Heparin-induced thrombocytopenia (HIT)is an antibody-mediated disorder that occurs with variable frequency in patients exposed to heparin. HIT antibodies preferentially recognize large macromolecular complexes formed between PF4 and heparin over a narrow range of molar ratios, but the biophysical properties of complexes that initiate antibody production are unknown. To identify structural determinants underlying PF4/heparin immunogenicity, we characterized the in vitro interactions of murine PF4 (mPF4) and heparin with respect to light absorption, size, and surface charge (zeta potential). We show that PF4/heparin macromolecular assembly occurs through colloidal interactions, wherein heparin facilitates the growth of complexes through charge neutralization. The size of PF4/heparin macromolecules is governed by the molar ratios of the reactants. Maximal complex size occurs at molar ratios of PF4/ heparin at which surface charge is neutral. When mice are immunized with complexes that differ in size and/or zeta potential, antibody formation varies inversely with heparin concentration and is most robust in animals immunized with complexes displaying a net positive zetapotential. These studies suggest that the clinical heterogeneity in the HIT immune response may be due in part to requirements for specific biophysical parameters of the PF4/heparin complexes that occur in settings of intense platelet activation and PF4 release. IntroductionHeparin-induced thrombocytopenia (HIT) is a drug-dependent immune disorder caused by antibodies to complexes between platelet factor 4 (PF4) and heparin. PF4/heparin antibodies are detected in virtually all patients with HIT, but can also occur in the absence of disease in patients treated with unfractionated heparin (UFH), low-molecular-weight heparin (LMWH), or the synthetic pentasaccharide, fondaparinux, and other heparin-like molecules. [1][2][3] The prevalence of PF4/heparin antibodies varies widely among patient populations and appears to be significantly influenced by the clinical context of drug exposure and heparin formulation. Antibodies are detected most commonly (27%-61%) in patients undergoing cardiopulmonary bypass (CPB) surgery, 4-9 but occur far less frequently in uremic, obstetric, and pediatric patients even after prolonged heparin exposure. [10][11][12] General medical and surgical patients are reported to have intermediate rates of seroconversion, ranging from 8% to 21%. 1 Why only a subset of patients with anti-PF4/heparin antibodies develops HIT is not known. One likely determinant is antigen concentration. Patients undergoing CPB have high circulating levels of both PF4 (560-750 ng/mL 13,14 ) and heparin (3-4 Units/ mL 15 ). Another determinant may be the physical composition of the antigen. We recently reported that when PF4 and UFH associate over a narrow range of molar ratios approximating 1:1, they form ultralarge macromolecular complexes (ULCs, Ͼ 670 kDa). 16 Assembly of macromolecular complexes is influenced profoundly by small changes in the stoichiome...

Age-associated loss of muscle mass, or sarcopenia, contributes directly to frailty and an increased risk of falls and fractures among the elderly. Aged mice and elderly adults both show decreased muscle mass as well as relatively low levels of the fat-derived hormone leptin. Here we demonstrate that loss of muscle mass and myofiber size with aging in mice is associated with significant changes in the expression of specific miRNAs. 57 miRNAs were altered with aging in the mice and many of these miRNAs are, for the first time, reported to be associated specifically with age-related muscle atrophy. These include miR-221, previously identified in studies of myogenesis and muscle development as playing a role in the proliferation and terminal differentiation of myogenic precursors. We also treated aged mice with recombinant leptin, to determine whether leptin therapy could improve muscle mass and alter the miRNA expression profile of aging skeletal muscle. Leptin treatment significantly increased hindlimb muscle mass and extensor digitorum longus fiber size in aged mice. Furthermore, the expression of 37 miRNAs was altered in muscles of leptin treated mice. In particular, leptin treatment increased the expression of miR-31 and miR-223, miRNAs known to be elevated during muscle regeneration and repair. These findings suggest that aging in skeletal muscle is associated with marked changes in the expression of specific miRNAs, and that nutrient-related hormones such as leptin may be able to reverse muscle atrophy and alter the expression of atrophy-related miRNAs in aging skeletal muscle.

The immune response in heparin-induced thrombocytopenia is initiated by and directed to large multimolecular complexes of platelet factor 4 (PF4) and heparin (H). We have previously shown that PF4:H multimolecular complexes assemble through electrostatic interactions and, once formed, are highly immunogenic in vivo. Based on these observations, we hypothesized that other positively charged proteins would exhibit similar biologic interactions with H. To test this hypothesis, we selected 2 unrelated positively charged proteins, protamine (PRT) and lysozyme, and studied H-dependent interactions using in vitro and in vivo techniques. Our IntroductionHeparin-induced thrombocytopenia (HIT) is an immune-mediated disorder caused by antibodies that recognize multimolecular complexes of platelet factor 4 (PF4), a positively charged platelet protein, and heparin (H), a negatively charged carbohydrate. We, and others, have shown that PF4 and H complexes assemble primarily through nonspecific electrostatic interactions governed by principles of colloidal chemistry. [1][2][3][4][5] In colloidal systems, molecules of opposite charge "aggregate" or grow in size due to effects of charge neutralization. Particle interactions are frequently dependent on stoichiometric ratios of the 2 compounds, with the largest complexes occurring at molar ratios of the compounds leading to charge neutralization. When either compound is in molar excess, charge restabilization occurs and repulsive forces predominate, leading to reduced complex size and/or complex disassembly.Studies to date indicate that PF4/H multimolecular complex formation is central to the pathogenesis of HIT. The characteristic bell-shaped curve seen with HIT antibody binding over a range of H concentrations coincides with H-dependent formation of multimolecular complexes. 2,3 HIT antibody binding, as gauged by serologic assays or functional studies of platelet activation, is optimal when multimolecular complexes form at or near equimolar ratios of PF4:H. However, antibody binding is markedly reduced with increasing H concentrations, a phenomenon that can be directly attributed to loss of complex formation. [2][3][4] Recent studies from our laboratory indicate that similar H-dependent changes affect the immunogenicity of PF4/H complexes in vivo. 5,6 Our studies demonstrate that PF4/H complexes are immunogenic over a certain range of H concentrations associated with multimolecular complex formation and that the immune response is attenuated when PF4 or H is given alone or when H is in molar excess of PF4. 5 H and H-like molecules bind several positively charged proteins in addition to PF4. 7 These H-binding proteins (HBPs) are structurally and functionally diverse, and include, to name a few, nuclear proteins (protamine), enzymes (C1 esterase and lysozyme), adhesion molecules (fibronectin and vitronectin) growth factors (fibroblast growth factor), and lipid-binding proteins (apolipoprotein E and lipoprotein lipase). To date, it appears that a majority of HBP-H interactions a...

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Frequent somatic mutations of BRAF (v-raf murine sarcoma viral oncogene homolog B) exon T1799A, which are implicated in the initial events of promutagenic cellular proliferation, are detected in both malignant melanomas (MM) and melanocytic nevi (MN). Most of the data regarding BRAF exon T1799A mutation have been from Caucasian cohorts, and a comprehensive screening of a homogeneous population is lacking. A total of 379 cases of MN and 195 cases of MM were collected from Chinese Han living in three geographical regions in China, i.e., northeast, southwest, and northwest China. BRAF exon T1799A mutation was detected by PCR and sequencing from microdissected tumors. In all, 59.8% cases of MN harbored BRAF exon T1799A mutation. Samples from regions with high UV exposure had higher detection rates than regions with lower UV exposure (73.5, 67.0, and 38.9%, respectively; χ(2) = 31.674, P = 1.59E-7). There were no differences in mutation rates between congenital and acquired MN; however, acquired MN with advanced age of onset had a higher mutation rate than those with younger age of onset (χ(2) = 13.23, P = 0.02). In all, 15.0% cases of MM harbored the BRAF mutation. The mutation rate in MM was not affected by region, histological type, gender, pattern of UV exposure, and age. The study suggests that the mutation is not necessarily associated with malignant transformation.

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Langerhans cells (LCs) are skin-residential dendritic cells that regulate skin immunity. MicroRNAs (miRNAs) are key regulators in the control of biological functions in a variety of cell types. Deletion of all miRNAs interrupts the homeostasis and function of epidermal LCs. However, the roles of individual miRNAs in regulating LC development and function are still completely unknown. MiRNA miR-233 is especially expressed in the myeloid compartment. Here, we reported that miR-223 is highly expressed in freshly isolated epidermal LCs, and tested whether miR-223 regulates LC development and function using miR-223 knockout (KO) mice. We found that the number, maturation, migration and phagocytic capacity of LCs were comparable between miR-223KO and wild-type mice. However, lack of miR-223 significantly increases LCs-mediated antigen-specific CD8+ T cell proliferation in vivo and in vitro, while LCs from KO and WT mice showed comparable stimulation for antigen-specific CD4+ T cells. Our data suggest that miR-223 negatively regulates LC cross-presentation, but may not be required for normal LC homeostasis and development.