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Sun N, Chen YQ, Chen YS, Gao L, Deng RW, Huang J, Fan YL, Gao X, Sun BF, Dong NN, Yu B, Gu X, Wu BX. Plasma Deoxycholic Acid Levels are Associated with Hemodynamic and Clinical Outcomes in Acute Pulmonary Embolism Patients. Cardiovasc Toxicol 2024:10.1007/s12012-024-09893-y. [PMID: 39008240 DOI: 10.1007/s12012-024-09893-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 07/05/2024] [Indexed: 07/16/2024]
Abstract
This study aimed to evaluate the correlation of plasma deoxycholic acid (DCA) levels with clinical and hemodynamic parameters in acute pulmonary embolism (APE) patients. Total 149 APE adult patients were prospectively recruited. Plasma DCA levels were measured using rapid resolution liquid chromatography-quadrupole time-of-flight mass spectrometry. Baseline clinical and hemodynamic parameters were evaluated according to plasma DCA levels. The plasma DCA levels were significantly lower in APE patients than in those without APE (P < 0.001). APE patients with adverse events had lower plasma DCA levels (P < 0.001). Low DCA group patients presented more adverse cardiac function, higher NT-proBNP levels (P = 0.010), and higher WHO functional class levels (P = 0.023). Low DCA group also presented with an adverse hemodynamic status, with higher pulmonary vascular resistance levels (P = 0.027) and lower cardiac index levels (P = 0.024). Both cardiac function and hemodynamic parameters correlated well with plasma DCA levels. Kaplan-Meier survival analysis demonstrated that APE patients with lower plasma DCA levels had a significantly higher event rate (P = 0.009). In the univariate and multivariate Cox regression analyses, the plasma DCA level was an independent predictor of clinical worsening events after adjusting for age, sex, WHO functional class, NT-proBNP level, pulmonary vascular resistance, and cardiac index (HR 0.370, 95% CI 0.161, 0.852; P = 0.019). Low plasma DCA levels predicted adverse cardiac function and hemodynamic collapse. A low DCA level was correlated with a higher clinical worsening event rate and could be an independent predictor of clinical outcomes in multivariate analysis.
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Affiliation(s)
- Na Sun
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, 150086, China
- Key Laboratory of Myocardial Ischemia, Ministry Education, Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, 150086, China
| | - Yi-Qiang Chen
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, 150086, China
| | - Yan-Sheng Chen
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, 150086, China
- Key Laboratory of Myocardial Ischemia, Ministry Education, Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, 150086, China
| | - Lei Gao
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, 150086, China
| | - Run-Wei Deng
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, 150086, China
- Key Laboratory of Myocardial Ischemia, Ministry Education, Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, 150086, China
| | - Jing Huang
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, 150086, China
- Key Laboratory of Myocardial Ischemia, Ministry Education, Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, 150086, China
| | - You-Li Fan
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, 150086, China
- Key Laboratory of Myocardial Ischemia, Ministry Education, Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, 150086, China
| | - Xuan Gao
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, 150086, China
- Key Laboratory of Myocardial Ischemia, Ministry Education, Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, 150086, China
| | - Bin-Feng Sun
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, 150086, China
| | - Na-Na Dong
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, 150086, China
- Key Laboratory of Myocardial Ischemia, Ministry Education, Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, 150086, China
| | - Bo Yu
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, 150086, China
- Key Laboratory of Myocardial Ischemia, Ministry Education, Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, 150086, China
| | - Xia Gu
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, 150086, China.
- Key Laboratory of Myocardial Ischemia, Ministry Education, Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, 150086, China.
- Cardiovascular Imaging Center, Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, 150086, China.
| | - Bing-Xiang Wu
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, 150086, China.
- Key Laboratory of Myocardial Ischemia, Ministry Education, Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin, 150086, China.
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Signorelli SS, Barbagallo A, Oliveri Conti G, Fiore M, Cristaldi A, Ferrante M. Oxidative Status, Iron Plasma Levels in Venous Thrombosis Patients. Antioxidants (Basel) 2024; 13:689. [PMID: 38929128 PMCID: PMC11200582 DOI: 10.3390/antiox13060689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 04/29/2024] [Accepted: 05/15/2024] [Indexed: 06/28/2024] Open
Abstract
Exaggerated clot induces venous thrombosis (VTE); oxidative stress (OxS) can to be postulated as additional risk factor. This study evaluates firstly OxS by measuring surrogate biomarkers (malondialdehyde-MDA, 4-hydroxinonenal-4-HNE, superoxide desmutase enzyme (SOD)), secondly the iron (Fe) plasma level and thirdly the hepcidin protein (Hep) level in patients with VTE. A case control study was performed enrolling twenty hospitalized patients and an equal number of healthy individuals. In VTE patients, the following results were found. The MDA was 8.38 ± 0.5 µM/L, the 4-HNE measured 2.75 ± 0.03 µM/L and the SOD was 0.025 ± 0.01 U/mL. The I was 73.10 ± 10 µg/dL and the He was 4.77 ± 0.52 ng/mL. In the control group, the MDA measured 5.5 ± 0.6 µM/L, the 4-HNE 2.24 ± 0.021 µM/L and the SOD 0.08 ± 0.12 U/mL. The Hep was 2.1 ± 0.55 ng/mL and the Fe was 88.2 ± 9.19 µg/dL. Differences were statistically significant. Results suggest that in VTE there is activated OxS, Fe deregulation and over-production of Hep. Fe deregulation induces OxS, leading both to inflammation in the clot activator and stimulation of the pro-thrombotic status. The study highlights OxS and Fe and their regulation as intriguing indicators for risk of VTE.
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Affiliation(s)
- Salvatore Santo Signorelli
- Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia 80, 95123 Catania, Italy
| | - Andrea Barbagallo
- Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia 80, 95123 Catania, Italy
| | - Gea Oliveri Conti
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, Hygiene and Public Health, University of Catania, Via Santa Sofia 73, 95123 Catania, Italy; (G.O.C.); (M.F.); (A.C.)
| | - Maria Fiore
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, Hygiene and Public Health, University of Catania, Via Santa Sofia 73, 95123 Catania, Italy; (G.O.C.); (M.F.); (A.C.)
| | - Antonio Cristaldi
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, Hygiene and Public Health, University of Catania, Via Santa Sofia 73, 95123 Catania, Italy; (G.O.C.); (M.F.); (A.C.)
| | - Margherita Ferrante
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, Hygiene and Public Health, University of Catania, Via Santa Sofia 73, 95123 Catania, Italy; (G.O.C.); (M.F.); (A.C.)
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Li Y, Ge J, Yin Y, He J, Shang L. Exploration on the effect of anserine on the alleviation of DVT and its molecular mechanism. Front Pharmacol 2024; 15:1402758. [PMID: 38846090 PMCID: PMC11154784 DOI: 10.3389/fphar.2024.1402758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 04/25/2024] [Indexed: 06/09/2024] Open
Abstract
Background This study aimed to explore the regulatory effect of anserine on HUVEC cell injury and thrombosis in deep venous thrombosis (DVT) rats, and to elucidate the underlying molecular mechanisms. Methods Non-targeted metabolomics data analyses were conducted using an ultra-performance liquid chromatography system Vanquish UHPLC and mass spectrometer to detect plasma metabolism profiles. The transcriptome sequencing and gene intervention experiments were performed to verify the regulatory effect. Further in vivo and in vitro experiments were performed. Enzyme-linked immunosorbent assay was used to detect the levels of P-selectin, E-selectin, and vWF, hematoxylin-eosin (HE) staining was performed to observe thrombotic and inflammatory cell infiltration, flow cytometry and TUNEL assays were performed to detect apoptosis, and qPCR and WB assays were conducted to determine the gene and protein expression. Results Anserine alleviated HUVECs injury, reduced adhesion molecule expression, and inflammation. It decreased P-selectin, E-selectin, vWF, THBD, TFPI levels, and apoptosis while promoting NOS3, ET-1, and NO release in HUVECs. In DVT rats, anserine reduced P-selectin, E-selectin, vWF, thrombosis, cell infiltration, apoptosis, and promoted NO release. Transcriptome sequencing and gene intervention confirmed anserine's regulation of the PI3K-Akt pathway and coagulation via MYB. CARNMT1, a regulatory enzyme for anserine metabolism, increased anserine content, inhibiting coagulation, thrombosis, cell infiltration, and promoting NO release in rats. Conclusion This study confirmed anserine could alleviate DVT by improving the inflammatory response, inhibiting blood agglutination, and promoting vasodilation, providing new potential therapeutic targets, important scientific evidence for the development of DVT management, and new clues for an in-depth understanding of its molecular mechanisms.
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Affiliation(s)
- Yan Li
- Department of Vascular and Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jingping Ge
- Department of Vascular and Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuanyuan Yin
- Department of Vascular and Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Juan He
- Department of Vascular and Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Longcheng Shang
- Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
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Zifkos K, Bochenek ML, Gogiraju R, Robert S, Pedrosa D, Kiouptsi K, Moiko K, Wagner M, Mahfoud F, Poncelet P, Münzel T, Ruf W, Reinhardt C, Panicot-Dubois L, Dubois C, Schäfer K. Endothelial PTP1B Deletion Promotes VWF Exocytosis and Venous Thromboinflammation. Circ Res 2024; 134:e93-e111. [PMID: 38563147 DOI: 10.1161/circresaha.124.324214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/25/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Endothelial activation promotes the release of procoagulant extracellular vesicles and inflammatory mediators from specialized storage granules. Endothelial membrane exocytosis is controlled by phosphorylation. We hypothesized that the absence of PTP1B (protein tyrosine phosphatase 1B) in endothelial cells promotes venous thromboinflammation by triggering endothelial membrane fusion and exocytosis. METHODS Mice with inducible endothelial deletion of PTP1B (End.PTP1B-KO) underwent inferior vena cava ligation to induce stenosis and venous thrombosis. Primary endothelial cells from transgenic mice and human umbilical vein endothelial cells were used for mechanistic studies. RESULTS Vascular ultrasound and histology showed significantly larger venous thrombi containing higher numbers of Ly6G (lymphocyte antigen 6 family member G)-positive neutrophils in mice with endothelial PTP1B deletion, and intravital microscopy confirmed the more pronounced neutrophil recruitment following inferior vena cava ligation. RT2 PCR profiler array and immunocytochemistry analysis revealed increased endothelial activation and adhesion molecule expression in primary End.PTP1B-KO endothelial cells, including CD62P (P-selectin) and VWF (von Willebrand factor). Pretreatment with the NF-κB (nuclear factor kappa B) kinase inhibitor BAY11-7082, antibodies neutralizing CD162 (P-selectin glycoprotein ligand-1) or VWF, or arginylglycylaspartic acid integrin-blocking peptides abolished the neutrophil adhesion to End.PTP1B-KO endothelial cells in vitro. Circulating levels of annexin V+ procoagulant endothelial CD62E+ (E-selectin) and neutrophil (Ly6G+) extracellular vesicles were also elevated in End.PTP1B-KO mice after inferior vena cava ligation. Higher plasma MPO (myeloperoxidase) and Cit-H3 (citrullinated histone-3) levels and neutrophil elastase activity indicated neutrophil activation and extracellular trap formation. Infusion of End.PTP1B-KO extracellular vesicles into C57BL/6J wild-type mice most prominently enhanced the recruitment of endogenous neutrophils, and this response was blunted in VWF-deficient mice or by VWF-blocking antibodies. Reduced PTP1B binding and tyrosine dephosphorylation of SNAP23 (synaptosome-associated protein 23) resulting in increased VWF exocytosis and neutrophil adhesion were identified as mechanisms, all of which could be restored by NF-κB kinase inhibition using BAY11-7082. CONCLUSIONS Our findings show that endothelial PTP1B deletion promotes venous thromboinflammation by enhancing SNAP23 phosphorylation, endothelial VWF exocytosis, and neutrophil recruitment.
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Affiliation(s)
- Konstantinos Zifkos
- Center for Thrombosis and Hemostasis (K.Z., M.L.B., D.P., K.K., W.R., C.R.), University Medical Center Mainz, Germany
| | - Magdalena L Bochenek
- Center for Thrombosis and Hemostasis (K.Z., M.L.B., D.P., K.K., W.R., C.R.), University Medical Center Mainz, Germany
- Department of Cardiology, Cardiology I (M.L.B., R.G., K.M., T.M., K.S.), University Medical Center Mainz, Germany
| | - Rajinikanth Gogiraju
- Department of Cardiology, Cardiology I (M.L.B., R.G., K.M., T.M., K.S.), University Medical Center Mainz, Germany
| | - Stéphane Robert
- Aix Marseille University, National Institute of Health and Medical Research (INSERM) 1263, National Research Institute for Agriculture, Food and Environment (INRAE), Cardiovascular and Nutrition Research Center (C2VN), France (S.R., L.P.-D., C.D.)
| | - Denise Pedrosa
- Center for Thrombosis and Hemostasis (K.Z., M.L.B., D.P., K.K., W.R., C.R.), University Medical Center Mainz, Germany
| | - Klytaimnistra Kiouptsi
- Center for Thrombosis and Hemostasis (K.Z., M.L.B., D.P., K.K., W.R., C.R.), University Medical Center Mainz, Germany
| | - Kateryna Moiko
- Department of Cardiology, Cardiology I (M.L.B., R.G., K.M., T.M., K.S.), University Medical Center Mainz, Germany
| | - Mathias Wagner
- Institute of Pathology, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg, Germany (M.W.)
| | - Felix Mahfoud
- Department of Internal Medicine III, Cardiology, Angiology and Internal Intensive Care Medicine, Saarland University Hospital and Saarland University, Homburg, Germany (F.M.)
| | | | - Thomas Münzel
- Department of Cardiology, Cardiology I (M.L.B., R.G., K.M., T.M., K.S.), University Medical Center Mainz, Germany
| | - Wolfram Ruf
- Center for Thrombosis and Hemostasis (K.Z., M.L.B., D.P., K.K., W.R., C.R.), University Medical Center Mainz, Germany
| | - Christoph Reinhardt
- Center for Thrombosis and Hemostasis (K.Z., M.L.B., D.P., K.K., W.R., C.R.), University Medical Center Mainz, Germany
| | - Laurence Panicot-Dubois
- Aix Marseille University, National Institute of Health and Medical Research (INSERM) 1263, National Research Institute for Agriculture, Food and Environment (INRAE), Cardiovascular and Nutrition Research Center (C2VN), France (S.R., L.P.-D., C.D.)
| | - Christophe Dubois
- Aix Marseille University, National Institute of Health and Medical Research (INSERM) 1263, National Research Institute for Agriculture, Food and Environment (INRAE), Cardiovascular and Nutrition Research Center (C2VN), France (S.R., L.P.-D., C.D.)
| | - Katrin Schäfer
- Department of Cardiology, Cardiology I (M.L.B., R.G., K.M., T.M., K.S.), University Medical Center Mainz, Germany
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Yang J, Xu J, Xu S, Fan Z, Zhu C, Wan J, Yang J, Xing X. Oxidative stress in acute pulmonary embolism: emerging roles and therapeutic implications. Thromb J 2024; 22:9. [PMID: 38216919 PMCID: PMC10785361 DOI: 10.1186/s12959-023-00577-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/25/2023] [Indexed: 01/14/2024] Open
Abstract
Oxidative stress is an imbalance between the body's reactive oxygen species and antioxidant defense mechanisms. Oxidative stress is involved in the development of several cardiovascular diseases, such as pulmonary hypertension, atherosclerosis, and diabetes mellitus. A growing number of studies have suggested the potential role of oxidative stress in the pathogenesis of pulmonary embolism. Biomarkers of oxidative stress in pulmonary embolism have also been explored, such as matrix metalloproteinases, asymmetric dimethylarginine, and neutrophil/lymphocyte ratio. Here, we comprehensively summarize some oxidative stress mechanisms and biomarkers in the development of acute pulmonary embolism and summarize related treatments based on antioxidant stress to explore effective treatment strategies for acute pulmonary embolism.
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Affiliation(s)
- Jingchao Yang
- Department of Pulmonary and Critical Care Medicine, First Affiliated Hospital of Kunming Medical University, 650032, Kunming, China
| | - Jinzhu Xu
- Department of Pulmonary and Critical Care Medicine, Yuxi Municipal Hospital of T.C. M, 653100, Yuxi, China
| | - Shuanglan Xu
- Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Yunnan University, 650021, Kunming, China
| | - Zeqin Fan
- Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Yunnan University, 650021, Kunming, China
| | - Chenshao Zhu
- Department of Pulmonary and Critical Care Medicine, First Affiliated Hospital of Kunming Medical University, 650032, Kunming, China
| | - Jianyuan Wan
- Department of Pulmonary and Critical Care Medicine, First Affiliated Hospital of Kunming Medical University, 650032, Kunming, China
| | - Jiao Yang
- Department of Pulmonary and Critical Care Medicine, First Affiliated Hospital of Kunming Medical University, 650032, Kunming, China.
| | - Xiqian Xing
- Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Yunnan University, 650021, Kunming, China.
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Imiela AM, Mikołajczyk TP, Guzik TJ, Pruszczyk P. Acute Pulmonary Embolism and Immunity in Animal Models. Arch Immunol Ther Exp (Warsz) 2024; 72:aite-2024-0003. [PMID: 38299563 DOI: 10.2478/aite-2024-0003] [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: 08/24/2023] [Accepted: 12/05/2023] [Indexed: 02/02/2024]
Abstract
Venous thromboembolism, encompassing acute pulmonary embolism (APE) and deep vein thrombosis (DVT), is a potentially fatal disease with complex pathophysiology. Traditionally, the Virchow triad provided a framework for understanding the pathogenic contributors to thrombus formation, which include endothelial dysfunction, alterations in blood flow and blood hypercoagulability. In the last years, it has become apparent that immunity plays a central role in thrombosis, interacting with classical prothrombotic mechanisms, oxidative stress and vascular factors. Thrombosis amplifies inflammation, and exaggerated inflammatory processes can trigger thrombosis mainly due to the activation of leukocytes, platelets, and endothelial cells. APE-related endothelium injury is a major trigger for immune system activation. Endothelium is also a key component mediating inflammatory reaction and it is relevant to maintain vascular permeability. Exaggerated right ventricular wall stress and overload, with coexisting systemic hypotension and hypoxemia, result in myocardial injury and necrosis. Hypoxia, tissue factor activation and cytokine storm are engaged in the thrombo-inflammatory processes. Thrombus development is characterized by inflammatory state vascular wall caused mainly by an early extravasation of leukocytes and intense selectins and cytokines production. Nevertheless, immunity of DVT is well described, little is known about potential chemokine and cellular differences between thrombus that develops in the vein and thrombus that detaches and lodges in the pulmonary circulation being a cause of APE. There is a paucity of data considering inflammatory state in the pulmonary artery wall during an acute episode of pulmonary embolism. The main aim of this review is to summarize the knowledge of immunity in acute phase of pulmonary embolism in experimental models.
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Affiliation(s)
- Anna M Imiela
- Department of Internal Medicine and Cardiology, Center for Venous Thromboembolism Disease, Medical University of Warsaw, Warsaw, Poland
| | - Tomasz P Mikołajczyk
- Department of Internal and Agricultural Medicine, Jagiellonian University Medical College, Krakow, Poland
- Center for Medical Genomics OMICRON, Jagiellonian University Medical College, Krakow, Poland
| | - Tomasz J Guzik
- Department of Internal and Agricultural Medicine, Jagiellonian University Medical College, Krakow, Poland
- Center for Medical Genomics OMICRON, Jagiellonian University Medical College, Krakow, Poland
- BHF Centre for Research Excellence, Centre for Cardiovascular Sciences, The University of Edinburgh, Edinburgh, UK
| | - Piotr Pruszczyk
- Department of Internal Medicine and Cardiology, Center for Venous Thromboembolism Disease, Medical University of Warsaw, Warsaw, Poland
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Chen Y, Fan C, Wang J, Jiang M. Rivaroxaban Combined with Atorvastatin Inhibits Acute Pulmonary Embolism by Promoting the Expression of NRF2/NQO1. Cardiovasc Drugs Ther 2023:10.1007/s10557-023-07479-4. [PMID: 37316694 DOI: 10.1007/s10557-023-07479-4] [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] [Accepted: 06/02/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND Atorvastatin and direct oral factor Xa inhibitors (for instance, rivaroxaban) are co-administrated in patients with atrial fibrillation. However, no studies have been conducted on the function of these two agents in acute pulmonary embolism (APE). Therefore, we investigated the effects of rivaroxaban + atorvastatin in rats with APE and explored the underlying mechanisms. METHODS Patients with APE were enrolled, and rats with APE were generated for different regimens. The mean pulmonary arterial pressure (mPAP), heart rate, and PaO2 of APE patients and rats were measured. The plasma levels of oxidative stress- and inflammation-related factors were measured, and the expression of platelet activation markers (CD63 and CD62P) was detected. The proteins targeted by rivaroxaban and atorvastatin, the targets associated with APE, and the genes aberrantly expressed in rats with APE were intersected to obtain candidate factors. RESULTS Rivaroxaban + atorvastatin reduced mPAP and increased PaO2 in patients and rats with APE. Rivaroxaban + atorvastatin repressed oxidative stress, inflammatory levels, and platelet activation during APE. NRF2 and NQO1 were increased in the lung of rats treated with rivaroxaban + atorvastatin. The therapeutic effect of the combination on APE rats was suppressed after NRF2 downregulation. NRF2 promoted the NQO1 transcription. NQO1 eliminated the inhibitory effect of sh-NRF2 on the combined therapy. CONCLUSION The alleviating effect of rivaroxaban + atorvastatin administration against APE correlates with NRF2/NQO1 expression.
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Affiliation(s)
- Yang Chen
- Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital, No. 16, Xinhua West Road, Yunhe District, Cangzhou, 061000, Hebei, P.R. China
| | - Cuncun Fan
- Department of Neurosurgery, Cangzhou Central Hospital, Cangzhou, 061000, Hebei, P.R. China
| | - Jinkun Wang
- Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital, No. 16, Xinhua West Road, Yunhe District, Cangzhou, 061000, Hebei, P.R. China
| | - Mingming Jiang
- Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital, No. 16, Xinhua West Road, Yunhe District, Cangzhou, 061000, Hebei, P.R. China.
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Sagcan G, Konukoglu D, Uzun H, Arseven O, Okumus G, Cuhadaroglu C. Importance of oxidative stress in the evaluation of acute pulmonary embolism severity. BMC Pulm Med 2022; 22:382. [PMID: 36253755 PMCID: PMC9575210 DOI: 10.1186/s12890-022-02076-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 05/23/2022] [Indexed: 12/05/2022] Open
Abstract
Background Pulmonary embolism (PE) is a common and potentially life-threatening disorder. Our study was aimed to investigate whether oxidative stress markers can be used as clinical markers in the evaluation of acute PE (APE) severity. Methods 47 patients with objectively documented diagnosis of APE were recorded. Of these patients, 14 had low-risk PE, 16 had moderate-risk PE, and 17 had high-risk PE. 21 healthy subjects were also enrolled in this study. Ischemia-modified albumin (IMA), prooxidants-antioxidants balance (PAB), advanced protein oxidation products (AOPPs), and ferric reducing antioxidant power (FRAP) were measured as oxidative stress parameters to evaluate the role of oxidative stress. Results In the low-risk and moderate-risk APE groups, AOPPs and PAB levels were significantly higher and FRAP levels were significantly lower than those in the control group. AOPPs and IMA levels in the patients with high-risk PE were significantly higher than those in both the low-risk and moderate-risk APE patients. There was a significant correlation between levels of AOPPs and the levels of both IMA (r: 0.462, p < 0.001) and PAB (r:0.378, p < 0.005). Serum FRAP levels were negatively correlated with PAB (r:− 0.683, p < 0.001) and AOPPs levels (r:− 0,384, p < 0.001). There was also a significant positive correlation between the serum IMA and PAB levels. Conclusions We clearly demonstrated that reactive oxygen species formation is significantly enhanced in APE. IMA and AOPPs may be used as clinical markers in the evaluation of APE severity in clinical practice. However, further studies with larger patient populations and longer follow-up periods are required to confirm the mechanisms underlying these findings.
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Affiliation(s)
- Gülseren Sagcan
- Department of Respiratory Medicine, Acibadem Medical Faculty, Acibadem University, Istanbul, Turkey.
| | - Dildar Konukoglu
- Department of Medical Biochemistry, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Hafize Uzun
- Department of Medical Biochemistry, Faculty of Medicine, İstanbul Atlas University, Istanbul, Turkey
| | - Orhan Arseven
- Department of Respiratory Medicine, İstanbul Medical Faculty, İstanbul University, Istanbul, Turkey
| | - Gulfer Okumus
- Department of Respiratory Medicine, İstanbul Medical Faculty, İstanbul University, Istanbul, Turkey
| | - Caglar Cuhadaroglu
- Department of Respiratory Medicine, Acibadem Medical Faculty, Acibadem University, Istanbul, Turkey
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Tayebi P, Zavareh MSH, Tayyebi G, Abdollahi FZ, Mahmoudlou F. Extensive Acute Lower Extremity Arterial Thrombosis: A Major Thrombus Formation Caused by COVID-19. Vasc Specialist Int 2021; 37:36. [PMID: 34814115 DOI: 10.5758/vsi.210039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/03/2021] [Accepted: 09/09/2021] [Indexed: 12/30/2022] Open
Abstract
Acute thromboembolic events have been frequently reported in patients with coronavirus disease 2019 (COVID-19) due to an increase in the coagulation system activity and endothelial dysfunction. This report describes a patient with COVID-19 who initially reported respiratory symptoms and developed acute lower limb ischemia secondary to extensive macrovascular arterial thrombosis, which was treated with thrombectomy. The development of such extensive arterial thrombosis with anticoagulants at therapeutic doses is a new sign of increased viral pathogenicity, and it is necessary to develop and apply updated prophylaxis protocols for thrombosis in these patients.
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Affiliation(s)
- Pouya Tayebi
- Department of Vascular and Endovascular Surgery, Rouhani Hospital, Babol, Iran
| | - Mahmoud Sadeghi Haddad Zavareh
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Gooya Tayyebi
- Department of Geriatric Psychiatry, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | | | - Fatemeh Mahmoudlou
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
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Wang MF, Li FX, Feng LF, Zhu CN, Fang SY, Su CM, Yang QF, Ji QY, Li WM. Development and validation of a novel risk assessment model to estimate the probability of pulmonary embolism in postoperative patients. Sci Rep 2021; 11:18087. [PMID: 34508171 PMCID: PMC8433319 DOI: 10.1038/s41598-021-97638-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 08/25/2021] [Indexed: 11/24/2022] Open
Abstract
Pulmonary embolism (PE) is a leading cause of mortality in postoperative patients. Numerous PE prevention clinical practice guidelines are available but not consistently implemented. This study aimed to develop and validate a novel risk assessment model to assess the risk of PE in postoperative patients. Patients who underwent Grade IV surgery between September 2012 and January 2020 (n = 26,536) at the Affiliated Dongyang Hospital of Wenzhou Medical University were enrolled in our study. PE was confirmed by an identified filling defect in the pulmonary artery system in CT pulmonary angiography. The PE incidence was evaluated before discharge. All preoperative data containing clinical and laboratory variables were extracted for each participant. A novel risk assessment model (RAM) for PE was developed with multivariate regression analysis. The discrimination ability of the RAM was evaluated by the area under the receiver operating characteristic curve, and model calibration was assessed by the Hosmer–Lemeshow statistic. We included 53 clinical and laboratory variables in this study. Among them, 296 postoperative patients developed PE before discharge, and the incidence rate was 1.04%. The distribution of variables between the training group and the validation group was balanced. After using multivariate stepwise regression, only variable age (OR 1.070 [1.054–1.087], P < 0.001), drinking (OR 0.477 [0.304–0.749], P = 0.001), malignant tumor (OR 2.552 [1.745–3.731], P < 0.001), anticoagulant (OR 3.719 [2.281–6.062], P < 0.001), lymphocyte percentage (OR 2.773 [2.342–3.285], P < 0.001), neutrophil percentage (OR 10.703 [8.337–13.739], P < 0.001), red blood cell (OR 1.872 [1.384–2.532], P < 0.001), total bilirubin (OR 1.038 [1.012–1.064], P < 0.001), direct bilirubin (OR 0.850 [0.779–0.928], P < 0.001), prothrombin time (OR 0.768 [0.636–0.926], P < 0.001) and fibrinogen (OR 0.772 [0.651–0.915], P < 0.001) were selected and significantly associated with PE. The final model included four variables: neutrophil percentage, age, malignant tumor and lymphocyte percentage. The AUC of the model was 0.949 (95% CI 0.932–0.966). The risk prediction model still showed good calibration, with reasonable agreement between the observed and predicted PE outcomes in the validation set (AUC 0.958). The information on sensitivity, specificity and predictive values according to cutoff points of the score in the training set suggested a threshold of 0.012 as the optimal cutoff value to define high-risk individuals. We developed a new approach to select hazard factors for PE in postoperative patients. This tool provided a consistent, accurate, and effective method for risk assessment. This finding may help decision-makers weigh the risk of PE and appropriately select PE prevention strategies.
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Affiliation(s)
- Mao-Feng Wang
- Department of Biomedical Sciences Laboratory, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, 322100, Zhejiang, China
| | - Fei-Xiang Li
- Department of Cardiology, Affiliated Dongyang Hospital of Wenzhou Medical University, Wuning West Road No. 60, Dongyang, 322100, Zhejiang, China
| | - Lan-Fang Feng
- Department of Respiratory, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, 322100, Zhejiang, China
| | - Chao-Nan Zhu
- Shanghai Key Laboratory of Artificial Intelligence for Medical Image and Knowledge Graph, Hangzhou, 310000, Zhejiang, China
| | - Shuang-Yan Fang
- Department of Respiratory, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, 322100, Zhejiang, China
| | - Cai-Min Su
- Department of Respiratory, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, 322100, Zhejiang, China
| | - Qiong-Fang Yang
- Department of Respiratory, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, 322100, Zhejiang, China
| | - Qiao-Ying Ji
- Department of Respiratory, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, 322100, Zhejiang, China
| | - Wei-Min Li
- Department of Cardiology, Affiliated Dongyang Hospital of Wenzhou Medical University, Wuning West Road No. 60, Dongyang, 322100, Zhejiang, China.
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Nitrite and tempol combination promotes synergic effects and alleviates right ventricular wall stress during acute pulmonary thromboembolism. Nitric Oxide 2021; 115:23-29. [PMID: 34133975 DOI: 10.1016/j.niox.2021.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 05/29/2021] [Accepted: 06/11/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The mechanical obstruction and pulmonary vasoconstriction are major determinants of the sudden right ventricular (RV) afterload increases observed during acute pulmonary thromboembolism (APT). Vasodilators and antioxidants agents have been shown to mitigate pulmonary hypertension. We examined whether sodium nitrite and the antioxidant tempol combination could be advantageous in an APT sheep model. METHODS APT was induced in anesthetized sheep by autologous blood clots (250 mg/kg) into the right atrium. Thirty minutes after APT induction, the animals received a continuous infusion of tempol (1.0 mg/kg/min), increasing sodium nitrite infusion (5, 15, and 50 μmol/kg), or a simultaneous combination of both drugs. Saline was used as a control treatment. Hemodynamic measurements were carried out every 15 min. Also, whole blood nitrite and serum 8-isoprostanes levels were measured. RESULTS APT induced sustained pulmonary hypertension, increased dp/dtmax, and rate pressure product (RPP). Nitrite or tempol treatments attenuated these increases (P < 0.05). When both drugs were combined, we found a robust reduction in the RV RPP compared with the treatments alone (P < 0.05). The sole nitrite infusion increased blood nitrite concentrations by 35 ± 6 μM (P < 0.05), whereas the nitrite and tempol combination produced higher blood nitrite concentrations by approximately 54 ± 7 μM. Tempol or nitrite infusions, both alone or combined, blunted the increases in 8-isoprostane concentrations observed after APT. CONCLUSIONS Nitrite and tempol combination protects against APT-induced RV wall stress. The association of both drugs may offer an advantage to treat RV failure during severe APT.
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Bontekoe E, Brailovsky Y, Hoppensteadt D, Bontekoe J, Siddiqui F, Newman J, Iqbal O, Reed T, Fareed J, Darki A. Upregulation of Inflammatory Cytokines in Pulmonary Embolism Using Biochip-Array Profiling. Clin Appl Thromb Hemost 2021; 27:10760296211013107. [PMID: 33969714 PMCID: PMC8113361 DOI: 10.1177/10760296211013107] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The complex pathophysiology of pulmonary embolism (PE) involves hemostatic activation, inflammatory processes, cellular dysfunction, and hemodynamic derangements. Due to the heterogeneity of this disease, risk stratification and diagnosis remains challenging. Biochip-array technology provides an integrated high throughput method for analyzing blood plasma samples for the simultaneous measurement of multiple biomarkers for potential risk stratification. Using biochip-array method, this study aimed to quantify the inflammatory biomarkers such as interleukin (IL)-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, vascular endothelial growth factor (VEGF), interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), monocyte chemoattractant protein-1 (MCP-1), and epidermal growth factor (EGF) in 109 clinically confirmed PE patients in comparison to the control group comprised of plasma samples collected from 48 healthy subjects. Cytokines IL-4, IL-6, IL-8, IL-10, IL-1β, and MCP-1 demonstrated varying level of significant increase (P < 0.05) in massive-risk PE patients compared to submassive- and low-risk PE patients. The upregulation of inflammatory cytokines in PE patients observed in this study suggest that inflammation plays an important role in the overall pathophysiology of this disease. The application of biochip-array technology may provide a useful approach to evaluate these biomarkers to understand the pathogenesis and risk stratification of PE patients.
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Affiliation(s)
- Emily Bontekoe
- Department of Pathology and Laboratory Medicine, Cardiovascular Research Institute, Hemostasis and Thrombosis Research Division, Loyola University Medical Center, Health Sciences Division, Maywood, IL, USA
| | - Yevgeniy Brailovsky
- Advanced Heart Failure, Mechanical Circulatory Support, Heart Transplant, Jefferson Heart Institute, Sidney Kimmel School of Medicine, Thomas Jefferson University, Philadelphia, PA, USA
| | - Debra Hoppensteadt
- Department of Pathology and Laboratory Medicine and Department of Pharmacology and Neuroscience, Cardiovascular Research Institute, Hemostasis and Thrombosis Research Division, Loyola University Chicago, Health Sciences Division, Maywood, IL, USA
| | - Jack Bontekoe
- Department of Pathology and Laboratory Medicine, Cardiovascular Research Institute, Hemostasis and Thrombosis Research Division, Loyola University Medical Center, Health Sciences Division, Maywood, IL, USA
| | - Fakiha Siddiqui
- Department of Pathology and Laboratory Medicine, Cardiovascular Research Institute, Hemostasis and Thrombosis Research Division, Loyola University Medical Center, Health Sciences Division, Maywood, IL, USA
| | - Joshua Newman
- Division of Cardiovascular Medicine, Department of Medicine, Loyola University Medical Center, Maywood, IL, USA
| | - Omer Iqbal
- Department of Pathology and Laboratory Medicine and Department of Ophthalmology, Cardiovascular Research Institute, Loyola University Medical Center, Maywood, IL, USA
| | - Trent Reed
- Department of Emergency Medicine, Loyola University Medical Center, Stritch School of Medicine, Maywood, IL, USA
| | - Jawed Fareed
- Department of Pathology and Laboratory Medicine and Department of Pharmacology and Neuroscience, Cardiovascular Research Institute, Hemostasis and Thrombosis Research Division, Loyola University Chicago, Health Sciences Division, Maywood, IL, USA
| | - Amir Darki
- Division of Cardiology, Department of Medicine, Loyola University Medical Center, Stritch School of Medicine, Maywood, IL, USA
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Sun N, Fan Y, Chang J, Chen Y, Gao X, Sun H, Wang Z, Gu X, Tian J, Zhao Y, Yu B, Tian J, Wu B. Plasma irisin level associated with hemodynamic parameters and predict clinical outcome in patients with acute pulmonary embolism. Respir Med 2020; 171:106072. [PMID: 32658835 DOI: 10.1016/j.rmed.2020.106072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND The purpose of the present study is to investigate the correlation of plasma irisin level and hemodynamic parameters in patients with acute pulmonary embolism (APE) and to estimate clinical outcome prediction value of plasma irisin level. METHODS We prospectively recruited 86 adult patients with APE in the present study. All recruited patients conduct measurement of plasma irisin levels using ELISA kits. Baseline clinical characteristics, hemodynamic parameters and prognostic conditions were evaluated according to different plasma irisin levels. RESULTS According to median values of irisin levels, APE patients were divided into high irisin group (irisin≥6.9 μg/ml) and low irisin group (irisin<6.9 μg/ml). Plasma NT-proBNP (P = 0.044), mean pulmonary artery pressure (mPAP, P = 0.013), systolic pulmonary artery pressure (sPAP, P = 0.001), mean right ventricular pressure (mRVP, P = 0.021) and systolic right ventricular pressure (sPVP, P = 0.003) were higher in low irisin group compared with high irisin group. Hemodynamic parameters of mPAP, sPAP, mRVP and sRVP were negatively correlated with plasma irisin levels. Kaplan- Meier survival analysis showed that APE patients with lower plasma irisin levels had significantly higher clinical worsening event rate (P = 0.026) and could be the independent predictor of prognosis in multivariate analysis (P = 0.035). CONCLUSION Plasma irisin level was negatively correlated with hemodynamic parameters in patients with APE. Low irisin group patients had significantly higher clinical worsening event rate and could be the independent predictor of clinical outcome in multivariate analysis.
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Affiliation(s)
- Na Sun
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China; Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, China
| | - Youli Fan
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jiaxue Chang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yiqiang Chen
- Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xuan Gao
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Hongru Sun
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China; Department of Epidemiology, Public Health College, Harbin Medical University, Harbin, China
| | - Zhuozhong Wang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China; Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, China
| | - Xia Gu
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China; Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, China; Department of Cardiology, Heilongjiang Provincial Hospital, Harbin, China
| | - Jiangtian Tian
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China; Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, China
| | - Yingzi Zhao
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Bo Yu
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China; Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, China
| | - Jinwei Tian
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China; Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, China.
| | - Bingxiang Wu
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China; Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, China.
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14
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Kuluöztürk M, İn E, İlhan N. Endocan as a marker of disease severity in pulmonary thromboembolism. CLINICAL RESPIRATORY JOURNAL 2019; 13:773-780. [PMID: 31556240 DOI: 10.1111/crj.13089] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/24/2019] [Accepted: 09/19/2019] [Indexed: 01/05/2023]
Abstract
INTRODUCTION The aim of this study is to determine the serum endocan levels in patients with pulmonary thromboembolism (PTE) and investigate whether a relationship exists between serum endocan levels and the disease severity. MATERIALS AND METHODS The study included 85 patients with acute PTE and 40 healthy control subjects. The patients with PTE were divided into three groups at admission as "high-risk", "intermediate-risk" and "low-risk", considering the guidelines of the European Society of Cardiology. Serum endocan levels in all participants' blood samples were measured. RESULTS The mean serum endocan levels were significantly higher in the PTE group, compared to the control subjects (P < 0.001). Serum endocan levels were significantly higher in the "high-risk" group when compared with patients in the "low-risk" and "intermediate-risk" groups (P < 0.001 and P < 0.01 respectively). Similarly, serum endocan levels were higher in the "intermediate-risk" group compared to those in the "low-risk" group (P < 0.001). There was a negative correlation between serum endocan levels and partial oxygen pressure (r = -0.262, P = 0.016), whereas a positive correlation was found between the serum endocan levels and systolic pulmonary arterial pressure (r = 0.296, P = 0.006). Additionally, endocan had an area under the curve in the receiver operating characteristic curve of 0.837 (0.768-0.907; 95% CI; P < 0.001) and cut-off value was 194.5 pg/mL (sensitivity 80%, specificity 72.5%). CONCLUSION Serum endocan levels were higher and related to the severity of the disease in PTE patients. Additionally, endocan could be an indicator to be used in the diagnosis of PTE and in the prediction of the disease severity.
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Affiliation(s)
- Mutlu Kuluöztürk
- Department of Pulmonary Medicine, Firat University Faculty of Medicine, Elazig, Turkey
| | - Erdal İn
- Department of Pulmonary Medicine, Firat University Faculty of Medicine, Elazig, Turkey
| | - Nevin İlhan
- Department of Medical Biochemistry, Firat University Faculty of Medicine, Elazig, Turkey
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Pereska Z, Chaparoska D, Bekarovski N, Jurukov I, Simonovska N, Babulovska A. Pulmonary thrombosis in acute organophosphate poisoning-Case report and literature overview of prothrombotic preconditioning in organophosphate toxicity. Toxicol Rep 2019; 6:550-555. [PMID: 31285996 PMCID: PMC6587046 DOI: 10.1016/j.toxrep.2019.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 06/03/2019] [Accepted: 06/06/2019] [Indexed: 12/12/2022] Open
Abstract
Acute OP poisoning complicated with pulmonary thrombosis during the first week of poisoning. Antidote treatment included atropine, whereas diazepam was administered in the first 48 h. There was no administration of oximes due to unavailability. Prolonged hypoxemia in acute OP intoxication indicates exclusion of thrombotic pulmonary event.
Objective Acute organophosphate (OP) poisonings are presented with acetylcholine-receptor overstimulation. There have been a few case reports of thrombotic complications in acute OP poisonings, as well as prolonged thrombosis preconditions in patients who survived this type of intoxications. The paper presents a case with pulmonary thrombosis (PT) that develops in the subacute phase of intentional acute OP poisoning, treated only with atropine, as well as a literature overview of OP-induced prothrombotic toxicity. Case report A middle aged woman was brought to the hospital after ingestion of unknown insecticide with suicidal intentions. She had a history of HTA (arterial hypertension), hyperlipidemia and untreated depression. The clinical features of poisoning were miosis, vomiting, dizziness, abdominal cramps and diarrhea. Soon after admission, she developed difficulties in breathing with decrease of serum pseudocholinesterase (2590...1769...1644...800 U/l), bibasal pulmonary crackles, drop of SpO2 to 84%. Antidote treatment included carbo medicinalis, atropine, and diazepam, without use of oximes. The seventh day pseudocholinesterase, the levels started to rise but the patient’s hyposaturation (SpO2 86-88%) persisted. Chest ultrasound detected hypoechoic subpleural lesion to the right. Haemostatic tests showed increased D-Dimmer (2312 ng/ml) with hypercoagulability. The CT pulmonary angiography confirmed PT and after the administration of low molecular heparin, her clinical condition improved. Conclusion Acute organophosphate poisoning treated with atropine showed a potential for inducing prothrombotic coagulation abnormalities, presented with PT. This life-threatening complication may additionally contribute to prolonged morbidity and mortality in OP poisonings, especially in patients with medical history of comorbidites.
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Affiliation(s)
- Zanina Pereska
- University Clinic of Toxicology, Medical Faculty, University "St. Cyril and Methodius", Clinical Campus Mother Theresa, Vodnjanska 17, 1000 Skopje, Republic of North Macedonia
| | - Daniela Chaparoska
- University Clinic of Toxicology, Medical Faculty, University "St. Cyril and Methodius", Clinical Campus Mother Theresa, Vodnjanska 17, 1000 Skopje, Republic of North Macedonia
| | - Niko Bekarovski
- University Clinic of Toxicology, Medical Faculty, University "St. Cyril and Methodius", Clinical Campus Mother Theresa, Vodnjanska 17, 1000 Skopje, Republic of North Macedonia
| | - Irena Jurukov
- University Clinic of Toxicology, Medical Faculty, University "St. Cyril and Methodius", Clinical Campus Mother Theresa, Vodnjanska 17, 1000 Skopje, Republic of North Macedonia
| | - Natasha Simonovska
- University Clinic of Toxicology, Medical Faculty, University "St. Cyril and Methodius", Clinical Campus Mother Theresa, Vodnjanska 17, 1000 Skopje, Republic of North Macedonia
| | - Aleksandra Babulovska
- University Clinic of Toxicology, Medical Faculty, University "St. Cyril and Methodius", Clinical Campus Mother Theresa, Vodnjanska 17, 1000 Skopje, Republic of North Macedonia
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Lin JW, Yang LH, Ren ZC, Mu DG, Li YQ, Yan JP, Wang LX, Chen C. Resveratrol downregulates TNF-α-induced monocyte chemoattractant protein-1 in primary rat pulmonary artery endothelial cells by P38 mitogen-activated protein kinase signaling. DRUG DESIGN DEVELOPMENT AND THERAPY 2019; 13:1843-1853. [PMID: 31213772 PMCID: PMC6549410 DOI: 10.2147/dddt.s184785] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 03/04/2019] [Indexed: 01/03/2023]
Abstract
Background: To evaluate the effects of resveratrol to monocyte chemoattractant protein-1 (MCP-1) and the role of p38 mitogen-activated protein kinase (MAPK) in this process in vitro. Materials and methods: Animal acute pulmonary
thromboembolism (PTE) model: rat model was established by infusion of an autologous blood clot into the pulmonary artery through a polyethylene catheter. One hundred and thirty-two rats were randomly and equally divided into ten groups: rats-control (untreated), rats-1% DMSO, rats-TNF-α, rats-TNF-α + resveratrol, rats-TNF-α +C1142, rats-TNF-α+SB203580, rats-TNF-α+resveratrol + SB203580, rats-resveratrol only, rats-C1142 only, and rats-SB203580 only. Rat pulmonary artery endothelial cells (RPAs) tests: RPAs were isolated from above animal and designated as: RPAs-control, RPAs-1% DMSO control, RPAs-TNF-α, RPAs-TNF-α + resveratrol, RPAs-TNF-α + C1142, RPAs-TNF-α + SB203580, RPAs-TNF-α + resveratrol + SB203580, RPAs-resveratrol only, RPAs-C1142 only, and RPAs-SB203580 only. Each group was further divided into 1, 4, and 8 hrs time point for evaluation (n=6 rats per time point) except RPAs-TNF-α + SB203580, RPAs-TNF-α + resveratrol + SB203580, RPAs-C1142 and RPAs-SB203580 only, which were evaluated at 8 hrs time point. At each time point, mRNA and protein expressions of RPAs of MCP-1 were measured. The phosphorylation of p38 MAPK (p-pMAPK) of RPAs was also detected. Results: We found that the RPAs-TNF-α elicited significant increases in MCP-1 expression and phosphorylation of p38 mitogen-activated protein kinase (p-p38 MAPK). Furthermore, the MCP-1 expressions of RPAs-Resveratrol, RPAs-C1142, and RPAs-SB203580 were significantly down-regulated, which was associated with robustly suppressed TNF-α-induced p-p38MAPK expression. Conclusion: Our findings suggested that MCP-1 was involved in the formation of TNF-α-induced inflammatory response, and resveratrol could down-regulate the expression of MCP-1 via TNF-α- inhibition, which might contribute to the decline of acute PTE-induced PH in vivo.
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Affiliation(s)
- Jian-Wei Lin
- Department of Cardiology, Xiasha Campus, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310018, Zhejiang, People's Republic of China
| | - Le-He Yang
- Department of Respiratory Medicine, Wenzhou Medical University, Wenzhou 325600, Zhejiang, People's Republic of China
| | - Zhuo-Chao Ren
- Department of Respiratory Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang, People's Republic of China
| | - De-Guang Mu
- Department of Respiratory Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang, People's Republic of China
| | - Ya-Qing Li
- Department of Respiratory Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang, People's Republic of China
| | - Jian-Ping Yan
- Department of Respiratory Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang, People's Republic of China
| | - Liang-Xing Wang
- Department of Respiratory Medicine, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou 325000, Zhejiang, People's Republic of China
| | - Chun Chen
- Department of Respiratory Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang, People's Republic of China
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Sun K, Xie Z, Wang J, Ling M, Li Y, Qiu C. Bioinformatics-based study to detect chemical compounds that show potential as treatments for pulmonary thromboembolism. Int J Mol Med 2018; 43:276-284. [PMID: 30431066 PMCID: PMC6257851 DOI: 10.3892/ijmm.2018.3987] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 09/27/2018] [Indexed: 01/29/2023] Open
Abstract
The objectives of the present study comprised the recognition of major genes related to pulmonary thromboembolism (PTE) and the evaluation of their functional enrichment levels, in addition to the identification of small chemical molecules that may offer potential for use in PTE treatment. The RNA expression profiling of GSE84738 was obtained from the Gene Expression Omnibus database. Following data preprocessing, the differently expressed genes (DEGs) between the PTE group and the control group were identified using the Linear Models for Microarray package. Subsequently, the protein‑protein interaction (PPI) network of these DEGs was examined using the Search Tool for the Retrieval of Interacting Genes/Proteins database, visualized via Cytoscape. The most significantly clustered modules in the network were identified using Multi Contrast Delayed Enhancement, a plugin of Cytoscape. Subsequently, functional enrichment analysis of the DEGs was performed, using the Database for Annotation Visualization and Integrated Discovery tool. Furthermore, the chemical‑target interaction networks were investigated using the Comparative Toxicogenomics Database as visualized via Cytoscape. A total of 548 DEGs (262 upregulated and 286 downregulated) were identified in the PTE group, compared with the control group. The upregulated and downregulated genes were enriched in Gene Ontology terms related to inflammation and eye sarcolemma, respectively. Tumor necrosis factor (TNF) and erb‑b2 receptor tyrosine kinase 2 (ERBB2) were upregulated genes that ranked higher in the PPI network (47 and 40 degrees, respectively) whereas C‑JUN was the most downregulated gene (46). Small chemical molecules ethinyl (135), cyclosporine (126), thrombomodulin precursor (113) and tretinoin (111) had >100 degrees in the DEG‑chemical interaction network. In addition, ethinyl targeted to TNF, whereas TNF and ERBB2 were targeted by cyclosporine, and tretinoin was a targeted chemical of ERBB2. Therefore, cyclosporine, ethinyl, and tretinoin may be potential targets for PTE treatment.
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Affiliation(s)
- Keyu Sun
- Emergency Department, Minhang Hospital, Fudan University, Shanghai 201100, P.R. China
| | - Zichen Xie
- Emergency Department, Minhang Hospital, Fudan University, Shanghai 201100, P.R. China
| | - Jiqin Wang
- Emergency Department, Minhang Hospital, Fudan University, Shanghai 201100, P.R. China
| | - Meirong Ling
- Emergency Department, Minhang Hospital, Fudan University, Shanghai 201100, P.R. China
| | - Yanyan Li
- Emergency Department, Minhang Hospital, Fudan University, Shanghai 201100, P.R. China
| | - Chao Qiu
- Institute of Biomedical Sciences, Fudan University, Shanghai 200032, P.R. China
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18
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Comparison of acute and convalescent biomarkers of inflammation in patients with acute pulmonary embolism treated with systemic fibrinolysis vs. placebo. Blood Coagul Fibrinolysis 2018; 28:675-680. [PMID: 28957940 DOI: 10.1097/mbc.0000000000000669] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
: Previous studies have associated biomarkers indicative of acute inflammation with pulmonary embolism, which may amplify coagulation, inhibit fibrinolysis and increase risk of venous thromboembolism (VTE) recurrence. The aim of this study was to measure inflammatory and hemostatic biomarkers in acute submassive pulmonary embolism at diagnosis and 3-month follow-up and to test the impact of treatment with fibrinolysis. Secondary analysis of a multicenter, double-blinded, randomized controlled trial including patients with submassive pulmonary embolism. Blood samples were obtained within 24 h of diagnosis and prior to bolus-dose tenecteplase (TNK) or placebo; all patients received standard anticoagulation and blood was redrawn 3 months later. Plasma concentrations of inflammatory [Interleukin 6 (IL-6), C-reactive protein (CRP), myeloperoxidase (MPO)] and hemostatic [plasminogen activator inhibitor-1 (PAI-1), fibrinogen, thrombin-activatable fibrinolysis inhibitor and D-dimer] biomarkers were quantified. The median values of the biomarkers of inflammation (IL-6, CRP, MPO) were all significantly decreased at 3-month follow-up, ranging from a 60 to 91% reduction over this time period. Concentrations of PAI-1 and fibrinogen did not change significantly. D-dimer concentration at 3-month follow-up was lower in patients treated with fibrinolysis vs. placebo and appeared to have a trend toward significance (placebo 310 vs. TNK 220 ng/ml, P = 0.051). Acute pulmonary embolism causes marked but transient inflammation, as demonstrated by the significant elevation in the inflammatory biomarkers at diagnosis, followed by their reduction in more than 80% of patients at 3-month follow-up.
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19
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Platelet hyperactivation, apoptosis and hypercoagulability in patients with acute pulmonary embolism. Thromb Res 2017; 155:106-115. [PMID: 28528289 DOI: 10.1016/j.thromres.2017.05.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 04/29/2017] [Accepted: 05/10/2017] [Indexed: 12/13/2022]
Abstract
Changes in systemic redox balance can alter platelet activation and aggregation. Acute pulmonary embolism (PE) is a systematic inflammatory disease associated with mechanical shear stress, increased thrombin, catecholamines, serotonin and hemolysis, which cumulatively can hyperactivate platelets and accelerate their turnover. We tested the hypothesis that platelets from patients with moderately severe PE will show hyperstimulation and a pre-apoptotic phenotype associated with microparticles (MPs) in plasma. Blood for platelet respiration and thromboelastography (TEG) was obtained at diagnosis and 24h later from patients (n=76) with image-proven PE, SBP>90mmHg and right ventricular dysfunction demonstrated by echocardiogram or elevated biomarkers. Controls (n=12) were healthy volunteers. At diagnosis, platelets from PE patients had significantly elevated baseline oxygen consumption compared with controls, explained primarily by accelerated electron transport and oxygen wasting with no measurable extramitochondrial oxygen consumption. On thromboelastography, unstimulated thrombin-independent maximum amplitude was increased with PE, 19±14.1 vs.10.5±7.8mm in controls (p=0.002). Compared with controls, platelets from PE patients showed elevated mitochondrial reactive oxygen species with decreased mitochondrial Bcl-2 protein content and increased cytosolic cytochrome C, coincident with strong annexin V binding, P selectin release from lysed platelets and in plasma MPs compared to controls (p<0.05). These results show evidence of platelet hyperactivation and apoptosis in patients with acute PE, and provide preliminary theoretical basis for further exploration of platelet inhibition in patients with more severe PE.
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Cervellin G, Buonocore R, Sanchis-Gomar F, Lippi G. Low serum bilirubin values are associated with pulmonary embolism in a case-control study. Clin Chem Lab Med 2017; 54:e229-30. [PMID: 26741350 DOI: 10.1515/cclm-2015-1156] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 11/30/2015] [Indexed: 11/15/2022]
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21
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Buyukterzi Z, Buyukterzi M, Kurtipek E, Alpaydin MS, Karaarslan S. Subclinical Atherosclerosis in Patients with Prior Pulmonary Thromboembolism. Med Princ Pract 2017; 26:321-324. [PMID: 28380485 PMCID: PMC5768129 DOI: 10.1159/000475466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 04/04/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Recent studies have indicated that endothelial dysfunction is common in patients with a prior history of pulmonary thromboembolism (PTE). Based on the established relationship between endothelial dysfunction and atherosclerosis, we aimed to investigate carotid intima-media thickness (cIMT) as a marker of subclinical atherosclerosis in patients who have a prior history of PTE. SUBJECTS AND METHODS Medical records belonging to patients with a history of PTE and age- and gender-matched control subjects among those who underwent transthoracic echocardiography in Konya Training and Research Hospital were reviewed. Echocardiographic findings and cIMT measurements were recorded. cIMT measurements were compared between patient and control groups, and then independent correlates of cIMT were investigated using appropriate statistical methods. RESULTS A total of 110 patients (64.02 ± 12.67 years, males: n = 79 [71.81%]; females: n = 31 [28.19%]) were found to be eligible for assessment. Of these patients, 55 (50.00%) had a history of PTE. Patients with a history of PTE had significantly greater cIMT (p = 0.040). In this group of patients, cIMT positively and significantly correlated with basal right ventricular (RV) diameter (r = 0.271, p = 0.022), RV diastolic area (r = 0.376, p = 0.002), and systolic pulmonary artery pressure (r = 0.248, p = 0.037). In the multivariate linear regression analysis, only RV diastolic area was independently associated with cIMT in patients with PTE (p = 0.010). CONCLUSION Patients with a history of PTE have increased cIMT when compared to healthy subjects, and cIMT, which is a marker of subclinical atherosclerosis, is independently associated with RV diameter in these patients.
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Affiliation(s)
- Zafer Buyukterzi
- Department of Cardiology, Konya Training and Research Hospital, Konya, Turkey
- *Zafer Buyukterzi, MD, Department of Cardiology, Konya Training and Research Hospital, TR-42090 Konya, Meram (Turkey), E-Mail
| | - Meral Buyukterzi
- Department of Radiology, Konya Training and Research Hospital, Konya, Turkey
| | - Ercan Kurtipek
- Department of Chest Diseases, Konya Training and Research Hospital, Konya, Turkey
| | | | - Sukru Karaarslan
- Department of Cardiology, Konya Training and Research Hospital, Konya, Turkey
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22
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Ozcan Cetin EH, Cetin MS, Canpolat U, Akdi A, Aras D, Temizhan A, Aydogdu S. Platelet-to-lymphocyte ratio as a novel marker of in-hospital and long-term adverse outcomes among patients with acute pulmonary embolism: A single center large-scale study. Thromb Res 2016; 150:33-40. [PMID: 28011405 DOI: 10.1016/j.thromres.2016.12.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 11/25/2016] [Accepted: 12/08/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND The interaction of platelets with leukocytes is a well-known process both in progression and prognosis of acute pulmonary embolism (PE). Recently, platelet to lymphocyte ratio (PLR) is emerged as an indirect inflammatory indicator which was shown to be associated with adverse cardiovascular events in various clinical conditions, including acute PE. However, the long-term prognostic value of PLR in acute PE has not been investigated thoroughly. Therefore, we aimed to assess the impact of PLR on both in-hospital and long-term adverse outcomes in acute PE. METHODS A total of 459 patients with definite diagnosis of acute PE between January 2009 and January 2016 were enrolled. On admission, blood sampling to calculate PLR and detailed clinical data were obtained. Patients were divided into tertiles according to the admission PLR levels. Simplified PE severity index (sPESI) score and computerized tomography (CT) based pulmonary artery obstruction index were calculated for each patient. RESULTS Mean sPESI score of the study population was 1.6. A total of 34 patients (7.4%) died during index hospitalization. At median 28.8months follow-up, all-cause mortality was observed in 81 patients (1.9%). Patients in the highest tertile of PLR revealed a higher rate of in-hospital adverse events including cardiogenic shock, the necessity for thrombolytic therapy and in-hospital mortality as well as long-term all-cause mortality. In multivariate analysis, the PLR was found to be a significant predictor of both in-hospital adverse events (OR: 1.588, 95% CI:1.116-2.154, p=0.004) and long-term all-cause mortality (OR:1.746, 95% CI:1.211-2.865, p=0.001). CONCLUSIONS The PLR, as a simple, inexpensive and available marker of inflammatory and prothrombotic status, seemed to be a novel predictor of in-hospital and long-term adverse outcomes in patients with acute PE.
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Affiliation(s)
- Elif Hande Ozcan Cetin
- Turkey Yuksek Ihtisas Training and Research Hospital, Cardiology Department, Ankara, Turkey.
| | - Mehmet Serkan Cetin
- Turkey Yuksek Ihtisas Training and Research Hospital, Cardiology Department, Ankara, Turkey
| | - Ugur Canpolat
- Hacettepe University Faculty of Medicine, Department of Cardiology, Ankara, Turkey
| | - Ahmet Akdi
- Turkey Yuksek Ihtisas Training and Research Hospital, Cardiology Department, Ankara, Turkey
| | - Dursun Aras
- Turkey Yuksek Ihtisas Training and Research Hospital, Cardiology Department, Ankara, Turkey
| | - Ahmet Temizhan
- Turkey Yuksek Ihtisas Training and Research Hospital, Cardiology Department, Ankara, Turkey
| | - Sinan Aydogdu
- Turkey Yuksek Ihtisas Training and Research Hospital, Cardiology Department, Ankara, Turkey
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The prognostic importance of thiol/disulfide homeostasis in patients with acute pulmonary thromboembolism. Am J Emerg Med 2016; 34:2315-2319. [DOI: 10.1016/j.ajem.2016.08.039] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 08/08/2016] [Accepted: 08/20/2016] [Indexed: 01/26/2023] Open
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Tang Z, Wang X, Huang J, Zhou X, Xie H, Zhu Q, Huang M, Ni S. Gene Expression Profiling of Pulmonary Artery in a Rabbit Model of Pulmonary Thromboembolism. PLoS One 2016; 11:e0164530. [PMID: 27798647 PMCID: PMC5087918 DOI: 10.1371/journal.pone.0164530] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 09/27/2016] [Indexed: 02/06/2023] Open
Abstract
Acute pulmonary thromboembolism (PTE) refers to the obstruction of thrombus in pulmonary artery or its branches. Recent studies have suggested that PTE-induced endothelium injury is the major physiological consequence of PTE. And it is reasonal to use PTE-induced endothelium injury to stratify disease severity. According to the massive morphologic and histologic findings, rabbit models could be applied to closely mimic the human PE. Genomewide gene expression profiling has not been attempted in PTE. In this study, we determined the accuracy of rabbit autologous thrombus PTE model for human PTE disease, then we applied gene expression array to identify gene expression changes in pulmonary arteries under PTE to identify potential molecular biomarkers and signaling pathways for PTE. We detected 1343 genes were upregulated and 923 genes were downregulated in PTE rabbits. The expression of several genes (IL-8, TNF-α, and CXCL5) with functional importance were further confirmed in transcript and protein levels. The most significantly differentially regulated genes were related to inflammation, immune disease, pulmonary disease, and cardiovascular diseases. Totally 87 genes were up-regulated in the inflammatory genes. We conclude that gene expression profiling in rabbit PTE model could extend the understanding of PTE pathogenesis at the molecular level. Our study provides the fundamental framework for future clinical research on human PTE, including identification of potential biomarkers for prognosis or therapeutic targets for PTE.
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Affiliation(s)
- Zhiyuan Tang
- Department of Respiratory Medicine, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China
| | - Xudong Wang
- Department of Laboratory Medicine, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China
| | - Jianfei Huang
- Department of Pathology, Affiliated Hospital of Nantong University. Nantong, 226001, Jiangsu, China
- Department of Clinical Bio-bank, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Xiaoyu Zhou
- Department of Respiratory Medicine, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China
| | - Hao Xie
- Key Lab of Drug Metabolism and Pharmacokinetics, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, Jiangsu, 210009, China
| | - Qilin Zhu
- Department of Respiratory Medicine, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China
| | - Minjie Huang
- Department of Respiratory Medicine, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China
| | - Songshi Ni
- Department of Respiratory Medicine, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China
- * E-mail:
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25
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Zagorski J, Kline JA. Differential effect of mild and severe pulmonary embolism on the rat lung transcriptome. Respir Res 2016; 17:86. [PMID: 27435598 PMCID: PMC4952270 DOI: 10.1186/s12931-016-0405-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 07/10/2016] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Pulmonary thromboembolism (PTE) is a common diagnosis and a leading cause of cardiovascular morbidity and mortality. A growing literature has associated PE with systemic inflammation, and global hyper-coagulability, which contribute to lung remodeling and clot recurrence. The source and mechanism of inflammation remains unstudied. In humans, inhibition of cholesterol synthesis with statins decreases biomarkers of inflammation. We test the differential effect of pulmonary vascular occlusion during mild and severe pulmonary embolism on the lung transcriptome. METHODS Experimental PE was induced in adult male rats by injection of 25 micron polystyrene microspheres into the jugular vein. The effect of Mild PE, (2-h right ventricular systolic pressure [RVSP] normal, 18-h RVSP 44 mmHg) and Severe PE (2-h RVSP > 50 mmHg; 18-h RVSP 44 mmHg) on lungs was assessed by measuring transcriptome-wide changes in gene expression by DNA microarrays. RESULTS Severe PE was associated with a large change in lung gene expression and in the expression of KEGG pathways and other gene functional annotation groups. Mild PE was also associated with a large number of significant changes in gene expression and in the expression of KEGG pathways and gene functional annotation groups, even after only 2 h of PE. Up-regulated pathways included increased adipocytokine, chemokine and cytokine signaling as well as cholesterol synthesis. CONCLUSIONS Mild PE without acute pulmonary hypertension (PH) increased lung gene expression of inflammatory pathways, including increased cholesterol synthesis. These data indicate that even mild persistent pulmonary vascular occlusion is capable of inciting an inflammatory response from the lung. These data imply the detrimental effect of unresolved pulmonary obstruction from PE.
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Affiliation(s)
- John Zagorski
- Department of Math and Sciences, Gaston College, Dallas, NC, 28014, USA
| | - Jeffrey A Kline
- Department of Emergency Medicine and Department of Cellular and Integrative Physiology, Indiana University Medical School, 720 Eskanazi Avenue, Indianapolis, IN, 46202, USA.
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26
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Assessment of heat shock proteins and endothelial dysfunction in acute pulmonary embolism. Blood Coagul Fibrinolysis 2016; 27:378-83. [DOI: 10.1097/mbc.0000000000000456] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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27
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Inflammation in venous thromboembolism: Cause or consequence? Int Immunopharmacol 2015; 28:655-65. [PMID: 26253657 DOI: 10.1016/j.intimp.2015.07.044] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 07/23/2015] [Accepted: 07/30/2015] [Indexed: 12/31/2022]
Abstract
Venous thromboembolism (VTE) which includes deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) is a moderately common disease especially in elderly population with high rate of recurrence and complications. Evidence is accumulating that VTE is not restricted to coagulation system and immune system appears to be involved in formation and resolution of thrombus. The present study was aimed at reviewing current evidences on immune system abnormalities such as alterations in cytokines, chemokines and immune cells. Also, current evidences suggest that; a, inflammation in general functions as a double-edged sword, b, inflammation can be both a cause and a consequence of VTE, and c, current anti-coagulation therapies are not well-equipped with the capacity to selectively inhibit inflammatory cells and pathways. Applying such inferences for selective pharmacological targeting of immune mediators in VTE and thereby for adoption of higher effective anti-thromboinflammatory strategies, either therapeutic or prophylactic, is henceforth to be considered as the line of research for future.
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28
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Asymmetric Pulmonary Hypermetabolism on 18F-FDG PET/CT Caused by Pulmonary Embolism. Clin Nucl Med 2015; 40:338-9. [DOI: 10.1097/rlu.0000000000000679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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