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Rasmussen A, Sevier S, Kelly JA, Glenn SB, Aberle T, Cooney CM, Grether A, James E, Ning J, Tesiram J, Morrisey J, Powe T, Drexel M, Daniel W, Namjou B, Ojwang JO, Nguyen KL, Cavett JW, Te JL, James JA, Scofield RH, Moser K, Gilkeson GS, Kamen DL, Carson CW, Quintero-del-Rio AI, del Carmen Ballesteros M, Punaro MG, Karp DR, Wallace DJ, Weisman M, Merrill JT, Rivera R, Petri MA, Albert DA, Espinoza LR, Utset TO, Shaver TS, Arthur E, Anaya JM, Bruner GR, Harley JB. The lupus family registry and repository. Rheumatology (Oxford) 2010; 50:47-59. [PMID: 20864496 DOI: 10.1093/rheumatology/keq302] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The Lupus Family Registry and Repository (LFRR) was established with the goal of assembling and distributing materials and data from families with one or more living members diagnosed with SLE, in order to address SLE genetics. In the present article, we describe the problems and solutions of the registry design and biometric data gathering; the protocols implemented to guarantee data quality and protection of participant privacy and consent; and the establishment of a local and international network of collaborators. At the same time, we illustrate how the LFRR has enabled progress in lupus genetics research, answering old scientific questions while laying out new challenges in the elucidation of the biologic mechanisms that underlie disease pathogenesis. Trained staff ascertain SLE cases, unaffected family members and population-based controls, proceeding in compliance with the relevant laws and standards; participant consent and privacy are central to the LFRR's effort. Data, DNA, serum, plasma, peripheral blood and transformed B-cell lines are collected and stored, and subject to strict quality control and safety measures. Coded data and materials derived from the registry are available for approved scientific users. The LFRR has contributed to the discovery of most of the 37 genetic associations now known to contribute to lupus through 104 publications. The LFRR contains 2618 lupus cases from 1954 pedigrees that are being studied by 76 approved users and their collaborators. The registry includes difficult to obtain populations, such as multiplex pedigrees, minority patients and affected males, and constitutes the largest collection of lupus pedigrees in the world. The LFRR is a useful resource for the discovery and characterization of genetic associations in SLE.
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Affiliation(s)
- Astrid Rasmussen
- Arthritis and Immunology Research Program, Oklahoma Medical Research Foundation, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Abstract
Abstract Systemic lupus erythematosus is a chronic, relapsing autoimmune disease that can affect multiple organ systems. An increased prevalence of drug allergy has been reported in lupus patients compared with the general population. Using a cohort of 417 lupus patients, we found a history of sulpha allergy in 27.3% of patients. European-American lupus patients with sulpha allergy are about two times more likely to suffer from lymphopenia, two times more likely to have anti-Ro autoantibody, and four times less likely to have anti-nRNP antibodies compared with lupus patients without a reported sulpha allergy ( P = 0.0075, 0.025, and 0.032, respectively). In African-American lupus patients, a history of sulpha allergy was associated with over three times increased odds of developing pericarditis ( P = 0.005).
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Affiliation(s)
- M Jeffries
- College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA; Arthritis & Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
| | - G Bruner
- Arthritis & Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
| | - S Glenn
- Arthritis & Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
| | | | - CW Carson
- Oklahoma Arthritis Center, Edmond, Oklahoma, USA
| | - JB Harley
- Arthritis & Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA; Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA; US Department of Veterans Affairs Medical Center, Oklahoma City, Oklahoma, USA
| | - AH Sawalha
- Arthritis & Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA; Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA; US Department of Veterans Affairs Medical Center, Oklahoma City, Oklahoma, USA
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Carson CW, Comp PC, Rezaie AR, Esmon NL, Esmon CT. Antibodies to thrombomodulin are found in patients with lupus anticoagulant and unexplained thrombosis. J Rheumatol 2000; 27:384-90. [PMID: 10685802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
OBJECTIVE To test the hypothesis that thrombomodulin (TM) may be a target for lupus anticoagulant (LAC) antibodies. METHODS A recombinant soluble form of TM was produced and used as an antigen for an ELISA to detect antibodies to TM (TMAB). Sixty-one samples from 58 patients identified by the coagulation laboratory as having a LAC and 200 patients with unexplained thrombosis were evaluated along with 201 healthy controls. RESULTS Eighteen (30%) of the 58 patients with a LAC and 20 (10%) of 200 patients with unexplained thrombosis had antibodies to TM. Similar antibodies were found in only 4 (2%) of 201 normal controls. TMAB show selectivity for TM lacking chondroitin sulfate, but do not otherwise have an immunodominant region. The IgG from 6 patients with TMAB was purified, and it bound TM in our ELISA. Three of the 6 IgG fractions inhibited protein C activation 40% to 70% compared to no inhibition in 7 healthy controls. CONCLUSION Some patients with LAC and unexplained thrombosis have antibodies to TM that may arise in response to TM that has been altered and lost its chondroitin sulfate attachment. Antibodies to TM may be an important risk factor for inflammation and thrombosis in these patients.
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Affiliation(s)
- C W Carson
- Oklahoma Medical Research Foundation, Department of Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City 73104, USA
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Kurosawa S, Stearns-Kurosawa DJ, Carson CW, D'Angelo A, Della Valle P, Esmon CT. Plasma levels of endothelial cell protein C receptor are elevated in patients with sepsis and systemic lupus erythematosus: lack of correlation with thrombomodulin suggests involvement of different pathological processes. Blood 1998; 91:725-7. [PMID: 9427734] [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: 02/05/2023] Open
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Houston DS, Carson CW, Esmon CT. Endothelial cells and extracellular calmodulin inhibit monocyte tumor necrosis factor release and augment neutrophil elastase release. J Biol Chem 1997; 272:11778-85. [PMID: 9115233 DOI: 10.1074/jbc.272.18.11778] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Cultured human umbilical vein endothelial cells inhibited tumor necrosis factor-alpha release from whole blood or isolated mononuclear cells exposed to endotoxin. In contrast, the endothelial cells augmented neutrophil elastase release in the same blood. A protein with these functional properties was isolated from endothelial cell-conditioned media and, surprisingly, was identified as calmodulin. Authentic calmodulin mimicked the effect of endothelium. 125I-Calmodulin bound to a high affinity site on monocytic cell lines (Kd approximately 30 nM, in agreement with its functional activity). Cross-linking of 125I-calmodulin to monocytic cells identified a candidate calmodulin receptor. We conclude that calmodulin possesses an extracellular signaling role in addition to its intracellular regulatory functions. Calmodulin released at sites of tissue injury or possibly by specific mechanisms in the endothelium can bind to receptors, modulating the activities of inflammatory cells.
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Affiliation(s)
- D S Houston
- Department of Internal Medicine and Manitoba Institute of Cell Biology, University of Manitoba, Winnipeg, Manitoba R3E 0V9, Canada.
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Laszik Z, Carson CW, Nadasdy T, Johnson LD, Lerner MR, Brackett DJ, Esmon CT, Silva FG. Lack of suppressed renal thrombomodulin expression in a septic rat model with glomerular thrombotic microangiopathy. J Transl Med 1994; 70:862-7. [PMID: 8015290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The thrombomodulin-dependent protein C anticoagulant pathway plays a major physiologic role in the down-regulation of the coagulation process. In cell culture, inflammatory cytokines or endotoxin can down-regulate endothelial thrombomodulin (TM) suggesting that suppressed TM expression may contribute to thrombotic complications noted in Gram-negative sepsis. EXPERIMENTAL DESIGN In the present study, we have examined TM expression in the kidneys of septic rats utilizing indirect immunofluorescence and have quantified TM antigen and TM activity in extracts of the same kidneys by enzyme-linked immunosorbent assays and protein C activation assays, respectively. Conscious Sprague-Dawley rats were injected intravenously with LD95 doses of live E. coli (N = 30), or endotoxin (N = 30). Control animals (N = 30) were injected with equivalent volumes of saline. The rats were killed 30, 90, 180, 360, and 720 minutes after the initiation of sepsis. RESULTS Glomerular capillary thrombosis developed by 180 minutes in approximately half of the animals after the initiation of sepsis. We failed to demonstrate suppressed TM expression in the kidneys of septic animals using immunofluorescence. Neither enzyme-linked immunosorbent assays, nor protein C activation assays showed decreased levels in TM antigen expression or activity at different time points during the sepsis. CONCLUSIONS These results indicate that suppressed TM expression does not contribute to the development of the glomerular capillary thrombosis in this septic rat model.
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Affiliation(s)
- Z Laszik
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City
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Liu LW, Rezaie AR, Carson CW, Esmon NL, Esmon CT. Occupancy of anion binding exosite 2 on thrombin determines Ca2+ dependence of protein C activation. J Biol Chem 1994; 269:11807-12. [PMID: 8163479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Thrombomodulin (TM) binds thrombin to form a complex that activates the plasma anticoagulant zymogen protein C. TM is an integral membrane glycoprotein that contains a chondroitin sulfate moiety. Interaction with thrombin involves both the protein component of TM, specifically the growth factor-like repeats 4-6 (TM 4-6), and chondroitin sulfate. Removal of chondroitin sulfate decreases the affinity for thrombin approximately 10-fold and shifts the Ca2+ dependence of protein C activation from simple saturation at > or = 500 microM Ca2+ to a distinct optimum at approximately 100 microM Ca2+. Thrombin possesses two regions of high positive charge, anion binding exosites 1 and 2. Anion binding exosite 1 interacts with the growth factor region of TM while exosite 2 is involved in binding prothrombin activation fragment 2 or heparin. We demonstrate that recombinant TM, truncated at the membrane-spanning domain, or TM 4-6 can bind thrombin when fragment 2 is present either covalently attached (meizothrombin des-fragment 1) or in reversible association. With meizothrombin des-fragment 1, the Ca2+ dependence of protein C activation is independent of the presence of the chondroitin sulfate on TM. At 0.27 mM Ca2+, TM containing chondroitin sulfate binds thrombin (Kd(app) = 0.3 nM) approximately 45 times tighter than meizothrombin des-fragment 1 (Kd(app) = 14 nM). However, the chondroitin-free form binds thrombin (Kd(app) = 2.4 nM) only approximately 4 times tighter than meizothrombin des-fragment 1 (Kd(app) = 9.4 nM). These studies suggest that occupancy of anion binding exosite 2 by either chondroitin sulfate or fragment 2 alters thrombin conformation resulting in the altered Ca2+ dependence of protein C activation.
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Affiliation(s)
- L W Liu
- Cardiovascular Biology Research Program, Oklahoma Medical Research Foundation, Oklahoma City
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Carson CW, Beall LD, Hunder GG, Johnson CM, Newman W. Soluble E-selectin is increased in inflammatory synovial fluid. J Rheumatol Suppl 1994; 21:605-11. [PMID: 7518520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To investigate the hypothesis that soluble E-selectin (sE-selectin) may be detected in synovial fluid (SF) and play a role in inflammatory arthritis. METHODS We used a sandwich ELISA to measure sE-selectin in the SF of 58 patients with rheumatoid arthritis (RA), 9 with psoriatic arthritis (PsA), 30 with osteoarthritis (OA), 13 with gout, and 9 with calcium pyrophosphate dihydrate crystal deposition disease (CPPD). RESULTS SF sE-selectin values in RA (mean 1.49 ng/ml, 0.18-3.90) and PsA (mean 1.36 ng/ml, 0.88-2.31) were significantly higher than those with OA (mean 0.83 ng/ml, 0.00-1.83), gout (mean 1.04 ng/ml, 0.11-3.42), or CPPD (mean 0.80 ng/ml, 0.20-1.47). Elevated SF sE-selectin was associated with elevated serum sE-selectin, erythrocyte sedimentation rate, and SF white blood cell count. CONCLUSION Our findings suggest that endothelial cell activation and E-selectin may contribute to the development of inflammatory processes.
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Affiliation(s)
- C W Carson
- Department of Medicine, Mayo Clinic/Foundation, Rochester, MN
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Carson CW, Beall LD, Hunder GG, Johnson CM, Newman W. Serum ELAM-1 is increased in vasculitis, scleroderma, and systemic lupus erythematosus. J Rheumatol 1993; 20:809-14. [PMID: 7687701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To investigate the state of endothelial cell activation in vasculitis, scleroderma, and systemic lupus erythematosus (SLE). METHODS We used a sandwich ELISA to quantitate a soluble form of endothelial leukocyte adhesion molecule-1 (sELAM) in serum. RESULTS sELAM was detected in serum from healthy individuals (mean 0.92 ng/ml). Levels were significantly higher in patients with giant cell arteritis (mean 2.04 ng/ml), polyarteritis nodosa (mean 2.08 ng/ml), scleroderma (mean 2.27 ng/ml), and SLE (mean 3.93 ng/ml). Elevated values were present in patients with both active and inactive disease. sELAM levels of > 3 ng/ml identified most patients with recent onset or active disease. CONCLUSION Our findings may reflect a low degree of endothelial cell activation in healthy persons that is increased in inflammatory diseases involving blood vessels. Elevated serum sELAM levels may reflect ongoing inflammatory processes in these diseases.
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Affiliation(s)
- C W Carson
- Department of Medicine, Mayo Clinic/Foundation, Rochester, MN
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Carson CW, Conn DL, Czaja AJ, Wright TL, Brecher ME. Frequency and significance of antibodies to hepatitis C virus in polyarteritis nodosa. J Rheumatol 1993; 20:304-9. [PMID: 8097250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
We tested sera from 56 patients to determine the seroprevalence of antibodies to hepatitis C virus (HCV) in polyarteritis nodosa (PAN), to assess the specificity of these antibodies for hepatitis C virus encoded antigens, and to evaluate the clinical features in patients with HCV infection and PAN. Eleven (20%) were positive for anti-HCV by an enzyme immunoassay. Three (5%) had specific antibodies to HCV encoded antigens detected by recombinant immunoblot assay (RIBA II) and had HCV RNA detected by polymerase chain reaction. Patients with HCV infection were more likely to have liver and skin involvement and a diminished serum complement.
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Affiliation(s)
- C W Carson
- Department of Medicine, Mayo Clinic and Foundation, Rochester, MN
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Newman W, Beall LD, Carson CW, Hunder GG, Graben N, Randhawa ZI, Gopal TV, Wiener-Kronish J, Matthay MA. Soluble E-selectin is found in supernatants of activated endothelial cells and is elevated in the serum of patients with septic shock. The Journal of Immunology 1993. [DOI: 10.4049/jimmunol.150.2.644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Abstract
A quantitative sandwich ELISA for E-selectin in the fluid phase (soluble E-selectin, sEs) has been developed that is sensitive to 100 pg/ml. The assay shows no reactivity with either L- or P-selectins. We have used this to determine the fate of E-selectin after cell-surface expression and to test whether levels measured in vivo may represent the state of endothelial activation. E-selectin was first detectable in supernatants of IL-1-stimulated endothelial cells at 24 h, and increased slowly up until 72 h. However, over this time period the total E-selectin detectable in the system (cells plus supernatants) declined dramatically. 125I-surface-labeled endothelial cells cultured for 24 h show an E-selectin of reduced m.w. in the supernatant, indicating that the molecule is shed from the surface. The shed form also appears to be slightly smaller than the intact membrane form as determined from immunoprecipitation and molecular sieving studies. In addition, the cytoplasmic domain of the molecule found in supernatants of activated endothelial cells and in serum is not intact as determined by loss of reactivity with an antipeptide antibody specific for the cytoplasmic domain. We have examined the sera of 71 normal individuals. Without exception, sEs was found in serum in the range of 0.13 to 2.8 ng/ml, suggesting that even in the absence of overt inflammatory processes E-selectin is being synthesized and released into the bloodstream. In addition, bacteremic patients with hypotension, but not those without, showed markedly elevated sEs values. As determined by cell-binding studies, the blood-derived form of E-selectin is biologically active.
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Affiliation(s)
- W Newman
- Department of Endothelial Cell Biology, Otsuka America Pharmaceutical, Inc., Rockville, MD 20850
| | - L D Beall
- Department of Endothelial Cell Biology, Otsuka America Pharmaceutical, Inc., Rockville, MD 20850
| | - C W Carson
- Department of Endothelial Cell Biology, Otsuka America Pharmaceutical, Inc., Rockville, MD 20850
| | - G G Hunder
- Department of Endothelial Cell Biology, Otsuka America Pharmaceutical, Inc., Rockville, MD 20850
| | - N Graben
- Department of Endothelial Cell Biology, Otsuka America Pharmaceutical, Inc., Rockville, MD 20850
| | - Z I Randhawa
- Department of Endothelial Cell Biology, Otsuka America Pharmaceutical, Inc., Rockville, MD 20850
| | - T V Gopal
- Department of Endothelial Cell Biology, Otsuka America Pharmaceutical, Inc., Rockville, MD 20850
| | - J Wiener-Kronish
- Department of Endothelial Cell Biology, Otsuka America Pharmaceutical, Inc., Rockville, MD 20850
| | - M A Matthay
- Department of Endothelial Cell Biology, Otsuka America Pharmaceutical, Inc., Rockville, MD 20850
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Newman W, Beall LD, Carson CW, Hunder GG, Graben N, Randhawa ZI, Gopal TV, Wiener-Kronish J, Matthay MA. Soluble E-selectin is found in supernatants of activated endothelial cells and is elevated in the serum of patients with septic shock. J Immunol 1993; 150:644-54. [PMID: 7678280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A quantitative sandwich ELISA for E-selectin in the fluid phase (soluble E-selectin, sEs) has been developed that is sensitive to 100 pg/ml. The assay shows no reactivity with either L- or P-selectins. We have used this to determine the fate of E-selectin after cell-surface expression and to test whether levels measured in vivo may represent the state of endothelial activation. E-selectin was first detectable in supernatants of IL-1-stimulated endothelial cells at 24 h, and increased slowly up until 72 h. However, over this time period the total E-selectin detectable in the system (cells plus supernatants) declined dramatically. 125I-surface-labeled endothelial cells cultured for 24 h show an E-selectin of reduced m.w. in the supernatant, indicating that the molecule is shed from the surface. The shed form also appears to be slightly smaller than the intact membrane form as determined from immunoprecipitation and molecular sieving studies. In addition, the cytoplasmic domain of the molecule found in supernatants of activated endothelial cells and in serum is not intact as determined by loss of reactivity with an antipeptide antibody specific for the cytoplasmic domain. We have examined the sera of 71 normal individuals. Without exception, sEs was found in serum in the range of 0.13 to 2.8 ng/ml, suggesting that even in the absence of overt inflammatory processes E-selectin is being synthesized and released into the bloodstream. In addition, bacteremic patients with hypotension, but not those without, showed markedly elevated sEs values. As determined by cell-binding studies, the blood-derived form of E-selectin is biologically active.
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Affiliation(s)
- W Newman
- Department of Endothelial Cell Biology, Otsuka America Pharmaceutical, Inc., Rockville, MD 20850
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Carson CW, Hunder GG, Kaplan KL, Johnson CM. Inducible release of an endothelial cell-specific protein. Am J Pathol 1991; 139:199-206. [PMID: 1853933 PMCID: PMC1886143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The authors investigated the release of an endothelial cell-specific protein (E92) by cultured porcine aortic endothelial cell cultures. Under normal culture conditions, endothelial cells released little or no E92 into the culture supernatant. Treatment with thrombin (0.01 to 10 units/ml), endotoxin (0.01 to 10 micrograms/ml), or interleukin-1 (0.01 to 3.0 units/ml), however, caused significant, dose-dependent increases in E92 detectable in the culture supernatants. Time-course experiments showed that maximum release of E92 into cellular supernatants occurred 24 hours after stimulation with all mediators. Parallel experiments used 51Cr-loaded endothelial cells as a measure of lethal cellular injury. None of the mediators caused significant injury at the doses observed to induce release of E92. These results suggest that the release of E92 into the supernatants of cultured endothelial cells is an inducible event. The data also support the hypothesis that detection of E92 antigen in sera from patients with rheumatic disease represents a marker of in vivo vascular endothelial cell activity.
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Affiliation(s)
- C W Carson
- Division of Rheumatology, Mayo Clinic/Foundation, Rochester, Minnesota 55905
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Carson CW, Ginsburg WW, Cohen MD, McLeod RA, Kitaoka HB. Tarsal coalition: An unusual cause of foot pain—Clinical spectrum and treatment in 129 patients. Semin Arthritis Rheum 1991. [DOI: 10.1016/0049-0172(91)90012-o] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Carson CW, Hunder GG, Kaplan KL, Johnson CM. Detection of circulating endothelial antigen. J Rheumatol Suppl 1991; 18:379-83. [PMID: 1856807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In order to determine whether endothelial cell antigens are detectable in serum from patients with rheumatic disease characterized by vascular involvement, we developed an ELISA using a monoclonal antibody directed against a 92,000 molecular weight endothelial cell specific antigen designated E92. Sera were assayed from 191 patients and 34 healthy controls. E92 was undetectable or present in very low concentrations in healthy controls and was elevated in most patients with an active rheumatic disease. Our results indicate that circulating endothelial antigens are present in rheumatic vascular syndromes and may provide a measure of endothelial cell function.
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Affiliation(s)
- C W Carson
- Department of Medicine, Mayo Clinic/Foundation, Rochester, MN 55905
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Fehlauer CS, Carson CW, Cannon GW, Ward JR, Samuelson CO, Williams HJ, Clegg DO. Methotrexate therapy in rheumatoid arthritis: 2-year retrospective followup study. J Rheumatol 1989; 16:307-12. [PMID: 2724249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Clinical and laboratory data in 124 patients with rheumatoid arthritis treated with methotrexate (MTX) were retrospectively reviewed over the initial 2 years after the start of treatment. Clinical improvement occurred in 103 (83%) patients after 12 weeks of treatment. At 2 years of followup, 60 patients (48%) continued to receive MTX with sustained clinical benefit. It has been discontinued in 64 (52%) patients (adverse drug reactions in 38, lack of clinical benefit in 15, and miscellaneous reasons in 11). Patients with adverse drug reactions had higher initial serum creatinine and blood urea nitrogen values than patients without adverse drug reactions.
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Affiliation(s)
- C S Fehlauer
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake
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Carson CW, Cannon GW, Egger MJ, Ward JR, Clegg DO. Pulmonary disease during the treatment of rheumatoid arthritis with low dose pulse methotrexate. Semin Arthritis Rheum 1987; 16:186-95. [PMID: 3823910 DOI: 10.1016/0049-0172(87)90021-7] [Citation(s) in RCA: 143] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Methotrexate therapy has been effective in the treatment of RA with short term experience suggesting little serious adverse reactions. Our review of 168 patients receiving methotrexate has identified nine patients with probable or possible methotrexate-induced pulmonary toxicity, giving a prevalence of 5% and an incidence of 3.9 per 100 patients per year. No clinical or laboratory features showed an association that could potentially predict the development of pulmonary disease. All patients experienced complete recovery with supportive care and/or corticosteroid therapy. Clinical monitoring for this complication is warranted in all patients receiving long term methotrexate therapy for RA.
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