PubMed Health⌕ Search

Biomedical subjects

P Joshua

Publications and source records attributed to P Joshua.

6 recordsLinked to original sources
PubMed2001

Acquired activated protein C resistance is associated with lupus anticoagulants and thrombotic events in pediatric patients with systemic lupus erythematosus.

Acquired activated protein C resistance (APCR) has been hypothesized as a possible mechanism by which antiphospholipid antibodies (APLAs) cause thrombotic events (TEs). However, available evidence for an association of acquired APCR with APLAs is limited. More importantly, an association of acquired APCR with TEs has not been demonstrated. The objective of the study was to determine, in pediatric patients with systemic lupus erythematosus (SLE), whether (1) acquired APCR is associated with the presence of APLAs, (2) APCR is associated with TEs, and (3) there is an interaction between APCR and APLAs in association with TEs. A cross-sectional cohort study of 59 consecutive, nonselected children with SLE was conducted. Primary clinical outcomes were symptomatic TEs, confirmed by objective radiographic tests. Laboratory testing included lupus anticoagulants (LAs), anticardiolipin antibodies (ACLAs), APC ratio, protein S, protein C, and factor V Leiden. The results revealed that TEs occurred in 10 (17%) of 59 patients. Acquired APCR was present in 18 (31%) of 58 patients. Acquired APCR was significantly associated with the presence of LAs but not ACLAs. Acquired APCR was also significantly associated with TEs. There was significant interaction between APCR and LAs in the association with TEs. Presence of both APCR and LAs was associated with the highest risk of a TE. Protein S and protein C concentrations were not associated with the presence of APLAs, APCR, or TEs. Presence of acquired APCR is a marker identifying LA-positive patients at high risk of TEs. Acquired APCR may reflect interference of LAs with the protein C pathway that may represent a mechanism of LA-associated TEs. (Blood. 2001;97:844-849)

Activated Protein C Resistance↗
PubMed1996

Differential mechanisms targeting type 1 plasminogen activator inhibitor and vitronectin into the storage granules of a human megakaryocytic cell line.

Type 1 plasminogen activator inhibitor (PAI-1) and its cofactor vitronectin (Vn) are stored within the alpha-granules of platelets. The two possible sources for their biosynthetic origin are endogenous synthesis in megakaryocytes or endocytosis from plasma. Using ultrastructural and confocal laser scanning microscopic (CLSM) image analysis, we observed that treatment of Dami cells, a human megakaryocytic cell line, with phorbol myristate acetate (PMA) induces the accumulation of PAI-1 and Vn in intracellular storage vacuoles that contain other alpha-granule proteins such as von Willebrand factor. To examine evidence for biosynthesis of PAI-1 and Vn by Dami cells, we immunoprecipitated PAI-1 and Vn from the conditioned media of cells biosynthetically radiolabeled with 35S-methionine in the presence or absence of PMA. In contrast to Hep G2 cells, which synthesize both PAI-1 and Vn, only 35S-PAI-1 was recovered from PMA-treated Dami cells. Reverse transcription-PCR analysis of RNA extracted from resting and PMA-treated Dami cells confirmed that PAI-1 mRNA expression was detectable at low levels in resting cells and induced by PMA treatment. In contrast, Vn mRNA was not detected. We examined binding and internalization (endocytosis) of PAI-1 and Vn by Dami cells using biotinylated analogs (b-PAI-1 and b-Vn). Flow cytometry analysis indicated that the binding of b-Vn to Dami cells was dose-dependent, saturable, and specific for multimeric forms of Vn. Cells were incubated at 4 degrees C or 37 degrees C and endocytosis of b-Vn was shown by probing electrophoretically fractionated cell lysates with 125I-labeled streptavidin. Only cells incubated at 37 degrees C internalized b-Vn. CLSM image analysis confirmed that the b-Vn was internalized and that it colocalized with PAI-1 in storage granules. The binding of b-Vn to cells was inhibited by the presence of PAI-1, and there was no evidence of specific b-PAI-1 binding or uptake to resting or PMA-treated cells. These data suggest that accumulation of PAI-1 in Dami cell storage granules is due to endogenous synthesis and that the accumulation of Vn is due to endocytosis of serum-derived Vn.

Base Sequence↗