Proteins CD59 Research Articles

TAK-573, an Anti-CD38/Attenuated Ifnα Fusion Protein, Has Clinical Activity and Modulates the Ifnα Receptor (IFNAR) Pathway in Patients with Relapsed/Refractory Multiple Myeloma

TAK-573, an Anti-CD38/Attenuated Ifnα Fusion Protein, Has Clinical Activity and Modulates the Ifnα Receptor (IFNAR) Pathway in Patients with Relapsed/Refractory Multiple Myeloma

BCX9930, an Oral Factor D Inhibitor, for the Potential Treatment of Alternative Pathway Mediated Diseases: Interim Results of a Phase 1 Study in Healthy Subjects

INTRODUCTION: Complement factor D is the rate-limiting enzyme for activation of the complement alternative pathway (AP). Targeting factor D is therefore an attractive therapeutic strategy for treatment of AP-mediated diseases including paroxysmal nocturnal hemoglobinuria (PNH), C3 glomerulopathy, and atypical hemolytic uremic syndrome. BCX9930 is a potent and selective orally bioavailable inhibitor of factor D in development for the treatment of PNH and other complement-mediated diseases. PNH is an acquired, chronic, non-malignant disorder of hematopoietic stem cells that is characterized by clonal deficiency of AP regulatory proteins CD55 and CD59, resulting in dysregulated AP amplification, opsonization, membrane attack complex (MAC) formation, and hemolysis. The approved intravenously (IV) administered C5 inhibitors eculizumab and ravulizumab inhibit MAC formation and intravascular hemolysis, but do not inhibit opsonization, leading to extravascular hemolysis and potentially incomplete treatment response. Inhibition of factor D is expected to prevent both intravascular and extravascular hemolysis in PNH, a distinct advantage over currently available parenteral therapies. METHODS: This abstract describes preliminary data in healthy subjects enrolled in the single ascending dose (SAD) and multiple ascending dose (MAD) evaluations of Study BCX9930-101 (NCT04330534), an ongoing first in human (FIH) study that includes randomized, double-blind, placebo-controlled evaluations of the safety and tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of BCX9930 in healthy subjects. Safety and tolerability are evaluated via clinical and laboratory monitoring. Plasma concentrations of BCX9930 are measured using a validated liquid chromatography-dual mass spectrometry (LC/MS/MS) assay; PD effects are assessed using multiple assays, including inhibition of AP activity in the AP-specific Wieslab (AP-W) and AP Hemolysis ([AP-H], lysis of rabbit red blood cells [RBCs] by human serum) assays. RESULTS: To date, 48 subjects have been enrolled into 6 SAD cohorts (n = 6 BCX9930, n = 2 placebo per cohort), with doses ranging from 10 to 1200 mg. Sixty subjects have been enrolled into 5 MAD cohorts (n = 10 BCX9930, n = 2 placebo per cohort), with doses ranging from 50 mg every 12 hours (Q12h) to 400 mg Q12h. The mean age of all enrolled subjects was 34.3 years and 50.9% were male. BCX9930 was safe and generally well-tolerated at all doses evaluated. There were no serious adverse events or dose-related safety signals. Mild headache was the most frequent treatment-emergent adverse event and showed no correlation with dose. A benign maculopapular exanthem attributed to study drug was observed following MAD administration. These events were mild or moderate in severity and resolved in a median of 5 days. BCX9930 exposure was approximately linear and dose-proportional across all evaluated SAD and MAD doses. Mean BCX9930 concentrations at 12 hours post dose were ≥ 8 to 10 times the factor D half-maximal effective concentration (EC50) for SAD doses ≥ 300 mg and for MAD doses ≥ 100 mg Q12h at steady-state. Rapid, dose-dependent AP suppression was observed following SAD and MAD, as measured by the AP-W and AP-H assays (Figure 1). AP suppression > 98% was observed in both assays at steady state for MAD doses ≥ 200 mg Q12h. Duration of complete suppression increased with dose and was ≥ 12 hours for MAD doses ≥ 200 mg Q12h. Doses ≥ 200 mg Q12h showed greater, more durable, and more consistent inhibition across subjects compared with doses ≤ 100 mg Q12h. PK/PD modeling of AP-H and AP-W demonstrates a clear concentration-response, with estimated EC50 values between 21.7 and 40.7 nM. These estimates are consistent with the in vitro IC50 for inhibition of proteolytic activity against the natural substrate C3bB of 28.1 nM. CONCLUSIONS: BCX9930 is a potent and selective orally bioavailable inhibitor of human complement factor D. In this preliminary analysis of an ongoing FIH study, BCX9930 displayed a promising safety and tolerability profile. Exposure was approximately linear and dose-proportional across a wide dose range, and complete and durable suppression of the AP was achieved. Together, these findings support further evaluation of BCX9930 in patients with PNH and other AP-mediated diseases. Disclosures Davidson: BioCryst Pharmaceuticals, Inc.:Current Employment.Mathis:BioCryst Pharmaceuticals, Inc.:Current Employment.Mair:Quotient Sciences:Current Employment.Gesty-Palmer:BioCryst Pharmaceuticals, Inc.:Current equity holder in publicly-traded company, Ended employment in the past 24 months.Cornpropst:BioCryst Pharmaceuticals, Inc.:Current Employment.Sheridan:BioCryst Pharmaceuticals, Inc.:Current Employment.Chen:BioCryst Pharmaceuticals, Inc.:Current Employment.Reynolds:BioCryst Pharmaceuticals, Inc.:Current Employment.Parker:BioCryst Pharmaceuticals, Inc.:Current Employment.Babu:BioCryst Pharmaceuticals, Inc.:Current Employment.

Dysphagia with Blood Disorder? an Unusual Presentation for Paroxysmal Nocturnal Hemoglobinuria

Paroxysmal Nocturnal Hemoglobinuria (PNH) is an acquired hemolytic disorder of the multipotent myeloid stem cells, due to underexpression of surface complement inhibitory proteins CD55 and CD59, affecting 0.13/100,000 patients per year. Besides anemia and thrombosis, PNH can also cause smooth muscle dystonias owing to various mechanisms in the body. Studies have described smooth muscle dystonias presenting as recurrent abdominal pain, lethargy and erectile dysfunction, but intermittent dysphagia is rare with PNH. We describe a case of dysphagia with negative work up as initial presentation of PNH. 16-year-old female with no significant past medical history presented to the clinic with 1 week of ongoing fatigue and difficulty swallowing. She never had any similar complaints in the past nor in her family. The dysphagia was progressively worsening, initially for solid, then with liquids, accompanied by nausea, vomiting and globus sensation in the middle chest. No prior psychiatric history, binging-purging behavior, chest pain, shortness of breath, heat/cold intolerance, weight changes, bladder or bowel dysfunction. She also denied any recent travels, allergies, transfusions, sick contacts, or over-the-counter medication use. Initial labwork showed Hb 11.2 g/dL, MCV 80 fL, WBC 9 x103 K/uL, and platelet 219,000 K/uL. Metabolic panel, troponin, BNP, ANA, rheumatoid factor, lyme serology, vitamin B12, folate and iron studies were within normal limits. Mentzer index <13, serum protein electrophoresis ruled out Thalassemia. LDH was elevated and Haptoglobin decreased. Direct and indirect Coomb's antibody test were negative. Peripheral smear showed normocytic normochromic anemia with normal morphology of RBCs. Flow cytometry showed lack of CD55 and CD59. Esophagogastroduodenoscopy, done for dysphagia, to rule out luminal obstruction was unremarkable. CT chest with contrast ruled out external compression on esophagus. Videofluoroscopic swallow study revealed segmental, dynamic obstruction to both solids and liquids in the lower third of the esophagus. Dysphagia was attributed to PNH and patient was started on eculizumab. She responded to the medication in 3 weeks, during which outpatient symptomatic therapy was given for her anemia along with soft semisolid diet. In PNH, the RBCs may have varying degree of CD59 and glycosyl phosphatidylinositol (GPI) anchor protein deficiency, with unaffected cells described as type I, partially affected cells called type II, and complete lack of the proteins deemed type III red cells. PNH red cell type III and type II red cells are 15 to 25 times and 3 to 5 times more sensitive to complement-mediated lysis than the type I normal red cells. This variability in the severity of the deficiency, as well as in the proportion of the cell population affected, defines the extent of the clinical manifestations of the disease. Approximately 40% of patients have a combination of types I, II and III PNH cells With hemolysis, after exceeding haptoglobin's binding capacity, the free hemoglobin binds any available nitrous oxide (NO) in the blood. Hemolysis also reduces endogenous NO generation by conversion of l-arginine, which is a component in NO generation, to ornithine, thereby further reducing the systemic availability of NO. NO is endogenous smooth muscle relaxor via activation of cGMP. Decreases in NO levels are hypothesized to cause smooth muscle contraction, manifesting as abdominal pain, erectile dysfunction and rarely, dysphagia in the lower two-third of the esophagus which is predominantly smooth muscle. These symptoms occur more commonly in patients with large PNH clone sizes and, therefore, higher hemolytic rates. In this case study, our focus was to recognize PNH among differentials for new onset dysphagia due to complement-mediated intravascular hemolysis causing gastrointestinal dysmotility. In doing so, invasive investigations may be avoided. Advance studies may be needed to completely understand the causes and correlate between PNH, intravascular hemolysis and dysphagia. Disclosures No relevant conflicts of interest to declare.

Fish complement C8 evolution, functional network analyses, and the theoretical interaction between C8 alpha chain and CD59

Complement C8, as a main component of the membrane attack complex, has only been identified in vertebrates. C8 comprises three subunits encoded by individual genes: C8a (alpha chain), C8b (beta chain), and C8g (gamma chain). However, in fish, there have been limited studies on the evolutionary history and systematic function of C8. In the present study, phylogenetic analysis indicated the complete divergence of C8 genes in different fish species. Codon usage bias analysis revealed the evolutionary complexity of C8 genes. Selective pressure analysis found that C8 genes have been affected by negative selection during evolution. Sequence alignment identified the sites that are under selective pressure. The systematic functions of C8 were revealed by gene co-expression and protein-protein interaction (PPI) network analyses. Notably, gene ontology enrichment analysis suggested that C8 proteins in zebrafish function mainly in the neuroendocrine system. Protein structural comparisons showed that putative functional residues and domains were conserved between the C8 subunits of human and grass carp. A preliminary study on the theoretical interaction between C8a and CD59 was performed according to the simulated protein stereo structure. The first functionally-related site was absent in the simulated conformation of the grass carp (Ctenopharyngodon idella) C8a–CD59 protein complex. We speculated that Tyr63 is involved in the functional loss of CD59 binding. The docking of CD59 to four potential sites (Met390, Ser391, Leu392, and Val405) in grass carp C8a was analyzed. The results of the present study provide a deeper understanding of the evolution and function of fish complement C8.

Estrogen Attenuates Traumatic Brain Injury by Inhibiting the Activation of Microglia and Astrocyte-Mediated Neuroinflammatory Responses.

Traumatic brain injury (TBI), which leads to high mortality and morbidity, is a prominent public health problem worldwide. Neuroinflammation involving microglia and astrocyte activation has been demonstrated to play critical role in the secondary injury induced by TBI. A1 astrocytes, which are induced by activated microglia, can directly kill neurons by secreting neurotoxic complement C3. Estrogen has been proved to possess neuroprotective effects, but the effect and underlying mechanism of estrogen on TBI-induced neuroinflammatory injury remain largely unclear. In this study, we constructed an adult male mouse model of TBI and immediately after injury treated the mice with 17β-estradiol (E2) (100μg/kg, once every day via intraperitoneal injection) for 3days. We found that E2 treatment significantly alleviated TBI-induced neurological deficits, neuronal injuries, and brain edema and significantly inhibited Iba1 and GFAP expression, which are markers of microglia and astrocyte activation, respectively. E2 treatment also significantly inhibited TLR4 and NF-κB protein expression, and significantly reduced the expression of the proinflammatory factors IL-1β, IL-6, and TNF-α. Moreover, E2 treatment significantly decreased the number of complement C3d/GFAP-positive cells and complement C3d protein expression. Taking these results together, we concluded that E2 treatment dramatically alleviates TBI neuroinflammatory injury by inhibiting TLR4/NF-κB pathway-mediated microglia and astrocyte activation and neuroinflammation and reducing A1-phenotype neurotoxic astrocyte activation. Our findings indicate that E2 treatment may be a potential therapy strategy for TBI-induced neuroinflammation injury.

IL-1/IL-1R signaling induced by all-trans-retinal contributes to complement alternative pathway activation in retinal pigment epithelium.

The underlying mechanisms of complement activation in Stargardt disease type 1 (STGD1) and age-related macular degeneration (AMD) are not fully understood. Overaccumulation of all-trans-retinal (atRAL) has been proposed as the pathogenic factor in both diseases. By incubating retinal pigment epithelium (RPE) cells with atRAL, we showed that C5b-9 membrane attack complexes (MACs) were generated mainly through complement alternative pathway. An increase in complement factor B (CFB) expression as well as downregulation of complement regulatory proteins CD46, CD55, CD59, and CFH were observed in RPE cells after atRAL treatment. Furthermore, interleukin-1β production was provoked in both atRAL-treated RPE cells and microglia/macrophages. Coincubation of RPE cells with interleukin-1 receptor antagonist (IL1Ra) and atRAL ameliorated complement activation and downregulated CFB expression by attenuating both p38 and c-Jun N-terminal kinase (JNK) signaling pathways. Our findings demonstrate that atRAL induces an autocrine/paracrine IL-1/IL-1R signaling to promote complement alternative pathway activation in RPE cells and provide a novel perspective on the pathomechanism of macular degeneration.

Cottonseed oil alleviates ischemic stroke injury by inhibiting the inflammatory activation of microglia and astrocyte

BackgroundIschemic stroke is the second leading cause of death globally. The narrow time window for administering effective thrombolytic therapy motivates the search for alternative prevention strategies. Microglia and astrocyte activation-mediated inflammation play a pivotal role in ischemic stroke injury. Cottonseed oil (CSO) has been shown to exert anti-inflammatory effects against peripheral tissue injury, although CSO is mostly used as a solvent for lipid-soluble drugs. However, the role of CSO in neuroprotection against stroke has not been previously reported.MethodsWe treated adult male rats with CSO (1.3 ml/kg, subcutaneous injection, once every other day for 3 weeks) and then constructed a middle cerebral artery occlusion (MCAO) model followed by 24 h of reperfusion. Then, we measured the neurological scores, infarction volume, neuronal injury, and brain edema; we also measured the levels of pro-inflammatory cytokines (IL-1β, IL-6, TNF-α), degree of microglial and astrocytic activation, protein expression levels of Toll-like receptor 4 (TLR4), nuclear factor kappa B (NF-κB), C3d and S100A10, and the presence of A1 type astrocytes and A2 type astrocytes.ResultsWe found that CSO treatment significantly improved the neurological deficit, reduced infarction volume, and alleviated neuronal injuries, blood–brain barrier (BBB) disruption, and brain edema. Additionally, CSO treatment significantly reduced microglial and astrocytic activation, inhibited TLR4 and NF-κB protein expression, and reduced the release of IL-1β, IL-6, and TNF-α. Finally, CSO treatment significantly decreased the number of C3d/glial fibrillary acidic protein (GFAP)-positive cells and C3d protein expression, and increased the number of S100A10/GFAP-positive cells and S100A10 protein expression.ConclusionOur results first found that CSO treatment alleviated ischemic stroke injury by reducing microglial and astrocytic activation and inflammation, which was related to the inhibition of TLR4/NF-κB pathway and the reduction of A1 phenotype neurotoxic astrocyte activation, suggesting that CSO could be a new strategy in the prevention of ischemic stroke.

ANTI-IL-6 ANTIBODY REDUCES ENDOTHELIAL MEDIATED PRO-INFLAMMATORY RESPONSES AND AFTER BINDING OF HLA-SPECIFIC DSA TO ENDOTHELIAL CELLS

Endothelial cell activation and microvascular inflammation are hallmarks of antibody-mediated rejection and expression of activation associated transcripts by intragraft endothelial cells is observed whether or not complement activation is indicated. HLA expression is strongly upregulated by the allograft microvasculature during rejection and is a target for Donor Specific Antibody (DSA) binding. DSA specific for HLA antigens are prevalent, are deleterious to the allograft and both complement-dependent and -independent pathways of DSA-mediated damage have been reported. We have developed an in vitro model of human microvascular endothelial cells to reveal that inflammation-induced HLA-DR expression results in the activation and differentiation of allogeneic CD4+-T into both IL-6-dependent pro-inflammatory Th17 and anti-inflammatory Treg (Taflin C. 2011). Endothelial binding of HLA-II-specific antibodies further increased IL-6 secretion and amplification of pro-inflammatory Th17 and Th1 (Lion J. 2016, Cross AR. 2019). In the current study we have evaluated whether a humanized monoclonal anti-IL-6 antibody (clazakizumab) can alter the outcome of HLA-specific antibody binding to endothelial cells. Human microvascular endothelial cells cells (HMEC-1 and primary renal glomerular cells) were cultured in the presence or absence of non-HLA matched PBMC as described (Taflin C 2011). Soluble factors were assesed by ELISA assay and CD4+-T sub-populations identified by intracellular cytokine labelling. C4d and C5b-9 deposition on endothelial cells were measured in the presence or absence of complement-containing human AB serum. Antibodies specific for HLA antigens were either monoclonal or purified DSA from transplant patient serum or plasma-exchange products. When endothelial cells were co-cultured with PBMC from non-HLA matched donors, addition of clazakizumab strongly reduced IL-6 at 24hrs and the decrease was maintained even after 72hrs. MCP-1 levels were also reduced. Activation of endothelial cells by HLA class I and II antibodies prior to co-culture further increased IL-6 and this was also decreased by clazakizumab. The cell-surface phenotype of endothelial cells in co-cultures was unaltered by clazakizumab whereas differentiation of Th17 and Th1 were both decreased (particularly IFNY+Th1). HLA-specific antibody binding activated complement, and clazakizumab did not have a direct effect on C4d or C5b-9 deposition on endothelial cells Neither steady-state expression of the complement regulatory proteins CD46, CD55 and CD59 nor their expression under conditions of complement activation were altered by clazakizumab. These data indicate that anti-IL-6 antibody may limit endothelial damage mediated by DSA binding to HLA class I or II. The results reveal the ability of clazakizumab to alter endothelial immunogenicity leading to reduced differentiation of pro-inflammatory CD4+-T. Moreover the decreased level of MCP-1 may limit recuitment of myeloid cells within the allograft. Société Française de Transplantation. EU-COST 17138. Vitaeris Inc. Vaincre la Mucoviscidose.

Eculizumab in the treatment of complement system disorders including paroxysmal nocturnal hemoglobinuria

The main function of the complement system is to provide humoral defence against foreign pathogens. It contributes to immune response and is a crucial component of innate immunity that provides immediate non-specific immune defence. Inherited or acquired deficiencies of the complement system associated with excessive activation or other impairments of complement activity have varied clinical manifestations. Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired clonal blood disorder that clinically manifests with anemia, thrombosis, chest and abdominal pain, chronic kidney disease and bone marrow failure. The complement-mediated hemolysis due to the lack of membrane-bound complement-regulatory proteins CD55 and CD59 is a central underlying mechanism of the disease and mortality associated with PNH. The severity of clinical symptoms determines the type of treatment which may include allogeneic hematopoietic stem cell transplantation and pathogenetic treatment through the inhibition of the complement system. Eculizumab, a humanized monoclonal anti-C5 antibody, has become the first complement inhibitor to show effectiveness in treating any of complement-mediated hemolytic anemias and now serves as a standard of treatment for patients with PNH. Brisk development of biotechnological methods for the production of new drugs in Russia has enabled the initiation of drug discovery efforts and the creation of the world's first biosimilar of Eculizumab.

Effects of Complement Regulators and Chemokine Receptors in Type 2 Diabetes

ABSTRACT CD55 and CD59 are complement regulatory proteins suggested to be related with progression of diabetes and its complications. The stromal cell-derived factor 1 (SDF-1) and C-X-C chemokine receptor type 4 (CXCR-4) are chemokine proteins. We aimed to investigate the relation of CD55 and CD59 expression levels and polymorphisms of SDF-1 and CXCR-4 with type 2 diabetes mellitus (T2DM) and its complications. Seventy-five T2DM patients and 73 controls were enrolled. Expression levels of CD55 and CD59 were measured by FACS Calibur; qRT-PCR was used to determine SDF-1 and CXCR-4 gene polymorphisms. CD55 and CD59 expressions in patients with nephropathy, retinopathy and cardiovascular disease were significantly lower than controls. Frequency of CXCR-4 T allele carrying was high in patients and created 1.6 fold risk for the disease (p = .07). CXCR-4 a allele carriers had decreased nephropathy; although there was no statistical significance in carrying CXCR-4 T allele, presence of nephropathy was approximately 2 times higher (p = .254). The nephropathy risk increased 10-fold in CXCR-4 TT genotype carriers (p = .02). All SDF-1 CC genotype carriers had retinopathy, so, it was considered that the CC genotype was effective in retinopathy development (p = .031). For the presence of cardiovascular disease, significant difference was observed for SDF-1 genotypes. Increased cardiovascular risk of 5- and 1.9-fold in SDF-1 T (p = .007) and CXCR-4 T (p = .216) allele carriers, respectively, was observed. We suggest that CD55 and CD59 protein levels and SDF-1 and CXCR-4 have predictive importance in process, complications and tendency of T2DM.

Transport of Extracellular Vesicles across the Blood-Brain Barrier: Brain Pharmacokinetics and Effects of Inflammation.

Extracellular vesicles can cross the blood–brain barrier (BBB), but little is known about passage. Here, we used multiple-time regression analysis to examine the ability of 10 exosome populations derived from mouse, human, cancerous, and non-cancerous cell lines to cross the BBB. All crossed the BBB, but rates varied over 10-fold. Lipopolysaccharide (LPS), an activator of the innate immune system, enhanced uptake independently of BBB disruption for six exosomes and decreased uptake for one. Wheatgerm agglutinin (WGA) modulated transport of five exosome populations, suggesting passage by adsorptive transcytosis. Mannose 6-phosphate inhibited uptake of J774A.1, demonstrating that its BBB transporter is the mannose 6-phosphate receptor. Uptake rates, patterns, and effects of LPS or WGA were not predicted by exosome source (mouse vs. human) or cancer status of the cell lines. The cell surface proteins CD46, AVβ6, AVβ3, and ICAM-1 were variably expressed but not predictive of transport rate nor responses to LPS or WGA. A brain-to-blood efflux mechanism variably affected CNS retention and explains how CNS-derived exosomes enter blood. In summary, all exosomes tested here readily crossed the BBB, but at varying rates and by a variety of vesicular-mediated mechanisms involving specific transporters, adsorptive transcytosis, and a brain-to-blood efflux system.

The expression and function of complement inhibitory protein CD55 in chronic rhinosinusitis with nasal polyp

Abstract Background The factors that regulating classic complement activation in chronic rhinosinusitis with nasal polyps (CRSwNP) remain largely unknown. CD55 functions as a complement regulatory protein by inhibiting the formation of C5 convertases. Objectives To investigate the expression, regulation, and function of CD55 in CRSwNP. Methods The expression of CD55 in sinonasal mucosal samples was investigated by quantitative RT-PCR, Western blotting, and immunofluorescence. The levels of C3d and C5b-9 in nasal tissue homogenates were analyzed by ELISA. Primary human nasal epithelial cells were cultured to investigate the regulation and function of CD55. Results The mRNA and protein levels of CD55 were reduced in eosinophilic nasal polyps compared with those in noneosinophilic nasal polyps and control tissues. CD55 was prominently expressed by nasal epithelial cells in sinonasal mucosa, which was downregulated by IL-4, IL-13, and Dermatophagoides pteronyssinus group 1. The levels of C3d and C5b-9 were upregulated in eosinophilic nasal polyps and were inversely correlated with CD55 expression levels. The conversion of C3 to C3d by primary human nasal epithelial cells was enhanced in those from eosinophilic nasal polyps in comparison to those from noneosinophilic polyps. The mRNA and protein expression of E-cadherin and ZO-1 were downregulated in eosinophilic nasal polyps and were positively correlated with CD55 expression levels. Conclusion The reduced expression of CD55 caused by local type 2 milieu lead to hyperactivation of complement and subsequent C5b-9 formation, which may further disrupt epithelial integrity in patients with eosinophilic CRSwNP.

Massively parallel Cas13 screens reveal principles for guide RNA design.

Type VI CRISPR enzymes are RNA-targeting proteins with nuclease activity that enable specific and robust target gene knock-down without altering the genome. To define rules for the design of Cas13d guide RNAs, we conducted massively-parallel screens targeting mRNAs of a green fluorescent protein (GFP) transgene and CD46, CD55 and CD71 cell surface proteins in human cells. In total, we measured the activity of 24,460 guide RNAs with and without mismatches relative to the target sequences. Knock-down efficacy is driven by guide RNA-specific features and target site context. Single mismatches generally reduce knock-down to a modest degree, but spacer nucleotides 15 – 21 are largely intolerant to target site mismatches. We developed a computational model to identify optimal guide RNAs and confirm its generalizability testing 3,979 guides targeting mRNAs of 48 endogenous genes. We show that Cas13 can be used in forward transcriptomic pooled screens and, using our model, predict optimized Cas13 guide RNAs for all protein-coding transcripts in the human genome.

Factor H-Inspired Design of Peptide Biomarkers of the Complement C3d Protein.

C3d is a hallmark protein of the complement system, whose presence is critical to measure the progression of several immune diseases. Here, we propose to directly target C3d through small peptides mimicking the binding of its natural ligand, the complement regulator Factor H (FH). Through iterative computational analysis and binding affinity experiments, we establish a rationale for the structure-based design of FH-inspired peptides, leading to low-micromolar affinity for C3d and stable binding over microsecond-length simulations. Our FH-inspired peptides call now for further optimization toward high-affinity binding and suggest that small peptides are promising as novel C3d biomarkers and therapeutic tools.

Epitope Molecularly Imprinted Polymer Nanoparticles for Chemo-/Photodynamic Synergistic Cancer Therapy Guided by Targeted Fluorescence Imaging.

It is a still tough task to precisely target cancer cells and efficiently improve the therapeutic efficacy of various therapies at the same time. Here, dual-template imprinting polymer nanoparticles (MIPs) with a core-shell structure were prepared, in which fluorescent silica nanoparticles (FSiO2) were the core and the imprinted polymer layers were the outermost shell. The imprinted layer was designed and constructed via free-radical precipitation approach on the surface of FSiO2, which simultaneously encapsulated gadolinium-doped silicon quantum dots and photosensitizers (Ce6). During the polymerization process, two template molecules were introduced into the mixtures, one was the epitope of CD59 protein (YNCPNPTADCK), which was overexpressed on the surface of a great deal of the solid cancers, and the other was antitumor agent doxorubicin (DOX) to be used for chemotherapy. Furthermore, the embedded Ce6 could generate toxic 1O2 under 655 nm laser irradiation to kill cancer cells, combining with the loaded-DOX to obtain a synergistic cancer therapy. Moreover, owing to the introduction of gadolinium-doped silicon quantum dots, Ce6, and DOX, the MIPs were endowed with targeted fluorescence imaging (FI) and MR imaging (MRI). In vitro and in vivo experiments had been conducted to demonstrate the excellent targeting ability and desirable treatment effect with negligible toxicity to healthy tissues and organs. As a consequence, the designed MIPs can promote the development of targeted recognition against biomarkers and precise treatment guided with cell imaging tools.

Complement activation in sickle cell disease: Dependence on cell density, hemolysis and modulation by hydroxyurea therapy.

The complement system is an innate immune defense cascade that can cause tissue damage when inappropriately activated. Evidence for complement over activation has been reported in small cohorts of patients with sickle cell disease (SCD). However, the mechanism governing complement activation in SCD has not been elucidated. Here, we observe that the plasma concentration of sC5b-9, a reliable marker for terminal complement activation, is increased at steady state in 61% of untreated SCD patients. We show that greater complement activation in vitro is promoted by SCD erythrocytes compared to normal ones, although no significant differences were observed in the regulatory proteins CD35, CD55, and CD59 in whole blood. Complement activation is positively correlated with the percentage of dense sickle cells (DRBCs). The expression levels of CD35, CD55, and CD59 are reduced in DRBCs, suggesting inefficient regulation when cell density increases. Moreover, the surface expression of the complement regulator CD46 on granulocytes was inversely correlated with the plasma sC5b-9. We also show increased complement deposition in cultured human endothelial cells incubated with SCD serum, which is diminished by the addition of the heme scavenger hemopexin. Treatment of SCD patients with hydroxyurea produces substantial reductions in complement activation, measured by sC5b-9 concentration and upregulation of CD46, as well as decreased complement activation on RBCs in vitro. In conclusion, complement over activation is a common pathogenic event in SCD that is associated with formation of DRBCs and hemolysis. And, it affects red cells, leukocytes and endothelial cells. This complement over activation is partly alleviated by hydroxyurea therapy.

Traumatic brain injury increases plasma astrocyte-derived exosome levels of neurotoxic complement proteins.

Possible involvement of complement (C) systems in the pathogenesis of traumatic brain injury (TBI) was investigated by quantifying Cproteins in plasma astrocyte-derived exosomes (ADEs) of subjects with sports-related TBI (sTBI) and TBI in military veterans (mtTBI) without cognitive impairment. All sTBI subjects (n=24) had mild injuries, whereas eight of the mtTBI subjects had moderate, and 17 had mild injuries. Plasma levels of ADEs were decreased after acute sTBI and returned to normal within months. Cprotein levels in ADEs were from 12- to 35-fold higher than the corresponding levels in neuron-derived exosomes. CD81 exosome marker-normalized ADE levels of classical pathway C4b, alternative pathway factor D and Bb, lectin pathway mannose-binding lectin (MBL), and shared neurotoxic effectors C3b and C5b-9 terminal C complex were significantly higher and those of C regulatory proteins CR1 and CD59 were lower in the first week of acute sTBI (n=12) than in controls (n=12). Most C abnormalities were no longer detected in chronic sTBI at 3-12 months after acute sTBI, except for elevated levels of factor D, Bb, and MBL. In contrast, significant elevations of ADE levels of C4b, factor D, Bb, MBL, C3b and C5b-9 terminal C complex, and depressions of CR1 and CD59 relative to those of controls were observed after 1-4 years in early chronic mtTBI (n=10) and persisted for decades except for normalization of Bb, MBL, and CD59 in late chronic mtTBI (n=15). Complement inhibitors may be useful therapeutically in acute TBI and post-concussion syndrome.

Thrombotic risk in paroxysmal nocturnal hemoglobinuria-like (PNH-like) phenotype.

The complement system is an essential component of the innate immune defence that, if overly activated, may damage organs and tissues. For this reason, there is a fine complement regulatory system. The complement modulation system includes two proteins with important regulatory activity, CD55 or decay accelerating factor (DAF) and CD59 or membrane inhibitor of reactive lysis (MIRL).The paroxysmal nocturnal hemoglobinuria (PNH) is a clonal and non-neoplastic disease characterized by intravascular haemolysis, occurrence of thrombosis and bone marrow failure.In clinical practice, in opposition to PNH, a variety of pathological conditions have been observed with an acquired and non-genetic deficiency of the regulatory proteins CD55 and CD59. This abnormal, non-clonal, reduced expression of complement regulatory proteins configures what we may define as PNH-like phenotype.Similarly to PNH, even in the PNH-like phenotype diseases there has been a greater exposure to the mediated complement cellular lysis and, a likely increased risk of thromboembolic events.Therefore, the knowledge of the potential roles of the complement system becomes necessary for a deeper understanding of several pathological conditions and for an improved clinical management of the patients.

Anti-HIV-1 antibodies trigger non-lytic complement deposition on infected cells.

The effect of anti-HIV-1 antibodies on complement activation at the surface of infected cells remains partly understood. Here, we show that a subset of anti-Envelope (Env) broadly neutralizing antibodies (bNAbs), targeting the CD4 binding site and the V3 loop, triggers C3 deposition and complement-dependent cytotoxicity (CDC) on Raji cells engineered to express high surface levels of HIV-1 Env. Primary CD4 T cells infected with laboratory-adapted or primary HIV-1 strains and treated with bNAbs are susceptible to C3 deposition but not to rapid CDC. The cellular protein CD59 and viral proteins Vpu and Nef protect infected cells from CDC mediated by bNAbs or by polyclonal IgGs from HIV-positive individuals. However, complement deposition accelerates the disappearance of infected cells within a few days of culture. Altogether, our results uncover the contribution of complement to the antiviral activity of anti-HIV-1 bNAbs.

MicroRNAs Affect Complement Regulator Expression and Mitochondrial Activity to Modulate Cell Resistance to Complement-Dependent Cytotoxicity.

MicroRNAs (miR) are small RNA molecules that shape the cell transcriptome and proteome through regulation of mRNA stability and translation. Here, we examined their function as determinants of cell resistance to complement-dependent cytotoxicity (CDC). To achieve this goal, we compared the expression of microRNAs between complement-resistant and -sensitive K562 leukemia, Raji lymphoma, and HCT-116 colorectal carcinoma cells. Global microRNA array analysis identified miR-150, miR-328, and miR-616 as regulators of CDC resistance. Inhibition of miR-150 reduced resistance, whereas inhibition of miR-328 or miR-616 enhanced cell resistance. Treatment of K562 cells with a sublytic dose of complement was shown to rapidly increase miR-150, miR-328, and miR-616 expression. Protein targets of these microRNAs were analyzed in K562 cells by mass spectrometry-based proteomics. Expression of the complement membrane regulatory proteins CD46 and CD59 was significantly enhanced after inhibition of miR-328 and miR-616. Enrichment of proteins of mitochondria, known target organelles in CDC, was observed after miR-150, miR-328, and miR-616 inhibition. In conclusion, miR-150, miR-328, and miR-616 regulate cell resistance to CDC by modifying the expression of the membrane complement regulators CD46 and CD59 and the response of the mitochondria to complement lytic attack. These microRNAs may be considered targets for intervention in complement-associated diseases and in anticancer, complement-based therapy.