Lu Gao

St George Hospital, Sydney, New South Wales, Australia

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Publications (2)16.17 Total impact

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    ABSTRACT: Factor XI (FXI), a disulfide-linked covalent homodimer, circulates in plasma, and upon activation initiates the intrinsic/consolidation phase of coagulation. We present evidence that disulfide bonds in FXI are reduced to free thiols by oxidoreductases thioredoxin-1 (TRX-1) and protein disulfide isomerase (PDI). We identified that Cys362-Cys482 and Cys118-Cys147 disulfide bonds are reduced by TRX-1. The activation of TRX-1-treated FXI by thrombin, FXIIa or FXIa was significantly increased compared to non-reduced FXI, indicating that the reduced factor is more efficiently activated than the oxidized protein. Using a novel ELISA system, we compared the amount of reduced FXI in antiphospholipid syndrome (APS) thrombosis patients with levels in healthy controls, and found that APS patients have higher levels of reduced FXI. This may have implication for understanding the contribution of FXI to APS thrombosis, and the predisposition to thrombosis in patients with elevated plasma levels of reduced FXI.
    Journal of Autoimmunity 06/2012; 39(3):121-9. DOI:10.1016/j.jaut.2012.05.005 · 8.41 Impact Factor
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    ABSTRACT: Beta-2-glycoprotein I (β2 GPI) constitutes the major autoantigen in the antiphospholipid syndrome (APS), a common acquired cause of arterial and venous thrombosis. We recently described the novel observation that β2 GPI may exist in healthy individuals in a free thiol (biochemically reduced) form. The present study was undertaken to quantify the levels of total, reduced, and posttranslationally modified oxidized β2 GPI in APS patients compared to various control groups. In a retrospective multicenter analysis, the proportion of β2 GPI with free thiols in serum from healthy volunteers was quantified. Assays for measurement of reduced as well as total circulating β2 GPI were developed and tested in the following groups: APS (with thrombosis) (n=139), autoimmune disease with or without persistent antiphospholipid antibodies (aPL) but without APS (n=188), vascular thrombosis without APS or aPL (n=38), and healthy volunteers (n=91). Total β2 GPI was significantly elevated in patients with APS (median 216.2 μg/ml [interquartile range 173.3-263.8]) as compared to healthy subjects (median 178.4 μg/ml [interquartile range 149.4-227.5] [P<0.0002]) or control patients with autoimmune disease or vascular thrombosis (both P<0.0001). The proportion of total β2 GPI in an oxidized form (i.e., lacking free thiols) was significantly greater in the APS group than in each of the 3 control groups (all P<0.0001). This large retrospective multicenter study shows that posttranslational modification of β2 GPI via thiol-exchange reactions is a highly specific phenomenon in the setting of APS thrombosis. Quantification of posttranslational modifications of β2 GPI in conjunction with standard laboratory tests for APS may offer the potential to more accurately predict the risk of occurrence of a thrombotic event in the setting of APS.
    Arthritis & Rheumatology 09/2011; 63(9):2774-82. DOI:10.1002/art.30383 · 7.76 Impact Factor