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1.  Late Na+ current and protracted electrical recovery are critical determinants of the aging myopathy 
Nature Communications  2015;6:8803.
The aging myopathy manifests itself with diastolic dysfunction and preserved ejection fraction. We raised the possibility that, in a mouse model of physiological aging, defects in electromechanical properties of cardiomyocytes are important determinants of the diastolic characteristics of the myocardium, independently from changes in structural composition of the muscle and collagen framework. Here we show that an increase in the late Na+ current (INaL) in aging cardiomyocytes prolongs the action potential (AP) and influences temporal kinetics of Ca2+ cycling and contractility. These alterations increase force development and passive tension. Inhibition of INaL shortens the AP and corrects dynamics of Ca2+ transient, cell contraction and relaxation. Similarly, repolarization and diastolic tension of the senescent myocardium are partly restored. Thus, INaL offers inotropic support, but negatively interferes with cellular and ventricular compliance, providing a new perspective of the biology of myocardial aging and the aetiology of the defective cardiac performance in the elderly.
The aging myopathy is characterized by diastolic dysfunction of unknown aetiology. Rota et al. show that increased late Na+ current (I NaL) underlies diastolic dysfunction in the aged heart, and that inhibiting I NaL improves diastolic indices and corrects the kinetics of cardiomyocyte contraction and relaxation in aged mice.
doi:10.1038/ncomms9803
PMCID: PMC4638135  PMID: 26541940
2.  Regulation and consequences of monocytosis 
Immunological reviews  2014;262(1):167-178.
Summary
Monocytes are part of the vertebrate innate immune system. Blood monocytes are produced by bone marrow and splenic progenitors that derive from hematopoietic stem cells (HSCs). In cardiovascular disease, such as atherosclerosis and myocardial infarction, HSCs proliferate at higher levels that in turn increase production of hematopoietic cells, including monocytes. Once produced in hematopoietic niches, monocytes intravasate blood vessels, circulate, and migrate to sites of inflammation. Monocyte recruitment to atherosclerotic plaque and the ischemic heart depends on various chemokines, such as CCL2, CX3CL1, and CCL5. Once in tissue, monocytes can differentiate into macrophages and dendritic cells. Macrophages are end-effector cells that regulate the steady state and tissue healing, but they can also promote disease. At sites of inflammation, monocytes and macrophages produce inflammatory cytokines, which can exacerbate disease progression. Macrophages can also phagocytose tissue debris and produce pro-healing cytokines. Additionally, macrophages are antigen-presenting cells and can prime T cells. The tissue environment, including cytokines and types of inflammation, instructs macrophage specialization. Understanding monocytosis and its consequences in disease will reveal new therapeutic opportunities without compromising steady state functions.
doi:10.1111/imr.12219
PMCID: PMC4203415  PMID: 25319334
monocytes/macrophages; stem cells; spleen
3.  Increased Microvascularization and Vessel Permeability Associate with Active Inflammation in Human Atheromata 
Background
Studies have shown the feasibility of imaging plaques with 2-Deoxy-2-[18F]fluoroglucose positron emission tomography (FDG-PET) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with inconsistent results. We sought to investigate the relationship between markers of inflammatory activation, plaque microvascularization and vessel wall permeability in subjects with carotid plaques using a multi-modality approach combining FDG-PET, DCE-MRI and histopathology.
Methods and Results
Thirty-two subjects with carotid stenoses underwent noninvasive imaging with FDG PET and DCE-MRI, 46.9% (n=15) prior to carotid endarterectomy (CEA). We measured FDG uptake (target to background ratio, TBR) by PET and Ktrans (reflecting microvascular permeability and perfusion) by MRI, and correlated imaging with immunohistochemical markers of macrophage content (CD68), activated inflammatory cells (MHC-II), and microvessels (CD31) in plaque and control regions. TBR and Ktrans correlated significantly with tertiles of CD68+ (P=0.009 and P=0.008, respectively), MHC-II+ (P=0.003 and P<0.001, respectively), and CD31+ (P=0.004 and P=0.008, respectively). Regions of plaques were associated with increased CD68+ (P=0.002), MHCII+ (P=0.002), CD31+ (P=0.02), TBR (P<0.0001), and Ktrans (P<0.0001), as compared to those without plaques. Microvascularization correlated with macrophage content (rs=0.52, P=0.007) and inflammatory activity (rs=0.68, P=0.0001), and TBR correlated with Ktrans(rs=0.53, P<0.0001). In multivariable mixed linear regression modeling, TBR remained independently associated with Ktrans [β(standard error) 2.68(0.47), P<0.0001].
Conclusions
Plaque regions with active inflammation, as determined by macrophage content and MHC-II expression, showed increased FDG uptake, which correlated with increased Ktrans and microvascularization. The correlation between Ktrans and TBR was moderate, direct, highly significant, and independent of clinical symptoms and plaque luminal severity.
doi:10.1161/CIRCIMAGING.114.002113
PMCID: PMC4237630  PMID: 25170063
plaque; inflammation; neovascularization; FDG-PET; DCE-MRI; histopathology
4.  Macrophages retain hematopoietic stem cells in the spleen via VCAM-1 
Dutta et al. show that targeting VACM-1 expression in splenic macrophages impairs extramedullary hematopoiesis, thus reducing inflammation in mouse ischemic heart and atherosclerotic plaques.
Splenic myelopoiesis provides a steady flow of leukocytes to inflamed tissues, and leukocytosis correlates with cardiovascular mortality. Yet regulation of hematopoietic stem cell (HSC) activity in the spleen is incompletely understood. Here, we show that red pulp vascular cell adhesion molecule 1 (VCAM-1)+ macrophages are essential to extramedullary myelopoiesis because these macrophages use the adhesion molecule VCAM-1 to retain HSCs in the spleen. Nanoparticle-enabled in vivo RNAi silencing of the receptor for macrophage colony stimulation factor (M-CSFR) blocked splenic macrophage maturation, reduced splenic VCAM-1 expression and compromised splenic HSC retention. Both, depleting macrophages in CD169 iDTR mice or silencing VCAM-1 in macrophages released HSCs from the spleen. When we silenced either VCAM-1 or M-CSFR in mice with myocardial infarction or in ApoE−/− mice with atherosclerosis, nanoparticle-enabled in vivo RNAi mitigated blood leukocytosis, limited inflammation in the ischemic heart, and reduced myeloid cell numbers in atherosclerotic plaques.
doi:10.1084/jem.20141642
PMCID: PMC4387283  PMID: 25800955
5.  Lp-PLA2 Antagonizes Left Ventricular Healing After Myocardial Infarction by Impairing the Appearance of Reparative Macrophages 
Circulation. Heart Failure  2015;8(5):980-987.
Supplemental Digital Content is available in the text.
Background—
Healing after myocardial infarction (MI) involves the biphasic accumulation of inflammatory Ly-6Chigh and reparative Ly-6Clow monocytes/macrophages. Excessive inflammation disrupts the balance between the 2 phases, impairs infarct healing, and contributes to left ventricle remodeling and heart failure. Lipoprotein-associated phospholipase A2 (Lp-PLA2), a member of the phospholipase A2 family of enzymes, produced predominantly by leukocytes, participates in host defenses and disease. Elevated Lp-PLA2 levels associate with increased risk of cardiovascular events across diverse patient populations, but the mechanisms by which the enzyme elicits its effects remain unclear. This study tested the role of Lp-PLA2 in healing after MI.
Methods and Results—
In response to MI, Lp-PLA2 levels markedly increased in the circulation. To test the functional importance of Lp-PLA2, we generated chimeric mice whose bone marrow–derived leukocytes were Lp-PLA2–deficient (bmLp-PLA2−/−). Compared with wild-type controls, bmLp-PLA2−/− mice subjected to MI had lower serum levels of inflammatory cytokines tumor necrosis factor-α, interleukin (IL)-1β, and IL-6, and decreased number of circulating inflammatory myeloid cells. Accordingly, bmLp-PLA2−/− mice developed smaller and less inflamed infarcts with reduced numbers of infiltrating neutrophils and inflammatory Ly-6Chigh monocytes. During the later, reparative phase, infarcts of bmLp-PLA2−/− mice contained Ly-6Clow macrophages with a skewed M2-prone gene expression signature, increased collagen deposition, fewer inflammatory cells, and improved indices of angiogenesis. Consequently, the hearts of bmLp-PLA2−/− mice healed more efficiently, as determined by improved left ventricle remodeling and ejection fraction.
Conclusions—
Lp-PLA2 augments the inflammatory response after MI and antagonizes healing by disrupting the balance between inflammation and repair, providing a rationale for focused study of ventricular function and heart failure after targeting this enzyme acutely in MI.
doi:10.1161/CIRCHEARTFAILURE.115.002334
PMCID: PMC4568849  PMID: 26232205
heart failure; inflammation; macrophages; monocytes; myocardial infarction
6.  Interleukin-3 amplifies acute inflammation and is a potential therapeutic target in sepsis 
Science (New York, N.Y.)  2015;347(6227):1260-1265.
Sepsis is a frequently fatal condition characterized by an uncontrolled and harmful host reaction to microbial infection. Despite the prevalence and severity of sepsis, we lack a fundamental grasp of its pathophysiology. Here we report that the cytokine interleukin (IL)-3 potentiates inflammation in sepsis. Using a mouse model of abdominal sepsis, we show that innate response activator (IRA) B cells produce IL-3, which induces myelopoiesis of Ly-6Chigh monocytes and neutrophils, and fuels a cytokine storm. IL-3 deficiency protects mice against sepsis. In humans with sepsis, high plasma IL-3 levels associate with high mortality even after adjusting for prognostic indicators. Altogether, this study deepens our understanding of immune activation, identifies IL-3 as an orchestrator of emergency myelopoiesis, and reveals a new therapeutic target for treating sepsis.
doi:10.1126/science.aaa4268
PMCID: PMC4376966  PMID: 25766237
7.  Do vascular smooth muscle cells differentiate to macrophages in atherosclerotic lesions? 
Circulation research  2014;115(7):605-606.
doi:10.1161/CIRCRESAHA.114.304925
PMCID: PMC4166538  PMID: 25214571
vascular smooth muscle cell; macrophage; atherosclerosis
8.  Targeting splenic hematopoietic stem cells in cardiovascular disease 
Oncotarget  2015;6(24):19918-19919.
PMCID: PMC4652955  PMID: 26343366
macrophage; hematopoietic stem cells; atherosclerosis
9.  Inhibiting macrophage proliferation suppresses atherosclerotic plaque inflammation 
Science advances  2015;1(3):e1400223.
Inflammation drives atherosclerotic plaque progression and rupture, and is a compelling therapeutic target. Consequently, attenuating inflammation by reducing local macrophage accumulation is an appealing approach. This can potentially be accomplished by either blocking blood monocyte recruitment to the plaque or increasing macrophage apoptosis and emigration. Because macrophage proliferation was recently shown to dominate macrophage accumulation in advanced plaques, locally inhibiting macrophage proliferation may reduce plaque inflammation and produce long-term therapeutic benefits. To test this hypothesis, we used nanoparticle-based delivery of simvastatin to inhibit plaque macrophage proliferation in apolipoprotein E deficient mice (Apoe−/−) with advanced atherosclerotic plaques. This resulted in rapid reduction of plaque inflammation and favorable phenotype remodeling. We then combined this short-term nanoparticle intervention with an eight-week oral statin treatment, and this regimen rapidly reduced and continuously suppressed plaque inflammation. Our results demonstrate that pharmacologically inhibiting local macrophage proliferation can effectively treat inflammation in atherosclerosis.
doi:10.1126/sciadv.1400223
PMCID: PMC4539616  PMID: 26295063
10.  Differential Contribution of Monocytes to Heart Macrophages in Steady-State and after Myocardial Infarction 
Circulation research  2014;115(2):284-295.
Rationale
Macrophages populate the steady-state myocardium. Previously, all macrophages were thought to arise from monocytes; however, it emerged that in several organs tissue-resident macrophages may self-maintain through local proliferation.
Objective
To study the contribution of monocytes to cardiac resident macrophages in steady-state, after macrophage depletion in CD11bDTR/+ mice and in myocardial infarction.
Methods and Results
Using in vivo fate mapping and flow cytometry, we estimated that during steady-state the heart macrophage population turns over in about one month. To explore the source of cardiac resident macrophages, we joined the circulation of mice using parabiosis. After 6 weeks, we observed blood monocyte chimerism of 35.3±3.4% while heart macrophages showed a much lower chimerism of 2.7±0.5% (p<0.01). Macrophages self renewed locally through proliferation: 2.1±0.3% incorporated BrdU 2 hours after a single injection and 13.7±1.4% heart macrophages stained positive for the cell cycle marker Ki67. The cells likely participate in defense against infection, as we found them to ingest fluorescently labeled bacteria. In ischemic myocardium, we observed that tissue resident macrophages died locally while some also migrated to hematopoietic organs. If the steady-state was perturbed by coronary ligation or diphtheria toxin-induced macrophage depletion in CD11bDTR/+ mice, blood monocytes replenished heart macrophages. However, in the chronic phase after myocardial infarction, macrophages residing in the infarct were again independent from the blood monocyte pool, returning to the steady-state situation.
Conclusions
In this study we show differential contribution of monocytes to heart macrophages during steady-state, after macrophage depletion or in the acute and chronic phase after myocardial infarction. We found that macrophages participate in the immunosurveillance of myocardial tissue. These data correspond with previous studies on tissue-resident macrophages and raise important questions on the fate and function of macrophages during the development of heart failure.
doi:10.1161/CIRCRESAHA.115.303567
PMCID: PMC4082439  PMID: 24786973
Macrophage; monocyte; heart; myocardial infarction; myocardial
11.  Regulating repair: Tregs in myocardial infarction 
Circulation research  2014;115(1):7-9.
doi:10.1161/CIRCRESAHA.114.304295
PMCID: PMC4094354  PMID: 24951758
myocardial infarction; monocyte; macrophage; lymphocyte; healing
12.  The journey from stem cell to macrophage 
Essential protectors against infection and injury, macrophages can also contribute to many common and fatal diseases. Here we discuss the mechanisms that control different types of macrophage activities in mice. We follow the cells’ maturational pathways over time and space, and elaborate on events that influence the type of macrophage eventually settling a particular destination. The nature of the precursor cells, developmental niches, tissues, environmental cues, and other connecting processes appear to contribute to the identity of macrophage type. Together, the spatial and developmental relationships of macrophages comprise a topo-ontogenic map that can guide our understanding of their biology.
doi:10.1111/nyas.12393
PMCID: PMC4074243  PMID: 24673186
macrophage; monocyte; hematopoesis
13.  Ly-6Chigh Monocytes Depend on Nr4a1 to Balance both Inflammatory and Reparative Phases in the Infarcted Myocardium 
Circulation research  2014;114(10):1611-1622.
Rationale
Healing after myocardial infarction (MI) involves the biphasic accumulation of inflammatory Ly-6Chigh and reparative Ly-6Clow monocytes/macrophages (Mo/MΦ). According to one model, Mo/MΦ heterogeneity in the heart originates in the blood and involves the sequential recruitment of distinct monocyte subsets that differentiate to distinct macrophages. Alternatively, heterogeneity may arise in tissue from one circulating subset via local macrophage differentiation and polarization. The orphan nuclear hormone receptor, Nr4a1, is essential to Ly-6Clow monocyte production but dispensable to Ly-6Clow macrophage differentiation; dependence on Nr4a1 can thus discriminate between systemic and local origins of macrophage heterogeneity.
Objective
This study tested the role of Nr4a1 in MI in the context of the two Mo/MΦ accumulation scenarios.
Methods and Results
We show that Ly-6Chigh monocytes infiltrate the infarcted myocardium and, unlike Ly-6Clow monocytes, differentiate to cardiac macrophages. In the early, inflammatory phase of acute myocardial ischemic injury, Ly-6Chigh monocytes accrue in response to a brief Ccl2 burst. In the second, reparative phase, accumulated Ly-6Chigh monocytes give rise to reparative Ly-6Clow F4/80high macrophages that proliferate locally. In the absence of Nr4a1, Ly-6Chigh monocytes express heightened levels of Ccr2 on their surface, avidly infiltrate the myocardium, and differentiate to abnormally inflammatory macrophages, which results in defective healing and compromised heart function.
Conclusions
Ly-6Chigh monocytes orchestrate both inflammatory and reparative phases during MI and depend on Nr4a1 to limit their influx and inflammatory cytokine expression.
doi:10.1161/CIRCRESAHA.114.303204
PMCID: PMC4017349  PMID: 24625784
Monocyte; macrophage; myocardial infarction; nuclear hormone receptor; healing
14.  Cardiac macrophages and their role in ischaemic heart disease 
Cardiovascular Research  2014;102(2):240-248.
Cardiac macrophages are abundant in the healthy heart and after myocardial infarction (MI). Different macrophage phenotypes likely promote myocardial health vs. disease. Infarct macrophages are inflammatory and derive from circulating monocytes produced by the haematopoietic system. These cells are centrally involved in inflammatory tissue remodelling, resolution of inflammation during post-MI healing, and left ventricular remodelling. Presumably, macrophages interact with myocytes, endothelial cells, and fibroblasts. Although macrophages are primarily recruited to the ischaemic myocardium, the remote non-ischaemic myocardium macrophage population changes dynamically after MI. Macrophages' known roles in defending the steady state and their pathological actions in other disease contexts provide a road map for exploring cardiac macrophages and their phenotypes, functions, and therapeutic potential. In our review, we summarize recent insights into the role of cardiac macrophages, focus on their actions after ischaemia, and highlight emerging research topics.
doi:10.1093/cvr/cvu025
PMCID: PMC3989449  PMID: 24501331
Macrophage; Myocardial infarction; Heart failure; Bone marrow; Spleen
15.  In vivo silencing of the transcription factor IRF5 reprograms the macrophage phenotype and improves infarct healing 
Objectives
The aim of the study was to test wether silencing of the transcription factor Interferon Regulatory Factor 5 (IRF5) in cardiac macrophages improves infarct healing and attenuates post-MI remodeling.
Background
In healing wounds, M1➛M2 macrophage phenotype transition supports resolution of inflammation and tissue repair. Persistence of inflammatory M1 macrophages may derail healing and compromise organ functions. The transcription factor IRF5 promotes genes associated with M1 macrophages.
Methods
Here we used nanoparticle-delivered siRNA to silence the transcription factor IRF5 in macrophages residing in myocardial infarcts (MI) and in surgically induced skin wounds in mice.
Results
Infarct macrophages expressed high levels of IRF5 during the early inflammatory wound healing stages (day 4 after coronary ligation) whereas expression of the transcription factor decreased during the resolution of inflammation (day 8). Following in vitro screening, we identified an siRNA sequence that, when delivered by nanoparticles to wound macrophages, efficiently suppressed expression of IRF5 in vivo. Reduction of IRF5 expression, a factor that regulates macrophage polarization, reduced inflammatory M1 macrophage markers, supported resolution of inflammation, accelerated cutaneous and infarct healing and attenuated development of post-MI heart failure after coronary ligation as measured by protease targeted FMT-CT imaging and cardiac MRI (p<0.05 respectively).
Conclusion
This work identifies a new therapeutic avenue to augment resolution of inflammation in healing infarcts by macrophage phenotype manipulation. This therapeutic concept may be used to attenuate post-MI remodeling and heart failure.
doi:10.1016/j.jacc.2013.11.023
PMCID: PMC3992176  PMID: 24361318
16.  Innate Response Activator B Cells Aggravate Atherosclerosis by Stimulating TH1 Adaptive Immunity 
Circulation  2014;129(16):1677-1687.
Background
Atherosclerotic lesions grow via the accumulation of leukocytes and oxidized lipoproteins in the vessel wall. Leukocytes can attenuate or augment atherosclerosis through the release of cytokines, chemokines, and other mediators. Deciphering how leukocytes develop, oppose and complement each other’s function, and shape the course of disease, can illuminate understanding of atherosclerosis. Innate response activator (IRA) B cells are a recently described population of GM-CSF-secreting cells of hitherto unknown function in atherosclerosis.
Methods and Results
Here we show that IRA B cells arise during atherosclerosis in mice and humans. In response to high cholesterol diet, IRA B cell numbers increase preferentially in secondary lymphoid organs via Myd88-dependent signaling. Mixed chimeric mice lacking B cell-derived GM-CSF develop smaller lesions with fewer macrophages and effector T cells. Mechanistically, IRA B cells promote the expansion of classical dendritic cells, which then generate IFNγ-producing TH1 cells. This IRA B cell-dependent TH1 skewing manifests in an IgG1 to IgG2c isotype switch in the immunoglobulin response against oxidized lipoproteins.
Conclusions
GM-CSF-producing IRA B cells alter adaptive immune processes and shift the leukocyte response toward a TH1-associated mileu that aggravates atherosclerosis.
doi:10.1161/CIRCULATIONAHA.113.006381
PMCID: PMC3997655  PMID: 24488984
atherosclerosis; immunology; B cells; Dendritic cells; T cells; Granulocyte macrophage colony-stimulating factor
17.  Imaging and Nanomedicine in Inflammatory Atherosclerosis 
Science translational medicine  2014;6(239):239sr1.
Bioengineering provides unique opportunities to better understand and manage atherosclerotic disease. The field is entering a new era that merges the latest biological insights into inflammatory disease processes with targeted imaging and nanomedicine. Preclinical cardiovascular molecular imaging allows the in vivo study of targeted nanotherapeutics specifically directed toward immune system components that drive atherosclerotic plaque development and complication. The first multicenter trials highlight the potential contribution of multimodality imaging to more efficient drug development. This review describes how the integration of engineering, nanotechnology, and cardiovascular immunology may yield precision diagnostics and efficient therapeutics for atherosclerosis and its ischemic complications.
doi:10.1126/scitranslmed.3005101
PMCID: PMC4110972  PMID: 24898749
18.  Inhibiting macrophage proliferation suppresses atherosclerotic plaque inflammation 
Science Advances  2015;1(3):e1400223.
Nanoparticle-based delivery of simvastatin inhibits plaque macrophage proliferation in apolipoprotein E–deficient mice.
Inflammation drives atherosclerotic plaque progression and rupture, and is a compelling therapeutic target. Consequently, attenuating inflammation by reducing local macrophage accumulation is an appealing approach. This can potentially be accomplished by either blocking blood monocyte recruitment to the plaque or increasing macrophage apoptosis and emigration. Because macrophage proliferation was recently shown to dominate macrophage accumulation in advanced plaques, locally inhibiting macrophage proliferation may reduce plaque inflammation and produce long-term therapeutic benefits. To test this hypothesis, we used nanoparticle-based delivery of simvastatin to inhibit plaque macrophage proliferation in apolipoprotein E–deficient mice (Apoe−/−) with advanced atherosclerotic plaques. This resulted in the rapid reduction of plaque inflammation and favorable phenotype remodeling. We then combined this short-term nanoparticle intervention with an 8-week oral statin treatment, and this regimen rapidly reduced and continuously suppressed plaque inflammation. Our results demonstrate that pharmacologically inhibiting local macrophage proliferation can effectively treat inflammation in atherosclerosis.
doi:10.1126/sciadv.1400223
PMCID: PMC4539616  PMID: 26295063
nanomedicine; atherosclerosis; inflammation; proliferation; macrophage; high-density lipoprotein; ApoE knockout mice; Molecular Imaging; radiochemistry
19.  Fluorescent leukocytes enter plaque on the microscope stage 
Circulation research  2014;114(5):740-741.
doi:10.1161/CIRCRESAHA.114.303520
PMCID: PMC3957183  PMID: 24577957
atherosclerosis; imaging; intravital microscopy; monocyte; neutrophil; platelet
20.  Monocyte subset accumulation in the human heart following acute myocardial infarction and the role of the spleen as monocyte reservoir 
European Heart Journal  2013;35(6):376-385.
Aims
Monocytes are critical mediators of healing following acute myocardial infarction (AMI), making them an interesting target to improve myocardial repair. The purpose of this study was a gain of insight into the source and recruitment of monocytes following AMI in humans.
Methods and results
Post-mortem tissue specimens of myocardium, spleen and bone marrow were collected from 28 patients who died at different time points after AMI. Twelve patients who died from other causes served as controls. The presence and localization of monocytes (CD14+ cells), and their CD14+CD16– and CD14+CD16+ subsets, were evaluated by immunohistochemical and immunofluorescence analyses. CD14+ cells localized at distinct regions of the infarcted myocardium in different phases of healing following AMI. In the inflammatory phase after AMI, CD14+ cells were predominantly located in the infarct border zone, adjacent to cardiomyocytes, and consisted for 85% (78–92%) of CD14+CD16– cells. In contrast, in the subsequent post-AMI proliferative phase, massive accumulation of CD14+ cells was observed in the infarct core, containing comparable proportions of both the CD14+CD16– [60% (31–67%)] and CD14+CD16+ subsets [40% (33–69%)]. Importantly, in AMI patients, of the number of CD14+ cells was decreased by 39% in the bone marrow and by 58% in the spleen, in comparison with control patients (P = 0.02 and <0.001, respectively).
Conclusions
Overall, this study showed a unique spatiotemporal pattern of monocyte accumulation in the human myocardium following AMI that coincides with a marked depletion of monocytes from the spleen, suggesting that the human spleen contains an important reservoir function for monocytes.
doi:10.1093/eurheartj/eht331
PMCID: PMC3916776  PMID: 23966310
Acute myocardial infarction; Inflammation; Monocytes; Spleen; Bone marrow
21.  In vivo endothelial siRNA delivery using polymeric nanoparticles with low molecular weight 
Nature nanotechnology  2014;9(8):648-655.
Dysfunctional endothelium contributes to more disease than any other tissue in the body. Small interfering RNAs (siRNAs) have the potential to help study and treat endothelial cells in vivo by durably silencing multiple genes simultaneously, but efficient siRNA delivery has so far remained challenging. Here we show that polymeric nanoparticles made of low molecular weight polyamines and lipids can deliver siRNA to endothelial cells with high efficiency, thereby facilitating the simultaneous silencing of multiple endothelial genes in vivo. Unlike lipid or lipid-like nanoparticles, this formulation does not significantly reduce gene expression in hepatocytes or immune cells even at the dosage necessary for endothelial gene silencing. It mediates the most durable non-liver silencing reported to date, and facilitates the delivery of siRNAs that modify endothelial function in mouse models of vascular permeability, emphysema, primary tumour growth, and metastasis. We believe these nanoparticles improve the ability to study endothelial gene function in vivo, and may be used to treat diseases caused by vascular dysfunction.
doi:10.1038/nnano.2014.84
PMCID: PMC4207430  PMID: 24813696
22.  Chronic variable stress activates hematopoietic stem cells 
Nature medicine  2014;20(7):754-758.
Exposure to psychosocial stress is a risk factor for many diseases, including atherosclerosis1,2. While incompletely understood, interaction between the psyche and the immune system provides one potential mechanism linking stress and disease inception and progression. Known crosstalk between the brain and immune system includes the hypothalamic–pituitary–adrenal axis, which centrally drives glucocorticoid production in the adrenal cortex, and the sympathetic–adrenal–medullary axis, which controls stress–induced catecholamine release in support of the fight–or–flight reflex3,4. It remains unknown however if chronic stress changes hematopoietic stem cell activity. Here we show that stress increases proliferation of these most primitive progenitors, giving rise to higher levels of disease–promoting inflammatory leukocytes. We found that chronic stress induced monocytosis and neutrophilia in humans. While investigating the source of leukocytosis in mice, we discovered that stress activates upstream hematopoietic stem cells. Sympathetic nerve fibers release surplus noradrenaline, which uses the β3 adrenergic receptor to signal bone marrow niche cells to decrease CXCL12 levels. Consequently, elevated hematopoietic stem cell proliferation increases output of neutrophils and inflammatory monocytes. When atherosclerosis–prone ApoE−/− mice encounter chronic stress, accelerated hematopoiesis promotes plaque features associated with vulnerable lesions that cause myocardial infarction and stroke in humans.
doi:10.1038/nm.3589
PMCID: PMC4087061  PMID: 24952646
23.  Direct Imaging of Cerebral Thromboemboli Using Computed Tomography and Fibrin-targeted Gold Nanoparticles 
Theranostics  2015;5(10):1098-1114.
Computed tomography (CT) is the current standard for time-critical decision-making in stroke patients, informing decisions on thrombolytic therapy with tissue plasminogen activator (tPA), which has a narrow therapeutic index. We aimed to develop a CT-based method to directly visualize cerebrovascular thrombi and guide thrombolytic therapy. Glycol-chitosan-coated gold nanoparticles (GC-AuNPs) were synthesized and conjugated to fibrin-targeting peptides, forming fib-GC-AuNP. This targeted imaging agent and non-targeted control agent were characterized in vitro and in vivo in C57Bl/6 mice (n = 107) with FeCl3-induced carotid thrombosis and/or embolic ischemic stroke. Fibrin-binding capacity was superior with fib-GC-AuNPs compared to GC-AuNPs, with thrombi visualized as high density on microCT (mCT). mCT imaging using fib-GC-AuNP allowed the prompt detection and quantification of cerebral thrombi, and monitoring of tPA-mediated thrombolytic effect, which reflected histological stroke outcome. Furthermore, recurrent thrombosis could be diagnosed by mCT without further nanoparticle administration for up to 3 weeks. fib-GC-AuNP-based direct cerebral thrombus imaging greatly enhance the value and information obtainable by regular CT, has multiple uses in basic / translational vascular research, and will likely allow personalized thrombolytic therapy in clinic by a) optimizing tPA-dosing to match thrombus burden, b) enabling the rational triage of patients to more radical therapies such as endovascular clot-retrieval, and c) potentially serving as a theranostic platform for targeted delivery of concurrent thrombolysis.
doi:10.7150/thno.11679
PMCID: PMC4508499  PMID: 26199648
direct thrombus imaging; gold nanoparticles; computed tomography; cerebral infarction; molecular imaging
24.  Pleural innate response activator B cells protect against pneumonia via a GM-CSF-IgM axis 
The Journal of Experimental Medicine  2014;211(6):1243-1256.
In response to lung infection, pleural innate response activator B cells produce GM-CSF–dependent IgM and ensure a frontline defense against bacterial invasion.
Pneumonia is a major cause of mortality worldwide and a serious problem in critical care medicine, but the immunophysiological processes that confer either protection or morbidity are not completely understood. We show that in response to lung infection, B1a B cells migrate from the pleural space to the lung parenchyma to secrete polyreactive emergency immunoglobulin M (IgM). The process requires innate response activator (IRA) B cells, a transitional B1a-derived inflammatory subset which controls IgM production via autocrine granulocyte/macrophage colony-stimulating factor (GM-CSF) signaling. The strategic location of these cells, coupled with the capacity to produce GM-CSF–dependent IgM, ensures effective early frontline defense against bacteria invading the lungs. The study describes a previously unrecognized GM-CSF-IgM axis and positions IRA B cells as orchestrators of protective IgM immunity.
doi:10.1084/jem.20131471
PMCID: PMC4042649  PMID: 24821911

Results 1-25 (102)