狼疮及其他自身免疫和非自身免疫性疾病中的激活接触系统和异常糖胺聚糖。
Activated contact system and abnormal glycosaminoglycans in lupus and other auto- and non-autoimmune diseases.
机构信息
Department of Pathology and Immunology, Washington University Medical School, St. Louis, Missouri, USA.
出版信息
Prog Mol Biol Transl Sci. 2010;93:443-72. doi: 10.1016/S1877-1173(10)93019-6.
Systemic lupus erythematosus (SLE), heparin-induced thrombocytopenia (HIT), rheumatoid arthritis (RA) are marked by the presence of autoantibodies against negatively changed DNA, phospholipids, heparin, and chondroitin sulfate, respectively. Heparin/protein complexes induce contact system activation in HIT patient plasmas. The activated contact system generates thrombin. Thrombin is responsible for thrombosis, a common cause of death and disabilities for both HIT and SLE. In this chapter, we analyze plasma contact system proteins, thrombin- and kallikrein-like activities, glucosamine and galactosamine content from SLE-, RA-, osteoarthritis (OA)-, and psoriasis (Ps)-patient plasmas in addition to pooled 30+ healthy patient plasmas. We found that all SLE patient plasmas exhibited abnormal contact systems marked by the absence of high molecular weight kininogen, the presence of processed C1 inhibitor (C1inh), the display of abnormal thrombin- and kallikrein-like activities, and increased levels of plasma glucosamine and galactosamine. Different patterns of contact system activation distinguish SLE, RA, and Ps whereas no contact system activation is observed in normal and OA patient plasmas. The presence of paradoxical "lupus anticoagulants" in certain thrombosis-prone SLE patient plasmas, marked by delayed clotting in clinical plasma test, was explained by the consumption of contact system proteins, especially high molecular weight kininogen. Finally, we discovered that mouse and human SLE autoantibodies bind to cell surface GAGs with structural selectivity. In conclusion, markers of abnormal contact system activation represent potential new targets for autoimmune disease diagnosis, prevention, and treatment. These markers might also be useful in monitoring SLE activity/severity and in pinpointing patients with SLE-associated arthritis and psoriasis.
系统性红斑狼疮(SLE)、肝素诱导的血小板减少症(HIT)、类风湿关节炎(RA)的特征分别是存在针对自身抗体的负性改变的 DNA、磷脂、肝素和硫酸软骨素。肝素/蛋白复合物在 HIT 患者的血浆中诱导接触系统的激活。被激活的接触系统生成凝血酶。凝血酶是 HIT 和 SLE 常见的血栓形成的原因,也是导致死亡和残疾的常见原因。在本章中,我们分析了来自 SLE、RA、骨关节炎(OA)和银屑病(Ps)患者的血浆接触系统蛋白、凝血酶-和激肽释放酶样活性、氨基葡萄糖和半乳糖胺的含量,以及来自 30 多个健康患者的混合血浆。我们发现,所有的 SLE 患者的血浆都表现出异常的接触系统,其特征是高分子量激肽原的缺失、加工型 C1 抑制剂(C1inh)的存在、异常的凝血酶-和激肽释放酶样活性以及血浆氨基葡萄糖和半乳糖胺水平的升高。不同模式的接触系统激活区分了 SLE、RA 和 Ps,而正常和 OA 患者的血浆中则没有接触系统的激活。某些血栓倾向的 SLE 患者血浆中存在反常的“狼疮抗凝剂”,这是由接触系统蛋白的消耗引起的,尤其是高分子量激肽原。最后,我们发现,鼠和人 SLE 自身抗体与细胞表面 GAG 具有结构选择性结合。总之,异常接触系统激活的标志物代表了自身免疫性疾病诊断、预防和治疗的潜在新靶点。这些标志物也可能有助于监测 SLE 的活动/严重程度,并确定与 SLE 相关的关节炎和银屑病患者。