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From www.bloodjournal.org by guest on August 1, 2017. For personal use only. 2994 CORRESPONDENCE criteria proposed by the Scientific Standardization Committee Subcommittee for Standardization of Lupus Anticoagulant.3 Anticardiolipin (aCLAb) and anti–b2-glycoprotein I (ab2GP1Ab) IgG antibodies had been tested using commercially available assays (Quanta Lite [Inova Diagnostics Inc, San Diego, CA] and Varelisa b2GP1 [Elias, Freiburg, Germany]). Antiprothrombin (aFIIAb) and anti-annexinV (aAnVAb) IgG antibodies had been assayed using enzyme-linked immunosorbent assay research kits (gift from J. Amiral, Diagnostica Stago, Asnières, France). All normal values were obtained using 200 control plasmas assuming that threshold values corresponded to the 99th percentiles. All patient plasmas were tested crude and after IgG depletion using protein A-sepharose. We systematically performed mixing studies using a 1:1 mixture of patient and normal plasma. Normal plasma has been prepared pooling the 200 control plasmas and was used crude (NP) or b2-glycoprotein I depleted after immunoaffinity chromatography (NPb2neg). We identified 42 patients with positive antiphospholipid antibodyrelated markers: 10 patients with an isolated LA (7 with a KCT-type LA and 3 with a dRVVT-type LA according to Galli et al1), 10 patients with isolated aCLAb (levels ranging from 25 to 68 GPL units, normal values lower than 14.5 GPL units), 10 patients with isolated ab2GP1Ab (levels ranging from 42 to 123 U/mL, normal values lower than 14.5 U/mL), 2 patients with isolated aFIIAb, and 10 patients with isolated aAnVAb (Table 1). We observed that plasmas with isolated positive ab2GP1Ab were the only ones to be associated with an acquired resistance to aPC, which disappeared in cases of IgG depletion. These plasmas generated resistance to aPC during mixing studies and the intensity of the inhibitory activity depended on the b2-glycoprotein I content of the normal plasma. We thereafter supplemented NP and NP-b2neg with IgG purified from plasmas with isolated positive anti–b2-glycoprotein I IgG antibodies (3:1; IgG concentration, 10 mg/mL in Tris-buffered saline). An acquired plasma resistance to aPC was induced only in the presence of plasma b2-glycoprotein I (median values and ranges of aPC-FV ratio: NP, 1.59 [1.19-1.88]; NP-b2neg, 2.22 [1.98-2.45]; P 5 .005; control values using IgG purified from normal plasma: NP, 2.30 [2.05-2.55], NP-b2neg, 2.28 [2.00-2.49]; nonsignificant). Thus, the modified aPC-resistance test, together with a mixing study performed in this test, can easily allow us to identify the acquired anticoagulant activity acting as an inhibitor of the aPC-mediated factor Va proteolysis. Concerning women with recurrent miscarriages positive for antiphospholipid antibody-related markers, only ab2GP1Ab is related with the impairment of the anti-factor V activity of aPC. This finding is concordant with data shown by Galli et al1 in their group of patients with mainly thrombotic antecedents. If acquired aPC resistance represents a pathogenic mechanism responsible for the clinical risk in a subgroup of antiphospholipidpositive patients, the modified aPC-resistance test should allow to identify plasmas positive for this peculiar anticoagulant activity. Eric Mercier Laboratoire d’Hématologie CHU Nı̂mes Nı̂mes, France Isabelle Quere Médecine Interne B et Maladies Vasculaires CHU, Montpellier Montpellier, France Pierre Mares Service de Gynécologie et Obstétrique CHU, Nı̂mes Nı̂mes, France Jean-Christophe Gris Laboratoire d’Hématologie Faculté de Pharmacie Montpellier, France REFERENCES 1. Galli M, Ruggeri L, Barbui T: Differential effects of anti–b2glycoprotein I and antiprothrombin antibodies on the anticoagulant activity of activated protein C. Blood 91:1999, 1998 2. Jorquera JI, Montoro JM, Fernandez MA, Aznar J: Modified test for activated protein C resistance. Lancet 344:1162, 1994 3. Brandt JT, Triplett DA, Alving B, Scharrer I: Criteria for the diagnosis of lupus anticoagulants: An update. Thromb Haemost 74:1185,1995 Antisense RNA Crossing Mitochondrial Membrane? To the Editor: In a recent article in Blood, Shirafuji et al1 report the isolation of a cDNA encoding an antisense RNA for subunit I of mitochondrial cytochrome c oxidase (MARCO). Expression of this cDNA in hematopoietic cell lines caused morphological changes and cell death. Although Shirafuji et al1 convincingly demonstrate that the antisense RNA induced these changes, we would take issue with the investigators on the suggested mechanism, namely interference with the corresponding mitochondrial gene transcript (COX I). Animal mitochondria represent a distinct cellular compartment that has its own mitochondrial DNA, encoding 13 proteins, including 3 subunits of cytochrome c oxidase. The mRNAs of the mitochondrial genes are translated on mitochondrial ribosomes. Whereas the protein components required for mitochondrial gene expression (polymerases, ribosomal proteins) are imported into mitochondria, all the necessary RNA components (transfer-RNAs, ribosomal RNAs) are encoded by the mitochondrial genome and are therefore not taken up from the cytoplasm.2 There is no indication of significant DNA or RNA uptake into mitochondria. Even for the nucleus-encoded small RNA components of two mitochondrial riboproteins (MRP-RNAse3 and RNAse P4) the import mechanism is unclear and may involve cotransport with the associated proteins. Nonspecific uptake of polynucleotides is unlikely, because the inner mitochondrial membrane is a nonpolar lipid bilayer with only a very limited permeability towards polar molecules. To support an antisense mechanism, the investigators would have to demonstrate that the MARCO-RNA actually crosses the mitochondrial membrane to interfere with the corresponding mitochondrial COX I gene transcript. Second, the investigators should have shown that other mitochondrial transcripts are not affected, because, otherwise, the reported reduction of the COX I mRNA could be interpreted as an unspecific feature associated with early stages of cell death. Finally, we would like to speculate on an alternative explanation for the findings of Shirafuji et al.1 Because all the mitochondrial genes encode very hydrophobic membrane proteins, they contain nucleotide sequences that are similar to a variety of other membrane spanning proteins. It is therefore conceivable that MARCO could affect the cytoplasmic translation of an important membrane protein that is located in the cytoplasm rather than in the mitochondria. Decreased expression of this protein may trigger cell death, with an associated early change in mitochondrial gene transcription. From www.bloodjournal.org by guest on August 1, 2017. For personal use only. CORRESPONDENCE 2995 Nevertheless, even the demonstration that mitochondrial (antisense) mRNAs can induce cell death when present in the cytoplasm might open new perspectives regarding the role of mitochondria in apoptosis. Götz Hofhaus Institut für Biochemie Norbert Gattermann Klinik für Hämatologie, Onkologie, und Klinische Immunologie Heinrich-Heine-Universität, Düsseldorf Düsseldorf, Germany José Antonio Enrı́quez Dpto. Bioquimica y Biologia Molecular y Celular Universidad de Zaragoza, Spain Zaragoza, Spain REFERENCES 1. Shirafuji N, Takahashi S, Matsuda S, Asano S: Mitochondrial antisense RNA for cytochrome c oxidase (MARCO) can induce morphological changes and cell death in human hematopoietic cell lines. Blood 90:4567, 1997 2. Attardi G, Schatz G: Biogenesis of mitochondria. Annu Rev Cell Biol 4:289, 1988 3. Chang DD, Clayton DA: A mammalian mitochondrial RNA processing activity contains nucleus-encoded RNA. Science 235:1178, 1987 4. Doersen C-J, Guerre-Takada C, Altman S, Attardi G: Characterization of an RNase P activity from HeLa cell mitochondria. Comparison with the cytosol RNase P activity. J Biol Chem 260:5942, 1985 Response I thank Dr Hofhaus for the interest in my study of expression cloning and characterization of MARCO (mitochondrial antisense RNA for cyto-c oxidase).1 He points out that it is doubtful that antisense RNA can cross mitochondrial membrane. It has been reported that tRNAs in the cytoplasm can cross mitochondrial membrane using their specific receptors, which can recognize specific nucleotide sequences and integrate tRNAs into mitochondria in accordance with ATP and TAS factor (sequence-specific RNA binding factor) or other cytoplasmic proteins.2 As I referred to in my report, small RNAs, including antisense RNAs, can also cross mitochondrial membrane with this mechanism.3,4 These receptors have been reported to recognize nucleotide sequence GAAA A/G G in Leishmania mitochondria system,4 GAAGGG, CGAGAGG, and CGAAGGG in trypanosomes and crithidia in 180 nt srRNA system,5 CGAGAG in 140 nt srRNA system,5 CGAATG in trypanosome 5S RNA system,6 and GGCAGAG and GGUAGAG in L tarentolae tRNA system.7 These observations have not been reported in the human mitochondria system; however, it is possible that also in the human system similar mechanisms work to integrate tRNAs and small RNAs into mitochondrial organella across mitochondrial membrane because of very high homology of mitochondrial nucleotide sequences beyond species specificity. The nucleotide sequence of MARCO contains three GAAAGG and one GGTAGAG.1 These sequences may be recognized by mitochondrial membrane receptor, and MARCO may be able to cross membrane. Also, it is not clear how large nucleotides can cross the mitochondrial membrane. It may be possible that, after MARCO is transcribed in the cytoplasm, partial digestion of RNA occurred, and small fragments of MARCO with receptor-recognized sequence can cross the mitochondrial membrane, as reported in the Kinetoplastid srRNA system in which cytoplasmic 28S rRNA precursor is processed posttranscriptionally.5 Otherwise, it may be possible that the entire MARCO RNA can cross mitochondrial membrane after binding to the receptor. Furthermore, as Dr Hofhaus points out, other mechanisms should be possible to induce cell death when MARCO is expressed in the cytoplasm. Thus, I agree with Dr Hofhaus that precise experiments are required to make clear the mechanism of the action of MARCO. Naoki Shirafuji Department of Hematology/Oncology The Institute of Medical Science The University of Tokyo Tokyo, Japan REFERENCES 1. Shirafuji N, Takahashi S, Matsuda S, Asano S: Mitochondrial antisense RNA for cytochrome c oxidase (MARCO) can induce morphologic changes and cell death in human hematopoietic cell lines. Blood 90:4567, 1997 2. Tarassov IA, Entelis NS: Mitochondrially-imported cytoplasmic tRNALys (CUU) of Saccharomyces cerevisiae: In vivo and in vitro targetting system. Nucleic Acids Res 20:1277, 1992 3. Ghosh A, Ghosh T, Ghosh S, Das S, Adhya A: Interaction of small ribosomal and transfer RNAs with a protein from Leishmania donovani. Nucleic Acids Res 22:1663, 1994 4. Mahapatra S, Ghosh T, Adhya S: Import of small RNAs into Leishmania mitochondria in vitro. Nucleic Acids Res 22:3381, 1994 5. White TC, Rudenko G, Borst P: Three small RNAs within the 10kb trypanosome rRNA transcription unit are analogous to domain VII of other eukaryotic 28S rRNAs. Nucleic Acids Res 14:9421, 1986 6. Lenardo MJ, Dorfman DM, Reddy LV, Donelson JE: Characterization of the Trypanosoma brucei 5S ribosomal RNA gene and transcript: The 5S rRNA is a spliced-leader-independent species. Gene 35:131, 1985 7. Lye LF, Chen DH, Suyama Y: Selective import of nuclearencoded tRNAs into mitochondria of the protozoan Leishmania tarentolae. Mol Biochem Parasitol 58:233, 1993 Magnetic Resonance Imaging in Myelofibrosis To the Editor: The recent review about magnetic resonance imaging (MRI) of the bone marrow in hematologic malignancies has suggested that MRI had little or no value in the evaluation of myelofibrosis (MF).1 Although MR findings did not also appear beneficial in the differential diagnosis of myelofibrosis, our data showed that MRI may have some importance in predicting the prognosis of this disorder. Thirteen patients with MF were evaluated (11 patients with primary MF and 2 patients with secondary MF) and diagnoses of MF were made according to previously defined criteria.2 Before the MR examination, bone marrow aspirates and biopsies from posterior iliac crest were From www.bloodjournal.org by guest on August 1, 2017. For personal use only. 1998 92: 2994-2995 Antisense RNA Crossing Mitochondrial Membrane? Götz Hofhaus, Norbert Gattermann and José Antonio Enri?quez Updated information and services can be found at: http://www.bloodjournal.org/content/92/8/2994.full.html Articles on similar topics can be found in the following Blood collections Information about reproducing this article in parts or in its entirety may be found online at: http://www.bloodjournal.org/site/misc/rights.xhtml#repub_requests Information about ordering reprints may be found online at: http://www.bloodjournal.org/site/misc/rights.xhtml#reprints Information about subscriptions and ASH membership may be found online at: http://www.bloodjournal.org/site/subscriptions/index.xhtml Blood (print ISSN 0006-4971, online ISSN 1528-0020), is published weekly by the American Society of Hematology, 2021 L St, NW, Suite 900, Washington DC 20036. Copyright 2011 by The American Society of Hematology; all rights reserved.