ROS-driven structural and functional fibrinogen modifications are reverted by interleukin-6 inhibition in Giant Cell Arteritis

Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved..

BACKGROUND: Cranial and extra-cranial vascular events are among the major determinants of morbidity and mortality in Giant Cell Arteritis (GCA). Vascular events seem mostly of inflammatory nature, although the precise pathogenetic mechanisms are still unclear. We investigated the role of oxidation-induced structural and functional fibrinogen modifications in GCA. The effects of the anti-IL6R tocilizumab in counteracting these mechanisms were also assessed.

MATERIALS AND METHODS: A cross-sectional study was conducted on 65 GCA patients and 65 matched controls. Leucocyte reactive oxygen species (ROS) production, redox state, and fibrinogen structural and functional features were compared between patients and controls. In 19 patients receiving tocilizumab, pre vs post treatment variations were assessed.

RESULTS: GCA patients displayed enhanced blood lymphocyte, monocyte and neutrophil ROS production compared to controls, with an increased plasma lipid peroxidation and a reduced total antioxidant capacity. This oxidative impairment resulted in a sustained fibrinogen oxidation (i.e. dityrosine content 320 (204-410) vs 136 (120-176) Relative Fluorescence Units (RFU), p < 0.0001), with marked alterations in fibrinogen secondary and tertiary structure [intrinsic fluorescence: 134 (101-227) vs 400 (366-433) RFU, p < 0.001]. Structural alterations paralleled a remarkable fibrinogen functional impairment, with a reduced ability to polymerize into fibrin and a lower fibrin susceptibility to plasmin-induced lysis. In patients receiving tocilizumab, a significant improvement in redox status was observed, accompanied by a significant improvement in fibrinogen structural and functional features (p < 0.001).

CONCLUSIONS: An impaired redox status accounts for structural and functional fibrinogen modifications in GCA, suggesting a potential role of tocilizumab for cardiovascular prevention in GCA.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:230

Enthalten in:

Thrombosis research - 230(2023) vom: 15. Okt., Seite 1-10

Sprache:

Englisch

Beteiligte Personen:

Bettiol, Alessandra [VerfasserIn]
Argento, Flavia Rita [VerfasserIn]
Fini, Eleonora [VerfasserIn]
Bello, Federica [VerfasserIn]
Di Scala, Gerardo [VerfasserIn]
Taddei, Niccolò [VerfasserIn]
Emmi, Giacomo [VerfasserIn]
Prisco, Domenico [VerfasserIn]
Becatti, Matteo [VerfasserIn]
Fiorillo, Claudia [VerfasserIn]

Links:

Volltext

Themen:

9001-31-4
9001-32-5
Fibrin
Fibrinogen
Giant cell arteritis
Hemostatics
Interleukin-6
Journal Article
Reactive Oxygen Species
Reactive oxygen species
Thrombosis
Vasculitis

Anmerkungen:

Date Completed 02.10.2023

Date Revised 12.10.2023

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.thromres.2023.08.011

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM360973973