Norfolk, VA, United States
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Mauriello C.T.,Eastern Virginia Medical School | Pallera H.K.,Old Dominion University | Sharp J.A.,Eastern Virginia Medical School | Woltmann J.L.,Eastern Virginia Medical School | And 9 more authors.
Molecular Immunology | Year: 2013

Previous experiments from our laboratories have identified peptides derived from the human astrovirus coat protein (CP) that bind C1q and mannose binding lectin (MBL) inhibiting activation of the classical and lectin pathways of complement, respectively. The purpose of this study was to evaluate the function of these coat protein peptides (CPPs) in an in vitro model of complement-mediated disease (ABO incompatibility), preliminarily assess their in vivo complement suppression profile and develop more highly potent derivatives of these molecules. E23A, a 30 amino acid CPP derivative previously demonstrated to inhibit classical pathway activation was able to dose-dependently inhibit lysis of AB erythrocytes treated with mismatched human O serum. Additionally, when injected into rats, E23A inhibited the animals' serum from lysing antibody-sensitized erythrocytes, providing preliminary in vivo functional evidence that this CPP can cross the species barrier to inhibit serum complement activity in rodents. A rational drug design approach was implemented to identify more potent CPP derivatives, resulting in the identification and characterization of a 15 residue peptide (polar assortant (PA)), which demonstrated both superior inhibition of classical complement pathway activation and robust binding to C1q collagen-like tails. PA also inhibited ABO incompatibility in vitro and demonstrated in vivo complement suppression up to 24. h post-injection. CPP's ability to inhibit ABO incompatibility in vitro, proof of concept in vivo inhibitory activity in rats and the development of the highly potent PA derivative set the stage for preclinical testing of this molecule in small animal models of complement-mediated disease. © 2012 Elsevier Ltd.


Hair P.S.,Eastern Virginia Medical School | Gronemus J.Q.,Eastern Virginia Medical School | Crawford K.B.,Eastern Virginia Medical School | Salvi V.P.,University of Texas Health Science Center at Tyler | And 6 more authors.
Molecular Immunology | Year: 2010

Human astroviruses (HAstVs) constitute a family of non-enveloped, RNA viruses which cause infantile gastroenteritis. We have previously demonstrated that purified HAstV coat protein (CP), multiple copies of which compose the viral capsid, bind C1q resulting in inhibition of classical complement pathway activity. The objective of this study was to further analyze the mechanism by which CP inhibits C1 activation. CP inhibited C1 activation, preventing cleavage of C1s to its active form in the presence of heat-aggregated IgG, a potent classical pathway activator. CP also inhibited generation of the potent anaphylatoxin C5a. CP dose-dependently bound to C1q, the isolated globular heads and the collagen-like regions of the C1q molecule. When CP was added to C1, C1s dissociated from C1q suggesting that CP functionally displaces the protease tetramer (C1s-C1r-C1r-C1s). Given the structural and functional relatedness of C1q and MBL, we subsequently investigated the interactions between CP and MBL. CP bound to purified MBL and was able to inhibit mannan-mediated activation of the lectin pathway. Interestingly, CP did not bind to a variant of MBL that replaces a lysine residue (Lys55) critical for binding to MASP-2, a functional homolog of C1s. Finally, CP was shown to cross the species barrier to inhibit C3 activation and MAC formation in rat serum. These findings suggest CP inhibits C1 and MBL activation via a novel mechanism of interference with the normal interaction of the recognition molecule with its cognate serine proteases. © 2010 Elsevier Ltd. All rights reserved.


Sharp J.A.,Eastern Virginia Medical School | Whitley P.H.,Red Cross | Cunnion K.M.,Eastern Virginia Medical School | Cunnion K.M.,Childrens Specialty Group | Krishna N.K.,Eastern Virginia Medical School
Frontiers in Immunology | Year: 2014

The classical pathway of complement plays multiple physiological roles including modulating immunological effectors initiated by adaptive immune responses and an essential homeostatic role in the clearance of damaged self-antigens. However, dysregulated classical pathway activation is associated with antibody-initiated, inflammatory diseases processes like cold agglutinin disease, acute intravascular hemolytic transfusion reaction (AIHTR), and acute/hyperacute transplantation rejection. To date, only one putative classical pathway inhibitor, C1 esterase inhibitor (C1-INH), is currently commercially available and its only approved indication is for replacement treatment in hereditary angioedema, which is predominantly a kinin pathway disease. Given the variety of disease conditions in which the classical pathway is implicated, development of therapeutics that specifically inhibits complement initiation represents a major unmet medical need. Our laboratory has identified a peptide that specifically inhibits the classical and lectin pathways of complement. In vitro studies have demonstrated that these peptide inhibitors of complement C1 (PIC1) bind to the collagen-like region of the initiator molecule of the classical pathway, C1q. PIC1 binding to C1q blocks activation of the associated serine proteases (C1s-C1r-C1r-C1s) and subsequent downstream complement activation. Rational design optimization of PIC1 has resulted in the generation of a highly potent derivative of 15 amino acids. PIC1 inhibits classical pathway mediated complement activation in ABO incompatibility in vitro and inhibiting classical pathway activation in vivo in rats. This review will focus on the pre-clinical development of PIC1 and discuss its potential as a therapeutic in antibody-mediated classical pathway disease, specifically AIHTR. © 2014 Sharp, Whitley, Cunnion and Krishna.


Krishna N.K.,Eastern Virginia Medical School | Cunnion K.M.,Eastern Virginia Medical School | Cunnion K.M.,Childrens Specialty Group
Medical Clinics of North America | Year: 2012

Clinical laboratories have traditionally relied on time-consuming phenotypic methods such as culture, serology, and biochemical tests for detection, identification, and characterization of microbial pathogens. Real-time polymerase chain reaction technology can now identify many pathogenic organisms that constitute infectious disease emergencies in normal and immune-compromised hosts. Use of this molecular technology for the accurate diagnosis of infectious disease agents by clinical laboratories reduces the time to diagnosis for many pathogens. This article is designed such that the clinician evaluating a patient with severe acute illness can reference the most relevant molecular diagnostics available pertinent to the predominant organ system involved. © 2012 Elsevier Inc.


Finklea L.B.,Eastern Virginia Medical School | Mohr M.R.,Eastern Virginia Medical School | Warthan M.M.,Eastern Virginia Medical School | Darrow D.H.,Eastern Virginia Medical School | And 2 more authors.
Pediatric Dermatology | Year: 2010

We present two rare cases of phacomatosis pigmentovascularis type IIb, with one patient demonstrating concurrent Sturge-Weber syndrome and Klippel-Trenaunay syndrome. To the best of our knowledge, this is the second infantile case meeting diagnostic criteria for systemic phacomatosis pigmentovascularis type IIb, Sturge-Weber syndrome and Klippel-Trenaunay syndrome in the English language literature. © 2010 Wiley Periodicals, Inc.


Gronemus J.Q.,Eastern Virginia Medical School | Hair P.S.,Eastern Virginia Medical School | Crawford K.B.,Eastern Virginia Medical School | Nyalwidhe J.O.,Eastern Virginia Medical School | And 3 more authors.
Molecular Immunology | Year: 2010

Previous work from our laboratories has demonstrated that purified, recombinant human astrovirus coat protein (HAstV CP) binds C1q and mannose-binding lectin (MBL) inhibiting activation of the classical and lectin pathways of complement, respectively. Analysis of the 787 amino acid CP molecule revealed that residues 79-139 share limited sequence homology with human neutrophil defensin-1 (HNP-1), a molecule previously demonstrated to bind C1q and MBL, inhibiting activation of the classical and lectin pathways of complement, respectively. A 30 amino acid peptide derived from this region of the CP molecule competitively inhibited the binding of wild-type CP to C1q. The parent peptide and various derivatives were subsequently assayed for C1q binding, inhibition of C1 and C4 activation as well as suppression of complement activation in hemolytic assays. The parent peptide and several derivatives inhibited complement activation in these functional assays to varying degrees. One peptide derivative in particular (E23A) displayed superior inhibition of complement activation in multiple assays of classical complement pathway activation. Further analysis revealed homology to a plant defensin allowing development of a proposed structural model for E23A. Based upon these findings, we hypothesize that further rationale optimization of E23A may result in a promising therapeutic inhibitor for the treatment of inflammatory and autoimmune diseases in which dysregulated activation of the classical and lectin pathways of complement contribute to pathogenesis. © 2010 Elsevier Ltd.


Sharp J.A.,Eastern Virginia Medical School | Cunnion K.M.,Eastern Virginia Medical School | Cunnion K.M.,Childrens Specialty Group | Cunnion K.M.,Childrens Hospital of The Kings Daughters
Molecular Immunology | Year: 2011

Staphylococcus aureus is a significant human pathogen that causes skin-structure, invasive, and hospital-associated infections worldwide. The complement system is vital to innate defense against many bacterial infections. As shown with other pathogens, mechanisms for circumventing complement attack may include recruitment of the complement regulatory protein factor H (fH). In the present study, we show that S. aureus binds fH in a dose-dependent and time-dependent manner. Interestingly, this interaction does not require complement activation nor C3-fragment presence and occurs efficiently in the absence of other serum components suggesting a mechanism other than bridging between intermediary molecules. However, fH binding is greater when incubated with normal human serum compared to heat-inactivated serum, which suggests that complement activation may enhance fH binding. S. aureus-bound fH was found to inhibit the alternative pathway through disruption of the alternative pathway C3 convertase as shown by an increase in Bb release and a decrease in total C3-fragment deposition. Furthermore, S. aureus-bound fH retains cofactor activity for factor-I mediated cleavage of C3b. These studies show that the acquisition of fH to the S. aureus surface inhibits complement-mediated opsonization via disruption of the alternative pathway convertase; thus, we report an immune-evasion mechanism not previously described for S. aureus. © 2010 Elsevier Ltd.


Hair P.S.,Eastern Virginia Medical School | Wagner S.M.,Eastern Virginia Medical School | Friederich P.T.,Eastern Virginia Medical School | Drake R.R.,Eastern Virginia Medical School | And 4 more authors.
Molecular Immunology | Year: 2012

Staphylococcus aureus is the major cause of human skin and soft-tissue infections as well as invasive infections like post-operative wound infections, septic arthritis, and osteomyelitis. The complement system plays an important role in the immunological control of many bacteria, but can be inhibited by a variety of strategies including recruitment of complement regulatory proteins like C4b-binding protein (C4BP). These experiments demonstrate that S. aureus opsonization with C4b occurs rapidly in serum and is predominantly initiated by anti-staphylococcal antibodies. Much of the S. aureus-bound C4b is quickly cleaved to the inactive forms iC4b and C4d. Clinical S. aureus strains rapidly bind significant amounts of the complement regulator C4BP from serum. S. aureus also binds purified C4BP. S. aureus-bound C4BP functions as a cofactor for factor I-mediated C4b cleavage to iC4b and C4d. In the absence of factor I, C4BP decreases classical pathway-mediated deposition of C3b on the S. aureus surface by inhibiting the classical pathway C3-convertase. In summary, C4BP is recruited to the S. aureus surface where it functions to inhibit C4 complement effectors, suggesting a previously undescribed immune evasion strategy for this pathogen. © 2012 Elsevier Ltd.


Sharp J.A.,Eastern Virginia Medical School | Echague C.G.,Eastern Virginia Medical School | Hair P.S.,Eastern Virginia Medical School | Ward M.D.,Eastern Virginia Medical School | And 6 more authors.
PLoS ONE | Year: 2012

Similar to other highly successful invasive bacterial pathogens, Staphylococcus aureus recruits the complement regulatory protein factor H (fH) to its surface to inhibit the alternative pathway of complement. Here, we report the identification of the surface-associated protein SdrE as a fH-binding protein using purified fH overlay of S. aureus fractionated cell wall proteins and fH cross-linking to S. aureus followed by mass spectrometry. Studies using recombinant SdrE revealed that rSdrE bound significant fH whether from serum or as a purified form, in both a time- and dose-dependent manner. Furthermore, rSdrE-bound fH exhibited cofactor functionality for factor I (fI)-mediated cleavage of C3b to iC3b which correlated positively with increasing amounts of fH. Expression of SdrE on the surface of the surrogate bacterium Lactococcus lactis enhanced recruitment of fH which resulted in increased iC3b generation. Moreover, surface expression of SdrE led to a reduction in C3-fragment deposition, less C5a generation, and reduced killing by polymorphonuclear cells. Thus, we report the first identification of a S. aureus protein associated with the staphylococcal surface that binds factor H as an immune evasion mechanism. © 2012 Sharp et al.


Segna K.G.,Eastern Virginia Medical School | Koch L.H.,Eastern Virginia Medical School | Williams J.V.,Childrens Specialty Group
Pediatric Dermatology | Year: 2011

Pseudomonas aeruginosa is common cause of folliculitis following contact with contaminated water. We report a case of pseudomonal folliculitis that occurred after swimming in a children's pool filled with water from a well. © 2011 Wiley Periodicals, Inc.

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