The Binding of the SARS-CoV-2 Spike Protein to Platelet Factor 4: A Proposed Mechanism for the Generation of Pathogenic Antibodies.

Pathogenic platelet factor 4 (PF4) antibodies contributed to the abnormal coagulation profiles in COVID-19 and vaccinated patients. However, the mechanism of what triggers the body to produce these antibodies has not yet been clarified. Similar patterns and many comparable features between the COVID-19 virus and heparin-induced thrombocytopenia (HIT) have been reported. Previously, we identified a new mechanism of autoimmunity in HIT in which PF4-antibodies self-clustered PF4 and exposed binding epitopes for other pathogenic PF4/eparin antibodies. Here, we first proved that the SARS-CoV-2 spike protein (SP) also binds to PF4. The binding was evidenced by the increase in mass and optical intensity as observed through quartz crystal microbalance and immunosorbent assay, while the switching of the surface zeta potential caused by protein interactions and binding affinity of PF4-SP were evaluated by dynamic light scattering and isothermal spectral shift analysis. Based on our results, we proposed a mechanism for the generation of PF4 antibodies in COVID-19 patients. We further validated the changes in zeta potential and interaction affinity between PF4 and SP and found that their binding mechanism differs from ACE2-SP binding. Importantly, the PF4/SP complexes facilitate the binding of anti-PF4/Heparin antibodies. Our findings offer a fresh perspective on PF4 engagement with the SARS-CoV-2 SP, illuminating the role of PF4/SP complexes in severe thrombotic events.

Mechanics of leukemic T-cell.

Cell mechanics is a factor that determines cell growth, migration, proliferation, or differentiation, as well as trafficking inside the cytoplasm and organization of organelles. Knowledge about cell mechanics is critical to gaining insight into these biological processes. Here, we used atomic force microscopy to examine the elasticity, an important parameter of cell mechanics, of non-adherent Jurkat leukemic T-cells in both interphase and mitotic phases. We found that the elasticity of an individual cell does not significantly change at interphase. When a cell starts to divide, its elasticity increases in the transition from metaphase to telophase during normal division while the cell is stiffened right after it enters mitosis during abnormal division. At the end of the division, the cell elasticity gradually returned to the value of the mother cell. These changes may originate from the changes in cell surface tension during modulating actomyosin at the cleavage furrow, redistributing cell organelles, and constricting the contractile ring to sever mother cell to form daughters. The difference in elasticity patterns suggests that there is a discrepancy in the redistribution of the cell organelles during normal and abnormal division.

Hypothermia from a two-component mixture comprising Amoxicillin and Sulbactam.

Hypothermia might be an adverse effect of Amoxicillin and/or Sulbactam, and clinicians should be aware of this effect. Further clinical and laboratory investigations are also needed to confirm and clarify the underlying mechanism of this side effect.

Direct monitoring of drug-induced mechanical response of individual cells by atomic force microscopy.

Mechanical characteristics of individual cells play a vital role in many biological processes and are considered as indicators of the cells' states. Disturbances including methyl-ß-cyclodextrin (MßCD) and cytochalasin D (cytoD) are known to significantly affect the state of cells, but little is known about the real-time response of single cells to these drugs in their physiological condition. Here, nanoindentation-based atomic force microscopy (AFM) was used to measure the elasticity of human embryonic kidney cells in the presence and absence of these pharmaceuticals. The results showed that depletion of cholesterol in the plasma membrane with MßCD resulted in cell stiffening whereas depolymerization of the actin cytoskeleton by cytoD resulted in cell softening. Using AFM for real-time measurements, we observed that cells mechanically responded right after these drugs were added. In more detail, the cell´s elasticity suddenly increased with increasing instability upon cholesterol extraction while it is rapidly decreased without changing cellular stability upon depolymerizing actin cytoskeleton. These results demonstrated that actin cytoskeleton and cholesterol contributed differently to the cell mechanical characteristics.

Physicochemical Characteristics of Platelet Factor 4 under Various Conditions are Relevant for Heparin-Induced Thrombocytopenia Testing.

Heparin-induced thrombocytopenia (HIT), an adverse drug effect, has gained much attention. Affected patients have a high risk of new thrombotic complications. In addition, HIT is also a model to study mechanisms of immune-mediated disorders. Platelet factor 4 (PF4) is the key protein involved. It is the basis for many diagnostic tests for HIT and is used for in vitro studies and in mouse models on the pathogenesis of HIT. Purified PF4 is known to easily form aggregates, which can cause artifacts in experiments. The impact of storage buffer, storage period, lyophilization, and temperature on the size of PF4 and PF4/heparin (H) complexes was assessed by dynamic light scattering (DLS), while enzyme immunoassay (EIA) was used to test the binding of anti-PF4/H antibodies (aPF4/H Abs) to PF4/H complexes. PF4 size was more stable in Hank's balanced salt solution (HBSS) compared to phosphate-buffered saline (PBS), especially during storage. Lyophilization further facilitated the formation of PF4 aggregates, while incubation of reconstituted lyophilized PF4 in PBS at 37 °C reduced PF4 aggregates. Complexes formed between lyophilized PF4 and heparin were larger, and they enhanced the binding of aPF4/H Abs in EIA compared to complexes between nonlyophilized PF4 and heparin, both in HBSS and PBS, possibly influencing in vitro test results. Our results may be helpful for mechanistic studies on the biological function of PF4 and for the improvement of assays for detecting aPF4/H Abs.

Reactivity of platelet-activating and nonplatelet-activating anti-PF4/heparin antibodies in enzyme immunosorbent assays under different conditions.

Essentials At low pH and low salt concentrations: Maximal conformational change of PF4 upon complexation with heparin occurs. Changing physicochemical conditions may become an approach to better discriminate the signal of platelet-activating- and nonactivating PF4/H Abs in antigen tests. BACKGROUND: Enzyme immunosorbent assays (EIA) are widely used to detect human antiplatelet factor 4/heparin antibodies (aPF4/H Abs) to rule out heparin-induced thrombocytopenia. EIAs cannot differentiate between clinically relevant, platelet-activating, and nonrelevant, nonplatelet-activating Abs and only ~50% of patients' sera testing positive by EIA contain antibodies that activate platelets. Recently, we have shown platelet-activating aPF4/H Abs bind more strongly to PF4/H complexes than nonplatelet-activating antibodies. Antigen-antibody interactions are known to depend on electrostatic interactions governed by pH, heat, and ionic strength. We tested whether changes in pH and ionic strength can improve the specificity of EIAs detecting aPF4/H Abs. METHODS: We investigated first the conformational change of PF4 when binding to heparin under various pH and salt conditions using circular dichroism spectroscopy, and then the binding of aPF4/H Abs to PF4/H complexes by EIA. RESULTS: Maximal conformational change of PF4 on complexation with heparin was identified at low pH and low salt concentrations. EIA tested with a large number of sera at 50 mmol/L NaCl, pH 6.0 shows a potential to increase the specificity for the detection of platelet-activating aPF4/H Abs. CONCLUSION: Changing physicochemical conditions may become an approach to better discriminate the signal of platelet-activating and nonactivating PF4/H Abs in antigen tests.

DNA aggregation induced by Mg2+ ions under different conditions.

Cations-induced DNA aggregation can modify the local structure of oligonucleotides and has potential applications in medicine and biotechnology. Here, we used atomic force microscopy to investigate λ-DNA aggregation on Mg2+ -treated glass (Mg2+ /glass) and in Mg2+ solution. Atomic force microscopy topography images showed that some DNA fragments were slightly stacked together on 10 mM Mg2+ /glass and stacked stronger on ≥50 mM Mg2+ /glass. They also showed that DNA aggregated stronger in Mg2+ solution than on Mg2+ /glass, ie, DNAs are strongly stacked and twisted at 10 mM Mg2+ , rolled together at 50 mM Mg2+ , and slightly aggregated to form small particles at 100 mM Mg2+ . At a specific condition, ie, heating λ-DNA to 92°C, cooling down to 75°C, adding Mg2+ , and vortexing the resulting solution, DNA strongly aggregated and formed pancake-like shapes at 10 and 50 mM or a large aggregate at 100 mM Mg2+ solutions. Our results may be helpful for medical applications and gene therapy using cation-DNA technology.

The Role of Single-Molecule Force Spectroscopy in Unraveling Typical and Autoimmune Heparin-induced Thrombocytopenia.

For the last two decades, heparins have been widely used as anticoagulants. Besides numerous advantages, up to 5% patients with heparin administration suffer from a major adverse drug effect known as heparin-induced thrombocytopenia (HIT). This typical HIT can result in deep vein thrombosis, pulmonary embolism, occlusion of a limb artery, acute myocardial infarct, stroke, and a systemic reaction or skin necrosis. The basis of HIT may lead to clinical insights. Recent studies using single-molecule force spectroscopy (SMFS)-based atomic force microscopy revealed detailed binding mechanisms of the interactions between platelet factor 4 (PF4) and heparins of different lengths in typical HIT. Especially, SMFS results allowed identifying a new mechanism of the autoimmune HIT caused by a subset of human-derived antibodies in patients without heparin exposure. The findings proved that not only heparin but also a subset of antibodies induce thrombocytopenia. In this review, the role of SMFS in unraveling a major adverse drug effect and insights into molecular mechanisms inducing thrombocytopenia by both heparins and antibodies will be discussed.

Biophysical characteristics of hematopoietic cells during division.

Cell division is managed by a complex and coordinated sequence of cytoskeleton alterations that give rise to major morphological changes. During dividing the cleavage furrow of the cell is significantly stiffened due to the accumulation of actomyosin. However, it is unclear whether the stiffness on top of the cell is changed or not. Here, we used atomic force microscopy to measure stiffness on this location of non-adhesion Jurkat T cell and its derivative D1.1 cell from interphase to cytokinesis. The results showed that during division the cell stiffness significantly increases at anaphase and telophase. These increases in cell stiffness are most likely due to the cell surface tension created by the pulling forces of the microtubules to separate sister chromatids in the anaphase and the contraction forces of the contractile ring to separate the mother cell into daughters in the telophase. The dynamic measurement of cell elasticity during cell division may be used as a tool to gain further insight into the involved molecules and mechanisms.

Insights into the interaction of CD4 with anti-CD4 antibodies.

Knowledge about the mechanism by which some antibodies can block HIV-1 entry is critical to our understanding of their function and may offer new avenues for controlling the adhesion of HIV-1 to the host cells. While much progress has been made, this mechanism remains unclear. Here, atomic force microscopy, isothermal titration calorimetry (ITC), and circular dichroism spectroscopy were used to measure some biophysical characteristics of the interaction of four-domains (D1-D4) membrane protein CD4 with anti-D3 antibody OKT4 and with HIV-1 entry blocking anti-D1 antibody Leu3a. The results showed that at 37°C they bind with similar binding strength, thermodynamics, and kinetics but with different assembly states. Further analyzing the interactions at different temperatures by ITC showed that binding of CD4 with Leu3a is characteristic for specific hydrophobic binding as well as for protein folding while with OKT4 comes from an extensive additional hydration upon binding and charge-related interactions within the binding site. Comparing these characteristics with those of HIV-1 gp120-CD4 interaction revealed that Leu3a binds to CD4 faster than HIV-1 followed by changing local structure of D1 to which HIV-1 binds leading to a prevention of viral entry.

Rupture Forces among Human Blood Platelets at different Degrees of Activation.

Little is known about mechanics underlying the interaction among platelets during activation and aggregation. Although the strength of a blood thrombus has likely major biological importance, no previous study has measured directly the adhesion forces of single platelet-platelet interaction at different activation states. Here, we filled this void first, by minimizing surface mediated platelet-activation and second, by generating a strong adhesion force between a single platelet and an AFM cantilever, preventing early platelet detachment. We applied our setup to measure rupture forces between two platelets using different platelet activation states, and blockade of platelet receptors. The rupture force was found to increase proportionally to the degree of platelet activation, but reduced with blockade of specific platelet receptors. Quantification of single platelet-platelet interaction provides major perspectives for testing and improving biocompatibility of new materials; quantifying the effect of drugs on platelet function; and assessing the mechanical characteristics of acquired/inherited platelet defects.

The role of CD4 on mechanical properties of live cell membrane.

Although much progress has been made in the characterization and identification of CD4 functions, its role in mechanical properties of cell membrane remains largely unknown. Here an atomic force microscopy (AFM) was used to investigate the roles of CD4 in the elasticity of the leukemic human Jurkat (clone E6-1) cell membranes. Analysis of the approach force curves with Hertz model for a completely elastic soft sample measured on the selected CD4+ and CD4- cells showed that CD4+ cell membrane was softer than CD4- one. To confirm that CD4 plays a role in altering cell elasticity, human embryonic kidney 293T cells were transiently transfected with wild type (wt) CD4 plasmid before being used in AFM nanoindentation experiments. The results also demonstrated CD4- membrane was stiffer than CD4+ one suggesting that CD4 integrated into plasma membrane and altered its mechanical properties. The study gives insights into the role of CD4 on cell membrane mechanical characteristics and might be helpful for development of cell biology and medicine.

Characteristic ultrasonography imaging of renal trauma at Viet Tiep hospital, Hai Phong

Determine ultrasonic features of renal trauma patients at Viet Tiep Hospital, Hai Phong city. Subject: 21 renal trauma patients (14 males and 7 females) with mean age 30.71±13.85 years treated from April 2001 to April 2002. Method: Use ultrasound examination, classify renal trauma. Results: ultrasound examination is 1st choice of imaging diagnosis because it is fast, noninvasive, and easy using in emergency situations. Among 21 renal trauma patients (13 patients in grade I, 2 patients in grade II, and 6 patients in grade III), ultrasonic findings were contusion and parenchymal hematoma (71.42%), rupture (swallow or deep) (28.57%), perirenal hematoma (23.81%). In cases of grade III renal trauma, ultrasound imagines showed shallow or deep rupture (5 of 6 cases) and perirenal hematoma (4 of 6 cases)