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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 7

Defibrotide alleviates histone-mediated endothelial activation and venous thrombosis in mice.

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Defibrotide alleviates histone-mediated endothelial activation and venou...
(A) Thrombus initiation in the IVC via placement of a fixed suture over a spacer that was subsequently removed. (B) Mice were injected with either histone (10 mg/kg) or saline via tail vein 1 hour prior to surgery. Meanwhile, defibrotide (150 mg/kg) or saline was administered by retro-orbital injection 24 hours prior to surgery and then immediately following closure of the abdomen. Thrombus weight was determined 24 hours later. Scatter plots are presented, with each data point representing a unique mouse (horizontal bars represent mean + SD); *P < 0.05 and **P < 0.01 by Kruskal-Wallis test followed by Dunn’s multiple comparison test. Data were presented as mean ± SD. (C) Representative thrombi from the experiments presented in panel B with rulers measuring thrombi in millimeters. (D and E) Serum samples from the experiments presented in B were tested for soluble E-selectin (D) and soluble P-selectin (E) by ELISA; *P < 0.05, **P < 0.01, ***P < 0.001, and ****P < 0.0001 by 1-way ANOVA corrected by Dunn’s multiple comparison test. Data were presented as mean ± SD. (F–H) Thrombus sections from B were stained for Ly6G+ and CD45+ cells. Positively stained cells were quantified in 4 randomly selected fields for each thrombus. **P < 0.01 and ***P < 0.001 by 1-way ANOVA corrected by Dunn’s multiple comparison test. Scale bars: 1000 μm. Data is presented as mean ± SD.

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