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Schwertz H, Rowley JW, Portier I, Middleton EA, Tolley ND, Campbell RA, Eustes AS, Chen K, Rondina MT. Human platelets display dysregulated sepsis-associated autophagy, induced by altered LC3 protein-protein interaction of the Vici-protein EPG5. Autophagy 2021; 18:1534-1550. [PMID: 34689707 DOI: 10.1080/15548627.2021.1990669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Platelets mediate central aspects of host responses during sepsis, an acute profoundly systemic inflammatory response due to infection. Macroautophagy/autophagy, which mediates critical aspects of cellular responses during inflammatory conditions, is known to be a functional cellular process in anucleate platelets, and is essential for normal platelet functions. Nevertheless, how sepsis may alter autophagy in platelets has never been established. Using platelets isolated from septic patients and matched healthy controls, we show that during clinical sepsis, the number of autophagosomes is increased in platelets, most likely due to an accumulation of autophagosomes, some containing mitochondria and indicative of mitophagy. Therefore, autophagy induction or early-stage autophagosome formation (as compared to decreased later-stage autophagosome maturation or autophagosome-late endosome/lysosome fusion) is normal or increased. This was consistent with decreased fusion of autophagosomes with lysosomes in platelets. EPG5 (ectopic P-granules autophagy protein 5 homolog), a protein essential for normal autophagy, expression did increase, while protein-protein interactions between EPG5 and MAP1LC3/LC3 (which orchestrate the fusion of autophagosomes and lysosomes) were significantly reduced in platelets during sepsis. Furthermore, data from a megakaryocyte model demonstrate the importance of TLR4 (toll like receptor 4), LPS-dependent signaling for regulating this mechanism. Similar phenotypes were also observed in platelets isolated from a patient with Vici syndrome: an inherited condition caused by a naturally occurring, loss-of-function mutation in EPG5. Together, we provide evidence that autophagic functions are aberrant in platelets during sepsis, due in part to reduced EPG5-LC3 interactions, regulated by TLR4 engagement, and the resultant accumulation of autophagosomes.Abbreviations: ACTB: beta actin; CLP: cecal ligation and puncture; Co-IP: co-immunoprecipitation; DAP: death associated protein; DMSO: dimethyl sulfoxide; EPG5: ectopic P-granules autophagy protein 5 homolog; ECL: enhanced chemiluminescence; HBSS: Hanks' balanced salt solution; HRP: horseradish peroxidase; ICU: intensive care unit; LPS: lipopolysaccharide; LAMP1: lysosomal associated membrane protein 1; MAP1LC3/LC3: microtubule associated protein 1 light chain 3; MTOR: mechanistic target of rapamycin kinase; MKs: megakaryocytes; PFA: paraformaldehyde; PBS: phosphate-buffered saline; PLA: proximity ligation assay; pRT-PCR: quantitative real-time polymerase chain reaction; RT: room temperature; SQSTM1/p62: sequestosome 1; SDS-PAGE: sodium dodecyl sulfate-polyacrylamide gel electrophoresis; TLR4: toll like receptor 4; TEM: transmission electron microscopy; WGA: wheat germ agglutinin.
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Affiliation(s)
- Hansjörg Schwertz
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA.,Work Wellness Clinic, University of Utah, Salt Lake City, UT, USA.,Division of Occupational Medicine, University of Utah, Salt Lake City, UT, USA.,Occupational Medicine, Billings Clinic Bozeman, Bozeman, MT, USA
| | - Jesse W Rowley
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA.,Division of Pulmonary Medicine, University of Utah, Salt Lake City, UT, USA
| | - Irina Portier
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA
| | - Elizabeth A Middleton
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA.,Division of Pulmonary Medicine, University of Utah, Salt Lake City, UT, USA
| | - Neal D Tolley
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA
| | - Robert A Campbell
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA.,Departments of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Alicia S Eustes
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA.,Department of Internal Medicine, University of Iowa in Iowa City, IA, USA
| | - Karin Chen
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA.,Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.,Department of Pediatrics, University of Washington School of Medicine, and Seattle Children's Hospital, Seattle, WA, USA
| | - Matthew T Rondina
- Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA.,Departments of Internal Medicine, University of Utah, Salt Lake City, UT, USA.,Department of Pathology, University of Utah, Salt Lake City, UT, USA.,Department of Internal Medicine, George E. Wahlen Salt Lake City VAMC, Salt Lake City, UT 84112, USA
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Abidi KT, Kamal NM, Bakkar AA, Almarri S, Abdullah R, Alsufyani M, Alharbi A. Vici syndrome with pathogenic homozygous EPG5 gene mutation: A case report and literature review. Medicine (Baltimore) 2020; 99:e22302. [PMID: 33120733 PMCID: PMC7581136 DOI: 10.1097/md.0000000000022302] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Vici syndrome (VICIS) is a rare, autosomal recessive neurodevelopmental disorder with multisystem involvement characterized by agenesis of the corpus callosum, congenital cataracts, cardiomyopathy, combined immunodeficiency, significant developmental delay, and hypopigmentation and in some cases loss of hearing. It is caused by mutations in Ectopic P-granules protein 5 gene, which is responsible for regulating autophagy activity. PATIENT CONCERN We report a 6-month-old Saudi female patient who was the second-born baby of first cousins. She was born by normal spontaneous vertex vaginal delivery. Parents noticed that she had global developmental delay and recurrent hospital admissions due to chest infections. DIAGNOSIS Brain magnetic resonance imaging showed brain atrophy with corpus callosum agenesis. Ophthalmology examination revealed bilateral congenital cataract. Molecular genetic testing identified the pathogenic homozygous variant c.4751T>A p. (Leu1584*) on exon 27 of the EPG5 gene and confirmed the diagnosis of Vici syndrome. INTERVENTIONS Supportive multidisciplinary care plan was initiated to this untreatable syndrome. OUTCOMES The patient died at the age of 6 months due to sepsis with uncompensated septic shock. LESSONS VICIS is a rare untreatable disorder with worldwide distribution. High index of suspicion is needed to diagnose it and family genetic counselling is crucial.
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Affiliation(s)
- Kamal T. Abidi
- Associate Professor of Pediatrics and Pediatric Nephrology. Faculty of Medecine, Al Manar University, Tunis, Tunisia
| | - Naglaa M. Kamal
- Professor of Pediatrics and Pediatric Hepatology, Pediatric Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | | | | | | | - Arwa Alharbi
- Medical Student, Faculty of Medicine, Taif University, Taif, KSA
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