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Wang Q, Shao G, Zhao X, Wong HH, Chin K, Zhao M, Bai A, Bloom MS, Love ZZ, Chu CR, Cheng Z, Robinson WH. Dysregulated fibrinolysis and plasmin activation promote the pathogenesis of osteoarthritis. JCI Insight 2024; 9:e173603. [PMID: 38502232 DOI: 10.1172/jci.insight.173603] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 03/05/2024] [Indexed: 03/21/2024] Open
Abstract
Joint injury is associated with risk for development of osteoarthritis (OA). Increasing evidence suggests that activation of fibrinolysis is involved in OA pathogenesis. However, the role of the fibrinolytic pathway is not well understood. Here, we showed that the fibrinolytic pathway, which includes plasminogen/plasmin, tissue plasminogen activator, urokinase plasminogen activator (uPA), and the uPA receptor (uPAR), was dysregulated in human OA joints. Pharmacological inhibition of plasmin attenuated OA progression after a destabilization of the medial meniscus in a mouse model whereas genetic deficiency of plasmin activator inhibitor, or injection of plasmin, exacerbated OA. We detected increased uptake of uPA/uPAR in mouse OA joints by microPET/CT imaging. In vitro studies identified that plasmin promotes OA development through multiple mechanisms, including the degradation of lubricin and cartilage proteoglycans and induction of inflammatory and degradative mediators. We showed that uPA and uPAR produced inflammatory and degradative mediators by activating the PI3K, 3'-phosphoinositide-dependent kinase-1, AKT, and ERK signaling cascades and activated matrix metalloproteinases to degrade proteoglycan. Together, we demonstrated that fibrinolysis contributes to the development of OA through multiple mechanisms and suggested that therapeutic targeting of the fibrinolysis pathway can prevent or slow development of OA.
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Affiliation(s)
- Qian Wang
- Division of Immunology & Rheumatology, Stanford School of Medicine, Stanford, California, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Guoqiang Shao
- Molecular Imaging Program at Stanford, Canary Center at Stanford for Cancer Early Detection
- Department of Radiology, Stanford Bio-X Program, and
| | - Xiaoyi Zhao
- Division of Immunology & Rheumatology, Stanford School of Medicine, Stanford, California, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Heidi H Wong
- Division of Immunology & Rheumatology, Stanford School of Medicine, Stanford, California, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Kate Chin
- Division of Immunology & Rheumatology, Stanford School of Medicine, Stanford, California, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Mackenzie Zhao
- Division of Immunology & Rheumatology, Stanford School of Medicine, Stanford, California, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Audrey Bai
- Division of Immunology & Rheumatology, Stanford School of Medicine, Stanford, California, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Michelle S Bloom
- Division of Immunology & Rheumatology, Stanford School of Medicine, Stanford, California, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Zelda Z Love
- Division of Immunology & Rheumatology, Stanford School of Medicine, Stanford, California, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Constance R Chu
- Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
- Department of Orthopaedic Surgery, Stanford School of Medicine, Stanford, California, USA
| | - Zhen Cheng
- Molecular Imaging Program at Stanford, Canary Center at Stanford for Cancer Early Detection
- Department of Radiology, Stanford Bio-X Program, and
| | - William H Robinson
- Division of Immunology & Rheumatology, Stanford School of Medicine, Stanford, California, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
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Gomez AM, Brewer RC, Moon JS, Acharya S, Kongpachith S, Wang Q, Jahanbani S, Wong HH, Lanz TV, Love ZZ, Min-Oo G, Niedziela-Majka A, Robinson WH. Anti-Citrullinated Protein Antibodies With Multiple Specificities Ameliorate Collagen Antibody-Induced Arthritis in a Time-Dependent Manner. Arthritis Rheumatol 2024; 76:181-191. [PMID: 37610274 DOI: 10.1002/art.42679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/23/2023] [Accepted: 08/17/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVE Anti-citrullinated protein antibodies (ACPAs) are highly specific for rheumatoid arthritis (RA) and have long been regarded as pathogenic. Despite substantial in vitro evidence supporting this claim, reports investigating the proinflammatory effects of ACPAs in animal models of arthritis are rare and include mixed results. Here, we sequenced the plasmablast antibody repertoire of a patient with RA and functionally characterized the encoded ACPAs. METHODS We expressed ACPAs from the antibody repertoire of a patient with RA and characterized their autoantigen specificities on antigen arrays and enzyme-linked immunosorbent assays. Binding affinities were estimated by bio-layer interferometry. Select ACPAs (n = 9) were tested in the collagen antibody-induced arthritis (CAIA) mouse model to evaluate their effects on joint inflammation. RESULTS Recombinant ACPAs bound preferentially and with high affinity (nanomolar range) to citrullinated (cit) autoantigens (primarily histones and fibrinogen) and to auto-cit peptidylarginine deiminase 4 (PAD4). ACPAs were grouped for in vivo testing based on their predominant cit-antigen specificities. Unexpectedly, injections of recombinant ACPAs significantly reduced paw thickness and arthritis severity in CAIA mice as compared with isotype-matched control antibodies (P ≤ 0.001). Bone erosion, synovitis, and cartilage damage were also significantly reduced (P ≤ 0.01). This amelioration of CAIA was observed for all the ACPAs tested and was independent of cit-PAD4 and cit-fibrinogen specificities. Furthermore, disease amelioration was more prominent when ACPAs were injected at earlier stages of CAIA than at later phases of the model. CONCLUSION Recombinant patient-derived ACPAs ameliorated CAIA. Their antiinflammatory effects were more preventive than therapeutic. This study highlights a potential protective role for ACPAs in arthritis.
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Affiliation(s)
- Alejandro M Gomez
- Stanford University School of Medicine, Stanford, and VA Palo Alto Health Care System, Palo Alto, California
| | - R Camille Brewer
- Stanford University School of Medicine, Stanford, and VA Palo Alto Health Care System, Palo Alto, California
| | - Jae-Seung Moon
- Stanford University School of Medicine, Stanford, and VA Palo Alto Health Care System, Palo Alto, California
| | - Suman Acharya
- Stanford University School of Medicine, Stanford, and VA Palo Alto Health Care System, Palo Alto, California
| | - Sarah Kongpachith
- Stanford University School of Medicine, Stanford, and VA Palo Alto Health Care System, Palo Alto, California
| | - Qian Wang
- Stanford University School of Medicine, Stanford, and VA Palo Alto Health Care System, Palo Alto, California
| | - Shaghayegh Jahanbani
- Stanford University School of Medicine, Stanford, and VA Palo Alto Health Care System, Palo Alto, California
| | - Heidi H Wong
- Stanford University School of Medicine, Stanford, and VA Palo Alto Health Care System, Palo Alto, California
| | - Tobias V Lanz
- Stanford University School of Medicine, Stanford, and VA Palo Alto Health Care System, Palo Alto, California
| | - Zelda Z Love
- Stanford University School of Medicine, Stanford, and VA Palo Alto Health Care System, Palo Alto, California
| | | | | | - William H Robinson
- Stanford University School of Medicine, Stanford, and VA Palo Alto Health Care System, Palo Alto, California
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Adamska JZ, Zia A, Bloom MS, Crofford LJ, Furst DE, Goldmuntz E, Keyes-Elstein L, Mayes MD, McSweeney P, Nash RA, Pinckney A, Welch B, Love ZZ, Sullivan KM, Robinson W. Myeloablative autologous haematopoietic stem cell transplantation resets the B cell repertoire to a more naïve state in patients with systemic sclerosis. Ann Rheum Dis 2023; 82:357-364. [PMID: 36241361 PMCID: PMC9918657 DOI: 10.1136/ard-2021-221925] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 09/16/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Myeloablative autologous haematopoietic stem cell transplant (HSCT) was recently demonstrated to provide significant benefit over cyclophosphamide (CYC) in the treatment of diffuse cutaneous systemic sclerosis (dcSSc) in the Scleroderma: Cyclophosphamide or Transplantation (SCOT) trial. As dysregulation of the B cell compartment has previously been described in dcSSc, we sought to gain insight into the effects of myeloablative autologous HSCT as compared with CYC. METHODS We sequenced the peripheral blood immunoglobulin heavy chain (IGH) repertoires in patients with dcSSc enrolled in the SCOT trial. RESULTS Myeloablative autologous HSCT was associated with a sustained increase in IgM isotype antibodies bearing a low mutation rate. Clonal expression was reduced in IGH repertoires following myeloablative autologous HSCT. Additionally, we identified a underusage of immunoglobulin heavy chain V gene 5-51 in patients with dcSSc, and usage normalised following myeloablative autologous HSCT but not CYC treatment. CONCLUSIONS Together, these findings suggest that myeloablative autologous HSCT resets the IGH repertoire to a more naïve state characterised by IgM-expressing B cells, providing a possible mechanism for the elimination of pathogenic B cells that may contribute to the benefit of HSCT over CYC in the treatment of dcSSc.
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Affiliation(s)
- Julia Z Adamska
- Division of Immunology and Rheumatology, Department of Medicine, Stanford University, Stanford, California, USA,VA Palo Alto Health Care System, Palo Alto, California, USA
| | - Amin Zia
- Division of Immunology and Rheumatology, Department of Medicine, Stanford University, Stanford, California, USA,VA Palo Alto Health Care System, Palo Alto, California, USA
| | - Michelle S Bloom
- Division of Immunology and Rheumatology, Department of Medicine, Stanford University, Stanford, California, USA,VA Palo Alto Health Care System, Palo Alto, California, USA
| | - Leslie J Crofford
- Division of Rheumatology and Immunology, Vanderbilt University, Nashville, Tennessee, USA
| | - Daniel E Furst
- Rheumatology, Univ of Cal at Los Angeles, Los Angeles, California, USA
| | - Ellen Goldmuntz
- Division of Allergy, Immunology, and Transplantation, NIH/NIAID, Bethesda, Maryland, USA
| | | | - Maureen D Mayes
- Rheumatology and Clinical Immunogenetics, The University of Texas Health Science Center Houston Medical School, Houston, Texas, USA
| | - Peter McSweeney
- Rocky Mountain Blood and Marrow Transplant Program, Colorado Blood Cancer Institute, Denver, Colorado, USA
| | - Richard A Nash
- Rocky Mountain Blood and Marrow Transplant Program, Colorado Blood Cancer Institute, Denver, Colorado, USA
| | | | - Beverly Welch
- Division of Allergy, Immunology, and Transplantation, NIH/NIAID, Bethesda, Maryland, USA
| | - Zelda Z Love
- Division of Immunology and Rheumatology, Department of Medicine, Stanford University, Stanford, California, USA
| | - Keith M Sullivan
- Department of Medicine, Duke University Health System, Durham, North Carolina, USA
| | - William Robinson
- Division of Immunology and Rheumatology, Department of Medicine, Stanford University, Stanford, California, USA .,VA Palo Alto Health Care System, Palo Alto, California, USA
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Jahanbani S, Hansen PS, Blum LK, Bastounis EE, Ramadoss NS, Pandrala M, Kirschmann JM, Blacker GS, Love ZZ, Weissman IL, Nemati F, Tal MC, Robinson WH. Increased macrophage phagocytic activity with TLR9 agonist conjugation of an anti- Borrelia burgdorferi monoclonal antibody. Clin Immunol 2023; 246:109180. [PMID: 36396013 DOI: 10.1016/j.clim.2022.109180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/25/2022] [Accepted: 11/03/2022] [Indexed: 11/16/2022]
Abstract
Borrelia burgdorferi (Bb) infection causes Lyme disease, for which there is need for more effective therapies. Here, we sequenced the antibody repertoire of plasmablasts in Bb-infected humans. We expressed recombinant monoclonal antibodies (mAbs) representing the identified plasmablast clonal families, and identified their binding specificities. Our recombinant anti-Bb mAbs exhibit a range of activity in mediating macrophage phagocytosis of Bb. To determine if we could increase the macrophage phagocytosis-promoting activity of our anti-Bb mAbs, we generated a TLR9-agonist CpG-oligo-conjugated anti-BmpA mAb. We demonstrated that our CpG-conjugated anti-BmpA mAb exhibited increased peak Bb phagocytosis at 12-24 h, and sustained macrophage phagocytosis over 60+ hrs. Further, our CpG-conjugated anti-BmpA mAb induced macrophages to exhibit a sustained activation morphology. Our findings demonstrate the potential for TLR9-agonist CpG-oligo conjugates to enhance mAb-mediated clearance of Bb, and this approach might also enhance the activity of other anti-microbial mAbs.
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Affiliation(s)
- Shaghayegh Jahanbani
- Division of Immunology and Rheumatology, Stanford School of Medicine, Stanford, CA, USA; VA Palo Alto Health Care System, Palo Alto, CA, USA; Department of Biotechnology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Paige S Hansen
- Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA; Stem cell and Regenerative Medicine, Stanford School of Medicine, Stanford, CA, USA
| | - Lisa K Blum
- Division of Immunology and Rheumatology, Stanford School of Medicine, Stanford, CA, USA; VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Effie E Bastounis
- Interfaculty Institute of Microbiology & Infection Medicine, Cluster of Excellence CMFI, EXC 2124, University of Tübingen, Tübingen, Baden-Württemberg, Germany
| | - Nitya S Ramadoss
- Division of Immunology and Rheumatology, Stanford School of Medicine, Stanford, CA, USA; VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Mallesh Pandrala
- Department of Radiology, Stanford School of Medicine, Stanford, CA, USA
| | - Jessica Marie Kirschmann
- Division of Immunology and Rheumatology, Stanford School of Medicine, Stanford, CA, USA; VA Palo Alto Health Care System, Palo Alto, CA, USA
| | | | - Zelda Z Love
- Division of Immunology and Rheumatology, Stanford School of Medicine, Stanford, CA, USA; VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Irving L Weissman
- Stem cell and Regenerative Medicine, Stanford School of Medicine, Stanford, CA, USA
| | - Fahimeh Nemati
- Department of Biotechnology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
| | - Michal Caspi Tal
- Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA; Stem cell and Regenerative Medicine, Stanford School of Medicine, Stanford, CA, USA.
| | - William H Robinson
- Division of Immunology and Rheumatology, Stanford School of Medicine, Stanford, CA, USA; VA Palo Alto Health Care System, Palo Alto, CA, USA.
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Zhao X, Younis S, Shi H, Hu S, Zia A, Wong HH, Elliott EE, Chang T, Bloom MS, Zhang W, Liu X, Lanz TV, Sharpe O, Love ZZ, Wang Q, Robinson WH. RNA-seq characterization of histamine-releasing mast cells as potential therapeutic target of osteoarthritis. Clin Immunol 2022; 244:109117. [PMID: 36109004 PMCID: PMC10752578 DOI: 10.1016/j.clim.2022.109117] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/23/2022] [Accepted: 09/01/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Mast cells in the osteoarthritis (OA) synovium correlate with disease severity. This study aimed to further elucidate the role of mast cells in OA by RNA-Seq analysis and pharmacological blockade of the activity of histamine, a key mast cell mediator, in murine OA. METHODS We examined OA synovial tissues and fluids by flow cytometry, immunostaining, single-cell and bulk RNA-Seq, qPCR, and ELISA. Cetirizine, a histamine H1 receptor (H1R) antagonist, was used to treat the destabilization of the medial meniscus (DMM) mouse model of OA. RESULTS Flow cytometry and immunohistology analysis of OA synovial cells revealed KIT+ FcεRI+ and TPSAB1+ mast cells. Single-cell RNA-Seq of OA synovial cells identified the expression of prototypical mast cell markers KIT, TPSAB1, CPA3 and HDC, as well as distinctive markers HPGD, CAVIN2, IL1RL1, PRG2, and CKLF, confirmed by bulk RNA-Seq and qPCR. A mast cell prototypical marker expression score classified 40 OA patients into three synovial pathotypes: mast cell-high, -medium, and -low. Additionally, we detected mast cell mediators including histamine, tryptase AB1, CPA3, PRG2, CAVIN2, and CKLF in OA synovial fluids. Elevated H1R expression was detected in human OA synovium, and treatment of mice with the H1 receptor antagonist cetirizine reduced the severity and OA-related mediators in DMM. CONCLUSION Based on differential expression of prototypical and distinct mast cell markers, human OA joints can be stratified into mast cell-high, -medium, and -low synovial tissue pathotypes. Pharmacologic blockade of histamine activity holds the potential to improve OA disease outcome.
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Affiliation(s)
- Xiaoyi Zhao
- VA Palo Alto Health Care System, Palo Alto, CA 94304, USA; Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, CA 94305, USA; Department of Joint Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Shady Younis
- VA Palo Alto Health Care System, Palo Alto, CA 94304, USA; Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Hui Shi
- VA Palo Alto Health Care System, Palo Alto, CA 94304, USA; Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Shu Hu
- VA Palo Alto Health Care System, Palo Alto, CA 94304, USA; Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Amin Zia
- VA Palo Alto Health Care System, Palo Alto, CA 94304, USA; Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Heidi H Wong
- VA Palo Alto Health Care System, Palo Alto, CA 94304, USA; Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Eileen E Elliott
- VA Palo Alto Health Care System, Palo Alto, CA 94304, USA; Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Tiffany Chang
- VA Palo Alto Health Care System, Palo Alto, CA 94304, USA; Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Michelle S Bloom
- VA Palo Alto Health Care System, Palo Alto, CA 94304, USA; Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Wei Zhang
- VA Palo Alto Health Care System, Palo Alto, CA 94304, USA; Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Xiangyang Liu
- VA Palo Alto Health Care System, Palo Alto, CA 94304, USA; Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Tobias Volker Lanz
- VA Palo Alto Health Care System, Palo Alto, CA 94304, USA; Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Orr Sharpe
- VA Palo Alto Health Care System, Palo Alto, CA 94304, USA; Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Zelda Z Love
- VA Palo Alto Health Care System, Palo Alto, CA 94304, USA; Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Qian Wang
- VA Palo Alto Health Care System, Palo Alto, CA 94304, USA; Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, CA 94305, USA.
| | - William H Robinson
- VA Palo Alto Health Care System, Palo Alto, CA 94304, USA; Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, CA 94305, USA.
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