101
|
Liang W, Fan Y, Lu H, Chang Z, Hu W, Sun J, Wang H, Zhu T, Wang J, Adili R, Garcia-Barrio MT, Holinstat M, Eitzman D, Zhang J, Chen YE. KLF11 (Krüppel-Like Factor 11) Inhibits Arterial Thrombosis via Suppression of Tissue Factor in the Vascular Wall. Arterioscler Thromb Vasc Biol 2020; 39:402-412. [PMID: 30602303 DOI: 10.1161/atvbaha.118.311612] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Objective- Mutations in Krüppel like factor-11 ( KLF11), a gene also known as maturity-onset diabetes mellitus of the young type 7, contribute to the development of diabetes mellitus. KLF11 has anti-inflammatory effects in endothelial cells and beneficial effects on stroke. However, the function of KLF11 in the cardiovascular system is not fully unraveled. In this study, we investigated the role of KLF11 in vascular smooth muscle cell biology and arterial thrombosis. Approach and Results- Using a ferric chloride-induced thrombosis model, we found that the occlusion time was significantly reduced in conventional Klf11 knockout mice, whereas bone marrow transplantation could not rescue this phenotype, suggesting that vascular KLF11 is critical for inhibition of arterial thrombosis. We further demonstrated that vascular smooth muscle cell-specific Klf11 knockout mice also exhibited significantly reduced occlusion time. The expression of tissue factor (encoded by the F3 gene), a main initiator of the coagulation cascade, was increased in the artery of Klf11 knockout mice, as determined by real-time quantitative polymerase chain reaction and immunofluorescence. Furthermore, vascular smooth muscle cells isolated from Klf11 knockout mouse aortas showed increased tissue factor expression, which was rescued by KLF11 overexpression. In human aortic smooth muscle cells, small interfering RNA-mediated knockdown of KLF11 increased tissue factor expression. Consistent results were observed on adenovirus-mediated overexpression of KLF11. Mechanistically, KLF11 downregulates F3 at the transcriptional level as determined by reporter and chromatin immunoprecipitation assays. Conclusions- Our data demonstrate that KLF11 is a novel transcriptional suppressor of F3 in vascular smooth muscle cells, constituting a potential molecular target for inhibition of arterial thrombosis.
Collapse
Affiliation(s)
- Wenying Liang
- From the Department of Internal Medicine, Cardiovascular Center, University of Michigan Medical Center, Ann Arbor (W.L., Y.F., H.L., Z.C., W.H., J.S., H.W., T.Z., J.W., M.T.G.-B., D.E., J.Z., Y.E.C.)
| | - Yanbo Fan
- From the Department of Internal Medicine, Cardiovascular Center, University of Michigan Medical Center, Ann Arbor (W.L., Y.F., H.L., Z.C., W.H., J.S., H.W., T.Z., J.W., M.T.G.-B., D.E., J.Z., Y.E.C.)
| | - Haocheng Lu
- From the Department of Internal Medicine, Cardiovascular Center, University of Michigan Medical Center, Ann Arbor (W.L., Y.F., H.L., Z.C., W.H., J.S., H.W., T.Z., J.W., M.T.G.-B., D.E., J.Z., Y.E.C.)
| | - Ziyi Chang
- From the Department of Internal Medicine, Cardiovascular Center, University of Michigan Medical Center, Ann Arbor (W.L., Y.F., H.L., Z.C., W.H., J.S., H.W., T.Z., J.W., M.T.G.-B., D.E., J.Z., Y.E.C.)
| | - Wenting Hu
- From the Department of Internal Medicine, Cardiovascular Center, University of Michigan Medical Center, Ann Arbor (W.L., Y.F., H.L., Z.C., W.H., J.S., H.W., T.Z., J.W., M.T.G.-B., D.E., J.Z., Y.E.C.)
| | - Jinjian Sun
- From the Department of Internal Medicine, Cardiovascular Center, University of Michigan Medical Center, Ann Arbor (W.L., Y.F., H.L., Z.C., W.H., J.S., H.W., T.Z., J.W., M.T.G.-B., D.E., J.Z., Y.E.C.)
| | - Huilun Wang
- From the Department of Internal Medicine, Cardiovascular Center, University of Michigan Medical Center, Ann Arbor (W.L., Y.F., H.L., Z.C., W.H., J.S., H.W., T.Z., J.W., M.T.G.-B., D.E., J.Z., Y.E.C.)
| | - Tianqing Zhu
- From the Department of Internal Medicine, Cardiovascular Center, University of Michigan Medical Center, Ann Arbor (W.L., Y.F., H.L., Z.C., W.H., J.S., H.W., T.Z., J.W., M.T.G.-B., D.E., J.Z., Y.E.C.)
| | - Jintao Wang
- From the Department of Internal Medicine, Cardiovascular Center, University of Michigan Medical Center, Ann Arbor (W.L., Y.F., H.L., Z.C., W.H., J.S., H.W., T.Z., J.W., M.T.G.-B., D.E., J.Z., Y.E.C.)
| | - Reheman Adili
- Department of Pharmacology, University of Michigan, Ann Arbor (R.A., M.H.)
| | - Minerva T Garcia-Barrio
- From the Department of Internal Medicine, Cardiovascular Center, University of Michigan Medical Center, Ann Arbor (W.L., Y.F., H.L., Z.C., W.H., J.S., H.W., T.Z., J.W., M.T.G.-B., D.E., J.Z., Y.E.C.)
| | - Michael Holinstat
- Department of Pharmacology, University of Michigan, Ann Arbor (R.A., M.H.)
| | - Daniel Eitzman
- From the Department of Internal Medicine, Cardiovascular Center, University of Michigan Medical Center, Ann Arbor (W.L., Y.F., H.L., Z.C., W.H., J.S., H.W., T.Z., J.W., M.T.G.-B., D.E., J.Z., Y.E.C.)
| | - Jifeng Zhang
- From the Department of Internal Medicine, Cardiovascular Center, University of Michigan Medical Center, Ann Arbor (W.L., Y.F., H.L., Z.C., W.H., J.S., H.W., T.Z., J.W., M.T.G.-B., D.E., J.Z., Y.E.C.)
| | - Y Eugene Chen
- From the Department of Internal Medicine, Cardiovascular Center, University of Michigan Medical Center, Ann Arbor (W.L., Y.F., H.L., Z.C., W.H., J.S., H.W., T.Z., J.W., M.T.G.-B., D.E., J.Z., Y.E.C.)
| |
Collapse
|
102
|
Role of surgeon intuition and computer-aided design in Fontan optimization: A computational fluid dynamics simulation study. J Thorac Cardiovasc Surg 2020; 160:203-212.e2. [PMID: 32057454 DOI: 10.1016/j.jtcvs.2019.12.068] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/27/2019] [Accepted: 12/13/2019] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Customized Fontan designs, generated by computer-aided design (CAD) and optimized by computational fluid dynamics simulations, can lead to novel, patient-specific Fontan conduits unconstrained by off-the-shelf grafts. The relative contributions of both surgical expertise and CAD to Fontan optimization have not been addressed. In this study, we assessed hemodynamic performance of Fontans designed by both surgeon's unconstrained modeling (SUM) and by CAD. METHODS Ten cardiac magnetic resonance imaging datasets were used to create 3-dimensional (3D) models of Fontans. Baseline computational fluid dynamics simulations assessed Fontan indexed power loss (iPL), hepatic flow distribution, and percentage of conduit surface area with abnormally low wall shear stress for venous flow (<1 dyne/cm2). Fontans not meeting thresholds were redesigned using 2 methods: SUM (ie, original venous anatomy without the Fontan was 3D printed and sent to surgeon for Fontan redesign with clay modeling) and CAD (ie, the same 3D geometry was sent to engineers for iterative Fontan redesign guided by computational fluid dynamics). Both groups were blinded to each other's results. RESULTS Eight Fontans were redesigned by SUM and CAD methods. Both SUM and CAD redesigns met iPL thresholds. SUM had lower iPL, whereas CAD demonstrated balanced hepatic flow distribution and lower wall shear stress percentage. Wall shear stress percentage shared an inverse relationship with iPL, preventing oversized Fontan designs. CONCLUSIONS Customized Fontan conduits with low iPL can be created by either a surgeon or CAD. CAD can also improve hepatic flow distribution and prevent oversized Fontan designs. Future studies should investigate workflows that combine SUM and CAD to optimize Fontan conduits.
Collapse
|
103
|
Tang Z, Kattula S, Holle LA, Cooley BC, Lin F, Wolberg AS. Factor XIII deficiency does not prevent FeCl 3-induced carotid artery thrombus formation in mice. Res Pract Thromb Haemost 2020; 4:111-116. [PMID: 31989092 PMCID: PMC6971319 DOI: 10.1002/rth2.12278] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 10/04/2019] [Accepted: 10/13/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The compositions of venous (red blood cell-rich) and arterial (platelet-rich) thrombi are mediated by distinct pathophysiologic processes; however, fibrin is a major structural component of both. The transglutaminase factor XIII (FXIII) stabilizes fibrin against mechanical and biochemical disruption and promotes red blood cell retention in contracted venous thrombi. Previous studies have shown factor XIII (FXIII) inhibition decreases whole blood clot mass and therefore, may be a therapeutic target for reducing venous thrombosis. The role of FXIII in arterial thrombogenesis is less studied, and the particular contribution of platelet FXIII remains unresolved. OBJECTIVE To determine whether FXIII reduction prevents experimental arterial thrombogenesis. METHODS Using wild-type mice and mice with genetically imposed deficiency in FXIII, we measured thrombus formation and stability following ferric chloride-induced arterial thrombosis. We also determined the impact of FXIII on the mass of contracted platelet-rich plasma clots. RESULTS Following vessel injury, F13a+/+ , F13a+/- , and F13a-/- mice developed occlusive arterial thrombi. FXIII deficiency did not significantly reduce the incidence or prolong the time to occlusion. FXIII deficiency also did not alter the timing of reflow events or decrease platelet-rich clot mass. CONCLUSIONS FXIII does not significantly alter the underlying pathophysiology of experimental arterial thrombus formation.
Collapse
Affiliation(s)
- Zhaoming Tang
- Department of Pathology and Laboratory MedicineUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Sravya Kattula
- Department of Pathology and Laboratory MedicineUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Lori A. Holle
- Department of Pathology and Laboratory MedicineUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Brian C. Cooley
- Department of Pathology and Laboratory MedicineUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Feng‐Chang Lin
- Department of Biostatistics and North Carolina Translational and Clinical Sciences InstituteUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Alisa S. Wolberg
- Department of Pathology and Laboratory MedicineUniversity of North Carolina at Chapel HillChapel HillNCUSA
| |
Collapse
|
104
|
|
105
|
SARS-CoV-2 and venous thromboembolic disease. Not everything is new. ANGIOLOGIA 2020. [DOI: 10.20960/angiologia.00173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
|
106
|
Khine K, Toor A, Khalighi K, Krishnamurthy M. Incidental descending thoracic aortic thrombus: the conundrum of medical versus surgical therapy. J Community Hosp Intern Med Perspect 2019; 9:491-494. [PMID: 32002156 PMCID: PMC6968514 DOI: 10.1080/20009666.2019.1684230] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 09/16/2019] [Indexed: 02/08/2023] Open
Abstract
Background: A mural thrombus in the descending thoracic aorta frequently leads to distal organ and acute limb ischemia, increasing overall morbidity and mortality. Early diagnosis is imperative as thrombi are usually discovered after end organ damage has taken place. The formation of a mural thrombus in descending aorta has not been fully explained; however, the principle of Virchow's triad for thrombogenesis (hypercoagulability, stasis of blood flow and endothelial injury) remains the likely pathophysiologic mechanism. Case Presentation: We present a case of a descending aortic thrombus incidentally detected on computed tomography scan in a 65-year-old female and successfully treated with anticoagulation, preventing subsequent complications. Conclusions: Suspicion for an aortic thrombus should arise when the origin is not known for acute onset distal limb or organ ischemia.
Collapse
Affiliation(s)
- Kay Khine
- Department of Internal Medicine, Easton Hospital, Easton, PA, USA
| | - Amit Toor
- Department of Internal Medicine, Easton Hospital, Easton, PA, USA
| | | | | |
Collapse
|
107
|
Gentile C, Stein L, Dhamoon MS. Alcohol-Related Hospital Encounters Trigger Thrombotic and Hemorrhagic Vascular Events. J Stroke Cerebrovasc Dis 2019; 28:104395. [PMID: 31540781 DOI: 10.1016/j.jstrokecerebrovasdis.2019.104395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 09/04/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND AND PURPOSE We investigated the associations between alcohol-related emergency department visits and hospitalizations and vascular events including acute ischemic stroke, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage. METHODS The New York State Inpatient and Emergency Department Databases were examined (2006-2013). Validated International Classification of Diseases 9th edition definitions identified index vascular hospitalizations and alcohol abuse encounters. We used case cross-over analysis with conditional logistic regression to estimate odds ratios (OR) for the association between alcohol-related encounters during 6 case periods (7, 14, 30, 60, 90, and 120 days before index event) compared to control periods (1 year before). Multivariate logistic regression was used to examine the association between an alcohol-related encounter within 6 months before index admission and 30-day readmission after discharge. RESULTS An alcohol encounter before index admission was associated with acute ischemic stroke (OR = 1.765 within 60 days, 1.418 within 90 days, and 1.287 within 120 days) and subarachnoid hemorrhage (OR = 2.375 within 90 days), but not ICH. Alcohol-related encounters within 6 months before index vascular events increased the likelihood of 30-day readmission after index admission. CONCLUSION We found that a recent alcohol-related counter was associated with occurrence of vascular events, but not ICH, as well as worse outcomes after index admission.
Collapse
Affiliation(s)
- Caroline Gentile
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Laura Stein
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Mandip S Dhamoon
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York.
| |
Collapse
|
108
|
Acute Occlusion of Descending Thoracic Aorta. Ann Vasc Surg 2019; 60:477.e15-477.e19. [DOI: 10.1016/j.avsg.2019.03.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 02/24/2019] [Accepted: 03/01/2019] [Indexed: 11/19/2022]
|
109
|
Venous thromboembolism risk for the contemporary bariatric surgeon. Surg Endosc 2019; 34:3521-3526. [PMID: 31559578 DOI: 10.1007/s00464-019-07134-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 09/17/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Postoperative venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), are the leading causes of morbidity and mortality after bariatric surgery. Although several studies have examined VTE, few have examined risk factors separately for DVT and PE after contemporary bariatric surgery, including laparoscopic sleeve gastrectomy (LSG). Our objective was to define risk factors for DVT and PE independently for both LSG and laparoscopic Roux-en-Y gastric bypass (LRYGB) patients using the largest validated bariatric surgery database. METHODS The metabolic and bariatric surgery accreditation and quality improvement program (MBSAQIP) database was queried to identify patients who underwent LSG or LRYGB between January 2015 and December 2017. Perioperative data were compared using bivariate analysis. Risk of DVT and PE after LSG or LRYGB was determined using multivariable logistic regression analysis. RESULTS During the study period, 369,032 bariatric cases (72% LSG, 28% LRYGB) were performed. The incidence of DVT was similar between LSG and LRYGB (0.2% vs. 0.2%, p = 0.96), while the incidence of PE was decreased for LSG compared to LRYGB (0.1% vs. 0.2%, p < 0.001). Operative length was associated with increased risk of postoperative DVT (OR 1.1, CI 1.01-1.30, p = 0.04) and postoperative PE (OR 1.4, CI 1.16-1.64, p < 0.001) after surgery. The largest independent risk factors for DVT were history of DVT (OR 6.2, CI 4.44-8.45, p < 0.001) and transfusion (OR 4.2, CI 2.48-6.63, p < 0.001). The largest independent risk factors for PE were transfusion (OR 5.0, CI 2.69-8.36, p < 0.001) and history of DVT (OR 2.8, CI 1.67-4.58, p < 0.001). LSG was associated with a decreased risk of PE compared to LRYGB (OR 0.7 CI 0.55-0.91, p = 0.01). CONCLUSIONS Prolonged operative length is associated with a higher risk of DVT and PE after either LSG or LRYGB. Transfusion and history of DVT are the largest risk factors for developing DVT and PE. There is a decreased risk of PE after LSG compared to LRYGB.
Collapse
|
110
|
Okazaki M, Oyama K, Kinoshita J, Miyashita T, Tajima H, Takamura H, Ninomiya I, Fushida S, Ohta T. Incidence of and risk factors for totally implantable vascular access device complications in patients with gastric cancer: A retrospective analysis. Mol Clin Oncol 2019; 11:343-348. [PMID: 31475061 PMCID: PMC6713938 DOI: 10.3892/mco.2019.1897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 06/27/2019] [Indexed: 01/17/2023] Open
Abstract
Totally implantable vascular access devices (TIVADs) are often used to administer chemotherapy by prolonged intravenous infusion. The objective of the present study was to investigate the incidence of long-term complications and identify risk factors associated with TIVAD placement in patients with gastric cancer. A total of 121 patients with gastric cancer who had undergone 150 TIVAD placement procedures for chemotherapy or supportive care were enrolled in the present retrospective cohort study. A number of risk factors were analyzed, including age, sex, hypertension, diabetes mellitus, history of thrombosis, body mass index, disease stage, and site and purpose of TIVAD. In total, 40 TIVADs (26.7%) developed long-term complications, of which 27 (18.0%) were infections, seven (4.7%) were catheter-related deep vein thrombosis (CR-DVT), and six (4.0%) were obstructions. Chemotherapy was associated with an increased rate of infectious adverse events (odds ratio 2.925; 95% CI, 1.104-7.750; P=0.031) according to the multivariate analysis. CR-DVT occurred more frequently in upper arm ports than in chest wall ports; however, this difference was not statistically significant (7.5 vs. 0.0%; P=0.084) according to the univariable analysis. All CR-DVTs developed in the upper arm sites. Chemotherapy and the upper arm site were associated with long-term complications in patients with TIVAD. However, further studies are needed to confirm the findings of the present study and to determine the reasons for the high incidence of long-term complications in these patients.
Collapse
Affiliation(s)
- Mitsuyoshi Okazaki
- Department of Gastroenterological Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Katsunobu Oyama
- Department of Gastroenterological Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Jun Kinoshita
- Department of Gastroenterological Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Tomoharu Miyashita
- Department of Gastroenterological Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Hidehiro Tajima
- Department of Gastroenterological Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Hiroyuki Takamura
- Department of Gastroenterological Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Itasu Ninomiya
- Department of Gastroenterological Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Sachio Fushida
- Department of Gastroenterological Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| | - Tetsuo Ohta
- Department of Gastroenterological Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan
| |
Collapse
|
111
|
Su YC, Hsu CH. Occurrence of complete heart block associated with acute renal infarction. Ann Noninvasive Electrocardiol 2019; 24:e12674. [PMID: 31353782 DOI: 10.1111/anec.12674] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 06/25/2019] [Indexed: 11/29/2022] Open
Abstract
Complete heart block (CHB) and acute renal infarction (ARI) are both uncommon diseases and seldom encountered in the clinical practice. We describe a rare case of pre-existing left bundle branch block, presenting simultaneously with CHB and ARI. The possible mechanism depends on prior presence of either CHB or ARI. If ARI occurs first, severe pain and embolism may enhance the vagal tone resulting in decrease in the heart rate and transient intraventricular conduction interruption, which subsequently causes CHB. The opposite scenario, CHB preceding ARI, is also possible. CHB can be physiologic and transient, with higher risk of development in the circumstance of pre-existing conduction system disturbances. Patients with CHB are predisposed to formation of thrombi and thromboemboli, giving rise to ARI. In conclusion, awareness and timely identification of the clinical manifestations of these two diseases may facilitate early diagnosis and prompt management.
Collapse
Affiliation(s)
- Yi-Ching Su
- Department of Family Medicine, Cardinal Tien Hospital, New Taipei, Taiwan
| | - Chun-Hsien Hsu
- Department of Family Medicine, Cardinal Tien Hospital, New Taipei, Taiwan.,Department of Family Medicine, Department of Geriatric Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.,School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan
| |
Collapse
|
112
|
Noro F, Gianfagna F, Gialluisi A, De Curtis A, Di Castelnuovo A, Napoleone E, Cerletti C, Donati MB, de Gaetano G, Hoylaerts MF, Iacoviello L, Izzi B. ZBTB12 DNA methylation is associated with coagulation- and inflammation-related blood cell parameters: findings from the Moli-family cohort. Clin Epigenetics 2019; 11:74. [PMID: 31077224 PMCID: PMC6511189 DOI: 10.1186/s13148-019-0665-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 04/09/2019] [Indexed: 12/12/2022] Open
Abstract
Background Zinc finger and BTB domain-containing protein 12 (ZBTB12) is a predicted transcription factor with potential role in hematopoietic development. Recent evidence linked low methylation level of ZBTB12 exon1 to myocardial infarction (MI) risk. However, the role of ZBTB12 in the pathogenesis of MI and cardiovascular disease in general is not yet clarified. We investigated the relation between ZBTB12 methylation and several blood parameters related to cardio-cerebrovascular risk in an Italian family-based cohort. Results ZBTB12 methylation was analyzed on white blood cells from the Moli-family cohort using the Sequenom EpiTYPER MassARRAY (Agena). A total of 13 CpG Sequenom units were analyzed in the small CpG island located in the only translated ZBTB12 exon. Principal component analysis (PCA) was performed to identify groups of CpG units with similar methylation estimates. Linear mixed effect regressions showed a positive association between methylation of ZBTB12 Factor 2 (including CpG units 8, 9–10, 16, 21) and TNF-ɑ stimulated procoagulant activity, a measure of procoagulant and inflammatory potential of blood cells. In addition, we also found a negative association between methylation of ZBTB12 Factor 1 (mainly characterized by CpG units 1, 3–4, 5, 11, and 26) and white blood cell and granulocyte counts. An in silico prediction analysis identified granulopoiesis- and hematopoiesis-specific transcription factors to potentially bind DNA sequences encompassing CpG1, CpG3–4, and CpG11. Conclusions ZBTB12 hypomethylation is linked to shorter TNF-ɑ stimulated whole blood coagulation time and increased WBC and granulocyte counts, further elucidating the possible link between ZBTB12 methylation and cardiovascular disease risk. Electronic supplementary material The online version of this article (10.1186/s13148-019-0665-6) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Fabrizia Noro
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy
| | - Francesco Gianfagna
- Department of Medicine and Surgery, University of Insubria, Varese, Italy.,Mediterranea Cardiocentro, Naples, Italy
| | | | - Amalia De Curtis
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy
| | | | | | - Chiara Cerletti
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy
| | | | - Giovanni de Gaetano
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy
| | - Marc F Hoylaerts
- Department of Cardiovascular Sciences, Center for Molecular and Vascular Biology, University of Leuven, Leuven, Belgium
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy. .,Department of Medicine and Surgery, University of Insubria, Varese, Italy.
| | - Benedetta Izzi
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy
| | | |
Collapse
|
113
|
Sarrami-Foroushani A, Lassila T, Hejazi SM, Nagaraja S, Bacon A, Frangi AF. A computational model for prediction of clot platelet content in flow-diverted intracranial aneurysms. J Biomech 2019; 91:7-13. [PMID: 31104921 DOI: 10.1016/j.jbiomech.2019.04.045] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 03/14/2019] [Accepted: 04/30/2019] [Indexed: 01/30/2023]
Abstract
Treatment of intracranial aneurysms with flow-diverting stents is a safe and minimally invasive technique. The goal is stable embolisation that facilitates stent endothelialisation, and elimination of the aneurysm. However, it is not fully understood why some aneurysms fail to develop a stable clot even with sufficient levels of flow reduction. Computational prediction of thrombus formation dynamics can help predict the post-operative response in such challenging cases. In this work, we propose a new model of thrombus formation and platelet dynamics inside intracranial aneurysms. Our novel contribution combines platelet activation and transport with fibrin generation, which is key to characterising stable and unstable thrombus. The model is based on two types of thrombus inside aneurysms: red thrombus (fibrin- and erythrocyte-rich) can be found in unstable clots, while white thrombus (fibrin- and platelet-rich) can be found in stable clots. The thrombus generation model is coupled to a CFD model and the flow-induced platelet index (FiPi) is defined as a quantitative measure of clot stability. Our model is validated against an in vitro phantom study of two flow-diverting stents with different sizing. We demonstrate that our model accurately predicts the lower thrombus stability in the oversized stent scenario. This opens possibilities for using computational simulations to improve endovascular treatment planning and reduce adverse events, such as delayed haemorrhage of flow-diverted aneurysms.
Collapse
Affiliation(s)
- Ali Sarrami-Foroushani
- Centre for Computational Imaging and Simulation Technologies in Biomedicine (CISTIB), School of Computing, University of Leeds, Leeds, UK
| | - Toni Lassila
- Centre for Computational Imaging and Simulation Technologies in Biomedicine (CISTIB), School of Computing, University of Leeds, Leeds, UK
| | - Seyed Mostafa Hejazi
- Department of Electronic and Electrical Engineering, The University of Sheffield, Sheffield, UK
| | | | - Andrew Bacon
- Department of Neurosurgery, Royal Hallamshire Hospital, Sheffield, UK
| | - Alejandro F Frangi
- Centre for Computational Imaging and Simulation Technologies in Biomedicine (CISTIB), School of Computing, University of Leeds, Leeds, UK; Biomedical Imaging Department, Leeds Institute for Cardiovascular and Metabolic Medicine (LICAMM), School of Medicine, University of Leeds, Leeds, UK.
| |
Collapse
|
114
|
Yamada S, Hirao D, Miura N, Iwanaga T, Kawaguchi T, Yoshimura A, Oomori T, Nagasato T, Maruyama I, Fukushima R. Comparison between blood coagulability in the intra-atrial and peripheral regions during the acute phase after rapid atrial pacing. Exp Anim 2019; 68:137-146. [PMID: 30381652 PMCID: PMC6511516 DOI: 10.1538/expanim.18-0100] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Accepted: 10/01/2018] [Indexed: 12/21/2022] Open
Abstract
The changes in intra-atrial blood coagulability of acute phase after development of atrial fibrillation (AF) have not been elucidated in human. In the present study, blood coagulability were examined in the intra-atrial and peripheral regions during the acute phase after development of rapid atrial pacing (RAP) in experimentally created model dog similar to AF, using Total Thrombus-formation Analysis System (T-TAS) that is capable of comprehensively evaluating thrombogenicity in the bloodstream in the microvascular channel. According to the results, both the coagulating function-evaluating time to +10 kPa (T10) and occlusion time (OT) of the AR chip (chip for thrombus analysis mixed with coagulation and platelet) were significantly shortened in the atrial blood as early as 30 min after pacing (T10, 150.5 ± 40.5 s; OT, 212.4 ± 44.3 s) compared to the pre-pacing levels (T10, 194.5 ± 47.5 s; OT, 259.9 ± 49.5 s) (P<0.05). The OT of PL chip (chip for platelet thrombus analysis) was significantly shortened 30 min after pacing (231.8 ± 57.6 s), compared to the pre-pacing level (289.5 ± 96.0 s) (P<0.05). Meanwhile, none of T10 and OT of AR and PL chips showed any significant changes in the peripheral blood. The study demonstrated increase of blood coagulability 30 min after development of RAP. While no significant changes were observed in the peripheral blood in the present study, the outcome suggested that the anti-thrombus treatments are better to be started early after AF even if coagulability of the peripheral blood shows no change.
Collapse
Affiliation(s)
- Shusaku Yamada
- Animal Medical Center, Tokyo University of Agriculture and Technology, 3-5-8 Sawai-cho, Fuchushi, Tokyo 183-8509, Japan
| | - Daiki Hirao
- Animal Medical Center, Tokyo University of Agriculture and Technology, 3-5-8 Sawai-cho, Fuchushi, Tokyo 183-8509, Japan
| | - Naoki Miura
- Joint Faculty of Veterinary Medicine, Kagoshima University, 1-21-24 Koorimoto, Kagoshima 890-0065, Japan
| | - Tomoko Iwanaga
- Joint Faculty of Veterinary Medicine, Kagoshima University, 1-21-24 Koorimoto, Kagoshima 890-0065, Japan
| | - Takae Kawaguchi
- Animal Medical Center, Tokyo University of Agriculture and Technology, 3-5-8 Sawai-cho, Fuchushi, Tokyo 183-8509, Japan
| | - Aritada Yoshimura
- Animal Medical Center, Tokyo University of Agriculture and Technology, 3-5-8 Sawai-cho, Fuchushi, Tokyo 183-8509, Japan
| | - Takahiro Oomori
- Animal Medical Center, Tokyo University of Agriculture and Technology, 3-5-8 Sawai-cho, Fuchushi, Tokyo 183-8509, Japan
| | - Tomoka Nagasato
- Department of System Biology in Thromboregulation, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Ikuro Maruyama
- Department of System Biology in Thromboregulation, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Ryuji Fukushima
- Animal Medical Center, Tokyo University of Agriculture and Technology, 3-5-8 Sawai-cho, Fuchushi, Tokyo 183-8509, Japan
| |
Collapse
|
115
|
Effects of Perioperative Venous Thromboembolism on Outcomes in Soft Tissue Reconstruction of Traumatic Lower Extremity Injuries. Ann Plast Surg 2019; 82:S345-S349. [DOI: 10.1097/sap.0000000000001871] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
116
|
Szakács Z, Csiszár B, Kenyeres P, Sarlós P, Erőss B, Hussain A, Nagy Á, Kőszegi B, Veczák I, Farkas N, Bódis E, Márta K, Szentesi A, Tőkés-Füzesi M, Berki T, Vincze Á, Tóth K, Hegyi P, Bajor J. Haemorheological and haemostatic alterations in coeliac disease and inflammatory bowel disease in comparison with non-coeliac, non-IBD subjects (HERMES): a case-control study protocol. BMJ Open 2019; 9:e026315. [PMID: 30904871 PMCID: PMC6475350 DOI: 10.1136/bmjopen-2018-026315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Haemorheological and haemostatic changes predispose to the development of arterial and venous thrombotic events; however, limited information is available on the status of these changes in coeliac disease (CeD) and inflammatory bowel disease (IBD). In this study, we aim to describe the haemorheological and haemostatic profiles of CeD and IBD patients in a Hungarian cohort of patients to investigate whether any alterations contribute to elevated thrombotic risk. METHODS AND ANALYSIS This is a case-control study involving newly diagnosed and followed CeD and IBD patients with age-matched and sex-matched non-CeD, non-IBD subjects with an allocation ratio of 1:1:1.After informed consent is obtained, a detailed medical history will be collected, including venous and arterial thrombotic risk factors and medications. Symptoms in CeD patients will be assessed with the Gastrointestinal Symptoms Rating Scale, and disease activity in IBD patients will be determined by disease-specific scores. Dietary adherence will be assessed among CeD patients with a thorough interview together with a measurement of self-reported adherence, dietary knowledge and urine analysis (detection of gluten immunogenic peptides). In addition to routine laboratory parameters, haemorheological (ie, erythrocyte deformability and aggregation, viscosity of whole blood and plasma) and haemostatic parameters (eg, protein C, protein S and antithrombin) with immunological indicators (ie, coeliac-specific serology and antiphospholipid antibodies) will be measured from venous blood for every participant.Primary and secondary outcomes will be haemorheological and haemostatic parameters, respectively. Univariate and multivariate statistics will be used to compare CeD and IBD patients to control subjects. Subgroup analysis will be performed by disease type in IBD, (Crohn's disease and ulcerose colitis), dietary adherence in CeD, and disease activity in IBD and CeD. ETHICS AND DISSEMINATION The study was approved by the Regional and Local Research Ethics Committee, University of Pécs (Ref. No. 6917). Findings will be disseminated at research conferences and in peer-reviewed journals. TRIAL REGISTRATION NUMBER ISRCTN49677481.
Collapse
Affiliation(s)
- Zsolt Szakács
- János Szentágothai Research Center, University of Pécs, Pécs, Hungary
- Clinical Medicine Doctoral School, University of Szeged, Szeged, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Beáta Csiszár
- János Szentágothai Research Center, University of Pécs, Pécs, Hungary
- Division of Cardiology and Angiology, First Department of Medicine, University of Pécs, Pécs, Hungary
| | - Péter Kenyeres
- János Szentágothai Research Center, University of Pécs, Pécs, Hungary
- Division of Cardiology and Angiology, First Department of Medicine, University of Pécs, Pécs, Hungary
| | - Patrícia Sarlós
- János Szentágothai Research Center, University of Pécs, Pécs, Hungary
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Bálint Erőss
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Alizadeh Hussain
- János Szentágothai Research Center, University of Pécs, Pécs, Hungary
- Division of Hematology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Ágnes Nagy
- Division of Hematology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Balázs Kőszegi
- Department of Biochemistry and Medical Chemistry, Medical School, University of Pécs, Pécs, Hungary
| | - Ibolya Veczák
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Nelli Farkas
- Institute of Bioanalysis, Medical School, University of Pécs, Pécs, Hungary
| | - Emőke Bódis
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Katalin Márta
- János Szentágothai Research Center, University of Pécs, Pécs, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Andrea Szentesi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Margit Tőkés-Füzesi
- Department of Laboratory Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Tímea Berki
- Department of Immunology and Biotechnology, Medical School, University of Pécs, Pécs, Hungary
| | - Áron Vincze
- János Szentágothai Research Center, University of Pécs, Pécs, Hungary
- Clinical Medicine Doctoral School, University of Szeged, Szeged, Hungary
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Kálmán Tóth
- János Szentágothai Research Center, University of Pécs, Pécs, Hungary
- Division of Cardiology and Angiology, First Department of Medicine, University of Pécs, Pécs, Hungary
| | - Péter Hegyi
- János Szentágothai Research Center, University of Pécs, Pécs, Hungary
- Clinical Medicine Doctoral School, University of Szeged, Szeged, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Judit Bajor
- Clinical Medicine Doctoral School, University of Szeged, Szeged, Hungary
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| |
Collapse
|
117
|
Han S, Chen Y, Wang J, Zhang Q, Han B, Ge Y, Xiang Y, Liang R, Zhu X, You Y, Liao F. Anti-thrombosis Effects and Mechanisms by Xueshuantong Capsule Under Different Flow Conditions. Front Pharmacol 2019; 10:35. [PMID: 30792653 PMCID: PMC6374556 DOI: 10.3389/fphar.2019.00035] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 01/14/2019] [Indexed: 12/19/2022] Open
Abstract
Xueshuantong capsule (XST) is a patented traditional Chinese medicine used for the prevention and treatment of thrombosis. The molecular mechanism of anti-thrombotic effect of XST was investigated through the cross-talk among the platelets/leukocytes, endothelial cells (ECs), and flow shear stress. The Bioflux 1000 system was used to generate two levels of shear stress conditions: 0.1 and 0.9 Pa. Bioflux Metamorph microscopic imaging system was used to analyze the adhesion cell numbers. Protein expressions were detected by western blotting and flow cytometry. The flow-cytometry results showed that under 0.1 Pa flow, XST decreased ADP induced platelets CD62p surface expression in a concentration-dependent manner. Under 0.9 Pa flow, XST at a concentration of 0.15 g⋅L-1 reduced the platelets activation by 29.5%, and aspirin (ASA) showed no inhibitory effects. XST showed similar efficiency on monocytes adhesion both under 0.1 and 0.9 Pa flow conditions, and the inhibition rate was 30.2 and 28.3%, respectively. Under 0.9 Pa flow, the anti-adhesive effects of XST might be associated with the suppression of VE-cadherin and Cx43 in HUVECs. Blood flow not only acts as a drug transporter, but also exerts its effects to influence the pharmacodynamics of XST. Effects of XST on inhibiting platelets activation and suppressing platelets/leukocytes adhesion to injured ECs are not only concentration-dependent, but also shear stress-dependent. The mechanic forces combined with traditional Chinese medicine may be used as a precise treatment for cardiovascular diseases.
Collapse
Affiliation(s)
- Shuxian Han
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ying Chen
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jinyu Wang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qian Zhang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Bing Han
- Harbin Zhenbao Pharmaceutical Co., Ltd., Harbin, China
| | - Yimeng Ge
- Harbin Zhenbao Pharmaceutical Co., Ltd., Harbin, China
| | - Yanhua Xiang
- Harbin Zhenbao Pharmaceutical Co., Ltd., Harbin, China
| | - Rixin Liang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaoxin Zhu
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yun You
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Fulong Liao
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| |
Collapse
|
118
|
Salari F, Golpayegani M, Habibi Z, Yaghoubi S, Anbarlouei M, Mehdizadeh M, Nejat F. Evaluation of Lower Extremities' Vascular Characteristics in Myelomeningocele Patients: A Case-Control Study. Pediatr Neurosurg 2019; 54:324-328. [PMID: 31487737 DOI: 10.1159/000502403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 07/24/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Myelomeningocele (MMC) is the most common neural tube defect. Patients with MMC have multiple risk factors for venous thrombosis, but this complication rarely occurs. This lower rate of venous thrombosis in MMC children could be related to some characteristics of the vessels in the lower extremities. This study aimed at finding explanations for this dilemma. METHODS A case-control study was designed in the Children's Hospital Medical Center, Tehran considering paraplegic patients with MMC as the case group and nonparaplegic MMC patients as a control group. Doppler ultrasound was performed to evaluate femoral and popliteal arterial and venous properties. RESULTS Patients aged from 8 months to 12 years were evaluated. The mean diameter of the femoral arteries was 3.73 ± 0.23 and 4.72 ± 0.39 mm among paraplegic and nonparaplegic MMC patients, respectively (p = 0.02). The femoral artery flow was 0.52 ± 0.08 and 0.75 ± 0.06 L/min, respectively in the case and control groups (p = 0.015). The diameters of the femoral veins were 4.85 ± 0.34 and 5.13 ± 0.32 mm in the case and control groups, respectively (p > 0.05). Besides, the blood flows of the case and control groups' femoral veins were 0.27 ± 0.08 and 0.14 ± 0.01 L/min, respectively (p = 0.6). It turned out that lower extremities' arteries in the case group had significantly lower blood flow and diameter compared to those of the control group. However, the same venous properties did not show any significant differences. CONCLUSION The decreased arterial flow along with the unchanged venous properties leads to less stasis and better drainage of the blood, which in turn might result in a lower incidence of deep vein thrombosis.
Collapse
Affiliation(s)
- Farhad Salari
- Department of Neurosurgery, Tehran University of Medical Science, Tehran, Iran
| | - Mehdi Golpayegani
- Department of Neurosurgery, Tehran University of Medical Science, Tehran, Iran
| | - Zohreh Habibi
- Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahin Yaghoubi
- Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mousarreza Anbarlouei
- Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrzad Mehdizadeh
- Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farideh Nejat
- Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran,
| |
Collapse
|
119
|
Alves MT, Ortiz MMO, Dos Reis GVOP, Dusse LMS, Carvalho MDG, Fernandes AP, Gomes KB. The dual effect of C-peptide on cellular activation and atherosclerosis: Protective or not? Diabetes Metab Res Rev 2019; 35:e3071. [PMID: 30160822 DOI: 10.1002/dmrr.3071] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 08/14/2018] [Accepted: 08/21/2018] [Indexed: 12/12/2022]
Abstract
C-peptide is a cleavage product of proinsulin that acts on different type of cells, such as blood and endothelial cells. C-peptide biological effects may be different in type 1 and type 2 diabetes. Besides, there are further evidence for a functional interaction between C-peptide and insulin. In this way, C-peptide has ambiguous effects, acting as an antithrombotic or thrombotic molecule, depending on the physiological environment and disease conditions. Moreover, C-peptide regulates interaction of leucocytes, erythrocytes, and platelets with the endothelium. The beneficial effects include stimulation of nitric oxide production with its subsequent release by platelets and endothelium, the interaction with erythrocytes leading to the generation of adenosine triphosphate, and inhibition of atherogenic cytokine release. The undesirable action of C-peptide includes the chemotaxis of monocytes, lymphocytes, and smooth muscle cells. Also, C-peptide was related with increased lipid deposits and elevated smooth muscle cells proliferation in the vessel wall, contributing to atherosclerosis. Purpose of this review is to explore these dual roles of C-peptide on the blood, contributing at one side to haemostasis and the other to atherosclerotic process.
Collapse
Affiliation(s)
- Michelle Teodoro Alves
- Departamento de Biologia Geral, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Mylena Maira Oliveira Ortiz
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Luci Maria Sant'Ana Dusse
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Maria das Graças Carvalho
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ana Paula Fernandes
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Karina Braga Gomes
- Departamento de Biologia Geral, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| |
Collapse
|
120
|
Amaro E, Marvi TK, Posey SL, Benvenuti MA, An TJ, Dale KM, Lovejoy SA, Martus JE, Johnson ME, Mencio GA, Moore-Lotridge SN, Thomsen IP, Schoenecker JG. C-Reactive Protein Predicts Risk of Venous Thromboembolism in Pediatric Musculoskeletal Infection. J Pediatr Orthop 2019; 39:e62-e67. [PMID: 30300275 DOI: 10.1097/bpo.0000000000001256] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The rate of venous thromboembolism in children with musculoskeletal infections (MSKIs) is markedly elevated compared with hospitalized children in general. Predictive biomarkers to identify high-risk patients are needed to prevent the significant morbidity and rare mortality associated with thrombotic complications. We hypothesize that overactivation of the acute phase response is associated with the development of pathologic thrombi and we aim to determine whether elevations in C-reactive protein (CRP) are associated with increased rates of thrombosis in pediatric patients with MSKI. METHODS A retrospective cohort study measuring CRP in pediatric MSKI patients with or without thrombotic complications. RESULTS The magnitude and duration of elevation in CRP values correlated with the severity of infection and the development of pathologic thrombosis. In multivariable logistic regression, every 20 mg/L increase in peak CRP was associated with a 29% increased risk of thrombosis (P<0.001). Peak and total CRP were strong predictors of thrombosis with area under the receiver-operator curves of 0.90 and 0.92, respectively. CONCLUSIONS Future prospective studies are warranted to further define the discriminatory power of CRP in predicting infection-provoked thrombosis. Pharmacologic prophylaxis and increased surveillance should be strongly considered in patients with MSKI, particularly those with disseminated disease and marked elevation of CRP. LEVEL OF EVIDENCE Level III.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Stephanie N Moore-Lotridge
- Departments of Orthopaedics and Rehabilitation.,Department of Pharmacology, Vanderbilt University, Nashville, TN
| | - Isaac P Thomsen
- Pediatrics.,Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN
| | - Jonathan G Schoenecker
- Departments of Orthopaedics and Rehabilitation.,Pediatrics.,Department of Pharmacology, Vanderbilt University, Nashville, TN.,Pathology Microbiology and Immunology
| |
Collapse
|
121
|
Fomenko Y, Kolesnikova Y, Beynikova I, Muravlyova L, Sirota V, Bakirova R. Influence of Combined Therapy on Generation of Neutrophil Extracellular Traps in Patients with Cervical Cancer. Open Access Maced J Med Sci 2018; 6:2097-2100. [PMID: 30559867 PMCID: PMC6290443 DOI: 10.3889/oamjms.2018.483] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 11/06/2018] [Accepted: 11/07/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND According to several authors, neutrophil extracellular traps (NETs) play an important role in the mechanisms of cancer development and metastatic processes, which allows them to be considered as a potential new target for the treatment of cancer. AIM To investigate the presence of extracellular neutrophil traps in the blood of patients with cervical cancer on the background of the combined treatment. MATERIALS AND METHODS The study was conducted in 28 patients with cervical cancer. Group 1 received only radiation therapy; Groups 2-radiation therapy with ftorafur; Group 3-radiation therapy with cisplatin. To determine the number of spontaneous extracellular neutrophilic traps in the blood of the examined individuals, we used a technique of I.I. Dolgushin and Yu.S. Andreeva. RESULTS Peripheral blood neutrophils in 53.57% (33.87; 72.49) of cervical cancer patients showed the ability to generate NETs before treatment. The ability to form NETs was observed in neutrophils isolated from 66.67% (9.43; 99.16) patients of the Group 1. After radiation therapy with ftorafur, the ability of blood neutrophils to form NETs was observed in 50% (1.26; 98.74) of cervical cancer patients. After radiotherapy with cisplatin, 37.50% (15.20; 64.57) of patients were found to have NETs formation. CONCLUSION The ability to form NETs varied greatly after radiotherapy. The addition of chemotherapy drugs to radiation therapy did not increase the percentage of NETs in the blood of patients with cervical cancer but stimulated the appearance of basophil extracellular traps.
Collapse
Affiliation(s)
- Yuriy Fomenko
- Department of Oncology, Karaganda State Medical University, Karaganda, Kazakhstan
| | - Yevgeniya Kolesnikova
- Department of the Biological Chemistry, Karaganda State Medical University, Karaganda, Kazakhstan
| | - Irina Beynikova
- Department of the Biological Chemistry, Karaganda State Medical University, Karaganda, Kazakhstan
| | - Larissa Muravlyova
- Department of the Biological Chemistry, Karaganda State Medical University, Karaganda, Kazakhstan
| | - Valentina Sirota
- Department of Oncology, Karaganda State Medical University, Karaganda, Kazakhstan
| | - Ryszhan Bakirova
- Department of Internal Diseases, Karaganda State Medical University, Karaganda, Kazakhstan
| |
Collapse
|
122
|
Flueckiger P, Singleton M, Vasu S, Zhao D. Bioprosthetic tricuspid valve thrombosis: Percutaneous PFO closure to improve hypoxia and respiratory failure. Catheter Cardiovasc Interv 2018; 92:993-997. [PMID: 29068163 DOI: 10.1002/ccd.27217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 06/08/2017] [Accepted: 06/24/2017] [Indexed: 11/11/2022]
Abstract
Prosthetic valve thrombosis (PVT) is an increasingly recognized complication of bioprosthetic valve replacement, often resulting in abnormal hemodynamic, endothelial, and hemostatic conditions. Bioprosthetic PVT may lead to significant hemodynamic and clinical effects. In hemodynamically stable patients, first-line treatment for bioprosthetic PVT is systemic anticoagulation. However, concomitant cardiovascular pathology may lead to additional clinical sequalae that requires acute therapeutic interventions. We describe two cases in which bioprosthetic PVT leads to hemodynamically significant intracardiac shunting through pre-existing patent foramen ovales requiring percutaneous closure with a Cribriform AMPLATZER occluder device. We also review the treatment for bioprosthetic PVT and discuss important clinical and hemodynamic considerations.
Collapse
Affiliation(s)
- Peter Flueckiger
- Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Matthew Singleton
- Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Sujethra Vasu
- Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - David Zhao
- Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| |
Collapse
|
123
|
Yamada S, Hirao D, Miura N, Iwanaga T, Kawaguchi T, Yoshimura A, Oomori T, Nagasato T, Maruyama I, Fukushima R. Comparison of chronological changes in blood characteristics in the atrium and peripheral vessels after the development of non-valvular atrial fibrillation. Thromb Res 2018; 171:31-37. [PMID: 30245238 DOI: 10.1016/j.thromres.2018.09.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 07/28/2018] [Accepted: 09/04/2018] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Changes in blood characteristics in the atrium and peripheral vessels in patients with non-valvular atrial fibrillation (NVAF) are unclear. We investigated chronological changes in blood characteristics in the atrium and peripheral vessels in a dog model of NVAF by using a total thrombus-formation analysis system (T-TAS). MATERIALS AND METHODS In NVAF model dogs (n = 8, 390 bpm rapid atrial pacing), atrial and peripheral blood samples were collected. Using this blood, T-TAS was performed before and 1, 2, and 3 weeks after the onset of rapid atrial pacing. RESULTS Occlusion time (OT: time to +80 and +60 kPa in the AR and PL chips, respectively) and area under the flow pressure curve (AUC) were measured using the AR chip (for mixed white thrombus analysis) and PL chip (for platelet thrombus analysis). OT of the AR chip showed shortening as early as 1 week after NVAF onset, which continued for 3 weeks. OT of the PL chip showed significant shortening in atrium blood only 3 weeks after NVAF onset. By contrast, peripheral blood showed no significant changes in OT or AUC with both AR and PL chips. CONCLUSIONS In our dog model of NVAF, thrombus formation accelerated in the atrium as early as 1 week after NVAF onset and continued for 3 weeks, but no significant changes were found in peripheral blood. We conclude that antithrombotic therapy should be started early after NVAF onset even if no changes in coagulation activity are observed in peripheral blood.
Collapse
Affiliation(s)
- Shusaku Yamada
- Animal Medical Center, Tokyo University of Agriculture and Technology, 3-5-8 Sawai-cho, Fuchushi, Tokyo 183-8509, Japan
| | - Daiki Hirao
- Animal Medical Center, Tokyo University of Agriculture and Technology, 3-5-8 Sawai-cho, Fuchushi, Tokyo 183-8509, Japan
| | - Naoki Miura
- Joint Faculty of Veterinary Medicine, Kagoshima University, 1-21-24, Koorimoto, Kagoshima 890-0065, Japan
| | - Tomoko Iwanaga
- Joint Faculty of Veterinary Medicine, Kagoshima University, 1-21-24, Koorimoto, Kagoshima 890-0065, Japan
| | - Takae Kawaguchi
- Animal Medical Center, Tokyo University of Agriculture and Technology, 3-5-8 Sawai-cho, Fuchushi, Tokyo 183-8509, Japan
| | - Aritada Yoshimura
- Animal Medical Center, Tokyo University of Agriculture and Technology, 3-5-8 Sawai-cho, Fuchushi, Tokyo 183-8509, Japan
| | - Takahiro Oomori
- Animal Medical Center, Tokyo University of Agriculture and Technology, 3-5-8 Sawai-cho, Fuchushi, Tokyo 183-8509, Japan
| | - Tomoka Nagasato
- Department of System Biology in Thromboregulation, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan
| | - Ikuro Maruyama
- Department of System Biology in Thromboregulation, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan
| | - Ryuji Fukushima
- Animal Medical Center, Tokyo University of Agriculture and Technology, 3-5-8 Sawai-cho, Fuchushi, Tokyo 183-8509, Japan.
| |
Collapse
|
124
|
Strongly Coupled Morphological Features of Aortic Aneurysms Drive Intraluminal Thrombus. Sci Rep 2018; 8:13273. [PMID: 30185838 PMCID: PMC6125404 DOI: 10.1038/s41598-018-31637-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 08/15/2018] [Indexed: 01/13/2023] Open
Abstract
Over 75% of abdominal aortic aneurysms harbor an intraluminal thrombus, and increasing evidence suggests that biologically active thrombus contributes to the natural history of these potentially lethal lesions. Thrombus formation depends on the local hemodynamics, which in turn depends on morphological features of the aneurysm and near vasculature. We previously presented a hemodynamically motivated “thrombus formation potential” that predicts where and when thrombus might form. Herein, we combine detailed studies of the three-dimensional hemodynamics with methods of sparse grid collocation and interpolation via kriging to examine roles of five key morphological features of aneurysms on thrombus formation: lesion diameter, axial position, length, curvature, and renal artery position. Computational simulations suggest that maximum diameter is a key determinant of thrombogenicity, but other morphological features modulate this dependence. More distally located lesions tend to have a higher thrombus formation potential and shorter lesions tend to have a higher potential than longer lesions, given the same aneurysmal dilatation. Finally, movement of vortical structures through the infrarenal aorta and lesion can significantly affect thrombogenicity. Formation of intraluminal thrombus within an evolving abdominal aortic aneurysm thus depends on coupled morphological features, not all intuitive, and computational simulations can be useful for predicting thrombogenesis.
Collapse
|
125
|
Lee JK. Dental management of patients on anti-thrombotic agents. J Korean Assoc Oral Maxillofac Surg 2018; 44:143-150. [PMID: 30181980 PMCID: PMC6117462 DOI: 10.5125/jkaoms.2018.44.4.143] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 07/10/2018] [Indexed: 12/19/2022] Open
Abstract
The number of geriatric patients seeking dental service is ever-rising because of increased life expectancy, also with problem of increased chronic medical conditions. One of them are patients on anti-thrombotic medication. Bleeding complication after minor oral surgery by anti-thrombotic agents is of concerns to dentists on dental management of these patients. Risk and benefit of the anti-thrombotic agents must be weighed before initiating dental procedures, which should be established as a treatment guideline. Purpose of the paper is to optimize the management of the dental patients on anti-thrombotic medication via standardization of treatment protocol of such a patient.
Collapse
Affiliation(s)
- Jeong Keun Lee
- Department of Oral and Maxillofacial Surgery and Institute of Oral Health Science, Ajou University Dental Hospital, Ajou University School of Medicine, Suwon, Korea
| |
Collapse
|
126
|
Agrawal R, Ang B, Balne PK, Richards C, Smart T, Cardoso J, Shima D, Jones PH, Pavesio C. Non-Occlusive Retinal Vascular Inflammation and Role of Red Blood Cell Deformability in Birdshot Chorioretinopathy. Ocul Immunol Inflamm 2018; 27:978-986. [PMID: 29985708 DOI: 10.1080/09273948.2018.1485959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Purpose: To investigate differences in red blood cell (RBC) deformability between birdshot chorioretinopathy (BCR) subjects and matched controls, and to postulate its relationship with lack of vascular occlusion in BCR. Methods: In a single center, prospective, non-randomized mechanistic study, blood samples were collected from eight healthy controls and nine BCR patients, and subjected to biochemical and hematological tests, as well as RBC indices assessment using dual-beam optical tweezers. Results: The mean age of the controls was 52.37 ± 10.70 years and BCR patients was 53.44 ± 12.39 years. Initial cell size (Io) for the controls was 8.48 ± 0.25 μm and 8.87 ± 0.31 μm for BCR RBCs (p = 0.014). The deformability index (DI) for the controls was 0.066 ± 0.02 and that for BCR RBCs was 0.063 ± 0.03 (p = 0.441). Conclusion: There was no statistically significant difference in DI between RBCs from BCR and healthy controls. This may explain the rare occurrence of retinal vascular occlusion despite the underlying vasculitic pathophysiology of BCR.
Collapse
Affiliation(s)
- Rupesh Agrawal
- Moorfields Eye Hospital, NHS Foundation Trust , London , UK.,National Healthcare Group Eye Institute, Tan Tock Seng Hospital , Singapore.,Department of Mechanical Engineering, University College London , London , UK.,Institute of Ophthalmology, University College London , London , UK
| | - Bryan Ang
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital , Singapore
| | - Praveen Kumar Balne
- Translational Pre-Clinical Model Platform, Singapore Eye Research Institute , Singapore
| | | | - Thomas Smart
- Department of Physics and Astronomy, University College London , London , UK
| | - João Cardoso
- Moorfields Eye Hospital, NHS Foundation Trust , London , UK
| | - David Shima
- Institute of Ophthalmology, University College London , London , UK
| | - Philip H Jones
- Department of Physics and Astronomy, University College London , London , UK
| | - Carlos Pavesio
- Moorfields Eye Hospital, NHS Foundation Trust , London , UK.,Institute of Ophthalmology, University College London , London , UK
| |
Collapse
|
127
|
Swieringa F, Spronk HM, Heemskerk JW, van der Meijden PE. Integrating platelet and coagulation activation in fibrin clot formation. Res Pract Thromb Haemost 2018; 2:450-460. [PMID: 30046749 PMCID: PMC6046596 DOI: 10.1002/rth2.12107] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 03/31/2018] [Indexed: 12/21/2022] Open
Abstract
Platelets interact with the coagulation system in a multitude of ways, not only during the phases of thrombus formation, but also in specific areas within a formed thrombus. This review discusses current concepts of platelet control of thrombin generation, fibrin formation and structure, and anticoagulation. Indicated are how combined signalling via the platelet receptors for collagen (glycoprotein VI) and thrombin induces the secretion of (anti)coagulation factors, as well as surface exposure of phosphatidylserine, thereby catalysing thrombin generation. This procoagulant platelet response is also facilitated by the adhesive complexes glycoprotein Ib-V-IX and integrin αIIbβ3. In the buildup of a platelet-fibrin thrombus, the extrinsic, tissue factor-driven coagulation pathway is predominant in early stages, while the intrinsic, factor XII pathway seems to promote at later time points. Already early generation of thrombin enforces platelet responses and stimulates intra-thrombus heterogeneity with patches of loosely aggregated, contracted, and phosphatidylserine-exposing platelets. Fibrin actively formed on the surface of activated platelets supports thrombus growth, but also captures thrombin. The fibrin distribution in a thrombus appears to rely on the local procoagulant trigger and the blood flow rate. Clinical studies support the importance of the platelet-coagulation interplay, by showing beneficial effects of combination therapy in the secondary prevention of cardiovascular disease.
Collapse
Affiliation(s)
- Frauke Swieringa
- Department of BiochemistryCardiovascular Research Institute Maastricht (CARIM)Maastricht UniversityMaastrichtThe Netherlands
- Leibniz Institute for Analytical SciencesISASDortmundGermany
| | - Henri M.H. Spronk
- Department of BiochemistryCardiovascular Research Institute Maastricht (CARIM)Maastricht UniversityMaastrichtThe Netherlands
| | - Johan W.M. Heemskerk
- Department of BiochemistryCardiovascular Research Institute Maastricht (CARIM)Maastricht UniversityMaastrichtThe Netherlands
| | - Paola E.J. van der Meijden
- Department of BiochemistryCardiovascular Research Institute Maastricht (CARIM)Maastricht UniversityMaastrichtThe Netherlands
| |
Collapse
|
128
|
Effects of Natural Hirudin and Low Molecular Weight Heparin in Preventing Deep Venous Thrombosis in Aged Patients with Intertrochanteric Fracture. Sci Rep 2018; 8:8847. [PMID: 29891906 PMCID: PMC5995864 DOI: 10.1038/s41598-018-27243-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 05/29/2018] [Indexed: 02/05/2023] Open
Abstract
Our objective was to evaluate the efficacy and safety of natural hirudin and low molecular weight heparin (LMWH) in the prevention of perioperative deep venous thrombosis (DVT) in elderly patients with intertrochanteric fracture. From June 2014 to June 2017, 96 patients with intertrochanteric fractures were treated with proximal femoral nail antirotation (PFNA) were randomly divided into two groups. For DVT prevention, 45 patients were treated with oral natural hirudin and subcutaneous LMWH-calcium (test group) and 51 patients were treated with subcutaneous LMWH-calcium (control group). The mean intraoperative bleeding, wound drainage and incisional hematoma were higher in the test group, with no significant differences between the groups. There were significant differences in distal intramuscular venous thrombosis (P = 0.043). Both activated partial thromboplastin time (APTT), thrombin time (TT), and prothrombin time (PT) lengthened in both groups postoperatively, and there was a significant difference between the two groups two weeks postoperatively. D-dimer were significantly different and platelet count (PLT) did not differ between groups two weeks postoperatively. In elderly patients with unilateral intertrochanteric fracture after PFNA on anticoagulant therapy, the combination of natural hirudin and LMWH was more effective than that of LMWH-calcium alone, with no significant difference with regard to safety.
Collapse
|
129
|
Sepassi A, Chingcuanco F, Gordon R, Meier A, Divino V, DeKoven M, Ben-Joseph R. Resource utilization and charges of patients with and without diagnosed venous thromboembolism during primary hospitalization and after elective inpatient surgery: a retrospective study. J Med Econ 2018; 21:595-602. [PMID: 29480088 DOI: 10.1080/13696998.2018.1445635] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIMS To assess incremental charges of patients experiencing venous thromboembolisms (VTE) across various types of elective inpatient surgical procedures with administration of general anesthesia in the US. METHODS The authors performed a retrospective study utilizing data from a nationwide hospital operational records database from July 2014 through June 2015 to compare a group of inpatients experiencing a VTE event post-operatively to a propensity score matched group of inpatients who did not experience a VTE. Patients included in the analysis had a hospital admission for an elective inpatient surgical procedure with the use of general anesthesia. Procedures of the heart, brain, lungs, and obstetrical procedures were excluded, as these procedures often require a scheduled ICU stay post-operatively. Outcomes examined included VTE events during hospitalization, length of stay, unscheduled ICU transfers, number of days spent in the ICU if transferred, 3- and 30-day re-admissions, and total hospital charges incurred. RESULTS The study included 17,727 patients undergoing elective inpatient surgical procedures. Of these, 36 patients who experienced a VTE event were matched to 108 patients who did not. VTE events occurred in 0.2% of the study population, with most events occurring for patients undergoing total knee replacement. VTE patients had a mean total hospital charge of $60,814 vs $48,325 for non-VTE patients, resulting in a mean incremental charge of $11,979 (p < .05). Compared to non-VTE patients, VTE patients had longer length of stay (5.9 days vs 3.7 days, p < .001), experienced a higher rate of 3-day re-admissions (3 vs 0 patients) and 30-day re-admissions (7 vs 2 patients). CONCLUSIONS Patients undergoing elective inpatient surgical procedures with general anesthesia who had a VTE event during their primary hospitalization had a significantly longer length of stay and significantly higher total hospital charges than comparable patients without a VTE event.
Collapse
Affiliation(s)
- Aryana Sepassi
- a Skaggs School of Pharmacy and Pharmaceutical Sciences , University of California , San Diego , La Jolla, CA , USA
| | - Francine Chingcuanco
- b Health Economics and Outcomes Research, Millennium Health , San Diego , CA , USA
| | - Ronald Gordon
- c Department of Anesthesiology , UC San Diego Health System , San Diego , CA , USA
| | - Angela Meier
- c Department of Anesthesiology , UC San Diego Health System , San Diego , CA , USA
| | - Victoria Divino
- d Health Economics and Outcomes Research, IQVIA , Fairfax , VA , USA
| | - Mitch DeKoven
- d Health Economics and Outcomes Research, IQVIA , Fairfax , VA , USA
| | - Rami Ben-Joseph
- b Health Economics and Outcomes Research, Millennium Health , San Diego , CA , USA
| |
Collapse
|
130
|
Nakano F, Matsubara T, Ishigaki T, Hatazaki S, Mouri G, Nakatsuka Y, Suzuki H. Incidence and risk factor of deep venous thrombosis in patients undergoing craniotomy for brain tumors: A Japanese single-center, retrospective study. Thromb Res 2018; 165:95-100. [DOI: 10.1016/j.thromres.2018.03.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 02/20/2018] [Accepted: 03/24/2018] [Indexed: 02/06/2023]
|
131
|
Peshkova AD, Malyasyov DV, Bredikhin RA, Le Minh G, Andrianova IA, Tutwiler V, Nagaswami C, Weisel JW, Litvinov RI. Reduced Contraction of Blood Clots in Venous Thromboembolism Is a Potential Thrombogenic and Embologenic Mechanism. TH OPEN 2018; 2:e104-e115. [PMID: 31249934 PMCID: PMC6524864 DOI: 10.1055/s-0038-1635572] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 02/08/2018] [Indexed: 12/12/2022] Open
Abstract
Contraction (retraction) of the blood clot is a part of the clotting process driven by activated platelets attached to fibrin that can potentially modulate the obstructiveness and integrity of thrombi. The aim of this work was to reveal the pathogenic importance of contraction of clots and thrombi in venous thromboembolism (VTE). We investigated the kinetics of clot contraction in the blood of 55 patients with VTE. In addition, we studied the ultrastructure of ex vivo venous thrombi as well as the morphology and functionality of isolated platelets. Thrombi from VTE patients contained compressed polyhedral erythrocytes, a marker for clot contraction in vivo. The extent and rate of contraction were reduced by twofold in clots from the blood of VTE patients compared with healthy controls. The contraction of clots from the blood of patients with pulmonary embolism was significantly impaired compared with that of those with isolated venous thrombosis, suggesting that less compacted thrombi are prone to embolization. The reduced ability of clots to contract correlated with continuous platelet activation followed by their partial refractoriness. Morphologically, 75% of platelets from VTE patients were spontaneously activated (with filopodia) compared with only 21% from healthy controls. At the same time, platelets from VTE patients showed a 1.4-fold reduction in activation markers expressed in response to chemical activation when compared with healthy individuals. The results obtained suggest that the impaired contraction of thrombi is an underappreciated pathogenic mechanism in VTE that may regulate the obstructiveness and embologenicity of venous thrombi.
Collapse
Affiliation(s)
- Alina D Peshkova
- Department of Biochemistry and Biotechnology, Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russian Federation
| | - Dmitry V Malyasyov
- Department of Vascular Surgery, Inter-Regional Clinical Diagnostic Center, Kazan, Russian Federation
| | - Roman A Bredikhin
- Department of Vascular Surgery, Inter-Regional Clinical Diagnostic Center, Kazan, Russian Federation
| | - Giang Le Minh
- Department of Biochemistry and Biotechnology, Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russian Federation
| | - Izabella A Andrianova
- Department of Biochemistry and Biotechnology, Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russian Federation
| | - Valerie Tutwiler
- Department of Cell and Developmental Biology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States
| | - Chandrasekaran Nagaswami
- Department of Cell and Developmental Biology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States
| | - John W Weisel
- Department of Cell and Developmental Biology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States
| | - Rustem I Litvinov
- Department of Biochemistry and Biotechnology, Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russian Federation.,Department of Cell and Developmental Biology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States
| |
Collapse
|
132
|
Uhl B, Hirn S, Mildner K, Coletti R, Massberg S, Reichel CA, Rehberg M, Zeuschner D, Krombach F. The surface chemistry determines the spatio-temporal interaction dynamics of quantum dots in atherosclerotic lesions. Nanomedicine (Lond) 2018; 13:623-638. [PMID: 29334311 DOI: 10.2217/nnm-2017-0350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
AIM To optimize the design of nanoparticles for diagnosis or therapy of vascular diseases, it is mandatory to characterize the determinants of nano-bio interactions in vascular lesions. MATERIALS & METHODS Using ex vivo and in vivo microscopy, we analyzed the interactive behavior of quantum dots with different surface functionalizations in atherosclerotic lesions of ApoE-deficient mice. RESULTS We demonstrate that quantum dots with different surface functionalizations exhibit specific interactive behaviors with distinct molecular and cellular components of the injured vessel wall. Moreover, we show a role for fibrinogen in the regulation of the spatio-temporal interaction dynamics in atherosclerotic lesions. CONCLUSION Our findings emphasize the relevance of surface chemistry-driven nano-bio interactions on the differential in vivo behavior of nanoparticles in diseased tissue.
Collapse
Affiliation(s)
- Bernd Uhl
- Walter Brendel Centre of Experimental Medicine, Klinikum der Universität München, Munich, Germany.,Department of Otorhinolaryngology, Head & Neck Surgery, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Stephanie Hirn
- Walter Brendel Centre of Experimental Medicine, Klinikum der Universität München, Munich, Germany
| | - Karina Mildner
- Electron Microscopy Unit, Max Planck Institute for Molecular Biomedicine, Münster, Germany
| | - Raffaele Coletti
- Department of Cardiology, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Steffen Massberg
- Department of Cardiology, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Christoph A Reichel
- Walter Brendel Centre of Experimental Medicine, Klinikum der Universität München, Munich, Germany.,Department of Otorhinolaryngology, Head & Neck Surgery, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Markus Rehberg
- Walter Brendel Centre of Experimental Medicine, Klinikum der Universität München, Munich, Germany.,Institute for Stroke & Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Dagmar Zeuschner
- Electron Microscopy Unit, Max Planck Institute for Molecular Biomedicine, Münster, Germany
| | - Fritz Krombach
- Walter Brendel Centre of Experimental Medicine, Klinikum der Universität München, Munich, Germany
| |
Collapse
|
133
|
Hosseini E, Ghasemzadeh M. Intravascular leukocyte migration through platelet thrombi: directing leukocytes to sites of vascular injury. Thromb Haemost 2017; 113:1224-35. [DOI: 10.1160/th14-08-0662] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Accepted: 01/13/2015] [Indexed: 12/15/2022]
Abstract
SummaryLeukocytes recruitment to thrombi supports an intimate cellular interaction leading to the enhancement of pro-coagulant functions and pro-inflammatory responses at site of vascular injury. Recent observations of neutrophil extracellular traps (NETs) formation and its mutual reactions with platelet thrombi adds more clinical interest to the growing body of knowledge in the field of platelet-leukocyte crosstalk. However, having considered thrombus as a barrier between leukocytes and injured endothelium, the full inflammatory roles of these cells during thrombosis is still ill defined. The most recent observation of neutrophils migration into the thrombi is a phenomenon that highlights the inflammatory functions of leukocytes at the site of injury. It has been hypothesised that leukocytes migration might be associated with the conveyance of highly reactive pro-inflammatory and/or procoagulant mediators to sites of vascular injury. In addition, the evidence of neutrophils migration into arterial thrombi following traumatic and ischaemia-reperfusion injury highlights the already described role of these cells in atherosclerosis. Regardless of the mechanisms behind leukocyte migration, whether these migrated cells benefit normal homeostasis by their involvement in wound healing and vascular rebuilding or they increase unwilling inflammatory responses, could be of interest for future researches that provide new insight into biological importance of leukocyte recruitment to thrombi.
Collapse
|
134
|
Procoagulant platelets: generation, function, and therapeutic targeting in thrombosis. Blood 2017; 130:2171-2179. [DOI: 10.1182/blood-2017-05-787259] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 09/12/2017] [Indexed: 11/20/2022] Open
Abstract
Abstract
Current understanding of how platelets localize coagulation to wound sites has come mainly from studies of a subpopulation of activated platelets. In this review, we summarize data from the last 4 decades that have described these platelets with a range of descriptive titles and attributes. We identify striking overlaps in the reported characteristics of these platelets, which imply a single subpopulation of versatile platelets and thus suggest that their commonality requires unification of their description. We therefore propose the term procoagulant platelet as the unifying terminology. We discuss the agonist requirements and molecular drivers for the dramatic morphological transformation platelets undergo when becoming procoagulant. Finally, we provide perspectives on the biomarker potential of procoagulant platelets for thrombotic events as well as on the possible clinical benefits of inhibitors of carbonic anhydrase enzymes and the water channel Aquaporin-1 for targeting this subpopulation of platelets as antiprocoagulant antithrombotics.
Collapse
|
135
|
Ferreira D, de Sousa JA, Felicíssimo P, França A. Venous thromboembolism risk and prophylaxis in the Portuguese hospital care setting: The ARTE study. Rev Port Cardiol 2017; 36:823-830. [PMID: 29137835 DOI: 10.1016/j.repc.2017.01.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 01/22/2017] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Venous thromboembolism (VTE) is a relatively common complication during hospital stay and determination of VTE risk is critical to choosing the best prophylactic strategy for each patient. OBJECTIVES In the present study we studied the risk profile for VTE in hospitalized patients in a group of hospitals in Portugal. METHODS Based on an open cohort of 4248 patients hospitalized in surgical, internal medicine, orthopedic or oncology departments, we determined thromboembolic risk at admission by applying a new score, modified from the Caprini and Khorana scores. Thrombotic, embolic and bleeding events and death were assessed during hospital stay and at three and six months after discharge. RESULTS The median duration of hospital stay was five days and thromboembolic prophylaxis was implemented in 67.2% (n=2747) of the patients. A low molecular weight heparin was used as prophylaxis in the majority of cases (88.3%). Most patients were classified as high (68%) or intermediate risk (27%). The overall incidence of thromboembolic events was 1.5%. Major bleeding events were recorded in 3.89% of patients and all-cause mortality was 3.4%. CONCLUSIONS In this study, we propose a modified VTE risk score that effectively risk-stratifies a mixed inpatient population during hospital stay. The use of this score may result in improvement of thromboprophylaxis practices in hospitals.
Collapse
Affiliation(s)
- Daniel Ferreira
- Cardiovascular Center of Hospital da Luz Lisboa, Lisbon, Portugal.
| | | | - Paulo Felicíssimo
- Orthopedics Department of Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
| | - Ana França
- Cardiovascular Center of Hospital da Luz Lisboa, Lisbon, Portugal; Instituto Português do Sangue e da Transplantação (IPST), IP, Lisbon, Portugal
| |
Collapse
|
136
|
Ferreira D, de Sousa JA, Felicíssimo P, França A. Venous thromboembolism risk and prophylaxis in the Portuguese hospital care setting: The ARTE study. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2017. [DOI: 10.1016/j.repce.2017.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
137
|
Shen CJ, Kao CH, Hsu TY, Chen CY, Lin CL, Shih HM. Effect of alcohol intoxication on the risk of venous thromboembolism: A nationwide retrospective cohort study. Medicine (Baltimore) 2017; 96:e8041. [PMID: 29049192 PMCID: PMC5662358 DOI: 10.1097/md.0000000000008041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
This study investigated whether alcohol intoxication (AI) increases the risk of venous thromboembolism (VTE) by using the Taiwan National Health Insurance Research Database (NHIRD).Using data from the NHIRD, we assembled 61,229 patients with acute AI and randomly selected 244,916 controls. Each patient was monitored from 2000 to 2011 to identify those who were subsequently diagnosed with deep vein thrombosis (DVT) and pulmonary embolism (PE). Cox proportional hazard regression analysis was conducted to determine the risk of VTE in the patients with AI compared with the controls.The incidence rate of DVT during the 10 years follow-up period was 9.36 per 10,000 person-years and 2.07 per 10,000 person-years in the AI and non-AI cohorts, respectively. Moreover, the incidence rate of PE was 4 per 10,000 person-years in the AI cohort and 0.93 in the non-AI cohort. After adjustment for age, sex, and comorbidities, the risks of DVT and PE were 3.40 [95% confidence interval (CI) = 2.83-4.08] and 3.53 (95% CI = 2.69-4.65)-fold higher in the AI cohort than in the non-AI cohort.An increased incidence of VTE was observed among patients with AI. Therefore, physicians should carefully estimate the risk of VTE in patients with AI.
Collapse
Affiliation(s)
- Chih-Jung Shen
- Department of Emergency Medicine
- School of Medicine, College of Medicine
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine
- Department of Nuclear Medicine and PET Center
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan Management Office for Health Data
| | - Tai-Yi Hsu
- Department of Emergency Medicine
- School of Medicine, College of Medicine
| | - Chih-Yu Chen
- Department of Emergency Medicine
- School of Medicine, College of Medicine
| | - Cheng-Li Lin
- School of Medicine, College of Medicine
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan, Republic of China
| | - Hong-Mo Shih
- Department of Emergency Medicine
- School of Medicine, College of Medicine
| |
Collapse
|
138
|
Inhibition of plasmin generation in plasma by heparin, low molecular weight heparin, and a covalent antithrombin–heparin complex. Blood Coagul Fibrinolysis 2017; 28:431-437. [DOI: 10.1097/mbc.0000000000000611] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
139
|
Jain A, Barrile R, van der Meer AD, Mammoto A, Mammoto T, De Ceunynck K, Aisiku O, Otieno MA, Louden CS, Hamilton GA, Flaumenhaft R, Ingber DE. Primary Human Lung Alveolus-on-a-chip Model of Intravascular Thrombosis for Assessment of Therapeutics. Clin Pharmacol Ther 2017; 103:332-340. [PMID: 28516446 DOI: 10.1002/cpt.742] [Citation(s) in RCA: 191] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 04/26/2017] [Accepted: 05/08/2017] [Indexed: 12/26/2022]
Abstract
Pulmonary thrombosis is a significant cause of patient mortality; however, there are no effective in vitro models of thrombi formation in human lung microvessels that could also assess therapeutics and toxicology of antithrombotic drugs. Here, we show that a microfluidic lung alveolus-on-a-chip lined by human primary alveolar epithelium interfaced with endothelium and cultured under flowing whole blood can be used to perform quantitative analysis of organ-level contributions to inflammation-induced thrombosis. This microfluidic chip recapitulates in vivo responses, including platelet-endothelial dynamics and revealed that lipopolysaccharide (LPS) endotoxin indirectly stimulates intravascular thrombosis by activating the alveolar epithelium, rather than acting directly on endothelium. This model is also used to analyze inhibition of endothelial activation and thrombosis due to a protease activated receptor-1 (PAR-1) antagonist, demonstrating its ability to dissect complex responses and identify antithrombotic therapeutics. Thus, this methodology offers a new approach to study human pathophysiology of pulmonary thrombosis and advance drug development.
Collapse
Affiliation(s)
- A Jain
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA.,Vascular Biology Program and Department of Surgery, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA.,Division of Hemostasis and Thrombosis, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.,Department of Biomedical Engineering, Dwight Look College of Engineering, Texas A&M University, College Station, Texas, USA
| | - R Barrile
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA.,Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - A D van der Meer
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA.,MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - A Mammoto
- Vascular Biology Program and Department of Surgery, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - T Mammoto
- Vascular Biology Program and Department of Surgery, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - K De Ceunynck
- Division of Hemostasis and Thrombosis, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - O Aisiku
- Division of Hemostasis and Thrombosis, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - M A Otieno
- Janssen Pharmaceutical Research and Development, Pre-Clinical Development and Safety, Spring House, Pennsylvania, USA
| | - C S Louden
- Janssen Pharmaceutical Research and Development, Pre-Clinical Development and Safety, Spring House, Pennsylvania, USA
| | | | - R Flaumenhaft
- Division of Hemostasis and Thrombosis, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - D E Ingber
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA.,Vascular Biology Program and Department of Surgery, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA.,Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, Massachusetts, USA
| |
Collapse
|
140
|
Fei X, Yuan W, Jiang L, Wang H. Opposite effects of Agrimonia pilosa Ledeb aqueous extracts on blood coagulation function. ANNALS OF TRANSLATIONAL MEDICINE 2017; 5:157. [PMID: 28480193 DOI: 10.21037/atm.2017.03.17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Agrimonia pilosa Ledeb (APL) has showed anticoagulant and antithrombotic activities in some studies, whereas its actual effects on blood coagulation are still unclear. This study was designed to observe the in vitro effects of APL aqueous extracts on blood coagulation, as well as to investigate the underlying mechanisms. METHODS Studies were divided into four groups: 0, 4, 20, and 80 g/L of APL aqueous extracts mixed with plasma or whole blood samples. Clotting time of whole blood, plasma coagulation tests, activities of plasma coagulation factors, plasma calcium ion, platelet aggregation test, and platelet fibrinogen receptor as well as the blood viscosity were measured. RESULTS It was observed that the APL aqueous extracts in 4 g/L significantly prolonged the whole blood clotting time and activated partial thromboplastin time, shortened prothrombin time, decreased activities of coagulation factor VIII, IX and XI, and levels of platelet aggregation and fibrinogen receptor expression. However, coagulation factor VII activity, and blood viscosity were increased after the extracts treatment. And the effects of APL extracts were in a concentration-dependent manner (0-80 g/L). CONCLUSIONS The results suggest that APL aqueous extracts have a total anticoagulant activity, whereas they exhibit opposite effects of greater anticoagulant activity than pro-coagulant activity.
Collapse
Affiliation(s)
- Xianming Fei
- Center of Laboratory Medicine, Zhejiang Provincial People's Hospital, and People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - Wufeng Yuan
- Center of Laboratory Medicine, Zhejiang Provincial People's Hospital, and People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - Lei Jiang
- Center of Laboratory Medicine, Zhejiang Provincial People's Hospital, and People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - Huan Wang
- Center of Laboratory Medicine, Zhejiang Provincial People's Hospital, and People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
| |
Collapse
|
141
|
Nagy M, Heemskerk JWM, Swieringa F. Use of microfluidics to assess the platelet-based control of coagulation. Platelets 2017; 28:441-448. [PMID: 28358995 DOI: 10.1080/09537104.2017.1293809] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This paper provides an overview of the various types of microfluidic devices that are employed to study the complex processes of platelet activation and blood coagulation in whole blood under flow conditions. We elaborate on how these devices are used to detect impaired platelet-dependent fibrin formation in blood from mice or patients with specific bleeding disorders. We provide a practical guide on how to assess formation of a platelet-fibrin thrombus under flow, using equipment that is present in most laboratories. In addition, we describe current insights on how blood flow and shear rate alter the location of platelet populations, von Willebrand factor, coagulation factors, and fibrin in a growing thrombus. Finally, we discuss possibilities and limitations for the clinical use of microfluidic devices to evaluate a hemostatic or prothrombotic tendency in patient blood samples.
Collapse
Affiliation(s)
- Magdolna Nagy
- a Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM) , Maastricht University , Maastricht , The Netherlands
| | - Johan W M Heemskerk
- a Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM) , Maastricht University , Maastricht , The Netherlands
| | - Frauke Swieringa
- a Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM) , Maastricht University , Maastricht , The Netherlands.,b Department of Bioanalytics , Leibniz Institute for Analytical Sciences - ISAS- e.V. , Dortmund , Germany
| |
Collapse
|
142
|
Lázár E, Oltean PB, Jáni L, Kovács I, Nyulas T, Benedek I, Benedek I. Noninvasive Assessment of Coronary Arteries in Patients with Hematologic Disorders. JOURNAL OF INTERDISCIPLINARY MEDICINE 2017. [DOI: 10.1515/jim-2017-0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractHematological conditions and their treatments have an increased risk of cardiovascular events, and invasive interventions have a higher risk of periprocedural complications in this group of patients. The aim of this review was to evaluate the risk of invasive interventions in patients with hematologic disorders and to underline the role of noninvasive cardiovascular screening in patients with hematological disorders such as Hodgkin and non-Hodgkin lymphoma, anemia, hemophilia, thrombocythemia, polycythemia vera, and leukemia. Based on present knowledge in the field, our opinion is that the screening of patients with hematological diseases is very important to reduce the morbidity and mortality due to cardiovascular events. Noninvasive assessments are suitable for this purpose with a significantly lower risk compared to invasive interventions.
Collapse
|
143
|
Mozzini C, Garbin U, Fratta Pasini AM, Cominacini L. An exploratory look at NETosis in atherosclerosis. Intern Emerg Med 2017; 12:13-22. [PMID: 27655025 DOI: 10.1007/s11739-016-1543-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 09/15/2016] [Indexed: 02/07/2023]
Abstract
Current evidence suggests the likelihood of a link between venous thromboembolism (VTE) and atherosclerosis, although they have been traditionally considered as different pathological entities. The contribution of neutrophils to human atherogenesis has been underestimated, if compared to their contribution established in VTE. This is due to the major importance attributed to macrophages in plaque destabilization. Nevertheless, the role of neutrophils in atherogenesis deserves increasing attention. In particular, neutrophil extracellular traps (NETs) are net-like chromatin fibres that are released from dying neutrophils. The death of neutrophils with NETs formation is called NETosis. During activation, neutrophils produce reactive oxygen species (ROS), through the activation of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase. The main function of NETs is trapping and killing pathogens. Nevertheless, NETs formation has been observed in various chronic inflammatory diseases, autoimmune diseases, vasculitis, lung diseases, cancer and VTE. Recent studies suggest that NETs formation might contribute also to atherosclerosis progression. New data report the presence of NETs in the luminal portion of human atherosclerotic vessels and coronary specimens obtained from patients after acute myocardial infarction. Programmed death mechanisms in atherosclerosis such as apoptosis, efferocytosis and also NETosis, share common features and triggers. If defective, they can lead the cells to a switch from programmed death to necrosis, resulting in the release of pro-atherogenic factors, accumulation of cell debris and progression of the disease. This review provides evidence on the emerging role of neutrophils focusing on NETosis and oxidative stress burden in orchestrating common mechanisms in atherosclerosis and thrombosis.
Collapse
Affiliation(s)
- Chiara Mozzini
- Section of Internal Medicine, Department of Medicine, University of Verona, 10, Piazzale L.A. Scuro, 37134, Verona, Italy.
| | - Ulisse Garbin
- Section of Internal Medicine, Department of Medicine, University of Verona, 10, Piazzale L.A. Scuro, 37134, Verona, Italy
| | - Anna Maria Fratta Pasini
- Section of Internal Medicine, Department of Medicine, University of Verona, 10, Piazzale L.A. Scuro, 37134, Verona, Italy
| | - Luciano Cominacini
- Section of Internal Medicine, Department of Medicine, University of Verona, 10, Piazzale L.A. Scuro, 37134, Verona, Italy
| |
Collapse
|
144
|
Litvinov RI, Weisel JW. Role of red blood cells in haemostasis and thrombosis. ISBT SCIENCE SERIES 2017; 12:176-183. [PMID: 28458720 PMCID: PMC5404239 DOI: 10.1111/voxs.12331] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In contrast to an obsolete notion that erythrocytes, or red blood cells (RBCs), play a passive and minor role in hemostasis and thrombosis, over the past decades there has been increasing evidence that RBCs have biologically and clinically important functions in blood clotting and its disorders. This review summarizes the main mechanisms that underlie the involvement of RBCs in hemostasis and thrombosis in vivo, such as rheological effects on blood viscosity and platelet margination, aggregation and deformability of RBCs; direct adhesion and indirect biochemical interactions with endothelial cells and platelets, etc. The ability of stored and pathologically altered RBCs to generate thrombin through exposure of phosphatidylserine has been emphasized. The procoagulant and prothrombotic potential of RBC-derived microparticles transfused with stored RBCs or formed in various pathological conditions associated with hemolysis has been described along with prothrombotic effects of free hemoglobin and heme. Binding of fibrinogen or fibrin to RBCs may influence their effects on fibrin network structure, clot mechanical properties, and fibrinolytic resistance. Recent data on platelet-driven clot contraction show that RBCs compressed by platelets pulling on fibrin form a tightly packed array of polyhedral erythrocytes, or polyhedrocytes, which comprises a nearly impermeable barrier important for hemostasis and wound healing. RBCs may perform dual roles, both helping to stem bleeding but at the same time contributing to thrombosis in a variety of ways.
Collapse
Affiliation(s)
- Rustem I Litvinov
- Department of Cell and Developmental Biology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - John W Weisel
- Department of Cell and Developmental Biology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| |
Collapse
|
145
|
Wu X, Yao Z, Zhao L, Zhang Y, Cao M, Li T, Ding W, Liu Y, Deng R, Dong Z, Chen H, Novakovic VA, Bi Y, Kou J, Tian Y, Zhou J, Shi J. Phosphatidylserine on blood cells and endothelial cells contributes to the hypercoagulable state in cirrhosis. Liver Int 2016; 36:1800-1810. [PMID: 27206310 DOI: 10.1111/liv.13167] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 05/14/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND & AIMS The mechanism of thrombogenicity in cirrhosis is largely unknown. Our objective was to study the relationship between phosphatidylserine on blood cells and endothelial cells and the hypercoagulable state in cirrhotic patients. METHODS Patients with cirrhosis and healthy controls were studied. Lactadherin was used to quantify phosphatidylserine exposure on blood cells and endothelial cells. Procoagulant activity of cells was evaluated using clotting time and purified coagulation complex assays. Fibrin production was determined by turbidity. Phosphatidylserine exposure, fibrin strands and FVa/Xa binding on cells were observed using confocal microscopy. RESULTS Our study showed that phosphatidylserine exposure on erythrocytes, platelets and leucocytes in cirrhotic patients increased progressively with Child-Pugh categories. In addition, we found that endothelial cells treated with cirrhotic serum in vitro exposed more phosphatidylserine than those exposed to healthy serum. The exposed phosphatidylserine supported a shorter coagulation time and increased FXa, thrombin and fibrin formation. Notably, phosphatidylserine+ erythrocytes also promoted shorter coagulation times and more fibrin generation in cirrhotic microparticle-depleted plasma, regardless of Child-Pugh categories. Confocal microscopy data showed that the FVa/FXa complex and fibrin fibrils colocalized with phosphatidylserine on endothelial cells. Lactadherin significantly inhibited FXa and thrombin generation and consequently decreased fibrin production in normal or cirrhotic plasma. CONCLUSIONS These results lead us to believe that exposed phosphatidylserine on activated or injured erythrocytes, platelets, leucocytes and endothelial cells plays an important role in the hypercoagulable state in cirrhotic patients. Thus, blocking phosphatidylserine binding sites might be a new therapeutic target for preventing thrombosis.
Collapse
Affiliation(s)
- Xiaoming Wu
- Departments of Hematology, The First Hospital, Harbin Medical University, Harbin, China
| | - Zhipeng Yao
- Departments of Hematology, The First Hospital, Harbin Medical University, Harbin, China
| | - Lu Zhao
- Departments of Hematology, The First Hospital, Harbin Medical University, Harbin, China
| | - Yan Zhang
- Departments of Hematology, The First Hospital, Harbin Medical University, Harbin, China
| | - Muhua Cao
- Departments of Hematology, The First Hospital, Harbin Medical University, Harbin, China
| | - Tao Li
- Departments of Hematology, The First Hospital, Harbin Medical University, Harbin, China
| | - Wenbo Ding
- Department of Cardiology, The Second Hospital, Harbin Medical University, Harbin, China
| | - Yan Liu
- Departments of Hematology, The First Hospital, Harbin Medical University, Harbin, China
| | - Ruijuan Deng
- Departments of Hematology, The First Hospital, Harbin Medical University, Harbin, China
| | - Zengxiang Dong
- Department of Cardiology, The First Hospital, Harbin Medical University, Harbin, China
| | - He Chen
- Department of Pathology, Harbin Medical University, Harbin, China
| | - Valerie A Novakovic
- Department of Research, VA Boston Healthcare System, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yayan Bi
- Department of Cardiology, The First Hospital, Harbin Medical University, Harbin, China
| | - Junjie Kou
- Department of Cardiology, The Second Hospital, Harbin Medical University, Harbin, China
| | - Ye Tian
- Department of Cardiology, The First Hospital, Harbin Medical University, Harbin, China
| | - Jin Zhou
- Departments of Hematology, The First Hospital, Harbin Medical University, Harbin, China
| | - Jialan Shi
- Departments of Hematology, The First Hospital, Harbin Medical University, Harbin, China.,Department of Surgery, VA Boston Healthcare System, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
146
|
Dangas GD, Weitz JI, Giustino G, Makkar R, Mehran R. Prosthetic Heart Valve Thrombosis. J Am Coll Cardiol 2016; 68:2670-2689. [DOI: 10.1016/j.jacc.2016.09.958] [Citation(s) in RCA: 256] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 09/19/2016] [Accepted: 09/20/2016] [Indexed: 01/28/2023]
|
147
|
Garbeloti EJR, Paiva RCA, Restini CBA, Durand MT, Miranda CES, Teixeira VE. Biochemical biomarkers are not dependent on physical exercise in patients with spinal cord injury. BBA CLINICAL 2016; 6:5-11. [PMID: 27331022 PMCID: PMC4900297 DOI: 10.1016/j.bbacli.2016.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 04/29/2016] [Accepted: 05/03/2016] [Indexed: 11/05/2022]
|
148
|
Ahmad FI, Clayburgh DR. Venous thromboembolism in head and neck cancer surgery. CANCERS OF THE HEAD & NECK 2016; 1:13. [PMID: 31093343 PMCID: PMC6460546 DOI: 10.1186/s41199-016-0014-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 10/03/2016] [Indexed: 11/30/2022]
Abstract
Background Venous thromboembolism (VTE) is a major cause of perioperative morbidity and mortality. Historically, otolaryngology surgery has been seen as very low risk of VTE, given the relatively short procedures and healthy patient population. However, head and neck surgery patients have multiple additional risk factors for VTE compared to general otolaryngology patients, and only recently has research been directed at examining this population of patients regarding VTE risk. Review VTE has long been recognized as a major issue in other surgical specialties, with VTE rates of 15–60 % in some specialties in the absence of prophylaxis with either mechanical compression or anticoagulation. Multiple large-scale retrospective studies have shown that the incidence of VTE in otolaryngology patients is quite low, ranging between 0.1 and 1.6 %. However, these studies indicated that head and neck cancer patients may have an increased risk of VTE. Further retrospective studies focusing on head and neck cancer patients found a VTE rate of approximately 2 %, but one study also found a suspected VTE rate of 5.6 % based on clinical symptoms, indicating that retrospective studies may underreport the true incidence. A single prospective study found a 13 % risk of VTE after major head and neck surgery. Furthermore, risk stratification using the Caprini risk assessment model demonstrates that the highest risk patients may have a VTE risk of 18.3 %, although this may be lowered (but not eliminated) through the use of appropriate prophylactic anticoagulation. Conclusion VTE is likely a more significant concern in head and neck surgery patients than previously realized. Appropriate prophylaxis with mechanical compression and anticoagulation is essential; risk stratification may serve as a useful tool to identify head and neck cancer patients at highest risk for VTE.
Collapse
Affiliation(s)
- Faisal I Ahmad
- Department of Otolaryngology- Head & Neck Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, PV01, Portland, OR 97239 USA
| | - Daniel R Clayburgh
- Department of Otolaryngology- Head & Neck Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, PV01, Portland, OR 97239 USA
| |
Collapse
|
149
|
Bayram F, Diri H, Sener EF, Dundar M, Simsek Y. Genetic expressions of thrombophilic factors in patients with Sheehan's syndrome. Gynecol Endocrinol 2016; 32:908-911. [PMID: 27425780 DOI: 10.1080/09513590.2016.1198763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate the roles of factors associated with coagulation in the etiology and pathogenesis of Sheehan's syndrome (SS) which is a frequent cause of hypopituitarism in underdeveloped and developing regions of the world. METHODS Mean prothrombin time (PT), activated partial thromboplastin time (APTT) and expression levels of genes, which included methylenetetrahydrofolate reductase (MTHFR), angiotensin I converting enzyme (ACE), coagulation factor V (FV), FVII, FVIII and FIX in 44 patients with SS were compared with 43 healthy subjects. RESULTS The mean expression level of the ACE gene was significantly lower, while that of the FV gene was significantly higher in the patients with SS. No significant difference was found between the patients with SS and the healthy subjects in the comparisons of the remaining gene expression values, as well as in the PT and APTT values. CONCLUSION An increased expression of the FV gene may be a contributing factor for the development of SS in some patients. Further studies are required to clarify the roles of coagulation disorders in the development of SS.
Collapse
Affiliation(s)
| | | | | | - Munis Dundar
- c Department of Medical Genetics , Erciyes University Medical School , Kayseri , Turkey
| | | |
Collapse
|
150
|
The Role of Pulmonary Veins in Cancer Progression from a Computed Tomography Viewpoint. JOURNAL OF ONCOLOGY 2016; 2016:1872627. [PMID: 27746816 PMCID: PMC5055964 DOI: 10.1155/2016/1872627] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 08/25/2016] [Indexed: 12/21/2022]
Abstract
Background. We studied the role of pulmonary veins in cancer progression using computed tomography (CT) scans. Methods. We obtained data from 260 patients with pulmonary vein obstruction syndrome (PVOS). We used CT scans to investigate pulmonary lesions in relation to pulmonary veins. We divided the lesions into central and peripheral lesions by their anatomical location: in the lung parenchymal tissue or pulmonary vein; in the superior or inferior pulmonary vein; and by unilateral or bilateral presence in the lungs. Results. Of the 260 PVOS patients, 226 (87%) had central lesions, 231 (89%) had peripheral lesions, and 190 (75%) had mixed central and peripheral lesions. Among the 226 central lesions, 93% had lesions within the superior pulmonary vein, either bilaterally or unilaterally. Among the 231 peripheral lesions, 65% involved bilateral lungs, 70% involved lesions within the inferior pulmonary veins, and 23% had obvious metastatic extensions into the left atrium. All patients exhibited nodules within their pulmonary veins. The predeath status included respiratory failure (40%) and loss of consciousness (60%). Conclusion. CT scans play an important role in following tumor progression within pulmonary veins. Besides respiratory distress, PVOS cancer cells entering centrally can result in cardiac and cerebral events and loss of consciousness or can metastasize peripherally from the pulmonary veins to the lungs.
Collapse
|