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Editorial
Earth: The planet of the annexins
La Tierra: el planeta de las anexinas
José Martínez-Gonzáleza,b,c,
Corresponding author
jose.martinez@iibb.csic.es

Corresponding author.
, Irene Corralesd,e
a Instituto de Investigaciones Biomédicas de Barcelona-Consejo Superior de Investigaciones Científicas (IIBB-CSIC), Barcelona, Spain
b CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
c Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain
d Laboratorio de Coagulopatías Congénitas, Banc de Sang i Teixits (BST), Barcelona, Spain
e Vall d'Hebron Institut de Recerca-Universitat Autònoma de Barcelona (VHIR-UAB), Barcelona, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Annexins are a protein superfamily evolutionarily retained and widely extended in nature&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Hundreds of these proteins are virtually present in living beings from the five kingdoms&#44; from complex multicellular eukaryotes to unicellular eukaryotes and different forms of prokaryotes&#46; They are classified into five categories&#58; annexin A &#40;in vertebrates&#41;&#44; annexin B &#40;in invertebrates&#41;&#44; annexin C &#40;in fungi&#41;&#44; annexin D &#40;in plants&#41; and annexin E &#40;in prokaryotes&#41;&#46; The first annexins were discovered at the end of the 1970&#8217;s and the beginning of the 1980&#8217;s by groups who were researching scaffolding-involved proteins that were bound to membranes and other proteins&#46; The two essential characteristics that define annexins are their ability to bind to Ca2&#43;-dependent phospholipids and the presence of their C-terminal domain end characteristic of some 70 aminoacid repeat sequences&#46; The N-terminal domain&#44; which is less preserved&#44; is thought to be the component which evolves faster and is responsible for the variety of functions of these proteins&#46; Their function is closely linked to their capacity to dynamically and reversibly bind to cellular membranes&#44; which they stabilize&#44; promoting interactions in cytoplasmic membrane and Ca2&#43;-regulated endocytic and exocytic processes&#46; Although most annexins are cytoplasmic&#44; there are nuclear forms and some which are relevant at cardiovascular level located on the cellular surface area where they act as co-receptors or are secreted and circulate through the blood stream&#46; Twelve annexins &#40;Anx&#41; have been identified in human beings with a highly varied tissue expression and distribution pattern&#44; that is called AnxA1 to AnxA13 &#40;to date no gene has been allocated to AnxA12&#41;&#46; The fact that deficient animal models in some of them were perfectly viable suggested that at first they could be highly redundant&#46; However&#44; posterior investigation has revealed a high level of specialisation that we are only just beginning to understand&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Due to their great variety and versatility they become essential components of multiple biological processes&#44; such as the organisation and repair of membranes&#44; vesicular traffic and subcellular traffic&#44; calcium metabolism&#44; proliferation&#44; differentiation&#44; apoptosis&#44; adhesion&#44; migration and invasion&#46; Their common involvement in several human pathologies has led to the coining of the term &#8220;&#8216;annexinopathies&#8217;&#8217; to refer to diseases where the function of annexin levels have been altered&#46; In recent years a large number of publications has familiarized us with the annexins involved in highly prevalent diseases such as cardiovascular diseases&#44; diabetes&#44; obesity&#44; autoimmune diseases&#44; cancer and infections&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#8211;6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In this issue of <span class="elsevierStyleItalic">Clin&#46; Invest&#46; Arterioscler</span>&#46;&#44; M&#233;ndez-Barbero et al&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> present an exhaustive review of the biology of annexins which is mainly focused on their impact in inflammation and other key mechanisms in the vascular remodelling associated with atherosclerosis&#46; Mention is also made of their vital role in cellular membranes and in vesicular traffic that converts them into essential elements in the control of intracellular cholesterol homeostatic&#46; Several annexins&#44; such as A1&#44; A2&#44; A6 and A8 have effectively been involved in the cellular transport of cholesterol through the endocytic pathway&#44; especially at late endosome level&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Out of them all it is AnxA6 that appears to play the most important role in the control of cholesterol distribution in intracellular compartments&#46; On regulating membrane cholesterol content the annexins interfere with SNARE &#40;<span class="elsevierStyleItalic">Soluble N-ethylmaleimide-sensitive fusion-Attachment protein &#91;SNAP&#93; Receptors</span>&#41; proteins&#44; a group of membrane proteins which are cholesterol-dependent that aid the fusion and traffic of vesicles responsible for transporting the molecules that are required for cell functioning&#46; The article reviews published findings from the last two decades on annexins and atherosclerosis&#44; focusing mainly on annexins A1&#44; A2&#44; A3&#44; A5 and A7&#46; AnxA1 is notable as an anti-inflammatory molecule through glucocorticoids regulation and innate immune response activation&#46; This annexin reduces the attachment of neutrophils to the vascular endothelium and increases apoptosis&#44; whilst inducing recruitment and differentiation of monocytes to anti-inflammatory phenotypes&#44; effects that would explain its antiatherogenic activity&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> The expression of AnxA1 increases in carotid platelets of asymptomatic patients&#44; and in experimental atherosclerosis models the administration of a peptide derived from this protein reduces the progression of atherosclerosis and stabilises the platelets&#44; highlighting its role in atherosclerosis and its therapeutic potential&#46; In fact&#44; as our knowledge of AnxA1 increases so does the revelation of its multifaceted nature&#46; AnxA1 has recently been related to the aggregation of extracellular vesicles and vascular calcification<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&#59; at platelet level thrombin signalling is suppressed&#44; activation of the CIIbB3 receptor is reduced and through selective modification of determinant of the surface area &#40;e&#46;g&#46; phosphatidylserene&#41; it promotes the phagocytosis of the platelets through neutrophils&#44; thus triggering active resolution&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> All these mechanisms are important in atherotrombosis&#46; The &#8216;&#8216;dialogue&#8217;&#8217; between the ABCA1 cholesterol transporter and AnxA1&#44; the expression of which is regulated by ApoAI&#44; could also contribute to its atheroprotector role&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> Thus the results from a recent animal test and patient study suggest that AnxA1 regulates the lipid metabolism and improves the progression of diabetic nephropathy&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> AnxA2 is unique in its interaction with a S100 protein &#40;protein p11&#41;&#44; thanks to which it acts as a plasminogen receptor and tissue activator of plasminogen &#40;tPA&#41;&#44; playing a relevant role in fibrinolysis<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> and modulating the thrombotic effect of tPA&#46;5 These activities of AnxA2 suggest they could reduce the hypercoagulability of the blood and thereby modulate atherothrombosis&#46; Furthermore&#44; its expression in macrophages and smooth vascular muscles cells &#40;SVMC&#41; is linked with the migration of these in atherosclerosis and restenosis&#44; and their interaction with C5 integrin with inflammatory response&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> Last but not least is their interaction with the protein convertase subtilisin&#47;kexin type NF-KB &#40;PCSK9&#41;&#44; which it inhibits&#44; acting as an endogenous modulator&#44; participating in one of the main regulation mechanisms of LDL circulating levels&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> In the most highly studied annexin group and on which there is greater proof that links those with vascular biology AnxA5 also plays a part&#46; This annexin is secreted and circulates in the blood stream&#46; Its ability to bind to phosfatidylserine from the cellular membrane confers it with antithrombotic&#44; antiapoptotic and anti-inflammatory properties and has made it an essential tool for analysing cell death and in molecular imaging studies&#44; for detecting high risk platelets&#46; AnxA5 regulates the polarisation of macrophages<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> and appears to intervene mainly in the initial phases of atherogenesis&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> In different preclinical models the administration of a recombinant protein reduces adhesion of leukocytes and macrophages and has been able to reduce the development of atherosclerotic lesions and make them more stable&#46; It also reduces inflammation and myocardial damage in models of ischemia-reperfusion injury&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> In patients&#44; the circulating levels of AnxA5 have been inversely related with the severity of coronary stenosis&#44; for which the oxLDL&#47;AnxA5 ratio appears to be a better marker than LDL circulating levels&#46; These and other results in the M&#233;ndez-Barbero and col&#46; Review make AnxA5 into one of the most interesting annexins as a biomarker and prospective treatment for atherosclerosis and its complications&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Although the annexins mentioned up until now are those that have been most credibly involved with some of the mechanisms involved at the onset&#44; progression and clinical complication of atherosclerosis&#44; others appear to also play a major role on a cardiovascular level&#46; We should not fail to mention AnxA3 for its involvement in angiogenesis and because its silencing promotes the repair of myocardial infarction4 and salvages SVMC function in intracranial aneurisms&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> Finally&#44; the important role of AnxA7 in Ca2&#43; homeostasis is particularly noteworthy in cardiac conditions such as auricular fibrillation&#44; ventricular tachycardia&#44; arrhythmias and cardiac remodelling&#46; Its inhibition also reduces the size of&#44; atherosclerotic lesions and stabilizes them&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> The abundance of experimental evidence supporting the potential of annexins as therapeutic targets is increasing day by day&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">To sum up&#44; in what is now over 40 years since the first annexins were described&#44; we have learned much about the complex biology of these proteins&#44; about their huge functional variety and their potential as therapeutic targets&#46; This explains the huge interest these proteins have given rise to in the international scientific community&#46; It is such that the advances in this field are reviewed and discussed periodically in specific congresses&#44; such as the biennial International <span class="elsevierStyleItalic">Conference on Annexins</span>&#44; which&#44; following a forced absence due to COVID-19&#44; will again be celebrated in Stockholm in June in 2022 and this will be its 11th edition&#46; This series of conferences has been key to the dissemination and promotion of the intense biomedical research that has been undertaken around these proteins&#46; The near future will undoubtedly favour us with surprising novelties on this singular family of proteins&#46; We hope that the M&#233;ndez-Barbero and col&#46; review stimulates interest in annexins among the readers of <span class="elsevierStyleItalic">Clin&#46; Invest&#46; Arterioscler&#46;</span> and in general among all those interested in this positively translational research&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Mart&#237;nez-Gonz&#225;lez J&#44; Corrales I&#46; La Tierra&#58; el planeta de las anexinas&#46; Clin Investig Arterioscler&#46; 2021&#59;33&#58;195&#8211;197&#46;</p>"
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