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de Jong MJM, Depuydt MAC, Schaftenaar FH, Liu K, Maters D, Wezel A, Smeets HJ, Kuiper J, Bot I, van Gisbergen K, Slütter B. Resident Memory T Cells in the Atherosclerotic Lesion Associate With Reduced Macrophage Content and Increased Lesion Stability. Arterioscler Thromb Vasc Biol 2024. [PMID: 38634281 DOI: 10.1161/atvbaha.123.320511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/14/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Tissue resident memory T (TRM) cells are a T-cell subset that resides at the site of prior antigen recognition to protect the body against reoccurring encounters. Besides their protective function, TRM cells have also been implicated in inflammatory disorders. TRM cells are characterized by the expression of CD69 and transcription factors Hobit (homolog of Blimp-1 [B lymphocyte-induced maturation protein 1] in T cells) and Blimp-1. As the majority of T cells in the arterial intima expresses CD69, TRM cells may contribute to the pathogenesis of atherosclerosis as well. Here, we aimed to assess the presence and potential role of TRM cells in atherosclerosis. METHODS To identify TRM cells in human atherosclerotic lesions, a single-cell RNA-sequencing data set was interrogated, and T-cell phenotypes were compared with that of integrated predefined TRM cells. The presence and phenotype of TRM in atherosclerotic lesions was corroborated using a mouse model that enabled tracking of Hobit-expressing TRM cells. To explore the function of TRM cells during atherogenesis, RAG1-/- (RAG1 deficient) LDLr-/- (low-density lipoprotein receptor knockout) mice received a bone marrow transplant from HobitKO/CREBlimp-1flox/flox mice, which exhibit abrogated TRM cell formation, whereafter the mice were fed a Western-type diet for 10 weeks. RESULTS Human atherosclerotic lesions contained T cells that exhibited a TRM cell-associated gene signature. Moreover, a fraction of these T cells clustered together with predefined TRM cells upon integration. The presence of Hobit-expressing TRM cells in the atherosclerotic lesion was confirmed in mice. These lesion-derived TRM cells were characterized by the expression of CD69 and CD49α. Moreover, we demonstrated that this small T-cell subset significantly affects lesion composition, by reducing the amount of intralesional macrophages and increasing collagen content. CONCLUSIONS TRM cells, characterized by the expression of CD69 and CD49α, constitute a minor population in atherosclerotic lesions and are associated with increased lesion stability in a Hobit and Blimp-1 knockout mouse model.
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Affiliation(s)
- M J M de Jong
- Division of Biotherapeutics, Leiden Academic Centre for Drug Research, Leiden University, the Netherlands (M.J.M.d.J., M.A.C.D., F.H.S., K.L., D.M., J.K., I.B., B.S.)
| | - M A C Depuydt
- Division of Biotherapeutics, Leiden Academic Centre for Drug Research, Leiden University, the Netherlands (M.J.M.d.J., M.A.C.D., F.H.S., K.L., D.M., J.K., I.B., B.S.)
| | - F H Schaftenaar
- Division of Biotherapeutics, Leiden Academic Centre for Drug Research, Leiden University, the Netherlands (M.J.M.d.J., M.A.C.D., F.H.S., K.L., D.M., J.K., I.B., B.S.)
| | - K Liu
- Division of Biotherapeutics, Leiden Academic Centre for Drug Research, Leiden University, the Netherlands (M.J.M.d.J., M.A.C.D., F.H.S., K.L., D.M., J.K., I.B., B.S.)
| | - D Maters
- Division of Biotherapeutics, Leiden Academic Centre for Drug Research, Leiden University, the Netherlands (M.J.M.d.J., M.A.C.D., F.H.S., K.L., D.M., J.K., I.B., B.S.)
| | - Anouk Wezel
- Department of Surgery, Haaglanden Medical Center, The Hague, the Netherlands (A.W., H.J.S.)
| | - Harm J Smeets
- Department of Surgery, Haaglanden Medical Center, The Hague, the Netherlands (A.W., H.J.S.)
| | - J Kuiper
- Division of Biotherapeutics, Leiden Academic Centre for Drug Research, Leiden University, the Netherlands (M.J.M.d.J., M.A.C.D., F.H.S., K.L., D.M., J.K., I.B., B.S.)
| | - I Bot
- Division of Biotherapeutics, Leiden Academic Centre for Drug Research, Leiden University, the Netherlands (M.J.M.d.J., M.A.C.D., F.H.S., K.L., D.M., J.K., I.B., B.S.)
| | - K van Gisbergen
- van Gisbergen Lab, Tissue Immunity, Champalimaud Research, Lisbon, Portugal (K.v.G.)
| | - B Slütter
- Division of Biotherapeutics, Leiden Academic Centre for Drug Research, Leiden University, the Netherlands (M.J.M.d.J., M.A.C.D., F.H.S., K.L., D.M., J.K., I.B., B.S.)
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2
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Grievink HW, Smit V, Huisman BW, Gal P, Yavuz Y, Klerks C, Binder CJ, Bot I, Kuiper J, Foks AC, Moerland M. Cardiovascular risk factors: The effects of ageing and smoking on the immune system, an observational clinical study. Front Immunol 2022; 13:968815. [PMID: 36189218 PMCID: PMC9519851 DOI: 10.3389/fimmu.2022.968815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/29/2022] [Indexed: 11/29/2022] Open
Abstract
Currently immunomodulatory compounds are under investigation for use in patients with cardiovascular disease, caused by atherosclerosis. These trials, using recurrent cardiovascular events as endpoint, require enrollment of large patient groups. We investigated the effect of key risk factors for atherosclerosis development, ageing and smoking, on the immune system, with the objective to identify biomarkers differentiating between human populations, and potentially serving as endpoints for future phase 1B trials with immunomodulatory compounds. Blood was collected from young healthy volunteers (aged 18-25 years, n=30), young smokers (18-25 years, n=20), elderly healthy volunteers (>60 years, n=20), heavy smokers (>45 years, 15 packyears, n=11) and patients with stable coronary artery disease (CAD) (>60 years, n=27). Circulating immune cell subsets were characterized by flow cytometry, and collected plasma was evaluated by proteomics (Olink). Clear ageing effects were observed, mostly illustrated by a lower level in CD8+ and naïve CD4+ and CD8+ T cells, with an increase in CD4+ and CD8+ effector memory T cells in elderly healthy volunteers compared to young healthy volunteers. Heavy smokers showed a more inflammatory cellular phenotype, especially a shift in Th1/Th2 ratio: higher Th1 and lower Th2 percentages compared to young healthy volunteers. A significant decrease in circulating atheroprotective oxLDL-specific IgM was found in patients with CAD compared to young healthy volunteers. Elevated pro-inflammatory and chemotactic proteins TREM1 and CCL11 were observed in elderly volunteers compared to young volunteers. In addition, heavy smokers had an increase in pro-inflammatory cytokine IL-6 and lysosomal protein LAMP3. These data show that ageing and smoking are associated with an inflammatory immunophenotype, and that heavy smokers or aged individuals may serve as potential populations for future clinical trials investigating immunomodulatory drugs targeted for cardiovascular disease.
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Affiliation(s)
- H. W. Grievink
- Centre for Human Drug Research, Leiden, Netherlands
- Division of BioTherapeutics, Leiden Academic Center for Drug Research, Leiden University, Leiden, Netherlands
| | - V. Smit
- Division of BioTherapeutics, Leiden Academic Center for Drug Research, Leiden University, Leiden, Netherlands
| | - B. W. Huisman
- Centre for Human Drug Research, Leiden, Netherlands
- Department of Gynecology and Obstetrics, Leiden University Medical Center, Leiden, Netherlands
| | - P. Gal
- Centre for Human Drug Research, Leiden, Netherlands
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, Netherlands
| | - Y. Yavuz
- Centre for Human Drug Research, Leiden, Netherlands
| | - C. Klerks
- Centre for Human Drug Research, Leiden, Netherlands
| | - C. J. Binder
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - I. Bot
- Division of BioTherapeutics, Leiden Academic Center for Drug Research, Leiden University, Leiden, Netherlands
| | - J. Kuiper
- Division of BioTherapeutics, Leiden Academic Center for Drug Research, Leiden University, Leiden, Netherlands
| | - A. C. Foks
- Division of BioTherapeutics, Leiden Academic Center for Drug Research, Leiden University, Leiden, Netherlands
| | - M. Moerland
- Centre for Human Drug Research, Leiden, Netherlands
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, Netherlands
- *Correspondence: M. Moerland,
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3
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Hemme E, Delfos L, Depuydt MAC, Bernabe Kleijn MNA, Schaftenaar FH, Foks AC, Kuiper J, Bot I. Brutons tyrosine kinase inhibition to suppress mast cell activation in atherosclerosis. Cardiovasc Res 2022. [DOI: 10.1093/cvr/cvac066.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Dutch Heart Foundation
Aim
Acute cardiovascular diseases, such as myocardial infarction or stroke, are still a major cause of death in Western Society. The main underlying pathology of cardiovascular diseases is atherosclerosis, which is caused by the accumulation of lipids and inflammatory cells in the vessel wall, in so-called atherosclerotic plaques. Mast cells accumulate within these atherosclerotic plaques and activation of mast cells leads to the progression and destabilization of advanced plaques via the secretion of pro-inflammatory mediators and cytokines. Mast cells can be activated by various stimuli, of which crosslinking of the Fcε receptor I (FcεRI) with IgE-antigen complexes is best known. Bruton’s tyrosine kinase (BTK), a cytoplasmic nonreceptor tyrosine kinase, is involved in the downstream signaling of FcεRI-mediated mast cell activation and degranulation. Therefore, BTK might be an attractive target to interfere in the FcεRI-mediated mast cell activation pathway. In this study, we thus aimed to assess the effects of the BTK inhibitor ACP-196 on FcεRI-mediated mast cell activation, plaque progression and destabilization in an atherosclerotic mouse model.
Methods and Results
Male LDLr knockout mice, 7-11 weeks old, were treated with ACP-196 (25 mg/kg p.o., n=15) or control solvent (n=14) three times per week for eight weeks. During treatment, mice were fed a Western-type diet (WTD) to induce atherosclerotic plaque formation. During the experiment, plasma total cholesterol levels and body weight did not differ between the control and treatment group. After eight weeks, mice were sacrificed and hearts were isolated to determine atherosclerotic plaque size and stability in the aortic root by histology. Other immunological relevant tissues, such as aorta, spleen and mediastinal lymph nodes were harvested to examine mast cell activation status and other immune cells by flow cytometry. After eight weeks of ACP-196 treatment in LDLr knockout mice, a significant 59% reduction in the frequency of CD117+ FcεRI+ mast cells was observed in aortic plaques of ACP-196 treated mice (0.24±0.06%) compared to control mice (0.57±0.08%, p<0.05), while relative mast cell activation status was not affected. Additionally, ACP-196 treatment inhibited B cell maturation in the circulation, spleen, mediastinal lymph nodes and peritoneal cavity of LDLr knockout mice compared to control mice. However, these effects on immune cells did not translate into effects on atherosclerosis, as ACP-196 treatment (size:12.3±2%; collagen:14.5±1.9%) did not significantly affect atherosclerotic plaque size and collagen content when compared to control mice (size:11.5±1.4%; collagen: 13.6±1.5%).
Conclusions
Conclusively, these findings suggest that ACP-196 treatment leads to reduced migration of mast cells to the atherosclerotic plaques of LDLr knockout mice, but does not directly affect mast cell activation and initial atherosclerotic lesion development.
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Affiliation(s)
- E Hemme
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
| | - L Delfos
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
| | - MAC Depuydt
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
| | | | - FH Schaftenaar
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
| | - AC Foks
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
| | - J Kuiper
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
| | - I Bot
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
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4
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De Jong M, Depuydt MAC, Lozano Vigario F, Van Veelen PA, Kuiper J, Slutter BA. Virus specific CD8+ T-cells accumulate, but do not recognize antigen, in the atherosclerotic lesion. Cardiovasc Res 2022. [DOI: 10.1093/cvr/cvac066.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): ERA CVD
Dutch Heart Foundation
Viral infections have been associated with the progression of atherosclerosis. CD8+ T-cells directed against common viruses, such as influenza and Epstein-Barr virus, have been detected inside of human atherosclerotic lesions. These virus specific CD8+ T-cells have been hypothesized to contribute to the development of atherosclerosis, however, their mechanism of action in the atherosclerotic lesion remains unclear. This study aimed to characterize the behavior of virus specific CD8+ T-cells in the atherosclerotic lesion.
The presence of virus specific CD8+ T-cells in atherosclerotic lesions was assessed by performing T-cell receptor (TCR)-β sequencing on human endarterectomy samples and patient matched blood samples (N=10). These TCRs were subsequently compared to known virus specific TCR sequences. Virus specific CD8+ T-cells seemed to accumulate in the atherosclerotic lesion (mean=3.5%), compared to patient matched blood samples (mean=2.0%) (p=0.053). Moreover, these virus specific CD8+ T-cells produced significantly more IFN-γ (p=0.0009) and Granzyme B (p=0.0038) in response to external stimuli, suggesting these T-cells may play a pro-inflammatory role in the pathogenesis of atherosclerosis.
To investigate if virus specific CD8+ T-cells can be stimulated in situ, the immunopeptidome of 51 pooled human plaques was determined and matched with various viral peptidomes. Only one peptide presented in the atherosclerotic lesions matched a viral peptidome, rendering almost all virus specific CD8+ T-cells in the lesion antigen non-specific.
In conclusion, virus specific CD8+ T-cells are enriched in atherosclerotic lesions and have an activated phenotype, compared to other plaque residing CD8+ T-cells. The absence of virus specific antigen presentation in the atherosclerotic lesion suggests that if these CD8+ T-cells contribute to inflammation, they do so in an antigen independent manner.
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Affiliation(s)
- M De Jong
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
| | - MAC Depuydt
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
| | - F Lozano Vigario
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
| | - PA Van Veelen
- Leiden University Medical Center, Proteomics and Metabolomics , Leiden , Netherlands (The)
| | - J Kuiper
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
| | - BA Slutter
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
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5
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De Mol J, Postel R, Smit V, Bernabe Kleijn MNA, Bot I, Kuiper J, Foks AC. B cell depletion skews cd4+ t cell towards a pro-inflammatory phenotype in aged atherosclerotic mice. Cardiovasc Res 2022. [DOI: 10.1093/cvr/cvac066.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Dutch Heart Foundation
ERA CVD
Aims
Aging is associated with changes in the composition and function of the immune system, such as decreased B cell numbers and reduced antibody responses (1). In addition, aging is related to an increased incidence of inflammatory diseases, such as the lipid-driven chronic inflammatory disease atherosclerosis, the main underlying cause of cardiovascular disease (2). B cells play a major role in atherosclerosis progression by antibody secretion, antigen presentation and T cell regulation. Different B cell subsets, with either proatherogenic or antiatherogenic properties, have been identified in atherosclerosis, but the impact of aging on B cells during atherosclerosis remains to be elucidated. In contrast to young atherosclerotic mice where few B cells are found within the plaque, single cell RNA sequencing and flow cytometry data from our group revealed that B cells are one of the most dominant leukocytes present in atherosclerotic aortas from naturally aged LDLr-/- mice. In this study, we aimed to gain further insights into the role of these aged B cells on T cell immunity in atherosclerosis by depleting B cells in aged atherosclerotic mice.
Methods and Results
Aged (85-95 weeks) atherosclerotic male LDLr-/- mice were kept on a chow diet for six weeks, during which the mice received 250 µg B cell-depleting anti-CD20 antibody (Genentech) (n=12) or 250 µg rat IgG2a isotype control (n=12) once a week intraperitoneally. Mice that received the anti-CD20 antibody showed effective B cell depletion in the blood and lymphoid organs, such as the spleen and lymph nodes, but also locally in the atherosclerotic plaque. In addition, B cell depleted mice showed a significant increase in the percentage of T-bet expressing CD4+ T cells in aortic plaques compared to control mice (αCD20: 25.05±2.88% vs. ctrl: 15.94±2.14%, p<0.05). Furthermore, the percentage of RORyt+ and IL-17+ CD4+ T cells in the spleen and heart draining lymph nodes was increased after B cell depletion, indicating a shift towards Th17 differentiation.
Conclusions
Collectively, we show that CD20+ B cell depletion in aged LDLr-/- mice skews CD4+ T cells towards a Th1 phenotype in the atherosclerotic plaque and towards a Th17 phenotype in lymphoid organs, suggesting a protective role for aged B cells in atherosclerosis. However, B cells are a heterogeneous population and further research should elucidate whether aged B cells exert a pro- or anti-atherogenic role. In conclusion, our results indicate that aged B cells have an important function in CD4+ T cell differentiation and could be attractive targets to combat age-related cardiovascular disease.
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Affiliation(s)
- J De Mol
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
| | - R Postel
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
| | - V Smit
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
| | | | - I Bot
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
| | - J Kuiper
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
| | - AC Foks
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
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6
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Depuydt MAC, Smit V, Lozano Vigario F, Bernabe Kleijn MNA, De Vries MR, Quax PHA, Wezel A, Smeets HJ, Kuiper J, Foks AC, Bot I, Slutter B. Granzyme B+ CD4+ T cells associate with an unstable plaque phenotype in advanced human atherosclerosis. Cardiovasc Res 2022. [DOI: 10.1093/cvr/cvac066.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): The Dutch Heart Foundation
Cytotoxic CD4+ T cells have previously been found in peripheral blood of patients with coronary artery disease (1), however their occurrence in atherosclerotic plaques and their association with the pathophysiology of atherosclerosis has not been established.
Single-cell RNA sequencing was performed on human carotid atherosclerotic plaques of 18 patients to identify specific T cell populations (2). Next, human femoral and carotid atherosclerotic plaques (n=95) and matched blood samples (n=49) were analyzed by flow cytometry for the presence of CD4+GZMB+ T cells. Plaque morphology was assessed by Movat’s Pentachrome staining.
A distinct cytotoxic GZMB+ PRF1+ CD28- CD4+ T cell cluster was identified using single-cell RNA sequencing. Furthermore, flow cytometry analysis showed that the percentage of GZMB+CD4+ T cells was significantly elevated in plaque compared to blood (Blood: 12.17±2.0 vs. Plaque: 17.40±1.0; P=0.0002). Moreover, a significant positive correlation was observed between the percentage of GZMB+CD4+ T cells in blood versus plaque (P=0.031). In line with the proinflammatory character of these cells, we found a positive association of GZMB+CD4+ T cells (P=0.036) with necrotic core size, whereas no correlation was found with this subtype in the circulation.
In this study we have shown an enrichment of cytotoxic CD4+ T cells in atherosclerotic lesions, which positively correlate with necrotic core size. Future studies are aimed at elucidating the role of these cells in advanced atherosclerosis.
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Affiliation(s)
- MAC Depuydt
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
| | - V Smit
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
| | - F Lozano Vigario
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
| | | | - MR De Vries
- Leiden University Medical Center, Department of Surgery , Leiden , Netherlands (The)
| | - PHA Quax
- Leiden University Medical Center, Department of Surgery , Leiden , Netherlands (The)
| | - A Wezel
- Haaglanden Medical Center, Department of Surgery , The Hague , Netherlands (The)
| | - HJ Smeets
- Haaglanden Medical Center, Department of Surgery , The Hague , Netherlands (The)
| | - J Kuiper
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
| | - AC Foks
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
| | - I Bot
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
| | - B Slutter
- Leiden Academic Center for Drug Researh , Leiden , Netherlands (The)
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7
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Trivedi R, John J, Ghodke A, Trivedi J, Munigangaiah S, Dheerendra S, Balain B, Ockendon M, Kuiper J. Intrathecal morphine in combination with bupivacaine as pre-emptive analgesia in posterior lumbar fusion surgery: a retrospective cohort study. J Orthop Surg Res 2022; 17:241. [PMID: 35436917 PMCID: PMC9017052 DOI: 10.1186/s13018-022-03124-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 03/31/2022] [Indexed: 11/17/2022] Open
Abstract
Background The purpose of this study was to evaluate the efficacy of intrathecal morphine (ITM) in combination with bupivacaine as pre-emptive analgesia in patients undergoing posterior lumbar fusion surgery. This is in comparison with traditional opioid analgesics such as intravenous (IV) morphine. Methods Two groups were identified retrospectively. The first (ITM group) included patients who had general anaesthesia (GA) with low-dose spinal anaesthesia prior to induction using 1–4 mls of 0.25% bupivacaine and 0.2 mg ITM. 1 ml of 0.25% bupivacaine was administered per hour of predicted surgery time, up to a maximum of 4 ml. The insertion level for the spinal anaesthetic corresponded to the spinal level of the iliac crest line and the level at which the spinal cord terminated. The control group had GA without any spinal anaesthesia. Patients were instead administered opioid analgesia in the form of IV morphine or diamorphine. The primary outcome was the consumption of opioids administered intraoperatively and in recovery, and over the first 48 h following discharge from the post-anaesthesia care unit (PACU). Total opioid dose was measured, and a morphine equivalent dose was calculated. Secondary outcomes included visual analogue scale (VAS) pain scores in recovery and at day two postoperatively, and the length of stay in hospital. Results For the ITM group, the median total amount of IV morphine equivalent administered intraoperatively and in recovery, was 0 mg versus 17 mg. The median total amount morphine equivalent, administered over the first 48 h following discharge from PACU was 20 mg versus 80 mg. Both are in comparison with the control group. The median length of stay was over 1 day less and the median VAS for pain in recovery was 6 points lower. No evidence was found for a difference in the worst VAS for pain at day two postoperatively. Conclusion ITM in combination with bupivacaine results in a significantly decreased use of perioperative opioids. In addition, length of hospital stay is reduced and so too is patient perceived pain intensity. Trial registration The study was approved by the ethics committee at The Robert Jones and Agnes Hunt Orthopaedic Hospital as a service improvement project (Approval no. 1617_004).
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Affiliation(s)
- R Trivedi
- The Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry, SY10 7AG, UK.
| | - J John
- The Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry, SY10 7AG, UK
| | - A Ghodke
- The Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry, SY10 7AG, UK
| | - J Trivedi
- The Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry, SY10 7AG, UK
| | - S Munigangaiah
- The Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry, SY10 7AG, UK
| | - S Dheerendra
- The Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry, SY10 7AG, UK
| | - B Balain
- The Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry, SY10 7AG, UK
| | - M Ockendon
- The Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry, SY10 7AG, UK
| | - J Kuiper
- The Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry, SY10 7AG, UK
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8
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de Vries MR, Ewing MM, de Jong RCM, MacArthur MR, Karper JC, Peters EAB, Nordzell M, Karabina SAP, Sexton D, Dahlbom I, Bergman A, Mitchell JR, Frostegård J, Kuiper J, Ninio E, Jukema JW, Pettersson K, Quax PHA. Identification of IgG1 isotype phosphorylcholine antibodies for the treatment of inflammatory cardiovascular diseases. J Intern Med 2021; 290:141-156. [PMID: 33342002 PMCID: PMC8359267 DOI: 10.1111/joim.13234] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/23/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Phosphorylcholine (PC) is an important pro-inflammatory damage-associated molecular pattern. Previous data have shown that natural IgM anti-PC protects against cardiovascular disease. We aimed to develop a monoclonal PC IgG antibody with anti-inflammatory and anti-atherosclerotic properties. METHODS Using various techniques PC antibodies were validated and optimized. In vivo testing was performed in a femoral artery cuff model in ApoE3*Leiden mice. Safety studies are performed in rats and cynomolgus monkeys. RESULTS A chimeric anti-PC (PC-mAb(T15), consisting of a human IgG1 Fc and a mouse T15/E06 Fab) was produced, and this was shown to bind specifically to epitopes in human atherosclerotic tissues. The cuff model results in rapid induction of inflammatory genes and altered expression of genes associated with ER stress and choline metabolism in the lesions. Treatment with PC-mAb(T15) reduced accelerated atherosclerosis via reduced expression of endoplasmic reticulum stress markers and CCL2 production. Recombinant anti-PC Fab fragments were identified by phage display and cloned into fully human IgG1 backbones creating a human monoclonal IgG1 anti-PC (PC-mAbs) that specifically bind PC, apoptotic cells and oxLDL. Based on preventing macrophage oxLDL uptake and CCL2 production, four monoclonal PC-mAbs were selected, which to various extent reduced vascular inflammation and lesion development. Additional optimization and validation of two PC-mAb antibodies resulted in selection of PC-mAb X19-A05, which inhibited accelerated atherosclerosis. Clinical grade production of this antibody (ATH3G10) significantly attenuated vascular inflammation and accelerated atherosclerosis and was tolerated in safety studies in rats and cynomolgus monkeys. CONCLUSIONS Chimeric anti-PCs can prevent accelerated atherosclerosis by inhibiting vascular inflammation directly and through reduced macrophage oxLDL uptake resulting in decreased lesions. PC-mAb represents a novel strategy for cardiovascular disease prevention.
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Affiliation(s)
- M. R. de Vries
- From theDeptartment of SurgeryLUMCLeidenThe Netherlands
- Einthoven Laboratory for Experimental Vascular MedicineLUMCLeidenThe Netherlands
| | - M. M. Ewing
- From theDeptartment of SurgeryLUMCLeidenThe Netherlands
- Einthoven Laboratory for Experimental Vascular MedicineLUMCLeidenThe Netherlands
- Deptartment of CardiologyLUMCLeidenThe Netherlands
| | - R. C. M. de Jong
- From theDeptartment of SurgeryLUMCLeidenThe Netherlands
- Einthoven Laboratory for Experimental Vascular MedicineLUMCLeidenThe Netherlands
| | - M. R. MacArthur
- Department of Molecular MetabolismHarvard T.H. Chan School of Public HealthBostonMAUSA
| | - J. C. Karper
- From theDeptartment of SurgeryLUMCLeidenThe Netherlands
- Einthoven Laboratory for Experimental Vascular MedicineLUMCLeidenThe Netherlands
| | - E. A. B. Peters
- From theDeptartment of SurgeryLUMCLeidenThe Netherlands
- Einthoven Laboratory for Experimental Vascular MedicineLUMCLeidenThe Netherlands
| | | | - S. A. P. Karabina
- INSERM UMR_S 933Hôpital Armand‐TrousseauSorbonne UniversitéParisFrance
| | | | - I. Dahlbom
- Dept. of MedicineKarolinska University Hospital Huddinge and Karolinska InstitutetStockholmSweden
| | | | - J. R. Mitchell
- Department of Molecular MetabolismHarvard T.H. Chan School of Public HealthBostonMAUSA
| | - J. Frostegård
- Dept. of MedicineKarolinska University Hospital Huddinge and Karolinska InstitutetStockholmSweden
| | - J. Kuiper
- Division of BioTherapeuticsLACDRLeidenThe Netherlands
| | - E. Ninio
- INSERM UMR_S 1166‐ICANGenomics and Pathophysiology of Cardiovascular DiseasesInstitute of Cardiometabolism and NutritionPitié‐Salpêtrière HôpitalSorbonne UniversitéParisFrance
| | - J. W. Jukema
- Einthoven Laboratory for Experimental Vascular MedicineLUMCLeidenThe Netherlands
- Deptartment of CardiologyLUMCLeidenThe Netherlands
| | | | - P. H. A. Quax
- From theDeptartment of SurgeryLUMCLeidenThe Netherlands
- Einthoven Laboratory for Experimental Vascular MedicineLUMCLeidenThe Netherlands
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9
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van der Heijden T, Bot I, Kuiper J. The IL-12 cytokine family in cardiovascular diseases. Cytokine 2019; 122:154188. [DOI: 10.1016/j.cyto.2017.10.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 10/06/2017] [Accepted: 10/10/2017] [Indexed: 12/15/2022]
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10
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Douna H, Smit V, Puijvelde van G, Binder C, Bot I, Kuchroo V, Lichtman A, Kuiper J, Foks A. Tim-1 Mucin Domain-Mutant Mice Display Exacerbated Atherosclerosis. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.074] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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11
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Douna H, Amersfoort J, Schaftenaar F, Bot I, Binder C, Yagita H, van Puijvelde G, Kuiper J, Foks A. Btla Stimulation Protects Against Atherosclerosis By Regulating Follicular B Cells. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.290] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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12
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Van Der Laan S, Slenders L, Depuydt M, Prange K, Granneman L, Elbersen D, Boltjes A, de Jager S, Slütter B, Bot I, Winther M, Kuiper J, Mokry M, Asselbergs F, Pasterkamp G. Mapping Genes To Cardiovascular Susceptibility Loci At A Single-Cell Resolution. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.060] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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13
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Mokry M, Depuydt M, Prange K, Slenders L, Elbersen D, Granneman L, de Jager S, Slütter B, Bot I, de Winther M, Kuiper J, Asselbergs F, van der Laan S, Pasterkamp G. Single Cell Rna-Sequencing Identifies Numerous Cell Sub-Types And Suggests Lineage Plasticity In Human Atherosclerotic Plaques. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.280] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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14
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Benne N, van Duijn J, Vigario FL, Leboux R, van Veelen P, Jiskoot W, Kuiper J, Slütter B. Vaccination with a regulatory t-cell inducing vaccine formulation containing apob100 peptides, reduces atherosclerosis in mice. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.289] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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15
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Kuiper J, Broer J, van der Wouden JC. Association between physical exercise and psychosocial problems in 96 617 Dutch adolescents in secondary education: a cross-sectional study. Eur J Public Health 2019; 28:468-473. [PMID: 29325004 DOI: 10.1093/eurpub/ckx230] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Psychosocial problems negatively affect school performance, social skills and mental development. In recent years, researchers have investigated the relationship between physical activity and psychological health. With this large school-based study, we examined whether physically inactive adolescents and slightly active adolescents experience more psychosocial problems compared with active adolescents. Methods This study is based on the Dutch National Youth Health Monitor. This monitor uses a, school-based, cross-sectional questionnaire conducted among 96 617 adolescents in 2015. To examine the association between physical exercise and psychosocial problems, multi-level linear regression was carried out. Results The weighted average Strengths and Difficulties Questionnaire score of active adolescents was lower than that of inactive adolescents. Adolescents who are inactive had 12% (β = 1.12; 95% CI: 1.10-1.14; P <0 .001) more psychosocial problems compared with active adolescents. Further, inactive adolescents had a higher score on the subscales emotional problems (β = 1.19; 95% CI: 1.17-1.22; P < 0.001) and problems with peers (β = 1.16; 95% CI: 1.14-1.19; P < 0.001). There was no statistical significant difference in total score of the Strengths and Difficulties Questionnaire between active and slightly active adolescents. Conclusion Physically active adolescents have fewer psychosocial problems compared with physically inactive adolescents. Not only is this association significant, but there is an indication that it is also of clinical relevance.
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Affiliation(s)
- J Kuiper
- Department of Epidemiology, Municipal Public Health Service Groningen, Groningen, The Netherlands
| | - J Broer
- Department of Epidemiology, Municipal Public Health Service Groningen, Groningen, The Netherlands
| | - J C van der Wouden
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
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16
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Amersfoort J, Kuiper J, Bot I. Reply to "Lipocalin-2 contributes to experimental atherosclerosis in a stage-dependent manner". Atherosclerosis 2018; 278:323-324. [PMID: 30195727 DOI: 10.1016/j.atherosclerosis.2018.08.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 08/23/2018] [Indexed: 11/30/2022]
Affiliation(s)
- J Amersfoort
- Division of Biotherapeutics, LACDR, Leiden University, Einsteinweg 55, 2333CC, Leiden, the Netherlands.
| | - J Kuiper
- Division of Biotherapeutics, LACDR, Leiden University, Einsteinweg 55, 2333CC, Leiden, the Netherlands
| | - I Bot
- Division of Biotherapeutics, LACDR, Leiden University, Einsteinweg 55, 2333CC, Leiden, the Netherlands
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17
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Even G, Kiss M, Laschet J, Ozvar Kozma M, Simon T, Wigren M, Gaston A, Procopio E, Le Borgne-Moynnier M, Nilsson J, Kuiper J, Nicoletti A, Binder C, Caligiuri G. Vaccination with Prevenar® boosts the production of anti-phosphorylcholine antibodies and protects APOE knockout mice from atherosclerosis. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.903] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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18
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Slütter B, Depuydt M, van Duijn J, Bot I, Wezel A, Koppejan H, Toes R, Kuiper J. Masscytometry identifies CD8 T-cell diversity in human atherosclerotic lesions. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.908] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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19
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Kuiper J, van de Bilt H, Martin U, van Berkel TJC. Uptake, Internalization and Degradation of the Novel Plasminogen Activator Reteplase (BM 06.022) in the Rat. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1649973] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryThe catabolism of the novel plasminogen activator reteplase (BM 06.022) was described. For this purpose BM 06.022 was radiolabelled with l25I or with the accumulating label l25I-tyramine cellobiose (l25I-TC).BM 06.022 was injected at a pharmacological dose of 380 μg/kg b.w. and it was cleared from the plasma in a biphasic manner with a half-life of about 1 min in the α-phase and t1/2of 20-28 min in the β-phase. 28% and 72% of the injected dose was cleared in the α-phase and β-phase, respectively. Initially liver, kidneys, skin, bones, lungs, spleen, and muscles contributed mainly to the plasma clearance. Only liver and the kidneys, however, were responsible for the uptake and subsequent degradation of BM 06.022 and contributed for 75% to the catabolism of BM 06.022. BM 06.022 was degraded in the lysosomal compartment of both organs. Parenchymal liver cells were responsible for 70% of the liver uptake of BM 06.022. BM 06.022 associated rapidly to isolated rat parenchymal liver cells and was subsequently degraded in the lysosomal compartment of these cells. BM 06.022 bound with low-affinity to the parenchymal liver cells (550 nM) and the binding of BM 06.022 could be displaced by t-PA (IC50 5.6 nM), indicating that the low-density lipoprotein receptor-related protein (LRP) could be involved in the binding of BM 06.022. GST-RAP, which is an inhibitor of LRP, could in vivo significantly inhibit the uptake of BM 06.022 in the liver.It is concluded that BM 06.022 is metabolized primarily in the liver and the kidneys. These organs take up and degrade BM 06.022 in the lysosomes. The uptake mechanism of BM 06.022 in the kidneys is unknown, while LRP is responsible for a low-affinity binding and uptake of BM 06.022 in parenchymal liver cells.
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Affiliation(s)
- J Kuiper
- The Division of Biopharmaceutics, Leiden/Amsterdam Center for Drug Research, Sylvius Laboratory, Leiden, The Netherlands
| | - H van de Bilt
- The Division of Biopharmaceutics, Leiden/Amsterdam Center for Drug Research, Sylvius Laboratory, Leiden, The Netherlands
| | - U Martin
- The Dept. of Pharmacology, Boehringer Mannheim, Mannheim, Germany
| | - Th J C van Berkel
- The Division of Biopharmaceutics, Leiden/Amsterdam Center for Drug Research, Sylvius Laboratory, Leiden, The Netherlands
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20
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Kuiper J, Otter M, Voorschuur AH, Zonneveld AJV, Rijken DC, Berkel TJCV. Characterization of the Interaction of a Complex of Tissue-type Plasminogen Activator and Plasminogen Activator Inhibitor Type 1 with Rat Liver Cells. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1649930] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryThe present study was undertaken in order to determine the recognition site for tissue-type plasminogen activator-plasminogen activator inhibitor type 1 [t-PA-PAI-1] complexes in rat liver in vivo and in vitro. After intravenous injection into rats t-PA-PAI-1 complexes were rapidly removed from the plasma and the liver took up 80% of the injected dose. Within the liver parenchymal and endothelial liver cells contributed mainly to the uptake of t-PA-PAI-1, and were responsible for 62% and 24% of the liver uptake, respectively. The interaction of t-PA- PAI-1 with isolated rat parenchymal liver cells was of high affinity (Kd 17 nM). A well-known antagonist of the α2-macroglobulin receptor (α2MR/low-density lipoprotein receptor-related protein (LRP), GST-39kDa protein (GST-39kDaP) efficiently inhibited the binding (IC50 0.7 nM) of t-PA-PAI-1 to rat parenchymal liver cells. The interaction of t-PA-PAI-1 with LRP on rat parenchymal liver cells was not Ca2+-dependent and is most probably mediated by a specific determinant on PAI-1, since an anti-PAI-1 monoclonal antibody inhibited the binding of t-PA-PAI-1, where as free t-PA did not. The binding of t-PA-PAI-1 to rat hepatocytes could not be inhibited by a complex of plasmin and α2-antiplasmin nor by various other ligands of LRP like β-VLDL and lactoferrin. Binding of t-PA-PAI-1 to rat parenchymal liver cells was followed by internalization and subsequent degradation in the lysosomal compartment.It is concluded that parenchymal and endothelial liver cells mediate the removal of t-PA-PAI-1 complexes from the circulation. LRP on rat parenchymal liver cells is responsible for the uptake and degradation of t-PA-PAI-1 and may therefore be important for the regulation of the t-PA levels in the circulation.
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Affiliation(s)
- J Kuiper
- The Division of Biopharmaceutics, Leiden Amsterdam Center for Drug Research, University of Leiden, Leiden, The Netherlands
| | - M Otter
- The Gaubius Laboratory, TNO Prevention and Health, Leiden, The Netherlands
| | - A H Voorschuur
- The Division of Biopharmaceutics, Leiden Amsterdam Center for Drug Research, University of Leiden, Leiden, The Netherlands
| | - A J van Zonneveld
- The Department of Biochemistry, Amsterdam Medical Center, Amsterdam, The Netherlands
| | - D C Rijken
- The Gaubius Laboratory, TNO Prevention and Health, Leiden, The Netherlands
| | - Th J C van Berkel
- The Division of Biopharmaceutics, Leiden Amsterdam Center for Drug Research, University of Leiden, Leiden, The Netherlands
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21
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Amersfoort J, Schaftenaar FH, Douna H, van Santbrink PJ, Kröner MJ, van Puijvelde GHM, Quax PHA, Kuiper J, Bot I. Lipocalin-2 contributes to experimental atherosclerosis in a stage-dependent manner. Atherosclerosis 2018; 275:214-224. [PMID: 29960897 DOI: 10.1016/j.atherosclerosis.2018.06.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 05/15/2018] [Accepted: 06/08/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS Lipocalin-2 (Lcn2) is a glycoprotein which can be secreted by immune cells. Several studies in humans have suggested Lcn2 can be used as a biomarker for the detection of unstable atherosclerotic lesions, partly as it is known to interact with MMP-9. METHODS In this study, we generated Ldlr-/-Lcn2-/- mice to assess the functional role of Lcn2 in different stages of atherosclerosis. Atherosclerotic lesions were characterized through histological analysis and myeloid cell populations were examined using flow cytometry. RESULTS We show that Ldlr-/-Lcn2-/- mice developed larger atherosclerotic lesions during earlier stages of atherosclerosis and had increased circulating Ly6Chi inflammatory monocytes compared to Ldlr-/- mice. Advanced atherosclerotic lesions from Ldlr-/-Lcn2-/- mice had decreased necrotic core area, suggesting Lcn2 deficiency may affect lesion stability. Furthermore, MMP-9 activity was diminished in plaques from Ldlr-/-Lcn2-/- mice. CONCLUSIONS Altogether, these findings suggest that Lcn2 deficiency promotes lesion growth in earlier stages of the disease while it decreases MMP-9 activity and necrotic core size in advanced atherosclerosis.
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Affiliation(s)
- J Amersfoort
- Division of Biotherapeutics, LACDR, Leiden University, Einsteinweg 55, 2333CC, Leiden, The Netherlands.
| | - F H Schaftenaar
- Division of Biotherapeutics, LACDR, Leiden University, Einsteinweg 55, 2333CC, Leiden, The Netherlands
| | - H Douna
- Division of Biotherapeutics, LACDR, Leiden University, Einsteinweg 55, 2333CC, Leiden, The Netherlands
| | - P J van Santbrink
- Division of Biotherapeutics, LACDR, Leiden University, Einsteinweg 55, 2333CC, Leiden, The Netherlands
| | - M J Kröner
- Division of Biotherapeutics, LACDR, Leiden University, Einsteinweg 55, 2333CC, Leiden, The Netherlands
| | - G H M van Puijvelde
- Division of Biotherapeutics, LACDR, Leiden University, Einsteinweg 55, 2333CC, Leiden, The Netherlands
| | - P H A Quax
- Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2333ZA, Leiden, The Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - J Kuiper
- Division of Biotherapeutics, LACDR, Leiden University, Einsteinweg 55, 2333CC, Leiden, The Netherlands
| | - I Bot
- Division of Biotherapeutics, LACDR, Leiden University, Einsteinweg 55, 2333CC, Leiden, The Netherlands
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22
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Van Ingen E, Foks AC, Kroner MJ, Agrawal S, Kuiper J, Quax PHA, Bot I, Nossent AY. 222Inhibition of microRNA-494 halts atherosclerotic plaque progression and stabilizes advanced atherosclerotic lesions. Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy060.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- E Van Ingen
- Leiden University Medical Center, Vascular Surgery, Leiden, Netherlands
| | - A C Foks
- Leiden Academic Center for Drug Researh, Leiden, Netherlands
| | - M J Kroner
- Leiden Academic Center for Drug Researh, Leiden, Netherlands
| | - S Agrawal
- Idera Pharmaceuticals, Boston, United States of America
| | - J Kuiper
- Leiden Academic Center for Drug Researh, Leiden, Netherlands
| | - PHA Quax
- Leiden University Medical Center, Vascular Surgery, Leiden, Netherlands
| | - I Bot
- Leiden Academic Center for Drug Researh, Leiden, Netherlands
| | - A Y Nossent
- Leiden University Medical Center, Vascular Surgery, Leiden, Netherlands
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23
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van der Kaaden ME, Groeneveld E, Barrett-Bergshoeff MM, van Berkel TJC, Kuiper J, Rijken DC. Characterization of the Binding of Urokinase-Type Plasminogen Activator to the Asialoglycoprotein Receptor. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1613158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryIn order to study the role of the asialoglycoprotein receptor (ASGPr) in the rapid plasma clearance of urokinase-type plasminogen activator (u-PA), a microtiter plate binding assay was developed using ASGPr purified from rat liver extracts. Urinary two-chain u-PA bound to immobilized ASGPr in a saturable manner with an EC50 of 0.2 µM. Binding was inhibited by rabbit antibodies against the ASGPr. In line with the known carbohydrate specificity of the ASGPr, GalNAc proved to be the most effective inhibitor from a series of monosaccharides, followed by Gal and Fuc, whereas GlcNAc was ineffective. The N-linked oligosaccharides of urinary u-PA do not terminate with the common Gal-GlcNAc element, but with a GalNAc-GlcNAc element which is partially sulfated. Sulfated forms of u-PA were separated from non-sulfated forms by using the lectin Wisteria floribunda agglutinin. Only the non-sulfated forms of u-PA (30% of the total) appeared to bind to the ASGPr. From different u-PA preparations used for thrombolytic therapy only urinary u-PA and u-PA produced by kidney cell cultures strongly bound to the ASGPr, whereas (recombinant) u-PA expressed in mouse myeloma cells, Chinese hamster ovary cells or E. coli scarcely bound to the receptor. It is concluded that u-PA bearing non-sulfated GalNAc-GlcNAc elements is specifically recognized by the ASGPr present on liver cells.
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Foks AC, Kuiper J. Immune checkpoint proteins: exploring their therapeutic potential to regulate atherosclerosis. Br J Pharmacol 2017; 174:3940-3955. [PMID: 28369782 DOI: 10.1111/bph.13802] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 02/17/2017] [Accepted: 03/15/2017] [Indexed: 12/23/2022] Open
Abstract
The immune system provides a large variety of immune checkpoint proteins, which involve both costimulatory and inhibitory proteins. Costimulatory proteins can promote cell survival, cell cycle progression and differentiation to effector and memory cells, whereas inhibitory proteins terminate these processes to halt ongoing inflammation. Immune checkpoint proteins play a pivotal role in atherosclerosis by regulating the activation and proliferation of various immune and non-immune cells, such as T-cells, macrophages and platelets. Upon activation within the atherosclerotic lesions or in secondary lymphoid organs, these cells produce large amounts of pro-atherogenic cytokines that contribute to the growth and destabilization of lesions, which can result in rupture of the lesion causing acute coronary syndromes, such as a myocardial infarction. Given the presence and regulatory capacity of immune checkpoint proteins in the circulation and atherosclerotic lesions of cardiovascular patients, modulation of these proteins by, for example, the use of monoclonal antibodies, offers unique opportunities to regulate pro-inflammatory immune responses in atherosclerosis. In this review, we highlight the latest advances on the role of immune checkpoint proteins, such as OX40-OX40L, CTLA-4 and TIM proteins, in atherosclerosis and discuss their therapeutic potential as promising immunotherapies to treat or prevent cardiovascular disease. LINKED ARTICLES This article is part of a themed section on Targeting Inflammation to Reduce Cardiovascular Disease Risk. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.22/issuetoc and http://onlinelibrary.wiley.com/doi/10.1111/bcp.v82.4/issuetoc.
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Affiliation(s)
- A C Foks
- Division of Biopharmaceutics, LACDR, Leiden University, Leiden, The Netherlands
| | - J Kuiper
- Division of Biopharmaceutics, LACDR, Leiden University, Leiden, The Netherlands
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25
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Tsiantoulas D, Bot I, Kiss M, Bartolini-Gritti B, Göderle L, Ozsvar-Kozma M, Perkmann T, Hartvigsen K, Bergthaler A, Conrad D, Kuiper J, Mallat Z, Jumaa H, Binder C. Deficiency of secreted IgM antibodies causes increased plasma IgE levels that promote atherosclerosis. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.097] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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26
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Heintjes E, Kuiper J, Lucius B, Penning-van Beest F, Kutikova L, Liem A, Herings R. Clinical characteristics and LDL-cholesterol management in patients with cardiovascular event and/or diabetes in the Netherlands. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.270] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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27
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Frodermann V, van Duijn J, van Puijvelde GHM, van Santbrink PJ, Lagraauw HM, de Vries MR, Quax PHA, Bot I, Foks AC, de Jager SCA, Kuiper J. Heat-killed Staphylococcus aureus reduces atherosclerosis by inducing anti-inflammatory macrophages. J Intern Med 2016; 279:592-605. [PMID: 26914137 DOI: 10.1111/joim.12484] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Staphylococcus aureus cell wall components can induce IL-10 responses by immune cells, which may be atheroprotective. Therefore, in this study, we investigated whether heat-killed S. aureus (HK-SA) could inhibit the development of atherosclerosis. METHODS Atherosclerosis-susceptible LDL receptor-deficient mice were administered intraperitoneal HK-SA twice weekly and fed a Western-type diet for 6 weeks. RESULTS HK-SA administration resulted in a 1.6-fold increase in IL-10 production by peritoneal macrophages and splenocytes, and a 12-fold increase in serum IL-10 levels. Moreover, aortic plaque ICAM-1, VCAM-1 and CCL2 expression levels were significantly downregulated by on average 40%. HK-SA-treated mice had reduced numbers of inflammatory Ly-6C(hi) monocytes as well as Th1 and Th17 cells in the circulation and spleen, respectively. Attenuated leucocyte recruitment resulted in a significant inhibition of macrophage and T cell infiltration in atherosclerotic plaques, culminating in a significant 34% reduction in the development of atherosclerosis. To determine the effects of intraperitoneal HK-SA treatment, we stimulated macrophages with HK-SA in vitro. This resulted in a significant toll-like receptor 2 (TLR2)-dependent increase in IL-10, arginase-1, iNOS, TNF-α, PD-L1, CCL22 and indoleamine 2,3-dioxygenase expression. It was found that phosphoinositide 3-kinase crucially determined the balance of pro- and anti-inflammatory gene expression. The HK-SA-induced macrophage phenotype resembled M2b-like immunoregulatory macrophages. CONCLUSIONS We have shown that HK-SA treatment induces strong anti-inflammatory IL-10 responses by macrophages, which are largely dependent on TLR2 and PI3K, and protects against the development of atherosclerosis. Commensalism with S. aureus could thus reduce cardiovascular events.
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Affiliation(s)
- V Frodermann
- Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - J van Duijn
- Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - G H M van Puijvelde
- Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - P J van Santbrink
- Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - H M Lagraauw
- Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - M R de Vries
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.,Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - P H A Quax
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.,Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - I Bot
- Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - A C Foks
- Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - S C A de Jager
- Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands.,Laboratory for Experimental Cardiology and Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J Kuiper
- Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
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Van Der Woude D, Hermans M, van der Velden D, Trouw L, Huizinga T, Kuiper J, Schalij M, Jukema W, Toes R. AB0086 Anti-Citrullinated Protein Antibodies in Patients with Cardiovascular Disease without RA. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Vromen T, Kraal JJ, Kuiper J, Spee RF, Peek N, Kemps HM. The influence of training characteristics on the effect of aerobic exercise training in patients with chronic heart failure: A meta-regression analysis. Int J Cardiol 2016; 208:120-7. [PMID: 26849686 DOI: 10.1016/j.ijcard.2016.01.207] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 01/18/2016] [Accepted: 01/22/2016] [Indexed: 11/26/2022]
Abstract
Although aerobic exercise training has shown to be an effective treatment for chronic heart failure patients, there has been a debate about the design of training programs and which training characteristics are the strongest determinants of improvement in exercise capacity. Therefore, we performed a meta-regression analysis to determine a ranking of the individual effect of the training characteristics on the improvement in exercise capacity of an aerobic exercise training program in chronic heart failure patients. We focused on four training characteristics; session frequency, session duration, training intensity and program length, and their product; total energy expenditure. A systematic literature search was performed for randomized controlled trials comparing continuous aerobic exercise training with usual care. Seventeen unique articles were included in our analysis. Total energy expenditure appeared the only training characteristic with a significant effect on improvement in exercise capacity. However, the results were strongly dominated by one trial (HF-action trial), accounting for 90% of the total patient population and showing controversial results compared to other studies. A repeated analysis excluding the HF-action trial confirmed that the increase in exercise capacity is primarily determined by total energy expenditure, followed by session frequency, session duration and session intensity. These results suggest that the design of a training program requires high total energy expenditure as a main goal. Increases in training frequency and session duration appear to yield the largest improvement in exercise capacity.
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Affiliation(s)
- T Vromen
- Department of Medical Informatics, Academic Medical Center, Amsterdam, the Netherlands; Department of Cardiology, Maxima Medical Center, Veldhoven, the Netherlands.
| | - J J Kraal
- Department of Medical Informatics, Academic Medical Center, Amsterdam, the Netherlands
| | - J Kuiper
- Department of Epidemiology, University Medical Center Groningen, Groningen, the Netherlands
| | - R F Spee
- Department of Cardiology, Maxima Medical Center, Veldhoven, the Netherlands
| | - N Peek
- Department of Medical Informatics, Academic Medical Center, Amsterdam, the Netherlands; MRC Health eResearch Centre, University of Manchester, Manchester, United Kingdom
| | - H M Kemps
- Department of Medical Informatics, Academic Medical Center, Amsterdam, the Netherlands; Department of Cardiology, Maxima Medical Center, Veldhoven, the Netherlands
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de Vries M, Wezel A, Maassen J, Kip P, Peters H, Karper J, Kuiper J, Bot I, Quax P. RP105 deficiency aggravates vein graft disease and lesion instability via increased inflammation and mast cell activation. Atherosclerosis 2015. [DOI: 10.1016/j.atherosclerosis.2015.04.108] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Affiliation(s)
- J. Kuiper
- Biologisch Laboratorium; vakgroep Biosystematiek Vrije Universiteit; De Boelelaan 1087 1081 HV Amsterdam
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van Dijk RA, Duinisveld AJF, Schaapherder AF, Mulder-Stapel A, Hamming JF, Kuiper J, de Boer OJ, van der Wal AC, Kolodgie FD, Virmani R, Lindeman JHN. A change in inflammatory footprint precedes plaque instability: a systematic evaluation of cellular aspects of the adaptive immune response in human atherosclerosis. J Am Heart Assoc 2015; 4:jah3876. [PMID: 25814626 PMCID: PMC4579929 DOI: 10.1161/jaha.114.001403] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background Experimental studies characterize adaptive immune response as a critical factor in the progression and complications of atherosclerosis. Yet, it is unclear whether these observations translate to the human situation. This study systematically evaluates cellular components of the adaptive immune response in a biobank of human aortas covering the full spectrum of atherosclerotic disease. Methods and Results A systematic analysis was performed on 114 well‐characterized perirenal aortic specimens with immunostaining for T‐cell subsets (CD3/4/8/45RA/45RO/FoxP3) and the Th1/non‐Th1/Th17 ratio (CD4+T‐bet+/CD4+T‐bet−/CD4+/interleukin‐17+ double staining). CD20 and CD138 were used to identify B cells and plasma cells, while B‐cell maturation was evaluated by AID/CD21 staining and expression of lymphoid homeostatic CXCL13. Scattered CD4 and CD8 cells with a T memory subtype were found in normal aorta and early, nonprogressive lesions. The total number of T cells increases in progressive atherosclerotic lesions (≈1:5 CD4/CD8 T‐cell ratio). A further increase in medial and adventitial T cells is found upon progression to vulnerable lesions. This critical stage is further hallmarked by de novo formation of adventitial lymphoidlike structures containing B cells and plasma cells, a process accompanied by transient expression of CXCL13. A dramatic reduction of T‐cell subsets, disappearance of lymphoid structures, and loss of CXCL13 expression characterize postruptured lesions. FoxP3 and Th17 T cells were minimally present throughout the atherosclerotic process. Conclusions Transient CXCL13 expression, restricted presence of B cells in human atherosclerosis, along with formation of nonfunctional extranodal lymphoid structures in the phase preceding plaque rupture, indicates a “critical” change in the inflammatory footprint before and during plaque destabilization.
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Affiliation(s)
- R A van Dijk
- Department of Vascular Surgery, Leiden University Medical Center, Leiden, The Netherlands (D., D., M.S., H., L.)
| | - A J F Duinisveld
- Department of Vascular Surgery, Leiden University Medical Center, Leiden, The Netherlands (D., D., M.S., H., L.)
| | - A F Schaapherder
- Department of Transplantation Surgery, Leiden University Medical Center, Leiden, The Netherlands (S.)
| | - A Mulder-Stapel
- Department of Vascular Surgery, Leiden University Medical Center, Leiden, The Netherlands (D., D., M.S., H., L.)
| | - J F Hamming
- Department of Vascular Surgery, Leiden University Medical Center, Leiden, The Netherlands (D., D., M.S., H., L.)
| | - J Kuiper
- Gorlaeus Laboratories, Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden, The Netherlands (K.)
| | - O J de Boer
- Department of Pathology, Academic Medical Center, Amsterdam, The Netherlands (B., W.)
| | - A C van der Wal
- Department of Pathology, Academic Medical Center, Amsterdam, The Netherlands (B., W.)
| | - F D Kolodgie
- CVPath Institute Inc., Gaithersburg, MD (K., V.)
| | - R Virmani
- CVPath Institute Inc., Gaithersburg, MD (K., V.)
| | - J H N Lindeman
- Department of Vascular Surgery, Leiden University Medical Center, Leiden, The Netherlands (D., D., M.S., H., L.)
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Abstract
Rupture of an atherosclerotic plaque is the major underlying cause of adverse cardiovascular events such as myocardial infarction or stroke. Therapeutic interventions should therefore be directed towards inhibiting growth of atherosclerotic lesions as well as towards prevention of lesion destabilization. Interestingly, the presence of mast cells has been demonstrated in both murine and human plaques, and multiple interventional murine studies have pointed out a direct role for mast cells in early and late stages of atherosclerosis. Moreover, it has recently been described that activated lesional mast cells correlate with major cardiovascular events in patients suffering from cardiovascular disease. This review focuses on the effect of different mast cell derived mediators in atherogenesis and in late stage plaque destabilization. Also, possible ligands for mast cell activation in the context of atherosclerosis are discussed. Finally, we will elaborate on the predictive value of mast cells, together with therapeutic implications, in cardiovascular disease.
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Affiliation(s)
| | | | | | - I Bot
- Ilze Bot, Division of Biopharmaceutics, Leiden Academic Centre for Drug Research Gorlaeus Laboratories, Leiden University Einsteinweg 55, 2333 CC, Leiden, The Netherlands, Tel. +31/(0)71/527 62 13, E-mail:
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Kuiper J, Hendriks L, Buijs E, De Langen J, Bahce I, Thunnissen E, Heideman D, Speel E, Dingemans A, Smit E. Leptomeningeal Metastases in Non-Small Cell Lung Cancer Patients with an Epidermal Growth Factor Receptor Mutation. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu349.53] [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: 11/14/2022] Open
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Wezel A, Welten S, Razawy W, Lagraauw M, de Vries M, Kandimalla E, Kuiper J, Quax P, Bot I, Nossent Y. 14q32 microrna inhibition reduces atherosclerotic lesion formation, increases plaque stability and lowers cholesterol levels. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.088] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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De Jager SCA, Van Pijvelde GH, Anas AA, Bot M, Asbach M, Habets KLL, Foks AC, Pasterkamp G, Van Der Poll T, Kuiper J. 36Leukocyte TLR5 deficiency inhibits atherosclerosis by reduced macrophage recruitment and defective T cell responsiveness. Cardiovasc Res 2014. [DOI: 10.1093/cvr/cvu078.2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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van der Velden D, Willems S, Quax PH, de Borst GJ, de Vries J, Moll FL, Kuiper J, Toes RE, de Jager SC, de Kleijn DP, Hoefer IE, Pasterkamp G, Bot I. Abstract 475: Circulating Immunoglobulins Are Not Associated With Intraplaque Mast Cell Number and Other Vulnerable Plaque Characteristics in Patients With Carotid Artery Stenosis. Arterioscler Thromb Vasc Biol 2014. [DOI: 10.1161/atvb.34.suppl_1.475] [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
Background:
Atherosclerosis is a chronic systemic inflammatory disease in which many immune cells participate. Recently we have shown that mast cell numbers are associated with atherosclerotic plaque vulnerability and interestingly with future cardiovascular events (S. Willems et.al. 2013). The endogenous trigger that activates mast cells within the lesion remains unidentified. We hypothesized that mast cells are activated via receptors for IgG and/or IgE.
In this study we aimed to establish whether specific immunoglobulin levels in plasma of atherosclerotic patients were related to intraplaque mast cell numbers. In addition, the levels were related to other vulnerable plaque characteristics and baseline clinical data.
Results:
Serum levels of total IgG, total IgE and oxLDL specific IgG were determined in 135 patients that underwent carotid endarterectomy. The studied patient population with a mean age of 67 and a male prevalence (71%) reflects a relatively typical population of patients with vascular occlusive diseases. The majority of patients were symptomatic (74%) as illustrated by the incidence of amaurosis fugax, a TIA or a stroke.
No associations were observed between either the serum immunoglobulin levels or the total mast cell numbers in atherosclerotic plaques (total IgG vs. total mast cells r= -0,038, p=0.664) (tIgE vs total mast cells r=-0.038, p=0.664) (oxLDL-IgG vs total mast cells r=0.137 p=0.114). Furthermore, no associations were found between immunoglobulin levels and the following plaque characteristics: lipid core size, degree of calcification, number of macrophages or smooth muscle cells, amount of collagen and number of microvessels.
Interestingly, we observed a negative association between statin use and total IgE (97.5 [43.1-276.8] vs. 157.3 [75.2-545.4] ng/mL, p=0.012) and statin use and oxLDL-IgG (288 [224-406] vs. 399 [282-584] mU/mL, p=0.004).
Conclusions:
In patients suffering from carotid artery disease, total IgG or IgE and oxLDL-IgG levels do not associate with plaque mast cell numbers or vulnerable plaque histopathological characteristics These data may indicate that other endogenous factors activate mast cells within the atherosclerotic plaque.
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Affiliation(s)
| | | | - P H Quax
- Dept of Surgery, LUMC, Leiden, Netherlands
| | - G J de Borst
- Dept of Vascular Surgery, UMCU, Utrecht, Netherlands
| | - J.P.P.M. de Vries
- Dept of Vascular Surgery, St. Antonius Hosp, Nieuwegein, Netherlands
| | - F L Moll
- Dept of Surgery, UMCU, Utrecht, Netherlands
| | - J Kuiper
- LACDR, Leiden Univ, Leiden, Netherlands
| | - R E Toes
- Dept of Rheumatology, LUMC, Leiden, Netherlands
| | | | | | - I E Hoefer
- Dept of Surgery, UMCU, Utrecht, Netherlands
| | | | - I Bot
- LACDR, Leiden Univ, Leiden, Netherlands
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38
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Karper J, De Jager SCA, Ewing MM, De Vries MR, Arens R, Bot I, Jukema JW, Kuiper J, Quax P. RP105 (cd180) as a TLR-4 regulator ameliorates atherosclerosis via its role on B-cells. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p2389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Karper JC, de Jager SCA, Ewing MM, de Vries MR, Bot I, van Santbrink PJ, Redeker A, Mallat Z, Binder CJ, Arens R, Jukema JW, Kuiper J, Quax PHA. An unexpected intriguing effect of Toll-like receptor regulator RP105 (CD180) on atherosclerosis formation with alterations on B-cell activation. Arterioscler Thromb Vasc Biol 2013; 33:2810-7. [PMID: 24115036 DOI: 10.1161/atvbaha.113.301882] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [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: 12/17/2022]
Abstract
OBJECTIVE In atherosclerosis, Toll-like receptors (TLRs) are traditionally linked to effects on tissue macrophages or foam cells. RP105, a structural TLR4 homolog, is an important regulator of TLR signaling. The effects of RP105 on TLR signaling vary for different leukocyte subsets known to be involved in atherosclerosis, making it unique in its role of either suppressing (in myeloid cells) or enhancing (in B cells) TLR-regulated inflammation in different cell types. We aimed to identify a role of TLR accessory molecule RP105 on circulating cells in atherosclerotic plaque formation. APPROACH AND RESULTS Irradiated low density lipoprotein receptor deficient mice received RP105(-/-) or wild-type bone marrow. RP105(-/-) chimeras displayed a 57% reduced plaque burden. Interestingly, total and activated B-cell numbers were significantly reduced in RP105(-/-) chimeras. Activation of B1 B cells was unaltered, suggesting that RP105 deficiency only affected inflammatory B2 B cells. IgM levels were unaltered, but anti-oxidized low-density lipoprotein and anti-malondialdehyde-modified low-density lipoprotein IgG2c antibody levels were significantly lower in RP105(-/-) chimeras, confirming effects on B2 B cells rather than B1 B cells. Moreover, B-cell activating factor expression was reduced in spleens of RP105(-/-) chimeras. CONCLUSIONS RP105 deficiency on circulating cells results in an intriguing unexpected TLR-associated mechanisms that decrease atherosclerotic lesion formation with alterations on proinflammatory B2 B cells.
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Affiliation(s)
- J C Karper
- From the Department of Surgery (J.C.K., M.M.E., M.R.d.V., J.W.J., P.H.A.Q.), Einthoven Laboratory for Experimental Vascular Medicine (J.C.K., M.M.E., M.R.d.V., P.H.A.Q.), Department of Cardiology (M.M.E., J.W.J.), and Department of Immunohematology and Blood Transfusion (A.R., R.A.), Leiden University Medical Center, Leiden, The Netherlands; Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands (S.C.A.d.J.); Division of Biopharmaceutics, Leiden Amsterdam Center for Drug Research, Leiden University, Leiden, The Netherlands (S.C.A.d.J., I.B., P.J.v.S., J.K.); Inserm U970, Paris Cardiovascular Research Center, Paris, France (Z.M.); Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria (C.J.B.); and Center for Molecular Medicine (CeMM) of the Austrian Academy of Sciences, Vienna, Austria (C.J.B.)
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Hall S, Kuiper J, Hardaway B. Outpatient Inotropes: An Ever-Lengthening Bridge to Transplant. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.388] [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: 11/30/2022] Open
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Abstract
Elliott traps are widely used in Australia to capture small terrestrial mammals. However, in some situations non-target species disturb the traps, resulting in fewer traps being available for the target species. This situation occurred on Faure Island Wildlife Sanctuary (Western Australia) where boodies (burrowing bettongs) were disturbing the Elliott traps deployed to monitor populations of shark bay mice and western barred bandicoots. This note presents the method used to alleviate this problem on Faure Island but would be more widely applicable in other situations where Elliott traps are disturbed by animals other than the target species.
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Abstract
The treatment of atherosclerosis is currently based on lipid lowering in combination with anti-inflammatory therapies that slow the progression of atherosclerosis. Still, we are not able to fully inhibit the formation or progression of atherosclerotic lesions. A very effective strategy in other disease pathologies is vaccination, in which the body is challenged with the culprit protein or micro-organism in order to create a highly specific humoral immune-response. Immunisation can typically be divided into active or passive immunisation. Active immunisation occurs naturally when the body is exposed to certain microbes or antigens, but also artificially in the case of vaccination. Exposure to a microbe or antigen will result in the production of (antigen specific) antibodies. Passive immunisation is defined as the transfer of humoral immunity (as a result of antibody transfer). Another mechanism to ensure immune-protection is tolerance induction. Immune tolerance occurs naturally to prevent immune responses to 'self-antigens', but can also be induced to non-self antigens. Acquired tolerance to foreign antigens is accompanied by suppression of cellular and/or humoral immune response to the introduced antigen. In its most effective way, vaccination can result in a lifelong protection against the targeted pathology, and therefore the development of an atherosclerosis-specific vaccination is of high importance in the future prevention of atherosclerosis. One of the difficulties in developing effective vaccination strategies for atherosclerosis is the selection of a specific antigen to target. So far vaccination strategies have been based on targeting of lipid-antigens, inflammation-derived antigens, and recently cell-based vaccination strategies have been employed; but also the cardiovascular 'side-effects' of infection-based vaccines are worthy of our attention. This review describes the current status-quo on classical antibody associated vaccination strategies but also includes promising immune-modulation approaches that may lead to a clinical application.
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Affiliation(s)
- S C A de Jager
- Dept. of Biopharmaceutics, Leiden/Amsterdam Center for Drug Research, Leiden University, Leiden, The Netherlands.
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Foks A, Frodermann V, ter Borg M, Habets K, Bot I, Zhao Y, van Eck M, van Berkel T, Kuiper J, van Puijvelde G. Differential effects of regulatory T cells on the initiation and regression of atherosclerosis. Atherosclerosis 2011; 218:53-60. [DOI: 10.1016/j.atherosclerosis.2011.04.029] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2010] [Revised: 04/08/2011] [Accepted: 04/21/2011] [Indexed: 02/09/2023]
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Wezel A, De Vries M, Schepers A, Kuiper J, Bot I, Quax P. Complement-factor C5a modulates vein graft remodeling and accelerated atherosclerosis via interference in Mast cell activation. Mol Immunol 2011. [DOI: 10.1016/j.molimm.2011.06.305] [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: 11/29/2022]
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45
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Foks A, van Puijvelde G, Hoekstra M, Kuiper J. Regulatory T cells reduce inflammation and hypercholesterolemia induced by Western-type diet. Atherosclerosis 2010. [DOI: 10.1016/j.atherosclerosis.2010.08.027] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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van Es T, van Puijvelde GHM, Foks AC, Habets KLL, Bot I, Gilboa E, Van Berkel TJC, Kuiper J. Vaccination against Foxp3(+) regulatory T cells aggravates atherosclerosis. Atherosclerosis 2009; 209:74-80. [PMID: 19765709 DOI: 10.1016/j.atherosclerosis.2009.08.041] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2009] [Revised: 08/20/2009] [Accepted: 08/21/2009] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Regulatory T cells are crucial for immune homeostasis and an impaired regulatory T cell function results in many pathological conditions. Regulatory T cells have already been described to be protective in atherosclerosis. However the exact contribution of Foxp3-expressing natural regulatory T cells in atherosclerosis has not been elucidated yet. METHODS AND RESULTS In this study we vaccinated LDL receptor deficient mice with dendritic cells which are transfected with Foxp3 encoding mRNA and studied the effect on initial atherosclerosis. Vaccination against Foxp3 resulted in a reduction of Foxp3(+) regulatory T cells in several organs and in an increase in initial atherosclerotic lesion formation. Furthermore we observed an increase in plaque cellularity and increased T cell proliferation in the Foxp3 vaccinated mice. CONCLUSION We further establish the protective role of Tregs in atherosclerosis. The results illustrate the important role for Foxp3-expressing regulatory T cells in atherosclerosis, thereby providing a potential opportunity for therapeutic intervention against this disease.
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Affiliation(s)
- T van Es
- Division of Biopharmaceutics, Leiden University, Leiden, The Netherlands
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van Es T, van Puijvelde GHM, Ramos OH, Segers FME, Joosten LA, van den Berg WB, Michon IM, de Vos P, van Berkel TJC, Kuiper J. Attenuated atherosclerosis upon IL-17R signaling disruption in LDLr deficient mice. Biochem Biophys Res Commun 2009; 388:261-5. [PMID: 19660432 DOI: 10.1016/j.bbrc.2009.07.152] [Citation(s) in RCA: 125] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2009] [Accepted: 07/29/2009] [Indexed: 01/08/2023]
Abstract
Atherosclerosis is an inflammatory disease characterized by the influx of macrophages and T cells and IL-17 may connect innate and adaptive immune responses involved in atherogenesis. We investigated the role of IL-17 receptor signaling in atherosclerosis and transplanted LDLr deficient recipient mice with IL-17R deficient bone marrow. Induction of atherosclerosis by Western-type diet induced a 46% reduction in lesion size in the aortic root and the plaque composition revealed no significant changes in collagen content and neutrophil counts, but a reduction in mast cell number and an increase in macrophage number. In addition, we observed a decrease in anti-oxLDL antibodies of the IgG class upon IL-17R BMT, while introduction of IL-17R deficient bone marrow resulted in a reduced IL-6 production and an increased IL-10 production. In conclusion, signaling via the IL-17 receptor in bone marrow derived cells enhances the process of atherosclerosis.
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Affiliation(s)
- T van Es
- Division of Biopharmaceutics, Leiden Amsterdam Center for Drug Research, Leiden University, Leiden, The Netherlands
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van Berkel T, Out R, Hoekstra M, Kuiper J, van Eck M. Abstract: S2-1 MACROPHAGE CHOLESTEROL HOMEOSTASIS AND ATHEROGENESIS. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71540-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Korporaal S, Meurs I, Vergeer M, van Berkel T, Kuiper J, Kuivenhoven J, van Eck M. Abstract: 1101 THE HDL RECEPTOR SR-BI MODULATES PLATELET FUNCTION AND SUSCEPTIBILITY TO THROMBOSIS IN VIVO. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)70427-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Jenniskens P, Shaddad MH, Numan D, Elsir S, Kudoda AM, Zolensky ME, Le L, Robinson GA, Friedrich JM, Rumble D, Steele A, Chesley SR, Fitzsimmons A, Duddy S, Hsieh HH, Ramsay G, Brown PG, Edwards WN, Tagliaferri E, Boslough MB, Spalding RE, Dantowitz R, Kozubal M, Pravec P, Borovicka J, Charvat Z, Vaubaillon J, Kuiper J, Albers J, Bishop JL, Mancinelli RL, Sandford SA, Milam SN, Nuevo M, Worden SP. The impact and recovery of asteroid 2008 TC(3). Nature 2009. [PMID: 19325630 DOI: 10.1038/nature07920.] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
In the absence of a firm link between individual meteorites and their asteroidal parent bodies, asteroids are typically characterized only by their light reflection properties, and grouped accordingly into classes. On 6 October 2008, a small asteroid was discovered with a flat reflectance spectrum in the 554-995 nm wavelength range, and designated 2008 TC(3) (refs 4-6). It subsequently hit the Earth. Because it exploded at 37 km altitude, no macroscopic fragments were expected to survive. Here we report that a dedicated search along the approach trajectory recovered 47 meteorites, fragments of a single body named Almahata Sitta, with a total mass of 3.95 kg. Analysis of one of these meteorites shows it to be an achondrite, a polymict ureilite, anomalous in its class: ultra-fine-grained and porous, with large carbonaceous grains. The combined asteroid and meteorite reflectance spectra identify the asteroid as F class, now firmly linked to dark carbon-rich anomalous ureilites, a material so fragile it was not previously represented in meteorite collections.
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Affiliation(s)
- P Jenniskens
- SETI Institute, Carl Sagan Center, 515 North Whisman Road, Mountain View, California 94043, USA.
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