Heterogeneous Expression of OLFM4 in Neutrophils and Plasma
Authors: Clemmensen Stine N. , Heebøll Sara , Koch Claus , Borregaard Niels 
Published: October 2019

Abstract
Introduction: Olfactomedin 4 (OLFM4) is a glycoprotein predominantly expressed in myeloid cells and in gastrointestinal tissues. OLFM4 is stored in specific granules of human neutrophils where it defines a subset of neutrophils ranging from 5-40% OLFM4 positive neutrophils. OLFM4 has been proposed to inhibit cathepsin C, a cysteine protease essential for activation of serine proteases. Elevated levels of OLFM4 has been seen primary myelofibrosis (PMF) patients, these patients furthermore display a significantly elevated serum OLFM4.
Methods: We developed monoclonal antibodies against OLFM4 and established an Enzyme Linked Immunosorbent Assay for OLFM4 for further investigation of OLFM4 in myeloid cells.
Results: We observed two populations of individuals with respect to OLFM4 levels in plasma, the majority with OLFM4 in plasma between 0 and 0.1 μg/mL, mean 0.028 μg/mL while approximately 10% had OLFM4 between 4 and 60 μg/mL, mean 15 μg/mL. The levels were constant over time.
The level did not relate to the size of the OLFM4 positive neutrophil subset detected in peripheral blood. We studied the biosynthesis of OLFM4 in isolated bone marrow cells from an individual with high plasma OLFM4 and an individual with low plasma OLFM4. The levels of OLFM4 mRNA were comparable and the amounts of OLFM4 synthesized and retained in cells were similar between the two individuals. We next determined whether OLFM4 might be produced by bone marrow cells and released into bone marrow plasma. Corresponding levels of OLFM4 determined in bone marrow plasma and blood plasma from two persons with high levels of OLFM4 showed lower levels in bone marrow plasma than in blood plasma, arguing against bone marrow as the direct source of OLFM4 in plasma.
To estimate the amount of OLFM4 generated daily during myelopoiesis, we quantitated the amount of OLFM4 in neutrophils from 3 sets of buffy coat neutrophils, each pooled from 4 healthy donors. The amount of OLFM4 was 1.2 μg/107 neutrophils. As the production of neutrophils is about 1 x 109 cells/kg body weight/day, this would indicate production of 10 mg OLFM4/day in an adult.
To rule out the liver as a production site, mRNA was determined by Affymetrix gene array in liver biopsies from 42 patients evaluated for liver steatosis. OLFM4 mRNA levels were uniformly at the border of detection in all (data not shown).
OLFM4 is secreted from PMA stimulated neutrophils in parallel with other specific granule proteins. When purified OLFM4 was added to medium from neutrophils induced to degranulate with PMA, the ability to detect OLFM4 was rapidly lost, indicating that OLFM4 is highly sensitive to proteolysis. Adding a cocktail of protease inhibitors to the material secreted from PMA activated neutrophils preserved OLFM4.
As we find that OLFM4 is highly sensitive to proteolysis we suggest that the differences in OLFM4 levels in plasma may be related to individual differences in the susceptibility of OLFM4 to escape degradation when neutrophils decease as part of their normal life cycle. Production of 10 mg OLFM4/day would support a plasma level of 3-4 µg/ml plasma depending of the half-life of OLFM4 in plasma. This hypothesis is not easily tested, but if proven correct, might open for novel insight into the fate of neutrophils after exiting circulation, an issue that is still a matter of debate.

Disclosures
No relevant conflicts of interest to declare.