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Fageräng B, Lau C, Mc Adam KE, Schjalm C, Christiansen D, Garred P, Nilsson PH, Mollnes TE. A novel selective leukocyte depletion human whole blood model reveals the specific roles of monocytes and granulocytes in the cytokine response to Escherichia coli. J Leukoc Biol 2024; 115:647-663. [PMID: 38057165 DOI: 10.1093/jleuko/qiad151] [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: 05/19/2023] [Revised: 10/28/2023] [Accepted: 11/19/2023] [Indexed: 12/08/2023] Open
Abstract
The lepirudin-based human whole blood model is a well-established ex vivo system to characterize inflammatory responses. However, the contribution of individual cell populations to cytokine release has not been investigated. Thus, we modified the model by selectively removing leukocyte subpopulations to elucidate their contribution to the inflammatory response. Lepirudin-anticoagulated whole blood was depleted from monocytes or granulocytes using StraightFrom Whole Blood MicroBeads. Reconstituted blood was incubated with Escherichia coli (108/mL) for 2 hours at 37 °C. CD11b, CD62P, and CD63 were detected by flow cytometry. Complement (C3bc, sC5b-9) and platelet activation (platelet factor 4, NAP-2) were measured by enzyme-linked immunosorbent assay. Cytokines were quantified by multiplex assay. A significant (P < 0.05) specific depletion of the monocyte (mean = 86%; 95% confidence interval = 71%-92%) and granulocyte (mean = 97%; 95% confidence interval = 96%-98%) population was obtained. Background activation induced by the depletion protocol was negligible for complement (C3bc and sC5b-9), leukocytes (CD11b), and platelets (NAP-2). Upon Escherichia coli incubation, release of 10 of the 24 cytokines was solely dependent on monocytes (interleukin [IL]-1β, IL-2, IL-4, IL-5, IL-17A, interferon-γ, granulocyte colony-stimulating factor, granulocyte-macrophage colony-stimulating factor, macrophage inflammatory protein-1α, and fibroblast growth factor-basic), whereas 8 were dependent on both monocytes and granulocytes (IL-1ra, IL-6, IL-8, IL-9, IL-10, macrophage inflammatory protein-1β, tumor necrosis factor, and eotaxin). Six cytokines were not monocyte or granulocyte dependent, of which platelet-derived growth factor and RANTES were mainly platelet dependent. We document an effective model for selective depletion of leukocyte subpopulations from whole blood, without causing background activation, allowing in-depth cellular characterization. The results are in accordance with monocytes playing a major role in cytokine release and expand our knowledge of the significant role of granulocytes in the response to E. coli.
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Affiliation(s)
- Beatrice Fageräng
- Department of Immunology, Oslo University Hospital, University of Oslo, Sognsvannsveien 20, 0372 Oslo, Norway
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, Faculty of Health and Medical Sciences, University of Copenhagen, Ole Maaloesvej 26, 2200 Copenhagen, Denmark
| | - Corinna Lau
- Research Laboratory, Nordland Hospital, Parkveien 95, 8005 Bodø, Norway
| | - Karin Ekholt Mc Adam
- Department of Immunology, Oslo University Hospital, University of Oslo, Sognsvannsveien 20, 0372 Oslo, Norway
| | - Camilla Schjalm
- Department of Immunology, Oslo University Hospital, University of Oslo, Sognsvannsveien 20, 0372 Oslo, Norway
| | | | - Peter Garred
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, Faculty of Health and Medical Sciences, University of Copenhagen, Ole Maaloesvej 26, 2200 Copenhagen, Denmark
| | - Per H Nilsson
- Department of Immunology, Oslo University Hospital, University of Oslo, Sognsvannsveien 20, 0372 Oslo, Norway
- Linnæus Center of Biomaterials Chemistry, Linnæus University, Universitetsplatsen 1, 391 82 Kalmar, Sweden
- Department of Chemistry and Biomedical Sciences, Linnaeus University, Universitetsplatsen 1, 391 82 Kalmar, Sweden
| | - Tom Eirik Mollnes
- Department of Immunology, Oslo University Hospital, University of Oslo, Sognsvannsveien 20, 0372 Oslo, Norway
- Research Laboratory, Nordland Hospital, Parkveien 95, 8005 Bodø, Norway
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Gramstad OR, Schjalm C, Mollnes TE, Nielsen EW. Increased thromboinflammatory load in hereditary angioedema. Clin Exp Immunol 2023; 214:170-181. [PMID: 37561062 PMCID: PMC10714191 DOI: 10.1093/cei/uxad091] [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: 03/14/2023] [Revised: 06/05/2023] [Accepted: 08/09/2023] [Indexed: 08/11/2023] Open
Abstract
C1 inhibitor (C1Inh) is a serine protease inhibitor involved in the kallikrein-kinin system, the complement system, the coagulation system, and the fibrinolytic system. In addition to the plasma leakage observed in hereditary angioedema (HAE), C1Inh deficiency may also affect these systems, which are important for thrombosis and inflammation. The aim of this study was to investigate the thromboinflammatory load in C1Inh deficiency. We measured 27 cytokines including interleukins, chemokines, interferons, growth factors, and regulators using multiplex technology. Complement activation (C4d, C3bc, and sC5b-C9/TCC), haemostatic markers (β-thromboglobulin (β-TG), thrombin-antithrombin complexes (TAT), prothrombin fragment 1 + 2 (F1 + 2), active plasminogen activator inhibitor-1 (PAI-1), and the neutrophil activation marker myeloperoxidase (MPO) were measured by enzyme immunoassays. Plasma and serum samples were collected from 20 patients with HAE type 1 or 2 in clinical remission and compared with 20 healthy age- and sex-matched controls. Compared to healthy controls, HAE patients had significantly higher levels of tumour necrosis factor (TNF), interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-7, IL-9, IL-12, and IL-17A, chemokine ligand (CXCL) 8, chemokine ligand (CCL) 3, CCL4, IL-1 receptor antagonist (IL-1RA), granulocyte-macrophage colony-stimulating factor (GM-CSF), fibroblast growth factor (FGF) 2 and platelet-derived growth factor (PDGF)-BB. HAE patients also had higher levels of TAT and F1 + 2. Although granulocyte colony-stimulating factor (G-CSF), β-TG and PAI-1 were higher in HAE patients, the differences did not reach statistical significance after correction for multiple testing. In conclusion, C1Inh deficiency is associated with an increased baseline thromboinflammatory load. These findings may reflect that HAE patients are in a subclinical attack state outside of clinically apparent oedema attacks.
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Affiliation(s)
- Olav Rogde Gramstad
- Department of Dermatology and Venerology, Oslo University Hospital, Oslo, Norway
| | - Camilla Schjalm
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Immunology, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Tom Eirik Mollnes
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Immunology, Oslo University Hospital, University of Oslo, Oslo, Norway
- Research Laboratory, Nordland Hospital, Bodø, Norway
| | - Erik Waage Nielsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Research Laboratory, Nordland Hospital, Bodø, Norway
- Department of Anesthesia and Intensive Care Medicine, Nordland Hospital, Bodø, Norway
- Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
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Thorgersen EB, Asvall J, Schjalm C, McAdam KE, Bruland ØS, Larsen SG, Mollnes TE. Effect of Intraperitoneal 224Radium-Labelled Microparticles on Compartmentalized Inflammation After Cytoreductive Surgery and Hypertherm Intraperitoneal Chemotherapy. Technol Cancer Res Treat 2023; 22:15330338231192902. [PMID: 37574949 PMCID: PMC10426314 DOI: 10.1177/15330338231192902] [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] [Indexed: 08/15/2023] Open
Abstract
Despite extensive treatment with surgery and chemotherapy many patients with peritoneal metastases from colorectal cancer experience intraperitoneal disease relapse. The α-emitting 224radium-labelled microparticle radionuclide therapeutic Radspherin® is being explored as a novel treatment option for these patients. Radspherin® is specially designed to give local radiation to the surface of the peritoneal cavity and potentially kill remaining attached micrometastases as well as free-floating cancer cells, thus preventing future relapse. The effect of Radspherin® on the immune system is not known. Systemic and local inflammatory responses were analyzed in plasma, intraperitoneal fluid and urine collected prospectively as part of a phase 1 dose-escalation study of intraperitoneal instillation of the α-emitting therapeutic radiopharmaceutical Radspherin®, at baseline and the first 7 postoperative days from nine patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. All patients additionally received intraperitoneal instillation of Radspherin® on postoperative day 2. Complement activation products C3bc and the terminal complement complex were analyzed using enzyme-linked immunosorbent assay. Cytokines (n = 27), including interleukins, chemokines, interferons and growth factors, were analyzed using multiplex technique. The time course and magnitude of the postoperative cytokine response after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy displayed a modest systemic response in plasma, in contrast to a substantial local intraperitoneal response. After administration of Radspherin®, a significant increase (P < 0.05) in TNF and MIP-1β was observed in both plasma and peritoneal fluid, whereas IL-9 increased only in plasma and IFNγ and IL1-RA only in peritoneal fluid. Only minor changes were seen for the majority of the inflammatory markers after Radspherin® administration. Our study showed a predominately local rather than systemic inflammatory response to cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Radspherin® had overall modest impact on the inflammation.
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Affiliation(s)
- Ebbe Billmann Thorgersen
- Department of Gastroenterological Surgery, Oslo University Hospital, The Radium Hospital, Oslo, Norway
| | - Jørund Asvall
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Camilla Schjalm
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Immunology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Karin Ekholt McAdam
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Immunology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Øyvind Sverre Bruland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Oncology, Oslo University Hospital, The Radium Hospital, Oslo, Norway
| | - Stein Gunnar Larsen
- Department of Gastroenterological Surgery, Oslo University Hospital, The Radium Hospital, Oslo, Norway
| | - Tom Eirik Mollnes
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Immunology, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Research Laboratory, Nordland Hospital, Bodø, Norway
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Torp MK, Ranheim T, Schjalm C, Hjorth M, Heiestad C, Dalen KT, Nilsson PH, Mollnes TE, Pischke SE, Lien E, Vaage J, Yndestad A, Stensløkken KO. Intracellular Complement Component 3 Attenuated Ischemia-Reperfusion Injury in the Isolated Buffer-Perfused Mouse Heart and Is Associated With Improved Metabolic Homeostasis. Front Immunol 2022; 13:870811. [PMID: 35432387 PMCID: PMC9011808 DOI: 10.3389/fimmu.2022.870811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Received: 02/07/2022] [Accepted: 03/08/2022] [Indexed: 12/25/2022] Open
Abstract
The innate immune system is rapidly activated during myocardial infarction and blockade of extracellular complement system reduces infarct size. Intracellular complement, however, appears to be closely linked to metabolic pathways and its role in ischemia-reperfusion injury is unknown and may be different from complement activation in the circulation. The purpose of the present study was to investigate the role of intracellular complement in isolated, retrogradely buffer-perfused hearts and cardiac cells from adult male wild type mice (WT) and from adult male mice with knockout of complement component 3 (C3KO). Main findings: (i) Intracellular C3 protein was expressed in isolated cardiomyocytes and in whole hearts, (ii) after ischemia-reperfusion injury, C3KO hearts had larger infarct size (32 ± 9% in C3KO vs. 22 ± 7% in WT; p=0.008) and impaired post-ischemic relaxation compared to WT hearts, (iii) C3KO cardiomyocytes had lower basal oxidative respiration compared to WT cardiomyocytes, (iv) blocking mTOR decreased Akt phosphorylation in WT, but not in C3KO cardiomyocytes, (v) after ischemia, WT hearts had higher levels of ATP, but lower levels of both reduced and oxidized nicotinamide adenine dinucleotide (NADH and NAD+, respectively) compared to C3KO hearts. Conclusion: intracellular C3 protected the heart against ischemia-reperfusion injury, possibly due to its role in metabolic pathways important for energy production and cell survival.
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Affiliation(s)
- M-K. Torp
- Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- *Correspondence: M-K. Torp,
| | - T. Ranheim
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
- Division of Surgery, Inflammatory Diseases and Transplantation, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - C. Schjalm
- Department of Immunology, Institute of Clinical Medicine University of Oslo, Oslo, Norway
| | - M. Hjorth
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - C.M. Heiestad
- Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - K. T. Dalen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - P. H. Nilsson
- Department of Immunology, Institute of Clinical Medicine University of Oslo, Oslo, Norway
- Linnaeus Centre for Biomaterials Chemistry, and the Department of Chemistry and Biomedicine, Linnaeus University, Kalmar, Sweden
| | - T. E. Mollnes
- Department of Immunology, Institute of Clinical Medicine University of Oslo, Oslo, Norway
- Stiftelsen Kristian Gerhard Jebsen (K.G. Jebsen) Inflammation Research Center (IRC), University of Oslo, Oslo, Norway
- Research Laboratory, Nordland Hospital, Bodø, and Faculty of Health Sciences, Stiftelsen Kristian Gerhard Jebsen (K.G. Jebsen) Thrombosis Research and Expertise Center (TREC), University of Tromsø, Tromsø, Norway
- Centre of Molecular Inflammation Research, Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - S. E. Pischke
- Department of Immunology, Institute of Clinical Medicine University of Oslo, Oslo, Norway
- Department of Research & Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - E. Lien
- Centre of Molecular Inflammation Research, Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Division of Infectious Diseases and Immunology, Program in Innate Immunity, Department of Medicine, UMass Medical School, Worchester, MA, United States
| | - J. Vaage
- Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Research & Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - A. Yndestad
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
| | - K-O. Stensløkken
- Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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Holt MF, Michelsen AE, Shahini N, Bjørkelund E, Bendz CH, Massey RJ, Schjalm C, Halvorsen B, Broch K, Ueland T, Gullestad L, Nilsson PH, Aukrust P, Mollnes TE, Louwe MC. The Alternative Complement Pathway Is Activated Without a Corresponding Terminal Pathway Activation in Patients With Heart Failure. Front Immunol 2022; 12:800978. [PMID: 35003128 PMCID: PMC8738166 DOI: 10.3389/fimmu.2021.800978] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 12/08/2021] [Indexed: 01/15/2023] Open
Abstract
Objective Dysregulation of the complement system has been described in patients with heart failure (HF). However, data on the alternative pathway are scarce and it is unknown if levels of factor B (FB) and the C3 convertase C3bBbP are elevated in these patients. We hypothesized that plasma levels of FB and C3bBbP would be associated with disease severity and survival in patients with HF. Methods We analyzed plasma levels of FB, C3bBbP, and terminal C5b-9 complement complex (TCC) in 343 HF patients and 27 healthy controls. Results Compared with controls, patients with HF had elevated levels of circulating FB (1.6-fold, p < 0.001) and C3bBbP (1.3-fold, p < 0.001). In contrast, TCC, reflecting the terminal pathway, was not significantly increased (p = 0.15 vs controls). FB was associated with NT-proBNP, troponin, eGFR, and i.e., C-reactive protein. FB, C3bBbP and TCC were not associated with mortality in HF during a mean follow up of 4.3 years. Conclusion Our findings suggest that in patients with HF, the alternative pathway is activated. However, this is not accompanied by activation of the terminal pathway.
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Affiliation(s)
- Margrethe Flesvig Holt
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Annika E Michelsen
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Negar Shahini
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
| | - Elisabeth Bjørkelund
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Christina Holt Bendz
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Richard J Massey
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Camilla Schjalm
- Department of Immunology, Oslo University Hospital Rikshospitalet and University of Oslo, Oslo, Norway
| | - Bente Halvorsen
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kaspar Broch
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,K.G. Jebsen Cardiac Research Center, Center for Heart Failure Research, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Thor Ueland
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Faculty of Health Sciences, K. G. Jebsen Thrombosis Research Center, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Lars Gullestad
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,K.G. Jebsen Cardiac Research Center, Center for Heart Failure Research, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Per H Nilsson
- Department of Immunology, Oslo University Hospital Rikshospitalet and University of Oslo, Oslo, Norway.,Linnaeus Centre for Biomaterials Chemistry, Linnaeus University, Kalmar, Sweden
| | - Pål Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Tom Eirik Mollnes
- Department of Immunology, Oslo University Hospital Rikshospitalet and University of Oslo, Oslo, Norway.,Faculty of Health Sciences, K. G. Jebsen Thrombosis Research Center, University of Tromsø - The Arctic University of Norway, Tromsø, Norway.,Research Laboratory, Nordland Hospital, Bodø, Norway.,Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Mieke C Louwe
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
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Medeiros PMC, Schjalm C, Christiansen D, Sokolova M, Pischke SE, Würzner R, Mollnes TE, Barratt-Due A. Vitamin C, Hydrocortisone, and the Combination Thereof Significantly Inhibited Two of Nine Inflammatory Markers Induced by Escherichia Coli But Not by Staphylococcus Aureus - When Incubated in Human Whole Blood. Shock 2022; 57:72-80. [PMID: 34265830 PMCID: PMC8663529 DOI: 10.1097/shk.0000000000001834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/29/2021] [Indexed: 11/27/2022]
Abstract
ABSTRACT Vitamin C combined with hydrocortisone is increasingly being used to treat septic patients, even though this treatment regimen is based on questionable evidence. When used, a marked effect on key players of innate immunity would be expected, as sepsis is featured by a dysregulated immune response.Here, we explored the effect of vitamin C and hydrocortisone alone and combined, in an ex vivo human whole-blood model of Escherichia coli- or Staphylococcus aureus-induced inflammation. Inflammatory markers for activation of complement (terminal C5b-9 complement complex [TCC]), granulocytes (myeloperoxidase), platelets (β-thromboglobulin), cytokines (tumor necrosis factor [TNF], IL-1β, IL6, and IL-8), and leukocytes (CD11b and oxidative burst) were quantified, by enzyme-linked immunosorbent assay, multiplex technology, and flow cytometry.In E. coli- and S. aureus-stimulated whole blood, a broad dose-titration of vitamin C and hydrocortisone alone did not lead to dose-response effects for the central innate immune mediators TCC and IL-6. Hence, the clinically relevant doses were used further. Compared to the untreated control sample, two of the nine biomarkers induced by E. coli were reduced by hydrocortisone and/or vitamin C. TNF was reduced by hydrocortisone alone (19%, P = 0.01) and by the combination (31%, P = 0.01). The oxidative burst of monocytes and granulocytes was reduced for both drugs alone and their combination, (ranging 8-19%, P < 0.05). Using S. aureus, neither of the drugs, alone nor in combination, had any effects on the nine biomarkers.In conclusion, despite the limitation of the ex vivo model, the effect of vitamin C and hydrocortisone on bacteria-induced inflammatory response in human whole blood is limited and following the clinical data.
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Affiliation(s)
| | - Camilla Schjalm
- Department of Immunology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Dorte Christiansen
- Research Laboratory, Nordland Hospital, Bodø and Faculty of Health Sciences, K. G. Jebsen Center, University of Tromsø, Norway
| | - Marina Sokolova
- Department of Immunology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Soeren Erik Pischke
- Department of Immunology, Oslo University Hospital and University of Oslo, Oslo, Norway
- Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Reinhard Würzner
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Tom Eirik Mollnes
- Department of Immunology, Oslo University Hospital and University of Oslo, Oslo, Norway
- Research Laboratory, Nordland Hospital, Bodø and Faculty of Health Sciences, K. G. Jebsen Center, University of Tromsø, Norway
- Center of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Andreas Barratt-Due
- Department of Immunology, Oslo University Hospital and University of Oslo, Oslo, Norway
- Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
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Thomas AM, Chaban V, Pischke SE, Orrem HL, Bosnes V, Sunde K, Seljeflot I, Lundqvist C, Nakstad ER, Andersen GØ, Schjalm C, Mollnes TE, Barratt-Due A. Complement ratios C3bc/C3 and sC5b-9/C5 do not increase the sensitivity of detecting acute complement activation systemically. Mol Immunol 2021; 141:273-279. [PMID: 34906905 DOI: 10.1016/j.molimm.2021.11.016] [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: 08/30/2021] [Revised: 11/08/2021] [Accepted: 11/21/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Complement activation plays an important pathogenic role in numerous diseases. The ratio between an activation product and its parent protein is suggested to be more sensitive to detect complement activation than the activation product itself. In the present study we explored whether the ratio between the activation product and the parent protein for C3 (C3bc/C3) and for C5 (sC5b-9/C5) increased the sensitivity to detect complement activation in acute clinical settings compared to the activation product alone. MATERIALS AND METHODS Samples from patients with acute heart failure following ST-elevated myocardial infarction (STEMI) and from patients with out-of-hospital cardiac arrest (OHCA) were used. C3, C3bc and C5, sC5b-9 were analysed in 629 and 672 patient samples, respectively. Healthy controls (n = 20) served to determine reference cut-off values for activation products and ratios, defined as two SD above the mean. RESULTS Increased C3bc/C3- and sC5b-9/C5 ratios were vastly dependent on C3bc and sC5b-9. Thus, 99.5 % and 98.1 % of the increased C3bc/C3- and sC5b-9/C5 ratios were solely dependent on increased C3bc and sC5b-9, respectively. Significantly decreased C3 and C5 caused increased ratios in only 3/600 (0.5 %) and 4/319 (1.3 %) samples, respectively. Strong correlations between C3bc and C3bc/C3-ratio and between sC5b-9 and sC5b-9/C5-ratio were found in the STEMI- (r = 0.926 and r = 0.786, respectively) and the OHCA-population (r = 0.908 and r = 0.843, respectively; p < 0.0001 for all). Importantly, sC5b-9 identified worse outcome groups better than sC5b-9/C5-ratio. CONCLUSION C3bc and sC5b-9 were sensitive markers of complement activation. The ratios of C3bc/C3 and sC5b-9/C5 did not improve detection of complement activation systemically.
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Affiliation(s)
- Anub Mathew Thomas
- Department of Immunology, Oslo University Hospital and University of Oslo, Norway; Department of Neurology, Drammen Hospital, Vestre Viken Hospital Trust, Norway
| | - Viktoriia Chaban
- Department of Immunology, Oslo University Hospital and University of Oslo, Norway
| | - Søren E Pischke
- Department of Immunology, Oslo University Hospital and University of Oslo, Norway; Division of Emergencies and Critical Care, Oslo University Hospital, Norway
| | - Hilde Lang Orrem
- Department of Immunology, Oslo University Hospital and University of Oslo, Norway; Division of Emergencies and Critical Care, Oslo University Hospital, Norway
| | - Vidar Bosnes
- Department of Immunology, Section of Medical Immunology, Oslo University Hospital, Oslo, Norway
| | - Kjetil Sunde
- Division of Emergencies and Critical Care, Oslo University Hospital, Norway; Institute of Clinical Medicine, University of Oslo, Norway
| | - Ingebjørg Seljeflot
- Institute of Clinical Medicine, University of Oslo, Norway; Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Norway; Department of Cardiology, Oslo University Hospital, Norway
| | - Christofer Lundqvist
- Institute of Clinical Medicine, University of Oslo, Norway; Department of Neurology, Akershus University Hospital, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Oslo, Norway
| | - Espen Rostrup Nakstad
- Norwegian National Unit for CBRNE Medicine, Division of Medicine, Oslo University Hospital, Norway
| | | | - Camilla Schjalm
- Department of Immunology, Oslo University Hospital and University of Oslo, Norway
| | - Tom Eirik Mollnes
- Department of Immunology, Oslo University Hospital and University of Oslo, Norway; Research Laboratory, Nordland Hospital, Bodø, Norway; K.G. Jebsen TREC, University of Tromsø, Norway; Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Andreas Barratt-Due
- Department of Immunology, Oslo University Hospital and University of Oslo, Norway; Division of Emergencies and Critical Care, Oslo University Hospital, Norway.
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Nilsson PH, Johnson C, Quach QH, Macpherson A, Durrant O, Pischke SE, Fure H, Landsem A, Bergseth G, Schjalm C, Haugaard-Kedström LM, Huber-Lang M, van den Elsen J, Brekke OL, Mollnes TE. A Conformational Change of Complement C5 Is Required for Thrombin-Mediated Cleavage, Revealed by a Novel Ex Vivo Human Whole Blood Model Preserving Full Thrombin Activity. J Immunol 2021; 207:1641-1651. [PMID: 34380648 PMCID: PMC8428748 DOI: 10.4049/jimmunol.2001471] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 07/09/2021] [Indexed: 11/19/2022]
Abstract
Thrombin activation of C5 connects thrombosis to inflammation. Complement research in whole blood ex vivo necessitates anticoagulation, which potentially interferes with the inflammatory modulation by thrombin. We challenged the concept of thrombin as an activator of native C5 by analyzing complement activation and C5 cleavage in human whole blood anticoagulated with Gly-Pro-Arg-Pro (GPRP), a peptide targeting fibrin polymerization downstream of thrombin, allowing complete endogenous thrombin generation. GPRP dose-dependently inhibited coagulation but allowed for platelet activation in accordance with thrombin generation. Spontaneous and bacterial-induced complement activation by Escherichia coli and Staphylococcus aureus, analyzed at the level of C3 and C5, were similar in blood anticoagulated with GPRP and the thrombin inhibitor lepirudin. In the GPRP model, endogenous thrombin, even at supra-physiologic concentrations, did not cleave native C5, despite efficiently cleaving commercially sourced purified C5 protein, both in buffer and when added to C5-deficient serum. In normal serum, only exogenously added, commercially sourced C5 was cleaved, whereas the native plasma C5 remained intact. Crucially, affinity-purified C5, eluted under mild conditions using an MgCl2 solution, was not cleaved by thrombin. Acidification of plasma to pH ≤ 6.8 by hydrochloric or lactic acid induced a C5 antigenic change, nonreversible by pH neutralization, that permitted cleavage by thrombin. Circular dichroism on purified C5 confirmed the structural change during acidification. Thus, we propose that pH-induced conformational change allows thrombin-mediated cleavage of C5 and that, contrary to previous reports, thrombin does not cleave plasma C5 in its native form, suggesting that thrombin cleavage of C5 may be restricted to certain pathophysiological conditions.
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Affiliation(s)
- Per H Nilsson
- Department of Immunology, University of Oslo and Oslo University Hospital Rikshospitalet, Oslo, Norway
- Linnaeus Centre for Biomaterials Chemistry, Linnaeus University, Kalmar, Sweden
- Department of Chemistry and Biomedical Sciences, Linnaeus University, Kalmar, Sweden
| | - Christina Johnson
- Department of Immunology, University of Oslo and Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Quang Huy Quach
- Department of Immunology, University of Oslo and Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Alex Macpherson
- UCB, Slough, UK
- Department of Biology and Biochemistry, University of Bath, Bath, United Kingdom
| | - Oliver Durrant
- UCB, Slough, UK
- Department of Biology and Biochemistry, University of Bath, Bath, United Kingdom
| | - Soeren E Pischke
- Department of Immunology, University of Oslo and Oslo University Hospital Rikshospitalet, Oslo, Norway
- Clinic for Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Hilde Fure
- Research Laboratory, Nordland Hospital, Bodø, Norway
| | - Anne Landsem
- Research Laboratory, Nordland Hospital, Bodø, Norway
- Faculty of Health Sciences, K. G. Jebsen Thrombosis Research Center, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | | | - Camilla Schjalm
- Department of Immunology, University of Oslo and Oslo University Hospital Rikshospitalet, Oslo, Norway
| | | | - Markus Huber-Lang
- Department of Orthopedic Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital of Ulm, Ulm, Germany
| | - Jean van den Elsen
- Department of Biology and Biochemistry, University of Bath, Bath, United Kingdom
- Centre for Therapeutic Innovation, University of Bath, Bath, UK; and
| | - Ole-Lars Brekke
- Research Laboratory, Nordland Hospital, Bodø, Norway
- Faculty of Health Sciences, K. G. Jebsen Thrombosis Research Center, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Tom Eirik Mollnes
- Department of Immunology, University of Oslo and Oslo University Hospital Rikshospitalet, Oslo, Norway;
- Research Laboratory, Nordland Hospital, Bodø, Norway
- Faculty of Health Sciences, K. G. Jebsen Thrombosis Research Center, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
- Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway
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9
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Chaban V, Nakstad ER, Stær-Jensen H, Schjalm C, Seljeflot I, Vaage J, Lundqvist C, Benth JŠ, Sunde K, Mollnes TE, Andersen GØ, Pischke SE. Complement activation is associated with poor outcome after out-of-hospital cardiac arrest. Resuscitation 2021; 166:129-136. [PMID: 34126135 DOI: 10.1016/j.resuscitation.2021.05.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/04/2021] [Accepted: 05/30/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND Cardiopulmonary resuscitation after cardiac arrest initiates a whole-body ischemia-reperfusion injury, which may activate the innate immune system, including the complement system. We hypothesized that complement activation and subsequent release of soluble endothelial activation markers were associated with cerebral outcome including death. METHODS Outcome was assessed at six months and defined by cerebral performance category scale (1-2; good outcome, 3-5; poor outcome including death) in 232 resuscitated out-of-hospital cardiac arrest patients. Plasma samples obtained at admission and day three were analysed for complement activation products C3bc, the soluble terminal complement complex (sC5b-9), and soluble CD14. Endothelial cell activation was measured by soluble markers syndecan-1, sE-selectin, thrombomodulin, and vascular cell adhesion molecule. RESULTS Forty-nine percent of the patients had good outcome. C3bc and sC5b-9 were significantly higher at admission compared to day three (p < 0.001 for both) and in patients with poor compared to good outcome (p = 0.03 and p < 0.001, respectively). Unadjusted, higher sC5b-9 at admission was associated with poor outcome (odds ratio 1.08 (95% CI 1.01-1.14), p = 0.024). Adjusted, sC5b-9 was still associated with outcome, but the association became non-significant when time to return-of-spontaneous-circulation above 25 min was included as a covariate. Endothelial cell activation markers increased from admission to day three, but only sE-selectin and thrombomodulin were significantly higher in patients with poor versus good outcome (p = 0.004 and p = 0.03, respectively) and correlated to sCD14 and sC5b-9/C3bc, respectively. CONCLUSION Complement system activation, reflected by sC5b-9 at admission, leading to subsequent endothelial cell activation, was associated with poor outcome in out-of-hospital cardiac arrest patients.
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Affiliation(s)
- Viktoriia Chaban
- Dept. of Immunology, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Espen R Nakstad
- Dept. of Acute Medicine, Oslo University Hospital, Oslo, Norway
| | - Henrik Stær-Jensen
- Dept. of Anaesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Camilla Schjalm
- Dept. of Immunology, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Ingebjørg Seljeflot
- Dept. of Cardiology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jarle Vaage
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Dept. of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway; Section of Physiology, Dept. of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Christofer Lundqvist
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Dept. of Neurology, Akershus University Hospital, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Oslo, Norway
| | - Jūratė Šaltytė Benth
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Oslo, Norway
| | - Kjetil Sunde
- Dept. of Anaesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tom Eirik Mollnes
- Dept. of Immunology, University of Oslo and Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Research Laboratory, Nordland Hospital Bodø, and K.G. Jebsen TREC, University of Tromsø, Norway; Centre of Molecular Inflammation Research, Department of Clinical and Molecular Research, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Søren Erik Pischke
- Dept. of Immunology, University of Oslo and Oslo University Hospital, Oslo, Norway; Dept. of Anaesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Dept. of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
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10
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Thorgersen EB, Asvall J, Frøysnes IS, Schjalm C, Larsen SG, Dueland S, Andersson Y, Fodstad Ø, Mollnes TE, Flatmark K. Increased Local Inflammatory Response to MOC31PE Immunotoxin After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy. Ann Surg Oncol 2021; 28:5252-5262. [PMID: 34019185 PMCID: PMC8349350 DOI: 10.1245/s10434-021-10022-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 02/26/2021] [Indexed: 11/18/2022]
Abstract
Background Despite extensive cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC), most patients with resectable peritoneal metastases from colorectal cancer experience disease relapse. MOC31PE immunotoxin is being explored as a novel treatment option for these patients. MOC31PE targets the cancer-associated epithelial cell adhesion molecule, and kills cancer cells by distinct mechanisms, simultaneously causing immune activation by induction of immunogenic cell death (ICD). Methods Systemic and local cytokine responses were analyzed in serum and intraperitoneal fluid samples collected the first three postoperative days from clinically comparable patients undergoing CRS-HIPEC with (n = 12) or without (n = 26) intraperitoneal instillation of MOC31PE. A broad panel of 27 pro- and antiinflammatory interleukins, chemokines, interferons, and growth factors was analyzed using multiplex technology. Results The time course and magnitude of the systemic and local postoperative cytokine response after CRS-HIPEC were highly compartmentalized, with modest systemic responses contrasting substantial intraperitoneal responses. Administration of MOC31PE resulted in changes that were broader and of higher magnitude compared with CRS-HIPEC alone. Significantly increased levels of innate proinflammatory cytokines, such as interleukin (IL)-6, IL-1β, and tumor necrosis factor (TNF) as well as an interesting time response curve for the strong T-cell stimulator interferon (IFN)-γ and its associated chemokine interferon gamma-induced protein/chemokine (C-X-C motif) ligand 10 (IP-10) were detected, all associated with ICD. Conclusions Our study revealed a predominately local rather than systemic inflammatory response to CRS-HIPEC, which was strongly enhanced by MOC31PE treatment. The MOC31PE-induced intraperitoneal inflammatory reaction could contribute to improve remnant cancer cell killing, but the mechanisms remain to be elucidated in future studies. Supplementary Information The online version contains supplementary material available at 10.1245/s10434-021-10022-0.
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Affiliation(s)
- Ebbe Billmann Thorgersen
- Department of Gastroenterological Surgery, Oslo University Hospital The Radium Hospital, Oslo, Norway. .,Department of Immunology, Oslo University Hospital Rikshospitalet, Oslo, Norway.
| | - Jørund Asvall
- Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ida Storhaug Frøysnes
- Department of Tumor Biology, Oslo University Hospital The Radium Hospital, Oslo, Norway
| | - Camilla Schjalm
- Department of Immunology, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Stein Gunnar Larsen
- Department of Gastroenterological Surgery, Oslo University Hospital The Radium Hospital, Oslo, Norway
| | - Svein Dueland
- Department of Oncology, Oslo University Hospital The Radium Hospital, Oslo, Norway
| | - Yvonne Andersson
- Department of Tumor Biology, Oslo University Hospital The Radium Hospital, Oslo, Norway
| | - Øystein Fodstad
- Department of Tumor Biology, Oslo University Hospital The Radium Hospital, Oslo, Norway
| | - Tom Eirik Mollnes
- Department of Immunology, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway.,Research Laboratory, Nordland Hospital, Bodø, and Faculty of Health Sciences, K.G. Jebsen TREC, University of Tromsø, Tromsø, Norway.,Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kjersti Flatmark
- Department of Gastroenterological Surgery, Oslo University Hospital The Radium Hospital, Oslo, Norway.,Department of Tumor Biology, Oslo University Hospital The Radium Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
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11
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Storm BS, Halvorsen PS, Skulstad H, Dybwik K, Schjalm C, Christiansen D, Wisløff‐Aase K, Fosse E, Braaten T, Nielsen EW, Mollnes TE. Open chest and pericardium facilitate transpulmonary passage of venous air emboli. Acta Anaesthesiol Scand 2021; 65:648-655. [PMID: 33595102 DOI: 10.1111/aas.13796] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 12/30/2020] [Accepted: 02/03/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND Transpulmonary passage of air emboli can lead to fatal brain- and myocardial infarctions. We studied whether pigs with open chest and pericardium had a greater transpulmonary passage of venous air emboli than pigs with closed thorax. METHODS We allocated pigs with verified closed foramen ovale to venous air infusion with either open chest with sternotomy and opening of the pleura and pericardium (n = 8) or closed thorax (n = 16). All pigs received a five-hour intravenous infusion of ambient air, starting at 4-6 mL/kg/h and increased by 2 mL/kg/h each hour. We assessed transpulmonary air passage by transesophageal M-mode echocardiography and present the results as median with inter-quartile range (IQR). RESULTS Transpulmonary air passage occurred in all pigs with open chest and pericardium and in nine pigs with closed thorax (56%). Compared to pigs with closed thorax, pigs with open chest and pericardium had a shorter to air passage (10 minutes (5-16) vs. 120 minutes (44-212), P < .0001), a smaller volume of infused air at the time of transpulmonary passage (12 mL (10-23) vs.170 mL (107-494), P < .0001), shorter time to death (122 minutes (48-185) vs 263 minutes (248-300, P = .0005) and a smaller volume of infused air at the time of death (264 mL (53-466) vs 727 mL (564-968), P = .001). In pigs with open chest and, infused air and time to death correlated strongly (r = 0.95, P = .001). CONCLUSION Open chest and pericardium facilitated the transpulmonary passage of intravenously infused air in pigs.
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Affiliation(s)
- Benjamin S. Storm
- Department of Anesthesia and Intensive Care Medicine Nordland Hospital Bodø Norway
- Institute of Clinical Medicine University of Tromsø Tromsø Norway
- Faculty of Nursing and Health Sciences Nord University Bodø Norway
| | - Per Steinar Halvorsen
- The Intervention Centre RikshospitaletOslo University Hospital Oslo Norway
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Helge Skulstad
- Department of Cardiology RikshospitaletOslo University Hospital Oslo Norway
| | - Knut Dybwik
- Department of Anesthesia and Intensive Care Medicine Nordland Hospital Bodø Norway
- Faculty of Nursing and Health Sciences Nord University Bodø Norway
| | - Camilla Schjalm
- Department of Immunology Oslo University HospitalUniversity of Oslo Oslo Norway
| | - Dorte Christiansen
- Research Laboratory Nordland Hospital Bodø Norway
- Faculty of Health Sciences K.G. Jebsen TRECUniversity of Tromsø Tromsø Norway
| | - Kristin Wisløff‐Aase
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Emergencies and Critical Care RikshospitaletOslo University Hospital Oslo Norway
| | - Erik Fosse
- The Intervention Centre RikshospitaletOslo University Hospital Oslo Norway
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Tonje Braaten
- Faculty of Nursing and Health Sciences Nord University Bodø Norway
- Department of Community Medicine University of Tromsø Tromsø Norway
| | - Erik W. Nielsen
- Department of Anesthesia and Intensive Care Medicine Nordland Hospital Bodø Norway
- Institute of Clinical Medicine University of Tromsø Tromsø Norway
- Faculty of Nursing and Health Sciences Nord University Bodø Norway
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
- Research Laboratory Nordland Hospital Bodø Norway
| | - Tom E. Mollnes
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Immunology Oslo University HospitalUniversity of Oslo Oslo Norway
- Research Laboratory Nordland Hospital Bodø Norway
- Faculty of Health Sciences K.G. Jebsen TRECUniversity of Tromsø Tromsø Norway
- Centre of Molecular Inflammation Research Norwegian University of Science and Technology Trondheim Norway
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12
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Sundnes O, Ottestad W, Schjalm C, Lundbäck P, la Cour Poulsen L, Mollnes TE, Haraldsen G, Eken T. Rapid systemic surge of IL-33 after severe human trauma: a prospective observational study. Mol Med 2021; 27:29. [PMID: 33771098 PMCID: PMC8004436 DOI: 10.1186/s10020-021-00288-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 03/08/2021] [Indexed: 01/12/2023] Open
Abstract
Background Alarmins are considered proximal mediators of the immune response after tissue injury. Understanding their biology could pave the way for development of new therapeutic targets and biomarkers in human disease, including multiple trauma. In this study we explored high-resolution concentration kinetics of the alarmin interleukin-33 (IL-33) early after human trauma. Methods Plasma samples were serially collected from 136 trauma patients immediately after hospital admission, 2, 4, 6, and 8 h thereafter, and every morning in the ICU. Levels of IL-33 and its decoy receptor sST2 were measured by immunoassays. Results We observed a rapid and transient surge of IL-33 in a subset of critically injured patients. These patients had more widespread tissue injuries and a greater degree of early coagulopathy. IL-33 half-life (t1/2) was 1.4 h (95% CI 1.2–1.6). sST2 displayed a distinctly different pattern with low initial levels but massive increase at later time points. Conclusions We describe for the first time early high-resolution IL-33 concentration kinetics in individual patients after trauma and correlate systemic IL-33 release to clinical data. These findings provide insight into a potentially important axis of danger signaling in humans. Supplementary Information The online version contains supplementary material available at 10.1186/s10020-021-00288-1.
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Affiliation(s)
- Olav Sundnes
- K.G Jebsen Inflammation Research Centre, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Pathology, Oslo University Hospital, Rikshospitalet, N-0027, Oslo, Norway.,Department of Dermatology, Oslo University Hospital, Oslo, Norway
| | - William Ottestad
- Department of Anaesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital Ullevål, Oslo, Norway.,Division of Critical Care, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Camilla Schjalm
- K.G Jebsen Inflammation Research Centre, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Peter Lundbäck
- K.G Jebsen Inflammation Research Centre, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Pathology, Oslo University Hospital, Rikshospitalet, N-0027, Oslo, Norway
| | - Lars la Cour Poulsen
- K.G Jebsen Inflammation Research Centre, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Pathology, Oslo University Hospital, Rikshospitalet, N-0027, Oslo, Norway
| | - Tom Eirik Mollnes
- K.G Jebsen Inflammation Research Centre, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Immunology, Oslo University Hospital, Oslo, Norway.,Reserach Laboratory, Nordland Hospital, Bodø, and K.G.Jebsen TREC, University of Tromsø, Tromsø, Norway.,Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Guttorm Haraldsen
- K.G Jebsen Inflammation Research Centre, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway. .,Department of Pathology, Oslo University Hospital, Rikshospitalet, N-0027, Oslo, Norway.
| | - Torsten Eken
- Department of Anaesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital Ullevål, Oslo, Norway.,Division of Critical Care, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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13
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Holter JC, Pischke SE, de Boer E, Lind A, Jenum S, Holten AR, Tonby K, Barratt-Due A, Sokolova M, Schjalm C, Chaban V, Kolderup A, Tran T, Tollefsrud Gjølberg T, Skeie LG, Hesstvedt L, Ormåsen V, Fevang B, Austad C, Müller KE, Fladeby C, Holberg-Petersen M, Halvorsen B, Müller F, Aukrust P, Dudman S, Ueland T, Andersen JT, Lund-Johansen F, Heggelund L, Dyrhol-Riise AM, Mollnes TE. Systemic complement activation is associated with respiratory failure in COVID-19 hospitalized patients. Proc Natl Acad Sci U S A 2020; 117:25018-25025. [PMID: 32943538 PMCID: PMC7547220 DOI: 10.1073/pnas.2010540117] [Citation(s) in RCA: 238] [Impact Index Per Article: 59.5] [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] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Respiratory failure in the acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is hypothesized to be driven by an overreacting innate immune response, where the complement system is a key player. In this prospective cohort study of 39 hospitalized coronavirus disease COVID-19 patients, we describe systemic complement activation and its association with development of respiratory failure. Clinical data and biological samples were obtained at admission, days 3 to 5, and days 7 to 10. Respiratory failure was defined as PO2/FiO2 ratio of ≤40 kPa. Complement activation products covering the classical/lectin (C4d), alternative (C3bBbP) and common pathway (C3bc, C5a, and sC5b-9), the lectin pathway recognition molecule MBL, and antibody serology were analyzed by enzyme-immunoassays; viral load by PCR. Controls comprised healthy blood donors. Consistently increased systemic complement activation was observed in the majority of COVID-19 patients during hospital stay. At admission, sC5b-9 and C4d were significantly higher in patients with than without respiratory failure (P = 0.008 and P = 0.034). Logistic regression showed increasing odds of respiratory failure with sC5b-9 (odds ratio 31.9, 95% CI 1.4 to 746, P = 0.03) and need for oxygen therapy with C4d (11.7, 1.1 to 130, P = 0.045). Admission sC5b-9 and C4d correlated significantly to ferritin (r = 0.64, P < 0.001; r = 0.69, P < 0.001). C4d, sC5b-9, and C5a correlated with antiviral antibodies, but not with viral load. Systemic complement activation is associated with respiratory failure in COVID-19 patients and provides a rationale for investigating complement inhibitors in future clinical trials.
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Affiliation(s)
- Jan C Holter
- Department of Microbiology, Oslo University Hospital, 0424 Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway
| | - Soeren E Pischke
- Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway;
- Division of Emergencies and Critical Care, Oslo University Hospital, 0424 Oslo, Norway
- Department of Immunology, Oslo University Hospital, 0424 Oslo, Norway
| | - Eline de Boer
- Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway
- Department of Immunology, Oslo University Hospital, 0424 Oslo, Norway
| | - Andreas Lind
- Department of Microbiology, Oslo University Hospital, 0424 Oslo, Norway
| | - Synne Jenum
- Department of Infectious Diseases, Oslo University Hospital, 0424 Oslo, Norway
| | - Aleksander R Holten
- Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway
- Department of Acute Medicine, Oslo University Hospital, 0424 Oslo, Norway
| | - Kristian Tonby
- Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway
- Department of Infectious Diseases, Oslo University Hospital, 0424 Oslo, Norway
| | - Andreas Barratt-Due
- Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway
- Division of Emergencies and Critical Care, Oslo University Hospital, 0424 Oslo, Norway
- Department of Immunology, Oslo University Hospital, 0424 Oslo, Norway
| | - Marina Sokolova
- Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway
- Department of Immunology, Oslo University Hospital, 0424 Oslo, Norway
| | - Camilla Schjalm
- Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway
- Department of Immunology, Oslo University Hospital, 0424 Oslo, Norway
| | - Viktoriia Chaban
- Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway
- Department of Immunology, Oslo University Hospital, 0424 Oslo, Norway
| | - Anette Kolderup
- Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway
- Department of Pharmacology, University of Oslo, 0315 Oslo, Norway
| | - Trung Tran
- Department of Immunology, Oslo University Hospital, 0424 Oslo, Norway
| | - Torleif Tollefsrud Gjølberg
- Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway
- Department of Immunology, Oslo University Hospital, 0424 Oslo, Norway
- Department of Pharmacology, University of Oslo, 0315 Oslo, Norway
- Department of Ophthalmology, Oslo University Hospital, 0424 Oslo, Norway
| | - Linda G Skeie
- Department of Infectious Diseases, Oslo University Hospital, 0424 Oslo, Norway
| | - Liv Hesstvedt
- Department of Infectious Diseases, Oslo University Hospital, 0424 Oslo, Norway
| | - Vidar Ormåsen
- Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway
- Department of Infectious Diseases, Oslo University Hospital, 0424 Oslo, Norway
| | - Børre Fevang
- Research Institute of Internal Medicine, Oslo University Hospital, 0424 Oslo, Norway
- Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, 0424 Oslo, Norway
| | - Cathrine Austad
- Department of Internal Medicine, Vestre Viken Hospital Trust, 3004 Drammen, Norway
| | - Karl Erik Müller
- Department of Internal Medicine, Vestre Viken Hospital Trust, 3004 Drammen, Norway
- Department of Clinical Science, Faculty of Medicine, University of Bergen, 5007 Bergen, Norway
| | - Cathrine Fladeby
- Department of Microbiology, Oslo University Hospital, 0424 Oslo, Norway
| | | | - Bente Halvorsen
- Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway
- Research Institute of Internal Medicine, Oslo University Hospital, 0424 Oslo, Norway
| | - Fredrik Müller
- Department of Microbiology, Oslo University Hospital, 0424 Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway
| | - Pål Aukrust
- Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway
- Research Institute of Internal Medicine, Oslo University Hospital, 0424 Oslo, Norway
- Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, 0424 Oslo, Norway
- Faculty of Health Sciences, K.G. Jebsen Thrombosis Research and Expertise Center, University of Tromsø, 9037 Tromsø, Norway
| | - Susanne Dudman
- Department of Microbiology, Oslo University Hospital, 0424 Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway
| | - Thor Ueland
- Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway
- Research Institute of Internal Medicine, Oslo University Hospital, 0424 Oslo, Norway
- Faculty of Health Sciences, K.G. Jebsen Thrombosis Research and Expertise Center, University of Tromsø, 9037 Tromsø, Norway
| | - Jan Terje Andersen
- Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway
- Department of Immunology, Oslo University Hospital, 0424 Oslo, Norway
| | - Fridtjof Lund-Johansen
- Department of Immunology, Oslo University Hospital, 0424 Oslo, Norway
- ImmunoLingo Convergence Centre, University of Oslo, 0315 Oslo, Norway
| | - Lars Heggelund
- Department of Internal Medicine, Vestre Viken Hospital Trust, 3004 Drammen, Norway
- Department of Clinical Science, Faculty of Medicine, University of Bergen, 5007 Bergen, Norway
| | - Anne M Dyrhol-Riise
- Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway
- Department of Infectious Diseases, Oslo University Hospital, 0424 Oslo, Norway
| | - Tom E Mollnes
- Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway
- Department of Immunology, Oslo University Hospital, 0424 Oslo, Norway
- Faculty of Health Sciences, K.G. Jebsen Thrombosis Research and Expertise Center, University of Tromsø, 9037 Tromsø, Norway
- Research Laboratory, Nordland Hospital Bodø, 8092 Bodø, Norway
- Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, 7491 Trondheim, Norway
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14
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van den Heuvel LP, van de Kar NCAJ, Duineveld C, Sarlea A, van der Velden TJAM, Liebrand WTB, van Kraaij S, Schjalm C, Bouwmeester R, Wetzels JFM, Mollnes TE, Volokhina EB. The complement component C5 is not responsible for the alternative pathway activity in rabbit erythrocyte hemolytic assays during eculizumab treatment. Cell Mol Immunol 2020; 17:653-655. [PMID: 32210393 DOI: 10.1038/s41423-020-0406-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 11/09/2022] Open
Affiliation(s)
- Lambertus P van den Heuvel
- Department of Pediatric Nephrology Amalia Children's Hospital, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands.,Department of Laboratory Medicine, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands.,Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Nicole C A J van de Kar
- Department of Pediatric Nephrology Amalia Children's Hospital, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - Caroline Duineveld
- Department of Nephrology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Andrei Sarlea
- Department of Pediatric Nephrology Amalia Children's Hospital, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - Thea J A M van der Velden
- Department of Pediatric Nephrology Amalia Children's Hospital, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - Wilhelmus T B Liebrand
- Department of Pediatric Nephrology Amalia Children's Hospital, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - Sanne van Kraaij
- Department of Laboratory Medicine, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - Camilla Schjalm
- Department of Immunology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Romy Bouwmeester
- Department of Pediatric Nephrology Amalia Children's Hospital, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - Jack F M Wetzels
- Department of Nephrology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Tom E Mollnes
- Department of Immunology, Oslo University Hospital and University of Oslo, Oslo, Norway.,Research Laboratory, Nordland Hospital, Bodø, and K. G. Jebsen TREC, University of Tromsø, Tromsø, Norway.,Center of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Elena B Volokhina
- Department of Pediatric Nephrology Amalia Children's Hospital, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands. .,Department of Laboratory Medicine, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands.
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15
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Grinde D, Øverland T, Lima K, Schjalm C, Mollnes TE, Abrahamsen TG. Complement Activation in 22q11.2 Deletion Syndrome. J Clin Immunol 2020; 40:515-523. [PMID: 32152940 PMCID: PMC7142058 DOI: 10.1007/s10875-020-00766-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 07/09/2019] [Accepted: 02/19/2020] [Indexed: 12/05/2022]
Abstract
The 22q11.2 deletion syndrome (22q11.2 del), also known as DiGeorge syndrome, is a genetic disorder with an estimated incidence of 1:3000 to 1:6000 births. These patients may suffer from affection of many organ systems with cardiac malformations, immunodeficiency, hypoparathyroidism, autoimmunity, palate anomalies, and psychiatric disorders being the most frequent. The importance of the complement system in 22q11.2 del has not been investigated. The objective of this study was to evaluate the complement system in relation to clinical and immunological parameters in patients. A national cohort of patients (n = 69) with a proven heterozygous deletion of chromosome 22q11.2 and a group of age and sex matched controls (n = 56) were studied. Functional capacity of the classical, lectin, and alternative pathways of the complement system as well as complement activation products C3bc and terminal complement complex (TCC) were accessed and correlated to clinical features. All patients in our study had normal complement activation in both classical and alternative pathways. The frequency of mannose-binding lectin deficiency was comparable to the normal population. The patients had significantly raised plasma levels of C3bc and a slight, but not significant, increase in TCC compared with controls. This increase was associated with the presence of psychiatric disorders in patients. The present study shows no complement deficiencies in 22q11.2 deletion syndrome. On the contrary, there are signs of increased complement activation in these patients. Complement activation is particularly associated with the presence of psychiatric disorders.
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Affiliation(s)
- Dina Grinde
- Department of Pediatric Research, Oslo University Hospital, Oslo, Norway.
| | - Torstein Øverland
- Department of Pediatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Kari Lima
- Department of Pediatric Medicine, Oslo University Hospital, Oslo, Norway.,Department of Endocrinology, Akershus University Hospital, Lørenskog, Norway
| | - Camilla Schjalm
- Department of Immunology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Tom Eirik Mollnes
- Department of Immunology, Oslo University Hospital and University of Oslo, Oslo, Norway.,Research Laboratory, Nordland Hospital, Bodø, and K.G. Jebsen TREC, University of Tromsø, Tromsø, Norway.,Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tore G Abrahamsen
- Center for Rare Diseases, Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
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16
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Thomas AM, Schjalm C, Nilsson PH, Lindenskov PHH, Rørtveit R, Solberg R, Saugstad OD, Berglund MM, Strömberg P, Lau C, Espevik T, Jansen JH, Castellheim A, Mollnes TE, Barratt-Due A. Combined Inhibition of C5 and CD14 Attenuates Systemic Inflammation in a Piglet Model of Meconium Aspiration Syndrome. Neonatology 2018; 113:322-330. [PMID: 29486477 PMCID: PMC6008878 DOI: 10.1159/000486542] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 12/28/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND Meconium aspiration syndrome (MAS) is a severe lung condition affecting newborns and it can lead to a systemic inflammatory response. We previously documented complement activation and cytokine release in a piglet MAS model. Additionally, we showed ex vivo that meconium-induced inflammation was dependent on complement and Toll-like receptors. OBJECTIVES To assess the efficacy of the combined inhibition of complement (C5) and CD14 on systemic inflammation induced in a forceful piglet MAS model. METHODS Thirty piglets were randomly allocated to a treatment group receiving the C5-inhibitor SOBI002 and anti-CD14 (n = 15) and a nontreated control group (n = 15). MAS was induced by intratracheal meconium instillation, and the piglets were observed for 5 h. Complement, cytokines, and myeloperoxidase (MPO) were measured by ELISA. RESULTS SOBI002 ablated C5 activity and the formation of the terminal complement complex in vivo. The combined inhibition attenuated the inflammasome cytokines IL-1β and IL-6 by 60 (p = 0.029) and 44% (p = 0.01), respectively, and also MPO activity in the bronchoalveolar fluid by 42% (p = 0.017). Ex vivo experiments in human blood revealed that the combined regimen attenuated meconium-induced MPO release by 64% (p = 0.008), but there was only a negligible effect with single inhibition, indicating a synergic cross-talk between the key molecules C5 and CD14. CONCLUSION Combined inhibition of C5 and CD14 attenuates meconium-induced inflammation in vivo and this could become a future therapeutic regimen for MAS.
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Affiliation(s)
- Anub Mathew Thomas
- Department of Immunology, Oslo University Hospital and K.G. Jebsen IRC, University of Oslo, Oslo, Norway
| | - Camilla Schjalm
- Department of Immunology, Oslo University Hospital and K.G. Jebsen IRC, University of Oslo, Oslo, Norway
| | - Per H Nilsson
- Department of Immunology, Oslo University Hospital and K.G. Jebsen IRC, University of Oslo, Oslo, Norway.,Linnaeus Centre for Biomaterials Chemistry, Linnaeus University, Kalmar, Sweden
| | - Paal H H Lindenskov
- Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Runa Rørtveit
- Faculty of Veterinary Medicine and Biosciences, Norwegian University of Life Sciences, Oslo/Ås, Norway
| | - Rønnaug Solberg
- Department of Pediatric Research, Oslo University Hospital, University of Oslo, Oslo, Norway.,Institute of Surgical Research, Oslo University Hospital, Oslo, Norway
| | - Ola Didrik Saugstad
- Department of Pediatric Research, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Magnus M Berglund
- Research and Translational Science, Swedish Orphan Biovitrum, Stockholm, Sweden
| | - Patrik Strömberg
- Research and Translational Science, Swedish Orphan Biovitrum, Stockholm, Sweden
| | - Corinna Lau
- Research Laboratory, Nordland Hospital, Bodø, Norway
| | - Terje Espevik
- Center of Molecular Inflammatory Research and Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Johan Høgset Jansen
- Faculty of Veterinary Medicine and Biosciences, Norwegian University of Life Sciences, Oslo/Ås, Norway
| | - Albert Castellheim
- Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Tom Eirik Mollnes
- Department of Immunology, Oslo University Hospital and K.G. Jebsen IRC, University of Oslo, Oslo, Norway.,Research Laboratory, Nordland Hospital, Bodø, Norway.,Center of Molecular Inflammatory Research and Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,K.G Jebsen TREC, University of Tromsø, Tromsø, Norway
| | - Andreas Barratt-Due
- Department of Immunology, Oslo University Hospital and K.G. Jebsen IRC, University of Oslo, Oslo, Norway.,Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
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17
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Genster N, Østrup O, Schjalm C, Mollnes TE, Cowland JB, Garred P. Ficolins do not alter host immune responses to lipopolysaccharide-induced inflammation in vivo. Mol Immunol 2017. [DOI: 10.1016/j.molimm.2017.06.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Schjalm C, Thorgersen EB, Aandahl EM, Stubberud VB, Mollnes TE, Pischke SE. A novel model for complement studies and intervention in kidney ischemia/reperfusion injury. Mol Immunol 2017. [DOI: 10.1016/j.molimm.2017.06.215] [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: 11/16/2022]
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19
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Genster N, Østrup O, Schjalm C, Eirik Mollnes T, Cowland JB, Garred P. Ficolins do not alter host immune responses to lipopolysaccharide-induced inflammation in vivo. Sci Rep 2017; 7:3852. [PMID: 28634324 PMCID: PMC5478672 DOI: 10.1038/s41598-017-04121-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 05/09/2017] [Indexed: 11/17/2022] Open
Abstract
Ficolins are a family of pattern recognition molecules that are capable of activating the lectin pathway of complement. A limited number of reports have demonstrated a protective role of ficolins in animal models of infection. In addition, an immune modulatory role of ficolins has been suggested. Yet, the contribution of ficolins to inflammatory disease processes remains elusive. To address this, we investigated ficolin deficient mice during a lipopolysaccharide (LPS)-induced model of systemic inflammation. Although murine serum ficolin was shown to bind LPS in vitro, there was no difference between wildtype and ficolin deficient mice in morbidity and mortality by LPS-induced inflammation. Moreover, there was no difference between wildtype and ficolin deficient mice in the inflammatory cytokine profiles after LPS challenge. These findings were substantiated by microarray analysis revealing an unaltered spleen transcriptome profile in ficolin deficient mice compared to wildtype mice. Collectively, results from this study demonstrate that ficolins are not involved in host response to LPS-induced systemic inflammation.
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Affiliation(s)
- Ninette Genster
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Olga Østrup
- Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Camilla Schjalm
- Department of Immunology, Oslo University Hospital, Rikshospitalet, 0424, Oslo, Norway
| | - Tom Eirik Mollnes
- Department of Immunology, Oslo University Hospital, Rikshospitalet, 0424, Oslo, Norway
- Research Laboratory, Nordland Hospital, Bodø, and K.J. Jebsen TREC, University of Tromsø, Tromsø, Norway
- Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jack B Cowland
- The Granulocyte Research Laboratory, Department of Hematology, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Genetics, Copenhagen University Hospital, Copenhagen, Denmark
| | - Peter Garred
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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20
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Otterdal K, Portillo A, Astrup E, Ludviksen JK, Schjalm C, Raoult D, Olano JP, Halvorsen B, Oteo JA, Aukrust P, Mollnes TE, Nilsson PH. Rickettsia conorii is a potent complement activator in vivo and combined inhibition of complement and CD14 is required for attenuation of the cytokine response ex vivo. Immunobiology 2016. [DOI: 10.1016/j.imbio.2016.06.176] [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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21
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Otterdal K, Portillo A, Astrup E, Ludviksen JK, Schjalm C, Raoult D, Olano JP, Halvorsen B, Oteo JA, Aukrust P, Mollnes TE, Nilsson PH. Rickettsia conorii is a potent complement activator in vivo and combined inhibition of complement and CD14 is required for attenuation of the cytokine response ex vivo. Clin Microbiol Infect 2016; 22:734.e1-6. [PMID: 27217049 DOI: 10.1016/j.cmi.2016.05.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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: 03/01/2016] [Revised: 05/03/2016] [Accepted: 05/10/2016] [Indexed: 11/19/2022]
Abstract
Mediterranean spotted fever caused by Rickettsia conorii is a potentially lethal disease characterized by vascular inflammation affecting multiple organs. Studies of R. conorii so far have focused on activation of inflammatory cells and their release of inflammatory cytokines, but complement activation has not been investigated in R. conorii-infected patients. Here, we performed a comprehensive analysis of complement activation markers and the soluble cross-talking co-receptor CD14 (sCD14) in plasma from R. conorii-infected patients. The clinical data were supplemented with ex vivo experiments where the cytokine response was characterized in human whole blood stimulated with R. conorii. Complement activation markers at the level of C3 (C3bc, C3bBbP) and terminal pathway activation (sC5b-9), as well as sCD14, were markedly elevated (p <0.01 for all), and closely correlated (p <0.05 for all), in patients at admission compared with healthy matched controls. All tested markers were significantly reduced to baseline values at time of follow up. Rickettsia conorii incubated in human whole blood was shown to trigger complement activation accompanied by release of the inflammatory cytokines interleukin-1β (IL-1β), IL-6, IL-8 and tumour necrosis factor. Whereas inhibition of either C3 or CD14 had only a minor effect on released cytokines, combined inhibition of C3 and CD14 resulted in significant reduction, virtually to baseline levels, of the four cytokines (p <0.05 for all). Our data show that complement is markedly activated upon R. conorii infection and complement activation is, together with CD14, responsible for a major part of the cytokine response induced by R. conorii in human whole blood.
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Affiliation(s)
- K Otterdal
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - A Portillo
- Centre of Rickettsioses and Arthropod-Borne Diseases, Department of Infectious Diseases, Hospital San Pedro-Center of Biomedical Research from La Rioja (CIBIR), Logroño, Spain
| | - E Astrup
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway
| | - J K Ludviksen
- Research Laboratory, Nordland Hospital, Bodø, Norway
| | - C Schjalm
- Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Immunology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - D Raoult
- Unité des Rickettsies, Université de la Mediterranée, Marseille, France
| | - J P Olano
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
| | - B Halvorsen
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway; K.G. Jebsen Inflammatory Research Center, University of Oslo, Oslo, Norway
| | - J A Oteo
- Centre of Rickettsioses and Arthropod-Borne Diseases, Department of Infectious Diseases, Hospital San Pedro-Center of Biomedical Research from La Rioja (CIBIR), Logroño, Spain
| | - P Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway; K.G. Jebsen Inflammatory Research Center, University of Oslo, Oslo, Norway; Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - T E Mollnes
- Faculty of Medicine, University of Oslo, Oslo, Norway; Research Laboratory, Nordland Hospital, Bodø, Norway; Department of Immunology, Oslo University Hospital Rikshospitalet, Oslo, Norway; K.G. Jebsen Inflammatory Research Center, University of Oslo, Oslo, Norway; Faculty of Health Sciences, K.G Jebsen TREC, University of Tromsø, Tromsø, Norway; Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - P H Nilsson
- Department of Immunology, Oslo University Hospital Rikshospitalet, Oslo, Norway; K.G. Jebsen Inflammatory Research Center, University of Oslo, Oslo, Norway.
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22
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Nesset CK, Kong XY, Damme M, Schjalm C, Roos N, Løberg EM, Eskild W. Age-dependent development of liver fibrosis in Glmp (gt/gt) mice. Fibrogenesis Tissue Repair 2016; 9:5. [PMID: 27141234 PMCID: PMC4852418 DOI: 10.1186/s13069-016-0042-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 04/20/2016] [Indexed: 02/08/2023]
Abstract
Background Mice lacking glycosylated lysosomal membrane protein (Glmpgt/gt mice) have liver fibrosis as the predominant phenotype due to chronic liver injury. The Glmpgt/gt mice grow and reproduce at the same rate as their wild-type siblings. Life expectancy is around 18 months. Methods Wild-type and Glmpgt/gt mice were studied between 1 week and 18 months of age. Livers were analyzed using histological, immunohistochemical, biochemical, and qPCR analyses. Results It was shown that Glmpgt/gt mice were not born with liver injury; however, it appeared shortly after birth as indicated by excess collagen expression, deposition of fibrous collagen in the periportal areas, and increased levels of hydroxyproline in Glmpgt/gt liver. Liver functional tests indicated a chronic, mild liver injury. Markers of inflammation, fibrosis, apoptosis, and modulation of extracellular matrix increased from an early age, peaking around 4 months of age and followed by attenuation of these signals. To compensate for loss of hepatocytes, the oval cell compartment was activated, with the highest activity of the oval cells detected at 3 months of age, suggesting insufficient hepatocyte proliferation in Glmpgt/gt mice around this age. Although constant proliferation of hepatocytes and oval cells maintained adequate hepatic function in Glmpgt/gt mice, it also resulted in a higher frequency of liver tumors in older animals. Conclusions The Glmpgt/gt mouse is proposed as a model for slowly progressing liver fibrosis and possibly as a model for a yet undescribed human lysosomal disorder. Electronic supplementary material The online version of this article (doi:10.1186/s13069-016-0042-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Xiang Yi Kong
- Department of Bioscience, University of Oslo, Oslo, Norway ; Research Institute for Internal Medicine, University of Oslo, Oslo, Norway ; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway ; K.G. Jebsen Inflammation Research Centre, University of Oslo, Oslo, Norway
| | - Markus Damme
- Institute of Biochemistry, Christian-Albrechts-Universität Kiel, Kiel, Germany
| | | | - Norbert Roos
- Department of Bioscience, University of Oslo, Oslo, Norway
| | - Else Marit Løberg
- Department of Pathology, Oslo University Hospital Ullevaal, Oslo, Norway
| | - Winnie Eskild
- Department of Bioscience, University of Oslo, Oslo, Norway
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23
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Kong XY, Kase ET, Herskedal A, Schjalm C, Damme M, Nesset CK, Thoresen GH, Rustan AC, Eskild W. Lack of the Lysosomal Membrane Protein, GLMP, in Mice Results in Metabolic Dysregulation in Liver. PLoS One 2015; 10:e0129402. [PMID: 26047317 PMCID: PMC4457871 DOI: 10.1371/journal.pone.0129402] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 05/07/2015] [Indexed: 12/25/2022] Open
Abstract
Ablation of glycosylated lysosomal membrane protein (GLMP, formerly known as NCU-G1) has been shown to cause chronic liver injury which progresses into liver fibrosis in mice. Both lysosomal dysfunction and chronic liver injury can cause metabolic dysregulation. Glmpgt/gt mice (formerly known as Ncu-g1gt/gtmice) were studied between 3 weeks and 9 months of age. Body weight gain and feed efficiency of Glmpgt/gt mice were comparable to wild type siblings, only at the age of 9 months the Glmpgt/gt siblings had significantly reduced body weight. Reduced size of epididymal fat pads was accompanied by hepatosplenomegaly in Glmpgt/gt mice. Blood analysis revealed reduced levels of blood glucose, circulating triacylglycerol and non-esterified fatty acids in Glmpgt/gt mice. Increased flux of glucose, increased de novo lipogenesis and lipid accumulation were detected in Glmpgt/gt primary hepatocytes, as well as elevated triacylglycerol levels in Glmpgt/gt liver homogenates, compared to hepatocytes and liver from wild type mice. Gene expression analysis showed an increased expression of genes involved in fatty acid uptake and lipogenesis in Glmpgt/gt liver compared to wild type. Our findings are in agreement with the metabolic alterations observed in other mouse models lacking lysosomal proteins, and with alterations characteristic for advanced chronic liver injury.
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Affiliation(s)
- Xiang Yi Kong
- Department of Bioscience, University of Oslo, Oslo, Norway
| | - Eili Tranheim Kase
- Department of Pharmaceutical Biosciences, School of Pharmacy, University of Oslo, Oslo, Norway
| | | | | | - Markus Damme
- Institute of Biochemistry, Christian-Albrechts-Universität Kiel, Kiel, Germany
| | | | - G. Hege Thoresen
- Department of Pharmaceutical Biosciences, School of Pharmacy, University of Oslo, Oslo, Norway
- Department of Pharmacology, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Arild C. Rustan
- Department of Pharmaceutical Biosciences, School of Pharmacy, University of Oslo, Oslo, Norway
| | - Winnie Eskild
- Department of Bioscience, University of Oslo, Oslo, Norway
- * E-mail:
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