grossi C, Capri M, Salvioli S, Castellani G, Franceschi C, Monti D. Immune parameters identify Italian centenarians with a longer five-year survival independent of their health and functional status. Exp Gerontol 2014; 54:14-20. [PMID: 24487345 DOI: 10.1016/j.exger.2014.01.023] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [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: 11/06/2013] [Revised: 01/22/2014] [Accepted: 01/24/2014] [Indexed: 10/25/2022]
Abstract
Centenarians are rare and exceptional individuals characterized by a peculiar phenotype. They are the best example of healthy aging in humans as most of them have escaped or substantially delayed the onset of major age-related diseases. Within this scenario, the purpose of the present work was to understand if immune status is associated with survival and health status in centenarians. To this aim, 116 centenarians were concomitantly characterized for their immunological, health and functional status, and followed-up for five-year survival. On the basis of previous knowledge we focused on a core of fundamental and basic immune parameters (number of leukocytes, monocytes, total lymphocytes, CD3(+) T lymphocytes, CD4(+) helper T lymphocytes, CD8(+) cytotoxic T lymphocytes, CD19(+) B lymphocytes and plasma levels of IgM), and the most important findings can be summarized as follows: i. a hierarchical cluster analysis was able to define Cluster1 (88 centenarians) and Cluster2 (28 centenarians) characterized by low and high values of all these immune parameters, respectively; ii. centenarians of Cluster2 showed a statistically longer five-year survival and more favorable values of other important immune (naïve, activated/memory and effector/memory T cells) and metabolic (glycemia, insulin and HOMA-IR) parameters, in accord with previous observations that centenarians have a peculiar immune profile, a preserved insulin pathway and a lower incidence of type 2 diabetes; and iii. unexpectedly, parameters related to frailty, as well as functional and cognitive status, did not show any significant correlation with the immune clustering, despite being capable per se of predicting survival. In conclusion, high values of basic immunological parameters and important T cell subsets correlate with five-year survival in centenarians, independent of other phenotypic characteristics. This unexpected biological scenario is compatible with the general hypothesis that in centenarians a progressive disconnection and loss of biological coherence among the different functions of the body occur, where survival/mortality result from the failure of any of these domains which apparently follow an independent age-related trajectory.
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Affiliation(s)
- L Bucci
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - R Ostan
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - E Giampieri
- Physics and Astronomy Department, University of Bologna, Bologna, Italy
| | - E Cevenini
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - E Pini
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - M Scurti
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - R Vescovini
- Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - P Sansoni
- Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - C Caruso
- Immunosenescence Unit, Department of Pathobiology and Biomedical Methodologies, University of Palermo, Palermo, Italy
| | - D Mari
- Geriatric Unit IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, University of Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - F Ronchetti
- Geriatric Unit IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, University of Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - M O Borghi
- Geriatric Unit IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, University of Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - G Ogliari
- Geriatric Unit IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, University of Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - C Grossi
- Department of Clinical Sciences and Community Health, University of Milan, Italy; Experimental Laboratory of Immuno-rheumatology, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - M Capri
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy; CIG-Interdepartmental Centre L. Galvani, University of Bologna, Bologna, Italy
| | - S Salvioli
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy; CIG-Interdepartmental Centre L. Galvani, University of Bologna, Bologna, Italy
| | - G Castellani
- Physics and Astronomy Department, University of Bologna, Bologna, Italy; Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - C Franceschi
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy; CIG-Interdepartmental Centre L. Galvani, University of Bologna, Bologna, Italy.
| | - D Monti
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
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Ingegnoli F, Gualtierotti R, Schioppo T, Orenti A, Boracchi P, Lubatti C, Mastaglio C, Galbiati V, Murgo A, Zeni S, Grossi C, Borghi O, Rosenberg W, Castelnovo L, Meroni Pier L. Fibrosis biomarkers in isolated Raynaud's phenomenon: too little, too soon? Ann Rheum Dis 2013; 73:940-1. [PMID: 24344159 DOI: 10.1136/annrheumdis-2013-204009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Francesca Ingegnoli
- Department of Clinical Science & Community Health, Division of Rheumatology, Istituto Gaetano Pini, University of Milano, , Milano, Italy
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Ingegnoli F, Gualtierotti R, Schioppo T, Orenti A, Boracchi P, Lubatti C, Murgo A, Zeni S, Mastaglio C, Galbiati V, Monti G, Grossi C, Borghi O, Rosenberg W, Meroni PL. FRI0403 How early starts increased collagen synthesis in systemic sclerosis? Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Meroni P, Raschi E, Chighizola C, Grossi C, Ronda N, Gatti R, Borghi M. OP0060 Beta2GPI and TLR4 interaction on endothelial cells: A bridge between innate and adaptive immunity in APS. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Chighizola C, Pregnolato F, Grossi C, Gerosa M, Norman G, Mahler M, Borghi MO, Meroni PL. A5.5 Antibodies against Domain I of β2 Glycoprotein I in Antiphospholipid Antibody Syndrome. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-203219.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barili F, Pacini D, Capo A, Rasovic O, Grossi C, Alamanni F, Di Bartolomeo R, Parolari A. Does EuroSCORE II perform better than its original versions? A multicentre validation study. Eur Heart J 2013; 34:22-29. [DOI: 10.1093/eurheartj/ehs342] [Citation(s) in RCA: 119] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Baeza A, Corbacho JA, Rodríguez A, Galván J, García-Tenorio R, Manjón G, Mantero J, Vioque I, Arnold D, Grossi C, Serrano I, Vallés I, Vargas A. Influence of the Fukushima Dai-ichi nuclear accident on Spanish environmental radioactivity levels. J Environ Radioact 2012; 114:138-145. [PMID: 22538124 DOI: 10.1016/j.jenvrad.2012.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Revised: 02/13/2012] [Accepted: 03/01/2012] [Indexed: 05/31/2023]
Abstract
This paper presents measurements of the effect of the atmospheric radioactive release from the Fukushima Dai-ichi nuclear power station at three sites belonging to the Spanish environmental monitoring system. Measured values varied depending on the locations of the sites in Spain and their respective climatic characteristics. (134)Cs, (136)Cs, (137)Cs, (131)I, and (132)Te activity concentrations in filter samples were studied and associated levels of (131)I fallout were estimated from wet and dry deposition. Particulate aerosol activity concentrations ranges, in μBq/m(3), were 1.63-3080 ((131)I), 2.8-690 ((137)Cs), 1.3-620 ((134)Cs) and 3.6-330 ((132)Te), while the associated (131)I fallout was roughly estimated to be less than 20 Bq/m(2), Gaseous (131)I was also detected and the (131)I-gaseous/(131)I-total ratio increased at the three stations from approximately 0.75 at the end of March to 0.85-0.9 during the first few days of April. Finally, the presence of (131)I in some crucial parts of the food chain was also studied. (131)I was detected in samples from goat's and cow's milk (maximum levels of 1.11 Bq/L) and in broadleaf plants (maximum level 1.42 Bq/kg).
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Affiliation(s)
- A Baeza
- LARUEX, Dpt. Applied Physics, Faculty of Veterinary Science, University of Extremadura, Avda. Universidad, s/n, 10003 Cáceres, Spain.
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Meroni PL, Raschi E, Grossi C, Pregnolato F, Trespidi L, Acaia B, Borghi MO. Obstetric and vascular APS: Same autoantibodies but different diseases? Lupus 2012; 21:708-10. [DOI: 10.1177/0961203312438116] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Beta2 glycoprotein I (β2GPI)-dependent antiphospholipid antibodies (aPLs) are the main pathogenic autoantibody population and at the same time the laboratory diagnostic tool for the antiphospholipid syndrome (APS). These antibodies are responsible for both the vascular and the obstetric manifestations of the syndrome but the pathogenic mechanisms behind these manifestations are not the same. For example, thrombotic events do not appear to play a major role in APS miscarriages and a direct reactivity of β2GPI-dependent aPLs on decidual and trophoblast cells was reported. A local expression of β2GPI on these tissues was reported both in physiological conditions and in APS women, thus explaining the local tropism of the autoantibodies. The two hit hypothesis was suggested to explain why the vascular manifestations of APS may occur only occasionally in spite of the persistent presence of aPLs. This is not apparently the case for the obstetric variant of the syndrome, making the difference even more striking. A different pathogenesis may also provide the rationale for the well-known fact that the vascular and the obstetric manifestations may occur independently although in a minority of cases.
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Affiliation(s)
- PL Meroni
- Division of Rheumatology, Istituto G Pini, Italy
- Department of Internal Medicine, University of Milan, Italy
| | - E Raschi
- Experimental Laboratory of Immunological and Rheumatologic Research, IRCCS Istituto Auxologico Italiano, Italy
| | - C Grossi
- Experimental Laboratory of Immunological and Rheumatologic Research, IRCCS Istituto Auxologico Italiano, Italy
| | - F Pregnolato
- Experimental Laboratory of Immunological and Rheumatologic Research, IRCCS Istituto Auxologico Italiano, Italy
| | - L Trespidi
- Unità Operativa Ostetricia e Ginecologia, Fondazione Ospedale Maggiore, Milan, Italy
| | - B Acaia
- Unità Operativa Ostetricia e Ginecologia, Fondazione Ospedale Maggiore, Milan, Italy
| | - MO Borghi
- Department of Internal Medicine, University of Milan, Italy
- Experimental Laboratory of Immunological and Rheumatologic Research, IRCCS Istituto Auxologico Italiano, Italy
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de la Torre YM, Pregnolato F, D’Amelio F, Grossi C, DiSimone N, Pasqualini F, Nebuloni M, Chen P, Pierangeli S, Bassani N, Ambrogi F, Borghi MO, Vecchi A, Locati M, Meroni PL. Anti-phospholipid induced murine fetal loss: novel protective effect of a peptide targeting the β2 glycoprotein I phospholipid-binding site. Implications for human fetal loss. J Autoimmun 2012; 38:J209-15. [PMID: 22196923 PMCID: PMC3313005 DOI: 10.1016/j.jaut.2011.11.009] [Citation(s) in RCA: 42] [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] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Revised: 11/21/2011] [Accepted: 11/22/2011] [Indexed: 10/14/2022]
Abstract
β2 glycoprotein I (β2GPI)-dependent anti-phospholipid antibodies (aPL) induce thrombosis and affect pregnancy. The CMV-derived synthetic peptide TIFI mimics the PL-binding site of β2GPI and inhibits β2GPI cell-binding in vitro and aPL-mediated thrombosis in vivo. Here we investigated the effect of TIFI on aPL-induced fetal loss in mice. TIFI inhibitory effect on in vitro aPL binding to human trophoblasts was evaluated by indirect immunofluorescence and ELISA. TIFI effect on aPL-induced fetal loss was investigated in pregnant C57BL/6 mice treated with aPL or normal IgG (NHS). Placenta/fetus weight and histology and RNA expression were analyzed. TIFI, but not the control peptide VITT, displayed a dose-dependent inhibition of aPL binding to trophoblasts in vitro. Injection of low doses of aPL at day 0 of pregnancy caused growth retardation and increased fetal loss rate, both significantly reduced by TIFI but not VITT. Consistent with observations in humans, histological analysis showed no evidence of inflammation in this model, as confirmed by the absence of an inflammatory signature in gene expression analysis, which in turn revealed a TIFI-dependent modulation of molecules involved in differentiation and development processes. These findings support the non-inflammatory pathogenic role of aPL and suggest innovative therapeutic approaches to aPL-dependent fetal loss.
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Affiliation(s)
| | | | - Fabio D’Amelio
- Department of Internal Medicine, University of Milan, Italy
| | | | | | | | - Manuela Nebuloni
- L. Sacco Department of Medical Science, University of Milan, Italy
| | - Pojen Chen
- Department of Medicine, University of Los Angeles, CA -USA
| | - Silvia Pierangeli
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX - USA
| | | | | | - Maria-Orietta Borghi
- Istituto Auxologico Italiano, Milan, Italy
- Department of Internal Medicine, University of Milan, Italy
| | | | - Massimo Locati
- Istituto Clinico Humanitas, Rozzano, Italy
- Department of Translational Medicine, University of Milan, Italy
| | - Pier-Luigi Meroni
- Istituto Auxologico Italiano, Milan, Italy
- Department of Internal Medicine, University of Milan, Italy
- Istituto G. Pini, Milan, Italy
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Milani A, Mauri S, Beltrami C, Brunelli V, Cherchi G, Clerici M, Grossi C, Gandini A, Brunoldi A, Magon G. 4155 ORAL How Can We Measure Nursing Sensitive Outcomes in an Oncology Nursing Minimum Data Set (ONMDS)? Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71321-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Dossena E, Orlando L, Di Leo M, Roveda L, Grossi C, Milani A. P33 Responsibility, autonomy, visibility. Are we ready to the primary nursing? Eur J Oncol Nurs 2010. [DOI: 10.1016/s1462-3889(10)70097-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Cugno M, Borghi MO, Lonati LM, Ghiadoni L, Gerosa M, Grossi C, De Angelis V, Magnaghi G, Tincani A, Mari D, Riboldi P, Meroni PL. Patients with antiphospholipid syndrome display endothelial perturbation. J Autoimmun 2009; 34:105-10. [PMID: 19656656 DOI: 10.1016/j.jaut.2009.07.004] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2009] [Revised: 07/18/2009] [Accepted: 07/20/2009] [Indexed: 01/04/2023]
Abstract
BACKGROUND There is strong evidence that antiphospholipid antibodies (aPL) perturb endothelium both in vitro and in experimental animal models. by inducing a vasculopathy and an endothelial pro-inflammatory/coagulant phenotype. However, few contrasting studies raised the issue about the possibility to detect a comparable endothelial perturbation in anti-phospholipid syndrome (APS) patients. The aim of this observational case-control study was to evaluate several parameters of endothelial perturbation in patients with APS and without any other atherosclerosis risk factor. PATIENTS AND METHODS We investigated plasma levels of soluble adhesion molecules (s-ICAM-1, s-VCAM-1, s-E-selectin), soluble thrombomodulin (sTM), von Willebrand factor (vWF) and tissue plasminogen activator (t-PA) by solid-phase assays in 40 selected APS patients and 40 age- and sex-matched healthy subjects. In addition, we evaluated circulating endothelial cells by flow cytometry and brachial artery flow-mediated vasodilation. Patients and controls were free of conditions known to affect both the biological and the functional endothelial parameters. RESULTS Plasma levels of sTM, s-E-selectin and s-VCAM-1 did not differ from controls, while a significant increase in s-ICAM-1 (P = 0.029), t-PA (P = 0.003) and vWF titres (P = 0.002) was found. Circulating mature endothelial cells were also significantly higher in patients than in controls (P = 0.05) and decreased during both vitamin K antagonists (P = 0.001) and antiplatelet (P = 0.032) treatments. Mean brachial artery flow-mediated vasodilation responses were significantly impaired compared to healthy subjects (P = 0.0001). CONCLUSIONS As a whole these findings indicate that APS patients display an endothelial perturbation in the absence of other detectable traditional risk factors for atherosclerosis.
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Affiliation(s)
- Massimo Cugno
- Department of Internal Medicine, University of Milan, IRCCS Foundation Maggiore Hospital Policlinico, Mangiagalli, Regina Elena, Italy
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Cavazzana A, Pengo V, Tonello M, Noventa F, Grossi C, Borghi MO, de Moerloose P, Reber G, Ruffatti A. Anti-beta(2)-glycoprotein I ELISA assay: the influence of different antigen preparations. Thromb Haemost 2009; 101:789-791. [PMID: 19350132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Raschi E, Borghi MO, Grossi C, Broggini V, Pierangeli S, Meroni PL. Toll-like receptors: another player in the pathogenesis of the anti-phospholipid syndrome. Lupus 2009; 17:937-42. [PMID: 18827059 DOI: 10.1177/0961203308095140] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The anti-phospholipid syndrome (APS) is a systemic autoimmune disease characterized by an adaptive immune response against self phospholipid (PL)--binding proteins. Although APS is considered as an autoantibody-mediated disease, there is now evidence that anti-phospholipid antibodies (aPL) are necessary but not sufficient to trigger some of the clinical manifestations of the syndrome. For example, mediators of the innate immunity are recognized to be additional second hits able to induce the thrombotic events in the presence of aPL. Finally, environmental agents - in particular infectious ones - were reported to act as triggers for the production of autoantibodies cross-reacting with PL-binding proteins as well as inflammatory stimuli that potentiate the aPL thrombogenic effect. Altogether, these findings suggest a role for the innate immunity in APS pathogenesis. Toll-like receptors (TLR) are receptors that induce prompt inflammatory responses and mediate functional activation in immune effector cells. There is evidence that aPL, and in particular anti-beta(2) glycoprotein I (beta(2)GPI) antibodies, may activate endothelial cells and monocytes through TLR-4-dependent signalling. Whether or not TLR may behave as surface receptors for beta(2)GPI is still matter of research. Drugs or molecules able to interfere with TLR involvement may represent new therapeutic approaches for APS.
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Affiliation(s)
- E Raschi
- Allergy, Clinical Immunology and Rheumatology Unit, IRCCS Istituto Auxologico Italiano, Department of Internal Medicine, University of Milan, Milan, Italy
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Pierangeli SS, Chen PP, Raschi E, Scurati S, Grossi C, Borghi MO, Palomo I, Harris EN, Meroni PL. Antiphospholipid antibodies and the antiphospholipid syndrome: pathogenic mechanisms. Semin Thromb Hemost 2008; 34:236-50. [PMID: 18720303 DOI: 10.1055/s-0028-1082267] [Citation(s) in RCA: 121] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Antiphospholipid antibodies (Abs) are associated with thrombosis and are a risk factor for recurrent pregnancy loss and obstetric complications in patients with the antiphospholipid syndrome. It is generally accepted that the major autoantigen for aPL Abs is beta (2) glycoprotein I, which mediates the binding of aPL Abs to target cells (i.e., endothelial cells, monocytes, platelets, trophoblasts, etc.) leading to thrombosis and fetal loss. This article addresses molecular events triggered by aPL Abs on endothelial cells, platelets, and monocytes and complement activation, as well as a review of the current knowledge with regard to the putative receptor(s) recognized by aPL Abs on target cells as well as novel mechanisms that involve fibrinolytic processes. A section is devoted to the description of thrombotic and inflammatory processes that lead to obstetric complications mediated by aPL Abs. Based on experimental evidence using in vitro and in vivo models, new targeted therapies for treatment and/or prevention of thrombosis and pregnancy loss in antiphospholipid syndrome are proposed.
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Affiliation(s)
- Silvia S Pierangeli
- Division of Rheumatology, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX 77555-1165, USA.
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