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Chen Y, Liang J, Li Q, Zhou J, Xu J, Xiong D, Jiang H, Ye S, Chen J. Clinical outcome of lung transplantation for chronic thromboembolic pulmonary hypertension. BMC Pulm Med 2024; 24:410. [PMID: 39187801 PMCID: PMC11346220 DOI: 10.1186/s12890-024-03213-4] [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: 04/06/2024] [Accepted: 08/09/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Chronic thromboembolic pulmonary hypertension (CTEPH) is a type of pulmonary hypertension with a low incidence. Despite pulmonary endarterectomy(PEA) being the preferred treatment for CTEPH, for patients who failed medical therapy and who are not suitable candidates for PEA, lung transplantation (LT) is still the only effective treatment for end-stage CTEPH; however, there are currently very few reports on the efficacy of LT for CTEPH. METHODS We retrospectively analyzed the clinical data of seven patients diagnosed with CTEPH between July 2019 and July 2021. The follow-up deadline was March, 2022. RESULTS The mean age at admission was 54 ± 12 years. The average value of mean pulmonary artery pressure (mPAP) was 40 ± 5 mmHg. The mean preoperative oxygenation index(PaO2/FiO2) was 203 ± 56 mm Hg. After evaluation, one patient underwent left LT and the rest underwent bilateral LT. Three patients received intraoperative veno-venous extracorporeal membrane oxygenation (ECMO) support, and four patients received intraoperative veno-arterial ECMO support. The average postoperative mPAP was 19 ± 4 mmHg. The mean postoperative oxygenation index(PaO2/FiO2) was 388 ± 83 mmHg. There was a significant difference between the preoperative and postoperative mPAP and oxygenation index(PaO2/FiO2). All patients recovered well and were discharged 37 ± 19 days postoperatively. The mean follow-up duration was 19 ± 8 months. There was no recurrence of CTEPH. CONCLUSIONS LT is an effective treatment for end-stage CTEPH, which can improve cardiopulmonary function and quality of life and prolong survival. Patients who are unable to tolerate PEA should be considered for LT as early as possible when internal medicine failed.
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Affiliation(s)
- Yuan Chen
- Wuxi Lung Transplant Center, Department of Thoracic Surgery, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, 299 Qingyang Road, Wuxi, 214023, Jiangsu, China
| | - Jialong Liang
- Wuxi Lung Transplant Center, Department of Thoracic Surgery, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, 299 Qingyang Road, Wuxi, 214023, Jiangsu, China
| | - Qian Li
- The Taihu Rehabilitation Hospital of Jiangsu Province (The Taihu Sanatorium of Jiangsu Province), Wuxi, Jiangsu, China
| | - Jintao Zhou
- Wuxi Lung Transplant Center, Department of Thoracic Surgery, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, 299 Qingyang Road, Wuxi, 214023, Jiangsu, China
| | - Jian Xu
- Wuxi Lung Transplant Center, Department of Thoracic Surgery, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, 299 Qingyang Road, Wuxi, 214023, Jiangsu, China
| | - Dian Xiong
- Wuxi Lung Transplant Center, Department of Thoracic Surgery, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, 299 Qingyang Road, Wuxi, 214023, Jiangsu, China
| | - Huachi Jiang
- Wuxi Lung Transplant Center, Department of Thoracic Surgery, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, 299 Qingyang Road, Wuxi, 214023, Jiangsu, China
| | - Shugao Ye
- Wuxi Lung Transplant Center, Department of Thoracic Surgery, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, 299 Qingyang Road, Wuxi, 214023, Jiangsu, China.
| | - Jingyu Chen
- Wuxi Lung Transplant Center, Department of Thoracic Surgery, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, 299 Qingyang Road, Wuxi, 214023, Jiangsu, China.
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Ackermann M, Werlein C, Plucinski E, Leypold S, Kühnel MP, Verleden SE, Khalil HA, Länger F, Welte T, Mentzer SJ, Jonigk DD. The role of vasculature and angiogenesis in respiratory diseases. Angiogenesis 2024; 27:293-310. [PMID: 38580869 PMCID: PMC11303512 DOI: 10.1007/s10456-024-09910-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/11/2024] [Indexed: 04/07/2024]
Abstract
In European countries, nearly 10% of all hospital admissions are related to respiratory diseases, mainly chronic life-threatening diseases such as COPD, pulmonary hypertension, IPF or lung cancer. The contribution of blood vessels and angiogenesis to lung regeneration, remodeling and disease progression has been increasingly appreciated. The vascular supply of the lung shows the peculiarity of dual perfusion of the pulmonary circulation (vasa publica), which maintains a functional blood-gas barrier, and the bronchial circulation (vasa privata), which reveals a profiled capacity for angiogenesis (namely intussusceptive and sprouting angiogenesis) and alveolar-vascular remodeling by the recruitment of endothelial precursor cells. The aim of this review is to outline the importance of vascular remodeling and angiogenesis in a variety of non-neoplastic and neoplastic acute and chronic respiratory diseases such as lung infection, COPD, lung fibrosis, pulmonary hypertension and lung cancer.
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Affiliation(s)
- Maximilian Ackermann
- Institute of Pathology, University Clinics of RWTH University, Aachen, Germany.
- Institute of Pathology and Molecular Pathology, Helios University Clinic Wuppertal, University of Witten/Herdecke, Witten, Germany.
- Institute of Anatomy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
| | | | - Edith Plucinski
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Sophie Leypold
- Institute of Pathology, University Clinics of RWTH University, Aachen, Germany
| | - Mark P Kühnel
- Institute of Pathology, University Clinics of RWTH University, Aachen, Germany
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - Stijn E Verleden
- Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), University of Antwerp, Antwerp, Belgium
| | - Hassan A Khalil
- Division of Thoracic and Cardiac Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, USA
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Florian Länger
- Institute of Pathology, University Clinics of RWTH University, Aachen, Germany
| | - Tobias Welte
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
| | - Steven J Mentzer
- Division of Thoracic and Cardiac Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, USA
- Laboratory of Adaptive and Regenerative Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Danny D Jonigk
- Institute of Pathology, University Clinics of RWTH University, Aachen, Germany
- Member of the German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
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3
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Tobal R, Potjewijd J, van Doorn D, van Empel V, Damoiseaux J, van Paassen P. High Prevalence of Myositis-Specific and Associated Antibodies in Patients with Pulmonary Hypertension. Diagnostics (Basel) 2024; 14:1471. [PMID: 39061608 PMCID: PMC11276054 DOI: 10.3390/diagnostics14141471] [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: 05/01/2024] [Revised: 07/01/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024] Open
Abstract
Pulmonary hypertension (PH) is a serious condition linked to immune-system dysfunction. Myositis-specific/associated antibodies (MSAs/MAAs) play a role in idiopathic inflammatory myopathy (IIM) and interstitial lung disease (ILD), but their significance in PH remains unclear. We believe the presence of these antibodies may be underestimated. This study analyzed adult PH patients without pre-existing IIM for MSA/MAA prevalence using a line-blot assay. We compared PH patients with and without ILD signs to a cohort clinically suspected of IIM/ILD (n = 558). Our PH cohort (n = 121) showed a significantly higher prevalence of overall weak positive MSAs/MAAs and positive overlap syndrome-associated MAAs than the suspected IIM/ILD group (p < 0.001). Notably, MSAs/MAAs were found in PH patients both with and without ILD, though more prevalent in those with ILD. Anti-synthetase and anti-overlap syndrome antibodies were the most common. Our study is the first to systematically show a high MSA/MAA prevalence in PH without IIM presentation. This highlights the need to consider PH when diagnosing MSA/MAA-associated conditions. We recommend MSA/MAA screening for newly diagnosed PH, especially in those with ILD, for early detection and potential immunomodulatory treatment. Further research should explore the link between MSAs/MAAs and PH, and the value of monitoring patients with weak MSA/MAA positivity over time.
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Affiliation(s)
- Rachid Tobal
- Department of Internal Medicine, Division of Nephrology and Clinical and Experimental Immunology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands; (D.v.D.); (P.v.P.)
| | - Judith Potjewijd
- Department of Internal Medicine, Division of Nephrology and Clinical and Experimental Immunology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands; (D.v.D.); (P.v.P.)
| | - Daan van Doorn
- Department of Internal Medicine, Division of Nephrology and Clinical and Experimental Immunology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands; (D.v.D.); (P.v.P.)
| | - Vanessa van Empel
- Department of Cardiology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands;
| | - Jan Damoiseaux
- Central Diagnostic Laboratory, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands;
| | - Pieter van Paassen
- Department of Internal Medicine, Division of Nephrology and Clinical and Experimental Immunology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands; (D.v.D.); (P.v.P.)
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4
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Jiang W, Jia W, Dong C. Under the dual effect of inflammation and pulmonary fibrosis, CTD-ILD patients possess a greater susceptibility to VTE. Thromb J 2024; 22:34. [PMID: 38576023 PMCID: PMC10993540 DOI: 10.1186/s12959-024-00599-3] [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: 11/15/2023] [Accepted: 03/18/2024] [Indexed: 04/06/2024] Open
Abstract
As an autoimmune disease, the persistent systemic inflammatory response associated with connective tissue disease (CTD) is involved in the development of venous thromboembolism (VTE). However, clinical data showed that the risk of VTE in patients differed between subtypes of CTD, suggesting that different subtypes may have independent mechanisms to promote the development of VTE, but the specific mechanism lacks sufficient research at present. The development of pulmonary fibrosis also contributes to the development of VTE, and therefore, patients with CTD-associated interstitial lung disease (CTD-ILD) may be at higher risk of VTE than patients with CTD alone or patients with ILD alone. In addition, the activation of the coagulation cascade response will drive further progression of the patient's pre-existing pulmonary fibrosis, which will continue to increase the patient's risk of VTE and adversely affect prognosis. Currently, the treatment for CTD-ILD is mainly immunosuppressive and antirheumatic therapy, such as the use of glucocorticoids and janus kinase-inhibitors (JAKis), but, paradoxically, these drugs are also involved in the formation of patients' coagulation tendency, making the clinical treatment of CTD-ILD patients with a higher risk of developing VTE challenging. In this article, we review the potential risk factors and related mechanisms for the development of VTE in CTD-ILD patients to provide a reference for clinical treatment and prevention.
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Affiliation(s)
- Wenli Jiang
- Department of Pulmonary and Critical Care Medicine, Second Hospital, Jilin University, 130041, Changchun, China
| | - Wenhui Jia
- Department of Pulmonary and Critical Care Medicine, Second Hospital, Jilin University, 130041, Changchun, China
| | - Chunling Dong
- Department of Pulmonary and Critical Care Medicine, Second Hospital, Jilin University, 130041, Changchun, China.
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5
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Feugray G, Miranda S, Le Cam Duchez V, Bellien J, Billoir P. Endothelial Progenitor Cells in Autoimmune Disorders. Stem Cell Rev Rep 2023; 19:2597-2611. [PMID: 37676423 DOI: 10.1007/s12015-023-10617-y] [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] [Accepted: 08/26/2023] [Indexed: 09/08/2023]
Abstract
Circulating endothelial progenitor cells (EPCs) were first described in 1997 by Asahara et al. as "putative endothelial cells" from human peripheral blood. The study of endothelial progenitors is also intensifying in several pathologies associated with endothelial damage, including diabetes, myocardial infarction, sepsis, pulmonary arterial hypertension, obstructive bronchopneumopathy and transplantation. EPCs have been studied in several autoimmune diseases with endothelial involvement such as systemic lupus erythematosus, thrombotic thrombocytopenic purpura, antineutrophil cytoplasmic antibodies, vasculitis, rheumatoid arthritis, Goujerot-Sjögren and antiphospholipid syndrome. Factors involved in endothelial damage are due to overexpression of pro-inflammatory cytokines and/or autoantibodies. Management of these pathologies, particularly the long-term use of glucocorticoids and methotrexate, promote atherosclerosis. A lack of standardized assessment of the number and function of EPCs represents a serious challenge for the use of EPCs as prognostic markers of cardiovascular diseases (CVD). The objective of this review was to describe EPCs, their properties and their involvement in several autoimmune diseases.
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Affiliation(s)
- Guillaume Feugray
- UNIROUEN, INSERM U1096 EnVI, CHU Rouen, Department of General Biochemistry, Normandie University, F-76000, Rouen, France
| | - Sébastien Miranda
- UNIROUEN, INSERM U1096, CHU Rouen. Department of Internal Medicine, Normandie University, Rouen, France
| | | | - Jérémy Bellien
- UNIROUEN, INSERM U1096 EnVI, CHU Rouen, Department of Pharmacology, Normandie University, F-76000, Rouen, France
| | - Paul Billoir
- UNIROUEN, INSERM U1096, CHU Rouen. Department of Internal Medicine, Normandie University, Rouen, France.
- Normandy Univ, U1096, Rouen University Hospital, Vascular Hemostasis Unit, Rouen, France.
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6
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Cras A, Larghero J, Rossi E, Blandinières A, Gaussem P, Smadja DM. Nestin is a New Partner in Endothelial Colony Forming Cell Angiogenic Potential. Stem Cell Rev Rep 2023; 19:2541-2550. [PMID: 37452965 DOI: 10.1007/s12015-023-10587-1] [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] [Accepted: 07/04/2023] [Indexed: 07/18/2023]
Abstract
Nestin, an intermediate filament protein expressed by progenitor cells, is associated with tissue regeneration. Although nestin expression has been reported in poorly differentiated and newly formed blood vessels, its role in endothelial cells remains unclear. In this study, we investigated the involvement of nestin in the angiogenic properties of endothelial colony-forming cells (ECFCs) derived from human umbilical cord blood. Our results demonstrate that ECFCs express high levels of nestin, and that its inhibition by small interfering RNAs decreased ECFC proliferation, migration in response to SDF-1 and VEGF-A, tubulogenesis, and adhesion on collagen. These effects are associated with modulation of focal adhesion kinase phosphorylation. Furthermore, nestin silencing resulted in reduced revascularization in a mouse hindlimb ischemia model. In conclusion, these findings provide evidence that nestin more than being a structural protein, is an active player in ECFC angiogenic properties.
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Affiliation(s)
- Audrey Cras
- Université de Paris Cité, INSERM, Innovative Therapies in Hemostasis, F-75006, Paris, France
- Cell therapy unit, AP-HP, Saint Louis Hospital, F-75010, Paris, France
| | - Jérôme Larghero
- Cell therapy unit, AP-HP, Saint Louis Hospital, F-75010, Paris, France
- Université de Paris Cité, INSERM, U976, CIC-BT, F-75010, Paris, France
| | - Elisa Rossi
- Université de Paris Cité, INSERM, Innovative Therapies in Hemostasis, F-75006, Paris, France
| | - Adeline Blandinières
- Université de Paris Cité, INSERM, Innovative Therapies in Hemostasis, F-75006, Paris, France
- Hematology department, AP-HP, Georges Pompidou European Hospital, F-75015, Paris, France
| | - Pascale Gaussem
- Université de Paris Cité, INSERM, Innovative Therapies in Hemostasis, F-75006, Paris, France
- Hematology department, AP-HP, Georges Pompidou European Hospital, F-75015, Paris, France
| | - David M Smadja
- Université de Paris Cité, INSERM, Innovative Therapies in Hemostasis, F-75006, Paris, France.
- Hematology department, AP-HP, Georges Pompidou European Hospital, F-75015, Paris, France.
- Inserm Innovative Therapies in Haemostasis, 56 rue Leblanc, F-75015, Paris, France.
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7
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Borek I, Birnhuber A, Voelkel NF, Marsh LM, Kwapiszewska G. The vascular perspective on acute and chronic lung disease. J Clin Invest 2023; 133:e170502. [PMID: 37581311 PMCID: PMC10425217 DOI: 10.1172/jci170502] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023] Open
Abstract
The pulmonary vasculature has been frequently overlooked in acute and chronic lung diseases, such as acute respiratory distress syndrome (ARDS), pulmonary fibrosis (PF), and chronic obstructive pulmonary disease (COPD). The primary emphasis in the management of these parenchymal disorders has largely revolved around the injury and aberrant repair of epithelial cells. However, there is increasing evidence that the vascular endothelium plays an active role in the development of acute and chronic lung diseases. The endothelial cell network in the capillary bed and the arterial and venous vessels provides a metabolically highly active barrier that controls the migration of immune cells, regulates vascular tone and permeability, and participates in the remodeling processes. Phenotypically and functionally altered endothelial cells, and remodeled vessels, can be found in acute and chronic lung diseases, although to different degrees, likely because of disease-specific mechanisms. Since vascular remodeling is associated with pulmonary hypertension, which worsens patient outcomes and survival, it is crucial to understand the underlying vascular alterations. In this Review, we describe the current knowledge regarding the role of the pulmonary vasculature in the development and progression of ARDS, PF, and COPD; we also outline future research directions with the hope of facilitating the development of mechanism-based therapies.
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Affiliation(s)
- Izabela Borek
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
| | - Anna Birnhuber
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
- Otto Loewi Research Center, Division of Physiology and Pathophysiology, Medical University of Graz, Graz, Austria
| | - Norbert F. Voelkel
- Pulmonary Medicine Department, University of Amsterdam Medical Centers, Amsterdam, Netherlands
- Department of Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Leigh M. Marsh
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
- Otto Loewi Research Center, Division of Physiology and Pathophysiology, Medical University of Graz, Graz, Austria
| | - Grazyna Kwapiszewska
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
- Otto Loewi Research Center, Division of Physiology and Pathophysiology, Medical University of Graz, Graz, Austria
- Institute for Lung Health, German Lung Center (DZL), Cardiopulmonary Institute, Giessen, Germany
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Bacci M, Cancellara A, Ciceri R, Romualdi E, Pessi V, Tumminello F, Fantuzzi M, Donadini MP, Lodigiani C, Della Bella S, Calcaterra F, Mavilio D. Development of Personalized Thrombogenesis and Thrombin Generation Assays to Assess Endothelial Dysfunction in Cardiovascular Diseases. Biomedicines 2023; 11:1669. [PMID: 37371764 DOI: 10.3390/biomedicines11061669] [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: 04/26/2023] [Revised: 05/25/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
The study of endothelial dysfunction (ED) is crucial to identify the pathogenetic mechanism(s) and provide indications for patient management in cardiovascular diseases. It is currently hindered by the limited availability of patient-specific primary endothelial cells (ECs). Endothelial colony-forming cells (ECFCs) represent an optimal non-invasive tool to overcome this issue. Therefore, we investigated the use of ECFCs as a substrate in thrombogenesis and thrombin generation assay (TGA) to assess ED. Both assays were set up on human umbilical vein endothelial cells (HUVECs) and then tested on ECFCs obtained from healthy donors. To prove the ability of the assays to detect endothelial activation, ECs stimulated with TNFα were compared with unstimulated ECs. EC activation was confirmed by the upregulation of VCAM-1 and Tissue Factor expression. Both assays discriminated between unstimulated and activated HUVECs and ECFCs, as significantly higher platelet deposition and fibrin formation in thrombogenesis assay, and thrombin generation in TGA, were observed when TNFα-activated ECs were used as a substrate. The amount of fibrin and thrombin measured in the two assays were directly correlated. Our results support the combined use of a thrombogenesis assay and TGA performed on patient-derived ECFCs to provide a personalized global assessment of ED relevant to the patient's hemostatic profile.
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Affiliation(s)
- Monica Bacci
- Center for Thrombosis and Hemorrhagic Diseases, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Assunta Cancellara
- Department of Medical Biotechnologies and Translational Medicine, University of Milan, 20089 Rozzano, Italy
- Unit of Clinical and Experimental Immunology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Roberta Ciceri
- Department of Medical Biotechnologies and Translational Medicine, University of Milan, 20089 Rozzano, Italy
- Unit of Clinical and Experimental Immunology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Erica Romualdi
- Centro Trombosi ed Emostasi, Ospedale di Circolo e Fondazione Macchi, ASST Sette Laghi, 21100 Varese, Italy
- UO Medicina 2, Ospedale di Circolo e Fondazione Macchi, ASST Sette Laghi, 21100 Varese, Italy
| | - Valentina Pessi
- Dipartimento di Medicina e Chirurgia, Università Dell'Insubria, 21100 Varese, Italy
| | - Fabio Tumminello
- Center for Thrombosis and Hemorrhagic Diseases, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Italy
| | - Martina Fantuzzi
- Dipartimento di Medicina e Chirurgia, Università Dell'Insubria, 21100 Varese, Italy
| | - Marco Paolo Donadini
- Centro Trombosi ed Emostasi, Ospedale di Circolo e Fondazione Macchi, ASST Sette Laghi, 21100 Varese, Italy
- Dipartimento di Medicina e Chirurgia, Università Dell'Insubria, 21100 Varese, Italy
| | - Corrado Lodigiani
- Center for Thrombosis and Hemorrhagic Diseases, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Silvia Della Bella
- Department of Medical Biotechnologies and Translational Medicine, University of Milan, 20089 Rozzano, Italy
- Unit of Clinical and Experimental Immunology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Francesca Calcaterra
- Department of Medical Biotechnologies and Translational Medicine, University of Milan, 20089 Rozzano, Italy
- Unit of Clinical and Experimental Immunology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Domenico Mavilio
- Department of Medical Biotechnologies and Translational Medicine, University of Milan, 20089 Rozzano, Italy
- Unit of Clinical and Experimental Immunology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
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9
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Schwarz N, Müller J, Yadegari H, McRae HL, Reda S, Hamedani NS, Oldenburg J, Pötzsch B, Rühl H. Ex Vivo Modeling of the PC (Protein C) Pathway Using Endothelial Cells and Plasma: A Personalized Approach. Arterioscler Thromb Vasc Biol 2023; 43:109-119. [PMID: 36353988 DOI: 10.1161/atvbaha.122.318433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The endothelial cell-dependent PC (protein C) pathway is critically involved in the regulation of coagulation, anti-inflammatory, and cytoprotective signaling. Its reactivity shows high interindividual variability, and it contributes to prothrombotic disorders, such as the FVL (factor V Leiden) mutation. METHODS Endothelial colony-forming cells (ECFCs) were isolated from heparinized peripheral blood from healthy individuals and FVL carriers. Confluent monolayers of ECFCs were overlaid with plasma, and thrombin formation was initiated by addition of tissue factor (1 pmol/L). Subsequently, thrombin and APC (activated PC) formation rates were measured over time using oligonucleotide-based enzyme capture assays. To induce downregulation of TM (thrombomodulin) expression, ECFCs were stimulated with IL-1β (interleukin 1β). In vivo APC response rates were monitored in study participants after infusion of low-dose rFVIIa (recombinant activated factor VII). RESULTS The median peak APC concentration was 1.12 nmol/L in experiments with IL-1β stimulated ECFCs and 3.66 nmol/L without IL-1β. Although thrombin formation rates were comparable, APC formation rates were significantly higher in FVL carriers (n=6) compared to noncarriers (n=5) as evidenced by a higher ratio between the area under the curve of APC generation to the area under the curve of thrombin generation (median 0.090 versus 0.031, P=0.017). These ex vivo results were correlated with an increased APC response to rFVIIa-induced thrombin formation in FVL carriers in vivo. CONCLUSIONS Patient-specific ex vivo modeling of the PC pathway was achieved using blood-derived ECFCs. The correlation between in and ex vivo APC response rates confirms that the autologous PC model accurately depicts the in vivo situation.
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Affiliation(s)
- Nadine Schwarz
- Institute of Experimental Hematology and Transfusion Medicine, University Hospital Bonn, Germany
| | - Jens Müller
- Institute of Experimental Hematology and Transfusion Medicine, University Hospital Bonn, Germany
| | - Hamideh Yadegari
- Institute of Experimental Hematology and Transfusion Medicine, University Hospital Bonn, Germany
| | - Hannah L McRae
- Institute of Experimental Hematology and Transfusion Medicine, University Hospital Bonn, Germany
| | - Sara Reda
- Institute of Experimental Hematology and Transfusion Medicine, University Hospital Bonn, Germany
| | - Nasim Shahidi Hamedani
- Institute of Experimental Hematology and Transfusion Medicine, University Hospital Bonn, Germany
| | - Johannes Oldenburg
- Institute of Experimental Hematology and Transfusion Medicine, University Hospital Bonn, Germany
| | - Bernd Pötzsch
- Institute of Experimental Hematology and Transfusion Medicine, University Hospital Bonn, Germany
| | - Heiko Rühl
- Institute of Experimental Hematology and Transfusion Medicine, University Hospital Bonn, Germany
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10
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Robertson JO, Erzurum SC, Asosingh K. Pathological Roles for Endothelial Colony-Forming Cells in Neonatal and Adult Lung Disease. Am J Respir Cell Mol Biol 2023; 68:13-22. [PMID: 36215049 PMCID: PMC9817912 DOI: 10.1165/rcmb.2022-0318ps] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 10/10/2022] [Indexed: 02/05/2023] Open
Abstract
Endothelial colony-forming cells (ECFCs) are vascular resident and circulating endothelial cell subtypes with potent angiogenic capacity, a hierarchy of single-cell clonogenic potentials, and the ability to participate in de novo blood vessel formation and endothelial repair. Existing literature regarding ECFCs in neonatal and adult pulmonary diseases is confounded by the study of ambiguously defined "endothelial progenitor cells," which are often not true ECFCs. This review contrasts adult and fetal ECFCs, discusses the effect of prematurity on ECFCs, and examines their different pathological roles in neonatal and adult pulmonary diseases, such as bronchopulmonary dysplasia, congenital diaphragmatic hernia, pulmonary artery hypertension, pulmonary fibrosis, and chronic obstructive pulmonary disease. Therapeutic potential is also discussed in light of available preclinical data.
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Affiliation(s)
| | - Serpil C. Erzurum
- Department of Inflammation and Immunity, Cleveland Clinic Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Kewal Asosingh
- Department of Inflammation and Immunity, Cleveland Clinic Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
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11
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Détriché G, Gendron N, Philippe A, Gruest M, Billoir P, Rossi E, Guerin CL, Lokajczyk A, Brabant S, Prié D, Mirault T, Smadja DM. Gonadotropins as novel active partners in vascular diseases: Insight from angiogenic properties and thrombotic potential of endothelial colony-forming cells. J Thromb Haemost 2022; 20:230-237. [PMID: 34623025 DOI: 10.1111/jth.15549] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 10/06/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND The impact of estrogen and testosterone on atherosclerotic cardiovascular disease is well known, but the role of the gonadotropins follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin (PRL) to some extent remain less studied. OBJECTIVES To explore the angiogenic potential of gonadotropins on endothelial colony-forming cells (ECFCs). METHODS We examined the effects of various doses of gonadotropins on ECFCs obtained from cord blood by assessing colony number, proliferation, migration, and sprouting ability. Moreover, we studied thrombin generation in ECFCs exposed to gonadotropins by performing a thrombin generation assay. Finally, we determined the levels of circulating gonadotropins in 30 men, to exclude the effect of estrogen, with lower extremity arterial disease (LEAD), in comparison with age- and sex-matched controls. RESULTS Exposure to FSH, LH, or PRL resulted in an increase in ECFC migration but showed no effect on proliferation or ECFC commitment from cord blood mononuclear cells. Using a three-dimensional fibrin gel assay, we showed that ECFC sprouting was significantly enhanced by gonadotropins. Exposure to FSH also increased the thrombin generation of ECFCs exposed to FSH. Finally, FSH and LH levels in men with LEAD were higher than those in controls. CONCLUSION Gonadotropins increase ECFC-related angiogenesis and may be involved in thrombin generation in cardiovascular disease. Gonadotropins may act as biomarkers; moreover, we hypothesize that gonadotropin-blocking strategies may be a novel interesting therapeutic approach in atherosclerotic cardiovascular disease.
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Affiliation(s)
- Grégoire Détriché
- INSERM, Innovative Therapies in Haemostasis, Université de Paris, Paris, France
- Biosurgical Research Lab (Carpentier Foundation), Vascular Medicine Department, Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France
| | - Nicolas Gendron
- INSERM, Innovative Therapies in Haemostasis, Université de Paris, Paris, France
- Biosurgical Research Lab (Carpentier Foundation), Hematology Department, Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France
| | - Aurélien Philippe
- INSERM, Innovative Therapies in Haemostasis, Université de Paris, Paris, France
- Biosurgical Research Lab (Carpentier Foundation), Hematology Department, Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France
| | - Maxime Gruest
- INSERM, Innovative Therapies in Haemostasis, Université de Paris, Paris, France
- Biosurgical Research Lab (Carpentier Foundation), Hematology Department, Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France
| | - Paul Billoir
- Vascular Hemostasis Unit, UNIROUEN, INSERM U1096, Rouen University Hospital, Normandie Univ, Rouen, France
| | - Elisa Rossi
- INSERM, Innovative Therapies in Haemostasis, Université de Paris, Paris, France
| | - Coralie L Guerin
- INSERM, Innovative Therapies in Haemostasis, Université de Paris, Paris, France
- Cytometry Platform, Institut Curie, Paris, France
- Department of Infection and Immunity, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Anna Lokajczyk
- INSERM, Innovative Therapies in Haemostasis, Université de Paris, Paris, France
| | - Séverine Brabant
- AP-HP, Department of Functional Explorations, Necker Enfants Malades Hospital, Paris-Centre University, Paris Cedex, France
| | - Dominique Prié
- AP-HP, Department of Functional Explorations, Necker Enfants Malades Hospital, Paris-Centre University, Paris Cedex, France
| | - Tristan Mirault
- INSERM, Innovative Therapies in Haemostasis, Université de Paris, Paris, France
- Biosurgical Research Lab (Carpentier Foundation), Vascular Medicine Department, Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France
| | - David M Smadja
- INSERM, Innovative Therapies in Haemostasis, Université de Paris, Paris, France
- Biosurgical Research Lab (Carpentier Foundation), Hematology Department, Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France
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12
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Feugray G, Kasonga F, Chamouni P, Barbay V, Fresel M, Hélène Chretien M, Brunel S, Le Cam Duchez V, Billoir P. Factor XII deficiency evaluated by thrombin generation assay. Clin Biochem 2021; 100:42-47. [PMID: 34843733 DOI: 10.1016/j.clinbiochem.2021.11.014] [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: 07/29/2021] [Revised: 11/06/2021] [Accepted: 11/22/2021] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Coagulation factor XII (FXII) plays a role in thrombin generation, fibrinolysis, inflammation, angiogenesis, chemotaxis and diapedesis. FXII deficiency is not associated with bleeding risk unlike other coagulation factors. MATERIALS/METHODS We investigated thrombin generation assay (TGA) profile modification in FXII deficiency and the correlation with TGA and deficiency severity. TGA was performed in platelet poor plasma (PPP) with tissue factor (1 pmol/L) and phospholipid (4 µmol/L) standardized concentration. Thrombin generation profiles were compared in 54 patients with FXII deficiency, 25 healthy controls and 23 patients with hemophilia A (factor VIII (FVIII) deficiency. Patients with FXII deficiency were classified in three groups based on FXII activity (30-50%, 10-29%, <10%). FVIII deficiency was included as a bleeding control group. RESULTS As expected, we found a correlation between FXII deficiency and activated partial thromboplastin time (aPTT). A decrease of thrombin generation was observed in healthy controls and all FXII deficiency groups. A decrease of endogenous thrombin potential (ETP), peak and velocity was observed in patients with FVIII deficiency compared to FXII deficiency. A decrease of thrombin generation was noted in patients with FXII deficiency and bleeding history compared to patients with FXII deficiency and thrombosis history. CONCLUSION In this study, thrombin generation profiles were not sensitive to FXII deficiency. TGA could distinguish bleeding and thrombotic tendency in FXII deficiency. Our results should therefore be considered as exploratory and deserve confirmation.
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Affiliation(s)
- Guillaume Feugray
- Normandie Univ, UNIROUEN, INSERM U1096, Rouen University Hospital, Vascular Hemostasis Unit, F 76000 Rouen, France
| | - Fiston Kasonga
- Rouen University Hospital, Vascular Hemostasis Unit, F 76000 Rouen, France
| | - Pierre Chamouni
- Rouen University Hospital, Hemophilia Care Center, F 76000 Rouen, France
| | - Virginie Barbay
- Rouen University Hospital, Vascular Hemostasis Unit, F 76000 Rouen, France; Rouen University Hospital, Hemophilia Care Center, F 76000 Rouen, France
| | - Marielle Fresel
- Rouen University Hospital, Vascular Hemostasis Unit, F 76000 Rouen, France
| | | | - Sabine Brunel
- Rouen University Hospital, Vascular Hemostasis Unit, F 76000 Rouen, France
| | - Véronique Le Cam Duchez
- Normandie Univ, UNIROUEN, INSERM U1096, Rouen University Hospital, Vascular Hemostasis Unit, F 76000 Rouen, France
| | - Paul Billoir
- Normandie Univ, UNIROUEN, INSERM U1096, Rouen University Hospital, Vascular Hemostasis Unit, F 76000 Rouen, France.
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13
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Kasonga F, Feugray G, Chamouni P, Barbay V, Fresel M, Chretien MH, Brunel S, Le Cam Duchez V, Billoir P. Evaluation of thrombin generation assay in factor XI deficiency. Clin Chim Acta 2021; 523:348-354. [PMID: 34670127 DOI: 10.1016/j.cca.2021.10.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/15/2021] [Accepted: 10/15/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Factor XI (FXI) deficiency is characterized by a lack of correlation between FXI plasma levels and the occurrence of hemorrhagic events. The main objective of our study was to determine whether thrombin generation assay (TGA) could be used to assess the hemorrhagic phenotype of patients with FXI deficiency. MATERIAL AND METHODS All patients had confirmed laboratory measurement of FXI < 50% in two plasma samples. Relevant bleeding history was evaluated by a senior physician. TGA was performed with Calibrated Automated Thrombography, in platelet poor plasma, from patients and healthy controls. The assay was performed with PPP low reagent (1 pM of human tissue factor). RESULTS Seventy-six patients with FXI deficiency were included between 2011 and 2020. Among them, eight patients had severe deficiency (FXI < 15%). Mean age was 34 years [range: 9-77]. Endogenous thrombin potential (ETP) was significantly lower in patients with FXI deficiency and bleeding (573 nM·min [225-1214]) or no bleeding (732 nM·min [222-1435]), compared to healthy controls (1184 nM·min [933-1518]). No difference was observed for ETP and peak between patients with FXI deficiency and bleeding and patients with FXI deficiency and no bleeding. No difference was observed for ETP (923 nM·min [377-1497] vs 1063 nM·min [252-2529]), peak (82 nM [28-154] vs 131 nM [20-330]) or velocity (13.7 nM/min [3.6-29.6] vs 26.5 nM/min [2.5-90]) in women with (n = 4) and without history (n = 17) of post-partum bleeding. No difference of thrombin generation was observed in pregnant women with FXI deficiency (ETP: 1395 nM·min [351-2529]; peak: 154 nM [26-330]; velocity: 29.6 nM/min [4.1-90.0]), compared to healthy controls and a control group of healthy pregnant women. CONCLUSION In conclusion, under our experimental condition, a non-significant decrease of thrombin generation was observed in plasma samples of patients with FXI deficiency and bleeding. Our results suggest an increase of coagulation parameters during pregnancy in women with FXI deficiency. A larger sample size or other experimental conditions are required to evaluate the use of TGA in FXI deficiency.
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Affiliation(s)
- Fiston Kasonga
- CHU Rouen, Vascular Hemostasis Unit, F-76000 Rouen, France
| | - Guillaume Feugray
- Normandie Univ, UNIROUEN, INSERM U1096, CHU Rouen, Vascular Hemostasis Unit, F-76000 Rouen, France
| | | | - Virginie Barbay
- CHU Rouen, Vascular Hemostasis Unit, F-76000 Rouen, France; CHU Rouen, Hemophilia Care Center, F 76000 Rouen, France
| | | | | | - Sabine Brunel
- CHU Rouen, Vascular Hemostasis Unit, F-76000 Rouen, France
| | - Véronique Le Cam Duchez
- Normandie Univ, UNIROUEN, INSERM U1096, CHU Rouen, Vascular Hemostasis Unit, F-76000 Rouen, France
| | - Paul Billoir
- Normandie Univ, UNIROUEN, INSERM U1096, CHU Rouen, Vascular Hemostasis Unit, F-76000 Rouen, France.
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14
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Smadja DM, Philippe A, Bory O, Gendron N, Beauvais A, Gruest M, Peron N, Khider L, Guerin CL, Goudot G, Levavasseur F, Duchemin J, Pene F, Cheurfa C, Szwebel TA, Sourdeau E, Planquette B, Hauw-Berlemont C, Hermann B, Gaussem P, Samama CM, Mirault T, Terrier B, Sanchez O, Rance B, Fontenay M, Diehl JL, Chocron R. Placental growth factor level in plasma predicts COVID-19 severity and in-hospital mortality. J Thromb Haemost 2021; 19:1823-1830. [PMID: 33830623 PMCID: PMC8250221 DOI: 10.1111/jth.15339] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/17/2021] [Accepted: 03/25/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is a respiratory disease associated with vascular inflammation and endothelial injury. OBJECTIVES To correlate circulating angiogenic markers vascular endothelial growth factor A (VEGF-A), placental growth factor (PlGF), and fibroblast growth factor 2 (FGF-2) to in-hospital mortality in COVID-19 adult patients. METHODS Consecutive ambulatory and hospitalized patients with COVID-19 infection were enrolled. VEGF-A, PlGF, and FGF-2 were measured in each patient ≤48 h following admission. RESULTS The study enrolled 237 patients with suspected COVID-19: 208 patients had a positive diagnostic for COVID-19, of whom 23 were mild outpatients and 185 patients hospitalized after admission. Levels of VEGF-A, PlGF, and FGF-2 significantly increase with the severity of the disease (P < .001). Using a logistic regression model, we found a significant association between the increase of FGF-2 or PlGF and mortality (odds ratio [OR] 1.11, 95% confidence interval [CI; 1.07-1.16], P < .001 for FGF-2 and OR 1.07 95% CI [1.04-1.10], P < .001 for PlGF) while no association were found for VEGF-A levels. Receiver operating characteristic curve analysis was performed and we identified PlGF above 30 pg/ml as the best predictor of in-hospital mortality in COVID-19 patients. Survival analysis for PlGF confirmed its interest for in-hospital mortality prediction, by using a Kaplan-Meier survival curve (P = .001) and a Cox proportional hazard model adjusted to age, body mass index, D-dimer, and C-reactive protein (3.23 95% CI [1.29-8.11], P = .001). CONCLUSION Angiogenic factor PlGF is a relevant predictive factor for in-hospital mortality in COVID-19 patients. More than a biomarker, we hypothesize that PlGF blocking strategies could be a new interesting therapeutic approach in COVID-19.
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Affiliation(s)
- David M Smadja
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, Paris, France
- Hematology Department and Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
| | - Aurélien Philippe
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, Paris, France
- Hematology Department and Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
| | - Olivier Bory
- Université de Paris, Emergency Department, Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
| | - Nicolas Gendron
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, Paris, France
- Hematology Department and Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
| | - Agathe Beauvais
- Université de Paris, Emergency Department, Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
| | - Maxime Gruest
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, Paris, France
- Hematology Department and Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
| | - Nicolas Peron
- Université de Paris, Intensive Care Department, Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
| | - Lina Khider
- Université de Paris, Vascular Medicine Department and Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
| | - Coralie L Guerin
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, Paris, France
- Curie Institute, Cytometry Department, Paris, France
| | - Guillaume Goudot
- Université de Paris, Vascular Medicine Department and Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
| | - Françoise Levavasseur
- Université de Paris, Institut Cochin, INSERM, Paris, France
- Hematology Department Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
| | - Jérome Duchemin
- Université de Paris, Institut Cochin, INSERM, Paris, France
- Hematology Department Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
| | - Frédéric Pene
- Internal Medicine Department, Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
| | - Cherifa Cheurfa
- Intensive Care Medicine and Reanimation Department, Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
| | - Tali-Anne Szwebel
- Internal Medicine Department, Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
| | - Elise Sourdeau
- Emergency Unit, Hôpital Hôtel-Dieu, Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
| | - Benjamin Planquette
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, Paris, France
- Respiratory Medicine Department and Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
| | - Caroline Hauw-Berlemont
- Université de Paris, Intensive Care Department, Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
| | - Bertrand Hermann
- Université de Paris, Intensive Care Department, Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
| | - Pascale Gaussem
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, Paris, France
- Hematology Department and Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
| | - Charles-Marc Samama
- Intensive Care Medicine and Reanimation Department, Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
| | - Tristan Mirault
- Université de Paris, PARCC, INSERM, Paris, France
- Vascular Medicine Department, Assistance Publique - Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
| | - Benjamin Terrier
- Internal Medicine Department, Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
- Université de Paris, PARCC, INSERM, Paris, France
| | - Olivier Sanchez
- Emergency Unit, Hôpital Hôtel-Dieu, Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
| | - Bastien Rance
- Université de Paris, Department of Medical Informatics, AP-HP, Georges Pompidou European Hospital, Paris, France
| | - Michaela Fontenay
- Université de Paris, Institut Cochin, INSERM, Paris, France
- Hematology Department Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
| | - Jean-Luc Diehl
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, Paris, France
- Intensive Care Unit and Biosurgical Research Lab (Carpentier Foundation), Assistance Publique - Hôpitaux de Paris-Centre (APHP-CUP), Paris, France
| | - Richard Chocron
- Université de Paris, PARCC, INSERM U970, Paris, France
- Emergency Department, AH-HP-Centre Université de Paris (APHP-CUP), Paris, France
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15
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Hypercoagulability Evaluation in Antiphospholipid Syndrome without Anticoagulation Treatment with Thrombin Generation Assay: A Preliminary Study. J Clin Med 2021; 10:jcm10122728. [PMID: 34205545 PMCID: PMC8234883 DOI: 10.3390/jcm10122728] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/14/2021] [Accepted: 06/18/2021] [Indexed: 01/25/2023] Open
Abstract
Antiphospholipid syndrome (APS) is associated with thrombotic events (tAPS) and/or obstetrical morbidity (oAPS), with persisting antiphospholipid antibodies (aPL). Despite an update of aPL in 2006, several patients had typical clinical events without the classical biological criteria. The aim of our study was to evaluate the hypercoagulability state with both thrombin generation (TG) profiles and activated protein C resistance (aPCR) in different types of APS. Methods: We retrospectively included 41 patients with Sydney criteria classification (tAPS, oAPS) and no clinical manifestation of APS with persistent aPL (biological APS). A thrombin generation assay was performed with a Fluoroskan Ascent fluorometer in platelet-poor plasma (PPP). Activated protein C resistance was measured as a ratio: ETP+aPC/ETP-aPC × 100. Results: Thrombotic APS and oAPS had an increase of global thrombin generation (ETPcontrol = 808 nM.min (756–853) vs. 1265 nM.min (956–1741) and 1863 nM.min (1434–2080), respectively) (Peakcontrol = 78 nM (74–86) vs. 153 nM (109–215) and 254 nM.min (232–289), respectively). Biological APS had only a lag time increase (Tcontrol = 4.89 ± 1.65 min vs. 13.6 ± 3.9 min). An increased aPCR was observed in tAPS (52.7 ± 16.4%), oAPS (64.1 ± 14.6%) as compared to the control group (27.2 ± 13.8%). Conclusion: Our data suggest an increase of thrombin generation in thrombotic and obstetrical APS and no hypercoagulable states in patients with biological APS. The study of a prospective and a larger controlled cohort could determine the TGA useful for APS monitoring and could confirm an aPCR evaluation in PPP.
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16
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Billoir P, Alexandre K, Duflot T, Roger M, Miranda S, Goria O, Joly LM, Demeyere M, Feugray G, Brunel V, Etienne M, Le Cam Duchez V. Investigation of Coagulation Biomarkers to Assess Clinical Deterioration in SARS-CoV-2 Infection. Front Med (Lausanne) 2021; 8:670694. [PMID: 34150806 PMCID: PMC8211892 DOI: 10.3389/fmed.2021.670694] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/05/2021] [Indexed: 01/08/2023] Open
Abstract
Since December 2019, a pandemic caused by a new coronavirus has spread to more than 170 countries around the world. Worsening infected patients requiring intensive care unit (ICU) admission associated with 30% of mortality. A part of worsening is induced by hemostasis deregulation. The aim of this study was to investigate the association of coagulation activation in COVID-19 progression. Thirty-five of the 99 patients got clinically worse. The final model of the logistic regression analysis revealed that O2 requirement (RR = 7.27 [1.50–19.31]), monocytes below 0.2G/L (RR = 2.88 [1.67–3.19]), fibrinogen levels (RR = 1.45 [1.17–1.82] per g/L increase), prothrombin fragments 1+2 higher than 290 pM (RR = 2.39 [1.20–3.30]), and thrombin peak (RR = 1.28 [1.03–1.59] per 50 nM increase) were associated with an increased risk of clinical worsening. A fibrinogen level threshold of 5.5 g/L, a thrombin peak measurement threshold of 99 pM, and O2 requirement associated with clinical outcome in more than 80% of our cohort. In conclusion, we identified fibrinogen and thrombin peak at admission as coagulation biomarkers associated with an increased risk of ICU admission or death. This finding allows initiating steroids and triage for worsening patients. Our results should therefore be considered as exploratory and deserve confirmation.
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Affiliation(s)
- Paul Billoir
- Normandie Univ, UNIROUEN, INSERM U1096, CHU Rouen, Vascular Hemostasis Unit, Rouen, France.,F-CRIN INNOVTE, St-Étienne, France
| | - Kevin Alexandre
- Normandie Univ, UNIROUEN, EA2656, CHU Rouen, Department of Infectious Diseases, Rouen, France
| | - Thomas Duflot
- Normandie Univ, UNIROUEN, INSERM U1096, CHU Rouen, Department of Pharmacology, Rouen, France
| | - Maxime Roger
- CHU Rouen, Department of Pneumology, Rouen, France
| | - Sébastien Miranda
- F-CRIN INNOVTE, St-Étienne, France.,Normandie Univ, UNIROUEN, INSERM U1096, CHU Rouen, Department of Internal Medicine, Rouen, France
| | - Odile Goria
- CHU Rouen, Department of Gastroenterology and Hepatology, Rouen, France
| | - Luc Marie Joly
- Department of Emergency Medicine, Normandie Univ, UNIROUEN, CHU Rouen, Rouen, France
| | | | - Guillaume Feugray
- Normandie Univ, UNIROUEN, INSERM U1096, CHU Rouen, Vascular Hemostasis Unit, Rouen, France
| | - Valery Brunel
- Department of General Biochemistry, CHU Rouen, Rouen, France
| | - Manuel Etienne
- Normandie Univ, UNIROUEN, EA2656, CHU Rouen, Department of Infectious Diseases, Rouen, France
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17
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Guerin CL, Guyonnet L, Goudot G, Revets D, Konstantinou M, Chipont A, Chocron R, Blandinieres A, Khider L, Rancic J, Peronino C, Debuc B, Cras A, Knosp C, Latremouille C, Capel A, Ollert M, Diehl JL, Jansen P, Planquette B, Sanchez O, Gaussem P, Mirault T, Carpentier A, Gendron N, Smadja DM. Multidimensional Proteomic Approach of Endothelial Progenitors Demonstrate Expression of KDR Restricted to CD19 Cells. Stem Cell Rev Rep 2020; 17:639-651. [PMID: 33205351 PMCID: PMC7670993 DOI: 10.1007/s12015-020-10062-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2020] [Indexed: 12/16/2022]
Abstract
Endothelial progenitor cells (EPCs) are involved in vasculogenesis and cardiovascular diseases. However, the phenotype of circulating EPCs remains elusive but they are more often described as CD34+KDR+. The aim of the study was to extensively characterize circulating potential vasculogenic stem cell candidates in two populations of patients with cardiovascular disease by powerful multidimensional single cell complementary cytometric approaches (mass, imaging and flow). We identified cellular candidates in one patient before and after bioprosthetic total artificial heart implantation and results were confirmed in healthy peripheral and cord blood by mass cytometry. We also quantified cellular candidates in 10 patients with different COVID-19 severity. Both C-TAH implantation and COVID-19 at critical stage induce a redistribution of circulating CD34+ and CD19+ sub-populations in peripheral blood. After C-TAH implantation, circulating CD34+ progenitor cells expressed c-Kit stem marker while specific subsets CD34+CD133−/+CD45−/dimc-Kit+KDR− were mobilized. KDR was only expressed by CD19+ B-lymphocytes and CD14+ monocytes subpopulations in circulation. We confirmed by mass cytometry this KDR expression on CD19+ in healthy peripheral and cord blood, also with a VE-cadherin expression, confirming absence of endothelial lineage marker on CD34+ subtypes. In COVID-19, a significant mobilization of CD34+c-Kit+KDR− cells was observed between moderate and critical COVID-19 patients regardless CD133 or CD45 expression. In order to better evaluate EPC phenotype, we performed imaging flow cytometry measurements of immature CD34+KDR+ cells in cord blood and showed that, after elimination of non-circular events, those cells were all CD19+. During COVID-19, a significant mobilization of CD19+KDR+ per million of CD45+ cells was observed between moderate and critical COVID-19 patients regardless of CD34 expression. CD34+c-Kit+ cells are mobilized in both cardiovascular disease described here. KDR cells in peripheral blood are CD19 positive cells and are not classic vasculogenic stem and/or progenitor cells. A better evaluation of c-Kit and KDR expressing cells will lead to the redefinition of circulating endothelial progenitors. Graphical abstractCentral illustration figure. Multidimensional proteomic approach of endothelial progenitors demonstrate expression of KDR restricted to CD19 cells. Endothelial progenitor cells (EPCs) are involved in cardiovascular diseases, however their phenotype remains elusive. We elucidated here EPCs phenotype by a deep characterization by multidimensional single cell complementary cytometric approaches after Bioprosthetic total artificial heart implantation and during COVID-19. We showed a redistribution of circulating CD34+ and CD19+ sub-populations in both situations. None of the immature cell population expresses KDR. Mobilized CD34+ expressed c-Kit. Imaging flow cytometry demonstrated that CD34+KDR+ cells, after elimination of non-circular events, are all CD19+. Our results suggest a new definition of circulating EPCs and emphasize involvement of CD19 cells in cardiovascular disease. ![]()
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Affiliation(s)
- Coralie L Guerin
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, F-75006, Paris, France.,Cytometry Platform, Institut Curie, F-75006, Paris, France.,Department of Infection and Immunity, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Léa Guyonnet
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, F-75006, Paris, France.,Cytometry Platform, Institut Curie, F-75006, Paris, France.,Department of Infection and Immunity, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Guillaume Goudot
- Vascular Medicine Department and Biosurgical Research Laboratory (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, Université de Paris, F-75015, Paris, France
| | - Dominique Revets
- Department of Infection and Immunity, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Maria Konstantinou
- Department of Infection and Immunity, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Anna Chipont
- Department of Infection and Immunity, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Richard Chocron
- PARCC, INSERM, Université de Paris, F-75006, Paris, France.,Emergency Department, AH-HP, Georges Pompidou European Hospital, F-75015, Paris, France
| | - Adeline Blandinieres
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, F-75006, Paris, France.,Hematology Department and Biosurgical Research Laboratory (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, F-75015, Paris, France
| | - Lina Khider
- Vascular Medicine Department and Biosurgical Research Laboratory (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, Université de Paris, F-75015, Paris, France
| | - Jeanne Rancic
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, F-75006, Paris, France.,Biosurgical Research Laboratory (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, F-75015, Paris, France
| | - Christophe Peronino
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, F-75006, Paris, France.,Hematology Department and Biosurgical Research Laboratory (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, F-75015, Paris, France
| | - Benjamin Debuc
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, F-75006, Paris, France.,Plastic Surgery Department, AH-HP, Georges Pompidou European Hospital, F-75015, Paris, France
| | - Audrey Cras
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, F-75006, Paris, France.,Cell therapy Unit, AP-HP, Saint Louis Hospital, F-75010, Paris, France
| | - Camille Knosp
- PARCC, INSERM, Université de Paris, F-75006, Paris, France
| | - Christian Latremouille
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, F-75006, Paris, France.,Cardiovascular Surgery Department and Biosurgical Research Laboratory (Carpentier Foundation) AP-HP, Georges Pompidou European Hospital, F-75015, Paris, France
| | | | - Markus Ollert
- Department of Infection and Immunity, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Jean-Luc Diehl
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, F-75006, Paris, France.,Biosurgical Research Laboratory (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, F-75015, Paris, France.,Intensive Care Department and Biosurgical Research Laboratory (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, F-75015, Paris, France
| | | | - Benjamin Planquette
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, F-75006, Paris, France.,Biosurgical Research Laboratory (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, F-75015, Paris, France.,Respiratory Medicine department and Biosurgical Research Laboratory (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, F-75015, Paris, France
| | - Olivier Sanchez
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, F-75006, Paris, France.,Biosurgical Research Laboratory (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, F-75015, Paris, France.,Respiratory Medicine department and Biosurgical Research Laboratory (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, F-75015, Paris, France
| | - Pascale Gaussem
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, F-75006, Paris, France.,Hematology Department, AH-HP, Georges Pompidou European Hospital, F-75015, Paris, France
| | - Tristan Mirault
- PARCC, INSERM, Université de Paris, F-75006, Paris, France.,Vascular Medicine department, AH-HP, Georges Pompidou European Hospital, F-75015, Paris, France
| | - Alain Carpentier
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, F-75006, Paris, France.,Cardiovascular Surgery Department and Biosurgical Research Laboratory (Carpentier Foundation) AP-HP, Georges Pompidou European Hospital, F-75015, Paris, France
| | - Nicolas Gendron
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, F-75006, Paris, France.,Hematology Department and Biosurgical Research Laboratory (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, F-75015, Paris, France
| | - David M Smadja
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, F-75006, Paris, France. .,Hematology Department and Biosurgical Research Laboratory (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, F-75015, Paris, France. .,European Hospital Georges Pompidou, Inserm UMR-S 1140, 20 rue Leblanc, 75015, Paris, France.
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