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Raja A, Karch J, Shih AF, De La Garza H, De Zepeda Diaz AJ, Maymone MBC, Phillips TJ, Secemsky E, Vashi N. Part II: Cutaneous manifestations of peripheral vascular disease. J Am Acad Dermatol 2023; 89:211-226. [PMID: 35504485 DOI: 10.1016/j.jaad.2021.05.077] [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: 11/23/2020] [Revised: 04/29/2021] [Accepted: 05/19/2021] [Indexed: 10/18/2022]
Abstract
In this Part 2 of a 2-part continuing medical education series, we review the epidemiology of peripheral vascular disease, its association with cutaneous symptoms, and the diagnosis and evaluation of cutaneous features of vascular disorders. As peripheral vascular disease becomes more prevalent globally, it is essential for dermatologists to become competent at accurately recognizing and diagnosing cutaneous manifestations and directing individuals to receive appropriate care and treatment.
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Affiliation(s)
- Aishwarya Raja
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jamie Karch
- Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Allen F Shih
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
| | - Henriette De La Garza
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
| | | | - Mayra B C Maymone
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Tania J Phillips
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
| | - Eric Secemsky
- Smith Center for Outcomes Research, Departments of Cardiology and Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Neelam Vashi
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts; Department of Dermatology, US Department of Veteran Affairs, Boston Health Care System, Boston, Massachusetts.
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Hang S, Chen H, Wu W, Wang S, Fang Y, Sheng R, Tu Q, Guo R. Progress in Isoindolone Alkaloid Derivatives from Marine Microorganism: Pharmacology, Preparation, and Mechanism. Mar Drugs 2022; 20:md20060405. [PMID: 35736208 PMCID: PMC9227046 DOI: 10.3390/md20060405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/11/2022] [Accepted: 06/17/2022] [Indexed: 12/15/2022] Open
Abstract
Compound 1 (SMTP-7, also FGFC1), an isoindolone alkaloid from marine fungi Starchbotrys longispora FG216 and fungi Stachybotrys microspora IFO 30018, possessed diverse bioactivities such as thrombolysis, anti-inflammatory and anti-oxidative properties, and so on. It may be widely used for the treatment of various diseases, including cerebral infarction, stroke, ischemia/reperfusion damage, acute kidney injury, etc. Especially in cerebral infarction, compound 1 could reduce hemorrhagic transformation along with thrombolytic therapy, as the traditional therapies are accompanied with bleeding risks. In the latest studies, compound 1 selectively inhibited the growth of NSCLC cells with EGFR mutation, thus demonstrating its excellent anti-cancer activity. Herein, we summarized pharmacological activities, preparation of staplabin congeners—especially compound 1—and the mechanism of compound 1, with potential therapeutic applications.
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Affiliation(s)
- Sijin Hang
- College of Food Science and Technology, Shanghai Ocean University, Shanghai 201306, China; (S.H.); (W.W.)
| | - Hui Chen
- Shanghai Engineering Center of Hadal Science and Technology, College of Marine Sciences, Shanghai Ocean University, Shanghai 201306, China;
| | - Wenhui Wu
- College of Food Science and Technology, Shanghai Ocean University, Shanghai 201306, China; (S.H.); (W.W.)
| | - Shiyi Wang
- AIEN Institute, Shanghai Ocean University, Shanghai 201306, China;
| | - Yiwen Fang
- Department of Chemistry, College of Science, Shantou University, Shantou 515063, China;
| | - Ruilong Sheng
- CQM-Centro de Química da Madeira, Campus da Penteada, Universidade da Madeira, 9000-390 Funchal, Portugal;
| | - Qidong Tu
- Jiangxi Provincial Key Laboratory of Drug Design and Evaluation, School of Pharmacy, Jiangxi Science & Technology Normal University, Nanchang 330013, China
- Correspondence: (Q.T.); (R.G.)
| | - Ruihua Guo
- College of Food Science and Technology, Shanghai Ocean University, Shanghai 201306, China; (S.H.); (W.W.)
- Shanghai Engineering Research Center of Aquatic-Product Processing & Preservation, Shanghai 201306, China
- Laboratory of Quality and Safety Risk Assessment for Aquatic Products on Storage and Preservation (Shanghai), Ministry of Agriculture, Shanghai 201306, China
- Correspondence: (Q.T.); (R.G.)
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Nusbaum KB, Korman AM, Tyler KH, Kaffenberger JA, Trinidad JC, Dean S, Cataland S, Kaffenberger BH. In vitro diagnostics for the medical dermatologist. Part II: Hypercoagulability tests. J Am Acad Dermatol 2021; 85:301-310. [PMID: 33852929 DOI: 10.1016/j.jaad.2021.03.108] [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: 01/14/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
The skin often provides initial clues of hypercoagulability with features such as livedo reticularis, livedo racemosa, retiform purpura, necrosis, and ulcerations. Because these cutaneous manifestations are nonspecific, laboratory testing is often needed to evaluate for underlying causes of hypercoagulability. Importantly, these disorders are reported to be the most common mimicker, resulting in an erroneous diagnosis of pyoderma gangrenosum. Understanding inherent properties of, and indications for, available tests is necessary for appropriate ordering and interpretation of results. Additionally, ordering of these tests in an indiscriminate manner may lead to inaccurate results, complicating the interpretation and approach to management. This second article in this continuing medical education series summarizes information on methodology, test characteristics, and limitations of several in vitro laboratory tests used for the work up of hypercoagulability and vasculopathic disease as it pertains to dermatologic disease.
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Affiliation(s)
| | - Abraham M Korman
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Kelly H Tyler
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Jessica A Kaffenberger
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - John C Trinidad
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Steven Dean
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Spero Cataland
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Benjamin H Kaffenberger
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio.
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Hasumi K, Suzuki E. Impact of SMTP Targeting Plasminogen and Soluble Epoxide Hydrolase on Thrombolysis, Inflammation, and Ischemic Stroke. Int J Mol Sci 2021; 22:954. [PMID: 33477998 PMCID: PMC7835936 DOI: 10.3390/ijms22020954] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/10/2021] [Accepted: 01/12/2021] [Indexed: 12/11/2022] Open
Abstract
Stachybotrys microspora triprenyl phenol (SMTP) is a large family of small molecules derived from the fungus S. microspora. SMTP acts as a zymogen modulator (specifically, plasminogen modulator) that alters plasminogen conformation to enhance its binding to fibrin and subsequent fibrinolysis. Certain SMTP congeners exert anti-inflammatory effects by targeting soluble epoxide hydrolase. SMTP congeners with both plasminogen modulation activity and anti-inflammatory activity ameliorate various aspects of ischemic stroke in rodents and primates. A remarkable feature of SMTP efficacy is the suppression of hemorrhagic transformation, which is exacerbated by conventional thrombolytic treatments. No drug with such properties has been developed yet, and SMTP would be the first to promote thrombolysis but suppress disease-associated bleeding. On the basis of these findings, one SMTP congener is under clinical study and development. This review summarizes the discovery, mechanism of action, pharmacological activities, and development of SMTP.
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Affiliation(s)
- Keiji Hasumi
- Department of Applied Biological Science, Tokyo University of Agriculture and Technology, Tokyo 183-8509, Japan;
- Division of Research and Development, TMS Co., Ltd., Tokyo 183-0023, Japan
| | - Eriko Suzuki
- Department of Applied Biological Science, Tokyo University of Agriculture and Technology, Tokyo 183-8509, Japan;
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Sousa ID, Barbosa AR, Salvador GH, Frihling BE, Santa-Rita PH, Soares AM, Pessôa HL, Marchi-Salvador DP. Secondary hemostasis studies of crude venom and isolated proteins from the snake Crotalus durissus terrificus. Int J Biol Macromol 2019; 131:127-133. [DOI: 10.1016/j.ijbiomac.2019.03.059] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 03/09/2019] [Accepted: 03/09/2019] [Indexed: 10/27/2022]
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Malkani RH, Karia R, Thadani S. A Study of Risk Factors of Chronic Venous Insufficiency and its Association with Features Suggestive of Preceding or Present Deep Venous Thrombosis. Indian J Dermatol 2019; 64:366-371. [PMID: 31543530 PMCID: PMC6749769 DOI: 10.4103/ijd.ijd_271_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background: Deep venous thrombosis (DVT), even though resolved, may damage the valves and may lead to chronic venous insufficiency (CVI). We designed the present study to examine the thrombotic markers or other ultrasound features in the absence of active thrombosis in patients presenting with features suggestive of CVI. Materials and Methods: It was a cross-sectional study of 50 DVT patients. We collected a detailed history of presenting symptoms (onset, progression, and duration) and associated history of aggravating factors. After classifying the patients, color Doppler investigation for DVT and venous incompetence and blood investigations such as Factor V, D-Dimer, total cholesterol, total triglycerides, homocysteine, high-density lipoproteins, low-density lipoproteins (LDL), and very LDL were done. Results: We found a raised Factor V significantly more in patients classified as severe under clinical classification compared with nonsevere (19% and 0%; P = 0.05) and in patients with a high Venous Severity Clinical Score (VSCS) compared to those with a low VSCS score (17% and 0%; P = 0.03). We also found that perforators were significantly more in patients with a high VSCS score (88% and 58%; P = 0.02), in patients with a primary venous etiology compared with those without any venous etiology (97% and 1%; P < 0.0001), in patients with obstruction/reflux compared to those without any pathology (95% and 0%; P < 0.0001), and in patients with severe clinical classification compared with nonsevere patient (95% and 55%; P = 0.002). Conclusions: Clinical or subclinical DVT, an important cause of CVI, may not always be seen on ultrasound, especially after resolution. However, they may have the presence of blood parameters (Factor V and hyperhomocysteinemia) suggestive of DVT; these can be used as proxy markers for the current or previous DVT.
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Affiliation(s)
- Ram H Malkani
- Department of Dermatology, Jaslok Hospital, Mumbai, Maharashtra, India
| | - Rusina Karia
- Department of Dermatology, Jaslok Hospital, Mumbai, Maharashtra, India
| | - Sneh Thadani
- Department of Dermatology, Jaslok Hospital, Mumbai, Maharashtra, India
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De Souza VR, Lemos VMVD, Lafayette DDSA, Lemos RSD, Fontes LDBC, Lima GMTD, Correia CWDB, Domingues ALC, Aroucha AQDMS, Oliveira IMD, Santos GP, Vanderlei AM, Lemos VMVD, Peter JVS, Vieira JO, Mariano ARP, Gomes TA, Ferraz AMDS, Amaral JHSD, Lins EM, Bezerra MAC, Araújo PSRD, Vasconcelos AFD, Correia MDCDB, Costa MFH. The first reported case of factor V Leiden mutation with agenesis of superior vena cava: A case report. Medicine (Baltimore) 2018; 97:e10511. [PMID: 29851773 PMCID: PMC6392798 DOI: 10.1097/md.0000000000010511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Total absence of superior vena cava (ASVC) is a very rare anomaly, and the patient usually suffers from superior vena cava syndrome (SVCS) or conduction disturbances. PATIENT CONCERNS We report a 36-year-old white male, born and living in Brazil, without comorbidities presented to hematologist thrombotic episodes even under anticoagulant therapy. On his first hematologic appointment, he had no active complaints except by the fullness after meals, and his physical examination presented remarkable collateral circulation in the chest. DIAGNOSES Congenital ASVC associated with factor V Leiden mutation. OUTCOMES In his magnetic resonance angiography of the thorax, a great amount of collateral circulation and communication of the azygos and hemiazygos veins with inferior vena cava were evident, as well as the absence of the upper cava vein. Furthermore, heterozygous genetic mutation was found for Leiden factor V. LESSONS This case gives us the lesson that we need to include ASVC in the differential diagnosis of SVCS. The importance of the V-Leiden factor as a joint risk with this congenital defect for venous thromboembolism episodes was also highlighted.
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Affiliation(s)
- Valter Romão De Souza
- Universidade Federal de Pernambuco, Recife, Brazil Fundação de Hematologia e Hemoterapia de Pernambuco, Recife, Brazil Federal University of Pernambuco Society for Haematology, Recife, Brazil Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Brazil Universidade de Pernambuco, Av. Agamenon Magalhaes, Recife, Brazil
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