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Gui M, Zhao B, Huang J, Chen E, Qu H, Mao E. Pathogenesis and Therapy of Coagulation Disorders in Severe Acute Pancreatitis. J Inflamm Res 2023; 16:57-67. [PMID: 36636248 PMCID: PMC9831125 DOI: 10.2147/jir.s388216] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/12/2022] [Indexed: 01/07/2023] Open
Abstract
Ischemia superimposed upon pancreatic edema leads to acute necrotizing pancreatitis. One possible mechanism contributing to ischemia is intravascular thrombogenesis since fibrin deposits have been detected in pancreatic capillaries by electron microscope. Current experimental and clinical data provided compelling evidence that the disorders in the blood coagulation system play a critical role in the pathogenesis of severe acute pancreatitis (SAP). This leads to microcirculatory failure of intra- and extrapancreatic organs and multiple organ failure and increases the case fatality rate. However, the mechanism of coagulopathy underlying SAP is not yet clear, although some anticoagulant drugs have entered clinical practice showing improvement in prognosis. Thus, enhanced understanding of the process might improve the treatment strategies with safety and high efficacy. Herein, the pathogenesis of the coagulation system of SAP was reviewed with a focus on the coagulation pathway, intercellular interactions, and complement system, thereby illustrating some anticoagulant therapies and potential therapeutic targets.
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Affiliation(s)
- Menglu Gui
- Department of Emergency, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Bing Zhao
- Department of Emergency, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Jun Huang
- Department of Cardiovascular Medicine, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Erzhen Chen
- Department of Emergency, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Hongping Qu
- Department of Critical Care Medicine, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Enqiang Mao
- Department of Emergency, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China,Correspondence: Enqiang Mao, Department of Emergency, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Huangpu District, Shanghai, People’s Republic of China, Tel +86 13501747906, Email
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Ng MSY, Suen JY, Tung JP, Fraser JF. Endothelialized flow models for blood transfusion research. Haematologica 2019; 104:428-434. [PMID: 30765473 PMCID: PMC6395319 DOI: 10.3324/haematol.2018.205203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 01/15/2019] [Indexed: 01/21/2023] Open
Affiliation(s)
- Monica S Y Ng
- Critical Care Research Group, Faculty of Medicine, University of Queensland, Brisbane
- Research and Development, Australian Red Cross Blood Service, Brisbane, Australia
| | - Jacky Y Suen
- Critical Care Research Group, Faculty of Medicine, University of Queensland, Brisbane
| | - John-Paul Tung
- Critical Care Research Group, Faculty of Medicine, University of Queensland, Brisbane
- Research and Development, Australian Red Cross Blood Service, Brisbane, Australia
| | - John F Fraser
- Critical Care Research Group, Faculty of Medicine, University of Queensland, Brisbane
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3
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Kidneys From α1,3-Galactosyltransferase Knockout/Human Heme Oxygenase-1/Human A20 Transgenic Pigs Are Protected From Rejection During Ex Vivo Perfusion With Human Blood. Transplant Direct 2015; 1:e23. [PMID: 27500225 PMCID: PMC4946468 DOI: 10.1097/txd.0000000000000533] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 06/12/2015] [Indexed: 01/16/2023] Open
Abstract
Supplemental digital content is available in the text. Multiple modifications of the porcine genome are required to prevent rejection after pig-to-primate xenotransplantation. Here, we produced pigs with a knockout of the α1,3-galactosyltransferase gene (GGTA1-KO) combined with transgenic expression of the human anti-apoptotic/anti-inflammatory molecules heme oxygenase-1 and A20, and investigated their xenoprotective properties.
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Mazza G, Stoiber M, Pfeiffer D, Schima H. Atraumatic Pulsatile Leukocyte Circulation for Long-Term In Vitro Dynamic Culture and Adhesion Assays. Artif Organs 2015; 39:973-8. [DOI: 10.1111/aor.12474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Giulia Mazza
- Center for Biomedical Technology; Danube University Krems; Krems Austria
- Center for Integrated Sensor Systems; Danube University Krems; Krems Austria
| | - Martin Stoiber
- Center for Medical Physics and Biomedical Engineering; Ludwig Boltzmann-Cluster for Cardiovascular Research; Medical University of Vienna; Vienna Austria
| | - Dagmar Pfeiffer
- Center for Biomedical Technology; Danube University Krems; Krems Austria
- Institute of Cell Biology, Histology and Embryology; Medical University Graz; Graz Austria
| | - Heinrich Schima
- Center for Integrated Sensor Systems; Danube University Krems; Krems Austria
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Evaluation on potential contributions of protease activated receptors related mediators in allergic inflammation. Mediators Inflamm 2014; 2014:829068. [PMID: 24876677 PMCID: PMC4021743 DOI: 10.1155/2014/829068] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 01/20/2014] [Indexed: 01/16/2023] Open
Abstract
Protease activated receptors (PARs) have been recognized as a distinctive four-member family of seven transmembrane G protein-coupled receptors (GPCRs) that can be cleaved by certain serine proteases. In recent years, there has been considerable interest in the role of PARs in allergic inflammation, the fundamental pathologic changes of allergy, but the potential roles of PARs in allergy remain obscure. Since many of these proteases are produced and actively involved in the pathologic process of inflammation including exudation of plasma components, inflammatory cell infiltration, and tissue damage and repair, PARs appear to make important contribution to allergy. The aim of the present review is to summarize the expression of PARs in inflammatory and structural cells, the influence of agonists or antagonists of PARs on cell behavior, and the involvement of PARs in allergic disorders, which will help us to better understand the roles of serine proteases and PARs in allergy.
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Diri H, Sener EF, Bayram F, Tascioglu N, Simsek Y, Dundar M. Etiopathogenesis of Sheehan's Syndrome: Roles of Coagulation Factors and TNF-Alpha. Int J Endocrinol 2014; 2014:514891. [PMID: 24891849 PMCID: PMC4003783 DOI: 10.1155/2014/514891] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 03/10/2014] [Accepted: 03/26/2014] [Indexed: 01/14/2023] Open
Abstract
Sheehan's Syndrome (SS) is defined as pituitary hormone deficiency due to ischemic infarction of the pituitary gland as a result of massive postpartum uterine hemorrhage. Herein, we aimed to investigate the roles of Factor II (G20210A), Factor V (G1691A), MTHFR (C677T and A1298C), PAI-1 4G/5G, and TNF- α (-308 G > A) gene polymorphisms in the etiopathogenesis of SS. Venous blood samples were obtained from 53 cases with SS and 43 healthy women. Standard methods were used to extract the genomic DNAs. Factor II (G20210A), Factor V (G1691A), and MTHFR (C677T and A1298C) polymorphisms were identified by real-time PCR. PAI-1 4G/5G and TNF- α (-308 G > A) gene polymorphisms were detected with polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) methods. According to statistical analysis, none of the polymorphisms were found to be significantly higher in the SS group compared to the control group. Hence, we suggest that genetic factors other than Factor II, Factor V, MTHFR, PAI-1, and TNF- α gene polymorphisms should be researched in the etiopathogenesis of SS.
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Affiliation(s)
- Halit Diri
- Department of Endocrinology, Erciyes University Medical School, 38039 Kayseri, Turkey
| | - Elif Funda Sener
- Department of Medical Biology, Erciyes University Medical School, 38039 Kayseri, Turkey
| | - Fahri Bayram
- Department of Endocrinology, Erciyes University Medical School, 38039 Kayseri, Turkey
| | - Nazife Tascioglu
- Department of Medical Genetics, Erciyes University Medical School, 38039 Kayseri, Turkey
| | - Yasin Simsek
- Department of Endocrinology, Erciyes University Medical School, 38039 Kayseri, Turkey
| | - Munis Dundar
- Department of Medical Genetics, Erciyes University Medical School, 38039 Kayseri, Turkey
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Holtom E, Usherwood JR, Macey MG, Lawson C. Microparticle formation after co-culture of human whole blood and umbilical artery in a novel in vitro model of flow. Cytometry A 2011; 81:390-9. [PMID: 22213485 DOI: 10.1002/cyto.a.22010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2011] [Revised: 10/11/2011] [Accepted: 12/06/2011] [Indexed: 02/05/2023]
Abstract
Cardiovascular disease (CVD) is now the largest killer in western society, and the importance of interactions between vascular endothelium and circulating blood components in disease pathogenesis is well established. Microparticles are a heterogeneous population of <1 μm blood borne particles that arise from blebbing or shedding of cell membranes. The microparticle population includes several classes of apoptotic bodies; however, increased numbers of procoagulant microparticles have been described in plasma from people with CVD. We have previously demonstrated that interactions of monocytes and platelets with isolated inflamed endothelial cells lead to production of pro-coagulant tissue factor bearing microparticles under laminar flow conditions. Here we have investigated microparticle production after perfusion of human whole blood through intact inflamed human umbilical artery. When blood was perfused through umbilical arteries which had been pre-stimulated with tumour necrosis factor (TNFα) for 18 h under flow conditions, there was significantly increased production of microparticles from both platelet and non-platelet sources, in particular from erythrocytes. To determine whether microparticles generated during interactions with inflamed endothelium could induce a pro-inflammatory response in trans, we isolated microparticles by centrifugation after co-culture and incubated with isolated quiescent endothelial cells followed by measurement of reactive oxygen species formation. Microparticles derived from co-culture with inflamed endothelium induced significantly enhanced levels of reactive oxygen species (ROS). These data suggest that presence of an inflamed endothelium causes release of pro-inflammatory microparticles from circulating blood cells, which could contribute to prolonged endothelial activation and subsequent atherosclerotic changes in blood vessels subjected to inflammatory insult.
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Affiliation(s)
- Emma Holtom
- Department of Veterinary Basic Sciences, Royal Veterinary College, London, United Kingdom
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Macey MG, Wolf SI, Lawson C. Microparticle formation after exposure of blood to activated endothelium under flow. Cytometry A 2010; 77:761-8. [PMID: 20653016 DOI: 10.1002/cyto.a.20919] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Increased numbers of circulating microparticles (MPs) are indicative of poor clinical outcome in a number of inflammatory disorders, including atherosclerosis. Platelets and megakaryocytes are a major source of MP and are identified by presence of CD42b on the MP surface. MP shed from activated platelets can be identified by presence of P-selectin (CD62P). Tissue factor (TF) is the principal initiator of blood coagulation and its activity has been identified in MPs derived from patient plasma, which may contribute to thrombosis. Here, we have investigated by flow cytometry the expression of TF and CD62P on MP after exposure of diluted whole blood to TNF-activated endothelial cells (EC) both under static conditions and in our newly established model of flow. MPs were significantly increased in blood subjected to flow and this was further enhanced after exposure of blood to TNF-activated EC. MP surface expression of CD62P or TF was upregulated following exposure to TNF-activated EC under flow compared with flow with nonactivated EC or after static coculture with and without prior EC activation. These data strongly suggest that interactions of blood with inflamed EC can modulate production of CD62P and TF bearing MP under flow conditions, and thus may contribute to a prothrombotic environment.
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Affiliation(s)
- Marion G Macey
- Department of Haematology, The Royal London Hospital, London, UK
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Marotta F, Harada M, Minelli E, Yadav H, Polimeni A, Lorenzetti A, Locorotondo N. Progression of atherosclerotic lesions in the arteries and related gene expression: protective effect of phytonutrients. Rejuvenation Res 2010; 13:242-5. [PMID: 20370493 DOI: 10.1089/rej.2009.0949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
We investigated the effect of the phytocompound Denshici-to-Chiusei (DTS) on the atherogenesis in apolipoprotein E(-/-)/low-density lipoprotein receptor(-/-) (apoE(-/-)/LDL receptor(-/-)) mice (E0). E0 mice were fed for 16 weeks with: (1) placebo or (2) 25 mg or (3) 50 mg of DTS/day. Aortic lesions were reduced by 38% (p < 0.01) in mice fed 50 mg/day, whereas peritoneal macrophages after both dosages had a 45%-60% lower (p < 0.01) capacity to oxidize LDL and to degrade it. This was associated with reduced LDL-associated lipoperoxides and a 22% inhibition (p < 0.05) in LDL aggregation. Tumor necrosis factor-alpha (TNF-alpha) expression and immunoreactivity in the aortic media increased five-fold, but this was significantly mitigated by DTS (50 mg > 25 mg) (p < 0.05). DTS significantly attenuated inflammatory mechanisms preceding atherogenesis with reduced LDL susceptibility to oxidation-aggregation.
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