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Zawia A, Arnold ND, West L, Pickworth JA, Turton H, Iremonger J, Braithwaite AT, Cañedo J, Johnston SA, Thompson AAR, Miller G, Lawrie A. Altered Macrophage Polarization Induces Experimental Pulmonary Hypertension and Is Observed in Patients With Pulmonary Arterial Hypertension. Arterioscler Thromb Vasc Biol 2020; 41:430-445. [PMID: 33147993 PMCID: PMC7752239 DOI: 10.1161/atvbaha.120.314639] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Supplemental Digital Content is available in the text. To determine whether global reduction of CD68 (cluster of differentiation) macrophages impacts the development of experimental pulmonary arterial hypertension (PAH) and whether this reduction affects the balance of pro- and anti-inflammatory macrophages within the lung. Additionally, to determine whether there is evidence of an altered macrophage polarization in patients with PAH.
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Affiliation(s)
- Amira Zawia
- Department of Infection, Immunity and Cardiovascular Disease (A.Z., N.D.A., L.W., J.A.P., H.T., J.I., A.T.B., J.C., S.A.J., A.A.R.T., A.L.), University of Sheffield, United Kingdom
| | - Nadine D Arnold
- Department of Infection, Immunity and Cardiovascular Disease (A.Z., N.D.A., L.W., J.A.P., H.T., J.I., A.T.B., J.C., S.A.J., A.A.R.T., A.L.), University of Sheffield, United Kingdom
| | - Laura West
- Department of Infection, Immunity and Cardiovascular Disease (A.Z., N.D.A., L.W., J.A.P., H.T., J.I., A.T.B., J.C., S.A.J., A.A.R.T., A.L.), University of Sheffield, United Kingdom
| | - Josephine A Pickworth
- Department of Infection, Immunity and Cardiovascular Disease (A.Z., N.D.A., L.W., J.A.P., H.T., J.I., A.T.B., J.C., S.A.J., A.A.R.T., A.L.), University of Sheffield, United Kingdom
| | - Helena Turton
- Department of Infection, Immunity and Cardiovascular Disease (A.Z., N.D.A., L.W., J.A.P., H.T., J.I., A.T.B., J.C., S.A.J., A.A.R.T., A.L.), University of Sheffield, United Kingdom
| | - James Iremonger
- Department of Infection, Immunity and Cardiovascular Disease (A.Z., N.D.A., L.W., J.A.P., H.T., J.I., A.T.B., J.C., S.A.J., A.A.R.T., A.L.), University of Sheffield, United Kingdom
| | - Adam T Braithwaite
- Department of Infection, Immunity and Cardiovascular Disease (A.Z., N.D.A., L.W., J.A.P., H.T., J.I., A.T.B., J.C., S.A.J., A.A.R.T., A.L.), University of Sheffield, United Kingdom
| | - Jaime Cañedo
- Department of Infection, Immunity and Cardiovascular Disease (A.Z., N.D.A., L.W., J.A.P., H.T., J.I., A.T.B., J.C., S.A.J., A.A.R.T., A.L.), University of Sheffield, United Kingdom
| | - Simon A Johnston
- Department of Infection, Immunity and Cardiovascular Disease (A.Z., N.D.A., L.W., J.A.P., H.T., J.I., A.T.B., J.C., S.A.J., A.A.R.T., A.L.), University of Sheffield, United Kingdom
| | - A A Roger Thompson
- Department of Infection, Immunity and Cardiovascular Disease (A.Z., N.D.A., L.W., J.A.P., H.T., J.I., A.T.B., J.C., S.A.J., A.A.R.T., A.L.), University of Sheffield, United Kingdom
| | - Gaynor Miller
- Department of Oncology and Metabolism (G.M.), University of Sheffield, United Kingdom.,College of Medical and Dental Science, University of Birmingham, United Kingdom (G.M.)
| | - Allan Lawrie
- Department of Infection, Immunity and Cardiovascular Disease (A.Z., N.D.A., L.W., J.A.P., H.T., J.I., A.T.B., J.C., S.A.J., A.A.R.T., A.L.), University of Sheffield, United Kingdom
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Arnold ND, Pickworth JA, West LE, Dawson S, Carvalho JA, Casbolt H, Braithwaite AT, Iremonger J, Renshall L, Germaschewski V, McCourt M, Bland-Ward P, Kowash H, Hameed AG, Rothman AMK, Frid MG, Roger Thompson AA, Evans HR, Southwood M, Morrell NW, Crossman DC, Whyte MKB, Stenmark KR, Newman CM, Kiely DG, Francis SE, Lawrie A. A therapeutic antibody targeting osteoprotegerin attenuates severe experimental pulmonary arterial hypertension. Nat Commun 2019; 10:5183. [PMID: 31729368 PMCID: PMC6858314 DOI: 10.1038/s41467-019-13139-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 10/23/2019] [Indexed: 12/11/2022] Open
Abstract
Pulmonary arterial hypertension (PAH) is a rare but fatal disease. Current treatments increase life expectancy but have limited impact on the progressive pulmonary vascular remodelling that drives PAH. Osteoprotegerin (OPG) is increased within serum and lesions of patients with idiopathic PAH and is a mitogen and migratory stimulus for pulmonary artery smooth muscle cells (PASMCs). Here, we report that the pro-proliferative and migratory phenotype in PASMCs stimulated with OPG is mediated via the Fas receptor and that treatment with a human antibody targeting OPG can attenuate pulmonary vascular remodelling associated with PAH in multiple rodent models of early and late treatment. We also demonstrate that the therapeutic efficacy of the anti-OPG antibody approach in the presence of standard of care vasodilator therapy is mediated by a reduction in pulmonary vascular remodelling. Targeting OPG with a therapeutic antibody is a potential treatment strategy in PAH. Pulmonary arterial hypertension (PAH) is characterised by progressive pulmonary vascular remodelling. Here, Arnold et al. develop a therapeutic antibody targeting osteoprotegerin and find it attenuates pulmonary vascular remodelling in multiple rodent models of PAH, alone or in combination with standard of care vasodilator therapy.
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Affiliation(s)
- Nadine D Arnold
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2RX, UK
| | - Josephine A Pickworth
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2RX, UK
| | - Laura E West
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2RX, UK
| | - Sarah Dawson
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2RX, UK
| | | | - Helen Casbolt
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2RX, UK
| | - Adam T Braithwaite
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2RX, UK
| | - James Iremonger
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2RX, UK
| | - Lewis Renshall
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2RX, UK
| | | | - Matthew McCourt
- Kymab Ltd, Babraham Research Campus, Cambridge, CB22 3AT, UK
| | | | - Hager Kowash
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2RX, UK
| | - Abdul G Hameed
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2RX, UK
| | - Alexander M K Rothman
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2RX, UK
| | - Maria G Frid
- Cardiovascular Pulmonary Research Laboratories, Departments of Pediatrics and Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - A A Roger Thompson
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2RX, UK
| | - Holly R Evans
- Department of Chemistry, University of Sheffield, Sheffield, S3 7HF, UK
| | - Mark Southwood
- Department of Medicine, University of Cambridge School of Clinical Medicine, Addenbrooke's and Papworth Hospital, Cambridge, CB2 0QQ, UK
| | - Nicholas W Morrell
- Department of Medicine, University of Cambridge School of Clinical Medicine, Addenbrooke's and Papworth Hospital, Cambridge, CB2 0QQ, UK
| | - David C Crossman
- School of Medicine, University of St. Andrews, St, Andrews, KY16 9AJ, UK
| | - Moira K B Whyte
- MRC/University of Edinburgh Centre for Inflammation Research, University of Edinburgh, The Queens Medical Research Institute, Edinburgh, EH16 4TJ, UK
| | - Kurt R Stenmark
- Cardiovascular Pulmonary Research Laboratories, Departments of Pediatrics and Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Christopher M Newman
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2RX, UK
| | - David G Kiely
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2RX, UK.,Sheffield Pulmonary Vascular Disease Unit, Sheffield Teaching Hospitals Foundation Trust, Royal Hallamshire Hospital, Sheffield, S10 2JF, UK
| | - Sheila E Francis
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2RX, UK
| | - Allan Lawrie
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2RX, UK.
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Farkas D, Thompson AAR, Bhagwani AR, Hultman S, Ji H, Kotha N, Farr G, Arnold ND, Braithwaite A, Casbolt H, Cole JE, Sabroe I, Monaco C, Cool CD, Goncharova EA, Lawrie A, Farkas L. Toll-like Receptor 3 Is a Therapeutic Target for Pulmonary Hypertension. Am J Respir Crit Care Med 2019; 199:199-210. [PMID: 30211629 PMCID: PMC6353001 DOI: 10.1164/rccm.201707-1370oc] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 09/12/2018] [Indexed: 12/25/2022] Open
Abstract
RATIONALE Pulmonary arterial hypertension (PAH) is characterized by vascular cell proliferation and endothelial cell apoptosis. TLR3 (Toll-like receptor 3) is a receptor for double-stranded RNA and has been recently implicated in vascular protection. OBJECTIVES To study the expression and role of TLR3 in PAH and to determine whether a TLR3 agonist reduces pulmonary hypertension in preclinical models. METHODS Lung tissue and endothelial cells from patients with PAH were investigated by polymerase chain reaction, immunofluorescence, and apoptosis assays. TLR3-/- and TLR3+/+ mice were exposed to chronic hypoxia and SU5416. Chronic hypoxia or chronic hypoxia/SU5416 rats were treated with the TLR3 agonist polyinosinic/polycytidylic acid (Poly[I:C]). MEASUREMENTS AND MAIN RESULTS TLR3 expression was reduced in PAH patient lung tissue and endothelial cells, and TLR3-/- mice exhibited more severe pulmonary hypertension following exposure to chronic hypoxia/SU5416. TLR3 knockdown promoted double-stranded RNA signaling via other intracellular RNA receptors in endothelial cells. This was associated with greater susceptibility to apoptosis, a known driver of pulmonary vascular remodeling. Poly(I:C) increased TLR3 expression via IL-10 in rat endothelial cells. In vivo, high-dose Poly(I:C) reduced pulmonary hypertension in both rat models in proof-of-principle experiments. In addition, Poly(I:C) also reduced right ventricular failure in established pulmonary hypertension. CONCLUSIONS Our work identifies a novel role for TLR3 in PAH based on the findings that reduced expression of TLR3 contributes to endothelial apoptosis and pulmonary vascular remodeling.
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Affiliation(s)
- Daniela Farkas
- Division of Pulmonary Disease and Critical Care Medicine, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - A. A. Roger Thompson
- Department of Infection, Immunity & Cardiovascular Disease, Faculty of Medicine, Dentistry & Health, University of Sheffield, Sheffield, United Kingdom
| | - Aneel R. Bhagwani
- Division of Pulmonary Disease and Critical Care Medicine, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - Schuyler Hultman
- Division of Pulmonary Disease and Critical Care Medicine, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - Hyun Ji
- Division of Pulmonary Disease and Critical Care Medicine, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - Naveen Kotha
- Division of Pulmonary Disease and Critical Care Medicine, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - Grant Farr
- Division of Pulmonary Disease and Critical Care Medicine, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - Nadine D. Arnold
- Department of Infection, Immunity & Cardiovascular Disease, Faculty of Medicine, Dentistry & Health, University of Sheffield, Sheffield, United Kingdom
| | - Adam Braithwaite
- Department of Infection, Immunity & Cardiovascular Disease, Faculty of Medicine, Dentistry & Health, University of Sheffield, Sheffield, United Kingdom
| | - Helen Casbolt
- Department of Infection, Immunity & Cardiovascular Disease, Faculty of Medicine, Dentistry & Health, University of Sheffield, Sheffield, United Kingdom
| | - Jennifer E. Cole
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom
| | - Ian Sabroe
- Department of Infection, Immunity & Cardiovascular Disease, Faculty of Medicine, Dentistry & Health, University of Sheffield, Sheffield, United Kingdom
| | - Claudia Monaco
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom
| | - Carlyne D. Cool
- Department of Pathology, University of Colorado Denver, Denver, Colorado; and
| | - Elena A. Goncharova
- Pittsburgh Heart, Lung and Blood Vascular Medicine Institute, Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, and
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Allan Lawrie
- Department of Infection, Immunity & Cardiovascular Disease, Faculty of Medicine, Dentistry & Health, University of Sheffield, Sheffield, United Kingdom
| | - Laszlo Farkas
- Division of Pulmonary Disease and Critical Care Medicine, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia
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Thompson AAR, Arnold ND, Braithwaite AT, Casbolt HL, Iremonger J, Pickworth JA, Monaco C, Cole JE, Sabroe I, Lawrie A. S87 Deficiency of toll-like receptor 3 (TLR3) exacerbates pulmonary hypertension in mice. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Rothman AMK, Arnold ND, Chang W, Watson O, Swift AJ, Condliffe R, Elliot CA, Kiely DG, Suvarna SK, Gunn J, Lawrie A. Pulmonary artery denervation reduces pulmonary artery pressure and induces histological changes in an acute porcine model of pulmonary hypertension. Circ Cardiovasc Interv 2016; 8:e002569. [PMID: 26553697 PMCID: PMC4648184 DOI: 10.1161/circinterventions.115.002569] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pulmonary arterial hypertension is a devastating disease with high morbidity and mortality and limited treatment options. Recent studies have shown that pulmonary artery denervation improves pulmonary hemodynamics in an experimental model and in an early clinical trial. We aimed to evaluate the nerve distribution around the pulmonary artery, to determine the effect of radiofrequency pulmonary artery denervation on acute pulmonary hypertension induced by vasoconstriction, and to demonstrate denervation of the pulmonary artery at a histological level. METHODS AND RESULTS Histological evaluation identified a circumferential distribution of nerves around the proximal pulmonary arteries. Nerves were smaller in diameter, greater in number, and located in closer proximity to the luminal aspect of the pulmonary arterial wall beyond the pulmonary artery bifurcation. To determine the effect of pulmonary arterial denervation acute pulmonary hypertension was induced in 8 pigs by intravenous infusion of thromboxane A2 analogue. Animals were assigned to either pulmonary artery denervation, using a prototype radiofrequency catheter and generator, or a sham procedure. Pulmonary artery denervation resulted in reduced mean pulmonary artery pressure and pulmonary vascular resistance and increased cardiac output. Ablation lesions on the luminal surface of the pulmonary artery were accompanied by histological and biochemical alteration in adventitial nerves and correlated with improved hemodynamic parameters. CONCLUSIONS Pulmonary artery denervation offers the possibility of a new treatment option for patients with pulmonary arterial hypertension. Further work is required to determine the long-term efficacy and safety.
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Affiliation(s)
- Alexander M K Rothman
- From the Department of Cardiovascular Science (A.M.K.R., N.D.A., O.W., S.K.S., J.G., A.L.), Academic Unit of Radiology (A.J.S.), and INSIGNEO, Institute for Insilico Medicine (A.M.K.R., A.J.S., J.G.), University of Sheffield, Sheffield, United Kingdom; Medtronic Inc, Santa Rosa, CA (W.C.); and Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom (R.C., C.A.E., D.G.K.).
| | - Nadine D Arnold
- From the Department of Cardiovascular Science (A.M.K.R., N.D.A., O.W., S.K.S., J.G., A.L.), Academic Unit of Radiology (A.J.S.), and INSIGNEO, Institute for Insilico Medicine (A.M.K.R., A.J.S., J.G.), University of Sheffield, Sheffield, United Kingdom; Medtronic Inc, Santa Rosa, CA (W.C.); and Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom (R.C., C.A.E., D.G.K.)
| | - William Chang
- From the Department of Cardiovascular Science (A.M.K.R., N.D.A., O.W., S.K.S., J.G., A.L.), Academic Unit of Radiology (A.J.S.), and INSIGNEO, Institute for Insilico Medicine (A.M.K.R., A.J.S., J.G.), University of Sheffield, Sheffield, United Kingdom; Medtronic Inc, Santa Rosa, CA (W.C.); and Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom (R.C., C.A.E., D.G.K.)
| | - Oliver Watson
- From the Department of Cardiovascular Science (A.M.K.R., N.D.A., O.W., S.K.S., J.G., A.L.), Academic Unit of Radiology (A.J.S.), and INSIGNEO, Institute for Insilico Medicine (A.M.K.R., A.J.S., J.G.), University of Sheffield, Sheffield, United Kingdom; Medtronic Inc, Santa Rosa, CA (W.C.); and Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom (R.C., C.A.E., D.G.K.)
| | - Andrew J Swift
- From the Department of Cardiovascular Science (A.M.K.R., N.D.A., O.W., S.K.S., J.G., A.L.), Academic Unit of Radiology (A.J.S.), and INSIGNEO, Institute for Insilico Medicine (A.M.K.R., A.J.S., J.G.), University of Sheffield, Sheffield, United Kingdom; Medtronic Inc, Santa Rosa, CA (W.C.); and Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom (R.C., C.A.E., D.G.K.)
| | - Robin Condliffe
- From the Department of Cardiovascular Science (A.M.K.R., N.D.A., O.W., S.K.S., J.G., A.L.), Academic Unit of Radiology (A.J.S.), and INSIGNEO, Institute for Insilico Medicine (A.M.K.R., A.J.S., J.G.), University of Sheffield, Sheffield, United Kingdom; Medtronic Inc, Santa Rosa, CA (W.C.); and Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom (R.C., C.A.E., D.G.K.)
| | - Charlie A Elliot
- From the Department of Cardiovascular Science (A.M.K.R., N.D.A., O.W., S.K.S., J.G., A.L.), Academic Unit of Radiology (A.J.S.), and INSIGNEO, Institute for Insilico Medicine (A.M.K.R., A.J.S., J.G.), University of Sheffield, Sheffield, United Kingdom; Medtronic Inc, Santa Rosa, CA (W.C.); and Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom (R.C., C.A.E., D.G.K.)
| | - David G Kiely
- From the Department of Cardiovascular Science (A.M.K.R., N.D.A., O.W., S.K.S., J.G., A.L.), Academic Unit of Radiology (A.J.S.), and INSIGNEO, Institute for Insilico Medicine (A.M.K.R., A.J.S., J.G.), University of Sheffield, Sheffield, United Kingdom; Medtronic Inc, Santa Rosa, CA (W.C.); and Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom (R.C., C.A.E., D.G.K.)
| | - S Kim Suvarna
- From the Department of Cardiovascular Science (A.M.K.R., N.D.A., O.W., S.K.S., J.G., A.L.), Academic Unit of Radiology (A.J.S.), and INSIGNEO, Institute for Insilico Medicine (A.M.K.R., A.J.S., J.G.), University of Sheffield, Sheffield, United Kingdom; Medtronic Inc, Santa Rosa, CA (W.C.); and Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom (R.C., C.A.E., D.G.K.)
| | - Julian Gunn
- From the Department of Cardiovascular Science (A.M.K.R., N.D.A., O.W., S.K.S., J.G., A.L.), Academic Unit of Radiology (A.J.S.), and INSIGNEO, Institute for Insilico Medicine (A.M.K.R., A.J.S., J.G.), University of Sheffield, Sheffield, United Kingdom; Medtronic Inc, Santa Rosa, CA (W.C.); and Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom (R.C., C.A.E., D.G.K.)
| | - Allan Lawrie
- From the Department of Cardiovascular Science (A.M.K.R., N.D.A., O.W., S.K.S., J.G., A.L.), Academic Unit of Radiology (A.J.S.), and INSIGNEO, Institute for Insilico Medicine (A.M.K.R., A.J.S., J.G.), University of Sheffield, Sheffield, United Kingdom; Medtronic Inc, Santa Rosa, CA (W.C.); and Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom (R.C., C.A.E., D.G.K.)
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Rothman AMK, Arnold ND, Pickworth JA, Iremonger J, Ciuclan L, Allen R, Guth-Gundel S, Southwood M, Morrell NW, Thomas M, Francis SE, Rowlands DJ, Lawrie A. E microRNA-140-5p and SMURF1 Regulate Pulmonary Arterial Hypertension. Heart 2016. [DOI: 10.1136/heartjnl-2016-309890.224] [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: 11/03/2022] Open
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Rothman AMK, Arnold ND, Pickworth JA, Iremonger J, Ciuclan L, Allen RMH, Guth-Gundel S, Southwood M, Morrell NW, Thomas M, Francis SE, Rowlands DJ, Lawrie A. MicroRNA-140-5p and SMURF1 regulate pulmonary arterial hypertension. J Clin Invest 2016; 126:2495-508. [PMID: 27214554 DOI: 10.1172/jci83361] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 03/31/2016] [Indexed: 12/21/2022] Open
Abstract
Loss of the growth-suppressive effects of bone morphogenetic protein (BMP) signaling has been demonstrated to promote pulmonary arterial endothelial cell dysfunction and induce pulmonary arterial smooth muscle cell (PASMC) proliferation, leading to the development of pulmonary arterial hypertension (PAH). MicroRNAs (miRs) mediate higher order regulation of cellular function through coordinated modulation of mRNA targets; however, miR expression is altered by disease development and drug therapy. Here, we examined treatment-naive patients and experimental models of PAH and identified a reduction in the levels of miR-140-5p. Inhibition of miR-140-5p promoted PASMC proliferation and migration in vitro. In rat models of PAH, nebulized delivery of miR-140-5p mimic prevented the development of PAH and attenuated the progression of established PAH. Network and pathway analysis identified SMAD-specific E3 ubiquitin protein ligase 1 (SMURF1) as a key miR-140-5p target and regulator of BMP signaling. Evaluation of human tissue revealed that SMURF1 is increased in patients with PAH. miR-140-5p mimic or SMURF1 knockdown in PASMCs altered BMP signaling, further supporting these factors as regulators of BMP signaling. Finally, Smurf1 deletion protected mice from PAH, demonstrating a critical role in disease development. Together, these studies identify both miR-140-5p and SMURF1 as key regulators of disease pathology and as potential therapeutic targets for the treatment of PAH.
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Rothman AMK, Arnold ND, Pickworth JA, Iremonger J, Ciuclan L, Allen R, Guth-Gundel S, Southwood M, Morrell NW, Francis SE, Rowlands DJ, Lawrie A. T5 MicroRNA-140–5p Regulates Disease Phenotype in Experimental Pulmonary Arterial Hypertension via SMURF1. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Hameed AG, Arnold ND, Chamberlain J, Pickworth J, Newman CMH, Crossman DC, Francis SE, Lawrie A. 03 Tissue Trail Drives Pulmonary Vascular Remodeling and its Inhibition Reverses Experimental Pulmonary Arterial Hypertension. Heart 2012. [DOI: 10.1136/heartjnl-2012-302951.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Hameed AG, Arnold ND, Chamberlain J, Pickworth JA, Paiva C, Dawson S, Cross S, Long L, Zhao L, Morrell NW, Crossman DC, Newman CMH, Kiely DG, Francis SE, Lawrie A. Inhibition of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) reverses experimental pulmonary hypertension. ACTA ACUST UNITED AC 2012; 209:1919-35. [PMID: 23071256 PMCID: PMC3478928 DOI: 10.1084/jem.20112716] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Genetic deletion of TRAIL or antibody blockade prevents the development of pulmonary arterial hypertension and can reverse vascular remodeling in established disease. Pulmonary arterial hypertension (PAH) is a life-threatening disease characterized by the progressive narrowing and occlusion of small pulmonary arteries. Current therapies fail to fully reverse this vascular remodeling. Identifying key pathways in disease pathogenesis is therefore required for the development of new-targeted therapeutics. We have previously reported tumor necrosis factor–related apoptosis-inducing ligand (TRAIL) immunoreactivity within pulmonary vascular lesions from patients with idiopathic PAH and animal models. Because TRAIL can induce both endothelial cell apoptosis and smooth muscle cell proliferation in the systemic circulation, we hypothesized that TRAIL is an important mediator in the pathogenesis of PAH. We demonstrate for the first time that TRAIL is a potent stimulus for pulmonary vascular remodeling in human cells and rodent models. Furthermore, antibody blockade or genetic deletion of TRAIL prevents the development of PAH in three independent rodent models. Finally, anti-TRAIL antibody treatment of rodents with established PAH reverses pulmonary vascular remodeling by reducing proliferation and inducing apoptosis, improves hemodynamic indices, and significantly increases survival. These preclinical investigations are the first to demonstrate the importance of TRAIL in PAH pathogenesis and highlight its potential as a novel therapeutic target to direct future translational therapies.
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Affiliation(s)
- Abdul G Hameed
- Department of Cardiovascular Science, 2 Department of Neuroscience, University of Sheffield, S10 2RX Sheffield, UK
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Sung HY, Francis SE, Arnold ND, Holland K, Ernst V, Angyal A, Kiss-Toth E. Enhanced macrophage tribbles-1 expression in murine experimental atherosclerosis. Biology (Basel) 2012; 1:43-57. [PMID: 24832046 PMCID: PMC4011034 DOI: 10.3390/biology1010043] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 03/13/2012] [Accepted: 03/31/2012] [Indexed: 02/04/2023]
Abstract
Development of the atherosclerotic plaque involves a complex interplay between a number of cell types and an extensive inter-cellular communication via cell bound as well as soluble mediators. The family of tribbles proteins has recently been identified as novel controllers of pro-inflammatory signal transduction. The objective of this study was to address the expression pattern of all three tribbles proteins in atherosclerotic plaques from a mouse model of atherosclerosis. Each tribbles were expressed in vascular smooth muscle cells, endothelial cells as well as in resident macrophages of mouse atherosclerotic plaques. The role of IL-1 mediated inflammatory events in controlling tribbles expression was also addressed by inducing experimental atherosclerosis in ApoE−/−IL1R1−/− (double knockout) mice. Immunohistochemical analysis of these mice showed a selective decrease in the percentage of trb-1 expressing macrophages, compared to the ApoE−/− cohort (14.7% ± 1.55 vs. 26.3% ± 1.19). The biological significance of this finding was verified in vitro where overexpression of trb-1 in macrophages led to a significant attenuation (~70%) of IL-6 production as well as a suppressed IL-12 expression induced by a proinflammatory stimulus. In this in vitro setting, expression of truncated trb-1 mutants suggests that the kinase domain of this protein is sufficient to exert this inhibitory action.
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Affiliation(s)
- Hye Youn Sung
- Department of Cardiovascular Science, University of Sheffield, Sheffield, S10 2RX, UK.
| | - Sheila E Francis
- Department of Cardiovascular Science, University of Sheffield, Sheffield, S10 2RX, UK.
| | - Nadine D Arnold
- Department of Cardiovascular Science, University of Sheffield, Sheffield, S10 2RX, UK.
| | - Karen Holland
- Department of Cardiovascular Science, University of Sheffield, Sheffield, S10 2RX, UK.
| | - Vanessa Ernst
- Department of Cardiovascular Science, University of Sheffield, Sheffield, S10 2RX, UK.
| | - Adrienn Angyal
- Department of Cardiovascular Science, University of Sheffield, Sheffield, S10 2RX, UK.
| | - Endre Kiss-Toth
- Department of Cardiovascular Science, University of Sheffield, Sheffield, S10 2RX, UK.
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Morton AC, Siotia A, Arnold ND, Korgul P, Bowles J, Heppenstall J, Gunn J. Simultaneous kissing stent technique to treat left main stem bifurcation disease. Catheter Cardiovasc Interv 2007; 69:209-15. [PMID: 17195202 DOI: 10.1002/ccd.20944] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND While several endovascular techniques have been developed for treating arterial bifurcation lesions, there is, as yet, no single, widely accepted technique for treating left main stem (LMS) bifurcation lesions with stents. The simultaneous kissing stent (SCS) technique seems particularly suited for such lesions. The authors describe a consecutive cohort of patients with LMS bifurcation stenosis treated with this technique and present mechanistic insights from a porcine model. METHODS Thirty consecutive patients with LMS bifurcation stenosis +/- multivessel disease were treated with SCS technique using paclitaxel-eluting stents. The technique involves simultaneous implantation of two stents (LMS-LAD and LMS-Cx) so that the proximal end of both stents lie at the same level in the body of LMS. Symptom status was recorded and follow-up angiography was performed. In addition, four pigs underwent SCS implantation of the LMS and were studied by direct examination, histology, and scanning electron microscopy. RESULTS The patients' mean age was 63, 26 were elective and 19 were male. Paclitaxel-eluting stents (Taxus, Boston Scientific) were used. There was one in-hospital death in a highly unstable patient. At 6-month follow-up angiography, two patients required target lesion revascularization. At 13 +/- 3 month follow-up, the remaining patients remain well, with no other major adverse cardiac events. The animals all survived with patent stents. SEM demonstrated full re-endothelialization and histology showed a thin but complete neointima covering the stent struts. CONCLUSION The SCS technique for treating LMS bifurcation disease with paclitaxel-eluting stents is safe and feasible. Medium term clinical and angiographic results are good. An endothelium and a thin neointima cover the metal struts.
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Affiliation(s)
- Allison C Morton
- Division of Clinical Sciences (North), Cardiovascular Research Unit, University of Sheffield, Sheffield, United Kingdom
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Dean CJ, Morton AC, Arnold ND, Hose DR, Crossman DC, Gunn J. Relative importance of the components of stent geometry to stretch induced in-stent neointima formation. Heart 2006; 91:1603-4. [PMID: 16287746 PMCID: PMC1769247 DOI: 10.1136/hrt.2004.047050] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Morton AC, Arnold ND, Gunn J, Varcoe R, Francis SE, Dower SK, Crossman DC. Interleukin-1 receptor antagonist alters the response to vessel wall injury in a porcine coronary artery model. Cardiovasc Res 2005; 68:493-501. [PMID: 16099441 DOI: 10.1016/j.cardiores.2005.06.026] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2005] [Revised: 06/23/2005] [Accepted: 06/24/2005] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To determine the influence of IL-1 on the arterial response to experimental injury in porcine models of percutaneous coronary intervention (PCI). METHODS An intravenous (i.v.) bolus of 0.5 mg/kg followed by a subcutaneous (s.c.) infusion of 2 mg/kg/24 h of human IL-1 receptor antagonist (IL-1ra) inhibited neutrophil recruitment in response to intradermal IL-1. Using this dose regimen, five groups of pigs were studied: Group 1, oversized balloon angioplasty of 2 coronary vessels (14-day infusion, 28th day sacrifice and analysis); Groups 2, 3, 4, and 5, oversized stenting of 2 coronary vessels (Group 2: 14-day infusion, 28th day analysis; Group 3: 14-day infusion, 14th day analysis; Group 4: 28-day infusion, 28th day analysis; Group 5: 28-day infusion, 90th day analysis). Neointimal area was quantified by standard means. RESULTS In Group 1, IL-1ra resulted in a 23% decrease in neointimal area (p=0.04); in Group 2, a 34% increase (p=0.001); in Group 3, a 38% decrease (p<0.0001); in Group 4, a 34% decrease (p=0.0004); and in Group 5, a 41% decrease (p=0.00001). CONCLUSIONS IL-1ra was associated with a sustained, significant reduction in neointima after vessel wall injury as long as it is given for the duration of the stimulation of the IL-1 system, in this case at least 28 days. This suggests that therapies based on the antagonism of IL-1 may modulate the coronary artery response to injury.
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Affiliation(s)
- Allison C Morton
- Cardiovascular Research Unit, Division of Clinical Sciences (Northern General Hospital), University of Sheffield, Sheffield S5 7AU, UK
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15
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Abstract
OBJECTIVE To investigate the response of very small coronary arteries to stent deployment and balloon angioplasty. SETTING Normal porcine coronary arteries. METHODS 24 pigs underwent intervention to two main coronary arteries, in segments 2.0 mm in diameter, with balloons whose diameter was 2.5 mm at standard pressure. Twelve arteries received a BiodivYsio small vessel (SV) stent; 12 an NIR SV stent; 12 standard BiodivYsio stent, and 12 balloon only. The arteries were harvested at 28 days, fixed, embedded in plastic, and cut and ground in cross section. The injury score and histomorphometry were assessed. RESULTS The BiodivYsio SV stent was associated with 20% less injury (p = 0.16), a 30% larger lumen (p = 0.13), and a 25% smaller neointima (p = 0.03) than the NIR SV stent, despite identical oversize. The standard BiodivYsio stent exhibited less recoil but 29% greater injury (p = 0.01), 59% more neointima (p = 0.00), and 18% less lumen (p = 0.27) than the BiodivYsio SV. Of all interventions, balloon only was associated with little injury, little neointima, major vessel shrinkage, and the largest lumen. CONCLUSION Despite uniform oversize dilatation, both injury and response varied widely in very small porcine coronary arteries, depending on whether a stent or balloon was used, the stent design, and the number and/or thickness of struts. The response to different stent designs is considerable and is related to the degree of injury.
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Affiliation(s)
- A C Morton
- Cardiovascular Research Group, Division of Clinical Sciences (Northern General Hospital), University of Sheffield, Sheffield, UK
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Milton SV, Gluskin E, Arnold ND, Benson C, Berg W, Biedron SG, Borland M, Chae YC, Dejus RJ, Den Hartog PK, Deriy B, Erdmann M, Eidelman YI, Hahne MW, Huang Z, Kim KJ, Lewellen JW, Li Y, Lumpkin AH, Makarov O, Moog ER, Nassiri A, Sajaev V, Soliday R, Tieman BJ, Trakhtenberg EM, Travish G, Vasserman IB, Vinokurov NA, Wang XJ, Wiemerslage G, Yang BX. Exponential Gain and Saturation of a Self-Amplified Spontaneous Emission Free-Electron Laser. Science 2001; 292:2037-41. [PMID: 11358995 DOI: 10.1126/science.1059955] [Citation(s) in RCA: 223] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Self-amplified spontaneous emission in a free-electron laser has been proposed for the generation of very high brightness coherent x-rays. This process involves passing a high-energy, high-charge, short-pulse, low-energy-spread, and low-emittance electron beam through the periodic magnetic field of a long series of high-quality undulator magnets. The radiation produced grows exponentially in intensity until it reaches a saturation point. We report on the demonstration of self-amplified spontaneous emission gain, exponential growth, and saturation at visible (530 nanometers) and ultraviolet (385 nanometers) wavelengths. Good agreement between theory and simulation indicates that scaling to much shorter wavelengths may be possible. These results confirm the physics behind the self-amplified spontaneous emission process and forward the development of an operational x-ray free-electron laser.
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Affiliation(s)
- S V Milton
- Advanced Photon Source, Argonne National Laboratory, Argonne, IL 60439, USA.
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Chamberlain J, Gunn J, Francis SE, Holt CM, Arnold ND, Cumberland DC, Ferguson MW, Crossman DC. TGFbeta is active, and correlates with activators of TGFbeta, following porcine coronary angioplasty. Cardiovasc Res 2001; 50:125-36. [PMID: 11282085 DOI: 10.1016/s0008-6363(01)00199-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Restenosis following angioplasty involves processes that may be influenced by local production of cytokines. We investigated the expression of active and total transforming growth factor beta (TGFbeta) following porcine coronary angioplasty (PTCA), and have correlated this with the expression of potential in vivo activators of TGFbeta: mannose-6-phosphate/insulin-like growth factor-II (M6P/IGF-II) receptor and thrombospondin-1. METHODS Oversized porcine PTCA was performed and the arteries excised after selected intervals. Levels of in situ active and total (active plus latent) TGFbeta were determined using a modified plasminogen activator-inhibitor/luciferase bioassay. RESULTS Levels of active TGFbeta significantly increased 2 h to 7 days after angioplasty, compared to non-injured controls. Levels returned to baseline by 28 days. Active TGFbeta in tissues adjacent to the injured artery did not change. Total TGFbeta was significantly higher than controls 2-6 h after injury. M6P/IGF-II receptor mRNA was upregulated between 6 h and 3 days after injury, with protein detectable at 3-28 days. Thrombospondin-1 was detected between 1 h and 14 days. CONCLUSIONS We conclude that balloon injury causes an early rapid increase in levels of active TGFbeta, that correlates with the expression of TGFbeta activators. Thus, TGFbeta is a good potential target for anti-restenotic therapies.
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Affiliation(s)
- J Chamberlain
- Cardiovascular Research Group, Section of Medicine, University of Sheffield, Clinical Sciences Centre, Northern General Hospital, Herries Road, Sheffield, S5 7AU, UK.
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Milton SV, Gluskin E, Biedron SG, Dejus RJ, Galayda JN, Kim K, Lewellen JW, Moog ER, Sajaev V, Sereno NS, Travish G, Vinokurov NA, Arnold ND, Benson C, Berg W, Biggs JA, Borland M, Carwardine JA, Chae Y, Decker G, Deriy BN, Erdmann MJ, Friedsam H, Gold C, Grelick AE. Observation of self-amplified spontaneous emission and exponential growth at 530 nm. Phys Rev Lett 2000; 85:988-991. [PMID: 10991456 DOI: 10.1103/physrevlett.85.988] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2000] [Indexed: 05/23/2023]
Abstract
Experimental evidence for self-amplified spontaneous emission (SASE) at 530 nm is reported. The measurements were made at the low-energy undulator test line facility at the Advanced Photon Source, Argonne National Laboratory. The experimental setup and details of the experimental results are presented, as well as preliminary analysis. This experiment extends to shorter wavelengths the operational knowledge of a linac-based SASE free-electron laser and explicitly shows the predicted exponential growth in intensity of the optical pulse as a function of length along the undulator.
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Affiliation(s)
- SV Milton
- Advanced Photon Source, Argonne National Laboratory, Argonne, Illinois 60439, USA
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Thuerauf DJ, Arnold ND, Zechner D, Hanford DS, DeMartin KM, McDonough PM, Prywes R, Glembotski CC. p38 Mitogen-activated protein kinase mediates the transcriptional induction of the atrial natriuretic factor gene through a serum response element. A potential role for the transcription factor ATF6. J Biol Chem 1998; 273:20636-43. [PMID: 9685422 DOI: 10.1074/jbc.273.32.20636] [Citation(s) in RCA: 105] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
In various cell types certain stresses can stimulate p38 mitogen-activated protein kinase (p38 MAPK), leading to the transcriptional activation of genes that contribute to appropriate compensatory responses. In this report the mechanism of p38-activated transcription was studied in cardiac myocytes where this MAPK is a key regulator of the cell growth and the cardiac-specific gene induction that occurs in response to potentially stressful stimuli. In the cardiac atrial natriuretic factor (ANF) gene, a promoter-proximal serum response element (SRE), which binds serum response factor (SRF), was shown to be critical for ANF induction in primary cardiac myocytes transfected with the selective p38 MAPK activator, MKK6 (Glu). This ANF SRE does not possess sequences typically required for the binding of the Ets-related ternary complex factors (TCFs), such as Elk-1, indicating that p38-mediated induction through this element may take place independently of such TCFs. Although p38 did not phosphorylate SRF in vitro, it efficiently phosphorylated ATF6, a newly discovered SRF-binding protein that is believed to serve as a co-activator of SRF-inducible transcription at SREs. Expression of an ATF6 antisense RNA blocked p38-mediated ANF induction through the ANF SRE. Moreover, when fused to the Gal4 DNA-binding domain, an N-terminal 273-amino acid fragment of ATF6 was sufficient to support trans-activation of Gal4/luciferase expression in response to p38 but not the other stress kinase, N-terminal Jun kinase (JNK); p38-activating cardiac growth promoters also stimulated ATF6 trans-activation. These results indicate that through ATF6, p38 can augment SRE-mediated transcription independently of Ets-related TCFs, representing a novel mechanism of SRF-dependent transcription by MAP kinases.
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Affiliation(s)
- D J Thuerauf
- Department of Biology and Molecular Biology, Institute, San Diego State University, San Diego, California 92182, USA
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Nichols WC, Koller DL, Slovis B, Foroud T, Terry VH, Arnold ND, Siemieniak DR, Wheeler L, Phillips JA, Newman JH, Conneally PM, Ginsburg D, Loyd JE. Localization of the gene for familial primary pulmonary hypertension to chromosome 2q31-32. Nat Genet 1997; 15:277-80. [PMID: 9054941 DOI: 10.1038/ng0397-277] [Citation(s) in RCA: 200] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Primary pulmonary hypertension (PPH), an often fatal disease, is characterized by elevated pulmonary artery pressures in the absence of a secondary cause. Endovascular occlusion in the smallest pulmonary arteries occurs by proliferation of cells and matrix, with thrombus and vasospasm. Diagnosis is often delayed because the initial symptoms of fatigue and dyspnea on exertion are nonspecific and definitive diagnosis requires invasive procedures. The average life expectancy after diagnosis is two to three years with death usually due to progressive right heart failure. The aetiology of the disease is unknown. Although most cases appear to be sporadic, approximately 6% of cases recorded in the NIH Primary Pulmonary Hypertension Registry are inherited in an autosomal dominant manner with reduced penetrance. Following a genome-wide search using a set of highly polymorphic short tandem repeat (STR) markers and 19 affected individuals from six families, initial evidence for linkage was obtained with two chromosome 2q markers. We subsequently genotyped patients and all available family members for 19 additional markers spanning approximately 40 centiMorgans (cM) on the long arm of chromosome 2. We obtained a maximum two-point lod score of 6.97 at theta = 0 with the marker D2S389; multipoint linkage analysis yielded a maximum lod score of 7.86 with the marker D2S311. Haplotype analysis established a minimum candidate interval of approximately 25 cM.
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Affiliation(s)
- W C Nichols
- Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109, USA
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Nichols WC, Seligsohn U, Zivelin A, Terry VH, Arnold ND, Siemieniak DR, Kaufman RJ, Ginsburg D. Linkage of combined factors V and VIII deficiency to chromosome 18q by homozygosity mapping. J Clin Invest 1997; 99:596-601. [PMID: 9045860 PMCID: PMC507840 DOI: 10.1172/jci119201] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Combined Factors V and VIII deficiency is an autosomal recessive bleeding disorder identified in at least 58 families comprising a number of different ethnic groups. Affected patients present with a moderate bleeding tendency and have Factor V and Factor VIII levels in the range of 5-30% of normal. The highest frequency of the mutant gene is found in Jews of Sephardic and Middle Eastern origin living in Israel with an estimated disease frequency of 1:100,000. We sought to identify the gene responsible for combined Factors V and VIII deficiency using a positional cloning approach. Of 14 affected individuals from 8 unrelated Jewish families, 12 were the offspring of first-cousin marriages. After a genome-wide search using 241 highly polymorphic short tandem repeat (STR) markers, 13 of the 14 affected patients were homozygous for two closely linked 18q markers. Patients and all available family members were genotyped for 11 additional STRs spanning approximately 11 cM on the long arm of chromosome 18. Multipoint linkage analysis yielded a maximal log of the odds (LOD) score of 13.22. Haplotype analysis identified a number of recombinant individuals and established a minimum candidate interval of 2.5 cM for the gene responsible for combined Factors V and VIII deficiency. The product of this locus is likely to operate at a common step in the biosynthetic pathway for these two functionally and structurally homologous coagulation proteins. Identification of this gene should provide new insight into the biology of Factor V and Factor VIII production.
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Affiliation(s)
- W C Nichols
- Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109-0650, USA
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Nichols WC, Antin JH, Lunetta KL, Terry VH, Hertel CE, Wheatley MA, Arnold ND, Siemieniak DR, Boehnke M, Ginsburg D. Polymorphism of adhesion molecule CD31 is not a significant risk factor for graft-versus-host disease. Blood 1996; 88:4429-34. [PMID: 8977234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Mismatch between bone marrow transplant (BMT) patient and donor for an amino acid polymorphism within the adhesion molecule CD31 has recently been reported to increase risk for the development of graft-versus-host disease (GVHD). We further examined this association in a larger series of 301 BMT patients (227 with grade III/IV GVHD and 74 with grade 0 GVHD) and their HLA-identical sibling donors. CD31 genotypes were determined by polymerase chain reaction and restriction endonuclease digestion. The role of mismatch at the CD31 locus in the development of GVHD was assessed by analyzing the extent of CD31 identity and CD31 compatibility among the grade 0 GVHD and grade III/IV GVHD sibling pairs. No significant association between CD31 mismatch and the development of severe GVHD was detected in our overall patient population. Sixty-three percent of grade III/IV GVHD sibling pairs and 69% of grade 0 GVHD sibling pairs had CD31 genotypes that were identical (P = .36, odds ratio = 1.30). In addition, neither the grade 0 GVHD group (P = .10) nor the grade III/IV GVHD group (P = .27) differed significantly from the expected probability of identity between sibling pairs. Mismatch at the CD31 polymorphism between recipients and donors showed no consistent association with the development of GVHD. Current evidence does not support the value of CD31 mismatch in the selection of BMT donors.
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Affiliation(s)
- W C Nichols
- Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109-0650, USA
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