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Affiliation(s)
- Elizabeth A Middleton
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Program in Molecular Medicine, University of Utah School of Medicine, Eccles Institute of Human Genetics, 15 North 2030 East, Room #4220, Salt Lake City, UT 84112, USA
| | - Guy A Zimmerman
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Program in Molecular Medicine, University of Utah School of Medicine, Eccles Institute of Human Genetics, 15 North 2030 East, Room #4220, Salt Lake City, UT 84112, USA.
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Eustes AS, Campbell RA, Middleton EA, Tolley ND, Manne BK, Montenont E, Rowley JW, Krauel K, Blair A, Guo L, Kosaka Y, Medeiros-de-Moraes IM, Lacerda M, Hottz ED, Neto HCF, Zimmerman GA, Weyrich AS, Petrey A, Rondina MT. Heparanase expression and activity are increased in platelets during clinical sepsis. J Thromb Haemost 2021; 19:1319-1330. [PMID: 33587773 PMCID: PMC8218538 DOI: 10.1111/jth.15266] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/22/2021] [Accepted: 02/08/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Heparanase (HPSE) is the only known mammalian enzyme that can degrade heparan sulfate. Heparan sulfate proteoglycans are essential components of the glycocalyx, and maintain physiological barriers between the blood and endothelial cells. HPSE increases during sepsis, which contributes to injurious glyocalyx degradation, loss of endothelial barrier function, and mortality. OBJECTIVES As platelets are one of the most abundant cellular sources of HPSE, we sought to determine whether HPSE expression and activity increases in human platelets during clinical sepsis. We also examined associations between platelet HPSE expression and clinical outcomes. PATIENTS/METHODS Expression and activity of HPSE was determined in platelets isolated from septic patients (n = 59) and, for comparison, sex-matched healthy donors (n = 46) using complementary transcriptomic, proteomic, and functional enzymatic assays. Septic patients were followed for the primary outcome of mortality, and clinical data were captured prospectively for septic patients. RESULTS The mRNA expression of HPSE was significantly increased in platelets isolated from septic patients. Ribosomal footprint profiling, followed by [S35] methionine labeling assays, demonstrated that HPSE mRNA translation and HPSE protein synthesis were significantly upregulated in platelets during sepsis. While both the pro- and active forms of HPSE protein increased in platelets during sepsis, only the active form of HPSE protein significantly correlated with sepsis-associated mortality. Consistent with transcriptomic and proteomic upregulation, HPSE enzymatic activity was also increased in platelets during sepsis. CONCLUSIONS During clinical sepsis HPSE, translation, and enzymatic activity are increased in platelets. Increased expression of the active form of HPSE protein is associated with sepsis-associated mortality.
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Affiliation(s)
- Alicia S Eustes
- Department of Internal Medicine and Molecular Medicine Program, University of Utah, Salt Lake City, Utah, USA
- Department of Pathology, University of Utah, Salt Lake City, Utah, USA
- Hospitals and Clinics Pathology, Internal Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Robert A Campbell
- Department of Internal Medicine and Molecular Medicine Program, University of Utah, Salt Lake City, Utah, USA
| | - Elizabeth A Middleton
- Department of Internal Medicine and Molecular Medicine Program, University of Utah, Salt Lake City, Utah, USA
| | - Neal D Tolley
- Department of Internal Medicine and Molecular Medicine Program, University of Utah, Salt Lake City, Utah, USA
| | - Bhanu K Manne
- Department of Internal Medicine and Molecular Medicine Program, University of Utah, Salt Lake City, Utah, USA
| | - Emilie Montenont
- Department of Internal Medicine and Molecular Medicine Program, University of Utah, Salt Lake City, Utah, USA
| | - Jesse W Rowley
- Department of Internal Medicine and Molecular Medicine Program, University of Utah, Salt Lake City, Utah, USA
| | - Krystin Krauel
- Department of Internal Medicine and Molecular Medicine Program, University of Utah, Salt Lake City, Utah, USA
- Department of Cardiology and Angiology I, Heart Center, University of Freiburg, Freiburg, Germany
| | - Antoinette Blair
- Department of Internal Medicine and Molecular Medicine Program, University of Utah, Salt Lake City, Utah, USA
| | - Li Guo
- Department of Internal Medicine and Molecular Medicine Program, University of Utah, Salt Lake City, Utah, USA
| | - Yasuhiro Kosaka
- Department of Internal Medicine and Molecular Medicine Program, University of Utah, Salt Lake City, Utah, USA
| | - Isabel M Medeiros-de-Moraes
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (Fiocruz, Rio de Janeiro and Manaus, Brazil
| | - Marcus Lacerda
- Fundacao de Medicina Tropical - Dr. Heitor Vieira Dourado (FMT-HVD) and Fiocruz Manaus, Manaus, Brazil
| | - Eugenio D Hottz
- Department of Internal Medicine and Molecular Medicine Program, University of Utah, Salt Lake City, Utah, USA
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (Fiocruz, Rio de Janeiro and Manaus, Brazil
- Immunothrombosis Laboratory, Department of Biochemistry, Federal University of Juiz de Fora, Juiz de Fora, Brazil
- Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil
| | - Hugo Castro Faria Neto
- Fundacao de Medicina Tropical - Dr. Heitor Vieira Dourado (FMT-HVD) and Fiocruz Manaus, Manaus, Brazil
| | - Guy A Zimmerman
- Department of Internal Medicine and Molecular Medicine Program, University of Utah, Salt Lake City, Utah, USA
| | - Andrew S Weyrich
- Department of Internal Medicine and Molecular Medicine Program, University of Utah, Salt Lake City, Utah, USA
- Department of Pathology, University of Utah, Salt Lake City, Utah, USA
| | - Aaron Petrey
- Department of Internal Medicine and Molecular Medicine Program, University of Utah, Salt Lake City, Utah, USA
- Department of Pathology, University of Utah, Salt Lake City, Utah, USA
| | - Matthew T Rondina
- Department of Internal Medicine and Molecular Medicine Program, University of Utah, Salt Lake City, Utah, USA
- Department of Pathology, University of Utah, Salt Lake City, Utah, USA
- Department of Internal Medicine and GRECC, George E. Wahlen VAMC, Salt Lake City, Utah, USA
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Granja MG, Alves LP, Leardini-Tristão M, Saul ME, Bortoni LC, de Moraes FM, Ferreira EC, de Moraes BPT, da Silva VZ, Dos Santos AFR, Silva AR, Gonçalves-de-Albuquerque CF, Bambini-Junior V, Weyrich AS, Rondina MT, Zimmerman GA, de Castro-Faria-Neto HC. Inflammatory, synaptic, motor, and behavioral alterations induced by gestational sepsis on the offspring at different stages of life. J Neuroinflammation 2021; 18:60. [PMID: 33632243 PMCID: PMC7905683 DOI: 10.1186/s12974-021-02106-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 02/09/2021] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The term sepsis is used to designate a systemic condition of infection and inflammation associated with hemodynamic changes that result in organic dysfunction. Gestational sepsis can impair the development of the central nervous system and may promote permanent behavior alterations in the offspring. The aim of our work was to evaluate the effects of maternal sepsis on inflammatory cytokine levels and synaptic proteins in the hippocampus, neocortex, frontal cortex, and cerebellum of neonatal, young, and adult mice. Additionally, we analyzed the motor development, behavioral features, and cognitive impairments in neonatal, young and adult offspring. METHODS Pregnant mice at the 14th embryonic day (E14) were intratracheally instilled with saline 0.9% solution (control group) or Klebsiella spp. (3 × 108 CFU) (sepsis group) and started on meropenem after 5 h. The offspring was sacrificed at postnatal day (P) 2, P8, P30, and P60 and samples of liver, lung, and brain were collected for TNF-α, IL-1β, and IL-6 measurements by ELISA. Synaptophysin, PSD95, and β-tubulin levels were analyzed by Western blot. Motor tests were performed at all analyzed ages and behavioral assessments were performed in offspring at P30 and P60. RESULTS Gestational sepsis induces a systemic pro-inflammatory response in neonates at P2 and P8 characterized by an increase in cytokine levels. Maternal sepsis induced systemic downregulation of pro-inflammatory cytokines, while in the hippocampus, neocortex, frontal cortex, and cerebellum an inflammatory response was detected. These changes in the brain immunity were accompanied by a reduction of synaptophysin and PSD95 levels in the hippocampus, neocortex, frontal cortex, and cerebellum, in all ages. Behavioral tests demonstrated motor impairment in neonates, and depressive-like behavior, fear-conditioned memory, and learning impairments in animals at P30 and P60, while spatial memory abilities were affected only at P60, indicating that gestational sepsis not only induces an inflammatory response in neonatal mouse brains, but also affects neurodevelopment, and leads to a plethora of behavioral alterations and cognitive impairments in the offspring. CONCLUSION These data suggest that maternal sepsis may be causatively related to the development of depression, learning, and memory impairments in the litter.
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Affiliation(s)
- Marcelo Gomes Granja
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz - Fiocruz, Rio de Janeiro, Brazil
- Programa de Pós-graduação em Biologia Molecular e Celular, Universidade Federal do Estado do Rio de Janeiro - UNIRIO, Rio de Janeiro, Brazil
| | - Letícia Pires Alves
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz - Fiocruz, Rio de Janeiro, Brazil
- Programa de Pós-graduação em Biologia Molecular e Celular, Universidade Federal do Estado do Rio de Janeiro - UNIRIO, Rio de Janeiro, Brazil
| | - Marina Leardini-Tristão
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz - Fiocruz, Rio de Janeiro, Brazil
| | - Michelle Edelman Saul
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz - Fiocruz, Rio de Janeiro, Brazil
- Faculdade de Medicina, Universidade Estácio de Sá - UNESA, Rio de Janeiro, Brazil
| | - Letícia Coelho Bortoni
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz - Fiocruz, Rio de Janeiro, Brazil
- Faculdade de Medicina, Universidade Estácio de Sá - UNESA, Rio de Janeiro, Brazil
| | - Flávia Maciel de Moraes
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz - Fiocruz, Rio de Janeiro, Brazil
| | - Erica Camila Ferreira
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz - Fiocruz, Rio de Janeiro, Brazil
| | - Bianca Portugal Tavares de Moraes
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz - Fiocruz, Rio de Janeiro, Brazil
- Programa de Pós-graduação em Neurociências, Universidade Federal Fluminense - UFF, Niterói, Rio de Janeiro, Brazil
| | - Victória Zerboni da Silva
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz - Fiocruz, Rio de Janeiro, Brazil
| | | | - Adriana Ribeiro Silva
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz - Fiocruz, Rio de Janeiro, Brazil
| | | | - Victorio Bambini-Junior
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, PR1 2HE, Lancashire, Preston, England, UK
| | - Andrew S Weyrich
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, PR1 2HE, Lancashire, Preston, England, UK
| | - Matthew T Rondina
- Department of Internal Medicine and Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA
- Department of Internal Medicine and Pathology, University of Utah, Salt Lake City, UT, USA
- Department of Internal Medicine and GRECC, George E. Wahlen VAMC, Salt Lake City, UT, USA
| | - Guy A Zimmerman
- Department of Internal Medicine and Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA
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Zimmerman GA. Platelets: inflammatory effector cells in the conflagration of cystic fibrosis lung disease. J Clin Invest 2020; 130:1632-1634. [PMID: 32175918 DOI: 10.1172/jci135949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Cystic fibrosis (CF) is a multisystem disorder, but progressive inflammatory lung disease causes the greatest burden of morbidity and death. Recent translational and mechanistic studies of samples from patients, and observations in animal models, indicate that platelets may drive lung injury and contribute to dysregulated host defense in CF lung disease. In this issue of the JCI, Ortiz-Muñoz and Yu et al. explored the role that the cystic fibrosis transmembrane conductance regulator (CFTR) plays in platelet-related inflammation. The authors used mouse and human model systems to show that CFTR dysfunction in platelets increased calcium entry though the transient receptor potential cation channel 6 (TRPC6), causing hyperactivation and consequent experimental lung inflammation. The study persuasively suggests that platelets are critical thromboinflammatory effector cells in CF lung disease. In the context of platelet-related organ injury seen in a variety of other diseases and syndromes, platelets may also contribute to nonpulmonary manifestations and comorbidities of CF.
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Barbosa-Lima G, Hottz ED, de Assis EF, Liechocki S, Souza TML, Zimmerman GA, Bozza FA, Bozza PT. Dengue virus-activated platelets modulate monocyte immunometabolic response through lipid droplet biogenesis and cytokine signaling. J Leukoc Biol 2020; 108:1293-1306. [PMID: 32663907 DOI: 10.1002/jlb.4ma0620-658r] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 02/29/2020] [Revised: 06/11/2020] [Accepted: 06/28/2020] [Indexed: 01/09/2023] Open
Abstract
Dengue is characterized as one of the most important arthropod-borne human viral diseases, representing a public health problem. Increased activation of immune cells is involved in the progression of infection to severe forms. Recently, our group demonstrated the contribution of platelet-monocyte interaction to inflammatory responses in dengue, adding to evolving evidence that platelets have inflammatory functions and can regulate different aspects of innate immune responses. Furthermore, stimuli-specific-activated platelets can promote phenotypic changes and metabolic reprogramming in monocytes. Thus, this study aimed to evaluate the roles of dengue virus (DENV)-activated platelets on immunometabolic reprogramming of monocytes in vitro, focusing on lipid droplet (LD) biogenesis. We demonstrated that platelets exposed to DENV in vitro form aggregates with monocytes and signal to LD formation and CXCL8/IL-8, IL-10, CCL2, and PGE2 secretion. Pharmacologic inhibition of LD biogenesis prevents PGE2 secretion, but not CXCL8/IL-8 release, by platelet-monocyte complexes. In exploring the mechanisms involved, we demonstrated that LD formation in monocytes exposed to DENV-activated platelets is partially dependent on platelet-produced MIF. Additionally, LD formation is higher in monocytes, which have platelets adhered on their surface, suggesting that beyond paracrine signaling, platelet adhesion is an important event in platelet-mediated modulation of lipid metabolism in monocytes. Together, our results demonstrate that activated platelets aggregate with monocytes during DENV infection and signal to LD biogenesis and the secretion of inflammatory mediators, which may contribute to dengue immunopathogenesis.
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Affiliation(s)
- Giselle Barbosa-Lima
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Eugenio D Hottz
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.,Laboratory of Immunothrombosis, Department of Biochemistry, Federal University of Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil
| | - Edson F de Assis
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Sally Liechocki
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Thiago Moreno L Souza
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.,National Institute for Science and Technology on Innovation on Neglected Diseases (INCT/IDN), Center for Technological Development in Health (CDTS), Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Guy A Zimmerman
- Molecular Medicine Program and Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Fernando A Bozza
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.,Intensive Medicine Laboratory, National Institute of Infectious Disease Evandro Chagas, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.,D'Or Institute of Research, Rio de Janeiro, RJ, Brazil
| | - Patricia T Bozza
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
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de Azevedo-Quintanilha IG, Medeiros-de-Moraes IM, Ferreira AC, Reis PA, Vieira-de-Abreu A, Campbell RA, Weyrich AS, Bozza PT, Zimmerman GA, Castro-Faria-Neto HC. Haem oxygenase protects against thrombocytopaenia and malaria-associated lung injury. Malar J 2020; 19:234. [PMID: 32611348 PMCID: PMC7327213 DOI: 10.1186/s12936-020-03305-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 06/20/2020] [Indexed: 11/10/2022] Open
Abstract
Background Malaria-triggered lung injury can occur in both severe and non-severe cases. Platelets may interact with parasitized erythrocytes, leukocytes and endothelium. These interactions can lead to microvessel obstructions and induce release of inflammatory mediators. Induction of the haem oxygenase enzyme is important in the host’s response to free haem and to several other molecules generated by infectious or non-infectious diseases. In addition, an important role for the haem oxygenase-1 isotype has been demonstrated in experimental cerebral malaria and in clinical cases. Therefore, the present work aims to determine the influence of haem oxygenase in thrombocytopaenia and acute pulmonary injury during infection with Plasmodium berghei strain NK65. Methods C57BL/6 mice were infected with P. berghei and analysed 7-10 days post-infection. For each experiment, Cobalt Protoporphyrin IX/CoPPIX or saline were administered. Bronchoalveolar lavage fluid was used for total and differential leukocyte count and for protein measurement. Lungs were used for histological analyses or for analysis of cytokines and western blotting. The lung permeability was analysed by Evans blue dye concentration. Platelet-leukocyte aggregate formation was assayed using the flow cytometer. Results Plasmodium berghei NK65 infection generated an intense lung injury, with increased levels of inflammatory mediators, oedema, and cell migration into the lung. Plasmodium berghei infection was also accompanied by marked thrombocytopaenia and formation of platelet-leukocyte aggregates in peripheral blood. Treatment with the HO-1 inducer cobalt protoporphyrin IX (CoPPIX) modified the inflammatory response but did not affect the evolution of parasitaemia. Animals treated with CoPPIX showed an improvement in lung injury, with decreased inflammatory infiltrate in the lung parenchyma, oedema and reduced thrombocytopaenia. Conclusion Data here presented suggest that treatment with CoPPIX inducer leads to less severe pulmonary lung injury and thrombocytopaenia during malaria infection, thus increasing animal survival.
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Affiliation(s)
| | | | - André C Ferreira
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.,Universidade Iguaçu, Nova Iguaçu, RJ, Brazil
| | - Patrícia A Reis
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Adriana Vieira-de-Abreu
- Division of Endocrinology, Metabolism, and Diabetes, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Robert A Campbell
- Department of Internal Medicine and Program in Molecular Medicine, University of Utah, Salt Lake City, UT, USA
| | - Andrew S Weyrich
- Department of Internal Medicine and Program in Molecular Medicine, University of Utah, Salt Lake City, UT, USA
| | - Patricia T Bozza
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Guy A Zimmerman
- Department of Internal Medicine and Program in Molecular Medicine, University of Utah, Salt Lake City, UT, USA
| | - Hugo C Castro-Faria-Neto
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
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de Azevedo-Quintanilha IG, Vieira-de-Abreu A, Ferreira AC, Reis PA, Silva TI, Nascimento DDO, Campbell RA, Estato V, Weyrich AS, Bozza PT, Zimmerman GA, Castro-Faria-Neto HC. Integrin αDβ2 influences cerebral edema, leukocyte accumulation and neurologic outcomes in experimental severe malaria. PLoS One 2019; 14:e0224610. [PMID: 31869339 PMCID: PMC6927624 DOI: 10.1371/journal.pone.0224610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 10/17/2019] [Indexed: 12/30/2022] Open
Abstract
Malaria is an infectious disease of major worldwide clinical importance that causes a variety of severe, or complicated, syndromes including cerebral malaria, which is often fatal. Leukocyte integrins are essential for host defense but also mediate physiologic responses of the innate and adaptive immune systems. We previously showed that targeted deletion of the αD subunit (αD-/-) of the αDβ2 integrin, which is expressed on key leukocyte subsets in mice and humans, leads to absent expression of the integrin heterodimer on murine macrophages and reduces mortality in mice infected with Plasmodium berghei ANKA (P. berghei ANKA). To further identify mechanisms involved in the protective effect of αD deletion in this model of severe malaria we examined wild type C57BL/6 (WT) and αD-/- mice after P. berghei ANKA infection and found that vessel plugging and leukocyte infiltration were significantly decreased in the brains of αD-/- animals. Intravital microscopy demonstrated decreased rolling and adhesion of leukocytes in cerebral vessels of αD-/- mice. Flow cytometry analysis showed decreased T-lymphocyte accumulation in the brains of infected αD-/- animals. Evans blue dye exclusion assays demonstrated significantly less dye extravasation in the brains of αD-/- mice, indicating preserved blood-brain barrier integrity. WT mice that were salvaged from P. berghei ANKA infection by treatment with chloroquine had impaired aversive memory, which was not observed in αD-/- mice. We conclude that deletion of integrin αDβ2 alters the natural course of experimental severe malaria, demonstrating previously unrecognized activities of a key leukocyte integrin in immune-inflammatory responses that mediate cerebral involvement.
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Affiliation(s)
| | - Adriana Vieira-de-Abreu
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - André C. Ferreira
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Patricia A. Reis
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tathiany I. Silva
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Danielle de O. Nascimento
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Robert A. Campbell
- Department of Internal Medicine and Program in Molecular Medicine, University of Utah, Salt Lake City, Utah, United States of America
| | - Vanessa Estato
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Andrew S. Weyrich
- Department of Internal Medicine and Program in Molecular Medicine, University of Utah, Salt Lake City, Utah, United States of America
| | - Patrícia T. Bozza
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Guy A. Zimmerman
- Department of Internal Medicine and Program in Molecular Medicine, University of Utah, Salt Lake City, Utah, United States of America
| | - Hugo C. Castro-Faria-Neto
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
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Campbell RA, Cody MJ, Manne BK, Zimmerman GA, Yost CC. Interleukin 6 receptor alpha expression in PMNs isolated from prematurely born neonates: decreased expression is associated with differential mTOR signaling. Pediatr Res 2019; 86:55-62. [PMID: 30965356 PMCID: PMC6594868 DOI: 10.1038/s41390-019-0388-6] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/15/2019] [Accepted: 03/27/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND Dysregulated inflammation leads to morbidity and mortality in neonates. Neutrophil-mediated inflammation can cause inflammatory tissue damage. The mammalian target of rapamycin (mTOR) pathway governs IL-6Rα protein expression in human neutrophils. Shed IL-6Rα then participates in trans-signaling of IL-6/IL-6Rα to cells not otherwise sensitive to IL-6. Signaling to endothelial cells triggers efferocytosis where macrophages limit persistent inflammation by phagocytizing neutrophils. We hypothesized that preterm neonatal PMNs fail to synthesize IL-6Rα due to alterations in mTOR signaling. METHODS We studied IL-6Rα expression, PAF receptor expression, and mTOR signaling in plasma and PAF-stimulated PMNs isolated from newborn infants and healthy adults using ELISA, real-time RT-PCR, western blotting, flow cytometry, and immunocytochemistry with phospho-specific antibodies. RESULTS Compared to healthy adults, plasma from neonates contains significantly less soluble IL-6Rα. IL-6Rα mRNA expression in PAF-stimulated PMNs does not differ between neonates and adults, but IL-6Rα protein expression is decreased in preterm neonatal PMNs. Rapamycin, an mTOR inhibitor, blocks IL-6Rα protein expression. mTOR signaling following PAF stimulation is decreased in preterm neonatal PMNs. CONCLUSIONS Preterm neonatal PMNs exhibit decreased mTOR pathway signaling leading to decreased IL-6Rα synthesis. Decreased synthesis of IL-6Rα by neonatal PMNs may result in decreased IL-6/IL-6Rα trans-signaling with prolonged inflammatory response and increased morbidity.
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Affiliation(s)
- Robert A. Campbell
- Program in Molecular Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Mark J. Cody
- Department of Pediatrics/Neonatology, University of Utah, Salt Lake City, Utah, USA
| | - Bhanu K. Manne
- Program in Molecular Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Guy A. Zimmerman
- Program in Molecular Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Christian C. Yost
- Department of Pediatrics/Neonatology, University of Utah, Salt Lake City, Utah, USA,Program in Molecular Medicine, University of Utah, Salt Lake City, Utah, USA,Corresponding Author: Christian Con Yost, MD, Department of Pediatrics/Neonatology, University of Utah School of Medicine, Williams Building, 295 Chipeta Way, Salt Lake City, UT 84108, Phone: 801-581-7052; Fax: 801-585-7395,
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Campbell RA, Schwertz H, Hottz ED, Rowley JW, Manne BK, Washington AV, Hunter-Mellado R, Tolley ND, Christensen M, Eustes AS, Montenont E, Bhatlekar S, Ventrone CH, Kirkpatrick BD, Pierce KK, Whitehead SS, Diehl SA, Bray PF, Zimmerman GA, Kosaka Y, Bozza PT, Bozza FA, Weyrich AS, Rondina MT. Human megakaryocytes possess intrinsic antiviral immunity through regulated induction of IFITM3. Blood 2019; 133:2013-2026. [PMID: 30723081 PMCID: PMC6509546 DOI: 10.1182/blood-2018-09-873984] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [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] [Received: 09/09/2018] [Accepted: 01/22/2019] [Indexed: 02/07/2023] Open
Abstract
Evolving evidence indicates that platelets and megakaryocytes (MKs) have unexpected activities in inflammation and infection; whether viral infections upregulate biologically active, antiviral immune genes in platelets and MKs is unknown, however. We examined antiviral immune genes in these cells in dengue and influenza infections, viruses that are global public health threats. Using complementary biochemical, pharmacological, and genetic approaches, we examined the regulation and function of interferon-induced transmembrane protein 3 (IFITM3), an antiviral immune effector gene not previously studied in human platelets and MKs. IFITM3 was markedly upregulated in platelets isolated from patients during clinical influenza and dengue virus (DENV) infections. Lower IFITM3 expression in platelets correlated with increased illness severity and mortality in patients. Administering a live, attenuated DENV vaccine to healthy subjects significantly increased platelet IFITM3 expression. Infecting human MKs with DENV selectively increased type I interferons and IFITM3. Overexpression of IFITM3 in MKs was sufficient to prevent DENV infection. In naturally occurring, genetic loss-of-function studies, MKs from healthy subjects harboring a homozygous mutation in IFITM3 (rs12252-C, a common single-nucleotide polymorphism in areas of the world where DENV is endemic) were significantly more susceptible to DENV infection. DENV-induced MK secretion of interferons prevented infection of bystander MKs and hematopoietic stem cells. Thus, viral infections upregulate IFITM3 in human platelets and MKs, and IFITM3 expression is associated with adverse clinical outcomes. These observations establish, for the first time, that human MKs possess antiviral functions, preventing DENV infection of MKs and hematopoietic stem cells after local immune signaling.
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Affiliation(s)
- Robert A Campbell
- University of Utah Molecular Medicine Program, Salt Lake City, UT
- Department of Internal Medicine and
| | - Hansjorg Schwertz
- University of Utah Molecular Medicine Program, Salt Lake City, UT
- Department of Internal Medicine and
- Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, UT
| | - Eugenio D Hottz
- University of Utah Molecular Medicine Program, Salt Lake City, UT
- Instituto Nacional de Infectologia Evandro Chagas and
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Jesse W Rowley
- University of Utah Molecular Medicine Program, Salt Lake City, UT
- Department of Internal Medicine and
| | | | - A Valance Washington
- Department of Biology, University of Puerto Rico-Rio Piedras, San Juan, Puerto Rico
- Department of Internal Medicine, Universidad Central del Caribe, Bayamón, Puerto Rico
| | - Robert Hunter-Mellado
- Department of Biology, University of Puerto Rico-Rio Piedras, San Juan, Puerto Rico
- Department of Internal Medicine, Universidad Central del Caribe, Bayamón, Puerto Rico
| | - Neal D Tolley
- University of Utah Molecular Medicine Program, Salt Lake City, UT
| | | | - Alicia S Eustes
- University of Utah Molecular Medicine Program, Salt Lake City, UT
| | - Emilie Montenont
- University of Utah Molecular Medicine Program, Salt Lake City, UT
| | - Seema Bhatlekar
- University of Utah Molecular Medicine Program, Salt Lake City, UT
| | - Cassandra H Ventrone
- Vaccine Testing Center, Department of Microbiology and Molecular Genetics, University of Vermont Larner College of Medicine, Burlington, VT
| | - Beth D Kirkpatrick
- Vaccine Testing Center, Department of Microbiology and Molecular Genetics, University of Vermont Larner College of Medicine, Burlington, VT
| | - Kristen K Pierce
- Vaccine Testing Center, Department of Microbiology and Molecular Genetics, University of Vermont Larner College of Medicine, Burlington, VT
| | - Stephen S Whitehead
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Sean A Diehl
- Vaccine Testing Center, Department of Microbiology and Molecular Genetics, University of Vermont Larner College of Medicine, Burlington, VT
| | - Paul F Bray
- University of Utah Molecular Medicine Program, Salt Lake City, UT
- Department of Internal Medicine and
| | - Guy A Zimmerman
- University of Utah Molecular Medicine Program, Salt Lake City, UT
- Department of Internal Medicine and
| | - Yasuhiro Kosaka
- University of Utah Molecular Medicine Program, Salt Lake City, UT
| | - Patricia T Bozza
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Fernando A Bozza
- Instituto Nacional de Infectologia Evandro Chagas and
- Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro, Brazil; and
| | - Andrew S Weyrich
- University of Utah Molecular Medicine Program, Salt Lake City, UT
- Department of Internal Medicine and
| | - Matthew T Rondina
- University of Utah Molecular Medicine Program, Salt Lake City, UT
- Department of Internal Medicine and
- Department of Internal Medicine, George E. Wahlen Veterans Affairs Medical Center and Geriatric Research, Education, and Clinical Center, Salt Lake City, UT
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Hottz ED, Quirino-Teixeira AC, Valls-de-Souza R, Zimmerman GA, Bozza FA, Bozza PT. Platelet function in HIV plus dengue coinfection associates with reduced inflammation and milder dengue illness. Sci Rep 2019; 9:7096. [PMID: 31068600 PMCID: PMC6506591 DOI: 10.1038/s41598-019-43275-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 12/21/2018] [Accepted: 04/12/2019] [Indexed: 12/11/2022] Open
Abstract
HIV-infected subjects under virological control still exhibit a persistent proinflammatory state. Thus, chronic HIV infection changes the host homeostasis towards an adapted immune response that may affect the outcome of coinfections. However, little is known about the impact of HIV infection on inflammatory amplification and clinical presentation in dengue. Platelets have been shown to participate in immune response in dengue and HIV. We hypothesized that altered platelet responses in HIV-infected subjects may contribute to altered inflammatory milieu and disease progression in dengue. We prospectively followed a cohort of 84 DENV-infected patients of whom 29 were coinfected with HIV under virological control. We report that dengue and HIV coinfection progress with reduced inflammation and milder disease progression with lower risk of vascular instability. Even though the degree of thrombocytopenia and platelet activation were similar between dengue-infected and HIV plus dengue-coinfected patients, plasma levels of the platelet-derived chemokines RANTES/CCL5 and PF4/CXCL4 were lower in coinfection. Consistently, platelets from coinfected patients presented defective secretion of the stored-chemokines PF4 and RANTES, but not newly synthesized IL-1β, when cultured ex vivo. These data indicate that platelets from HIV-infected subjects release lower levels of chemokines during dengue illness, which may contribute to milder clinical presentation during coinfection.
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Affiliation(s)
- Eugenio D Hottz
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz (IOC) - Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
- Laboratório de análise de glicoconjugados, Departamento de Bioquímica, Instituto de Ciências Biológicas (ICB) - Universidade Federal de Juiz de Fora (UFJF), Minas, Gerais, Brazil
| | - Anna Cecíllia Quirino-Teixeira
- Laboratório de análise de glicoconjugados, Departamento de Bioquímica, Instituto de Ciências Biológicas (ICB) - Universidade Federal de Juiz de Fora (UFJF), Minas, Gerais, Brazil
| | - Rogério Valls-de-Souza
- Laboratório de doenças febrís agudas, Instituto Nacional de Infectologia Evandro Chagas (INI), FIOCRUZ, Rio de Janeiro, Brazil
| | - Guy A Zimmerman
- Molecular Medicine Program, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Fernando A Bozza
- Laboratório de Medicina Intensiva, INI, FIOCRUZ, Rio de Janeiro, Brazil.
- Instituto D'Or de Pesquisa e Ensino (IDOr), Rio de Janeiro, Brazil.
| | - Patrícia T Bozza
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz (IOC) - Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil.
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11
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Middleton EA, Rondina MT, Schwertz H, Zimmerman GA. Amicus or Adversary Revisited: Platelets in Acute Lung Injury and Acute Respiratory Distress Syndrome. Am J Respir Cell Mol Biol 2019; 59:18-35. [PMID: 29553813 DOI: 10.1165/rcmb.2017-0420tr] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Platelets are essential cellular effectors of hemostasis and contribute to disease as circulating effectors of pathologic thrombosis. These are their most widely known biologic activities. Nevertheless, recent observations demonstrate that platelets have a much more intricate repertoire beyond these traditional functions and that they are specialized for contributions to vascular barrier integrity, organ repair, antimicrobial host defense, inflammation, and activities across the immune continuum. Paradoxically, on the basis of clinical investigations and animal models of disease, some of these newly discovered activities of platelets appear to contribute to tissue injury. Studies in the last decade indicate unique interactions of platelets and their precursor, the megakaryocyte, in the lung and implicate platelets as essential effectors in experimental acute lung injury and clinical acute respiratory distress syndrome. Additional discoveries derived from evolving work will be required to precisely define the contributions of platelets to complex subphenotypes of acute lung injury and to determine if these remarkable and versatile blood cells are therapeutic targets in acute respiratory distress syndrome.
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Affiliation(s)
- Elizabeth A Middleton
- 1 Division of Pulmonary and Critical Care Medicine, and.,2 Program in Molecular Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Matthew T Rondina
- 3 Division of General Internal Medicine, Department of Internal Medicine.,2 Program in Molecular Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Hansjorg Schwertz
- 4 Division of Vascular Surgery, Department of Surgery, and.,2 Program in Molecular Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Guy A Zimmerman
- 1 Division of Pulmonary and Critical Care Medicine, and.,2 Program in Molecular Medicine, University of Utah School of Medicine, Salt Lake City, Utah
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12
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Rondina MT, Zimmerman GA. The Role of Platelets in Inflammation. Platelets 2019. [DOI: 10.1016/b978-0-12-813456-6.00028-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: 02/21/2023]
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13
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Mesquita EC, Hottz ED, Amancio RT, Carneiro AB, Palhinha L, Coelho LE, Grinsztejn B, Zimmerman GA, Rondina MT, Weyrich AS, Bozza PT, Bozza FA. Persistent platelet activation and apoptosis in virologically suppressed HIV-infected individuals. Sci Rep 2018; 8:14999. [PMID: 30301959 PMCID: PMC6178345 DOI: 10.1038/s41598-018-33403-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 09/26/2018] [Indexed: 12/24/2022] Open
Abstract
Cardiovascular diseases and thrombotic events became major clinical problems in the combined antiretroviral therapy (cART) era. Although the precise mechanisms behind these clinical problems have not been fully elucidated, a persistent pro-inflammatory state plays a central role. As platelets play important roles on both, thrombus formation and inflammatory/immune response, we aimed at investigating platelet function in HIV-infected subjects virologically controlled through cART. We evaluate parameters of activation, mitochondrial function and activation of apoptosis pathways in platelets from 30 HIV-infected individuals under stable cART and 36 healthy volunteers. Despite viral control achieved through cART, HIV-infected individuals exhibited increased platelet activation as indicated by P-selectin expression and platelet spreading when adhered on fibrinogen-coated surfaces. Platelets from HIV-infected subjects also exhibited mitochondrial dysfunction and activation of apoptosis pathways. Finally, thrombin stimuli induced lower levels of P-selectin translocation and RANTES secretion, but not TXA2 synthesis, in platelets from HIV-infected individuals compared to control; and labeling of platelet alpha granules showed reduced granule content in platelets from HIV-infected individuals when compared to healthy subjects. In summary, platelets derived from HIV-infected individuals under stable cART exhibit a phenotype of increased activation, activation of the intrinsic pathway of apoptosis and undermined granule secretion in response to thrombin.
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Affiliation(s)
- Emersom C Mesquita
- Laboratório de Medicina Intensiva, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
| | - Eugenio D Hottz
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz (IOC) - Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
- Departamento de Bioquímica, Instituto de Ciências Biológicas - Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, Minas Gerais, Brazil
| | - Rodrigo T Amancio
- Laboratório de Medicina Intensiva, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
| | - Alan B Carneiro
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz (IOC) - Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
| | - Lohanna Palhinha
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz (IOC) - Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
| | - Lara E Coelho
- Laboratório de HIV, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
| | - Beatriz Grinsztejn
- Laboratório de HIV, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
| | - Guy A Zimmerman
- Molecular Medicine Program and Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Matthew T Rondina
- Molecular Medicine Program and Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Andrew S Weyrich
- Molecular Medicine Program and Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Patrícia T Bozza
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz (IOC) - Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
| | - Fernando A Bozza
- Laboratório de Medicina Intensiva, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil.
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil.
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Affiliation(s)
- Stephen M Prescott
- The Nora Eccles Harrison Cardiovascular Research and Training institute and the Departments of Internal Medicine and Biochemistry university of Utah, salt Lake city, Utah, U. S. A
| | - Thomas M McIntyre
- The Nora Eccles Harrison Cardiovascular Research and Training institute and the Departments of Internal Medicine and Biochemistry university of Utah, salt Lake city, Utah, U. S. A
| | - Guy A Zimmerman
- The Nora Eccles Harrison Cardiovascular Research and Training institute and the Departments of Internal Medicine and Biochemistry university of Utah, salt Lake city, Utah, U. S. A
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15
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Affiliation(s)
- Thomas M Mclntyre
- Department of Medicine, Nora Eccles Harrison CVRTI, Salt Lake City, UT, USA
| | - Vijayanand Modur
- Department of Medicine, Nora Eccles Harrison CVRTI, Salt Lake City, UT, USA
| | - Stephen M Prescott
- Department of Medicine, Eccles Institute of Human Genetics, University of Utah, Salt Lake City, UT, USA
| | - Guy A Zimmerman
- Department of Medicine, Nora Eccles Harrison CVRTI, Salt Lake City, UT, USA
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16
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Affiliation(s)
- Elizabeth A. Middleton
- Department of Internal MedicineUniversity of Utah School of MedicineSalt Lake City, Utahand
| | - Guy A. Zimmerman
- Department of Internal MedicineUniversity of Utah School of MedicineSalt Lake City, Utahand
- Program in Molecular MedicineUniversity of Utah School of MedicineSalt Lake City, Utah
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17
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Nascimento DDO, Vieira-de-Abreu A, Arcanjo AF, Bozza PT, Zimmerman GA, Castro-Faria-Neto HC. Integrin α Dβ 2 (CD11d/CD18) Modulates Leukocyte Accumulation, Pathogen Clearance, and Pyroptosis in Experimental Salmonella Typhimurium Infection. Front Immunol 2018; 9:1128. [PMID: 29881383 PMCID: PMC5977906 DOI: 10.3389/fimmu.2018.01128] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 05/04/2018] [Indexed: 12/14/2022] Open
Abstract
β2 integrins are critical in host defense responses to invading pathogens and inflammation. Previously, we reported that genetic deficiency of integrin αDβ2 in mice altered outcomes in experimental systemic infections including accelerated mortality in animals infected with Salmonella enterica serovar Typhimurium. Here, we show that deficiency of αDβ2 results in impaired accumulation of leukocytes in response to peritoneal infection by S. Typhimurium, impaired pathogen clearance in vivo, defective bacterial elimination by cultured peritoneal macrophages, and enhanced pyroptosis, a cell death process triggered by Salmonella. Salmonella-infected animals deficient in αDβ2 had increased levels of peritoneal cytokines in addition to other markers of pyroptosis, which may contribute to inflammatory injury and increased mortality in the context of impaired bacterial killing. These observations indicate important contributions of leukocyte integrins to the host response in experimental Salmonella infection and reveal previous activities of αDβ2 in bacterial infection.
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Affiliation(s)
| | - Adriana Vieira-de-Abreu
- Laboratório de Immunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.,Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Angélica F Arcanjo
- Laboratório de Immunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Patricia Torres Bozza
- Laboratório de Immunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Guy A Zimmerman
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States
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18
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Schwertz H, Rowley JW, Schumann GG, Thorack U, Campbell RA, Manne BK, Zimmerman GA, Weyrich AS, Rondina MT. Endogenous LINE-1 (Long Interspersed Nuclear Element-1) Reverse Transcriptase Activity in Platelets Controls Translational Events Through RNA-DNA Hybrids. Arterioscler Thromb Vasc Biol 2018; 38:801-815. [PMID: 29301786 DOI: 10.1161/atvbaha.117.310552] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 12/11/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE One source of endogenous reverse transcriptase (eRT) activity in nucleated cells is the LINE-1/L1 (long interspersed nuclear element-1), a non-LTR retrotransposon that is implicated in the regulation of gene expression. Nevertheless, the presence and function of eRT activity and LINE-1 in human platelets, an anucleate cell, has not previously been determined. APPROACH AND RESULTS We demonstrate that human and murine platelets possess robust eRT activity and identify the source as being LINE-1 ribonucleoprotein particles. Inhibition of eRT in vitro in isolated platelets from healthy individuals or in people with HIV treated with RT inhibitors enhanced global protein synthesis and platelet activation. If HIV patients were treated with reverse transcriptase inhibitor, we found that platelets from these patients had increased basal activation. We next discovered that eRT activity in platelets controlled the generation of RNA-DNA hybrids, which serve as translational repressors. Inhibition of platelet eRT lifted this RNA-DNA hybrid-induced translational block and was sufficient to increase protein expression of target RNAs identified by RNA-DNA hybrid immunoprecipitation. CONCLUSIONS Thus, we provide the first evidence that platelets possess L1-encoded eRT activity. We also demonstrate that platelet eRT activity regulates platelet hyperreactivity and thrombosis and controls RNA-DNA hybrid formation and identify that RNA-DNA hybrids function as a novel translational control mechanism in human platelets.
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Affiliation(s)
- Hansjörg Schwertz
- From the Molecular Medicine Program (H.S., J.W.R., R.A.C., B.K.M., G.A.Z., A.S.W., M.T.R.), Department of Internal Medicine (H.S., J.W.R., G.A.Z., A.S.W., M.T.R.), and Department of Surgery, Division of Vascular Surgery (H.S.), University of Utah, Salt Lake City; Department of Internal Medicine, George E. Wahlen Salt Lake City VAMC, UT (M.T.R.); Department of Immunology and Transfusion Medicine (U.T.) and Lichtenberg-Professor for Experimental Hemostasis (H.S.), University of Greifswald, Germany; and Division of Medical Biotechnology, Paul-Ehrlich-Institut, Langen, Germany (G.G.S.).
| | - Jesse W Rowley
- From the Molecular Medicine Program (H.S., J.W.R., R.A.C., B.K.M., G.A.Z., A.S.W., M.T.R.), Department of Internal Medicine (H.S., J.W.R., G.A.Z., A.S.W., M.T.R.), and Department of Surgery, Division of Vascular Surgery (H.S.), University of Utah, Salt Lake City; Department of Internal Medicine, George E. Wahlen Salt Lake City VAMC, UT (M.T.R.); Department of Immunology and Transfusion Medicine (U.T.) and Lichtenberg-Professor for Experimental Hemostasis (H.S.), University of Greifswald, Germany; and Division of Medical Biotechnology, Paul-Ehrlich-Institut, Langen, Germany (G.G.S.)
| | - Gerald G Schumann
- From the Molecular Medicine Program (H.S., J.W.R., R.A.C., B.K.M., G.A.Z., A.S.W., M.T.R.), Department of Internal Medicine (H.S., J.W.R., G.A.Z., A.S.W., M.T.R.), and Department of Surgery, Division of Vascular Surgery (H.S.), University of Utah, Salt Lake City; Department of Internal Medicine, George E. Wahlen Salt Lake City VAMC, UT (M.T.R.); Department of Immunology and Transfusion Medicine (U.T.) and Lichtenberg-Professor for Experimental Hemostasis (H.S.), University of Greifswald, Germany; and Division of Medical Biotechnology, Paul-Ehrlich-Institut, Langen, Germany (G.G.S.)
| | - Ulrike Thorack
- From the Molecular Medicine Program (H.S., J.W.R., R.A.C., B.K.M., G.A.Z., A.S.W., M.T.R.), Department of Internal Medicine (H.S., J.W.R., G.A.Z., A.S.W., M.T.R.), and Department of Surgery, Division of Vascular Surgery (H.S.), University of Utah, Salt Lake City; Department of Internal Medicine, George E. Wahlen Salt Lake City VAMC, UT (M.T.R.); Department of Immunology and Transfusion Medicine (U.T.) and Lichtenberg-Professor for Experimental Hemostasis (H.S.), University of Greifswald, Germany; and Division of Medical Biotechnology, Paul-Ehrlich-Institut, Langen, Germany (G.G.S.)
| | - Robert A Campbell
- From the Molecular Medicine Program (H.S., J.W.R., R.A.C., B.K.M., G.A.Z., A.S.W., M.T.R.), Department of Internal Medicine (H.S., J.W.R., G.A.Z., A.S.W., M.T.R.), and Department of Surgery, Division of Vascular Surgery (H.S.), University of Utah, Salt Lake City; Department of Internal Medicine, George E. Wahlen Salt Lake City VAMC, UT (M.T.R.); Department of Immunology and Transfusion Medicine (U.T.) and Lichtenberg-Professor for Experimental Hemostasis (H.S.), University of Greifswald, Germany; and Division of Medical Biotechnology, Paul-Ehrlich-Institut, Langen, Germany (G.G.S.)
| | - Bhanu Kanth Manne
- From the Molecular Medicine Program (H.S., J.W.R., R.A.C., B.K.M., G.A.Z., A.S.W., M.T.R.), Department of Internal Medicine (H.S., J.W.R., G.A.Z., A.S.W., M.T.R.), and Department of Surgery, Division of Vascular Surgery (H.S.), University of Utah, Salt Lake City; Department of Internal Medicine, George E. Wahlen Salt Lake City VAMC, UT (M.T.R.); Department of Immunology and Transfusion Medicine (U.T.) and Lichtenberg-Professor for Experimental Hemostasis (H.S.), University of Greifswald, Germany; and Division of Medical Biotechnology, Paul-Ehrlich-Institut, Langen, Germany (G.G.S.)
| | - Guy A Zimmerman
- From the Molecular Medicine Program (H.S., J.W.R., R.A.C., B.K.M., G.A.Z., A.S.W., M.T.R.), Department of Internal Medicine (H.S., J.W.R., G.A.Z., A.S.W., M.T.R.), and Department of Surgery, Division of Vascular Surgery (H.S.), University of Utah, Salt Lake City; Department of Internal Medicine, George E. Wahlen Salt Lake City VAMC, UT (M.T.R.); Department of Immunology and Transfusion Medicine (U.T.) and Lichtenberg-Professor for Experimental Hemostasis (H.S.), University of Greifswald, Germany; and Division of Medical Biotechnology, Paul-Ehrlich-Institut, Langen, Germany (G.G.S.)
| | - Andrew S Weyrich
- From the Molecular Medicine Program (H.S., J.W.R., R.A.C., B.K.M., G.A.Z., A.S.W., M.T.R.), Department of Internal Medicine (H.S., J.W.R., G.A.Z., A.S.W., M.T.R.), and Department of Surgery, Division of Vascular Surgery (H.S.), University of Utah, Salt Lake City; Department of Internal Medicine, George E. Wahlen Salt Lake City VAMC, UT (M.T.R.); Department of Immunology and Transfusion Medicine (U.T.) and Lichtenberg-Professor for Experimental Hemostasis (H.S.), University of Greifswald, Germany; and Division of Medical Biotechnology, Paul-Ehrlich-Institut, Langen, Germany (G.G.S.)
| | - Matthew T Rondina
- From the Molecular Medicine Program (H.S., J.W.R., R.A.C., B.K.M., G.A.Z., A.S.W., M.T.R.), Department of Internal Medicine (H.S., J.W.R., G.A.Z., A.S.W., M.T.R.), and Department of Surgery, Division of Vascular Surgery (H.S.), University of Utah, Salt Lake City; Department of Internal Medicine, George E. Wahlen Salt Lake City VAMC, UT (M.T.R.); Department of Immunology and Transfusion Medicine (U.T.) and Lichtenberg-Professor for Experimental Hemostasis (H.S.), University of Greifswald, Germany; and Division of Medical Biotechnology, Paul-Ehrlich-Institut, Langen, Germany (G.G.S.)
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Schwertz H, Rowley JW, Zimmerman GA, Weyrich AS, Rondina MT. Retinoic acid receptor-α regulates synthetic events in human platelets. J Thromb Haemost 2017; 15:2408-2418. [PMID: 28981191 DOI: 10.1111/jth.13861] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 04/20/2017] [Indexed: 12/01/2022]
Abstract
Essentials Platelets express retinoic acid receptor (RAR)α protein, specifically binding target mRNAs. mRNAs under RARα control include MAP1LC3B2, SLAIN2, and ANGPT1. All-trans retinoic acid (atRA) releases RARα from its target mRNA. RARα expressed in human platelets exerts translational control via direct mRNA binding. SUMMARY Background Translational control mechanisms in platelets are incompletely defined. Here, we determined whether the nuclear transcription factor RARα controls protein translational events in human platelets. Methods Isolated human platelets were treated with the pan-RAR agonist all-trans-retinoic acid (atRA). Global and targeted translational events were examined. Results Stimulation of platelets with atRA significantly increased global protein expression. RARα protein bound to a subset of platelet mRNAs, as measured by next-generation RNA-sequencing. In-depth analyses of 5' and 3'-untranslated regions of the RARα-bound mRNAs revealed consensus RARα binding sites in microtubule-associated protein 1 light chain 3 beta 2 (MAP1LC3B2), SLAIN motif-containing protein 2 (SLAIN2) and angiopoietin-1 (ANGPT1) transcripts. When platelets were treated with atRA, binding interactions between RARα protein and mRNA for MAP1LC3B2, SLAIN2 and ANGPT1 were significantly decreased. Consistent with the release of bound RARα protein from MAP1LCB2mRNA, we observed an increase in the synthesis of MAP1LC3B2 protein. Conclusions These findings provide the first evidence that RARα, a nuclear transcriptional factor, regulates synthetic events in anucleate human platelets. They also reveal an additional non-genomic role for RARα in platelets that may have implications for the vitamin A-dependent signaling in humans.
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Affiliation(s)
- H Schwertz
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA
- Departments of Surgery, University of Utah, Salt Lake City, UT, USA
| | - J W Rowley
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA
- Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - G A Zimmerman
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA
- Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - A S Weyrich
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA
- Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - M T Rondina
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA
- Internal Medicine, University of Utah, Salt Lake City, UT, USA
- The Geriatric Research Education and Clinical Center (GRECC), University of Utah, Salt Lake City, UT, USA
- Department of Internal Medicine at the George E. Wahlen Salt Lake City VAMC, Salt Lake City, Utah, USA
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20
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Campbell RA, Vieira-de-Abreu A, Rowley JW, Franks ZG, Manne BK, Rondina MT, Kraiss LW, Majersik JJ, Zimmerman GA, Weyrich AS. Clots Are Potent Triggers of Inflammatory Cell Gene Expression: Indications for Timely Fibrinolysis. Arterioscler Thromb Vasc Biol 2017; 37:1819-1827. [PMID: 28775073 DOI: 10.1161/atvbaha.117.309794] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 11/09/2016] [Accepted: 07/21/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Blood vessel wall damage often results in the formation of a fibrin clot that traps inflammatory cells, including monocytes. The effect of clot formation and subsequent lysis on the expression of monocyte-derived genes involved in the development and progression of ischemic stroke and other vascular diseases, however, is unknown. Determine whether clot formation and lysis regulates the expression of human monocyte-derived genes that modulate vascular diseases. APPROACH AND RESULTS We performed next-generation RNA sequencing on monocytes extracted from whole blood clots and using a purified plasma clot system. Numerous mRNAs were differentially expressed by monocytes embedded in clots compared with unclotted controls, and IL-8 (interleukin 8) and MCP-1 (monocyte chemoattractant protein-1) were among the upregulated transcripts in both models. Clotted plasma also increased expression of IL-8 and MCP-1, which far exceeded responses observed in lipopolysaccharide-stimulated monocytes. Upregulation of IL-8 and MCP-1 occurred in a thrombin-independent but fibrin-dependent manner. Fibrinolysis initiated shortly after plasma clot formation (ie, 1-2 hours) reduced the synthesis of IL-8 and MCP-1, whereas delayed fibrinolysis was far less effective. Consistent with these in vitro models, monocytes embedded in unresolved thrombi from patients undergoing thrombectomy stained positively for IL-8 and MCP-1. CONCLUSIONS These findings demonstrate that clots are potent inducers of monocyte gene expression and that timely fibrinolysis attenuates inflammatory responses, specifically IL-8 and MCP-1. Dampening of inflammatory gene expression by timely clot lysis may contribute to the clinically proven efficacy of fibrinolytic drug treatment within hours of stroke onset.
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Affiliation(s)
- Robert A Campbell
- From the Program in Molecular Medicine (R.A.C., J.W.R., Z.G.F., B.K.M., M.T.R., L.W.K., A.S.W.) and Departments of Internal Medicine (R.A.C., A.V.-d.-A., J.W.R., M.T.R., G.A.Z., A.S.W.), Surgery (L.W.K.), and Neurology (J.J.M.), University of Utah, Salt Lake City.
| | - Adriana Vieira-de-Abreu
- From the Program in Molecular Medicine (R.A.C., J.W.R., Z.G.F., B.K.M., M.T.R., L.W.K., A.S.W.) and Departments of Internal Medicine (R.A.C., A.V.-d.-A., J.W.R., M.T.R., G.A.Z., A.S.W.), Surgery (L.W.K.), and Neurology (J.J.M.), University of Utah, Salt Lake City
| | - Jesse W Rowley
- From the Program in Molecular Medicine (R.A.C., J.W.R., Z.G.F., B.K.M., M.T.R., L.W.K., A.S.W.) and Departments of Internal Medicine (R.A.C., A.V.-d.-A., J.W.R., M.T.R., G.A.Z., A.S.W.), Surgery (L.W.K.), and Neurology (J.J.M.), University of Utah, Salt Lake City
| | - Zechariah G Franks
- From the Program in Molecular Medicine (R.A.C., J.W.R., Z.G.F., B.K.M., M.T.R., L.W.K., A.S.W.) and Departments of Internal Medicine (R.A.C., A.V.-d.-A., J.W.R., M.T.R., G.A.Z., A.S.W.), Surgery (L.W.K.), and Neurology (J.J.M.), University of Utah, Salt Lake City
| | - Bhanu Kanth Manne
- From the Program in Molecular Medicine (R.A.C., J.W.R., Z.G.F., B.K.M., M.T.R., L.W.K., A.S.W.) and Departments of Internal Medicine (R.A.C., A.V.-d.-A., J.W.R., M.T.R., G.A.Z., A.S.W.), Surgery (L.W.K.), and Neurology (J.J.M.), University of Utah, Salt Lake City
| | - Matthew T Rondina
- From the Program in Molecular Medicine (R.A.C., J.W.R., Z.G.F., B.K.M., M.T.R., L.W.K., A.S.W.) and Departments of Internal Medicine (R.A.C., A.V.-d.-A., J.W.R., M.T.R., G.A.Z., A.S.W.), Surgery (L.W.K.), and Neurology (J.J.M.), University of Utah, Salt Lake City
| | - Larry W Kraiss
- From the Program in Molecular Medicine (R.A.C., J.W.R., Z.G.F., B.K.M., M.T.R., L.W.K., A.S.W.) and Departments of Internal Medicine (R.A.C., A.V.-d.-A., J.W.R., M.T.R., G.A.Z., A.S.W.), Surgery (L.W.K.), and Neurology (J.J.M.), University of Utah, Salt Lake City
| | - Jennifer J Majersik
- From the Program in Molecular Medicine (R.A.C., J.W.R., Z.G.F., B.K.M., M.T.R., L.W.K., A.S.W.) and Departments of Internal Medicine (R.A.C., A.V.-d.-A., J.W.R., M.T.R., G.A.Z., A.S.W.), Surgery (L.W.K.), and Neurology (J.J.M.), University of Utah, Salt Lake City
| | - Guy A Zimmerman
- From the Program in Molecular Medicine (R.A.C., J.W.R., Z.G.F., B.K.M., M.T.R., L.W.K., A.S.W.) and Departments of Internal Medicine (R.A.C., A.V.-d.-A., J.W.R., M.T.R., G.A.Z., A.S.W.), Surgery (L.W.K.), and Neurology (J.J.M.), University of Utah, Salt Lake City
| | - Andrew S Weyrich
- From the Program in Molecular Medicine (R.A.C., J.W.R., Z.G.F., B.K.M., M.T.R., L.W.K., A.S.W.) and Departments of Internal Medicine (R.A.C., A.V.-d.-A., J.W.R., M.T.R., G.A.Z., A.S.W.), Surgery (L.W.K.), and Neurology (J.J.M.), University of Utah, Salt Lake City
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21
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Trugilho MRDO, Hottz ED, Brunoro GVF, Teixeira-Ferreira A, Carvalho PC, Salazar GA, Zimmerman GA, Bozza FA, Bozza PT, Perales J. Platelet proteome reveals novel pathways of platelet activation and platelet-mediated immunoregulation in dengue. PLoS Pathog 2017; 13:e1006385. [PMID: 28542641 PMCID: PMC5453622 DOI: 10.1371/journal.ppat.1006385] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 06/01/2017] [Accepted: 04/27/2017] [Indexed: 12/27/2022] Open
Abstract
Dengue is the most prevalent human arbovirus disease worldwide. Dengue virus (DENV) infection causes syndromes varying from self-limiting febrile illness to severe dengue. Although dengue pathophysiology is not completely understood, it is widely accepted that increased inflammation plays important roles in dengue pathogenesis. Platelets are blood cells classically known as effectors of hemostasis which have been increasingly recognized to have major immune and inflammatory activities. Nevertheless, the phenotype and effector functions of platelets in dengue pathogenesis are not completely understood. Here we used quantitative proteomics to investigate the protein content of platelets in clinical samples from patients with dengue compared to platelets from healthy donors. Our assays revealed a set of 252 differentially abundant proteins. In silico analyses associated these proteins with key molecular events including platelet activation and inflammatory responses, and with events not previously attributed to platelets during dengue infection including antigen processing and presentation, proteasome activity, and expression of histones. From these results, we conducted functional assays using samples from a larger cohort of patients and demonstrated evidence for platelet activation indicated by P-selectin (CD62P) translocation and secretion of granule-stored chemokines by platelets. In addition, we found evidence that DENV infection triggers HLA class I synthesis and surface expression by a mechanism depending on functional proteasome activity. Furthermore, we demonstrate that cell-free histone H2A released during dengue infection binds to platelets, increasing platelet activation. These findings are consistent with functional importance of HLA class I, proteasome subunits, and histones that we found exclusively in proteome analysis of platelets in samples from dengue patients. Our study provides the first in-depth characterization of the platelet proteome in dengue, and sheds light on new mechanisms of platelet activation and platelet-mediated immune and inflammatory responses. Dengue is the most frequent hemorrhagic viral disease and re-emergent infection in the world. Recent decades were marked by a progressive global expansion of the infection including a higher frequency of severe dengue. Currently there is no effective vaccinal coverage or specific therapies, while efforts aimed at vector control have failed to stop the progression of epidemics and expansion of the disease. An increased understanding of the molecular physiology is of paramount importance for the establishment of new therapeutic targets and better clinical management. Dengue fever is characterized by thrombocytopenia and vascular leak. Although thrombocytopenia is a hallmark of dengue, the molecular phenotype and activities of platelets in the pathogenesis of dengue is not well elucidated. This work characterizes the proteome of platelets isolated from patients with dengue and includes validation of functionally-linked protein networks that we identified, using samples from a larger cohort of dengue patients. Moreover, in vitro experiments revealed activities of platelets that have recognized importance to dengue pathogenesis, including chemokine release, antigen presentation, and proteasome activity. Finally, our results identify circulating histones as a novel mechanism of platelet activation in dengue. These findings provide new evidence for platelet immune activities in dengue illness, and mark an advance in the understanding of this disease.
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Affiliation(s)
- Monique Ramos de Oliveira Trugilho
- Laboratório de Toxinologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Centro de Desenvolvimento Tecnológico em Saúde (CDTS), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Eugenio Damaceno Hottz
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Laboratório de Análise de Glicoconjugados, Departamento de Bioquímica, Instituto de Ciências Biológicas, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, Minas Gerais, Brazil
| | | | - André Teixeira-Ferreira
- Laboratório de Toxinologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Paulo Costa Carvalho
- Laboratório de Proteômica e Engenharia de Proteínas, Instituto Carlos Chagas (ICC), Fiocruz, Curitiba, Paraná, Brazil
| | - Gustavo Adolfo Salazar
- Computational Biology Group, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Guy A. Zimmerman
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, United States of America
| | - Fernando A. Bozza
- Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Patrícia T. Bozza
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- * E-mail: , (PTB); (JP)
| | - Jonas Perales
- Laboratório de Toxinologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- * E-mail: , (PTB); (JP)
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22
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Campbell RA, Vieira-de-Abreu A, Rowley JW, Franks ZG, Rondina MT, Kraiss LW, Majersik JJ, Zimmerman GA, Weyrich A. Abstract 354: Clots Are Potent Triggers of Inflammatory Cell Gene Expression: Indications for Timely Fibrinolysis. Arterioscler Thromb Vasc Biol 2017. [DOI: 10.1161/atvb.37.suppl_1.354] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective:
Blood vessel wall damage often results in the formation of a fibrin clot that traps inflammatory cells, including monocytes. The effect of clot formation and subsequent lysis on the expression of monocyte-derived genes involved in the development and progression of ischemic stroke and other vascular diseases, however, is unknown. Determine if clot formation and lysis regulates the expression of human monocyte-derived genes that modulate vascular diseases.
Approach and Results:
We performed Next Generation RNA sequencing on monocytes extracted from whole blood clots. Thousands of mRNAs were differentially expressed by monocytes from clotted versus unclotted whole blood, including upregulation of interleukin 8 (IL-8) and monocyte chemoattractant protein-1 (MCP-1). Clotted plasma also increased expression of IL-8 and MCP-1, which far exceeded responses observed in LPS-stimulated monocytes. Upregulation of IL-8 and MCP-1 occurred in a thrombin-independent, but fibrin-dependent manner. Fibrinolysis initiated shortly after plasma clot formation (i.e., 1-2 hours) reduced the synthesis of IL-8 and MCP-1, while delayed fibrinolysis was far less effective. Consistent with these
in vitro
models, monocytes embedded in unresolved thrombi from patients undergoing thrombectomy stained positively for IL-8 and MCP-1.
Conclusions:
These findings demonstrate that clots are potent inducers of monocyte gene expression, and that timely fibrinolysis attenuates inflammatory responses. Dampening of inflammatory gene expression by timely clot lysis may contribute to the clinically-proven efficacy of fibrinolytic drug treatment within hours of stroke onset.
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23
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Campbell RA, Smith T, Vieira-de-Abreu A, Franks ZG, Rowley JW, Rondina MT, Kraiss LW, Zimmerman GA, Weyrich AS. Abstract WMP76: Clots are Potent Triggers of Inflammatory Cell Gene Expression - Indications for Timely Fibrinolysis in Stroke. Stroke 2017. [DOI: 10.1161/str.48.suppl_1.wmp76] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Rationale:
Blood vessel wall damage often results in the formation of a fibrin clot that traps inflammatory cells, including monocytes. The effect of clot formation and subsequent lysis on the expression of monocyte-derived genes involved in the development and progression of ischemic stroke and other vascular diseases, however, is unknown.
Objective:
Determine if clot formation and lysis regulate the expression of human monocyte-derived genes that modulate vascular diseases.
Methods and Results:
We performed Next Generation RNA sequencing on monocytes extracted from whole blood clots. Thousands of mRNAs were significantly differentially expressed by monocytes from clotted versus unclotted whole blood (p>0.05), including upregulation of many inflammatory cytokines such as interleukin 8 (IL-8), IL-1β, tumor necrosis factor alpha, and monocyte chemoattractant protein-1 (MCP-1). Clotted plasma also increased expression of IL-8 and MCP-1, which far exceeded responses observed in LPS-stimulated monocytes. Upregulation of IL-8 and MCP-1 occurred in a thrombin-independent, but fibrin-dependent, manner. Fibrinolysis initiated shortly after plasma clot formation (i.e., 1-2 hours) reduced the global inflammatory response based on RNA-seq analysis and significantly reduced the synthesis of IL-8 and MCP-1 (p>0.05). Delayed fibrinolysis was far less effective in reducing inflammation. Consistent with these
in vitro
models, monocytes embedded in unresolved thrombi from patients undergoing thrombectomy stained positively for IL-8 and MCP-1.
Conclusion:
These findings demonstrate that clots are potent inducers of monocyte gene expression, and that timely fibrinolysis attenuates inflammatory responses. Dampening of inflammatory gene expression by timely clot lysis may contribute to the clinically-proven efficacy of fibrinolytic drug treatment within hours of stroke onset.
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Affiliation(s)
| | - Tammy Smith
- Molecular Medicine, Univ of Utah, Salt Lake City, UT
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24
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Rodrigues RS, Bozza FA, Hanrahan CJ, Wang LM, Wu Q, Hoffman JM, Zimmerman GA, Morton KA. 18F-fluoro-2-deoxyglucose PET informs neutrophil accumulation and activation in lipopolysaccharide-induced acute lung injury. Nucl Med Biol 2017; 48:52-62. [PMID: 28237630 DOI: 10.1016/j.nucmedbio.2017.01.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 10/14/2016] [Revised: 12/10/2016] [Accepted: 01/12/2017] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Molecular imaging of the earliest events related to the development of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) could facilitate therapeutic development and patient management. We previously reported that 18F-fluoro-2-deoxyglucose (18F-FDG) PET identifies ALI/ARDS prior to radiographic abnormalities. The purpose of this study was to establish the time courses of 18F-FDG uptake, edema and neutrophil recruitment in an endotoxin-induced acute lung injury model and to examine molecular events required for 14C-2DG uptake in activated neutrophils. METHODS Lung uptake of 18F-FDG was measured by PET in control male Sprague Dawley rats and at 2, 6 and 24h following the intraperitoneal injection of 10mg/kg LPS. Lung edema (attenuation) was measured by microCT. Neutrophil influx into the lungs was measured by myeloperoxidase assay. Control and activated human donor neutrophils were compared for uptake of 14C-2DG, transcription and content of hexokinase and GLUT isoforms and for hexokinase (HK) activity. RESULTS Significant uptake of 18F-FDG occurred by 2h following LPS, and progressively increased to 24h. Lung uptake of 18F-FDG preceded increased CT attenuation (lung edema). Myeloperoxidase activity in the lungs, supporting neutrophil influx, paralleled 18F-FDG uptake. Activation of isolated human neutrophils resulted in increased uptake of 14C-2DG, expression of GLUT 3 and GLUT 4 and expression and increased HK1 activity. CONCLUSION Systemic endotoxin-induced ALI results in very early and progressive uptake of 18F-FDG, parallels neutrophil accumulation and occurs earlier than lung injury edema. Activated neutrophils show increased uptake of 14C-2DG, expression of specific GLUT3, GLUT4 and HK1 protein and HK activity. ADVANCES IN KNOWLEDGE AND IMPLICATIONS FOR PATIENT CARE: 18F-FDG pulmonary uptake is an early biomarker of neutrophil recruitment in ALI and is associated with specific molecular events that mediate 14C-2DG uptake in activated neutrophils. 18F-FDG PET may provide a potential mechanism for early diagnosis and therapeutic assessment of ALI/ARDS.
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Affiliation(s)
- Rosana S Rodrigues
- Department of Radiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fernando A Bozza
- National Institute of Infectious Disease Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Christopher J Hanrahan
- Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Li-Ming Wang
- Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Qi Wu
- Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - John M Hoffman
- Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Guy A Zimmerman
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Kathryn A Morton
- Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA.
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Nance D, Campbell RA, Rowley JW, Downie JM, Jorde LB, Kahr WH, Mereby SA, Tolley ND, Zimmerman GA, Weyrich AS, Rondina MT. Combined variants in factor VIII and prostaglandin synthase-1 amplify hemorrhage severity across three generations of descendants. J Thromb Haemost 2016; 14:2230-2240. [PMID: 27629384 PMCID: PMC5501291 DOI: 10.1111/jth.13500] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 11/12/2015] [Accepted: 07/08/2016] [Indexed: 01/05/2023]
Abstract
Essentials Co-existent damaging variants are likely to cause more severe bleeding and may go undiagnosed. We determined pathogenic variants in a three-generational pedigree with excessive bleeding. Bleeding occurred with concurrent variants in prostaglandin synthase-1 (PTGS-1) and factor VIII. The PTGS-1 variant was associated with functional defects in the arachidonic acid pathway. SUMMARY Background Inherited human variants that concurrently cause disorders of primary hemostasis and coagulation are uncommon. Nevertheless, rare cases of co-existent damaging variants are likely to cause more severe bleeding and may go undiagnosed. Objective We prospectively sought to determine pathogenic variants in a three-generational pedigree with excessive bleeding. Patients/methods Platelet number, size and light transmission aggregometry to multiple agonists were evaluated in pedigree members. Transmission electron microscopy determined platelet morphology and granule content. Thromboxane release studies and light transmission aggregometry in the presence or absence of prostaglandin G2 assessed specific functional defects in the arachidonic acid pathway. Whole exome sequencing (WES) and targeted nucleotide sequence analysis identified potentially deleterious variants. Results Pedigree members with excessive bleeding had impaired platelet aggregation with arachidonic acid, epinephrine and low-dose ADP, as well as reduced platelet thromboxane B2 release. Impaired platelet aggregation in response to 2MesADP was rescued with prostaglandin G2 , a prostaglandin intermediate downstream of prostaglandin synthase-1 (PTGS-1) that aids in the production of thromboxane. WES identified a non-synonymous variant in the signal peptide of PTGS-1 (rs3842787; c.50C>T; p.Pro17Leu) that completely co-segregated with disease phenotype. A variant in the F8 gene causing hemophilia A (rs28935203; c.5096A>T; p.Y1699F) was also identified. Individuals with both variants had more severe bleeding manifestations than characteristic of mild hemophilia A alone. Conclusion We provide the first report of co-existing variants in both F8 and PTGS-1 genes in a three-generation pedigree. The PTGS-1 variant was associated with specific functional defects in the arachidonic acid pathway and more severe hemorrhage.
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Affiliation(s)
- D Nance
- The Division of Hematology, University of Utah, Salt Lake City, UT, USA
| | - R A Campbell
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA
| | - J W Rowley
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - J M Downie
- Department of Human Genetics, University of Utah, Salt Lake City, UT, USA
| | - L B Jorde
- Department of Human Genetics, University of Utah, Salt Lake City, UT, USA
| | - W H Kahr
- Department of Paediatrics, Division of Haematology/Oncology, University of Toronto, Toronto, ON, Canada
- Program in Cell Biology, Research Institute, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
- Department of Biochemistry, University of Toronto, Toronto, ON, Canada
| | - S A Mereby
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA
| | - N D Tolley
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA
| | - G A Zimmerman
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - A S Weyrich
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - M T Rondina
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- GRECC, George E. Wahlen Salt Lake City VAMC, Salt Lake City, UT, USA
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26
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Yost CC, Schwertz H, Cody MJ, Wallace JA, Campbell RA, Vieira-de-Abreu A, Araujo CV, Schubert S, Harris ES, Rowley JW, Rondina MT, Fulcher JM, Koening CL, Weyrich AS, Zimmerman GA. Neonatal NET-inhibitory factor and related peptides inhibit neutrophil extracellular trap formation. J Clin Invest 2016; 126:3783-3798. [PMID: 27599294 DOI: 10.1172/jci83873] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 07/28/2016] [Indexed: 12/22/2022] Open
Abstract
Neutrophil granulocytes, also called polymorphonuclear leukocytes (PMNs), extrude molecular lattices of decondensed chromatin studded with histones, granule enzymes, and antimicrobial peptides that are referred to as neutrophil extracellular traps (NETs). NETs capture and contain bacteria, viruses, and other pathogens. Nevertheless, experimental evidence indicates that NETs also cause inflammatory vascular and tissue damage, suggesting that identifying pathways that inhibit NET formation may have therapeutic implications. Here, we determined that neonatal NET-inhibitory factor (nNIF) is an inhibitor of NET formation in umbilical cord blood. In human neonatal and adult neutrophils, nNIF inhibits key terminal events in NET formation, including peptidyl arginine deiminase 4 (PAD4) activity, neutrophil nuclear histone citrullination, and nuclear decondensation. We also identified additional nNIF-related peptides (NRPs) that inhibit NET formation. nNIFs and NRPs blocked NET formation induced by pathogens, microbial toxins, and pharmacologic agonists in vitro and in mouse models of infection and systemic inflammation, and they improved mortality in murine models of systemic inflammation, which are associated with NET-induced collateral tissue injury. The identification of NRPs as neutrophil modulators that selectively interrupt NET generation at critical steps suggests their potential as therapeutic agents. Furthermore, our results indicate that nNIF may be an important regulator of NET formation in fetal and neonatal inflammation.
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Abstract
Platelets are essential for physiological hemostasis and are central in pathological thrombosis. These are their traditional and best known activities in health and disease. In addition, however, platelets have specializations that broaden their functional repertoire considerably. These functional capabilities, some of which are recently discovered, include the ability to sense and respond to infectious and immune signals and to act as inflammatory effector cells. Human platelets and platelets from mice and other experimental animals can link the innate and adaptive limbs of the immune system and act across the immune continuum, often also linking immune and hemostatic functions. Traditional and newly recognized facets of the biology of platelets are relevant to defensive, physiological immune responses of the lungs and to inflammatory lung diseases. The emerging view of platelets as blood cells that are much more diverse and versatile than previously thought further predicts that additional features of the biology of platelets and of megakaryocytes, the precursors of platelets, will be discovered and that some of these will also influence pulmonary immune defenses and inflammatory injury.
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Affiliation(s)
- Elizabeth A Middleton
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, and the Program in Molecular Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Andrew S Weyrich
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, and the Program in Molecular Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Guy A Zimmerman
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, and the Program in Molecular Medicine, University of Utah School of Medicine, Salt Lake City, Utah
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de Azevedo-Quintanilha IG, Vieira-de-Abreu A, Ferreira AC, Nascimento DO, Siqueira AM, Campbell RA, Teixeira Ferreira TP, Gutierrez TM, Ribeiro GM, E Silva PMR, Carvalho AR, Bozza PT, Zimmerman GA, Castro-Faria-Neto HC. Integrin αDβ2 (CD11d/CD18) mediates experimental malaria-associated acute respiratory distress syndrome (MA-ARDS). Malar J 2016; 15:393. [PMID: 27473068 PMCID: PMC4967320 DOI: 10.1186/s12936-016-1447-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 07/20/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Malaria-associated acute respiratory distress syndrome (MA-ARDS) is a potentially lethal complication of clinical malaria. Acute lung injury in MA-ARDS shares features with ARDS triggered by other causes, including alveolar inflammation and increased alveolar-capillary permeability, leading to leak of protein-rich pulmonary oedema fluid. Mechanisms and physiologic alterations in MA-ARDS can be examined in murine models of this syndrome. Integrin αDβ2 is a member of the leukocyte, or β2 (CD18), sub-family of integrins, and emerging observations indicate that it has important activities in leukocyte adhesion, accumulation and signalling. The goal was to perform analysis of the lungs of mice wild type C57Bl/6 (a D (+/+) ) and Knockout C57Bl/6 (a D (-/-) ) with malaria-associated acute lung injury to better determine the relevancy of the murine models and investigate the mechanism of disease. METHODS C57BL/6 wild type (a D (+/+) ) and deficient for CD11d sub-unit (a D (-/-) ) mice were monitored after infection with 10(5) Plasmodium berghei ANKA. CD11d subunit expression RNA was measured by real-time polymerase chain reaction, vascular barrier integrity by Evans blue dye (EBD) exclusion and cytokines by ELISA. Protein and leukocytes were measured in bronchoalveolar lavage fluid (BALF) samples. Tissue cellularity was measured by the point-counting technique, F4/80 and VCAM-1 expression by immunohistochemistry. Respiratory function was analysed by non-invasive BUXCO and mechanical ventilation. RESULTS Alveolar inflammation, vascular and interstitial accumulation of monocytes and macrophages, and disrupted alveolar-capillary barrier function with exudation of protein-rich pulmonary oedema fluid were present in P. berghei-infected wild type mice and were improved in αDβ2-deficient animals. Key pro-inflammatory cytokines were also decreased in lung tissue from α D (-/-) mice, providing a mechanistic explanation for reduced alveolar-capillary inflammation and leak. CONCLUSIONS The results indicate that αDβ2 is an important inflammatory effector molecule in P. berghei-induced MA-ARDS, and that leukocyte integrins regulate critical inflammatory and pathophysiologic events in this model of complicated malaria. Genetic deletion of integrin subunit αD in mice, leading to deficiency of integrin αDβ2, alters lung inflammation and acute lung injury in a mouse model of MA-ARDS caused by P. berghei.
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Affiliation(s)
- Isaclaudia G de Azevedo-Quintanilha
- Laboratório de Immunofarmacologia, Instituto Oswaldo Cruz, Fiocruz, Pavilhão Ozório de Almeida, Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, CEP 21045-900, Brazil.
| | - Adriana Vieira-de-Abreu
- Program in Molecular Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.
| | - André Costa Ferreira
- Laboratório de Immunofarmacologia, Instituto Oswaldo Cruz, Fiocruz, Pavilhão Ozório de Almeida, Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, CEP 21045-900, Brazil
| | - Daniele O Nascimento
- Laboratório de Immunofarmacologia, Instituto Oswaldo Cruz, Fiocruz, Pavilhão Ozório de Almeida, Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, CEP 21045-900, Brazil
| | - Alessandra M Siqueira
- Laboratório de Immunofarmacologia, Instituto Oswaldo Cruz, Fiocruz, Pavilhão Ozório de Almeida, Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, CEP 21045-900, Brazil
| | - Robert A Campbell
- Program in Molecular Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Tatiana P Teixeira Ferreira
- Laboratório de Inflamação, Instituto Oswaldo Cruz, Fiocruz, Pavilhão Ozório de Almeida, Rio de Janeiro, Brazil
| | - Tatiana M Gutierrez
- Laboratório de Immunofarmacologia, Instituto Oswaldo Cruz, Fiocruz, Pavilhão Ozório de Almeida, Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, CEP 21045-900, Brazil
| | - Gabriel M Ribeiro
- Laboratório de Engenharia Pulmonar no Programa de Engenharia Biomédica, Instituto Alberto Luiz Coimbra de Pós-Graduação e Pesquisa de Engenharia-COPPE/Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Patricia M R E Silva
- Laboratório de Inflamação, Instituto Oswaldo Cruz, Fiocruz, Pavilhão Ozório de Almeida, Rio de Janeiro, Brazil
| | - Alysson R Carvalho
- Laboratório de Fisiologia da Respiração, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Patricia T Bozza
- Laboratório de Immunofarmacologia, Instituto Oswaldo Cruz, Fiocruz, Pavilhão Ozório de Almeida, Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, CEP 21045-900, Brazil
| | - Guy A Zimmerman
- Program in Molecular Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Hugo C Castro-Faria-Neto
- Laboratório de Immunofarmacologia, Instituto Oswaldo Cruz, Fiocruz, Pavilhão Ozório de Almeida, Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, CEP 21045-900, Brazil.,Programa de Produtividade Científica, Universidade Estácio de Sá, Rio de Janeiro, RJ, Brazil
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Shih L, Kaplan D, Kraiss LW, Casper TC, Pendleton RC, Peters CL, Supiano MA, Zimmerman GA, Weyrich AS, Rondina MT. Platelet-Monocyte Aggregates and C-Reactive Protein are Associated with VTE in Older Surgical Patients. Sci Rep 2016; 6:27478. [PMID: 27270163 PMCID: PMC4895334 DOI: 10.1038/srep27478] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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: 02/12/2016] [Accepted: 05/19/2016] [Indexed: 01/26/2023] Open
Abstract
Emerging evidence implicates platelets as key mediators of venous thromboembolism (VTE). Nevertheless, the pathways by which platelets and circulating procoagulant proteins synergistically orchestrate VTE remain incompletely understood. We prospectively determined whether activated platelets and systemic procoagulant factors were associated with VTE in 32 older orthopedic surgery patients. Circulating platelet-monocyte aggregates (PMAs), p-selectin expression (P-SEL), and integrin αIIbβ3 activation (PAC-1 binding) were assessed pre-operatively and 24 hours post-operatively. The proinflammatory and procoagulant molecule C-reactive protein (CRP), which induces PMA formation in vitro, along with plasma d-dimer and fibrinogen levels were also measured. The primary outcome was VTE occurring within 30 days post-operatively. Overall, 40.6% of patients developed VTE. Patients with VTE had a significant increase in circulating PMAs and CRP post-operatively, compared to those without VTE. Changes in PMA and CRP in VTE patients were significantly correlated (r2 = 0.536, p = 0.004). In contrast, P-SEL expression and PAC-1 binding, fibrinogen levels, and d-dimers were not associated with VTE. This is the first study to identify that increased circulating PMAs and CRP levels are early markers associated with post-surgical VTE. Our findings also provide new clinical evidence supporting the interplay between PMAs and CRP in patients with VTE.
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Affiliation(s)
- Lauren Shih
- Department of Internal Medicine, University of Utah, Salt Lake City, USA
| | - David Kaplan
- Department of Internal Medicine, University of Utah, Salt Lake City, USA
| | - Larry W Kraiss
- Division of Vascular Surgery, University of Utah, Salt Lake City, USA
| | - T Charles Casper
- Study Design and Biostatistics Center, University of Utah, Salt Lake City, USA
| | - Robert C Pendleton
- Department of Internal Medicine, University of Utah, Salt Lake City, USA
| | | | - Mark A Supiano
- Division of Geriatrics, University of Utah, Salt Lake City, USA
| | - Guy A Zimmerman
- Department of Internal Medicine, University of Utah, Salt Lake City, USA
| | - Andrew S Weyrich
- Department of Internal Medicine, University of Utah, Salt Lake City, USA.,Molecular Medicine Program at the University of Utah Health Sciences Center, Salt Lake City, Utah
| | - Matthew T Rondina
- Department of Internal Medicine, University of Utah, Salt Lake City, USA.,Molecular Medicine Program at the University of Utah Health Sciences Center, Salt Lake City, Utah.,George E. Wahlen Salt Lake City VAMC GRECC, Salt Lake City, USA
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30
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Rondina MT, Freitag M, Pluthero FG, Kahr WHA, Rowley JW, Kraiss LW, Franks Z, Zimmerman GA, Weyrich AS, Schwertz H. Non-genomic activities of retinoic acid receptor alpha control actin cytoskeletal events in human platelets. J Thromb Haemost 2016; 14:1082-94. [PMID: 26848712 PMCID: PMC5497578 DOI: 10.1111/jth.13281] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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: 07/17/2015] [Indexed: 12/29/2022]
Abstract
UNLABELLED Essentials Platelets employ proteins/signaling pathways traditionally thought reserved for nuclear niche. We determined retinoic-acid-receptor alpha (RARα) expression and function in human platelets. RARα/actin-related protein-2/3 complex (Arp2/3) interact via non-genomic signaling in platelets. RARα regulates Arp2/3-mediated actin cytoskeletal dynamics and platelet spreading. SUMMARY Background Platelets utilize proteins and pathways classically reserved for the nuclear niche. Methods We determined whether human platelets express retinoic-acid-receptor family members, traditionally thought of as nuclear transcription factors, and deciphered the function of RARα. Results We found that RARα is robustly expressed in human platelets and megakaryocytes and interacts directly with actin-related protein-2/3 complex (Arp2/3) subunit 5 (Arp2/3s5). Arp2/3s5 co-localized with RARα in situ and regulated platelet cytoskeletal processes. The RARα ligand all-trans retinoic acid (atRA) disrupted RARα-Arp2/3 interactions. When isolated human platelets were treated with atRA, rapid cytoskeletal events (e.g. platelet spreading) were inhibited. In addition, when platelets were cultured for 18 h in the presence of atRA, actin-dependent morphological changes (e.g. extended cell body formation) were similarly inhibited. Using in vitro actin branching assays, RARα and Arp2/3-regulated complex actin branch formation was demonstrated. Consistent with inhibition of cytoskeletal processes in platelets, atRA, when added to this branching assay, resulted in dysregulated actin branching. Conclusion Our findings identify a previously unknown mechanism by which RARα regulates Arp2/3-mediated actin cytoskeletal dynamics through a non-genomic signaling pathway. These findings have broad implications in both nucleated and anucleate cells, where actin cytoskeletal events regulate cell morphology, movement and division.
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Affiliation(s)
- M T Rondina
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Department of Internal Medicine, George E. Wahlen Salt Lake City VAMC, Salt Lake City, UT, USA
| | - M Freitag
- Department of Immunology and Transfusion Medicine, University of Greifswald, Greifswald, Germany
| | - F G Pluthero
- Program in Cell Biology, Research Institute, Hospital for Sick Children, Toronto, ON, Canada
| | - W H A Kahr
- Program in Cell Biology, Research Institute, Hospital for Sick Children, Toronto, ON, Canada
- Departments of Paediatrics and Biochemistry, University of Toronto, Toronto, ON, Canada
| | - J W Rowley
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA
| | - L W Kraiss
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA
- Division of Vascular Surgery, Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Z Franks
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA
| | - G A Zimmerman
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - A S Weyrich
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - H Schwertz
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA
- Department of Immunology and Transfusion Medicine, University of Greifswald, Greifswald, Germany
- Division of Vascular Surgery, Department of Surgery, University of Utah, Salt Lake City, UT, USA
- Lichtenberg-Professor for Experimental Hemostasis, University of Greifswald, Greifswald, Germany
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Kaplan D, Casper TC, Elliott CG, Men S, Pendleton RC, Kraiss LW, Weyrich AS, Grissom CK, Zimmerman GA, Rondina MT. VTE Incidence and Risk Factors in Patients With Severe Sepsis and Septic Shock. Chest 2016; 148:1224-1230. [PMID: 26111103 DOI: 10.1378/chest.15-0287] [Citation(s) in RCA: 171] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Prospective studies on the incidence of VTE during severe sepsis and septic shock remain absent, hindering efficacy assessments regarding VTE prevention strategies in sepsis. METHODS We prospectively studied 113 consecutively enrolled patients in the ICU with severe sepsis and septic shock at three hospitals. All patients provided informed consent. VTE thromboprophylaxis was recorded for all patients. Patients underwent ultrasonography and were followed for VTE prior to ICU discharge. All-cause 28-day mortality was recorded. Variables from univariate analyses that were associated with VTE (including central venous catheter [CVC] insertion, age, length of stay, and mechanical ventilation) were included in a multivariable logistic regression analysis using backward stepwise elimination to determine VTE predictors. RESULTS Mean APACHE (Acute Physiology and Chronic Health Evaluation) II score was 18.2 ± 7.0, and age was 50 ± 18 years. Despite all patients receiving guideline-recommended thromboprophylaxis, the incidence of VTE was 37.2% (95% CI, 28.3-46.8). Most VTE events were clinically significant (defined as pulmonary embolism, proximal DVT, and/or symptomatic distal DVT) and associated with an increased length of stay (18.2 ± 9.9 days vs 13.4 ± 11.5 days, P < .05). Mortality was higher in patients with acute VTE but did not reach statistical significance. Insertion of a CVC and longer mechanical ventilation duration were significant VTE risk factors. VTE incidence did not differ by thromboprophylaxis type. CONCLUSIONS To our knowledge this is the first multicenter prospective study to identify a high incidence of VTE in patients with severe sepsis and septic shock, despite the use of universal, guideline-recommended thromboprophylaxis. Our findings suggest that the systemic inflammatory milieu of sepsis may uniquely predispose patients with sepsis to VTE. More effective VTE prevention strategies are necessary in patients with sepsis. TRIAL REGISTRY ClinicalTrials.gov; No.: NCT02353910; URL: www.clinicaltrials.gov.
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Affiliation(s)
- David Kaplan
- Department of Internal Medicine, University of Utah, Salt Lake City
| | - T Charles Casper
- Study Design and Biostatistics Center, University of Utah, Salt Lake City
| | - C Gregory Elliott
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Intermountain Medical Center, Murray, UT
| | - Shaohua Men
- Molecular Medicine Program, University of Utah, Salt Lake City
| | | | - Larry W Kraiss
- Eccles Institute of Human Genetics, and the Division of Vascular Surgery, University of Utah, Salt Lake City
| | - Andrew S Weyrich
- Department of Internal Medicine, University of Utah, Salt Lake City; Molecular Medicine Program, University of Utah, Salt Lake City
| | - Colin K Grissom
- Department of Internal Medicine, University of Utah, Salt Lake City; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Intermountain Medical Center, Murray, UT
| | - Guy A Zimmerman
- Department of Internal Medicine, University of Utah, Salt Lake City
| | - Matthew T Rondina
- Department of Internal Medicine, University of Utah, Salt Lake City; Molecular Medicine Program, University of Utah, Salt Lake City.
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Miyazaki Y, Vieira-de-Abreu A, Harris ES, Shah AM, Weyrich AS, Castro-Faria-Neto HC, Zimmerman GA. Integrin αDβ2 (CD11d/CD18) is expressed by human circulating and tissue myeloid leukocytes and mediates inflammatory signaling. PLoS One 2014; 9:e112770. [PMID: 25415295 PMCID: PMC4240710 DOI: 10.1371/journal.pone.0112770] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 10/16/2014] [Indexed: 12/22/2022] Open
Abstract
Integrin α(D)β(2) is the most recently identified member of the leukocyte, or β(2), subfamily of integrin heterodimers. Its distribution and functions on human leukocytes have not been clearly defined and are controversial. We examined these issues and found that α(D)β(2) is prominently expressed by leukocytes in whole blood from healthy human subjects, including most polymorphonuclear leukocytes and monocytes. We also found that α(D)β(2) is displayed by leukocytes in the alveoli of uninjured and inflamed human lungs and by human monocyte-derived macrophages and dendritic cells, indicating broad myeloid expression. Using freshly-isolated human monocytes, we found that α(D)β(2) delivers outside-in signals to pathways that regulate cell spreading and gene expression. Screening expression analysis followed by validation of candidate transcripts demonstrated that engagement of α(D)β(2) induces mRNAs encoding inflammatory chemokines and cytokines and secretion of their protein products. Thus, α(D)β(2) is a major member of the integrin repertoire of both circulating and tissue myeloid leukocytes in humans. Its broad expression and capacity for outside-in signaling indicate that it is likely to have important functions in clinical syndromes of infection, inflammation, and tissue injury.
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Affiliation(s)
- Yasunari Miyazaki
- Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Adriana Vieira-de-Abreu
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah 84112, United States of America
- Laboratório de Immunofarmacologia, Instituto Oswaldo Cruz, Fundacão Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Estelle S. Harris
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah 84112, United States of America
| | - Amrapali M. Shah
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah 84112, United States of America
| | - Andrew S. Weyrich
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah 84112, United States of America
- Program in Molecular Medicine, University of Utah School of Medicine, Salt Lake City, Utah 84112, United States of America
| | - Hugo C. Castro-Faria-Neto
- Laboratório de Immunofarmacologia, Instituto Oswaldo Cruz, Fundacão Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Guy A. Zimmerman
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah 84112, United States of America
- Laboratório de Immunofarmacologia, Instituto Oswaldo Cruz, Fundacão Oswaldo Cruz, Rio de Janeiro, Brazil
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Hottz ED, Medeiros-de-Moraes IM, Vieira-de-Abreu A, de Assis EF, Vals-de-Souza R, Castro-Faria-Neto HC, Weyrich AS, Zimmerman GA, Bozza FA, Bozza PT. Platelet activation and apoptosis modulate monocyte inflammatory responses in dengue. J Immunol 2014; 193:1864-72. [PMID: 25015827 DOI: 10.4049/jimmunol.1400091] [Citation(s) in RCA: 112] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Dengue is the most prevalent human arbovirus disease in the world. Dengue infection has a large spectrum of clinical manifestations, from self-limited febrile illness to severe syndromes accompanied by bleeding and shock. Thrombocytopenia and vascular leak with altered cytokine profiles in plasma are features of severe dengue. Although monocytes have been recognized as important sources of cytokines in dengue, the contributions of platelet-monocyte interactions to inflammatory responses in dengue have not been addressed. Patients with dengue were investigated for platelet-monocyte aggregate formation. Platelet-induced cytokine responses by monocytes and underlying mechanisms were also investigated in vitro. We observed increased levels of platelet-monocyte aggregates in blood samples from patients with dengue, especially patients with thrombocytopenia and increased vascular permeability. Moreover, the exposure of monocytes from healthy volunteers to platelets from patients with dengue induced the secretion of the cytokines IL-1β, IL-8, IL-10 and MCP-1, whereas exposure to platelets from healthy volunteers only induced the secretion of MCP-1. In addition to the well-established modulation of monocyte cytokine responses by activated platelets through P-selectin binding, we found that interaction of monocytes with apoptotic platelets mediate IL-10 secretion through phosphatidylserine recognition in platelet-monocyte aggregates. Moreover, IL-10 secretion required platelet-monocyte contact but not phagocytosis. Together, our results demonstrate that activated and apoptotic platelets aggregate with monocytes during dengue infection and signal specific cytokine responses that may contribute to the pathogenesis of dengue.
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Affiliation(s)
- Eugenio D Hottz
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21045-900, Brazil; Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, Brazil; Department of Medicine, University of Utah, Salt Lake City, UT 84112
| | - Isabel M Medeiros-de-Moraes
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21045-900, Brazil
| | - Adriana Vieira-de-Abreu
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21045-900, Brazil; Department of Medicine, University of Utah, Salt Lake City, UT 84112
| | - Edson F de Assis
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21045-900, Brazil
| | - Rogério Vals-de-Souza
- Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, Brazil
| | - Hugo C Castro-Faria-Neto
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21045-900, Brazil
| | - Andrew S Weyrich
- Department of Medicine, University of Utah, Salt Lake City, UT 84112; Molecular Medicine Program, University of Utah, Salt Lake City, UT 84112; and
| | - Guy A Zimmerman
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21045-900, Brazil; Department of Medicine, University of Utah, Salt Lake City, UT 84112
| | - Fernando A Bozza
- Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, Brazil; Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro 22281-110, Brazil
| | - Patrícia T Bozza
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21045-900, Brazil;
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Affiliation(s)
- Diana M Stafforini
- Department of Internal Medicine University of Utah, Salt Lake City, UT 84112 Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112
| | - Guy A Zimmerman
- Department of Internal Medicine University of Utah, Salt Lake City, UT 84112
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Rondina MT, Carlisle M, Fraughton T, Brown SM, Miller RR, Harris ES, Weyrich AS, Zimmerman GA, Supiano MA, Grissom CK. Platelet-monocyte aggregate formation and mortality risk in older patients with severe sepsis and septic shock. J Gerontol A Biol Sci Med Sci 2014; 70:225-31. [PMID: 24917177 DOI: 10.1093/gerona/glu082] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Aging-related changes in platelet and monocyte interactions may contribute to adverse outcomes in sepsis but remain relatively unexamined. We hypothesized that differential platelet-monocyte aggregate (PMA) formation in older septic patients alters inflammatory responses and mortality. METHODS We prospectively studied 113 septic adults admitted to the intensive care unit with severe sepsis or septic shock. Patients were dichotomized a priori into one of two groups: older (age ≥ 65 years, n = 28) and younger (age < 65 years, n = 85). PMA levels were measured in whole blood via flow cytometry within 24 hours of admission. Plasma levels of IL-6 and IL-8, proinflammatory cytokines produced by monocytes upon PMA formation, were determined by commercial assays. Patients were followed for the primary outcome of 28-day, all-cause mortality. RESULTS Elevated PMA levels were associated with an increased risk of mortality in older septic patients (hazard ratio for mortality 5.64, 95% confidence interval 0.64-49.61). This association remained after adjusting for potential confounding variables in multivariate regression. Receiver operating curve analyses demonstrated that PMA levels greater than or equal to 8.43% best predicted 28-day mortality in older septic patients (area under the receiver operating curve 0.82). Plasma IL-6 and IL-8 levels were also significantly higher in older nonsurvivors. In younger patients, neither PMA levels nor plasma monokines were significantly associated with mortality. CONCLUSIONS Increased PMA formation, and associated proinflammatory monokine synthesis, predicts mortality in older septic patients. Although larger studies are needed, our findings suggest that heightened PMA formation in older septic patients may contribute to injurious inflammatory responses and an increased risk of mortality.
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Affiliation(s)
- Matthew T Rondina
- Division of General Internal Medicine, Program in Molecular Medicine
| | | | - Tamra Fraughton
- Program in Molecular Medicine, Department of Psychology, and
| | - Samuel M Brown
- Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Utah, Salt Lake City. Division of Pulmonary and Critical Care Medicine,Intermountain Medical Center, Murray, Utah
| | - Russell R Miller
- Division of Pulmonary and Critical Care Medicine,Intermountain Medical Center, Murray, Utah
| | - Estelle S Harris
- Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Utah, Salt Lake City
| | - Andrew S Weyrich
- Program in Molecular Medicine, Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Utah, Salt Lake City
| | - Guy A Zimmerman
- Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Utah, Salt Lake City
| | - Mark A Supiano
- Division of Geriatric Medicine and Salt Lake City VA GRECC, University of Utah
| | - Colin K Grissom
- Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Utah, Salt Lake City. Division of Pulmonary and Critical Care Medicine,Intermountain Medical Center, Murray, Utah
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Schmid DI, Schwertz H, Jiang H, Campbell RA, Weyrich AS, McIntyre TM, Zimmerman GA, Kraiss LW. Translational control of JunB, an AP-1 transcription factor, in activated human endothelial cells. J Cell Biochem 2013; 114:1519-28. [PMID: 23297064 DOI: 10.1002/jcb.24493] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 12/18/2012] [Indexed: 12/31/2022]
Abstract
Stimulated endothelial cells (EC) assume an activated phenotype with pro-inflammatory and prothrombotic features, requiring new gene and protein expression. New protein synthesis in activated EC is largely regulated by transcriptional events controlled by a variety of transcription factors. However, post-transcriptional control of gene expression also influences phenotype and allows the cell to alter protein expression in a faster and more direct way than is typically possible with transcriptional mechanisms. We sought to demonstrate that post-transcriptional control of gene expression occurs during EC activation. Using thrombin-activated EC and a high-throughput, microarray-based approach, we identified a number of gene products that may be regulated through post-transcriptional mechanisms, including the AP-1 transcription factor JunB. Using polysome profiling, cytoplasts and other standard cell biologic techniques, JunB is shown to be regulated at a post-transcriptional level during EC activation. In activated EC, the AP-1 transcription factor JunB, is regulated on a post-transcriptional level. Signal-dependent control of translation may regulate transcription factor expression and therefore, subsequent transcriptional events in stimulated EC.
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Affiliation(s)
- Douglas I Schmid
- Division of Vascular Surgery, University of Utah Health Sciences Center, Salt Lake City, Utah 84132, USA
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Teixeira-da-Cunha MGA, Gomes RN, Roehrs N, Bozza FA, Prescott SM, Stafforini D, Zimmerman GA, Bozza PT, Castro-Faria-Neto HC. Bacterial clearance is improved in septic mice by platelet-activating factor-acetylhydrolase (PAF-AH) administration. PLoS One 2013; 8:e74567. [PMID: 24069320 PMCID: PMC3771912 DOI: 10.1371/journal.pone.0074567] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Accepted: 08/05/2013] [Indexed: 11/18/2022] Open
Abstract
Current evidence indicates that dysregulation of the host inflammatory response to infectious agents is central to the mortality of patients with sepsis. Strategies to block inflammatory mediators such as PAF have been investigated as adjuvant therapies for sepsis. PAF-AH, the enzyme responsible for PAF degradation, showed positive results in pre-clinical studies and phase II clinical trials, but the results of a phase III study were disappointing. In this study, we investigated the potential protective mechanism of PAF-AH in sepsis using the murine model of cecal ligation and puncture (CLP). Treatment with rPAF-AH increased peritoneal fluid levels of the anti-inflammatory mediators MCP-1/CCL2 after CLP. The numbers of bacteria (CFU) in the peritoneal cavity were decreased in the rPAF-AH-treated group, indicating more efficient bacterial clearance after rPAF-AH treatment. Interestingly, we observed increased levels of nitric oxide (NO) after PAF-AH administration, and rPAF-AH treatment did not decrease CFU numbers either in iNOS-deficient mice or in CCR2-deficient mice. We concluded that administration of exogenous rPAF-AH reduced inflammatory injury, altered cytokine levels and favored bacterial clearance with a clear impact on mortality through modulation of MCP-1/CCL2 and NO levels in a clinically relevant sepsis model.
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Affiliation(s)
| | - Rachel N. Gomes
- Laboratório De Imunofarmacologia, Instituto Oswaldo Cruz, Fiocruz, RJ, Brazil
- Laboratório de Investigação em Medicina Intensiva, IPEC, Fiocruz, RJ, Brazil
- * E-mail:
| | - Nathassia Roehrs
- Laboratório De Imunofarmacologia, Instituto Oswaldo Cruz, Fiocruz, RJ, Brazil
| | - Fernando A. Bozza
- Laboratório de Investigação em Medicina Intensiva, IPEC, Fiocruz, RJ, Brazil
| | - Stephen M. Prescott
- Oklahoma Medical Research Foundation, Oklahoma City, United States of America
| | - Diana Stafforini
- Huntsman Cancer Institute, Salt Lake City, Utah, United States of America
| | - Guy A. Zimmerman
- Program in Human Molecular Biology and Genetics, University of Utah, Salt Lake City, Utah, United States of America
| | - Patricia T. Bozza
- Laboratório De Imunofarmacologia, Instituto Oswaldo Cruz, Fiocruz, RJ, Brazil
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Floyd RA, Castro Faria Neto HC, Zimmerman GA, Hensley K, Towner RA. Nitrone-based therapeutics for neurodegenerative diseases: their use alone or in combination with lanthionines. Free Radic Biol Med 2013; 62:145-156. [PMID: 23419732 PMCID: PMC3715559 DOI: 10.1016/j.freeradbiomed.2013.01.033] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Revised: 01/25/2013] [Accepted: 01/29/2013] [Indexed: 01/12/2023]
Abstract
The possibility of free radical reactions occurring in biological processes led to the development and employment of novel methods and techniques focused on determining their existence and importance in normal and pathological conditions. For this reason the use of nitrones for spin trapping free radicals became widespread in the 1970s and 1980s, when surprisingly the first evidence of their potent biological properties was noted. Since then widespread exploration and demonstration of the potent biological properties of phenyl-tert-butylnitrone (PBN) and its derivatives took place in preclinical models of septic shock and then in experimental stroke. The most extensive commercial effort made to capitalize on the potent properties of the PBN-nitrones was for acute ischemic stroke. This occurred during 1993-2006, when the 2,4-disulfonylphenyl PBN derivative, called NXY-059 in the stroke studies, was shown to be safe in humans and was taken all the way through clinical phase 3 trials and then was deemed to be ineffective. As summarized in this review, because of its excellent human safety profile, 2,4-disulfonylphenyl PBN, now called OKN-007 in the cancer studies, was tested as an anti-cancer agent in several preclinical glioma models and shown to be very effective. Based on these studies this compound is now scheduled to enter into early clinical trials for astrocytoma/glioblastoma multiforme this year. The potential use of OKN-007 in combination with neurotropic compounds such as the lanthionine ketamine esters is discussed for glioblastoma multiforme as well as for various other indications leading to dementia, such as aging, septic shock, and malaria infections. There is much more research and development activity ongoing for various indications with the nitrones, alone or in combination with other active compounds, as briefly noted in this review.
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Affiliation(s)
- Robert A Floyd
- Experimental Therapeutics, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA.
| | | | - Guy A Zimmerman
- Laboratorio de Immunofarmacologia, Instituto Oswaldo Cruz, IOC, Fiocruz, Rio de Janeiro, Brazil; Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Kenneth Hensley
- Department of Pathology and Department of Neurosciences, University of Toledo Medical Center, Toledo, OH
| | - Rheal A Towner
- Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
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Abstract
Platelets are chief effector cells in hemostasis. In addition, they are multifaceted inflammatory cells with functions that span the continuum from innate immune responses to adaptive immunity. Activated platelets have key thromboinflammatory activities in a variety of vascular disorders and vasculopathies. Recently identified inflammatory and immune activities provide insights into the biology of these versatile blood cells that are directly relevant to human vascular diseases.
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Affiliation(s)
- Matthew T Rondina
- Department of Medicine and Program in Molecular Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
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Hottz ED, Oliveira MF, Nunes PCG, Nogueira RMR, Valls-de-Souza R, Da Poian AT, Weyrich AS, Zimmerman GA, Bozza PT, Bozza FA. Dengue induces platelet activation, mitochondrial dysfunction and cell death through mechanisms that involve DC-SIGN and caspases. J Thromb Haemost 2013; 11:951-62. [PMID: 23433144 PMCID: PMC3971842 DOI: 10.1111/jth.12178] [Citation(s) in RCA: 143] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 02/19/2013] [Indexed: 01/28/2023]
Abstract
BACKGROUND Worldwide, dengue is the most prevalent human arbovirus disease. Dengue infection may cause a range of clinical manifestations from self-limiting febrile illness through to a life-threatening syndrome accompanied by both bleeding and shock. Thrombocytopenia is frequently observed in mild and severe disease; however, the mechanisms involved in DENV-induced platelet activation and thrombocytopenia are incompletely understood. PATIENTS AND METHODS Freshly isolated platelets from patients with dengue were evaluated for markers of activation, mitochondrial alteration and activation of cell death pathways. In parallel, we examined direct DENV-induced activation and apoptosis of platelets obtained from healthy subjects. RESULTS We found that platelets from DENV-infected patients exhibited increased activation by comparison to control subjects. Moreover, platelets from DENV-infected patients exhibited classic signs of the intrinsic pathway of apoptosis that include increased surface phosphatidylserine exposure, mitochondrial depolarization and activation of caspase-9 and -3. Indeed, thrombocytopenia was shown to strongly associate with enhanced platelet activation and cell death in DENV-infected patients. Platelet activation, mitochondrial dysfunction and caspase-dependent phosphatidylserine exposure on platelets were also observed when platelets from healthy subjects were directly exposed to DENV in vitro. DENV-induced platelet activation was shown to occur through mechanisms largely dependent on DC-SIGN. CONCLUSIONS Together our results demonstrate that platelets from patients with dengue present signs of activation, mitochondrial dysfunction and activation of the apoptosis caspase cascade, which may contribute to the development of thrombocytopenia in patients with dengue. Our results also suggest the involvement of DC-SIGN as a critical receptor in DENV-dependent platelet activation.
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Affiliation(s)
- Eugenio D. Hottz
- Laboratório de Immunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Laboratório de Immunofarmacologia, Instituto de Pesquisa Clinica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Marcus F. Oliveira
- Instituto de Bioquímica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Priscila C. G. Nunes
- Laboratório de Flavivirus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Rita Maria R. Nogueira
- Laboratório de Flavivirus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Rogério Valls-de-Souza
- Laboratório de Immunofarmacologia, Instituto de Pesquisa Clinica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Andréa T. Da Poian
- Instituto de Bioquímica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Andrew S. Weyrich
- The Molecular Medicine Program, University of Utah, Salt Lake City, UT, United States of America
- Department of Medicine, University of Utah, Salt Lake City, UT, United States of America
| | - Guy A. Zimmerman
- Department of Medicine, University of Utah, Salt Lake City, UT, United States of America
| | - Patricia T. Bozza
- Laboratório de Immunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Fernando A. Bozza
- Laboratório de Immunofarmacologia, Instituto de Pesquisa Clinica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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Franks Z, Campbell RA, Vieira de Abreu A, Holloway JT, Marvin JE, Kraemer BF, Zimmerman GA, Weyrich AS, Rondina MT. Methicillin-resistant Staphylococcus aureus-induced thrombo-inflammatory response is reduced with timely antibiotic administration. Thromb Haemost 2013; 109:684-95. [PMID: 23348831 DOI: 10.1160/th12-08-0543] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 12/15/2012] [Indexed: 11/05/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) induces a pro-thrombotic and pro-inflammatory milieu. Although timely antibiotic administration in MRSAsepsis may improve outcomes by arresting bacterial growth, the effects of antibiotics on mitigating injurious thrombo-inflammatory cellular responses remains unexplored. Using a newly developed human whole blood model and an in vivo mouse model of MRSAinfection, we examined how antibiotics inhibit MRSAinduced thrombo-inflammatory pathways. Human whole blood was inoculated with MRSA. Thrombin generation and inflammatory cytokine synthesis was measured in the presence or absence of linezolid and vancomycin. C57BL/6 mice were injected with MRSA and the effect of vancomycin administration was examined. MRSAaccelerated thrombin generation in a time- and concentration-dependent manner andinduced the release of cytokines, including interleukin (IL)-6, IL-8, and monocyte chemotactic protein (MCP)-1. The increase in thrombin generation and inflammatory responses was mediated through the synthesis of tissue factor and cytokines, respectively, and the release of microparticles. The early administration of antibiotics restored normal thrombin generation patterns and significantly reduced the synthesis of cytokines. In contrast, when antibiotic administration was delayed, thrombin generation and cytokine synthesis were not significantly reduced. In mice infected with MRSA, early antibiotic administration reduced thrombin anti-thrombin complexes and cytokine synthesis, whereas delayed antibiotic administration did not. These data provide novel mechanistic evidence of the importance of prompt antibiotic administration in infectious syndromes.
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Affiliation(s)
- Zechariah Franks
- University of Utah, Department of Internal Medicine, 50 North Medical Drive, Room 4B120, SLC, Utah 84132, USA
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Andrews RK, Aster RH, Atkinson BT, Barnard MR, Bavry AA, Bayer AS, Beaulieu LM, Berndt MC, Berny-Lang MA, Bhatt DL, Bizzaro N, Bledzka K, Bouchard BA, Brass LF, Bray PF, Briggs C, Bussel JB, Cattaneo M, Chakravorty S, Chong BH, Clemetson J, Clemetson KJ, Coller BS, Covic L, Davì G, del Zoppo GJ, Dowling MR, Dubois C, Eisert WG, Evangelista V, Flaumenhaft R, Freedman JE, Freedman J, Frelinger AL, Furie BC, Furie B, Gardiner C, Gawaz M, Geisler T, Greinacher A, Gurbel PA, Harrison P, Hartwig JH, Hayward CP, Hughes CE, Ikeda Y, Israels SJ, Italiano JE, Jackson S, Jain S, Jones CI, Josefsson EC, Kaplan C, Kile BT, Kimura Y, Klement GL, Kolandaivelu K, Kuliopulos A, Kuter DJ, Lambert MP, Langer HF, Lebois M, Levin J, Lordkipanidzé M, Ma YQ, Mannucci PM, McCrae KR, Merrill-Skoloff G, Michelson AD, Moffat KA, Mutch NJ, Newman DK, Newman PE, Ni H, Nieuwland R, Ouwehand WH, Parsons J, Patrono C, Perrotta PL, Pesho MM, Plow EF, Politt AY, Poncz M, Poon MC, Provost P, Psaila B, Rao AK, Rinder HM, Roberts IA, Rondina MT, Ruggeri ZM, Santilli F, Schwertz H, Shai E, Silveira JR, Smith BR, Smith MC, Smyth SS, Snyder EL, Sobel M, Soranzo N, Stalker TJ, Sturk A, Sudo T, Sullivan S, Tantry US, Tefferi A, Tracy PB, Tsai HM, van der Pol E, Varon D, Vazzana N, Vieira-de-Abreu A, Wannemacher K, Ware J, Warkentin TE, Watson SP, Weyrich AS, White JG, Wilcox DA, Yeaman MR, Zhang P, Zhu L, Zimmerman GA. List of Contributors. Platelets 2013. [DOI: 10.1016/b978-0-12-387837-3.00072-9] [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: 11/25/2022]
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Abstract
Platelets and the lungs have an intimate relationship. Platelets are anucleate mammalian blood cells that continuously circulate through pulmonary vessels and that have major effector activities in hemostasis and inflammation. The lungs are reservoirs for megakaryocytes, the requisite precursor cell in thrombopoiesis, which is the intricate process by which platelets are generated. Platelets contribute to basal barrier integrity of the alveolar capillaries, which selectively restricts the transfer of water, proteins, and red blood cells out of the vessels. Platelets also contribute to pulmonary vascular repair. Although platelets bolster hemostatic and inflammatory defense of the healthy lung, experimental evidence and clinical evidence indicate that these blood cells are effectors of injury in a variety of pulmonary disorders and syndromes. Newly discovered biological capacities of platelets are being explored in the context of lung defense, disease, and remodeling.
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Affiliation(s)
- Andrew S. Weyrich
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah 84112
- Program in Molecular Medicine, University of Utah School of Medicine, Salt Lake City, Utah 84112
| | - Guy A. Zimmerman
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah 84112
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Rowley JW, Finn AV, French PA, Jennings LK, Bluestein D, Gross PL, Freedman JE, Steinhubl SR, Zimmerman GA, Becker RC, Dauerman HL, Smyth SS. Cardiovascular devices and platelet interactions: understanding the role of injury, flow, and cellular responses. Circ Cardiovasc Interv 2012; 5:296-304. [PMID: 22511738 DOI: 10.1161/circinterventions.111.965426] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Abstract
The acute respiratory distress syndrome (ARDS) is an important cause of acute respiratory failure that is often associated with multiple organ failure. Several clinical disorders can precipitate ARDS, including pneumonia, sepsis, aspiration of gastric contents, and major trauma. Physiologically, ARDS is characterized by increased permeability pulmonary edema, severe arterial hypoxemia, and impaired carbon dioxide excretion. Based on both experimental and clinical studies, progress has been made in understanding the mechanisms responsible for the pathogenesis and the resolution of lung injury, including the contribution of environmental and genetic factors. Improved survival has been achieved with the use of lung-protective ventilation. Future progress will depend on developing novel therapeutics that can facilitate and enhance lung repair.
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Affiliation(s)
- Michael A Matthay
- Cardiovascular Research Institute and Departments of Medicine and Anesthesia, UCSF, San Francisco, CA, USA.
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Harris ES, Smith TL, Springett GM, Weyrich AS, Zimmerman GA. Leukocyte adhesion deficiency-I variant syndrome (LAD-Iv, LAD-III): molecular characterization of the defect in an index family. Am J Hematol 2012; 87:311-3. [PMID: 22139635 DOI: 10.1002/ajh.22253] [Citation(s) in RCA: 16] [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] [Received: 09/30/2011] [Revised: 11/02/2011] [Accepted: 11/04/2011] [Indexed: 01/07/2023]
Abstract
Leukocyte adhesion deficiencies are rare clinical syndromes of impaired host defense that provide novel insights into regulation of immune and inflammatory responses. Leukocyte adhesion deficiency (LAD)-I variant (LAD-Iv), also called LAD-III, is a unique disorder in which inside-out signaling of β₁, β₂, and β₃ integrins on leukocytes and platelets is disrupted, leading to impaired cellular adhesion, recurrent infections, and bleeding. We originally reported the second patient with this disorder to be identified and characterized the adhesive deficiencies and functional phenotype of this subject's leukocytes. Here, we show that the molecular defect in this index subject is a new mutation in FERMT3 (KINDLIN-3) which encodes KINDLIN-3, a cytoskeletal protein that interacts with the cytoplasmic tails of β₁, β₂, and β₃ integrins and is required for inside-out and outside-in signaling of these heterodimers. We also report clinical features and previously unrecognized defects in cells from a new patient, a sibling of the original subject that we described who carries the same FERMT3 mutation. Mutations in FERMT3 have now been shown to be the basis for LAD-Iv/LAD-III in each of the four original patients or families that established this syndrome, including the family that we describe.
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Affiliation(s)
- Estelle S Harris
- Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.
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Rondina MT, Brewster B, Grissom CK, Zimmerman GA, Kastendieck DH, Harris ES, Weyrich AS. In vivo platelet activation in critically ill patients with primary 2009 influenza A(H1N1). Chest 2012; 141:1490-1495. [PMID: 22383669 DOI: 10.1378/chest.11-2860] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Changes in platelet reactivity during 2009 influenza A(H1N1) (A[H1N1]) have not been characterized. METHODS We prospectively examined platelet activation and cytokine responses in patients with A(H1N1) (n = 20), matched patients with bacterial pneumonia (n = 15), and nonhospitalized, healthy control subjects (n = 10). RESULTS Platelet-monocyte aggregation was higher in patients with A(H1N1) (21.4% ± 4.7%) compared with patients with pneumonia (10.9% ± 3.7%) and control subjects (8.1% ± 4.5%, P < .05). Similarly, PAC-1 (antibody that binds to the active conformation of integrin α(IIb)β(3)) binding to platelets is increased in patients with A(H1N1) (9.5% ± 4.7%) compared with patients with pneumonia (1.0% ± 0.7%) and healthy subjects (0.61% ± 0.15%, P < .10). PAC-1 binding was twofold higher in patients with A(H1N1) with shock vs those without shock. IL-6 levels were elevated in patients with A(H1N1), indicating systemic inflammation consistent with activation of circulating platelets. CONCLUSIONS These findings, derived from a small but documented cohort of patients, demonstrate that platelet activation responses during A(H1N1) are enhanced-exceeding responses in patients with bacterial pneumonia-and provide new evidence that platelets may contribute to inflammatory responses during A(H1N1).
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Affiliation(s)
- Matthew T Rondina
- Division of General Internal Medicine, University of Utah School of Medicine, Salt Lake City; Department of Internal Medicine, and the Program in Molecular Medicine, University of Utah School of Medicine, Salt Lake City.
| | - BreAnna Brewster
- Department of Internal Medicine, and the Program in Molecular Medicine, University of Utah School of Medicine, Salt Lake City
| | - Colin K Grissom
- The Division of Pulmonary and Critical Care Medicine, University of Utah School of Medicine, Salt Lake City; The Intermountain Medical Center, Division of Critical Care, Murray, UT
| | - Guy A Zimmerman
- The Division of Pulmonary and Critical Care Medicine, University of Utah School of Medicine, Salt Lake City
| | - Diana H Kastendieck
- Department of Internal Medicine, and the Program in Molecular Medicine, University of Utah School of Medicine, Salt Lake City
| | - Estelle S Harris
- The Division of Pulmonary and Critical Care Medicine, University of Utah School of Medicine, Salt Lake City
| | - Andrew S Weyrich
- The Division of Pulmonary and Critical Care Medicine, University of Utah School of Medicine, Salt Lake City; Department of Internal Medicine, and the Program in Molecular Medicine, University of Utah School of Medicine, Salt Lake City
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