1
|
Ali NH, Al-Kuraishy HM, Al-Gareeb AI, Alnaaim SA, Alexiou A, Papadakis M, Saad HM, Batiha GES. The probable role of tissue plasminogen activator/neuroserpin axis in Alzheimer's disease: a new perspective. Acta Neurol Belg 2024; 124:377-388. [PMID: 37917293 DOI: 10.1007/s13760-023-02403-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 10/09/2023] [Indexed: 11/04/2023]
Abstract
Alzheimer's disease (AD) is the most common type of dementia associated with amyloid beta (Aβ) deposition. Dysfunction of the neuronal clearance pathway promotes the accumulation of Aβ. The plasminogen-activating system (PAS) is controlled by various enzymes like tissue plasminogen activators (tPA). Neuronal tPA enhances the conversion of plasminogen to plasmin, which cleaves Aβ; this function is controlled by many inhibitors of PAS, including a plasminogen-activating inhibitor (PAI-1) and neuroserpin. Therefore, the objective of the present narrative review was to explore the potential role of tPA/neuroserpin in the pathogenesis of AD. PAI-1 activity is increased in AD, which is involved in accumulating Aβ. Progressive increase of Aβ level during AD neuropathology is correlated with the over-production of PAI-1 with subsequent reduction of plasmin and tPA activities. Reducing plasmin and tPA activities promote Aβ by reducing Aβ clearance. Neuroserpin plays a critical role in the pathogenesis of AD as it regulates the expression and accumulation of Aβ. Higher expression of neuroserpin inhibits the neuroprotective tPA and the generation of plasmin with subsequent reduction in the clearance of Aβ. These observations raise conflicting evidence on whether neuroserpin is neuroprotective or involved in AD progression. Thus, neuroserpin over-expression with subsequent reduction of tPA may propagate AD neuropathology.
Collapse
Affiliation(s)
- Naif H Ali
- Department of Internal Medicine, Medical College, Najran University, Najran, Saudi Arabia
| | - Hayder M Al-Kuraishy
- Department of Clinical Pharmacology and Medicine, College of Medicine, ALmustansiriyia University, PO Box 14132, Baghdad, Iraq
| | - Ali I Al-Gareeb
- Department of Clinical Pharmacology and Medicine, College of Medicine, ALmustansiriyia University, PO Box 14132, Baghdad, Iraq
| | - Saud A Alnaaim
- Clinical Neurosciences Department, College of Medicine, King Faisal University, Hofuf, Saudi Arabia
| | - Athanasios Alexiou
- Department of Science and Engineering, Novel Global Community Educational Foundation, Hebersham, NSW, 2770, Australia
- AFNP Med, 1030, Vienna, Austria
| | - Marios Papadakis
- Department of Surgery II, University Hospital Witten-Herdecke, Heusnerstrasse 40, University of Witten-Herdecke, 42283, Wuppertal, Germany.
| | - Hebatallah M Saad
- Department of Pathology, Faculty of Veterinary Medicine, Matrouh University, Matrouh, 51744, Matrouh, Egypt.
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, 22511, AlBeheira, Egypt.
| |
Collapse
|
2
|
Buysse J, Khan R, Aldoss O, Vijayakumar N, Karimi M, Mohammad Nijres B. Massive perinatal left ventricle infarction treated with tissue plasminogen activator: No ECMO - A case report. J Neonatal Perinatal Med 2022; 15:367-372. [PMID: 34806621 DOI: 10.3233/npm-210793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Neonatal myocardial infarction due to coronary thrombus is a rare cause of acute heart failure and is associated with high morbidity and mortality. We present a rare case of a full-term newborn who developed coronary artery thrombus treated with intracoronary recombinant tissue plasminogen activator infusion while undergoing therapeutic hypothermia. Also, we describe a unique treatment strategy to support systemic circulation sparing the patient from neonatal extracorporeal membrane oxygenation and its complications. Neonatal myocardial infarction should be suspected and ruled out in sick newborns.
Collapse
Affiliation(s)
- J Buysse
- Division of Cardiology, Department of Pediatrics, Stead Family Children's Hospital, The University of Iowa, Iowa City, IA, USA
| | - R Khan
- Division of Cardiology, Department of Pediatrics, Stead Family Children's Hospital, The University of Iowa, Iowa City, IA, USA
| | - O Aldoss
- Division of Cardiology, Department of Pediatrics, Stead Family Children's Hospital, The University of Iowa, Iowa City, IA, USA
| | - N Vijayakumar
- Division of Critical Care, Department of Pediatrics, Stead Family Children's Hospital, The University of Iowa, Iowa City, IA, USA
| | - M Karimi
- Department of Surgery, Section of Cardiothoracic Surgery, Congenital Cardiac Surgery, Stead Family Children's Hospital, The University of Iowa, Iowa City, IA, USA
| | - B Mohammad Nijres
- Division of Cardiology, Department of Pediatrics, Stead Family Children's Hospital, The University of Iowa, Iowa City, IA, USA
| |
Collapse
|
3
|
Segar DE, Amidon M, Scott J, Frommelt PC. Native Aortic Root Thrombus in 3-Year-Old Fontan Patient with Hypoplastic Left Heart Syndrome: Presentation and Echocardiographic Findings of This Life-Threatening Complication. ACTA ACUST UNITED AC 2021; 5:276-279. [PMID: 34712870 PMCID: PMC8530801 DOI: 10.1016/j.case.2021.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Native aortic root thrombus is a life-threatening complication in patients with HLHS. Echo evaluation of the native aortic root is an important consideration. Echo monitoring is a useful tool for assessment of thrombus response to therapy.
Collapse
Affiliation(s)
- David E Segar
- Department of Pediatric Cardiology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Matthew Amidon
- Department of Pediatric Critical Care, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Jake Scott
- Department of Pediatric Critical Care, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Peter C Frommelt
- Department of Pediatric Cardiology, Medical College of Wisconsin, Milwaukee, Wisconsin
| |
Collapse
|
4
|
Feier FH, Melere MU, Trein CS, da Silva CS, Lucchese A, Horbe A, Tonet F, Ricachinevsky C, Ferreira CT, Chedid MF, Kalil AN. Early hepatic arterial thrombosis in liver transplantation: Systemic intravenous alteplase as a potential rescue treatment after failed surgical revascularization. Pediatr Transplant 2021; 25:e13902. [PMID: 33111470 DOI: 10.1111/petr.13902] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/29/2020] [Accepted: 10/05/2020] [Indexed: 11/29/2022]
Abstract
eHAT is one of the most dreaded post-LT complication. Treatment approaches include retransplantation, revascularization, or observation. Systemic thrombolytic therapy is used in pediatric patients with thromboembolic events. However, there is no previous study reporting on the use of systemic r-tPA to treat eHAT. The treatment strategies used in patients with eHAT are described, focusing on two children who failed SR and were treated with systemic heparinization plus systemic r-tPA infusion. r-tPA-RP consists of intravenous systemic infusion at a dose of 0.3 mg/kg/h during 6 hours, for 5 days. First case (3-year) was transplanted with a whole liver, and second case (6-year) received a LLS from a living donor. HAT was diagnosed by doppler US and confirmed by angioCT scan in both patients in the first day after LT. They underwent SR and were clinically stable. Re-thrombosis occurred in both patients the day after, and r-TPA-RP was started-one patient required two r-TPA-RP for HAT recurrence. They presented minor bleeding, without repercussion. Hepatic artery recanalized after 10 and 3 days in the first and second patient, respectively. Retransplant was avoided, and one developed biliary strictures, successfully managed in the follow-up. r-TPA-RP avoided retransplantation after eHAT in these cases. To our knowledge, this is the first report of the use of systemic r-TPA to treat eHAT in children. This strategy may compose an algorithm to treat eHAT that failed SR in stable patients.
Collapse
Affiliation(s)
- Flávia H Feier
- Pediatric Liver Transplantation Unit, Hospital Santa Casa, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Melina U Melere
- Pediatric Liver Transplantation Unit, Hospital Santa Casa, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Cristine S Trein
- Pediatric Liver Transplantation Unit, Hospital Santa Casa, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Carolina Soares da Silva
- Pediatric Liver Transplantation Unit, Hospital Santa Casa, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Angelica Lucchese
- Pediatric Liver Transplantation Unit, Hospital Santa Casa, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Alex Horbe
- Interventional Radiology Unit, Hospital Santa Casa, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Fabio Tonet
- Division of Radiology, Hospital Santa Casa, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Claudia Ricachinevsky
- Pediatric Liver Transplantation Unit, Hospital Santa Casa, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Cristina T Ferreira
- Pediatric Liver Transplantation Unit, Hospital Santa Casa, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Marcio F Chedid
- Postgraduation Program in Surgery, Medical School of UFRGS, Porto Alegre, Brazil
| | - Antonio N Kalil
- Pediatric Liver Transplantation Unit, Hospital Santa Casa, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| |
Collapse
|
5
|
Abstract
Modified Blalock-Taussig shunt thrombosis is a life-threatening event. We describe an extremely rare catheter-induced shunt thrombosis in an infant with complex CHD and its successful treatment utilising a single low dose of local recombinant tissue plasminogen activator in conjunction with balloon angioplasty.
Collapse
|