1
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Asakura T, Okuda K, Chen G, Dang H, Kato T, Mikami Y, Schworer SA, Gilmore RC, Radicioni G, Hawkins P, Barbosa Cardenas SM, Saito M, Cawley AM, De la Cruz G, Chua M, Alexis NE, Masugi Y, Noone PG, Ribeiro CMP, Kesimer M, Olivier KN, Hasegawa N, Randell SH, O’Neal WK, Boucher RC. Proximal and Distal Bronchioles Contribute to the Pathogenesis of Non-Cystic Fibrosis Bronchiectasis. Am J Respir Crit Care Med 2024; 209:374-389. [PMID: 38016030 PMCID: PMC10878387 DOI: 10.1164/rccm.202306-1093oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 11/28/2023] [Indexed: 11/30/2023] Open
Abstract
Rationale: Non-cystic fibrosis bronchiectasis (NCFB) may originate in bronchiolar regions of the lung. Accordingly, there is a need to characterize the morphology and molecular characteristics of NCFB bronchioles. Objectives: Test the hypothesis that NCFB exhibits a major component of bronchiolar disease manifest by mucus plugging and ectasia. Methods: Morphologic criteria and region-specific epithelial gene expression, measured histologically and by RNA in situ hybridization and immunohistochemistry, identified proximal and distal bronchioles in excised NCFB lungs. RNA in situ hybridization and immunohistochemistry assessed bronchiolar mucus accumulation and mucin gene expression. CRISPR-Cas9-mediated IL-1R1 knockout in human bronchial epithelial cultures tested IL-1α and IL-1β contributions to mucin production. Spatial transcriptional profiling characterized NCFB distal bronchiolar gene expression. Measurements and Main Results: Bronchiolar perimeters and lumen areas per section area were increased in proximal, but not distal, bronchioles in NCFB versus control lungs, suggesting proximal bronchiolectasis. In NCFB, mucus plugging was observed in ectatic proximal bronchioles and associated nonectatic distal bronchioles in sections with disease. MUC5AC and MUC5B mucins were upregulated in NCFB proximal bronchioles, whereas MUC5B was selectively upregulated in distal bronchioles. Bronchiolar mucus plugs were populated by IL-1β-expressing macrophages. NCFB sterile sputum supernatants induced human bronchial epithelial MUC5B and MUC5AC expression that was >80% blocked by IL-1R1 ablation. Spatial transcriptional profiling identified upregulation of genes associated with secretory cells, hypoxia, interleukin pathways, and IL-1β-producing macrophages in mucus plugs and downregulation of epithelial ciliogenesis genes. Conclusions: NCFB exhibits distinctive proximal and distal bronchiolar disease. Both bronchiolar regions exhibit bronchiolar secretory cell features and mucus plugging but differ in mucin gene regulation and ectasia.
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Affiliation(s)
- Takanori Asakura
- Marsico Lung Institute/Cystic Fibrosis Research Center
- Department of Clinical Medicine, Laboratory of Bioregulatory Medicine, Kitasato University School of Pharmacy, Tokyo, Japan
- Department of Respiratory Medicine, Kitasato University, Kitasato Institute Hospital, Tokyo, Japan
- Division of Pulmonary Medicine, Department of Medicine
| | - Kenichi Okuda
- Marsico Lung Institute/Cystic Fibrosis Research Center
| | - Gang Chen
- Marsico Lung Institute/Cystic Fibrosis Research Center
| | - Hong Dang
- Marsico Lung Institute/Cystic Fibrosis Research Center
| | - Takafumi Kato
- Marsico Lung Institute/Cystic Fibrosis Research Center
| | - Yu Mikami
- Marsico Lung Institute/Cystic Fibrosis Research Center
| | | | | | | | | | | | - Minako Saito
- Marsico Lung Institute/Cystic Fibrosis Research Center
| | | | | | - Michael Chua
- Marsico Lung Institute/Cystic Fibrosis Research Center
| | - Neil E. Alexis
- Center for Environmental Medicine, Asthma, and Lung Biology, Division of Allergy and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | | | | | | | | | - Kenneth N. Olivier
- Marsico Lung Institute/Cystic Fibrosis Research Center
- Pulmonary Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland
| | - Naoki Hasegawa
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan; and
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2
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Kato T, Asakura T, Edwards CE, Dang H, Mikami Y, Okuda K, Chen G, Sun L, Gilmore RC, Hawkins P, De la Cruz G, Cooley MR, Bailey AB, Hewitt SM, Chertow DS, Borczuk AC, Salvatore S, Martinez FJ, Thorne LB, Askin FB, Ehre C, Randell SH, O’Neal WK, Baric RS, Boucher RC. Prevalence and Mechanisms of Mucus Accumulation in COVID-19 Lung Disease. Am J Respir Crit Care Med 2022; 206:1336-1352. [PMID: 35816430 PMCID: PMC9746856 DOI: 10.1164/rccm.202111-2606oc] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 07/06/2022] [Indexed: 01/27/2023] Open
Abstract
Rationale: The incidence and sites of mucus accumulation and molecular regulation of mucin gene expression in coronavirus (COVID-19) lung disease have not been reported. Objectives: To characterize the incidence of mucus accumulation and the mechanisms mediating mucin hypersecretion in COVID-19 lung disease. Methods: Airway mucus and mucins were evaluated in COVID-19 autopsy lungs by Alcian blue and periodic acid-Schiff staining, immunohistochemical staining, RNA in situ hybridization, and spatial transcriptional profiling. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected human bronchial epithelial (HBE) cultures were used to investigate mechanisms of SARS-CoV-2-induced mucin expression and synthesis and test candidate countermeasures. Measurements and Main Results: MUC5B and variably MUC5AC RNA concentrations were increased throughout all airway regions of COVID-19 autopsy lungs, notably in the subacute/chronic disease phase after SARS-CoV-2 clearance. In the distal lung, MUC5B-dominated mucus plugging was observed in 90% of subjects with COVID-19 in both morphologically identified bronchioles and microcysts, and MUC5B accumulated in damaged alveolar spaces. SARS-CoV-2-infected HBE cultures exhibited peak titers 3 days after inoculation, whereas induction of MUC5B/MUC5AC peaked 7-14 days after inoculation. SARS-CoV-2 infection of HBE cultures induced expression of epidermal growth factor receptor (EGFR) ligands and inflammatory cytokines (e.g., IL-1α/β) associated with mucin gene regulation. Inhibiting EGFR/IL-1R pathways or administration of dexamethasone reduced SARS-CoV-2-induced mucin expression. Conclusions: SARS-CoV-2 infection is associated with a high prevalence of distal airspace mucus accumulation and increased MUC5B expression in COVID-19 autopsy lungs. HBE culture studies identified roles for EGFR and IL-1R signaling in mucin gene regulation after SARS-CoV-2 infection. These data suggest that time-sensitive mucolytic agents, specific pathway inhibitors, or corticosteroid administration may be therapeutic for COVID-19 lung disease.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Stephen M. Hewitt
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Daniel S. Chertow
- Critical Care Medicine Department, National Institutes of Health Clinical Center, Bethesda, Maryland; and
| | | | | | | | - Leigh B. Thorne
- Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Frederic B. Askin
- Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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3
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Patel R, Ioannou A, Razvi Y, Chacko L, Venneri L, Martinez-Naharro A, Masi A, Lachmann H, Wechalekar A, Petrie A, Whelan C, Hawkins P, Gillmore J, Fontana M. Size matters - redefining sex differences among patients with transthyretin amyloid cardiomyopathy – have we been wrong all along? Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1760] [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
Background
Transthyretin amyloid cardiomyopathy (ATTR-CM) is most often diagnosed in men (1–5). The few available studies suggest affected women have a more favourable cardiac phenotype (5–8), but remain unclear regarding differences in outcomes.
Objectives and methods
To characterise sex differences among consecutive patients with non-hereditary and two prevalent forms of hereditary ATTR-CM diagnosed over a 20-year period at our specialist centre through analysis of deep phenotyping at presentation, changes on serial echocardiography and overall prognosis.
Results
In total, 1732 patients were studied, comprising: 1095 with wild-type (wt)ATTR-CM; 206 with T60A-hATTR-CM; and 431 with V122I-hATTR-CM. Female prevalence was greater in T60A-hATTR-CM (29.6%) and V122I-hATTR-CM (27.8%) compared to wtATTR-CM (6%). At presentation, females were 3.3 years older than males (81.9 vs 77.8 years for wtATTR-CM; 68.7 vs 65.1 years for T60A-hATTR-CM; 77.1 vs 74.9 years for V122I-hATTR-CM). At diagnosis, non-indexed measures of wall thickness were significantly greater in males (interventricular septum in diastole (IVSd) of 17.13mm in males & 16.15mm in females; p<0.001). When indexed for body surface area (BSA), we observed that the mean indexed IVSd was fairly constant in males throughout the study period, but in females, had a tendency to decrease over the same study period. Furthermore, BSA significantly influenced measures of disease severity. When indexed for BSA, overall structural and functional phenotype was similar between sexes; the few observed significant differences including indexed IVSd (9.62mm/m2 in females & 8.88mm/m2 in males; p<0.001), indexed left ventricular (LV) end-diastolic volume (35.07ml/m2 in females & 41.05ml/m2 in males; p<0.001) and indexed LV end-systolic volume (17.95ml/m2 in females & 21.74ml/m2 in males; p<0.001) suggested a mildly worse phenotype in females. No significant differences were observed in disease progression on serial echocardiography and mortality across the overall population (p=0.459) and when divided by genotype (p=0.730 for wtATTR-CM; p=0.161 for T60A-hATTR-CM; p=0.056 for V122I-hATTR-CM).
Conclusion
This study of a well-characterized large cohort of ATTR-CM patients, contrary to previous dogmas, did not demonstrate overall differences between sexes in either clinical phenotype, when indexed, or with respect to disease progression and prognosis. The analysis highlighted the deficiencies in using non-indexed values which can not only lead to the inaccurate perception of a milder clinical phenotype in women compared to men, but has been shown to result in female patients presenting at an older age and with a worse phenotype compared to men. These findings indicate the need for revision of existing clinical guidelines regarding awareness and diagnosis of ATTR-CM in women, and modification of clinical trials which currently use single non-indexed threshold for wall thickness as key inclusion criterion.
Funding Acknowledgement
Type of funding sources: Foundation.
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Affiliation(s)
- R Patel
- Royal Free Hospital , London , United Kingdom
| | - A Ioannou
- Royal Free Hospital , London , United Kingdom
| | - Y Razvi
- Royal Free Hospital , London , United Kingdom
| | - L Chacko
- Royal Free Hospital , London , United Kingdom
| | - L Venneri
- Royal Free Hospital , London , United Kingdom
| | | | - A Masi
- Royal Free Hospital , London , United Kingdom
| | - H Lachmann
- Royal Free Hospital , London , United Kingdom
| | | | - A Petrie
- University College London, Eastman Dental Institute , London , United Kingdom
| | - C Whelan
- Royal Free Hospital , London , United Kingdom
| | - P Hawkins
- Royal Free Hospital , London , United Kingdom
| | - J Gillmore
- Royal Free Hospital , London , United Kingdom
| | - M Fontana
- Royal Free Hospital , London , United Kingdom
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4
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Razvi Y, Patel R, Ioannou A, Rauf MU, Masi A, Porcari A, Blakeney I, Kaza N, Lachmann H, Whelan C, Venneri L, Martinez-Naharro A, Hawkins P, Fontana M, Gillmore JD. Cardiac transplantation in transthyretin amyloid cardiomyopathy: outcomes from three decades of tertiary centre experience. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1784] [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
Background
Transthyretin cardiac amyloidosis (ATTR-CM) is a progressive and fatal cardiomyopathy. Treatment options in patients with advanced heart failure are limited to cardiac transplantation (CT). Despite small case series demonstrating comparable outcomes with CT between patients with ATTR-CM and non-amyloid cardiomyopathies, ATTR-CM is considered to be an absolute contraindication to CT in some centres. This is in part due to a perceived risk of amyloid recurrence in the cardiac allograft. We report outcomes of patients with ATTR-CM assessed at our centre whom underwent CT over the past thirty years.
Methods
We retrospectively evaluated all ATTR-CM patients assessed at the UK National Amyloidosis Centre between 1990 and 2020 who underwent CT. Pre-transplantation disease and patient characteristics were determined and outcomes were compared with our large cohort of non-transplanted ATTR-CM patients. Censor date was 11th January 2022.
Results
Eleven (9 male, 2 female) patients with ATTR-CM underwent CT including 8 with wild-type ATTR-CM and 3 with variant ATTR-CM (ATTRv). Median age at CT was 60.3 years and median follow up post-CT was 65.7 months. Median (range) NT-proBNP concentration pre-transplant was 4478ng/L (1057–8778ng/L), median (range) left ventricular ejection fraction (LVEF) was 39% (27–56%) and mean (IQR) interventricular septal (IVSD) was 18 mm (15.9–20.1 mm). 8 patients were NYHA functional class III, the 3 remaining patients were class II.
One, three, and five-year survival was 100%, 89% and 86%, respectively and the longest surviving patient was censored >19 years post CT. Survival is at least comparable to UK and US CT outcome registry data for all non-amyloid patients undergoing CT. No patients had recurrence of amyloid in the cardiac allograft as assessed by endomyocardial biopsy and/or Tc-DPD scintigraphy. Two patients were commenced on Patisiran for amyloid polyneuropathy at 211 and 5 months post-CT. Graft rejection requiring treatment was observed in 2 patients, and successfully treated with intravenous steroids. Renal impairment was common, with 6 patients being left with chronic kidney disease.
Three patients died, including one with ATTRv-CM from complications of leptomeningeal amyloidosis. Survival among the cohort of patients who underwent CT was significantly longer than UK patients with ATTR-CM generally (P≤0.006), regardless of NAC ATTR disease stage and including those diagnosed under 65 years of age (P=0.028). (Figure 1) All surviving patients were NYHA functional class I at time of censor.
Conclusion
Our data indicates that cardiac transplantation is well tolerated, restores functional capacity, and prolongs survival in ATTR-CM with little risk of recurrence of amyloid in the cardiac allograft. We believe that our data argues strongly for ATTR-CM to be routinely included in the list of indications for cardiac transplantation.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- Y Razvi
- University College London , London , United Kingdom
| | - R Patel
- University College London , London , United Kingdom
| | - A Ioannou
- University College London , London , United Kingdom
| | - M U Rauf
- University College London , London , United Kingdom
| | - A Masi
- University College London , London , United Kingdom
| | - A Porcari
- University College London , London , United Kingdom
| | - I Blakeney
- University College London , London , United Kingdom
| | - N Kaza
- Imperial College London , London , United Kingdom
| | - H Lachmann
- University College London , London , United Kingdom
| | - C Whelan
- University College London , London , United Kingdom
| | - L Venneri
- University College London , London , United Kingdom
| | | | - P Hawkins
- University College London , London , United Kingdom
| | - M Fontana
- University College London , London , United Kingdom
| | - J D Gillmore
- University College London , London , United Kingdom
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5
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Patel R, Martinez-Naharro A, Kotecha T, Karia N, Ioannou A, Petrie A, Chacko L, Razvi Y, Lachmann H, Venneri L, Kellman P, Gillmore J, Hawkins P, Wechalekar A, Fontana M. Progression, regression and redefining the treatment response – cardiac magnetic resonance with T1 and extracellular volume mapping in cardiac light-chain amyloidosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.297] [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
Background
The presence and severity of cardiac involvement in AL amyloidosis is the main driver of prognosis [1]; patients with symptomatic heart failure frequently die within 6 months [1] but median survival has nearly doubled over the past decade, mainly due to significant improvements in chemotherapy. The haematological response to chemotherapy is principally evaluated with serial measurements of serum-free light-chains (FLC) [2]. The cardiac response to chemotherapy is assessed through changes in serum concentrations of brain natriuretic peptides (including NT-proBNP) and echocardiographic parameters [3–5]. Neither are able to directly measure cardiac amyloid burden. Cardiovascular magnetic resonance (CMR) with extra-cellular volume (ECV) mapping can measure the extent cardiac amyloid infiltration [6].
Aims
We investigated the ability of CMR to: 1) measure changes in response to chemotherapy; 2) assess the correlation between haematological response (HMR) and changes in cardiac amyloid; 3) assess the association between changes in cardiac amyloid and prognosis over and above existing predictors.
Methods
In total, 176 patients with cardiac light-chain amyloidosis treated with chemotherapy were assessed with FLC, NT-proBNP and CMR with ECV mapping at baseline (before chemotherapy), 6-months, 12-months & 24-months after commencing chemotherapy. Haematological response was categorized by reductions in FLC as: complete response (CR), very good partial response (VGPR), partial response (PR) or no response (NR). CMR response was categorized by changes in ECV as: progression (≥0.05 increase), stable (<0.05 change) or regression (≥0.05 decrease).
Results
A progressive increase in patients achieving either CR or VGPR was observed at each time point (61% of patients at 6-months, 71% at 12-months and 80% at 24-months). At 6-months, CMR regression was observed in 3% (all had either CR or VGPR) and progression in 32% (61% had either PR or NR; 39% had either CR or VGPR). At 1-year, CMR regression was observed in 22% (all had either CR or VGPR); progression in 22% (63% had either PR or NR; 37% had either CR or VGPR). At 2-years, CMR regression was observed in 38% (all had CR/VGPR); progression in 14% (80% had either PR or NR; 20% had either CR or VGPR). During follow-up (40±15 months), 36 (25%) patients died. CMR response at 6-months predicted death (progression HR 3.821; 95% CI 1.950–7.487; p<0.001) and remained independently associated with prognosis after adjusting for haematological response, NT-proBNP and longitudinal strain on echocardiography (p<0.01).
Conclusions
CMR demonstrates that cardiac amyloid deposits frequently regress following chemotherapy, but only in patients who achieve CR or VGPR, highlighting the need for deep haematological response. Changes in amyloid burden (ECV) predict outcomes after adjusting for known predictors, showing the crucial role of CMR in redefining treatment response.
Funding Acknowledgement
Type of funding sources: Foundation.
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Affiliation(s)
- R Patel
- Royal Free Hospital , London , United Kingdom
| | | | - T Kotecha
- Royal Free Hospital , London , United Kingdom
| | - N Karia
- Royal Free Hospital , London , United Kingdom
| | - A Ioannou
- Royal Free Hospital , London , United Kingdom
| | - A Petrie
- University College London, Eastman Dental Institute , London , United Kingdom
| | - L Chacko
- Royal Free Hospital , London , United Kingdom
| | - Y Razvi
- Royal Free Hospital , London , United Kingdom
| | - H Lachmann
- Royal Free Hospital , London , United Kingdom
| | - L Venneri
- Royal Free Hospital , London , United Kingdom
| | - P Kellman
- National Heart Lung and Blood Institute, National Institutes of Health , Bethesda , United States of America
| | - J Gillmore
- Royal Free Hospital , London , United Kingdom
| | - P Hawkins
- Royal Free Hospital , London , United Kingdom
| | | | - M Fontana
- Royal Free Hospital , London , United Kingdom
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6
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Dinnon KH, Leist SR, Okuda K, Dang H, Fritch EJ, Gully KL, De la Cruz G, Evangelista MD, Asakura T, Gilmore RC, Hawkins P, Nakano S, West A, Schäfer A, Gralinski LE, Everman JL, Sajuthi SP, Zweigart MR, Dong S, McBride J, Cooley MR, Hines JB, Love MK, Groshong SD, VanSchoiack A, Phelan SJ, Liang Y, Hether T, Leon M, Zumwalt RE, Barton LM, Duval EJ, Mukhopadhyay S, Stroberg E, Borczuk A, Thorne LB, Sakthivel MK, Lee YZ, Hagood JS, Mock JR, Seibold MA, O’Neal WK, Montgomery SA, Boucher RC, Baric RS. SARS-CoV-2 infection produces chronic pulmonary epithelial and immune cell dysfunction with fibrosis in mice. Sci Transl Med 2022; 14:eabo5070. [PMID: 35857635 PMCID: PMC9273046 DOI: 10.1126/scitranslmed.abo5070] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
A subset of individuals who recover from coronavirus disease 2019 (COVID-19) develop post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (PASC), but the mechanistic basis of PASC-associated lung abnormalities suffers from a lack of longitudinal tissue samples. The mouse-adapted SARS-CoV-2 strain MA10 produces an acute respiratory distress syndrome in mice similar to humans. To investigate PASC pathogenesis, studies of MA10-infected mice were extended from acute to clinical recovery phases. At 15 to 120 days after virus clearance, pulmonary histologic findings included subpleural lesions composed of collagen, proliferative fibroblasts, and chronic inflammation, including tertiary lymphoid structures. Longitudinal spatial transcriptional profiling identified global reparative and fibrotic pathways dysregulated in diseased regions, similar to human COVID-19. Populations of alveolar intermediate cells, coupled with focal up-regulation of profibrotic markers, were identified in persistently diseased regions. Early intervention with antiviral EIDD-2801 reduced chronic disease, and early antifibrotic agent (nintedanib) intervention modified early disease severity. This murine model provides opportunities to identify pathways associated with persistent SARS-CoV-2 pulmonary disease and test countermeasures to ameliorate PASC.
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Affiliation(s)
- Kenneth H. Dinnon
- Department of Microbiology & Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Sarah R. Leist
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Kenichi Okuda
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Hong Dang
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Ethan J. Fritch
- Department of Microbiology & Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Kendra L. Gully
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Gabriela De la Cruz
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Mia D. Evangelista
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Takanori Asakura
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Rodney C. Gilmore
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Padraig Hawkins
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Satoko Nakano
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Ande West
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Alexandra Schäfer
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Lisa E. Gralinski
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Jamie L. Everman
- Center for Genes, Environment, and Health, National Jewish Health, Denver, Colorado 80206, USA
| | - Satria P. Sajuthi
- Center for Genes, Environment, and Health, National Jewish Health, Denver, Colorado 80206, USA
| | - Mark R. Zweigart
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Stephanie Dong
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Jennifer McBride
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Michelle R. Cooley
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Jesse B. Hines
- Golden Point Scientific Laboratories, Hoover, Alabama 35216, USA
| | - Miriya K. Love
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Steve D. Groshong
- Division of Pathology, Department of Medicine, National Jewish Health, Denver, Colorado 80206, USA
| | | | | | - Yan Liang
- NanoString Technologies, Seattle, Washington 98109, USA
| | - Tyler Hether
- NanoString Technologies, Seattle, Washington 98109, USA
| | - Michael Leon
- NanoString Technologies, Seattle, Washington 98109, USA
| | - Ross E. Zumwalt
- Department of Pathology and Laboratory Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA
| | - Lisa M. Barton
- Office of the Chief Medical Examiner, Oklahoma City, Oklahoma 73105, USA
| | - Eric J. Duval
- Office of the Chief Medical Examiner, Oklahoma City, Oklahoma 73105, USA
| | | | - Edana Stroberg
- Office of the Chief Medical Examiner, Oklahoma City, Oklahoma 73105, USA
| | - Alain Borczuk
- Weill Cornell Medicine, New York, New York 10065, USA
| | - Leigh B. Thorne
- Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Muthu K. Sakthivel
- Department of Radiology, University of North Carolina at Chapel Hill, North Carolina 27599, USA
| | - Yueh Z. Lee
- Department of Radiology, University of North Carolina at Chapel Hill, North Carolina 27599, USA
- Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - James S. Hagood
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
- Department of Pediatrics, Pulmonology Division and Program for Rare and Interstitial Lung Disease, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Jason R. Mock
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
- Division of Pulmonary Diseases and Critical Care Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Max A. Seibold
- Center for Genes, Environment, and Health, National Jewish Health, Denver, Colorado 80206, USA
- Department of Pediatrics, National Jewish Health, Denver, Colorado 80206, USA
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, Colorado 80045, USA
| | - Wanda K. O’Neal
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
- Correspondence: wanda_o' (W.O.), (S.A.M.), (R.C.B.), (R.S.B.)
| | - Stephanie A. Montgomery
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
- Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
- Correspondence: wanda_o' (W.O.), (S.A.M.), (R.C.B.), (R.S.B.)
| | - Richard C. Boucher
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
- Correspondence: wanda_o' (W.O.), (S.A.M.), (R.C.B.), (R.S.B.)
| | - Ralph S. Baric
- Department of Microbiology & Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
- Rapidly Emerging Antiviral Drug Discovery Initiative, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
- Correspondence: wanda_o' (W.O.), (S.A.M.), (R.C.B.), (R.S.B.)
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7
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Dinnon KH, Leist SR, Okuda K, Dang H, Fritch EJ, Gully KL, De la Cruz G, Evangelista MD, Asakura T, Gilmore RC, Hawkins P, Nakano S, West A, Schäfer A, Gralinski LE, Everman JL, Sajuthi SP, Zweigart MR, Dong S, McBride J, Cooley MR, Hines JB, Love MK, Groshong SD, VanSchoiack A, Phelan SJ, Liang Y, Hether T, Leon M, Zumwalt RE, Barton LM, Duval EJ, Mukhopadhyay S, Stroberg E, Borczuk A, Thorne LB, Sakthivel MK, Lee YZ, Hagood JS, Mock JR, Seibold MA, O’Neal WK, Montgomery SA, Boucher RC, Baric RS. A model of persistent post SARS-CoV-2 induced lung disease for target identification and testing of therapeutic strategies. bioRxiv 2022:2022.02.15.480515. [PMID: 35194605 PMCID: PMC8863140 DOI: 10.1101/2022.02.15.480515] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
COVID-19 survivors develop post-acute sequelae of SARS-CoV-2 (PASC), but the mechanistic basis of PASC-associated lung abnormalities suffers from a lack of longitudinal samples. Mouse-adapted SARS-CoV-2 MA10 produces an acute respiratory distress syndrome (ARDS) in mice similar to humans. To investigate PASC pathogenesis, studies of MA10-infected mice were extended from acute disease through clinical recovery. At 15-120 days post-virus clearance, histologic evaluation identified subpleural lesions containing collagen, proliferative fibroblasts, and chronic inflammation with tertiary lymphoid structures. Longitudinal spatial transcriptional profiling identified global reparative and fibrotic pathways dysregulated in diseased regions, similar to human COVID-19. Populations of alveolar intermediate cells, coupled with focal upregulation of pro-fibrotic markers, were identified in persistently diseased regions. Early intervention with antiviral EIDD-2801 reduced chronic disease, and early anti-fibrotic agent (nintedanib) intervention modified early disease severity. This murine model provides opportunities to identify pathways associated with persistent SARS-CoV-2 pulmonary disease and test countermeasures to ameliorate PASC.
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Affiliation(s)
- Kenneth H. Dinnon
- Department of Microbiology & Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sarah R. Leist
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kenichi Okuda
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Hong Dang
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ethan J. Fritch
- Department of Microbiology & Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kendra L. Gully
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Gabriela De la Cruz
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Mia D. Evangelista
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Takanori Asakura
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Rodney C. Gilmore
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Padraig Hawkins
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Satoko Nakano
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ande West
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Alexandra Schäfer
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lisa E. Gralinski
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jamie L. Everman
- Center for Genes, Environment, and Health, National Jewish Health, Denver, Colorado, USA
| | - Satria P. Sajuthi
- Center for Genes, Environment, and Health, National Jewish Health, Denver, Colorado, USA
| | - Mark R. Zweigart
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Stephanie Dong
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jennifer McBride
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Michelle R. Cooley
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jesse B. Hines
- Golden Point Scientific Laboratories, Hoover, Alabama, USA
| | - Miriya K. Love
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Steve D. Groshong
- Division of Pathology, Department of Medicine, National Jewish Health, Denver, Colorado, USA
| | | | | | - Yan Liang
- NanoString Technologies, Seattle, Washington, USA
| | - Tyler Hether
- NanoString Technologies, Seattle, Washington, USA
| | - Michael Leon
- NanoString Technologies, Seattle, Washington, USA
| | - Ross E. Zumwalt
- Department of Pathology and Laboratory Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Lisa M. Barton
- Office of the Chief Medical Examiner, Oklahoma City, Oklahoma, USA
| | - Eric J. Duval
- Office of the Chief Medical Examiner, Oklahoma City, Oklahoma, USA
| | | | - Edana Stroberg
- Office of the Chief Medical Examiner, Oklahoma City, Oklahoma, USA
| | | | - Leigh B. Thorne
- Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Muthu K. Sakthivel
- Department of Radiology, University of North Carolina at Chapel Hill, North Carolina, USA
| | - Yueh Z. Lee
- Department of Radiology, University of North Carolina at Chapel Hill, North Carolina, USA
- Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - James S. Hagood
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Pediatrics, Pulmonology Division and Program for Rare and Interstitial Lung Disease, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jason R. Mock
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Division of Pulmonary Diseases and Critical Care Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Max A. Seibold
- Center for Genes, Environment, and Health, National Jewish Health, Denver, Colorado, USA
- Department of Pediatrics, National Jewish Health, Denver, Colorado, USA
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado-Denver, Denver, Colorado, USA
| | - Wanda K. O’Neal
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Stephanie A. Montgomery
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Richard C. Boucher
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ralph S. Baric
- Department of Microbiology & Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Rapidly Emerging Antiviral Drug Discovery Initiative, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Hawkins P, McEnery T, Gabillard-Lefort C, Bergin DA, Alfawaz B, Shutchaidat V, Meleady P, Henry M, Coleman O, Murphy M, McElvaney NG, Reeves EP. In vitro and in vivo modulation of NADPH oxidase activity and reactive oxygen species production in human neutrophils by α 1-antitrypsin. ERJ Open Res 2021; 7:00234-2021. [PMID: 34881324 PMCID: PMC8645872 DOI: 10.1183/23120541.00234-2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 08/29/2021] [Indexed: 12/17/2022] Open
Abstract
Oxidative stress from innate immune cells is a driving mechanism that underlies COPD pathogenesis. Individuals with α-1 antitrypsin (AAT) deficiency (AATD) have a dramatically increased risk of developing COPD. To understand this further, the aim of this study was to investigate whether AATD presents with altered neutrophil NADPH oxidase activation, due to the specific lack of plasma AAT. Experiments were performed using circulating neutrophils isolated from healthy controls and individuals with AATD. Superoxide anion (O2−) production was determined from the rate of reduction of cytochrome c. Quantification of membrane NADPH oxidase subunits was performed by mass spectrometry and Western blot analysis. The clinical significance of our in vitro findings was assessed in patients with AATD and severe COPD receiving intravenous AAT replacement therapy. In vitro, AAT significantly inhibited O2− production by stimulated neutrophils and suppressed receptor stimulation of cyclic adenosine monophosphate and extracellular signal-regulated kinase (ERK)1/2 phosphorylation. In addition, AAT reduced plasma membrane translocation of cytosolic phox components of the NADPH oxidase. Ex vivo, AATD neutrophils demonstrated increased plasma membrane-associated p67phox and p47phox and significantly increased O2− production. The described variance in phox protein membrane assembly was resolved post-AAT augmentation therapy in vivo, the effects of which significantly reduced AATD neutrophil O2− production to that of healthy control cells. These results expand our knowledge on the mechanism of neutrophil-driven airways disease associated with AATD. Therapeutic AAT augmentation modified neutrophil NADPH oxidase assembly and reactive oxygen species production, with implications for clinical use in conditions in which oxidative stress plays a pathogenic role. Circulating neutrophils in COPD due to α1-antitrypsin deficiency illustrate increased NADPH oxidase assembly and reactive oxygen species production, a defect corrected by α1-antitrypsin augmentation therapyhttps://bit.ly/38NNTzM
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Affiliation(s)
- Padraig Hawkins
- Irish Centre for Genetic Lung Disease, Dept of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - Thomas McEnery
- Irish Centre for Genetic Lung Disease, Dept of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - Claudie Gabillard-Lefort
- Irish Centre for Genetic Lung Disease, Dept of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - David A Bergin
- Irish Centre for Genetic Lung Disease, Dept of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - Bader Alfawaz
- Irish Centre for Genetic Lung Disease, Dept of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - Vipatsorn Shutchaidat
- Irish Centre for Genetic Lung Disease, Dept of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - Paula Meleady
- National Institute for Cellular Biology, Dublin City University, Glasnevin, Dublin, Ireland
| | - Michael Henry
- National Institute for Cellular Biology, Dublin City University, Glasnevin, Dublin, Ireland
| | - Orla Coleman
- National Institute for Cellular Biology, Dublin City University, Glasnevin, Dublin, Ireland
| | - Mark Murphy
- Irish Centre for Genetic Lung Disease, Dept of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - Noel G McElvaney
- Irish Centre for Genetic Lung Disease, Dept of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.,These authors contributed equally
| | - Emer P Reeves
- Irish Centre for Genetic Lung Disease, Dept of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.,These authors contributed equally
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9
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Hawkins P, Sya J, Hup NK, Murphy MP, McElvaney NG, Reeves EP. Alpha-1 Antitrypsin Augmentation Inhibits Proteolysis of Neutrophil Membrane Voltage-Gated Proton Channel-1 in Alpha-1 Deficient Individuals. ACTA ACUST UNITED AC 2021; 57:medicina57080814. [PMID: 34441020 PMCID: PMC8398194 DOI: 10.3390/medicina57080814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Alpha-1 antitrypsin is a serine protease inhibitor that demonstrates an array of immunomodulatory functions. Individuals with the genetic condition of alpha-1 antitrypsin deficiency (AATD) are at increased risk of early onset emphysematous lung disease. This lung disease is partly driven by neutrophil mediated lung destruction in an environment of low AAT. As peripheral neutrophil hyper-responsiveness in AATD leads to excessive degranulation and increased migration to the airways, we examined the expression of the membrane voltage-gated proton channel-1 (HVCN1), which is integrally linked to neutrophil function. The objectives of this study were to evaluate altered HVCN1 in AATD neutrophils, serine protease-dependent degradation of HVCN1, and to investigate the ability of serum AAT to control HVCN1 expression. Materials and Methods: Circulating neutrophils were purified from AATD patients (n = 20), AATD patients receiving AAT augmentation therapy (n = 3) and healthy controls (n = 20). HVCN1 neutrophil expression was assessed by flow cytometry and Western blot analysis. Neutrophil membrane bound elastase was measured by fluorescence resonance energy transfer. Results: In this study we demonstrated that HVCN1 protein is under-expressed in AATD neutrophils (p = 0.02), suggesting a link between reduced HVCN1 expression and AAT deficiency. We have demonstrated that HVCN1 undergoes significant proteolytic degradation in activated neutrophils (p < 0.0001), primarily due to neutrophil elastase activity (p = 0.0004). In addition, the treatment of AATD individuals with AAT augmentation therapy increased neutrophil plasma membrane HVCN1 expression (p = 0.01). Conclusions: Our results demonstrate reduced levels of HVCN1 in peripheral blood neutrophils that may influence the neutrophil-dominated immune response in the AATD airways and highlights the role of antiprotease treatment and specifically AAT augmentation therapy in protecting neutrophil membrane expression of HVCN1.
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10
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Hawkins P, Chawke L, Cormican L, Wikenheiser-Brokamp KA, Fabre A, Keane MP, McCarthy C. Autoimmune pulmonary alveolar proteinosis: a discrepancy between symptoms and CT findings. Lancet 2021; 398:e7. [PMID: 34274066 DOI: 10.1016/s0140-6736(21)01254-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/03/2021] [Accepted: 05/13/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Padraig Hawkins
- Department of Respiratory Medicine, St Vincent's University Hospital, Dublin, Ireland
| | - Liam Chawke
- Department of Respiratory Medicine, St Vincent's University Hospital, Dublin, Ireland
| | - Liam Cormican
- Department of Respiratory Medicine, Connolly Hospital, Blanchardstown, Dublin, Ireland
| | - Kathryn A Wikenheiser-Brokamp
- Division of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pathology and Laboratory Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Aurelie Fabre
- Department of Histopathology, St Vincent's University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Dublin, Ireland
| | - Michael P Keane
- Department of Respiratory Medicine, St Vincent's University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Dublin, Ireland
| | - Cormac McCarthy
- Department of Respiratory Medicine, St Vincent's University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Dublin, Ireland.
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Hawkins P, Doyle A, Gavin L, Fabre A, Murphy DJ, Dunican E, McCarthy C. A 33-Year-Old Man With Dyspnea, Chest Pain, and a Massive Pleural Effusion. Chest 2021; 159:e39-e43. [PMID: 33422239 DOI: 10.1016/j.chest.2020.08.2102] [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] [Received: 07/09/2020] [Revised: 07/29/2020] [Accepted: 08/04/2020] [Indexed: 10/22/2022] Open
Abstract
CASE PRESENTATION A 33-year-old white man presented to the ED with 1-month history of worsening dyspnea. He experienced gradual onset of right-sided scapular pain and shortness of breath on exertion that progressively worsened over the course of 1 month. He had a mild nonproductive cough and intermittent subjective fevers and reported weight loss of approximately 2 kg over 1 month. He had a history of two episodes of acute pancreatitis that was thought to be autoimmune in origin. He was a never smoker; he denied illicit drug use or recent alcohol consumption. He had no known TB exposure, but his mother had a history of sarcoidosis.
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Affiliation(s)
- Padraig Hawkins
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland
| | - Aoife Doyle
- Department of Histopathology, St. Vincent's University Hospital, Dublin, Ireland
| | - Leo Gavin
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland
| | - Aurelie Fabre
- Department of Histopathology, St. Vincent's University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Dublin, Ireland
| | - David J Murphy
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Dublin, Ireland
| | - Eleanor Dunican
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Dublin, Ireland
| | - Cormac McCarthy
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Dublin, Ireland.
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Bandera F, Martone R, Chacko L, Ganesananthan S, Gilbertson JA, Ponticos M, Petrie A, Cappelli F, Guazzi M, Potena L, Rapezzi C, Leone O, Hawkins P, Gillmore JD, Fontana M. Clinical importance of left atrial infiltration in cardiac transthyretin amyloidosis. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
INTRODUCTION
The clinical significance of left atrial (LA) involvement in ATTR amyloidosis cardiomyopathy (ATTR-CM) has not been characterized. The aims of this study were to characterize: (1)LA pathology in explanted ATTR-CM hearts; (2)LA mechanics using echocardiographic speckle-tracking in a large cohort of ATTR-CM patients; (3)to study the association with mortality.
METHODS AND RESULTS
Congo red staining and immunohistochemistry was performed to assess the presence, type and extent of amyloid and associated changes in 5 explanted ATTR-CM atria. Echo speckle-tracking was used to assess LA reservoir, conduit, contractile function and stiffness in 906 ATTR-CM patients (551 wt-ATTR-CM;93 T60A-ATTR-CM;241 V122I-ATTR-CM;21 other).
There was extensive ATTR amyloid infiltration in the 5 atria with loss of normal architecture, vessels remodelling, capillary disruption and subendocardial fibrosis. Echo speckle-tracking in 906 ATTR-CM patients demonstrated increased atrial stiffness [median(25th-75th quartile) 1.83(1.15-2.92)] that remained independently associated with prognosis, after adjusting for known predictors (lnLA stiff:HR = 1.26,CI 1.07-1.57;p = 0.009). There was substantial impairment of the three phasic functional atrial components [reservoir 8.86(5.94-12.97)%; conduit 6.5(4.53-9.28)%; contraction function 4.0(2.29-6.56)%]. Atrial contraction was absent in 21.6% of patients whose ECG showed sinus rhythm (SR)-"atrial electro-mechanical dissociation"(AEMD). AEMD was associated with poorer prognosis compared to SR patients with effective mechanical contraction (p < 0.0001). AEMD conferred a similar prognosis to patients in AF.
CONCLUSION
The phenotype of ATTR-CM includes significant infiltration of the atrial walls with progressive loss of atrial function and increased stiffness, which is a strong independent predictor of mortality. AEMD emerged as a distinctive phenotype identifying patients in SR with poor prognosis.
Abstract Figure.
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Affiliation(s)
- F Bandera
- IRCCS Polyclinic San Donato, Department of University Cardiology, Milan, Italy
| | - R Martone
- Royal Free Hospital, National Amyloidosis Centre, University College London, London, United Kingdom of Great Britain & Northern Ireland
| | - L Chacko
- Royal Free Hospital, National Amyloidosis Centre, University College London, London, United Kingdom of Great Britain & Northern Ireland
| | - S Ganesananthan
- Royal Free Hospital, National Amyloidosis Centre, University College London, London, United Kingdom of Great Britain & Northern Ireland
| | - JA Gilbertson
- Royal Free Hospital, National Amyloidosis Centre, University College London, London, United Kingdom of Great Britain & Northern Ireland
| | - M Ponticos
- Royal Free Hospital, National Amyloidosis Centre, University College London, London, United Kingdom of Great Britain & Northern Ireland
| | - A Petrie
- Royal Free Hospital, National Amyloidosis Centre, University College London, London, United Kingdom of Great Britain & Northern Ireland
| | - F Cappelli
- Careggi University Hospital (AOUC), Tuscan Regional Amyloid Center, Florence, Italy
| | - M Guazzi
- IRCCS Polyclinic San Donato, Department of University Cardiology, Milan, Italy
| | - L Potena
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - C Rapezzi
- University Hospital of Ferrara, Ferrara, Italy
| | - O Leone
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - P Hawkins
- Royal Free Hospital, National Amyloidosis Centre, University College London, London, United Kingdom of Great Britain & Northern Ireland
| | - JD Gillmore
- Royal Free Hospital, National Amyloidosis Centre, University College London, London, United Kingdom of Great Britain & Northern Ireland
| | - M Fontana
- Royal Free Hospital, National Amyloidosis Centre, University College London, London, United Kingdom of Great Britain & Northern Ireland
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Hayes E, Murphy MP, Pohl K, Browne N, McQuillan K, Saw LE, Foley C, Gargoum F, McElvaney OJ, Hawkins P, Gunaratnam C, McElvaney NG, Reeves EP. Altered Degranulation and pH of Neutrophil Phagosomes Impacts Antimicrobial Efficiency in Cystic Fibrosis. Front Immunol 2020; 11:600033. [PMID: 33391268 PMCID: PMC7775508 DOI: 10.3389/fimmu.2020.600033] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/16/2020] [Indexed: 12/14/2022] Open
Abstract
Studies have endeavored to understand the cause for impaired antimicrobial killing by neutrophils of people with cystic fibrosis (PWCF). The aim of this study was to focus on the bacterial phagosome. Possible alterations in degranulation of cytoplasmic granules and changes in pH were assessed. Circulating neutrophils were purified from PWCF (n = 28), PWCF receiving ivacaftor therapy (n = 10), and healthy controls (n = 28). Degranulation was assessed by Western blot analysis and flow cytometry. The pH of phagosomes was determined by use of BCECF-AM-labelled Staphylococcus aureus or SNARF labelled Candida albicans. The antibacterial effect of all treatments tested was determined by colony forming units enumeration. Bacterial killing by CF and healthy control neutrophils were found to differ (p = 0.0006). By use of flow cytometry and subcellular fractionation the kinetics of intraphagosomal degranulation were found to be significantly altered in CF phagosomes, as demonstrated by increased primary granule CD63 (p = 0.0001) and myeloperoxidase (MPO) content (p = 0.03). In contrast, decreased secondary and tertiary granule CD66b (p = 0.002) and decreased hCAP-18 and MMP-9 (p = 0.02), were observed. After 8 min phagocytosis the pH in phagosomes of neutrophils of PWCF was significantly elevated (p = 0.0001), and the percentage of viable bacteria was significantly increased compared to HC (p = 0.002). Results demonstrate that the recorded alterations in phagosomal pH generate suboptimal conditions for MPO related peroxidase, and α-defensin and azurocidine enzymatic killing of Staphylococcus aureus and Pseudomonas aeruginosa. The pattern of dysregulated MPO degranulation (p = 0.02) and prolonged phagosomal alkalinization in CF neutrophils were normalized in vivo following treatment with the ion channel potentiator ivacaftor (p = 0.04). Our results confirm that alterations of circulating neutrophils from PWCF are corrected by CFTR modulator therapy, and raise a question related to possible delayed proton channel activity in CF.
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Affiliation(s)
- Elaine Hayes
- Irish Centre for Genetic Lung Disease, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Mark P Murphy
- Irish Centre for Genetic Lung Disease, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Kerstin Pohl
- Irish Centre for Genetic Lung Disease, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Niall Browne
- Irish Centre for Genetic Lung Disease, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Karen McQuillan
- Irish Centre for Genetic Lung Disease, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Le Er Saw
- Irish Centre for Genetic Lung Disease, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Clare Foley
- Irish Centre for Genetic Lung Disease, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Fatma Gargoum
- Irish Centre for Genetic Lung Disease, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Oliver J McElvaney
- Irish Centre for Genetic Lung Disease, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Padraig Hawkins
- Irish Centre for Genetic Lung Disease, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Cedric Gunaratnam
- Irish Centre for Genetic Lung Disease, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Noel G McElvaney
- Irish Centre for Genetic Lung Disease, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Emer P Reeves
- Irish Centre for Genetic Lung Disease, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
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14
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Chacko L, Martinez-Naharro A, Kotecha T, Martone R, Hutt D, Lane T, Knight D, Moon J, Kellman P, Hawkins P, Gillmore J, Fontana M. Regression of cardiac amyloid deposits with novel therapeutics: reaching new frontiers in cardiac ATTR amyloidosis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Cardiac involvement is the main driver of outcome in ATTR amyloidosis. Advances in therapeutics hold potential in transforming the course of the disease but the impact on cardiac amyloid load is unknown. The aim of this study was to evaluate the impact of patisiran, a new double stranded RNA based gene silencing therapy and a stabilizer, diflunisal, on cardiac amyloid load as measured by CMR and T1 mapping, in patients with ATTR amyloidosis.
Methods and results
Thirty-two patients with hereditary cardiac amyloidosis were studied. Sixteen patients received treatment with patisiran, and sixteen control subjects did not receive any disease modifying treatment. Patients were assessed with echocardiogram, CMR, NT-proBNP and six-minute walk time measurements at baseline and at 1 year (Mean interval 11.45±3.08 months in treatment group, mean interval 12.82±5.06 months in the control group). CMR analysis comprised LV volumes, T1 mapping to measure the extracellular volume (ECV) occupied by amyloid, T2 mapping and late gadolinium enhancement imaging. At 1-year follow-up, there was a substantial reduction in cardiac amyloid burden, in keeping with cardiac amyloid regression in 45% of patients on treatment. Overall the treatment group showed a reduction in ECV at 1 year follow up compared to an increase in ECV at 1 year in the control group (−1.37%, 95% CI: −3.43 to 0.68% versus 5.02%, 95% CI: 2.86% to 7.18% respectively, p<0.001). The treatment group also showed an improvement in change in 6MWT at 1 year follow up compared to 6MWT at 1 year in the control group (−8.12 meters, 95% CI: −50.8 to 34.6 meters in the treatment group versus −132.27 meters, 95% CI: −216 to −48.6 meters in the control group, p=0.002). The treatment group showed a reduction in BNP at 1 year follow up compared to an increase in the control group (−567.87, 95% CI: −1288.90 to 153.15 in the treatment group versus 2004, 95% CI: 12.82 to 3995.45 in the control group, p<0.001). There was no significant difference from baseline and 1-year data between the control and treatment groups for the difference in echocardiographic parameters, native T1, T2. There was a significant reduction in the percentage of injected dose by 99Tc-DPD scintigraphy in treated patients at 1 year compared to baseline.
Conclusions
These findings provide the first compelling evidence of substantial cardiac amyloid regression in ATTR amyloidosis, as well as the potential for CMR to be used to track response in treated patients with ATTR cardiac amyloidosis. Combination therapy with transthyretin knock down and stabilizing agents may well be synergistic given enhanced stoichiometry of stabilizers in the face of much reduced plasma transthyretin concentration.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- L Chacko
- University College Hospital, London, United Kingdom
| | | | - T Kotecha
- University College Hospital, London, United Kingdom
| | - R Martone
- Careggi University Hospital, Florence, Italy
| | - D Hutt
- University College Hospital, London, United Kingdom
| | - T Lane
- University College Hospital, London, United Kingdom
| | - D Knight
- University College Hospital, London, United Kingdom
| | - J Moon
- Barts Heart Centre, London, United Kingdom
| | - P Kellman
- National Institutes of Health, Bethesda, United States of America
| | - P Hawkins
- University College Hospital, London, United Kingdom
| | - J Gillmore
- University College Hospital, London, United Kingdom
| | - M Fontana
- University College Hospital, London, United Kingdom
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15
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Cohen O, Ismail A, Manwani R, Ravichandran S, Foard D, Mahmood S, Sachchithanantham S, Martinez-Naharro A, Fontana M, Lachmann H, Hawkins P, Gillmore J, Whelan C, Wechalekar A. Global longitudinal strain predicts survival and response in patients with systemic AL amyloidosis. analysis of 915 patients from the ALchemy prospective trial. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Cardiac involvement determines prognosis in systemic AL amyloidosis. The extent is assessed by biomarker-based staging systems. This a prospective report of a large cohort of patients assessing the utility of changes in longitudinal function by 2D strain (GLS%), impairment - a hallmark of amyloidosis.
Purpose
To evaluate the prognostic role of GLS% and other echocardiographic parameters in systemic AL amyloidosis.
Methods
915 newly diagnosed patients seen at the UK National Amyloidosis Centre (February 2010–August 2017) were included. All patients underwent 6-monthly comprehensive assessments inclusive of echocardiogram. The European modification of the Mayo 2004 staging was used with Mayo stage III patients stratified into IIIa (NT-proBNP <8500ng/L) and IIIb (NT-proBNP ≥8500ng/L).
Results
653/915 (71.4%) patients had cardiac involvement. Mayo stage 1, 2, 3a and 3b in 144 (15.7%), 302 (33.0%) 344 (37.6%) and 125 (13.7%) respectively. The median NT-proBNP was 2228ng/L and TNT was 0.54ng/ml. The GLS% significantly worsened with increasing Mayo stage (p<0.0001 between GLS% for each Mayo stage). Poorer baseline GLS% associated with significantly worse OS and stratified patients into three groups: GLS% <−12.8%: OS 69.1 months; GLS% −12.8% to −9%: OS 54.5 months; GLS% >−9%: OS 45.3 months (p<0.0001). On univariate analysis, 11/14 parameters predicted survival (LV wall thickness, LV ejection fraction, systolic velocities of the septal (s'sep) and lateral mitral annulus (s' lat), mitral annulus movement at the lateral corner (e' lat), transmitral early peak flow velocity (E) divided by tissue Doppler mitral annular motion velocity (e') – E/e' and mitral annular plane systolic excursion (MAPSE)). Baseline GLS% >−17% was independent of Mayo stage in predicting survival [Mayo II: Hazard ratio (HR) 2.10 (95% CI: 1.12–3.92) p=0.02, Mayo III: HR 3.94 (95% CI: 2.13–7.32) p<0.0001, Mayo IV: HR 7.49 (95% CI: 3.94–14.21) p<0.0001, GLS <17%: HR 2.14 (95% CI: 1.59–2.88) p<0.0001]. At 12 months, only patients in a haematological complete response (CR) had significant improvement in overall GLS% (p=0.02) as well as baso-lateral (p=0.0004) and baso-septal (p=0.0001) GLS% and MAPSE (p=0.002). The OS was significantly better in patients who achieved a minimum absolute improvement in GLS% of 1.5% improvement (not reached in those with improved GLS% vs. 72 mo in those without) (p=0.034)).
Conclusion
These data show that baseline GLS% is an independent predictor of survival in AL amyloidosis. GLS% is the first functional marker that is independent of the Mayo staging in predicting outcomes and should be incorporated in prognostic staging for patients with AL amyloidosis. GLS% shows improvement in patients who achieve a complete haematologic response to treatment and improvement in GLS% of 1.5% is associated with improved outcomes. An absolute improvement in GLS% should be considered as a criterion for cardiac response in AL amyloidosis.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- O Cohen
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - A Ismail
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - R Manwani
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - S Ravichandran
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - D Foard
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - S Mahmood
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - S Sachchithanantham
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - A Martinez-Naharro
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - M Fontana
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - H Lachmann
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - P Hawkins
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - J Gillmore
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - C Whelan
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - A.D Wechalekar
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
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16
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Murphy MP, McEnery T, McQuillan K, McElvaney OF, McElvaney OJ, Landers S, Coleman O, Bussayajirapong A, Hawkins P, Henry M, Meleady P, Reeves EP, McElvaney NG. α 1 Antitrypsin therapy modulates the neutrophil membrane proteome and secretome. Eur Respir J 2020; 55:13993003.01678-2019. [PMID: 32060059 DOI: 10.1183/13993003.01678-2019] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 01/30/2020] [Indexed: 12/12/2022]
Abstract
Obstructive pulmonary disease in patients with α1 antitrypsin (AAT) deficiency (AATD) occurs earlier in life compared with patients without AATD. To understand this further, the aim of this study was to investigate whether AATD presents with altered neutrophil characteristics, due to the specific lack of plasma AAT, compared with non-AATD COPD.This study focussed on the neutrophil plasma membrane and, by use of label-free tandem mass spectrometry, the proteome of the neutrophil membrane was compared in forced expiratory volume in 1 s (FEV1)-matched AATD, non-AATD COPD and in AATD patients receiving weekly AAT augmentation therapy (n=6 patients per cohort). Altered protein expression in AATD was confirmed by Western blot, ELISA and fluorescence resonance energy transfer analysis.The neutrophil membrane proteome in AATD differed significantly from that of COPD as demonstrated by increased abundance and activity of primary granule proteins including neutrophil elastase on the cell surface in AATD. The signalling mechanism underlying increased degranulation involved Rac2 activation, subsequently resulting in proteinase-activated receptor 2 activation by serine proteinases and enhanced reactive oxygen species production. In vitro and ex vivo, AAT reduced primary granule release and the described plasma membrane variance was resolved post-AAT augmentation therapy in vivo, the effects of which significantly altered the AATD neutrophil membrane proteome to that of a non-AATD COPD cell.These results provide strong insight into the mechanism of neutrophil driven airways disease associated with AATD. Therapeutic AAT augmentation modified the membrane proteome to that of a typical COPD cell, with implications for clinical practice.
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Affiliation(s)
- Mark P Murphy
- Irish Centre for Genetic Lung Disease, Dept of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Thomas McEnery
- Irish Centre for Genetic Lung Disease, Dept of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Karen McQuillan
- Irish Centre for Genetic Lung Disease, Dept of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Oisín F McElvaney
- Irish Centre for Genetic Lung Disease, Dept of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Oliver J McElvaney
- Irish Centre for Genetic Lung Disease, Dept of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Sarah Landers
- Irish Centre for Genetic Lung Disease, Dept of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Orla Coleman
- National Institute for Cellular Biotechnology, Dublin City University, Glasnevin, Dublin, Ireland
| | - Anchalin Bussayajirapong
- Irish Centre for Genetic Lung Disease, Dept of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Padraig Hawkins
- Irish Centre for Genetic Lung Disease, Dept of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Michael Henry
- National Institute for Cellular Biotechnology, Dublin City University, Glasnevin, Dublin, Ireland
| | - Paula Meleady
- National Institute for Cellular Biotechnology, Dublin City University, Glasnevin, Dublin, Ireland
| | - Emer P Reeves
- Irish Centre for Genetic Lung Disease, Dept of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland .,Noel G. McElvaney and Emer P. Reeves share joint senior authorship
| | - Noel G McElvaney
- Irish Centre for Genetic Lung Disease, Dept of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland.,Noel G. McElvaney and Emer P. Reeves share joint senior authorship
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17
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Chacko L, Kotecha T, Martinez-Naharro A, Brown J, Knight D, Steriotis A, Little C, Moon J, Gilmore J, Hawkins P, Rakhit R, Patel N, Xue H, Kellman P, Fontana M. 1171Myocardial perfusion mapping in cardiac amyloidosis - exploring the spectrum from infiltration to ischaemia. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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
Background
Cardiac involvement is the main driver of outcome in systemic amyloidosis, but the relationship between amyloid deposits and outcomes is not well understood. The simple explanation of physical, mechanical replacement of the interstitium by amyloid seems insufficient. Preliminary studies support the hypothesis that myocardial ischaemia could contribute to cell damage.
Purpose
(1) To assess myocardial ischaemia in cardiac amyloidosis. (2) To compare patients with cardiac amyloidosis to patients assessed on invasive coronary angiography (ICA) to have normal coronary physiology (NCP), microvascular dysfunction (MVD) and triple vessel coronary disease (3VD). (3) To assess correlation of perfusion mapping to markers of disease severity and prognosis.
Methods
86 patients and 20 healthy volunteers (HV) underwent CMR at 1.5T (Siemens) with standard cine, PSIR-LGE, T1, T2, Extracellular Volume (ECV) mapping and adenosine stress with myocardial blood flow (MBF) mapping. Thirty-eight patients also underwent ICA with 3 vessel assessment of Index of Microcirculatory Resistance and Fractional Flow Reserve: 7 had cardiac amyloidosis, 8 had NCP, 15 had MVD and 8 had 3VD.
Results
Cardiac amyloidosis patients had severe reduction in stress MBF and myocardial perfusion reserve (MPR) (1.22ml/g/min±0.70 and 1.62±0.63) compared to HV (3.21ml/g/min±0.64, p<0.001 and 4.17±0.78, p<0.001), NCP (2.66±0.56, p<0.001 and 2.51±0.43, p=0.036) and MVD (2.10±0.31, p<0.001 and 2.29±0.87, p=0.014) with the degree of reduction being similar only to patients with 3VD (1.44±0.54, p=1.000 and 1.64±0.68, p=1.000) (Figure 1). Rest MBF was also lower in amyloidosis than HV. Cardiac amyloidosis stress MBF and MPR inversely correlated with amyloid burden (ECV, r=−0.715, p<0.001, transmurality of LGE, p<0.01), systolic dysfunction (EF, r=0.405, p<0.01), and blood biomarkers (NT-proBNP (r=−0.678, p<0.001) and Troponin T (r=−0.628, p<0.001)). There was a correlation between stress MBF and native T1 (r=−0.588, p<0.001) but not T2 (p=0.591). Stress MBF and MPR were early disease markers, being elevated in patients with early cardiac amyloid infiltration (raised ECV, no LGE, P<0.01 vs HV).
Conclusion
Myocardial ischaemia is common in cardiac amyloidosis – with stress MBF and MPR similar to that of patients with 3VD. The reduction correlates with the degree of amyloid infiltration and markers of adverse prognosis, highlighting the potential role of myocardial ischaemia as a key mechanism in the pathophysiology of cardiac amyloidosis.
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Affiliation(s)
- L Chacko
- University College Hospital, London, United Kingdom
| | - T Kotecha
- University College Hospital, London, United Kingdom
| | | | - J Brown
- University College Hospital, London, United Kingdom
| | - D Knight
- University College Hospital, London, United Kingdom
| | - A Steriotis
- University College Hospital, London, United Kingdom
| | - C Little
- University College Hospital, London, United Kingdom
| | - J Moon
- University College Hospital, London, United Kingdom
| | - J Gilmore
- University College Hospital, London, United Kingdom
| | - P Hawkins
- University College Hospital, London, United Kingdom
| | - R Rakhit
- University College Hospital, London, United Kingdom
| | - N Patel
- University College Hospital, London, United Kingdom
| | - H Xue
- National Institutes of Health, Bethesda, United States of America
| | - P Kellman
- National Institutes of Health, Bethesda, United States of America
| | - M Fontana
- University College Hospital, London, United Kingdom
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18
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Reeves EP, O'Dwyer CA, Dunlea DM, Wormald MR, Hawkins P, Alfares M, Kotton DN, Rowe SM, Wilson AA, McElvaney NG. Ataluren, a New Therapeutic for Alpha-1 Antitrypsin-Deficient Individuals with Nonsense Mutations. Am J Respir Crit Care Med 2019; 198:1099-1102. [PMID: 30011228 DOI: 10.1164/rccm.201802-0338le] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Emer P Reeves
- 1 Royal College of Surgeons in Ireland Dublin, Ireland
| | | | | | | | | | | | | | - Steven M Rowe
- 4 University of Alabama at Birmingham Birmingham, Alabama
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19
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Hawkins P, Logan PM, Reeves EP, McElvaney NG. Pneumothorax and lung cysts: a family affair. Lancet 2019; 393:2635. [PMID: 31258130 DOI: 10.1016/s0140-6736(19)31283-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/24/2019] [Accepted: 05/28/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Padraig Hawkins
- Irish Centre for Genetic Lung Disease, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
| | - P Mark Logan
- Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - Emer P Reeves
- Irish Centre for Genetic Lung Disease, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - Noel G McElvaney
- Irish Centre for Genetic Lung Disease, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
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20
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Chacko LA, Kotecha T, Martinez A, Brown J, Little C, Knight D, Patel N, Hawkins P, Gillmore J, Moon J, Steriotis A, Kellman P, Xue H, Fontana M. 319Myocardial perfusion mapping in cardiac amyloidosis: transformation from a disease of solely infiltration to myocardial ischaemia. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez102] [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: 11/14/2022] Open
Affiliation(s)
- L A Chacko
- University College Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - T Kotecha
- University College Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - A Martinez
- University College Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - J Brown
- University College Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - C Little
- University College Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - D Knight
- University College Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - N Patel
- University College Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - P Hawkins
- University College Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - J Gillmore
- University College Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - J Moon
- University College Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - A Steriotis
- University College Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - P Kellman
- University College Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - H Xue
- University College Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - M Fontana
- University College Hospital, London, United Kingdom of Great Britain & Northern Ireland
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21
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Martinez Naharro A, Kotecha T, Gonzalez-Lopez E, Corovic A, Anderson S, Chacko L, Brown J, Knight DS, Baksi AJ, Moon JC, Kellman P, Garcia-Pavia P, Gillmore J, Hawkins P, Fontana M. 549High prevalence of intracardiac thrombi in cardiac amyloidosis. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez125] [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: 11/14/2022] Open
Affiliation(s)
- A Martinez Naharro
- University College London, CMR Unit at Royal Free Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - T Kotecha
- University College London, CMR Unit at Royal Free Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - E Gonzalez-Lopez
- University Hospital Puerta de Hierro Majadahonda, Department of Cardiology, Madrid, Spain
| | - A Corovic
- University College London, CMR Unit at Royal Free Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - S Anderson
- University College London, CMR Unit at Royal Free Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - L Chacko
- University College London, CMR Unit at Royal Free Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - J Brown
- University College London, CMR Unit at Royal Free Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - D S Knight
- University College London, CMR Unit at Royal Free Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - A J Baksi
- Royal Brompton Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - J C Moon
- Barts Health NHS Trust, London, United Kingdom of Great Britain & Northern Ireland
| | - P Kellman
- National Institutes of Health, National Heart, Lung and Blood Institute, Bethesda, United States of America
| | - P Garcia-Pavia
- University Hospital Puerta de Hierro Majadahonda, Department of Cardiology, Madrid, Spain
| | - J Gillmore
- University College London, CMR Unit at Royal Free Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - P Hawkins
- University College London, CMR Unit at Royal Free Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - M Fontana
- University College London, CMR Unit at Royal Free Hospital, London, United Kingdom of Great Britain & Northern Ireland
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22
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Boldrini M, Baggiano A, Naharro AM, Kotecha T, Rezk T, Fayed H, Knight D, Moon J, Kellman P, Gillmore J, Hawkins P, Fontana M. 1161Accuracy of non contrast magnetic resonance for clinical diagnosis of cardiac amyloidosis - a 868 patient prospective study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.1161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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)
- M Boldrini
- University College London, UCL CMR Department, National Amyloidosis Center, Royal Free Hospital, London, United Kingdom
| | | | - A M Naharro
- University College London, UCL CMR Department, National Amyloidosis Center, Royal Free Hospital, London, United Kingdom
| | - T Kotecha
- University College London, UCL CMR Department, National Amyloidosis Center, Royal Free Hospital, London, United Kingdom
| | - T Rezk
- University College London, National Amyloidosis Center, London, United Kingdom
| | - H Fayed
- University College London, UCL CMR Department, National Amyloidosis Center, Royal Free Hospital, London, United Kingdom
| | - D Knight
- University College London, UCL CMR Department, National Amyloidosis Center, Royal Free Hospital, London, United Kingdom
| | - J Moon
- Barts Health NHS Trust, London, United Kingdom
| | - P Kellman
- National Institute of Health (Home), Washington, United States of America
| | - J Gillmore
- University College London, National Amyloidosis Center, London, United Kingdom
| | - P Hawkins
- University College London, National Amyloidosis Center, London, United Kingdom
| | - M Fontana
- University College London, UCL CMR Department, National Amyloidosis Center, Royal Free Hospital, London, United Kingdom
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23
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Bader R, Mannucci PMM, Tripodi A, Hirsh J, Keller F, Solleder EM, Hawkins P, Peng M, Pelzer H, Teijidor LM, Ramirez IF, Kolde HJ. Multicentric Evaluation of a New PT Reagent Based on Recombinant Human Tissue Factor and Synthetic Phospholipids. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1642433] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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
SummaryA new PT reagent based on recombinant human tissue factor and synthetic phospholipids (phosphatidyl choline and phosphatidyl serine) with defined fatty acid side chains was calibrated against BCT/253 and CRM 149R. A small but consistent bias in the International Sensitivity Index (ISI) value was obtained using either the human or rabbit brain reference material. ISI values were around 1.0 or slightly lower depending on the respective instrument. Mixing studies with factor deficient plasmas showed a high factor sensitivity especially for factor VII as compared to commercial rabbit brain or human placenta thromboplastin. In an international field trial the reagent was tested using fully or semi automated Electra™ coagulometers in 4 different laboratories. Results with normal samples were in excellent agreement among the different laboratories. Mean values were 10.9, 10.9, 11.0, 11,7 s with a range of 9.5 to 12.5 s. Results of males and females were not different. In patients with liver disease very similar PT activities were found as compared to sensitive rabbit brain or human placental thromboplastins. In normals and patients with oral anticoagulation INR values correlated very well against BCT (r = 0.98, regression line y =-0.07 + 0.9 x). The distribution of samples was linear over the whole range. In the comparison against sensitive rabbit brain thromboplastin or human placental thromboplastin similar correlations were found. In a few cases higher INR values were observed for the recombinant reagent especially in patients with intensive treatment. Factor assays in those patients showed at least the strong reduction of one vitamin Independent coagulation factor. Over all the linearity was better against the rabbit brain reagent than against the human placental reagent which is slightly less factor VII sensitive as shown in mixing studies with normal and factor VII deficient plasma. Precision studies in the 4 laboratories showed excellent reproducibility of lyophilised controls or local patient plasma pools for all reagents with a better performance of the recombinant reagent. C. V. values from day to day ranged from 1.3% to 5% for normal and abnormal controls.These results show that the recombinant PT reagent, especially in conjunction with a precise automated instrument, may improve the results of PT testing and thus may lead to better patient care.
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Affiliation(s)
- R Bader
- The IRCCS Maggiore Hospital and University, Policlinico Centro Hemophilia, Milano, Italy
| | - P M M Mannucci
- The IRCCS Maggiore Hospital and University, Policlinico Centro Hemophilia, Milano, Italy
| | - A Tripodi
- The IRCCS Maggiore Hospital and University, Policlinico Centro Hemophilia, Milano, Italy
| | - J Hirsh
- The Hamilton Civic Hospitals Research Centre, Hamilton, Ontario, Canada
| | - F Keller
- The Medizinische Universitätsklinik, Zentrallabor, Würzburg, Germany
| | - E M Solleder
- The Medizinische Universitätsklinik, Zentrallabor, Würzburg, Germany
| | - P Hawkins
- The Baxter Diagnostics, R & D, Miami, Florida, USA
| | - M Peng
- The Baxter Diagnostics, R & D, Miami, Florida, USA
| | - H Pelzer
- The Baxter Diagnostics, R & D, Miami, Florida, USA
| | - L M Teijidor
- The Baxter Diagnostics, R & D, Miami, Florida, USA
| | - I F Ramirez
- The Baxter Deutschland GmbH, Haemostase Europa, Unterschleißheim/München, Germany
| | - H-J Kolde
- The Baxter Deutschland GmbH, Haemostase Europa, Unterschleißheim/München, Germany
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24
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Alharbi A, Boguslavskiy AE, Austin D, Thiré N, Wood D, Hawkins P, McGrath F, Johnson AS, Lopez-Quintas I, Schmidt B, Légaré F, Marangos JP, Le AT, Bhardwaj R. Author Correction: Femtosecond Laser Mass Spectrometry and High Harmonic Spectroscopy of Xylene Isomers. Sci Rep 2018; 8:7536. [PMID: 29743528 PMCID: PMC5943455 DOI: 10.1038/s41598-018-25623-1] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Abdullah Alharbi
- Department of Physics, Advanced Research Complex, University of Ottawa, 25 Templeton Street, Ottawa, K1N6N5, Ontario, Canada.,King Abdulaziz City for Science and Technology (KACST), P.O. Box 6086, Riyadh, 11442, Saudi Arabia
| | - Andrey E Boguslavskiy
- Department of Physics, Advanced Research Complex, University of Ottawa, 25 Templeton Street, Ottawa, K1N6N5, Ontario, Canada
| | - Dane Austin
- Blackett Laboratory, Imperial College London, London, UK
| | - Nicolas Thiré
- INRS-EMT, Advanced Laser Light Source, 1650 Lionel-Boulet Bvd, Varennes, J3X1S2, Canada
| | - D Wood
- Blackett Laboratory, Imperial College London, London, UK
| | - P Hawkins
- Blackett Laboratory, Imperial College London, London, UK
| | | | - A S Johnson
- Blackett Laboratory, Imperial College London, London, UK
| | - I Lopez-Quintas
- Instituto de Química Física Rocasolano, IQFR-CSIC, Serrano 119, 28006, Madrid, Spain
| | - Bruno Schmidt
- INRS-EMT, Advanced Laser Light Source, 1650 Lionel-Boulet Bvd, Varennes, J3X1S2, Canada
| | - Francois Légaré
- INRS-EMT, Advanced Laser Light Source, 1650 Lionel-Boulet Bvd, Varennes, J3X1S2, Canada
| | - J P Marangos
- Blackett Laboratory, Imperial College London, London, UK.
| | - Anh-Thu Le
- J. R. Macdonald Laboratory, Physics Department, Kansas State University, Manhattan, Kansas, 66506-2604, USA.
| | - Ravi Bhardwaj
- Department of Physics, Advanced Research Complex, University of Ottawa, 25 Templeton Street, Ottawa, K1N6N5, Ontario, Canada.
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Hawkins P. Therapeutic advances in hereditary ATTR amyloidosis. Neuromuscul Disord 2018. [DOI: 10.1016/s0960-8966(18)30292-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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26
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Alharbi A, Boguslavskiy AE, Austin D, Thiré N, Wood D, Hawkins P, McGrath F, Johnson AS, Lopez-Quintas I, Schmidt B, Légaré F, Marangos JP, Le AT, Bhardwaj R. Femtosecond Laser Mass Spectrometry and High Harmonic Spectroscopy of Xylene Isomers. Sci Rep 2018; 8:3789. [PMID: 29491420 PMCID: PMC5830629 DOI: 10.1038/s41598-018-22055-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 10/09/2017] [Accepted: 02/12/2018] [Indexed: 11/09/2022] Open
Abstract
Structural isomers, molecules having the same chemical formula but with atoms bonded in different order, are hard to identify using conventional spectroscopy and mass spectrometry. They exhibit virtually indistinguishable mass spectra when ionized by electrons. Laser mass spectrometry based on photoionization of the isomers has emerged as a promising alternative but requires shaped ultrafast laser pulses. Here we use transform limited femtosecond pulses to distinguish the isomers using two methods. First, we probe doubly charged parent ions with circularly polarized light. We show that the yield of doubly charged ortho-xylene decreases while para-xylene increases over a range of laser intensities when the laser polarization is changed from linear to circular. Second, we probe high harmonic generation from randomly oriented isomer molecules subjected to an intense laser field. We show that the yield of high-order harmonics varies with the positioning of the methyl group in xylene isomers (ortho-, para- and meta-) and is due to differences in the strength of tunnel ionization and the overlap between the angular peaks of ionization and photo-recombination.
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Affiliation(s)
- Abdullah Alharbi
- Department of Physics, Advanced Research Complex, University of Ottawa, 25 Templeton Street, Ottawa, K1N6N5, Ontario, Canada.,King Abdulaziz City for Science and Technology (KACST), P.O. Box 6086, Riyadh, 11442, Saudi Arabia
| | - Andrey E Boguslavskiy
- Department of Physics, Advanced Research Complex, University of Ottawa, 25 Templeton Street, Ottawa, K1N6N5, Ontario, Canada
| | - Dane Austin
- Blackett Laboratory, Imperial College London, London, UK
| | - Nicolas Thiré
- INRS-EMT, Advanced Laser Light Source, 1650 Lionel-Boulet Bvd, Varennes, J3X1S2, Canada
| | - D Wood
- Blackett Laboratory, Imperial College London, London, UK
| | - P Hawkins
- Blackett Laboratory, Imperial College London, London, UK
| | | | - A S Johnson
- Blackett Laboratory, Imperial College London, London, UK
| | - I Lopez-Quintas
- Instituto de Química Física Rocasolano, IQFR-CSIC, Serrano 119, 28006, Madrid, Spain
| | - Bruno Schmidt
- INRS-EMT, Advanced Laser Light Source, 1650 Lionel-Boulet Bvd, Varennes, J3X1S2, Canada
| | - Francois Légaré
- INRS-EMT, Advanced Laser Light Source, 1650 Lionel-Boulet Bvd, Varennes, J3X1S2, Canada
| | - J P Marangos
- Blackett Laboratory, Imperial College London, London, UK.
| | - Anh-Thu Le
- J. R. Macdonald Laboratory, Physics Department, Kansas State University, Manhattan, Kansas, 66506-2604, USA.
| | - Ravi Bhardwaj
- Department of Physics, Advanced Research Complex, University of Ottawa, 25 Templeton Street, Ottawa, K1N6N5, Ontario, Canada.
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Storan ER, O' Gorman SM, Hawkins P, Aalto L, Murphy A, Markham T. Alpha-1-antitrypsin deficiency-related panniculitis: two cases with diverse clinical courses. Clin Exp Dermatol 2017; 42:520-522. [PMID: 28512995 DOI: 10.1111/ced.13102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2016] [Indexed: 11/30/2022]
Abstract
Alpha-1-antitrypsin deficiency (AATD)-related panniculitis is an extremely rare and underdiagnosed entity, and there is a paucity of data on its treatment. We report two cases of AATD-related panniculitis. The first was a 24-year-old woman with known AATD who presented with painful leg ulcers refractory to treatment with corticosteroids and colchicine. She had a good response to α1-antitrypsin infusions but required dose adjustment due to flares in disease activity. The second case was a 38-year-old woman who presented with painful nodules on the legs refractory to corticosteroid therapy. Laboratory investigations revealed severe AATD. She had an excellent response to colchicine therapy. In both these cases of AATD, panniculitis was the first clinical manifestation of the disease. AATD-related panniculitis may have none of the typical clinical clues for AATD, such as a family history, cirrhosis or emphysema. Early identification may help prevent these complications from developing.
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Affiliation(s)
- E R Storan
- Department of Dermatology, Galway University Hospital, Galway, Ireland
| | - S M O' Gorman
- Department of Dermatology, Galway University Hospital, Galway, Ireland
| | - P Hawkins
- Department of Respiratory Medicine, Beaumont Hospital, Dublin, Ireland
| | - L Aalto
- Department of Pathology, Galway University Hospital, Galway, Ireland
| | - A Murphy
- Department of Dermatology, Galway University Hospital, Galway, Ireland
| | - T Markham
- Department of Dermatology, Galway University Hospital, Galway, Ireland
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28
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da Silva Filho MI, Försti A, Weinhold N, Meziane I, Campo C, Huhn S, Nickel J, Hoffmann P, Nöthen MM, Jöckel KH, Landi S, Mitchell JS, Johnson D, Morgan GJ, Houlston R, Goldschmidt H, Jauch A, Milani P, Merlini G, Rowcieno D, Hawkins P, Hegenbart U, Palladini G, Wechalekar A, Schönland SO, Hemminki K. Genome-wide association study of immunoglobulin light chain amyloidosis in three patient cohorts: comparison with myeloma. Leukemia 2016; 31:1735-1742. [PMID: 28025584 DOI: 10.1038/leu.2016.387] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 10/28/2016] [Accepted: 11/30/2016] [Indexed: 01/27/2023]
Abstract
Immunoglobulin light chain (AL) amyloidosis is characterized by tissue deposition of amyloid fibers derived from immunoglobulin light chain. AL amyloidosis and multiple myeloma (MM) originate from monoclonal gammopathy of undetermined significance. We wanted to characterize germline susceptibility to AL amyloidosis using a genome-wide association study (GWAS) on 1229 AL amyloidosis patients from Germany, UK and Italy, and 7526 healthy local controls. For comparison with MM, recent GWAS data on 3790 cases were used. For AL amyloidosis, single nucleotide polymorphisms (SNPs) at 10 loci showed evidence of an association at P<10-5 with homogeneity of results from the 3 sample sets; some of these were previously documented to influence MM risk, including the SNP at the IRF4 binding site. In AL amyloidosis, rs9344 at the splice site of cyclin D1, promoting translocation (11;14), reached the highest significance, P=7.80 × 10-11; the SNP was only marginally significant in MM. SNP rs79419269 close to gene SMARCD3 involved in chromatin remodeling was also significant (P=5.2 × 10-8). These data provide evidence for common genetic susceptibility to AL amyloidosis and MM. Cyclin D1 is a more prominent driver in AL amyloidosis than in MM, but the links to aggregation of light chains need to be demonstrated.
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Affiliation(s)
- M I da Silva Filho
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A Försti
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Center for Primary Health Care Research, Lund University, Malmo, Sweden
| | - N Weinhold
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany.,Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - I Meziane
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - C Campo
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - S Huhn
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - J Nickel
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - P Hoffmann
- Institute of Human Genetics, University of Bonn, Bonn, Germany.,Department of Biomedicine, University of Basel, Basel, Switzerland
| | - M M Nöthen
- Institute of Human Genetics, University of Bonn, Bonn, Germany.,Department of Genomics, Life and Brain Research Center, University of Bonn, Bonn, Germany
| | - K-H Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Germany
| | - S Landi
- Department of Biology, University of Pisa, Pisa, Italy
| | - J S Mitchell
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Surrey, UK
| | - D Johnson
- Division of Molecular Pathology, The Institute of Cancer Research, Surrey, UK
| | - G J Morgan
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - R Houlston
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Surrey, UK.,Division of Molecular Pathology, The Institute of Cancer Research, Surrey, UK
| | - H Goldschmidt
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany.,National Centre of Tumor Diseases, Heidelberg, Germany
| | - A Jauch
- Institute of Human Genetics, University of Heidelberg, Heidelberg, Germany
| | - P Milani
- Department of Molecular Medicine, Amyloidosis Research and Treatment Center, Foundation 'Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo', University of Pavia, Pavia, Italy
| | - G Merlini
- Department of Molecular Medicine, Amyloidosis Research and Treatment Center, Foundation 'Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo', University of Pavia, Pavia, Italy
| | - D Rowcieno
- National Amyloidosis Centre, University College London Medical School, London UK
| | - P Hawkins
- National Amyloidosis Centre, University College London Medical School, London UK
| | - U Hegenbart
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - G Palladini
- Department of Molecular Medicine, Amyloidosis Research and Treatment Center, Foundation 'Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo', University of Pavia, Pavia, Italy
| | - A Wechalekar
- National Amyloidosis Centre, University College London Medical School, London UK
| | - S O Schönland
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - K Hemminki
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Center for Primary Health Care Research, Lund University, Malmo, Sweden
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29
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Omoyinmi E, Standing A, Keylock A, Rowczenio D, Melo Gomes S, Cullup T, Jenkins L, Gilmour K, Eleftheriou D, Lachmann H, Hawkins P, Klein N, Brogan P. SAT0010 A Targeted Next-Generation Sequencing Gene Panel for Autoinflammation. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3837] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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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30
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Kuegler A, Schatz S, Vander Beeken S, Jiang D, Rück A, De Geest B, Hawkins P, Scharffetter-Kochanek K, Anca S. 736 β 2 integrin-dependent activation of NOX2 oxidase in wound macrophages is required for physiological wound healing. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.779] [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: 10/21/2022]
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31
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Pepper R, Hutchinson M, Henderson S, Rowczenio D, Hawkins P, Lachmann H. Calprotectin (S100A8/A9) in Familial Mediterranean Fever. Pediatr Rheumatol Online J 2015. [PMCID: PMC4599818 DOI: 10.1186/1546-0096-13-s1-p120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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32
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Donnelly O, Youngstein T, Pepper R, Rowczenio D, Hawkins P, Lachmann H. Adult PFAPA - a single centre experience. Pediatr Rheumatol Online J 2015. [PMCID: PMC4599769 DOI: 10.1186/1546-0096-13-s1-p176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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33
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Gomes SM, Arostegui J, Omoyinmi E, Standing A, Klein N, Lachmann H, Hawkins P, Brogan P. Whole Exome Sequencing reveals a NLRP3 mutation in exon 5 in a patient with CINCA. Pediatr Rheumatol Online J 2015. [PMCID: PMC4597063 DOI: 10.1186/1546-0096-13-s1-p45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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34
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Rowczenio D, Iancu D, Trojer H, Gilbertson J, Gillmore J, Wechalekar A, Tekman M, Stanescu H, Kleta R, Lane T, Hawkins P, Lachmann H. Deletion in MEFV resulting in the loss of p.M694 residue as the cause of autosomal dominant familial Mediterranean fever in North Western European Caucasians - a case series and genetic exploration. Pediatr Rheumatol Online J 2015. [PMCID: PMC4596970 DOI: 10.1186/1546-0096-13-s1-o42] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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35
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Rowczenio D, Gomes SM, Aróstegui J, Omoyinmi E, Gonzalez-Roca E, Standing A, Eleftheriou D, Klein N, Brogan P, Lachmann H, Hawkins P. Late onset of the cryopyrin-associated periodic syndrome (CAPS) associated with low level of somatic mosaicism in six patients. Pediatr Rheumatol Online J 2015. [PMCID: PMC4597082 DOI: 10.1186/1546-0096-13-s1-p37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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36
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Rowczenio D, Trojer H, Baginska A, Gillmore J, Wechalekar A, Hawkins P, Lachmann H. Clinical symptoms and molecular investigations in 13 patients with Schnitzler syndrome identified at the single UK centre. Pediatr Rheumatol Online J 2015. [PMCID: PMC4596996 DOI: 10.1186/1546-0096-13-s1-p38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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37
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Standing A, Eleftheriou D, Paisan-Ruiz C, Rowcenzio D, Hong Y, Omoyinmi E, Woo P, Hawkins P, Lachmann H, Klein N, Brogan P. 8th International Congress of Familial Mediterranean Fever and Systemic Autoinflammatory Diseases. Pediatr Rheumatol Online J 2015; 13 Suppl 1:O1-P211. [PMID: 26424586 PMCID: PMC4597419 DOI: 10.1186/1546-0096-13-s1-o1] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- A Standing
- UCL Institute of Child Health, IIIP, London, UK
| | | | | | - D Rowcenzio
- UCL Royal Free Hospital, National Amyloidosis Centre, London, UK
| | - Y Hong
- UCL Institute of Child Health, IIIP, London, UK
| | - E Omoyinmi
- UCL Institute of Child Health, IIIP, London, UK
| | - P Woo
- University College London, London, UK
| | - P Hawkins
- UCL Royal Free Hospital, National Amyloidosis Centre, London, UK
| | - H Lachmann
- UCL Royal Free Hospital, National Amyloidosis Centre, London, UK
| | - N Klein
- UCL Institute of Child Health, IIIP, London, UK
| | - P Brogan
- UCL Institute of Child Health, IIIP, London, UK
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38
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Kuemmerle-Deschner J, Hoffman H, Hawkins P, van der Poll T, Walker U, Speziale A, Tilson H. SAT0524 Evaluation of Long-Term Safety and Effectiveness of Canakinumab Therapy in Patients with Cryopyrin-Associated Periodic Syndrome: Results from Beta-Confident Registry. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2224] [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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39
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Werner RA, Maya Y, Yamane T, Rischpler C, Fukushima K, Chen X, Lapa C, Herrmann K, Higuchi T, Thorn S, Stacy M, Purcell B, Doviak H, Shuman J, Perez E, Burdick J, Spinale F, Sinusas A, Treibel T, Bandula S, Fontana M, White S, Gilbertson J, Punwani S, Gillmore J, Hawkins P, Taylor S, Moon J, Caobelli F, Wollenweber T, Kuehn C, Bavendiek U, Schuetze C, Geworski L, Bauersachs J, Haverich A, Bengel F, Barysheva N, Merkulova I, Shabanova M, Gaman S, Veselova T, Shariya M, Kelion AD, Pakkal M, Chowdhury F, Nagaraj N, Birchall J, Dixon K, Banya W, Mccann G, Gershlick A, Rischpler C, Dirschinger R, Nicolosi S, Kossmann H, Meinicke A, Hanus F, Goetze K, Laugwitz K, Schwaiger M, Nekolla S, Rischpler C, Dirschinger R, Nicolosi S, Kossmann H, Meinicke A, Hanus F, Goetze K, Laugwitz K, Schwaiger M, Nekolla S. Moderated Poster Session 4: Monday 4 May 2015, 15:30-16:30 * Room: Moderated Poster Area. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev050] [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: 11/15/2022] Open
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40
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Sidhu M, Gulati A, Hawkins P, Cooper S. P70 Improved Lung Cancer Referral Rates And Early Diagnosis In A District General Hospital. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.211] [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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41
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Carr A, Pelayo A, Gilmore J, Hawkins P, Reilly M. P51 Neuropathy phenotype in hereditary transthyretin amyloidosis. Neuromuscul Disord 2014. [DOI: 10.1016/s0960-8966(14)70067-7] [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: 10/25/2022]
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42
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Bybee AK, Lachmann H, Omoyinmi E, Nedjai B, Woo P, Lane T, Savic S, Hawkins P, McDermott M. PW02-031 - Genetic and clinical manifestations of CAPS. Pediatr Rheumatol Online J 2013. [PMCID: PMC3952365 DOI: 10.1186/1546-0096-11-s1-a172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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43
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Drewe E, Negm O, Abduljabbar W, Hawkins P, Fairclough L, Todd I, Tighe P. OR13-005 – Investigation of clinical and laboratory significance of TNFRSF1A intron by reverse-phase protein microarray. Pediatr Rheumatol Online J 2013. [PMCID: PMC3952581 DOI: 10.1186/1546-0096-11-s1-a267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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44
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McColgan P, Viegas S, Gandhi S, Sheikh F, Pinney J, Fontana M, Rowczenio D, Shah S, Jaumuktane Z, Holton J, Schott J, Werring D, Hawkins P, Reilly MM. WEIGHT LOSS, ENCEPHALOPATHY, URINARY DIFFICULTIES AND NUMB FEET IN A NIGERIAN MAN. J Neurol Neurosurg Psychiatry 2013. [DOI: 10.1136/jnnp-2013-306573.139] [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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45
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Kuemmerle-Deschner J, Hawkins P, Hoffman H, van der Poll T, Walker U, Tilson H. THU0392 Beta-confident-registry: Efficacy and safety of canakinumab in cryopyrin associated periodic syndrome - 18 month follow-up. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2357] [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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46
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Karrar S, Shiwen X, Nikotorowicz-Buniak J, Abraham DJ, Denton C, Stratton R, Bayley R, Kite KA, Clay E, Smith JP, Kitas GD, Buckley C, Young SP, Ye L, Zhang L, Goodall J, Gaston H, Xu H, Lutalo PM, Zhao Y, Meng Choong L, Sangle S, Spencer J, D'Cruz D, Rysnik OJ, McHugh K, Bowness P, Rump-Goodrich L, Mattey D, Kehoe O, Middleton J, Cartwright A, Schmutz C, Askari A, Middleton J, Gardner DH, Jeffery LE, Raza K, Sansom DM, Clay E, Bayley R, Fitzpatrick M, Wallace G, Young S, Shaw J, Hatano H, Cauli A, Giles JL, McHugh K, Mathieu A, Bowness P, Kollnberger S, Webster S, Ellis L, O'Brien LM, Fitzmaurice TJ, Gaston H, Goodall J, Nazeer Moideen A, Evans L, Osgood L, Williams A, Jones S, Thomas C, O'Donnell V, Nowell M, Ouboussad L, Savic S, Dickie LJ, Hintze J, Wong CH, Cook GP, Buch M, Emery P, McDermott MF, Hardcastle SA, Gregson CL, Deere K, Davey Smith G, Dieppe P, Tobias JH, Dennison E, Edwards M, Bennett J, Coggon D, Palmer K, Cooper C, McWilliams D, Young A, Kiely PD, Walsh D, Taylor HJ, Harding I, Hutchinson J, Nelson I, Blom A, Tobias J, Clark E, Parker J, Bukhari M, McWilliams D, Jayakumar K, Young A, Kiely P, Walsh D, Diffin J, Lunt M, Marshall T, Chipping J, Symmons D, Verstappen S, Taylor HJ, Harding I, Hutchinson J, Nelson I, Tobias J, Clark E, Bluett J, Bowes J, Ho P, McHugh N, Buden D, Fitzgerald O, Barton A, Glossop JR, Nixon NB, Emes RD, Dawes PT, Farrell WE, Mattey DL, Scott IC, Steer S, Seegobin S, Hinks AM, Eyre S, Morgan A, Wilson AG, Hocking L, Wordsworth P, Barton A, Worthington J, Cope A, Lewis CM, Guerra S, Ahmed BA, Denton C, Abraham D, Fonseca C, Robinson J, Taylor J, Haroon Rashid L, Flynn E, Eyre S, Worthington J, Barton A, Isaacs J, Bowes J, Wilson AG, Barrett JH, Morgan A, Kingston B, Ahmed M, Kirwan JR, Marshall R, Chapman K, Pearson R, Heycock C, Kelly C, Rynne M, Saravanan V, Hamilton J, Saeed A, Coughlan R, Carey JJ, Farah Z, Matthews W, Bell C, Petford S, Tibbetts LM, Douglas KMJ, Holden W, Ledingham J, Fletcher M, Winfield R, Price Z, Mackay K, Dixon C, Oppong R, Jowett S, Nicholls E, Whitehurst D, Hill S, Hammond A, Hay E, Dziedzic K, Righetti C, Lebmeier M, Manning VL, Hurley M, Scott DL, Choy E, Bearne L, Nikiphorou E, Morris S, James D, Kiely P, Walsh D, Young A, Wong EC, Long J, Fletcher A, Fletcher M, Holmes S, Hockey P, Abbas M, Chattopadhyay C, Flint J, Gayed M, Schreiber K, Arthanari S, Nisar M, Khamashta M, Gordon C, Giles I, Robson J, Kiran A, Maskell J, Arden N, Hutchings A, Emin A, Culliford D, Dasgupta B, Hamilton W, Luqmani R, Jethwa H, Rowczenio D, Trojer H, Russell T, Loeffler J, Hawkins P, Lachmann H, Verma I, Syngle A, Krishan P, Garg N, Flint J, Gayed M, Schreiber K, Arthanari S, Nisar M, Khamashta M, Gordon C, Giles I, McGowan SP, Gerrard DT, Chinoy H, Ollier WE, Cooper RG, Lamb JA, Taborda L, Correia Azevedo P, Isenberg D, Leyland KM, Kiran A, Judge A, Hunter D, Hart D, Javaid MK, Arden N, Cooper C, Edwards MH, Litwic AE, Jameson KA, Deeg D, Cooper C, Dennison E, Edwards MH, Jameson KA, Cushnaghan J, Aihie Sayer A, Deeg D, Cooper C, Dennison E, Jagannath D, Parsons C, Cushnaghan J, Cooper C, Edwards MH, Dennison E, Stoppiello L, Mapp P, Ashraf S, Wilson D, Hill R, Scammell B, Walsh D, Wenham C, Shore P, Hodgson R, Grainger A, Aaron J, Hordon L, Conaghan P, Bar-Ziv Y, Beer Y, Ran Y, Benedict S, Halperin N, Drexler M, Mor A, Segal G, Lahad A, Haim A, Rath U, Morgensteren DM, Salai M, Elbaz A, Vasishta VG, Derrett-Smith E, Hoyles R, Khan K, Abraham DJ, Denton C, Ezeonyeji A, Takhar G, Denton C, Ong V, Loughrey L, Bissell LA, Hensor E, Abignano G, Redmond A, Buch M, Del Galdo F, Hall FC, Malaviya A, Nisar M, Baker S, Furlong A, Mitchell A, Godfrey AL, Ruddlesden M, Hadjinicolaou A, Hughes M, Moore T, O'Leary N, Tracey A, Ennis H, Dinsdale G, Roberts C, Herrick A, Denton CP, Guillevin L, Hunsche E, Rosenberg D, Schwierin B, Scott M, Krieg T, Anderson M, Hall FC, Herrick A, McHugh N, Matucci-Cerinic M, Alade R, Khan K, Xu S, Denton C, Ong V, Nihtyanova S, Ong V, Denton CP, Clark KE, Tam FWK, Unwin R, Khan K, Abraham DJ, Denton C, Stratton RJ, Nihtyanova S, Schreiber B, Ong V, Denton CP, Seng Edwin Lim C, Dasgupta B, Corsiero E, Sutcliffe N, Wardemann H, Pitzalis C, Bombardieri M, Tahir H, Donnelly S, Greenwood M, Smith TO, Easton V, Bacon H, Jerman E, Armon K, Poland F, Macgregor A, van der Heijde D, Sieper J, Elewaut D, Pangan AL, Nguyen D, Badenhorst C, Kirby S, White D, Harrison A, Garcia JA, Stebbings S, MacKay JW, Aboelmagd S, Gaffney K, van der Heijde D, Deodhar A, Braun J, Mack M, Hsu B, Gathany T, Han C, Inman RD, Cooper-Moss N, Packham J, Strauss V, Freeston JE, Coates L, Nam J, Moverley AR, Helliwell P, Hensor E, Wakefield R, Emery P, Conaghan P, Mease P, Fleischmann R, Wollenhaupt J, Deodhar A, Kielar D, Woltering F, Stach C, Hoepken B, Arledge T, van der Heijde D, Gladman D, Fleischmann R, Coteur G, Woltering F, Mease P, Kavanaugh A, Gladman D, van der Heijde D, Purcaru O, Mease P, McInnes I, Kavanaugh A, Gottlieb AB, Puig L, Rahman P, Ritchlin C, Li S, Wang Y, Mendelsohn A, Doyle M, Tillett W, Jadon D, Shaddick G, Cavill C, Robinson G, Sengupta R, Korendowych E, de Vries C, McHugh N, Thomas RC, Shuto T, Busquets-Perez N, Marzo-Ortega H, McGonagle D, Tillett W, Richards G, Cavill C, Sengupta R, Shuto T, Marzo-Ortega H, Thomas RC, Bingham S, Coates L, Emery P, John Hamlin P, Adshead R, Cambridge S, Donnelly S, Tahir H, Suppiah P, Cullinan M, Nolan A, Thompson WM, Stebbings S, Mathieson HR, Mackie SL, Bryer D, Buch M, Emery P, Marzo-Ortega H, Krutikov M, Gray L, Bruce E, Ho P, Marzo-Ortega H, Busquets-Perez N, Thomas RC, Gaffney K, Keat A, Innes W, Pandit R, Kay L, Lapshina S, Myasoutova L, Erdes S, Wallis D, Waldron N, McHugh N, Korendowych E, Thorne I, Harris C, Keat A, Garg N, Syngle A, Vohra K, Khinchi D, Verma I, Kaur L, Jones A, Harrison N, Harris D, Jones T, Rees J, Bennett A, Fazal S, Tugnet N, Barkham N, Basu N, McClean A, Harper L, Amft EN, Dhaun N, Luqmani RA, Little MA, Jayne DR, Flossmann O, McLaren J, Kumar V, Reid DM, Macfarlane GJ, Jones G, Yates M, Watts RA, Igali L, Mukhtyar C, Macgregor A, Robson J, Doll H, Yew S, Flossmann O, Suppiah R, Harper L, Hoglund P, Jayne D, Mukhtyar C, Westman K, Luqmani R, Win Maw W, Patil P, Williams M, Adizie T, Christidis D, Borg F, Dasgupta B, Robertson A, Croft AP, Smith S, Carr S, Youssouf S, Salama A, Pusey C, Harper L, Morgan M. Basic Science * 208. Stem Cell Factor Expression is Increased in the Skin of Patients with Systemic Sclerosis and Promotes Proliferation and Migration of Fibroblasts in vitro. Rheumatology (Oxford) 2013. [DOI: 10.1093/rheumatology/ket195] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Abstract
A novel oxygen (O(2)) and/or carbon dioxide (CO(2))-sensitive transducer for the measurement of both gaseous O(2) and CO(2) over the concentration ranges of O(2), 0-100% and CO(2), 0-10% has been described employing a solution of 10.6 muM fluorescein (FL) and 190 muM potassium hydroxide in a solvent mixtures of 1:1 (v/v) N,N'-diethylaniline (DEA) and N,N-dimethylformamide. Increasing O(2) concentrations cause the absorbance of the solution at a wavelength of 400 nm to increase owing to a contact charge transfer reaction existing between O(2) and DEA molecules, and increasing CO(2) concentrations produce a non-linear fall in absorbance at 520 nm as the colour of FL changes from its orange dianion form to the colourless neutral, lactonic form. Both processes are independent of each other and reversible. The response to changes in O(2) concentrations is in good agreement with Beer-Lambert's law and the response to changes in CO(2) concentrations in non-linear. A fibre optic sensing system based on this solvent-dye solution has been set up for continuous and reversible determination of both gaseous O(2) and CO(2). Possible applications include environmental and physiological monitoring of O(2) over the ranges of 0-100% and CO(2), 0-10%.
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Affiliation(s)
- M F Choi
- Faculty of Applied Sciences, University of the West of England, Coldharbour Lane, Frenchay, Bristol BS16 1QY, U.K
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Sado DM, Flett AS, Banypersad S, White S, Hughes D, Mehta A, Murphy E, Lachmann R, Hawkins P, Hausenloy D, McKenna W, Taylor A, Elliott P, Moon JC. 092 Interstitial expansion in health and disease—an equilibrium contrast CMR study. Heart 2012. [DOI: 10.1136/heartjnl-2012-301877b.92] [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: 11/04/2022]
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Kuemmerle-Deschner J, Rothenbacher D, Walker U, Tilson H, Hoffman H, Hawkins P. β-Confident-registry: aiming to be largest-ever studied cohort of cryopyrin-associated periodic syndromes (CAPS) patients. Study design and baseline characteristics. Pediatr Rheumatol Online J 2011. [PMCID: PMC3194513 DOI: 10.1186/1546-0096-9-s1-p16] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Hawkins P, Dennison N, Goodman G, Hetherington S, Llywelyn-Jones S, Ryder K, Smith AJ. Guidance on the severity classification of scientific procedures involving fish: report of a Working Group appointed by the Norwegian Consensus-Platform for the Replacement, Reduction and Refinement of animal experiments (Norecopa). Lab Anim 2011; 45:219-24. [PMID: 21558168 PMCID: PMC3175571 DOI: 10.1258/la.2011.010181] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The severity classification of procedures using animals is an important tool to help focus the implementation of refinement and to assist in reporting the application of the 3Rs (replacement, reduction and refinement). The recently revised Directive that regulates animal research and testing within the European Union requires Member States to ensure that all procedures are classified as ‘non-recovery’, ‘mild’, ‘moderate’ or ‘severe’, using assignment criteria set out by the European Commission (EC). However, these are focused upon terrestrial species, so are of limited relevance to fish users. A Working Group set up by the Norwegian Consensus-Platform for the 3Rs (Norecopa) has produced guidance on the classification of severity in scientific procedures involving fish, including examples of ‘subthreshold’, ‘mild’, ‘moderate’, ‘severe’ and ‘upper threshold’ procedures. The aims are to complement the EC guidelines and help to ensure that suffering in fish is effectively predicted and minimized. Norecopa has established a website (www.norecopa.no/categories) where more information on severity classification for procedures using fish, including field research, will be made available.
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Affiliation(s)
- P Hawkins
- Research Animals Department, RSPCA, Wilberforce Way, Southwater, West Sussex RH13 9RS, UK.
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