A positive direct Coombs' test in the absence of hemolytic anemia predicts high disease activity and poor renal response in systemic lupus erythematosus.

We determined the clinical utility of the direct Coombs' test in the absence of hemolytic anemia as an indicator of disease activity and therapeutic response in systemic lupus erythematosus (SLE). SLE patients without hemolytic anemia who visited our hospital from January 2016 to November 2016 were retrospectively evaluated with a direct Coombs' test. Clinical features, including SLE disease activity index (SLEDAI), treatment and laboratory findings were analyzed. For patients with lupus nephritis, we additionally evaluated the cumulative complete renal response rate over one year after induction therapy. Among 182 patients evaluated, 10 (5.8%) patients had a positive direct Coombs' test in the absence of hemolytic anemia. They had a higher SLEDAI ( p < 0.01), higher circulating immune complex levels ( p = 0.01), higher anti-DNA titers ( p < 0.01) and a lower complete renal response rate ( p = 0.03) compared with those who were negative. Multivariate analysis indicated that SLEDAI was an independent factor correlated with the direct Coombs' test without hemolytic anemia (odds ratio 2.4, 95% confidence interval 1.66-4.98, p < 0.01). A positive direct Coombs' test in the absence of hemolytic anemia may therefore represent a useful biomarker for assessing disease activity and therapeutic response.

Altered acetylation of proteins in patients with rheumatoid arthritis revealed by acetyl-proteomics.

OBJECTIVES: Post-translational modifications (PTMs) are often critical for the function of proteins as well as antigenicity of proteins. We here tried to elucidate alteration of PTMs in Rheumatoid arthritis (RA), focusing on acetylation. We applied acetyl-proteomics to peripheral blood mononuclear cells (PBMCs) to elucidate PTM difference between patients with RA and healthy donors. METHODS: Proteins, extracted from peripheral blood mononuclear cells (PBMCs) of 7 RA patients and 7 healthy donors, were separated by 2-dimansional electrophoresis. Acetylation ratios of each protein spot were estimated by the combination of Sypro Ruby staining and anti-acetylated lysine antibodies. Proteins highly acetylated in the RA group were identified by mass spectrometry. Focusing on α-enolase (ENO1), one of the identified proteins, involvement of histone deacetylases (HDACs) in the high acetylation was investigated. Furthermore, the effects of acetylation on the activity of ENO1 were investigated. RESULTS: In PBMCs from the patients with RA, 29 acetylated protein spots were detected. One of highly acetylated proteins in the RA patients was identified as ENO1. The acetylation of ENO1 was found to be regulated in part by HDAC1. The enzymatic activity of ENO1 was up-regulated by acetylation. CONCLUSIONS: Highly acetylated ENO1 may play roles in the pathophysiology of RA through the maintenance of activated lymphocytes by increasing glycolysis-derived energy supply.

Modulation of erythrocyte membrane material properties by Ca2+ and calmodulin. Implications for their role in regulation of skeletal protein interactions.

Skeletal proteins of the red blood cell apparently play an important role in regulating membrane material properties of deformability and stability. However, the role of various intracellular constituents in regulating membrane properties has not been clearly defined. To determine whether Ca2+ and calmodulin might play a role in this regulation, we measured the membrane stability and deformability of resealed ghosts prepared in the presence of varying concentrations of Ca2+ and calmodulin (CaM). For membranes resealed in the presence of Ca2+ and physiologic concentrations of CaM (2-8 microM), membrane stability decreased with increasing Ca2+ concentrations (greater than 1.0 microM). Moreover, Ca2+ and CaM-induced alterations in membrane stability were completely reversible. In the absence of CaM, an equivalent decrease in membrane stability was seen only when Ca2+ concentration was two orders of magnitude higher (greater than 100 microM). Calmodulin did not alter membrane stability in the absence of Ca2+. Compared with these changes in membrane stability, membrane deformability decreased only at Ca2+ concentrations greater than 100 microM, and calmodulin had no effect on Ca2+-induced decrease in membrane deformability. Examination of the effects of Ca2+ and CaM on various membrane interactions have enabled us to suggest that spectrin-protein 4.1-actin interaction may be one of the targets for the effect of Ca2+ and CaM. These results imply that Ca2+ and calmodulin can regulate membrane stability through modulation of skeletal protein interactions, and that these protein interactions are of a dynamic nature on intact membranes.

Restoration of normal membrane stability to unstable protein 4.1-deficient erythrocyte membranes by incorporation of purified protein 4.1.

Protein 4.1, a principal component of the erythrocyte membrane skeleton, is thought to be important in regulating membrane stability through its interaction with spectrin and actin. A key role for protein 4.1 has been indicated in studies in which deficiency of this protein was shown to result in marked instability of the membrane. In order to obtain direct evidence for the functional role of protein 4.1, we reconstituted protein 4.1-deficient membranes with purified protein 4.1 and showed restoration of membrane stability. Erythrocyte membranes totally and partially deficient in protein 4.1 were reconstituted by exchange hemolysis with various concentrations of purified protein 4.1, and their stability measured using an ektacytometer. Native erythrocyte membranes totally deficient in protein 4.1 were markedly unstable, while those partially deficient had intermediate reductions in membrane stability. Reconstitution with increasing concentrations of purified protein 4.1 resulted in progressive restoration of membrane stability. Near-normal membrane stability could be restored to both totally and partially protein 4.1-deficient membranes. In contrast, the addition of protein 4.1 to resealed membranes did not improve membrane stability. This implies that the added protein 4.1 must have access to the cell interior in order to affect membrane stability. Furthermore, in control experiments, the addition of protein 4.1 to normal membranes did not increase their stability. Also, the addition of purified spectrin and human serum albumin during resealing did not improve stability of protein 4.1-deficient membranes. These results provide direct evidence for the crucial role of protein 4.1 in regulating erythrocyte membrane stability.

Defective anion transport and marked spherocytosis with membrane instability caused by hereditary total deficiency of red cell band 3 in cattle due to a nonsense mutation.

We studied bovine subjects that exhibited a moderate uncompensated anemia with hereditary spherocytosis inherited in an autosomal incompletely dominant mode and retarded growth. Based on the results of SDS-PAGE, immunoblotting, and electron microscopic analysis by the freeze fracture method, we show here that the proband red cells lacked the band 3 protein completely. Sequence analysis of the proband band 3 cDNA and genomic DNA showed a C --> T substitution resulting in a nonsense mutation (CGA --> TGA; Arg --> Stop) at the position corresponding to codon 646 in human red cell band 3 cDNA. The proband red cells were deficient in spectrin, ankyrin, actin, and protein 4.2, resulting in a distorted and disrupted membrane skeletal network with decreased density. Therefore, the proband red cell membranes were extremely unstable and showed the loss of surface area in several distinct ways such as invagination, vesiculation, and extrusion of microvesicles, leading to the formation of spherocytes. Total deficiency of band 3 also resulted in defective Cl-/HCO3- exchange, causing mild acidosis with decreases in the HCO3- concentration and total CO2 in the proband blood. Our results demonstrate that band 3 indeed contributes to red cell membrane stability, CO2 transport, and acid-base homeostasis, but is not always essential to the survival of this mammal.

Deciphering the nuclear import pathway for the cytoskeletal red cell protein 4.1R.

The erythroid membrane cytoskeletal protein 4.1 is the prototypical member of a genetically and topologically complex family that is generated by combinatorial alternative splicing pathways and is localized at diverse intracellular sites including the nucleus. To explore the molecular determinants for nuclear localization, we transfected COS-7 cells with epitope-tagged versions of natural red cell protein 4.1 (4.1R) isoforms as well as mutagenized and truncated derivatives. Two distant topological sorting signals were required for efficient nuclear import of the 4.1R80 isoform: a basic peptide, KKKRER, encoded by alternative exon 16 and acting as a weak core nuclear localization signal (4.1R NLS), and an acidic peptide, EED, encoded by alternative exon 5. 4.1R80 isoforms lacking either of these two exons showed decreased nuclear import. Fusion of various 4.1R80 constructs to the cytoplasmic reporter protein pyruvate kinase confirmed a requirement for both motifs for full NLS function. 4.1R80 was efficiently imported in the nuclei of digitonin-permeabilized COS-7 cells in the presence of recombinant Rch1 (human importin alpha2), importin beta, and GTPase Ran. Quantitative analysis of protein-protein interactions using a resonant mirror detection technique showed that 4.1R80 bound to Rch1 in vitro with high affinity (KD = 30 nM). The affinity decreased at least 7- and 20-fold, respectively, if the EED motif in exon 5 or if 4.1R NLS in exon 16 was lacking or mutated, confirming that both motifs were required for efficient importin-mediated nuclear import of 4.1R80.

Changes in serum concentration and mRNA level of rat C-reactive protein.

C-reactive protein (CRP) is a typical acute-phase protein found in many animals. Several stimuli, including IL-6 produced by macrophages localized around the site of tissue injury and/or bacterial infection, induce CRP synthesis in liver. One of the authors (W.N.) reported previously that sex hormones also affect the serum CRP concentration in rats. However, little is known about the process of CRP production, including time-dependent changes in the CRP mRNA level in liver. In the present study, we observed time-dependent changes in the serum concentration of CRP and the CRP mRNA level in liver after the injection of turpentine-oil or estradiol-17 beta in rats (Wistar strain). After turpentine-oil injection, CRP mRNA increased, followed by an increase in the serum CRP concentration, indicating that inflammation enhances transcription of the CRP gene. In contrast, upon estradiol-17 beta administration, the serum CRP concentration decreased without any decline in the CRP mRNA level in liver. The latter finding suggests that rats may have an alternative mechanism for regulating the serum concentration of CRP.

Study of stimulation-secretion coupling in a flow culture system: periodic secretion of hepatocyte growth factor by interleukin-1 alpha-stimulated human embryonic lung fibroblasts.

In order to closely examine stimulation-secretion coupling, the authors developed a 'flow culture system' in which it is possible to continuously replace the culture medium. This lessens the effects of cell-derived products observed in the conventional culture system. We compared our flow culture system and the conventional culture system based on the secretion patterns and concentrations of human hepatocyte growth factor (HGF) produced by interleukin 1 alpha (IL-1 alpha)-stimulated human embryonic lung fibroblasts (MRC-5). While the cells in the conventional culture system secreted HGF at a nearly constant rate, the cells in the flow culture system secreted HGF periodically. Even short-term stimulation with IL-1 alpha for 4 h resulted in significant HGF secretion continuing for at least 46 h. Thus the inflammatory cytokine IL-1 alpha was shown to modulate fibroblast secretion of HGF. The periodic secretion of HGF may play an important role in tissue repair and regeneration. Based on the results of actually applying it, we conclude that our flow culture system is an efficient and accurate model for the detailed examination of stimulation-secretion coupling.

Regulation of erythrocyte ghost membrane mechanical stability by chlorpromazine.

Chlorpromazine (CPZ), a widely used tranquilizer, is known to induce stomatocytic shape changes in human erythrocytes. However, the effect of CPZ on membrane mechanical properties of erythrocyte membranes has not been documented. In the present study we show that CPZ induces a dose-dependent increase in mechanical stability of erythrocyte ghost membrane. Furthermore, we document that spectrin specifically binds to CPZ intercalated into inside-out vesicles depleted of all peripheral proteins. These findings imply that CPZ-induced mechanical stabilization of the erythrocyte ghost membranes may be mediated by direct binding of spectrin to the bilayer. Membrane active drugs that partition into lipid bilayer can thus induce cytoskeletal protein interactions with the membrane and modulate membrane material properties.

A cysteine protease activity from Plasmodium falciparum cleaves human erythrocyte ankyrin.

The malaria parasite Plasmodium falciparum undergoes distinct morphologic changes during its 48-h life cycle inside human red blood cells. Parasite proteinases appear to play important roles at all stages of the erythrocytic cycle of human malaria. Proteases involved in erythrocyte rupture and invasion are possibly required to breakdown erythrocyte membrane skeleton. To identify such proteases, soluble cytosolic extract of isolated trophozoites/schizonts was incubated with erythrocyte membrane ghosts or spectrin-actin depleted inside-out vesicles, which were then analyzed by SDS-PAGE. In both cases, a new protein band of 155 kDa was detected. The N-terminal peptide sequencing established that the 155 kDa band represents truncated ankyrin. Immunoblot analysis using defined monoclonal antibodies confirmed that ankyrin was cleaved at the C-terminus. While the enzyme preferentially cleaved ankyrin, degradation of protein 4.1 was also observed at high concentrations of the enzyme. The optimal activity of the purified enzyme, using ankyrin as substrate, was observed at pH 7.0-7.5, and the activity was strongly inhibited by standard inhibitors of cysteine proteinases (cystatin, NEM, leupeptin, E-64 and MDL 28 170), but not by inhibitors of aspartic (pepstatin) or serine (PMSF, DFP) proteinases. Furthermore, we demonstrate that protease digestion of ankyrin substantially reduces its interaction with ankyrin-depleted membrane vesicles. Ektacytometric measurements showed a dramatic increase in the rate of fragmentation of ghosts after treatment with the protease. Although the role of ankyrin cleavage in vivo remains to be determined, based on our findings we postulate that the parasite-derived cysteine protease activity cleaves host ankyrin thus weakening the ankyrin-band 3 binding interactions and destabilizing the erythrocyte membrane skeleton, which, in turn, facilitates parasite release. Further characterization of the enzyme may lead to the development of novel antimalarial drugs.

Acetylphosphate-induced Ca2+-Ca2+ exchange that is mediated by (Ca2+,Mg2+)-ATPase in sarcoplasmic reticulum vesicles.

Sarcoplasmic reticulum vesicles were preloaded with either 45Ca2+ or unlabeled Ca2+. 45Ca2+ efflux and influx were determined in the presence and absence of acetylphosphate. Phosphorylation of the membrane-bound (Ca2+,Mg2+)-ATPase by [32P]acetylphosphate was also determined. The rate of efflux with acetylphosphate was considerably higher than that without acetylphosphate. When the acetylphosphate concentration was greatly reduced by diluting the reaction mixture after the start of the reaction, the rate of the efflux decreased markedly. These results demonstrate the acceleration of 45Ca2+ efflux by acetylphosphate. This acetylphosphate-induced efflux required external Ca2+. The external Ca2+ concentration giving half-maximum activation of efflux was 3.8 microM. The Ca2+ concentration dependence of the efflux coincided with that of phosphorylation. When the acetylphosphate concentration was varied, the rate of acetylphosphate-induced efflux changed approximately in proportion to the phosphoenzyme concentration. These and other findings show that acetylphosphate-induced 45Ca2+ efflux represents Ca2+-Ca2+ exchange (between the external medium and the internal medium) mediated by the phosphoenzyme and further demonstrate the direct dissociation of Ca2+ from the Ca2+-bound phosphoenzyme to the external medium in Ca2+-Ca2+ exchange.

Nonerythroid membrane skeletal proteins in normal and diseased human skin.

A number of reports have described the presence and localization of membrane skeletal proteins in nonerythroid tissues and cultured cells. Interactions of these proteins, which have been extensively characterized in erythrocytes, may be physiologically important in other cell types. This review focuses on recent developments concerning proteins analogous to erythrocyte spectrin, protein 4.1, adducin and ankyrin in epidermal keratinocytes, and discusses their significance from physiological and pathological stand points. Keratinocyte proteins are involved in a wide variety of functions such as the cell-to-cell and cell-to-substratum adhesion, stratification, and maintenance of the cell shape. In epidermal keratinocytes, these nonerythroid membrane skeletal proteins may play a role in maintaining the polarity of membrane proteins by connecting them to the cytoskeleton, regulating cell-cell interdigitations and stabilizing newly synthesized cell membranes before elaboration of cell-cell interdigitations. Furthermore, altered expression and distribution of these proteins may be important in the pathogenesis of skin disease such as psoriasis.

Protein 4.1, a multifunctional protein of the erythrocyte membrane skeleton: structure and functions in erythrocytes and nonerythroid cells.

Protein 4.1 of red blood cells (4.1R) is a multifunctional protein essential for maintaining erythrocyte shape and membrane mechanical properties, such as deformability and stability, through lateral interactions with spectrin and actin in the skeletal network and vertical interactions with cytoplasmic domains of transmembrane proteins, glycophorin C, and band 3. The primary stucture of the major 80-kd isoform of 4.1R has been elucidated, and on the basis of this identification, the functional domains and sites for binding partners have been clarified. Posttranslational modification of 4.1 R, such as phosphorylation and proteolysis, as well as binding of regulatory proteins including calmodulin-Ca2+ to 4.1R, modulates its interactions with other membrane proteins and, consequently, the membrane functions of red blood cells. Alternative splicing occurs in the 4.1R gene, and various isoforms are expressed not only in erythroid but also in nonerythroid cells. This review introduces current knowledge on biochemical, biophysical, genetic, and functional aspects of 4.1R and its family proteins, 4.1G (general type), 4.1B (brain type), and 4.1N (neuron type), recently identified in nonerythroid cells.

Fluorescence correlation spectroscopy analysis of the hydrophobic interactions of protein 4.1 with phosphatidyl serine liposomes.

Fluorescence correlation spectroscopy (FCS) was applied to examine the interactions between a protein and a membrane lipid. The protein 4.1-phosphatidyl serine (PS) interactions served as the model system to demonstrate the membrane lipid-protein interactions. This protein was labeled with rhodamine and its interactions with PS-liposomes were measured by FCS. The present results clearly demonstrated that a small protein molecule, protein 4.1, interacts specifically with a large particle, a PS-liposome. This interaction appears to be hydrophobic and not electrostatic, since the bound protein 4.1 did not dissociate in solution and was specifically released from PS-liposomes by treatment with phospholipase A(2) (PLA(2)). In the present study, using FCS we could demonstrate that the serine residue of PS is required for protein 4.1 to bind to PS-liposomes and that the bound protein 4.1 is closely associated with the fatty acid of the PS molecule in the liposomes.

Immunoreactive analogues of erythrocyte ankyrin in human epidermal keratinocytes.

Using immunoblot and immunofluorescence analysis, we demonstrated the presence and localization of an immunoreactive form of erythrocyte ankyrin in human epidermal keratinocytes. Immunoblot analysis revealed that both human epidermis and cultured epidermal keratinocytes contained ankyrin-like proteins of molecular mass 210 kDa that crossreacted with antihuman erythrocyte ankyrin antibodies. Immunofluorescence microscopy revealed that the plasma membrane of epidermal keratinocytes was stained. Eccrine sweat gland cells and ductal cells were also stained. These results indicate that in human epidermal keratinocytes, eccrine sweat gland cells and ductal cells, an ankyrin-like protein is present as one of the membrane proteins. The present findings and our recent previous studies showing the presence of a spectrin-like protein (fodrin) and 4.1-like proteins in these cells enable us to suggest that a membrane skeletal protein lattice may exist in these cells.

Method for the simultaneous assay of initial velocities of lactate dehydrogenase isoenzymes following gel electrophoresis.

A method was developed for determining initial isoenzyme velocity in a model based on lactate dehydrogenase (LD, EC. 1.1.1.27). First, purified LD was fractionated by polyacrylamide disc gel electrophoresis. Following electrophoresis, the gel was cut into slices, each containing an isoenzyme, and the isoenzymes were subsequently extracted by slice homogenization into a buffer and their activity was measured by the reverse (pyruvate to lactate) LD reaction. The volume of LD solution positively correlated with the activity of all five isoenzymes. Isoenzyme recovery in all cases exceeded 80%, compared to isoenzyme activity before electrophoresis. The lower limit of detection was 6.5 mU/microliter for LD 1, as measured using this method. The kinetic parameters of isoenzymes following recovery were similar to literature values. The results indicate that the method described here represents an improvement in the measurement of initial LD isoenzyme velocity.

Immuno-analogues of erythrocyte protein 4.2 in thyroid gland.

Immuno-analogues of erythrocyte protein 4.2 were examined in rat thyroid tissues by immunohistochemical techniques. Immunofluorescence microscopy revealed that the peripheral cytoplasm below the apical plasma membrane of follicle epithelial cells was stained with antibodies against erythrocyte protein 4.2. The staining pattern was similar to that obtained with anti-ankyrin antibodies. The present and our recent results showing the presence of spectrin, protein 4.1 and ankyrin-like proteins in thyroid tissues indicate that most features of the erythrocyte membrane skeletal architecture are also expressed by thyroid follicle epithelial cells.

Localization of proteins immunologically related to erythrocyte protein 4.1, spectrin and ankyrin in thyroid gland.

Analogues of erythrocyte protein 4.1, spectrin and ankyrin were examined in the thyroid gland of pig and rat by immunohistochemical techniques. Analysis with immunofluorescence microscopy revealed that the peripheral cytoplasm and apical-lateral plasma membrane of follicle epithelial cells of thyroid glands were stained with antibodies against erythrocyte protein 4.1, spectrin, or ankyrin. The results indicate that membrane skeletal protein lattice might exist in thyroid follicle epithelial cells.

Regulation of red cell membrane deformability and stability by skeletal protein network.

The skeletal protein network of the red blood cell is thought to be important in regulating such membrane functions as deformability and stability. In the present study, we measured membrane deformability and stability of the resealed ghosts using an ektacytometer, a laser diffraction method, and identified the functional role of protein 4.1 and that of Ca2+ and calmodulin in maintaining membrane stability. To obtain direct evidence for a crucial role of protein 4.1 in maintaining membrane stability, we reconstituted protein 4.1-deficient membranes with purified protein 4.1. Although native membranes deficient in protein 4.1 had marked reduction in membrane stability, reconstitution with increasing concentrations of purified protein 4.1 resulted in progressive restoration of membrane stability, providing direct evidence that protein 4.1 is essential for normal membrane stability. To determine if Ca2+ and calmodulin could modulate membrane properties, we measured membrane stability and deformability of resealed ghosts prepared in the presence of varying concentrations of Ca2+ and physiologic concentrations of calmodulin. Our data show that Ca2+ concentrations in the range of 1 to 100 microM can markedly decrease membrane stability only in the presence of calmodulin, but not in its absence. In contrast, deformability decreased only at Ca2+ concentrations higher than 100 microM, and calmodulin had no effect. Examination of the the effects of Ca2+ and calmodulin on various membrane protein interactions has enabled us to suggest that the observed changes in membrane stability may be partly related to the effects of Ca2+ and calmodulin on spectrin-protein 4.1-actin interaction.

[The clinical significance of glycosylated ferritin in iron overloads and hematopoietic malignancies].

Serum ferritin concentration had been known to represent the amount of total body iron and has been clinically used as a parameter to evaluate the iron storage pool in a whole body. Glycosylated (secreted) and non-glycosylated (non-secreted) forms of serum ferritin (sFt) have been reported by others based on the difference in their affinity to concanavalin-A binding. In this report, we assessed the amount of glycosylated serum ferritin (Glyco-sFt) and the ratio (%) of Glyco-sFt/in hematopoietic disorders including iron overloads (n = 10), leukemias (n = 36), malignant lymphomas (n = 10), multiple myelomas (n = 3) and myelodysplastic syndromes (n = 12). A high percentage of Glyco-sFt was observed in normal healthy controls (n = 18, 78.1 +/- 7.4%) and iron-overloads (61.1 +/- 17.8%) as compared with that in hematopoietic malignancies (43.8 +/- 23.4%, p < 0.001). The amount of Glyco-sFt in iron-overloads was higher than that in hematopoietic malignancies with hyperferritinemia (p < 0.005). These data demonstrated that the same part of serum ferritin in hematopoietic malignancies was the non-secreted form and appeared to be derived from tumor cell lysis. We conclude that assessment of Glyco-Ft is a useful parameter to distinguish iron-overloads from malignant hematopoietic disorders both displaying hyperferritinemia.