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Cardiolipin synthase expression is essential for growth at elevated temperature and is regulated by factors affecting mitochondrial development.

Cardiolipin (CL) is a unique dimeric phospholipid localized primarily in the mitochondrial membrane. In eukaryotes, the enzyme CL synthase catalyses the synthesis of CL from two lipid substrates, CDP-diacylglycerol and phosphatidylglycerol. In earlier studies, we reported the purification of CL synthase from Saccharomyces cerevisiae and the cloning of the gene CRD1 (previously called CLS1) that encodes the enzyme. Because CL is an important component of the mitochondrial membrane, knowledge of its regulation will provide insight into the biogenesis of this organelle. To understand how CL synthesis is regulated, we analysed CRD1 expression by Northern blot analysis of RNA extracted from cells under a variety of growth conditions. CRD1 expression is regulated by mitochondrial development factors. CRD1 levels were 7- to 10-fold greater in stationary than in logarithmic growth phase, and threefold greater in wild-type than in rho 0 mutants. Expression was somewhat elevated during growth in glycerol/ethanol versus glucose media. In contrast, CRD1 expression was not regulated by the phospholipid precursors inositol and choline, and was not altered in the regulatory mutants ino2, ino4 and opi1. Mutations in cytochrome oxidase assembly, which led to reduced Crd1p enzyme activity, did not affect CRD1 expression. The crd1 null mutant makes a truncated CRD1 message. Although the null mutant can grow on both fermentable and non-fermentable carbon sources at lower temperatures, it cannot form colonies at 37 degrees C. In conclusion, CRD1 expression is controlled by factors affecting mitochondrial development, but not by the phospholipid precursors inositol and choline. Expression of CRD1 is essential for growth at elevated temperatures, suggesting that either CL or Crd1p is required for an essential cellular function.

Choline↗

Prevalence of anti-cardiolipin, anti-beta2 glycoprotein I, and anti-prothrombin antibodies in young patients with epilepsy.

PURPOSE: To measure anti-cardiolipin (aCL), anti-beta2 glycoprotein I (anti-beta2GPI), and anti-prothrombin (aPT) antibodies in young patients with epilepsy, and to correlate their presence with demographic data, clinical diagnoses, laboratory and neuroradiologic findings, and antiepileptic drugs (AEDs). METHODS: Sera from one hundred forty-two consecutive patients with epilepsy with a median age of 10 years were tested for aCL and anti-beta2GPI autoantibodies by solid-phase assays. aPT antibodies also were assayed in sera from 90 patients. Positive results were confirmed after a minimum of 6 weeks. Antinuclear antibodies (ANAs) and antibodies against extractable nuclear antigens (ENAs) also were tested. RESULTS: An overall positivity of 41 (28.8%) of 142 sera was found. Fifteen patients were positive for aCL, 25 for anti-beta2GPI, and 18 for aPT antibodies. Several patients (12%) displayed more than one specificity in their serum. Only one of these patients had a concurrent positivity for ANAs and ENAs. A predominance of younger patients was found in the antibody-positive group. All types of epilepsy were represented in the positive group. No relation between antibody positivity and AEDs was found. Diffuse ischemic lesions at computed tomography (CT)/magnetic resonance imaging (MRI) scans were present in higher percentages in patients who were antibody positive. No positive patient had a history of previous thrombosis or other features related to systemic lupus erythematosus (SLE), and no patient was born of a mother with SLE. CONCLUSIONS: Our study suggests a relation between epilepsy and aPL in young patients. A pathogenetic role for these autoantibodies cannot be excluded, and their determination might prove useful even from a therapeutic point of view.

Adolescent↗

Cardiolipin synthase is associated with a large complex in yeast mitochondria.

The phospholipid cardiolipin (CL) is ubiquitous in eucaryotes and is unique in structure, subcellular localization, and potential function. Previous studies have shown that CL is associated with major respiratory complexes in the mitochondrial membrane. To determine whether CL biosynthesis requires the presence of intact respiratory complexes, we measured activity of CL synthase, which catalyzes the synthesis of CL from cytidine diphosphate diacylglycerol and phosphatidylglycerol, in Saccharomyces cerevisiae strains with genetic defects in the oxidative phosphorylation system. Assembly mutants of cytochrome oxidase had significantly reduced CL synthase activity, while assembly mutants of respiratory complex III and the F0F1-ATPase were less inhibited. To obtain further information on the activity of CL synthase, we purified the enzyme and compared the size of the catalytic protein with the functional molecular mass. The enzyme was solubilized by Triton X-100 from KSCN-extracted mitochondrial membranes of S. cerevisiae. The functional molecular mass of Triton-solubilized CL synthase, determined by radiation inactivation, was 150-240 kDa, indicating that the functional enzyme was a large complex. After partial purification, the enzyme eluted from a Superose 12 gel filtration column with an apparent molecular mass of 70 kDa. CL synthase was further purified by hydroxylapatite and cytidine diphosphate diacylglycerol affinity chromatographies, Mono Q anion exchange FPLC, and preparative gel electrophoresis. These steps led to identification of a 28-kDa protein, which had catalytic activity when eluted from an SDS-polyacrylamide gel. This 28-kDa protein also reacted with an antiserum that inactivated the enzyme. We conclude that yeast CL synthase is a 28-kDa protein, which forms an oligomeric complex whose biogenesis and/or activity is influenced by the assembly of cyto-chrome oxidase.

Chromatography, Affinity↗

A multi-centre evaluation of the intra-assay and inter-assay variation of commercial and in-house anti-cardiolipin antibody assays.

AIMS: To assess the intra-assay (intra-run) and inter-assay (inter-run) variation of commercial and in-house IgG and IgM anti-cardiolipin antibody (aCL) assays/kits, and to determine an appropriate maximum value for inclusion in consensus guidelines. METHODS: Frozen aliquots of two patient specimens and one commercial control were sent to nine laboratories for the evaluation of eight commercial kits and one in-house assay. Intra-assay and inter-assay evaluations were performed with all three samples for IgG aCL, and one patient specimen for IgM aCL. RESULTS: The IgG and IgM aCL values varied considerably between the nine assays/kits. The majority of assays/kits demonstrated less than 20% intra-assay and inter-assay variation, with lower intra-assay and inter-assay variation observed with the commercial control. Single calibrator assays were not consistently associated with higher inter-assay variation than multi-point calibrator assays. CONCLUSIONS: An inter-assay coefficient of variation of 20% was determined to be an appropriate maximum value for inclusion in the Australasian aCL Working Party consensus guidelines. Improved standardisation between different assay/kits is still required.

Antibodies, Anticardiolipin↗

Anti-cardiolipin antibody testing and reporting practices among laboratories participating in a large external Quality Assurance Program.

AIMS: To investigate differences in anti-cardiolipin antibody (aCL) testing and reporting practices among diagnostic laboratories participating in the RCPA Quality Assurance Program (QAP) Immunology Program. METHODS: A survey was sent to all 58 laboratories enrolled for aCL testing in the RCPA QAP Program requesting the following information: (1). manufacturer/type of assay; (2). isotype tested; (3). use of calibrators and controls; (4). whether calibrators, control and patient specimens were performed in singles or duplicates; (5). whether results were reported semi-quantitatively and/or numerically; (6). values used to define negative/positive and semi-quantitative cut-offs and how they were determined; and (7). whether interpretative comments were provided and their content. RESULTS: Thirty-two surveys (55%) were received. Significant differences were present particularly in the following areas: (1). whether IgM isotype aCL testing was performed routinely or only on specific request; (2). whether controls/calibrators/specimens were tested in singles or duplicates; (3). whether results were reported numerically and/or semi-quantitatively; (4). the values used to define negative/positive and semi-quantitative range cut-offs; and (5). whether interpretative comments were provided and their content. CONCLUSIONS: These differences in testing and reporting practices are likely to contribute to the variation in aCL results reported by different laboratories, particularly among those using the same assay.

Antibodies, Anticardiolipin↗

Lymphocyte subpopulation frequency and presence of anti-cardiolipin and anti-nuclear antibodies in peripheral blood of Kuwaiti women experiencing recurrent pregnancy loss.

Recurrent pregnancy loss (RPL) is often associated with elevated levels of serum antiphospholipid antibodies, which contribute to the pathology of the disorder by promoting formation of thromboses, leading to placental infarction and fetal loss. Patients with recurrent pregnancy loss also exhibit pathological alterations in composition and activity of peripheral blood lymphocytes, which may be indicative of an autoimmune processes. This investigation examines the correlation between levels of anticardiolipin antibody (AC) and specific subsets of the lymphocyte repertoire in RPL patients, with the objective of further characterising the immunological basis for RPL. Non-pregnant Kuwaiti women with a history of RPL were subdivided into two cohorts based on presence or absence of elevated plasma antibodies to cardiolipin. Whole blood from these individuals was analysed by flow cytometry for selected lymphocyte subsets and compared with a non-RPL control population. When compared with controls and low AC titre subjects, women with a high AC titre exhibited significantly elevated percentages of pathogenic CD5+ B cells; two categories of activated T cells including CD4+CD25+ and CD8+CD25; NK cells and CD3+NK cells; naive (CD4+CD45RA+) cells; and transitional (CD45RO+CD45RA+) cells. In conclusion, women with elevated levels of AC antibodies possess substantially higher levels of activated T cells and pathogenic B cells, suggesting a fundamental predisposition to immune-mediated rejection of the fetus by these patients. Further characterisation of this phenomenon may allow development of novel intervention methods for management of RPL.

Journal Article↗

Clinical significance of immunoglobulin A versus immunoglobulins G and M anti-cardiolipin antibodies in patients with systemic lupus erythematosus. Correlation with thrombosis, thrombocytopenia, and recurrent abortion.

Serum levels of immunoglobulins (Ig) A, G, and M anti-cardiolipin (aCL) antibodies were determined by enzyme-linked immunosorbent assay in a group of selected systemic lupus erythematosus female patients. Patients were divided into three groups based on their clinical history of thrombosis with or without thrombocytopenia (group I), thrombocytopenia alone (group II), and neither of these (group III). After the aCL antibody levels were determined, the patients' obstetric histories of pregnancies and abortions were reviewed. A high incidence of one or more abortions was seen only in group I patients. A high prevalence of elevated levels of IgA and IgG (but not IgM) aCL antibodies was observed in group I patients. However, among the patients in group II, only the levels of IgA aCL antibodies were increased. In both groups, the addition of the IgA aCL determination--to the classical IgG and IgM aCL assays--increased the prevalence of positive reactors in 31.6%. These results indicate that high levels of IgA aCL antibodies correlated better with thrombocytopenia than either IgG or IgM. Also, the importance of including the determination of IgA aCL antibodies to assess properly the risk of thrombosis, thrombocytopenia, and recurrent abortions in systemic lupus erythematosus patients is demonstrated.

Abortion, Habitual↗

Anti-cardiolipin antibodies in sexual partners of recurrent aborters.

The presence of anti-cardiolipin antibodies (aCL) in women is an established risk factor for fetal loss, but these autoantibodies had not previously been investigated in the male partners of recurrent aborters. The prevalence of aCL in 144 male partners of couples with a history of recurrent miscarriage was 4.2%, which compares with 2.8% for 177 female partners of such couples, 5.9% of 254 blood donors (128 male, 126 female) and 0% of 74 women of good obstetric history sampled in the puerperium. In recurrent miscarriage couples, the presence of aCL in the women was associated with a poorer history and outlook, but these associations were not evident in couples where the male partner had aCL. The aCL of male partners also differed from those of their spouses in being less likely to show higher activity towards phosphatidylserine than towards phosphatidylcholine. A particular sub-population of aCL may be strongly represented in the male partners, the clinical significance of which remains to be established.

Abortion, Habitual↗

Increased incidence of anti-cardiolipin antibodies in patients with hepatitis C is not associated with aetiopathogenetic link to anti-phospholipid syndrome.

OBJECTIVE: Chronic infection with hepatitis C virus (HCV) has been found to be associated with various diseases known as extra-hepatic manifestations of HCV. Recently, HCV has been implicated as a cause of the antiphospholipid syndrome (APLS). We conducted a study in a well-characterized area for epidemiological and prospective studies in the north-western part of Greece in order to address whether an aetiopathogenesis exists between HCV and APLS. DESIGN: Seventy-five patients with chronic hepatitis C were investigated for the presence of anti-cardiolipin antibodies (anti-CL) and for a past medical history supportive to the diagnosis of APLS. In addition, 24 patients with well-defined APLS (primary or secondary) and 12 patients with systemic lupus erythematosus (SLE) were tested for the presence of markers of HCV infection (anti-HCV and HCV RNA). The SLE patients were anti-CL-positive but none of them had developed any of the known clinical features of APLS. In addition, 267 healthy subjects were investigated for the presence of anti-CL. METHODS: IgG and IgM anti-CL were determined by a quantitative isotype-specific solid phase enzyme-linked immunosorbent assay set up in our laboratory. Anti-HCV was determined using a third-generation enzyme immunoassay and a confirmatory third-generation recombinant immunoblot assay. Active virus replication was defined by the detection of HCV RNA using a combination assay based on a reverse transcriptase polymerase chain reaction and a DNA enzyme immunoassay. RESULTS: Of the HCV patients, 37.3% had IgG and/or IgM anti-CL (P<0.00005 compared to healthy controls (2.25%)). However, the mean titres of each specific isotype were significantly lower in HCV patients compared with those found in the APLS patients (P<0.05 for IgM and P<0.001 for IgG isotypes). The mean titres of IgG anti-CL were also significantly lower in HCV patients compared with those found in the SLE patients (P<0.01). All patients with APLS or SLE (n = 36) tested negative for HCV infection markers. In addition, neither thrombotic events nor thrombocytopenia were associated with a positive anti-CL test in HCV patients. CONCLUSIONS: A significant proportion of HCV patients (37.3%) had detectable anti-CL of low titre. However, this finding was not associated with the development of APLS. On the other hand, none of the APLS patients was positive for HCV. Taken together, our data rather failed to reveal an aetiopathogenetic link between HCV and APLS. For this reason, testing for HCV in patients with APLS or follow-up for the possibility of the development of APLS in HCV patients cannot be suggested, at least in Greek patients. More prospective studies of longer duration are required in order to address whether HCV is involved or not in the aetiopathogenesis of APLS.

Adolescent↗

Thiazide-induced kidney damage with circulating antibodies against myeloperoxidase and cardiolipin.

A 79-year-old man developed a renal insufficiency while on thiazide. Extrarenal symptoms were absent. Screening for antibodies revealed high titre for anti-myeloperoxidase and anti-cardiolipin antibodies, but no other antibodies were present. After withdrawal of the drug the progression of renal insufficiency ceased. Four months later the both antibodies had disappeared. We conclude, that antibodies against granulocytes will become a valuable diagnostic tool in diagnosing drug-induced vasculitis.

Aged↗

Clinical manifestations of chronic inflammatory demyelinating polyneuropathy with anti-cardiolipin antibodies.

OBJECTIVE: Chronic inflammatory demyelinating polyneuropathy (CIDP) is an autoimmune syndrome where certain autoantibodies define clinicopathologic subgroups. In the present study, serum anti-cardiolipin antibodies (aCL) were evaluated. MATERIALS AND METHODS: We investigated aCL in sera from 21 patients diagnosed with CIDP in our hospital between 1991 and 2001. The four CIDP patients with aCL (aCL+) were compared with 17 patients without aCL (aCL-). RESULTS: All aCL+ patients displayed sensory-motor polyneuropathy, with severity and distribution of weakness resembling those in aCL- patients. Anti-nuclear antibody titer of aCL+ patients were significantly higher than those in aCL- patients. None of aCL+ patients presented clinical manifestations of primary anti-phospholipid syndrome (APS), such as thromboses or recurrent abortion. Although the aCL+ patients were older and had more complications and more severe pathologic features than aCL- patients, they responded well to steroid pulse or intravenous immunoglobulin. CONCLUSION: The aCL in CIDP apparently differ from 'autoimmune' aCL in APS, instead being among the autoantibodies pathologically involved in CIDP subgroups.

Adult↗

Cardiolipin-specific phospholipase D of Haemophilus parainfluenzae. II. Characteristics and possible significance.

A phospholipase specific for cardiolipin (CL) was found in the membrane of Haemophilus parainfluenzae. The enzyme hydrolyzed CL to phosphatidic acid (PA) and phosphatidylglycerol (PG), indicating that it was a phospholipase D (an enzyme activity believed to be confined to higher plants). In addition to its substrate specificity, this enzyme was unusual in its requirement for Mg(2+) (K(m) of 1.3 mm) for maximal activity and its inhibition by chelating agents, heavy metals, some detergents, and organic solvents. When inhibitors of phospholipase activity were added to the growth medium, CL accumulated and PG disappeared in the membrane, suggesting that the phospholipase D was active in vivo. The activity of phospholipase D in cell-free homogenates was greater than expected from earlier studies of CL metabolism and greater than the other phospholipase activities detected in the homogenate. The high activity of the CL-specific phospholipase D suggests there might be a very active degradation of CL to PG and PA and an active resynthesis of CL from the hydrolysis products.

Autoradiography↗

Metabolism of phosphatidylglycerol, lysylphosphatidylglycerol, and cardiolipin of Staphylococcus aureus.

Staphylococcus aureus accumulated cardiolipin (CL) and lost phosphatidylglycerol (PG) during the stationary phase of growth. The minor lipids, phosphatidylethanolamine and phosphatidylglucose, also accumulated, whereas the lysylphosphatidylglycerol (LPG) content of the membrane remained constant as stationary phase continued. During exponential growth, the proportions and total content of phospholipids per cell remained constant. The metabolism of the phospholipids was examined under these conditions. In pulse-chase experiments, the phospholipids lost (14)C from the glycerols slower than (32)P. When the phospholipids were labeled with (14)C glycerol, the unacylated glycerols of PG and LPG lost (14)C, whereas the diacylated glycerols either accumulated or did not lose (14)C. In all experiments, the PG showed a more rapid metabolism than the LPG. When staphylococcal CL was hydrolyzed by Haemophilus parainfluenzae CL-specific phospholipase D into phosphatidic acid (PA) and PG, the incorporation of (32)P into both of the phosphates of CL was found to be parallel at both the PG and PA ends of the molecule. However, the specific activity of the (32)P at the PA end was twice that at the PG end of the molecule. The PG end of the CL apparently came from a portion of the cellular PG pool with about 20% the specific activity of the total cellular PG. The turnover of two of the glycerols of the PG portion of CL was like that of the cellular PG. The diacylated glycerol of the PG and of CL and of the membrane PG showed neither turnover nor incorporation of (14)C. Half of the radioactivity was lost from the middle glycerol of CL and the free glycerol of the cellular PG in one bacterial doubling. The diacylated glycerol from the other end of the CL molecule (the PA end) lost radioactivity almost as rapidly as the middle glycerol for 10 min. After the initial rapid loss, the turnover slowed to a rate 10 times slower than the middle glycerol, indicating that the (14)C was actually accumulating at this end of the molecule. The phosphates and glycerols involved in the hydrolysis and resynthesis of the CL molecule during exponential growth in S. aureus apparently come from different pools of PG.

Aerobiosis↗

Detection of a rapidly metabolizing portion of the membrane cardiolipin in Haemophilus parainfluenzae.

Heterogeneity in the metabolism of cardiolipin (CL) has been detected in Haemophilus parainfluenzae. Pulse-chase experiments showed that a portion of the total CL incorporated and then lost (32)P much more rapidly than the rest of the CL in the cells. The metabolism of each phosphate of the CL differed. The phosphate of the phosphatidyl glycerol (PG) portion of the CL had a more active metabolism than the phosphate of the phosphatidic acid portion of the molecule. Only a portion of the PG pool contributed to the formation of CL. Ethylenediaminetetraacetic acid inhibited the CL-specific phospholipase D in vitro and, when added to growing cells, resulted in more rapid PG metabolism, suggesting that CL hydrolysis contributed to the PG pool.

Autoradiography↗

Consequences of the inhibition of cardiolipin metabolism in Haemophilus parainfluenzae.

Examination of phospholipid metabolism in Haemophilus parainfluenzae with inhibitors of various cellular functions indicated that macromolecular synthesis and lipid metabolism can be dissociated at least for a short time. Two classes of inhibitors have relatively specific effects on cardiolipin (CL) metabolism. Pentachlorophenol and p-hydroxymercuribenzoate blocked CL synthesis but allowed CL hydrolysis to phosphatidic acid and phosphatidyl glycerol (PG); 3,3',4,5'-tetrachlorosalicylanilide (TCS) and carbonyl cyanide m-chlorophenylhydrazone (m-CCCP) blocked CL hydrolysis with the stoichiometric accumulation of CL. It appeared as if TCS and m-CCCP inhibited a vital activity coupled with the hydrolysis of CL by the highly active, CL-specific phospholipase D found in this organism. Because TCS and m-CCCP are thought to act by destroying the proton gradient thereby interrupting energy-dependent transport, it is possible that a highly active portion of the cellular CL could be coupled to some phase of this process.

Anti-Bacterial Agents↗

Biosynthesis of cardiolipin from phosphatidylglycerol in Staphylococcus aureus.

Cardiolipin (CL) synthetase from Staphylococcus aureus catalyzes the complete conversion of two molecules of phosphatidylglycerol (PG) to one molecule of CL and one molecule of glycerol. The fatty acids and phosphates of the two PG molecules can be quantitatively recovered in the CL. The enzyme is membrane-bound, shows a linear relationship with the product formed between 10 and 125 mug of membrane protein, has a pH optimum at 4.4, a temperature optimum between 37 and 45 C, a K(m) for PG of 2.1 x 10(-4)m, a V(max) of 200 nmoles of CL per min per mg of membrane protein, and does not require monovalent or divalent metals for activity. The enzyme has no nucleotide requirement and is not affected by prolonged dialysis, and treatment of the enzyme with charcoal has no effect on its activity. The enzyme has no phosphomonoesterase or phosphodiesterase activity, does not act on CL, is specific for PG, and CL and glycerol are the sole products of its activity. Other lipids do not stimulate or inhibit its activity. The enzyme is inhibited by organic solvents and some detergents. There is sufficient CL synthetase activity to account for CL synthesis during exponential growth. Inhibition of CL hydrolysis during growth results in an increase in CL that is balanced by a loss of PG. The activity of CL synthetase is not affected by cytidine diphosphate diglyceride but is inhibited competitively by the product, CL.

Acetates↗

An acquired-pseudo Bernard Soulier syndrome occurring with autoimmune chronic active hepatitis and anti-cardiolipin antibody.

A case of autoimmune chronic active hepatitis with unusual extrahepatic manifestations is described. The patient exhibited marked thrombocytopenia and platelet aggregation dysfunction and morphological changes suggesting an acquired Bernard Soulier-type syndrome. This has not previously been described in association with chronic active hepatitis. The patient also demonstrated significant titres of anti-cardiolipin antibodies. This is also a new finding in association with both the liver and platelet diseases. The platelet aggregation deficit was transferable in the patient's serum rather than being intrinsic to the platelets. The three previously reported cases of acquired Bernard Soulier are reviewed and possible mechanisms for the platelet dysfunction are discussed.

Adult↗

Autoantibodies against cardiolipin in the serum of patients with colorectal adenocarcinoma: their prognostic significance.

Using an ELISA method, the sera of 43 patients with colon adenocarcinoma (CA) and of 26 surgical patients with nonmalignant disease of the gastrointestinal tract were studied for the presence of autoantibodies against cardiolipin (CLP) before and 1 month after surgery. Forty healthy volunteers were used as controls. Fourteen CA patients were found to be positive for anti-CLP autoantibodies before surgical treatment, and 15 patients were found to be positive 1 month after surgery. The difference between the group of CA patients and either the group of patients with nonmalignant diseases of the GI tract, or the group of healthy individuals was statistically significant (p = 0.003). The group of CA patients with high anti-CLP serum titer had a better outcome compared with the group of patients without detectable autoantibody titer (p = 0.08), estimated based on the frequency of recurrences, during the follow-up period. Further studies are in progress to evaluate the significance of anti-CLP antibodies as a biological marker of prognosis in CA patients.

Adenocarcinoma↗