RESUMO
As vascular disease is complex and the various manifestations are influenced by differences in vascular bed architecture, exposure to shear and mechanical forces, cell types involved, and inflammatory responses, in vivo models are necessary to recapitulate the complex physiology and dynamic cellular interactions during pathogenesis. Murine knockout models are commonly used tools for investigators to study the role of a specific gene or pathway in multifaceted disease traits. Although valuable, these models are not perfect, and this is particularly true in regard to CD73 (cluster of differentiation 73), the extracellular enzyme that generates adenosine from AMP. At baseline, CD73-deficient mice do not present with an overt phenotype, whereas CD73-deficient humans present with the complex phenotype of vascular calcification, arteriomegaly and tortuosity, and calcification in small joints. In this review, we highlight the differences between the mouse and human systems and discuss the potential to leverage findings in mice to inform us on the human conditions.
Assuntos
5'-Nucleotidase/fisiologia , Doenças Vasculares/genética , 5'-Nucleotidase/antagonistas & inibidores , 5'-Nucleotidase/deficiência , 5'-Nucleotidase/genética , 5'-Nucleotidase/imunologia , Adenosina/metabolismo , Monofosfato de Adenosina/metabolismo , Animais , Ensaios Clínicos como Assunto , Modelos Animais de Doenças , Proteínas Ligadas por GPI/antagonistas & inibidores , Proteínas Ligadas por GPI/genética , Proteínas Ligadas por GPI/imunologia , Proteínas Ligadas por GPI/fisiologia , Humanos , Inflamação , Artropatias/genética , Artropatias/patologia , Camundongos Knockout , Terapia de Alvo Molecular , Neoplasias/tratamento farmacológico , Fenótipo , Especificidade da Espécie , Trombofilia/genética , Túnica Média/patologia , Calcificação Vascular/genética , Remodelação VascularRESUMO
Pyrimidine-5'-nucleotidase type I (P5'NI) deficiency is an autosomal recessive condition that causes nonspherocytic hemolytic anemia, characterized by marked basophilic stippling and pyrimidine nucleotide accumulation in erythrocytes. We herein present two African descendant patients, father and daughter, with P5'N deficiency, both born from first cousins. Investigation of the promoter polymorphism of the uridine diphospho glucuronosyl transferase 1A (UGT1A) gene revealed that the father was homozygous for the allele (TA7) and the daughter heterozygous (TA6/TA7). P5'NI gene (NT5C3) gene sequencing revealed a further change in homozygosity at amino acid position 56 (p.R56G), located in a highly conserved region. Both patients developed gallstones; however the father, who had undergone surgery for the removal of stones, had extremely severe intrahepatic cholestasis and, liver biopsy revealed fibrosis and siderosis grade III, leading us to believe that the homozygosity of the UGT1A polymorphism was responsible for the more severe clinical features in the father. Moreover, our results show how the clinical expression of hemolytic anemia is influenced by epistatic factors and we describe a new mutation in the P5'N gene associated with enzyme deficiency, iron overload, and severe gallstone formation. To our knowledge, this is the first description of P5'N deficiency in South Americans.
Assuntos
5'-Nucleotidase/deficiência , Anemia Hemolítica Congênita/genética , Colestase/genética , Doença de Gilbert/genética , Glicoproteínas/genética , Sobrecarga de Ferro/genética , Cirrose Hepática/genética , 5'-Nucleotidase/genética , Adulto , Alelos , Anemia Hemolítica Congênita/complicações , Anemia Hemolítica Congênita/enzimologia , Anemia Hemolítica Congênita/patologia , Criança , Colestase/complicações , Colestase/enzimologia , Colestase/patologia , Consanguinidade , Epistasia Genética , Feminino , Doença de Gilbert/complicações , Doença de Gilbert/enzimologia , Doença de Gilbert/patologia , Heterozigoto , Homozigoto , Humanos , Sobrecarga de Ferro/complicações , Sobrecarga de Ferro/enzimologia , Sobrecarga de Ferro/patologia , Fígado/enzimologia , Fígado/patologia , Cirrose Hepática/complicações , Cirrose Hepática/enzimologia , Cirrose Hepática/patologia , Masculino , Regiões Promotoras Genéticas , Análise de Sequência de DNARESUMO
Ecto-5'-nucleotidase (eNT/CD73, E.C.3.1.3.5) is a glycosyl phosphatidylinositol (GPI)-linked cell-surface protein with several functions, including the local generation of adenosine from AMP, with the consequent activation of adenosine receptors and the salvaging of extracellular nucleotides. It also apparently functions independently of this activity, e.g., in the mediation of cell-cell adhesion. Liver fibrosis can be considered as a dynamic and integrated cellular response to chronic liver injury and the activation of hepatic stellate cells (HSCs) plays a role in the fibrogenic process. eNT/CD73 and adenosine are reported to play an important role in hepatic fibrosis in murine models. Knockdown of eNT/CD73 leads to an increase in mRNA expression of tissue non-specific alkaline phosphatase (TNALP), another AMP-degrading enzyme and thus no alteration is seen in the total ecto-AMPase activity of the cell. eNT/CD73 knockdown also leads to changes in the expression of collagen I and a clear alteration of cell migration. We suggest that eNT/CD73 protein expression controls cell migration and collagen expression in a mechanism independent of changes in nucleotide metabolism.