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Endothelium-protective, histone-neutralizing properties of the polyanionic agent defibrotide
Hui Shi, Alex A. Gandhi, Stephanie A. Smith, Qiuyu Wang, Diane Chiang, Srilakshmi Yalavarthi, Ramadan A. Ali, Chao Liu, Gautam Sule, Pei-Suen Tsou, Yu Zuo, Yogendra Kanthi, Evan A. Farkash, Jiandie D. Lin, James H. Morrissey, Jason S. Knight
Hui Shi, Alex A. Gandhi, Stephanie A. Smith, Qiuyu Wang, Diane Chiang, Srilakshmi Yalavarthi, Ramadan A. Ali, Chao Liu, Gautam Sule, Pei-Suen Tsou, Yu Zuo, Yogendra Kanthi, Evan A. Farkash, Jiandie D. Lin, James H. Morrissey, Jason S. Knight
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Research Article Inflammation Vascular biology

Endothelium-protective, histone-neutralizing properties of the polyanionic agent defibrotide

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Abstract

Neutrophil-mediated activation and injury of the endothelium play roles in the pathogenesis of diverse disease states ranging from autoimmunity to cancer to COVID-19. Neutralization of cationic proteins (such as neutrophil extracellular trap–derived [NET-derived] histones) with polyanionic compounds has been suggested as a potential strategy for protecting the endothelium from such insults. Here, we report that the US Food and Drug Administration–approved polyanionic agent defibrotide (a pleiotropic mixture of oligonucleotides) directly engages histones and thereby blocks their pathological effects on endothelium. In vitro, defibrotide counteracted endothelial cell activation and pyroptosis-mediated cell death, whether triggered by purified NETs or recombinant histone H4. In vivo, defibrotide stabilized the endothelium and protected against histone-accelerated inferior vena cava thrombosis in mice. Mechanistically, defibrotide demonstrated direct and tight binding to histone H4 as detected by both electrophoretic mobility shift assay and surface plasmon resonance. Taken together, these data provide insights into the potential role of polyanionic compounds in protecting the endothelium from thromboinflammation with potential implications for myriad NET- and histone-accelerated disease states.

Authors

Hui Shi, Alex A. Gandhi, Stephanie A. Smith, Qiuyu Wang, Diane Chiang, Srilakshmi Yalavarthi, Ramadan A. Ali, Chao Liu, Gautam Sule, Pei-Suen Tsou, Yu Zuo, Yogendra Kanthi, Evan A. Farkash, Jiandie D. Lin, James H. Morrissey, Jason S. Knight

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Figure 1

Defibrotide inhibits the activation and permeability of cultured HUVECs by NETs.

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Defibrotide inhibits the activation and permeability of cultured HUVECs ...
(A–C) HUVECs were pretreated with defibrotide (10 μg/mL) for 30 minutes, followed by isolated NETs (1 μg DNA content/mL) for 4 hours. E-selectin (A), ICAM-1 (B), and VCAM-1 (C) mRNA levels were determined by qPCR. Mean ± SD is presented for 1 representative experiment out of 3 independent experiments, all with similar results; ****P < 0.0001 by 1-way ANOVA corrected by Dunnett’s test. (D–F) HUVECs were pretreated with defibrotide (10 μg/mL) for 30 minutes, followed by the addition of NETs for 6 hours. Surface expression of E-selectin (D), ICAM-1 (E), and VCAM-1 (F) were then detected by in-cell ELISA. (G) HUVEC monolayers were pretreated with defibrotide (10 μg/mL) for 30 minutes, followed by NETs (1 μg DNA content/mL) for 4 hours. Calcein-AM–labeled neutrophils were then added as described in Methods. Mean ± SD is presented for n = 3 independent experiments; **P < 0.01 and ***P < 0.001 by 1-way ANOVA corrected by Dunnett’s test. (H) HUVECs were treated as for A–C. Tissue factor mRNA levels were detected at 4 hours. Mean ± SD is presented for 1 representative experiment out of 3 independent experiments, all with similar results; ****P < 0.0001 as compared by 1-way ANOVA corrected by Dunnett’s test. (I) HUVECs were treated as for A–C. Cell permeability was assessed by measuring horseradish peroxidase (HRP) movement through EC monolayers in a Transwell system as described in Methods. Mean ± SD is presented for 1 representative experiment out of 3 independent experiments, all with similar results; **P < 0.01, ***P < 0.001 and ****P < 0.0001 by 2-way ANOVA corrected by Tukey’s test. #P < 0.05, ###P < 0.001, and ####P < 0.0001 by 2-way ANOVA corrected by Tukey’s test.

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