The Vascular Endothelial Growth Factor Inhibitors Ranibizumab and Aflibercept Markedly Increase Expression of Atherosclerosis-Associated Inflammatory Mediators on Vascular Endothelial Cells

Introduction

Recent studies have suggested that the VEGF inhibitors, Ranibizumab and Aflibercept may be associated with an excess of cardiovascular events, potentially driven by increasing atheroma instability, leading to plaque rupture and clinical events. Inflammation plays a key role in the progression of atherosclerotic plaque and particularly conversion to an unstable phenotype. Here, we sought to assess the in vitro effects of these drugs on the expression of key inflammatory mediators on endothelial cells.

Methods

Human coronary artery endothelial cells were co-incubated for 16h with Ranibizumab (0.11nM) or Aflibercept (0.45nM), as determined by each drug’s peak serum concentration (Cmax). Expression at protein (ELISA) and gene (RT-PCR) level of inflammatory chemokines CCL2, CCL5 and CXC3L1 as well as gene expression for the cell adhesion molecules VCAM-1, ICAM-1 and the key NF-κb protein p65 was assessed. VEGF-A protein levels were also determined.

Results

Both drugs significantly increased chemokine, cell adhesion molecule (CAM) and p65 expression, while decreasing VEGF-A protein secretion. At equivalent Cmax concentrations, Aflibercept was significantly more pro-inflammatory than Ranibizumab. Reduction of secreted VEGF-A levels significantly attenuated inflammatory effects of both drugs, whereas blockade of the VEGF-A receptor or silencing of VEGF-A gene synthesis alone had no effect, suggesting that binding of drug to secreted VEGF-A is crucial in promoting inflammation. Finally, blockade of Toll-like receptor 4 significantly reduced inflammatory effects of both drugs.

Conclusion

We demonstrated here, for the first time, that both drugs have potent pro-inflammatory effects, mediated via activation of Toll-like receptor 4 on the endothelial cell surface by drug bound to VEGF-A. Further studies are required to investigate whether these effects are also seen in vivo.     

A re-examination of the crystal structure of A-DNA using fiber diffraction data

Classical A-DNA helices with h = 0.25 nm may represent the greatest mass per unit length attainable by polynucleotide duplexes. The X-ray diffraction pattern from polycrystalline and well-oriented fibers of calf thymus DNA in its A-form has been carefully re-examined. Indexing on the basis of a C-face-centered monoclinic unit cell of dimensions a = 2.170 nm, b = 3.990 nm, c = 2.803 nm and beta = 96.82 degrees is superior to alternatives that have been proposed. Two right-handed. Watson-Crick base-paired, helical DNA chains with 2 X 11 nucleotides per 2.803 nm pitch, each carrying C3'-endo furanose rings, pass through the unit cell. The crystallography requires the two chains in the duplex to be antiparallel and conformationally identical but the 11 nucleotides in each pitch may be distinct. However, a secondary structure with a mononucleotide asymmetric unit provides as good an X-ray agreement as one with 11 distinct nucleotides. This relative lack of variability is quite different from what is observed in fibrous B-DNAs.     

STRUCTURE AND FUNCTION OF THE ALGAL PYRENOID. I. ULTRASTRUCTURE AND CYTOCHEMISTRY DURING ZOOSPOROGENESIS OF TETRACYSTIS EXCENTRICA1

The fine structure of the pyrenoid in the mature vegetative cell of Tetracystis excentrica Brown and Bold is described. During zoosporogenesis, the pyrenoid undergoes regression, and the ultrastructure of this process is described in detail. The ground substance undergoes dissolution, and reticulate fibrillar structures appear as well as intruding chloroplast thylakoids. Pyrenoid-associated starch plates diminish, and quantities of starch not associated with the pyrenoid are produced. New pyrenoids appear late in the division cycle after all other major organelles associated with the motile cell have been formed. Zoospore pyrenoids develop in thylakoid-free spaces of the chloroplast which are similar to the DNA-containing regions. The new pyrenoid ground substance, which is loosely fibrillar, arises in close proximity to starch grains which may be formed in the stroma. Then the zoospore pyrenoid produces 2 hemispherical starch plates identical to those in the mature vegetative cell. Zoospore pyrenoids lack the 2 convoluted thylakoids between the starch plates and the ground substance characteristic of those in the mature vegetative cell. Instead, the thylakoids are identical to those of the chloroplast at first, and then develop into a convoluted state in the vegetative cell. Cytochemical tests for DNA, RNA, and protein were made for the cytoplasm, nucleus, nucleolus, and pyrenoid. Conclusive evidence is presented for the presence of RNA in the cytoplasm and nucleolus, DNA in the nucleus, and protein in the pyrenoid. The tests did not conclusively demonstrate the presence or absence of DNA and RNA in the pyrenoid; however, they suggested that small amounts of both DNA and RNA may be present.     

Conformation of keratan sulphate

X-ray diffraction patterns from stretched films of keratan sulphate, isolated from bovine cornea, indicate that the molecules are twofold helices with an axial rise per disaccharide residue of 0.945 nm. These helices are oriented with their twofold screw axes parallel and about equally spaced, but are not further organized into regular crystalline arrays. Computer methods were used to construct a molecular model with the observed symmetry and axial rise per disaccharide residue, with standard bond lengths, bond angles and pyranose ring conformations and with a hydrogen bond of length 0.270 nm between O(3) of N-acetylglucosamine and O(5) of galactose. This model has no unacceptably short non-bonded interatomic distances. The intensity distribution of the diffraction pattern calculated from the co-ordinates of the model is in reasonable agreement with the observed intensity distribution. This keratan sulphate model is an extended polysaccharide chain fringed with charged sulphate side groups, and is similar to those that have already been reported for chondroitin sulphates and dermatan sulphate, paralleling the similarities in covalent structure and biological occurrence among these substances.     

Conformations and interactions of pectins: I. X-ray diffraction analyses of sodium pectate in neutral and acidified forms

X-ray diffraction patterns of uniaxially oriented, polycrystalline fibers of neutral sodium pectate can be indexed on the basis of an orthogonal unit cell with dimensions a = 0.84 nm, b = 1.43 nm, c (fiber axis) = 1.34 nm, which contains trisaccharide fragments of two polygalacturonic chains of opposite sense. The polysaccharide chains have 3₁ screw symmetry but are arranged in a lattice that has space group symmetry P2₁ (unique axis b). There are three sodium ions in each crystal asymmetric unit. They are all octahedrally co-ordinated to oxygen atoms of the galacturonan chains or of water molecules. Every oxygen atom is involved also in at least one hydrogen bond. Sodium pectate can be partially converted to pectic acid whose polysaccharide chains preserve the 3₁ pectate conformation, are packed in an orthogonal unit cell also with P2₁ symmetry but with quite different dimensions a = 0.99 nm, b (unique 2₁ axis) = 1.23 nm, c (fiber axis) = 1.33 nm. In this lattice, the polygalacturonic acid chains form corrugated sheets in which alternate molecules have opposite sense and are extensively hydrogen-bonded through their carboxyl groups.     

MORPHOLOGY AND DICHOTOMOUS VASCULATURE OF THE LEAF OF KINGDONIA UNIFLORA

Foster , Adriance S. (U. California, Berkeley), and Howard J. Arnott . Morphology and dichotomous vasculature of the leaf of Kingdonia uniflora. Amer. Jour. Bot. 47 (8): 684–698. Illus. 1960.—An intensive study of the nodal anatomy, petiolar vasculature and open dichotomous venation of the leaf of Kingdonia has revealed a type of foliar vascular system of unusual morphological and phylogenetic interest. The vascular supply at the nodal level consists of 4 collateral traces which diverge from a single gap into the sheathing leaf base. This type of nodal anatomy is perhaps primitive, and comparisons are made with the unilacunar nodes and the 2- and 4-parted leaf trace systems characteristic of many angiospermous cotyledons and the foliage leaves of certain woody ranalian genera. The petiole of Kingdonia is vascularized by 2 pairs of bundles which represent the upward continuation of the 4 leaf traces. A transition from an even (4) to an odd (3) number of strands occurs near the point of attachment of the 5, lobed, cuneiform lamina segments to the petiole. Each of the 2 abaxial bundles dichotomizes and the central derivative branches fuse to form a double bundle which enters the base of the median lamina segment. The 2 adaxial petiolar bundles diverge right and left into the bases of the paired lateral segments of the lamina. An analogous type of transition from an even to an odd number of veins occurs in many angiospermous cotyledons which develop a definable mid-vein. But, in Kingdonia, the bundles which enter the bases of the lamina segments give rise to systems of dichotomizing veinlets devoid of “mid-veins.” Although the majority of the terminal veinlets enter the marginal teeth of the lamina segments, “blind” endings, unrelated to the dentations, occur in all the leaves studied. Typically, all of the vein endings in a given lobule of a lamina segment are derived from the same dichotomous vein system. However, in some leaves, a veinlet dichotomizes directly below a sinus and the branches diverge into the marginal regions of 2 separate lobules. The phylogenetic significance of the occurrence of open dichotomous venation in such an herbaceous angiosperm as Kingdonia is briefly discussed. From a purely morphological viewpoint, the Kingdonia type of venation invites direct comparison with the venation of Sphenophyllum, certain ferns or Ginkgo rather than with any of the known reticulate venation patterns of modern angiosperms. Although the foliar venation of Kingdonia may represent the result of evolutionary reversion, the very rare anastomoses which occur seem primitive in type rather than “vestiges” of a former system of closed venation.     

Crystal and molecular structure of a collagen-like polypeptide (Pro-Pro-Gly)10

(Pro-Pro-Gly)₁₀ forms single crystals, providing X-ray diffraction data to 0.22 nm resolution. In the crystals, the polypeptides form triplexes that aggregate end-to-end in quasi-infinite helices with axial translation per tripeptide h = 0.287 nm and the corresponding rotation t = ?102.9 °. The structure, which may be an allomorph of collagen, has been refined by the linked-atom least-squares procedure. In addition, three water molecules per tripeptide have been detected by Fourier difference syntheses. One of them forms an intrachain hydrogen-bonded bridge O(Pro₂) - - - W - - - O(Gly). There are also interchain hydrogen bonds (Gly)NH - - - O(Pro₁) within the triplex.