Quantification of neutrophil and monocyte CD64 expression: a predictive biomarker for active tuberculosis

SETTING: QuantiFERON TB assay (QFT) is used to screen tuberculosis (TB) infection, but it cannot distinguish active TB from latent TB infection (LTBI).OBJECTIVE: To evaluate the quantitative expression of the high-affinity FCgamma receptor I (CD64) on neutrophils (NE) and monocytes (MO) in peripheral blood using flow cytometry, measured in antibody binding capacity (ABC) units as a predictive biomarker of TB.DESIGN: Fifty-two patients were enrolled (45 QFT-positive and 7 QFT-indeterminate). Cultures and molecular analyses were performed.RESULTS: Of the 45 QFT-positive patients, 29 were culture-positive (active TB) and 16 were negative (LTBI). The median NE CD64 ABC and MO CD64 ABC expression was significantly higher (P < 0.001) in culture-positive patients. The NE CD64 and MO CD64 area under the receiver operating characteristic curve values were respectively 0.948 (95%CI 0.838–0.992) and 0.989 (0.901–1.000). By setting the cut-off NE CD64 value at >2400 ABC or MO CD64 value >25 800 the assay sensitivity increased to 95.5% with 100% specificity and 100% positive predictive value. In the QFT-indeterminate group, five culture-positive cases had NE CD64 >2400 ABC or MO CD64 value >25 800; two culture-negative cases had lower values.CONCLUSION: The CD64 quantitative expression on peripheral blood cells may be used as a predictive biomarker for active TB.

P3113Functional deficiency in activating fcgamma receptor protects against aortic abdominal aneurysm in mice

Background and aim Abdominal aortic aneurysm (AAA) is a degenerative disorder characterized by a localized and permanent dilation of the aorta. Pathological features of AAA include proteolysis, vascular smooth muscle cells (VSMC) apoptosis, oxidative stress and inflammation. Previous studies have demonstrated the role of innate and adaptive immunity in the initiation and progression of AAA. However, the specific mechanisms of humoral, antibody-mediated, immune response elicited by self and non-self-antigens are not completely known. IgG Fc receptors (FcgammaR) play an important role in the initiation and regulation of many immunological and inflammatory processes, thus providing a link between humoral and cellular immune responses. In this work, we focus on IgG immune response against antigens exposed in the damaged vessel, analysing the specific role played by FcgammaR in the pathogenesis of AAA. Methods and results AAA was induced by aortic elastase perfusion in wild-type (WT) C57BL/6 mice (n=24 males, 12 weeks old). Compared with healthy aortas, AAA tissue showed IgG and IgM deposition and increased expression levels of activating (IA, IIIA and IVA) and inhibitory (IIB) FcgammaR (5-, 3-, 10, and 2-fold increases; p<0.005) at day 14 post-elastase perfusion. To explore the functional contribution of activating FcgammaR to AAA formation, parallel experiments were performed in mice deficient in gamma-chain (gamma-KO), the common signalling subunit of FcgammaRI, III and IV. Compared with WT mice, gamma-KO mice (n=21) exhibited lower IgG and IgM deposits (21±4% and 28±12% vs WT, respectively; p<0.02) and decreased AAA lesions with reduced aortic expansion (% vs WT: aortic wall thickness, 67±3%; aortic diameter, 55±3%; p<0.0001). AAA lesions from gamma-KO mice showed less disruption of elastin layers (Verhoeff-van Gieson staining) and reduced loss of medial VSMC (α-actin immunofluorescence). Inflammatory markers such as leukocyte content (CD68+ macrophages, Ly6G+ neutrophils, CD45R+ B cells, and CD3+ T lymphocytes) and the gene expression of chemokines (MCP-1, RANTES), adhesion molecules (ICAM-1), cytokines (TNFα, IFNg, IL-10) and metalloproteinases (MMP9) were all significantly lower in AAA lesions from gamma-KO mice than those from WT mice. In vitro, cross-linking of FcgammaR with fibrinogen-containing immune complexes triggers the gene expression of proinflammatory cytokines and chemokines in both VSMC and bone marrow-derived macrophages. Conclusion Activating FcgammaR participate in AAA formation by promoting inflammatory cell recruitment, and cytokine and matrix-degrading protease expression. Therefore, modulation of FcgammaR-dependent responses could be a promising therapeutic option for the treatment of AAA. Acknowledgement/Funding MINECO/FEDER (SAF2015-63696-R), ISCIII (FIS/FEDER PI17/01495), Spanish Society of Arteriosclerosis, La Caixa (HR17-00247), Conchita Rabago Foundation

Abstract 570: Deficiency of Inhibitory Fcgamma Receptor II Does Not Exacerbate Atherosclerosis

Objective: Functionally, Fcgamma receptors (FcgRs) can be classified as activating (FcgRI, III, and IV) and inhibitory (FcgRII, CD32b) receptors. We have reported that deletion of activating FcgRs in apoE knockout mice decreased atherosclerosis. In this report we investigated the hypothesis that the deficiency of inhibitory CD32b exacerbates atherosclerosis in a hypercholesterolemic mouse model. Approach and Results: ApoE-CD32b double knockout mice congenic to the C57BL/6 (apoE-CD32b B6 -/-) were generated and atherosclerotic lesions were assessed. Contrary to our hypothesis, arterial lesions were significantly decreased in chow or high fat diet fed apoE-CD32b B6 -/- male and female mice, relative to apoE-/- mice . Bone marrow chimera approach using apoE-/- mice transplanted with apoE-CD32b B6 -/- marrow also showed significantly reduced arterial lesions. ApoE-CD32b B6 -/- mice had increased levels of IL-10 and TGF-b by CD4+ T cells, while IFN-g and IL-17 was decreased. As our findings conflict with a previous report using apoE-CD32b 129/6 -/- mixed background, we investigated if strain differences contributed to the anti-inflammatory response. Macrophages from mixed apoE-CD32b 129/B6 -/- mice showed more IL-1b, IL-6 and MCP-1 in response to immune complexes, while congenic CD32b B6 -/- mice showed more IL-10 and significantly reduced IL-1b. Interestingly expression of lupus-associated slam genes, located in close proximity to cd32b in mouse chromosome 1, is upregulated only in mixed CD32b 129/B6 -/- mice. Conclusions: Our findings demonstrate a detrimental role for CD32b signaling in atherosclerosis and the contribution of anti-inflammatory cytokine responses in the attenuated lesions observed in apoE-CD32b B6 -/- mice. As 129/sv genome derived lupus associated genes have been implicated in lupus phenotype in CD32b 129/B6 -/- mice our findings suggest possible epistatic mechanism contributing to the decreased lesions.