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Cao W, Song Y, Bai X, Yang B, Li L, Wang X, Wang Y, Chang W, Chen Y, Wang Y, Chen J, Gao P, Jiao L, Xu X. Systemic-inflammatory indices and clinical outcomes in patients with anterior circulation acute ischemic stroke undergoing successful endovascular thrombectomy. Heliyon 2024; 10:e31122. [PMID: 38778990 PMCID: PMC11109896 DOI: 10.1016/j.heliyon.2024.e31122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 04/01/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024] Open
Abstract
Background There is a lack of comprehensive profile assessment on complete blood count (CBC)-derived systemic-inflammatory indices, and their correlations with clinical outcome in patients with anterior circulation acute ischemic stroke (AIS) who achieved successful recanalization by endovascular thrombectomy (EVT). Methods Patients with anterior circulation AIS caused by large vessel occlusion (AIS-LVO) were retrospectively screened from December 2018 to December 2022. Systemic-inflammatory indices including ratios of neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), platelet-to-lymphocyte (PLR), and platelet-to-neutrophil (PNR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate inflammation systemic index (AISI) on admission and the first day post-EVT were calculated. Their correlations with symptomatic intracranial hemorrhage (sICH) and unfavorable 90-day functional outcome (modified Rankin Scale score of 3-6) were analyzed. Results A total of 482 patients [65 (IQR, 56-72) years; 33 % female] were enrolled, of which 231 (47.9 %) had unfavorable 90-day outcome and 50 (10.4 %) developed sICH. Day 1 neutrophil and monocyte counts, NLR, MLR, PLR, SII, SIRI, and AISI were increased, while lymphocyte and PNR were decreased compared to their admission levels. In multivariate analyses, neutrophil count, NLR, SII, and AISI on day 1 were independently associated with 90-day functional outcome. Moreover, day 1 neutrophil count, NLR, MLR, PLR, PNR, SII, and SIRI were independently linked to the occurrence of sICH. No admission variables were identified as independent risk factors for patient outcomes. Conclusion CBC-derived systemic-inflammatory indices measured on the first day after successful EVT are predictive of 90-day functional outcome and the sICH occurrence in patients with anterior circulation AIS-LVO.
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Affiliation(s)
- Wenbo Cao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China
- China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China
- Jinan Hospital of Xuanwu Hospital, Capital Medical University, 5106 Jingshi Road, Jinan, Shandong, 250100, China
| | - Yiming Song
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China
- China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China
| | - Xuesong Bai
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China
- China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China
| | - Bin Yang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China
- China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China
| | - Long Li
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China
- China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China
- Jinan Hospital of Xuanwu Hospital, Capital Medical University, 5106 Jingshi Road, Jinan, Shandong, 250100, China
| | - Xinyu Wang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China
- China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China
| | - Yuxin Wang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China
- China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China
| | - Wenxuan Chang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China
- China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China
| | - Yanfei Chen
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China
- China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China
| | - Yabing Wang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China
- China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China
| | - Jian Chen
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China
- China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China
| | - Peng Gao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China
- China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China
| | - Liqun Jiao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China
- China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China
- Jinan Hospital of Xuanwu Hospital, Capital Medical University, 5106 Jingshi Road, Jinan, Shandong, 250100, China
- Department of Interventional Neuroradiology, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China
| | - Xin Xu
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China
- China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China
- Jinan Hospital of Xuanwu Hospital, Capital Medical University, 5106 Jingshi Road, Jinan, Shandong, 250100, China
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Gao X, Zhao X, Li J, Liu C, Li W, Zhao J, Li Z, Wang N, Wang F, Dong J, Yan X, Zhang J, Hu X, Jin J, Mang G, Ma R, Hu S. Neutrophil extracellular traps mediated by platelet microvesicles promote thrombosis and brain injury in acute ischemic stroke. Cell Commun Signal 2024; 22:50. [PMID: 38233928 PMCID: PMC10795390 DOI: 10.1186/s12964-023-01379-8] [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: 06/28/2023] [Accepted: 11/01/2023] [Indexed: 01/19/2024] Open
Abstract
AIMS Neutrophil extracellular traps (NETs) have been implicated in thrombotic diseases. There is no definitive explanation for how NETs form during acute ischemic strokes (AIS). The purpose of our study was to investigate the potential mechanism and role of NETs formation in the AIS process. METHODS As well as 45 healthy subjects, 45 patients with AIS had ELISA tests performed to detect NET markers. Expression of high-mobility group box 1 (HMGB1) on platelet microvesicles (PMVs) was analyzed by flow cytometry in healthy subjects and AIS patients' blood samples. We established middle cerebral artery occlusion (MCAO) mice model to elucidate the interaction between PMPs and NETs. RESULTS A significant elevation in NET markers was found in patient plasma in AIS patients, and neutrophils generated more NETs from patients' neutrophils. HMGB1 expression was upregulated on PMVs from AIS patients and induced NET formation. NETs enhanced Procoagulant activity (PCA) through tissue factor and via platelet activation. Targeting lactadherin in genetical and in pharmacology could regulate the formation of NETs in MCAO model. CONCLUSIONS NETs mediated by PMVs derived HMGB1 exacerbate thrombosis and brain injury in AIS. Video Abstract.
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Affiliation(s)
- Xin Gao
- Department of Neurosurgery, Cancer Center, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xinyi Zhao
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
- The Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin, Heilongjiang Province, China
| | - Jiacheng Li
- The Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin, Heilongjiang Province, China
| | - Chang Liu
- The Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin, Heilongjiang Province, China
| | - Wenqiang Li
- Department of Vascular Surgery, Jinshan Hospital of Fudan University, Shanghai, China
| | - Junjie Zhao
- Department of General Surgery, Changsha Fourth Hospital, Changsha, China
| | - Zhixi Li
- The Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin, Heilongjiang Province, China
| | - Nan Wang
- Department of Neurosurgery, Cancer Center, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Fang Wang
- Department of Neurosurgery, Cancer Center, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jiawei Dong
- Department of Neurosurgery, Cancer Center, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xiuwei Yan
- Department of Neurosurgery, Cancer Center, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jiheng Zhang
- Department of Neurosurgery, Cancer Center, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xueyan Hu
- Department of Neurosurgery, Cancer Center, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Jiaqi Jin
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Ge Mang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
- The Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin, Heilongjiang Province, China.
| | - Ruishuang Ma
- Department of Radiotherapy and Chemotherapy, The First Affiliated Hospital of Ningbo University, Ningbo, China.
- Department of Radiotherapy and Chemotherapy, Ningbo First Hospital of Ningbo, Ningbo, 315000, China.
| | - Shaoshan Hu
- Department of Neurosurgery, Cancer Center, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
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Wang Y, Wei X, Du W, Yuan C. Relationship between baseline mean platelet volume (MPV) and prognosis of patients with acute mild cerebral infarction undergoing intravenous thrombolysis with Alteplase. Pak J Med Sci 2024; 40:318-325. [PMID: 38356819 PMCID: PMC10862429 DOI: 10.12669/pjms.40.3.7493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 10/07/2023] [Accepted: 11/12/2023] [Indexed: 02/16/2024] Open
Abstract
Objective To investigate the relationship between baseline, mean platelet volume (MPV) and prognosis of patients with acute mild cerebral infarction undergoing intravenous thrombolysis with alteplase. Methods A retrospective analysis was conducted of clinical imaging and laboratory data of patients with acute mild cerebral infarction who received intravenous thrombolytic therapy with alteplase in Baoding No.1 Central Hospital between March 2018 and March 2021. According to mRS scores after three months, a total of 140 patients were divided into the good prognosis group(n=115) (mRS score Results Logistic regression analysis showed that 24 hour NIHSS score after thrombolysis and baseline MPV were independently correlated with 3-month prognosis. The ROC curve indicated an optimal cutoff value of 9.65 fl for MPV in predicting poor prognosis. The study also found that the increase of baseline MPV had a close bearing on the risk increase of END. Conclusion Baseline MPV is an independent risk factor for early neurological deterioration and three months poor prognosis in patients with acute mild cerebral infarction undergoing intravenous thrombolysis.
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Affiliation(s)
- Yanhao Wang
- Yanhao Wang, Department of Neurology, Baoding No.1 Central Hospital, Baoding 071000, Hebei, China
| | - Xiaoqing Wei
- Xiaoqing Wei, Department of Neurology, Baoding No.1 Central Hospital, Baoding 071000, Hebei, China
| | - Wei Du
- Wei Du, Department of Neurology, Baoding No.1 Central Hospital, Baoding 071000, Hebei, China
| | - Congcong Yuan
- Congcong Yuan, Department of Neurology, Baoding No.1 Central Hospital, Baoding 071000, Hebei, China
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Zhou Y, Luo Y, Liang H, Zhong P, Wu D. Applicability of the low-grade inflammation score in predicting 90-day functional outcomes after acute ischemic stroke. BMC Neurol 2023; 23:320. [PMID: 37679730 PMCID: PMC10483771 DOI: 10.1186/s12883-023-03365-6] [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: 03/05/2023] [Accepted: 08/17/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND AND PURPOSE The low-grade inflammation (LGI) score, a novel indicator of chronic LGI, combines C-reactive protein (CRP), leukocyte counts, the neutrophil/lymphocyte ratio (NLR), and the platelet (PLT) count to predict outcomes of patients with various conditions, such as cardiovascular diseases, cancers, and neurodegenerative diseases. However, few studies have examined the role of the LGI score in predicting functional outcomes of patients with ischemic stroke. The present study aimed to evaluate the association between the LGI score and functional outcomes of patients with ischemic stroke. METHODS A total of 1,215 patients were screened in the present study, and 876 patients were finally included in this retrospective observational study based on the inclusion and exclusion criteria. Blood tests were conducted within 24 h of admission. Severity of ischemic stroke was assessed using the NIHSS score with severe stroke denoted by NIHSS > 5. Early neurological deterioration (END) was defined as an increment in the total NIHSS score of ≥ 2 points within 7 days after admission. Patient outcomes were assessed on day 90 after stroke onset using the modified Rankin Scale (mRS). RESULTS The LGI score was positively correlated with baseline and the day 7 NIHSS scores (R2 = 0.119, p < 0.001;R2 = 0.123, p < 0.001). Multivariate regression analysis showed that the LGI score was an independent predictor of stroke severity and END. In the crude model, the LGI score in the fourth quartile was associated with a higher risk of poor outcomes on day 90 compared with the LGI score in the first quartile (OR = 5.02, 95% CI: 3.09-8.14, p for trend < 0.001). After adjusting for potential confounders, the LGI score in the fourth quartile was independently associated with poor outcomes on day 90 (OR = 2.65, 95% CI: 1.47-4.76, p for trend = 0.001). Finally, the ROC curve analysis showed an AUC of 0.682 for poor outcomes on day 90 after stroke onset. CONCLUSION The LGI score is strongly correlated with the severity of acute ischemic stroke and that the LGI score might be a good predictor for poor outcomes on day 90 in patients with acute ischemic stroke.
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Affiliation(s)
- Yang Zhou
- Emergency Department, Shaoxing People's Hospital, Shaoxing, Zhejiang Province, China
| | - Yufan Luo
- Department of Neurology, Shanghai Fifth People's Hospital, Fudan University, 801 Heqing Road, Minhang District, Shanghai, 200240, China
| | - Huazheng Liang
- Monash Suzhou Research Institute, Suzhou Industrial Park, Suzhou, Jiangsu Province, China
| | - Ping Zhong
- Department of Neurology, Shanghai Yangpu District Shidong Hospital, 999 Shiguang Road, Yangpu District, Shanghai, 200438, China.
| | - Danhong Wu
- Department of Neurology, Shanghai Fifth People's Hospital, Fudan University, 801 Heqing Road, Minhang District, Shanghai, 200240, China.
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Huang SJ, Zhang Y, Wang GH, Lu J, Chen PP, Zhang JX, Li XQ, Yuan BY, Liu XQ, Jiang TT, Wang MY, Liu WT, Ruan XZ, Liu BC, Ma KL. Deposition of platelet-derived microparticles in podocytes contributes to diabetic nephropathy. Int Urol Nephrol 2023; 55:355-366. [PMID: 35931920 DOI: 10.1007/s11255-022-03332-z] [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: 05/21/2021] [Accepted: 07/25/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Diabetic nephropathy (DN) is the leading cause of end-stage renal disease in the developed world. Podocyte injury is a critical cellular event involved in the progression of DN. Our previous studies demonstrated that platelet-derived microparticles (PMPs) mediated endothelial injury in diabetic rats. This study aimed to investigate whether PMPs are deposited in podocytes and to assess their potential effects on podocyte injury in DN. METHODS The deposition of PMPs in podocytes was assessed by immunofluorescent staining and electron microscopy. The changes in renal pathology and ultra-microstructure were assessed by periodic acid-Schiff staining and electron microscopy, respectively. The expression of inflammatory cytokines and extracellular matrix proteins was measured by immuno-histochemical staining and western blot. RESULTS PMPs were widely deposited in podocytes of glomeruli in diabetic patients and animal models and closely associated with DN progression. Interestingly, aspirin treatment significantly inhibited the accumulation of PMPs in the glomeruli of diabetic rats, alleviated mesangial matrix expansion and fusion of foot processes, and decreased the protein expression of inflammatory cytokines and extracellular matrix secretion. An in vitro study further confirmed the deposition of PMPs in podocytes. Moreover, PMP stimulation induced the phenotypic transition of podocytes through decreased podocin protein expression and increased protein expression of α-SMA and fibronectin, which was correlated with increased production of inflammatory cytokines. CONCLUSION Our findings demonstrated for the first time that the deposition of PMPs in podocytes contributed to the development of DN.
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Affiliation(s)
- Si Jia Huang
- Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Yang Zhang
- Renal Department, Nanjing First Hospital, Nanjing, 210006, China
| | - Gui Hua Wang
- Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Jian Lu
- Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Pei Pei Chen
- Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Jia Xiu Zhang
- Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Xue Qi Li
- Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Ben Yin Yuan
- Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Xiao Qi Liu
- Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Ting Ting Jiang
- Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Meng Ying Wang
- Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Wen Tao Liu
- Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Xiong Zhong Ruan
- John Moorhead Research Laboratory, Department of Renal Medicine, University College London (UCL) Medical School, Royal Free Campus, London, NW3 2PF, UK
| | - Bi Cheng Liu
- Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Kun Ling Ma
- Department of Nephrology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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Krammer TL, Kollars M, Kyrle PA, Hackl M, Eichinger S, Traby L. Plasma levels of platelet-enriched microRNAs change during antiplatelet therapy in healthy subjects. Front Pharmacol 2022; 13:1078722. [PMID: 36578552 PMCID: PMC9790905 DOI: 10.3389/fphar.2022.1078722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Abstract
Platelets are the main effectors of primary hemostasis but also cause thrombosis in pathological conditions. Antiplatelet drugs are the cornerstone for the prevention of adverse cardiovascular events. Monitoring the extent of platelet inhibition is essential. Currently available platelet function tests come with constraints, limiting use in antiplatelet drug development as well as in clinical routine. With this study, we aim to investigate whether plasma miRNAs might be suitable biomarkers for monitoring antiplatelet treatment. Platelet-poor plasma was obtained from a trial including 87 healthy male volunteers that either received ticagrelor (n = 44) or clopidogrel (n = 43). Blood was collected before drug intake and after 2 h, 6 h, and 24 h. We measured a panel of 11 platelet-enriched miRNAs (thrombomiRs) by RT-qPCR and selected four biomarker candidates (i.e., miR-223-3p, miR-150-5p, miR-126-3p, miR-24-3p). To further characterize those miRNAs, we performed correlation analyses with the number of extracellular vesicles and clotting time dependent on procoagulant vesicles (PPL assay). We show that platelet-enriched miRNAs in the circulation are significantly reduced upon P2Y12-mediated platelet inhibition. This effect occurred fast, reaching its peak after 2 h. Additionally, we demonstrate that higher baseline levels of thrombomiRs are linked to a stronger reduction upon antiplatelet therapy. Finally, we show that miRNAs from our panel might be the cargo of platelet-derived and procoagulant vesicles. In conclusion, we provide evidence that thrombomiR levels change within 2 h after pharmacological platelet inhibition and circulate the body within platelet-derived and procoagulant extracellular vesicles, rendering them potential biomarker candidates for the assessment of in vivo platelet function.
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Affiliation(s)
| | - Marietta Kollars
- Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Paul A. Kyrle
- Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | | | - Sabine Eichinger
- Department of Medicine I, Medical University of Vienna, Vienna, Austria,*Correspondence: Sabine Eichinger,
| | - Ludwig Traby
- Department of Medicine I, Medical University of Vienna, Vienna, Austria
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Neurovascular Unit-Derived Extracellular Vesicles: From Their Physiopathological Roles to Their Clinical Applications in Acute Brain Injuries. Biomedicines 2022; 10:biomedicines10092147. [PMID: 36140248 PMCID: PMC9495841 DOI: 10.3390/biomedicines10092147] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/26/2022] [Accepted: 08/28/2022] [Indexed: 11/16/2022] Open
Abstract
Extracellular vesicles (EVs) form a heterogeneous group of membrane-enclosed structures secreted by all cell types. EVs export encapsulated materials composed of proteins, lipids, and nucleic acids, making them a key mediator in cell–cell communication. In the context of the neurovascular unit (NVU), a tightly interacting multicellular brain complex, EVs play a role in intercellular communication and in maintaining NVU functionality. In addition, NVU-derived EVs can also impact peripheral tissues by crossing the blood–brain barrier (BBB) to reach the blood stream. As such, EVs have been shown to be involved in the physiopathology of numerous neurological diseases. The presence of NVU-released EVs in the systemic circulation offers an opportunity to discover new diagnostic and prognostic markers for those diseases. This review outlines the most recent studies reporting the role of NVU-derived EVs in physiological and pathological mechanisms of the NVU, focusing on neuroinflammation and neurodegenerative diseases. Then, the clinical application of EVs-containing molecules as biomarkers in acute brain injuries, such as stroke and traumatic brain injuries (TBI), is discussed.
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Mechanisms and Biomarker Potential of Extracellular Vesicles in Stroke. BIOLOGY 2022; 11:biology11081231. [PMID: 36009857 PMCID: PMC9405035 DOI: 10.3390/biology11081231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 07/29/2022] [Accepted: 08/12/2022] [Indexed: 12/11/2022]
Abstract
Simple Summary A stroke occurs when there is a lack of blood flow to the brain. Stroke injures the brain and can have devastating outcomes depending on the size and location of the brain tissue affected. Currently, there are only a limited number of treatment options for stroke. Extracellular vesicles are small vesicles secreted by cells. Importantly, extracellular vesicles have specific markers indicating the cell they were released from and can pass from the brain into the blood. For these reasons, assessing extracellular vesicles in the blood may create a window into changes occurring in the brain. Assessing changes in extracellular vesicles in the blood during stroke may produce new insight into the cellular changes in the brain causing injury during stroke. This in turn may generate potential targets for the development of future treatments. We summarize what is known about changes in brain-cell-specific extracellular vesicles during stroke and stress the importance of continuing to study these changes. Abstract Stoke is a prevalent and devastating neurologic condition with limited options for therapeutic management. Since brain tissue is rarely accessible clinically, peripheral biomarkers for the central nervous system’s (CNS’s) cellular response to stroke may prove critical for increasing our understanding of stroke pathology and elucidating novel therapeutic targets. Extracellular vesicles (EVs) are cell-derived, membrane-enclosed vesicles secreted by all cell types within the CNS that can freely pass the blood-brain barrier (BBB) and contain unique markers and content linked to their cell of origin. These unique qualities make brain-derived EVs novel candidates for non-invasive blood-based biomarkers of both cell specificity and cell physiological state during the progression of stroke and recovery. While studies are continuously emerging that are assessing the therapeutic potential of EVs and profiling EV cargo, a vast minority of these studies link EV content to specific cell types. A better understanding of cell-specific EV release during the acute, subacute, and chronic stages of stroke is needed to further elucidate the cellular processes responsible for stroke pathophysiology. Herein, we outline what is known about EV release from distinct cell types of the CNS during stroke and the potential of these EVs as peripheral biomarkers for cellular function in the CNS during stroke.
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Yalameha B, Nejabati HR, Nouri M. Circulating microparticles as indicators of cardiometabolic risk in PCOS. Clin Chim Acta 2022; 533:63-70. [PMID: 35718107 DOI: 10.1016/j.cca.2022.06.019] [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: 04/28/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 11/17/2022]
Abstract
Polycystic ovary syndrome (PCOS), the most prevalent endocrine disturbance of the female reproductive system, is associated with several pathologic conditions, such as metabolic syndrome, obesity, diabetes, dyslipidemia, and insulin resistance, all of which are tightly connected to its progression. These factors are associated with a type of extracellular vesicle, ie, microparticles (MPs), released by shedding due to cell activation and apoptosis. Circulating MPs (cMPs) are secreted by a variety of cells, such as platelets, endothelial, leukocytes, and erythrocytes, and contain cytoplasmic substances derived from parent cells that account for their biologic activity. Current evidence has clearly shown that increased cMPs contribute to endothelial dysfunction, diabetes, hypertriglyceridemia, metabolic syndrome, cardiovascular abnormalities as well as PCOS. It has also been reported that platelet and endothelial MPs are specifically increased in PCOS thus endangering vascular health and subsequent cardiovascular disease. Given the importance of cMPs in the pathophysiology of PCOS, we review the role of cMPs in PCOS with a special focus on cardiometabolic significance.
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Affiliation(s)
- Banafsheh Yalameha
- Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Reza Nejabati
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mohammad Nouri
- Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
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Diagnostic Performance of Circulating miRNAs and Extracellular Vesicles in Acute Ischemic Stroke. Int J Mol Sci 2022; 23:ijms23094530. [PMID: 35562921 PMCID: PMC9102701 DOI: 10.3390/ijms23094530] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/04/2022] [Accepted: 04/14/2022] [Indexed: 02/06/2023] Open
Abstract
Background: Increased inflammation activates blood coagulation system, higher platelet activation plays a key role in the pathophysiology of ischemic stroke (IS). During platelet activation and aggregation process, platelets may cause increased release of several proinflammatory, and prothrombotic mediators, including microRNAs (miRNAs) and extracellular vesicles (EVs). In the current study we aimed to assess circulating miRNAs profile related to platelet function and inflammation and circulating EVs from platelets, leukocytes, and endothelial cells to analyse their diagnostic and predictive utility in patients with acute IS. Methods: The study population consisted of 28 patients with the diagnosis of the acute IS. The control group consisted of 35 age- and gender-matched patients on acetylsalicylic acid (ASA) therapy without history of stroke and/or TIA with established stable coronary artery disease (CAD) and concomitant cardiovascular risk factors. Venous blood samples were collected from the control group and patients with IS on ASA therapy (a) 24 h after onset of acute IS, (b) 7-days following index hospitalization. Flow cytometry was used to determine the concentration of circulating EVs subtypes (from platelets, leukocytes, and endothelial cells) in platelet-depleted plasma and qRT-PCR was used to determine several circulating plasma miRNAs (miR-19a-3p, miR-186-5p and let-7f). Results: Patients with high platelet reactivity (HPR, based on arachidonic acid-induced platelet aggregometry) had significantly elevated platelet-EVs (CD62+) and leukocyte-EVs (CD45+) concentration compared to patients with normal platelet reactivity at the day of 1 acute-stroke (p = 0.012, p = 0.002, respectively). Diagnostic values of baseline miRNAs and EVs were evaluated with receiver operating characteristic (ROC) curve analysis. The area under the ROC curve for miR-19a-3p was 0.755 (95% CI, 0.63–0.88) p = 0.004, for let-7f, it was 0.874 (95% CI, 0.76–0.99) p = 0.0001; platelet-EVs was 0.776 (95% CI, 0.65–0.90) p = 0.001, whereas for leukocyte-EVs, it was 0.715 (95% CI, 0.57–0.87) p = 0.008. ROC curve showed that pooling the miR-19a-3p expressions, platelet-EVs, and leukocyte-EVs concentration yielded a higher AUC than the value of each individual biomarker as AUC was 0.893 (95% CI, 0.79–0.99). Patients with moderate stroke had significantly elevated miR-19a-3p expression levels compared to patients with minor stroke at the first day of IS. (AUC: 0.867, (95% CI, 0.74–0.10) p = 0.001). Conclusion: Combining different biomarkers of processes underlying IS pathophysiology might be beneficial for early diagnosis of ischemic events. Thus, we believe that in the future circulating biomarkers might be used in the prehospital phase of IS. In particular, circulating plasma EVs and non-coding RNAs including miRNAs are interesting candidates as bearers of circulating biomarkers due to their high stability in the blood and making them highly relevant biomarkers for IS diagnostics.
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Extracellular Vesicles and Thrombogenicity in Atrial Fibrillation. Int J Mol Sci 2022; 23:ijms23031774. [PMID: 35163695 PMCID: PMC8836440 DOI: 10.3390/ijms23031774] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 01/30/2022] [Accepted: 02/02/2022] [Indexed: 12/13/2022] Open
Abstract
Extracellular vesicles (EVs) are defined as a heterogenic group of lipid bilayer vesicular structures with a size in the range of 30–4000 nm that are released by all types of cultured cells. EVs derived from platelets, mononuclears, endothelial cells, and adipose tissue cells significantly increase in several cardiovascular diseases, including in atrial fibrillation (AF). EVs are engaged in cell-to-cell cooperation, endothelium integrity, inflammation, and immune response and are a cargo for several active molecules, such as regulatory peptides, receptors, growth factors, hormones, and lipids. Being transductors of the intercellular communication, EVs regulate angiogenesis, neovascularization, coagulation, and maintain tissue reparation. There is a large amount of evidence regarding the fact that AF is associated with elevated levels of EVs derived from platelets and mononuclears and a decreased number of EVs produced by endothelial cells. Moreover, some invasive procedures that are generally performed for the treatment of AF, i.e., pulmonary vein isolation, were found to be triggers for elevated levels of platelet and mononuclear EVs and, in turn, mediated the transient activation of the coagulation cascade. The review depicts the role of EVs in thrombogenicity in connection with a risk of thromboembolic complications, including ischemic stroke and systemic thromboembolism, in patients with various forms of AF.
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Sari O, Bashir AM. Early Change in Platelet Count and MPV Levels of Patients Who Received Hemodialysis for the First Time: Mogadishu Somalia Experience. Int J Clin Pract 2022; 2022:1503227. [PMID: 35832803 PMCID: PMC9262561 DOI: 10.1155/2022/1503227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 06/14/2022] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Mean platelet volume (MPV) is a marker used to assess the platelet' size and is also an indicator of platelet reactivity and prothrombotic status. OBJECTIVE In this study, we aimed to determine the relationship between MPV and biochemical parameters in patients who had received hemodialysis (HD) for the first time and then in respect of those same patients after their fourth HD. METHOD 151 HD patients were enrolled in this study. Patients were eligible for inclusion if they had received their first HD session during this study protocol. Prehemodialysis blood samples were taken. Most laboratory values, including mean platelet volume (MPV) level and platelets (PLT) count, were measured before the first HD and after the fourth HD session for each patient. RESULTS Among the patients in our study, the mean age profile of the male patients (n = 103; 68.2%) was found to be higher than that of the female patients (n = 48; 31.8%) (53.62 ± 18.19 vs. 46.17 ± 17.9 years) (p = 0.019).In the patients' laboratory results after the fourth HD session, MPV, MPV/Plt, and Na values had increased to those after the first HD session (p < 0.001). When age and gender status were taken into account, the level of weak positive correlation with white blood cell count (WBC), neutrophil, and red cell distribution width (RDW) was found, while the weak negative correlation with platelet to lymphocyte ratio (PLR) was found (p < 0.001). CONCLUSIONS In our study, we found that increase in MPV and MPV/PLT levels was significant in the fourth HD session of patients with CKD. It is also debatable that there are findings indicating an increase in platelet reactivity in the first weeks of the onset of HD. This could be an early indicator of the early prevention of cardiovascular diseases.
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Affiliation(s)
- Oznur Sari
- Department of Internal Medicine, Department of Health Services, General Directorate of Public Hospitals, Ministry of Health, Ankara, Turkey
| | - Ahmed Muhammad Bashir
- Department of Internal Medicine, Mogadishu Somalia Turkey, Recep Tayyip Erdogan, Training and Research Hospital, Mogadishu, Somalia
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Ždraljević M, Pekmezović T, Stanarčević P, Vukašinović I, Berisavac I, Ercegovac M, Vitošević F, Nestorović D, Cvetić V, Padjen V, Budimkić MS, Medjedović TŠ, Jovanović DR. Influence of Thrombocytopenia on the Outcome of Mechanical Thrombectomy in Patients with Acute Ischemic Stroke. J Stroke Cerebrovasc Dis 2021; 31:106240. [PMID: 34915307 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106240] [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: 07/22/2021] [Revised: 11/08/2021] [Accepted: 11/21/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Mechanical thrombectomy (MT) has become leading treatment option for acute ischemic stroke (AIS) due to large vessels occlusion (LVO). Platelet counts may affect outcome in patients with AIS or transient ischemic attack. The aim of our study was to determine the influence of thrombocytopenia on the safety and efficacy of MT in patients with AIS due to anterior circulation LVO. MATERIALS AND METHODS This study included 127 consecutive adult patients with AIS due to anterior circulation LVO who underwent MT. The patients were divided into 2 groups based on initial platelet count: with thrombocytopenia (<150 × 109/L) and without thrombocytopenia (≥150 × 109/L). Primary safety outcome was symptomatic intracerebral haemorrhage (SICH), while secondary safety outcome was stroke-related mortality. Efficacy outcome was functional independence, defined as modified Rankin Scale (mRS) score 0-2. Follow- up time was 90 days. RESULTS Initial thrombocytopenia (<150 × 109/L) was detected in 19 (15%) patients. Multivariable analysis showed that initial thrombocytopenia did not increase the risk of SICH and did not affect the short-term functional outcome (p = 0.587). However, initial thrombocytopenia increased the risk for stroke-related mortality (aOR 3.639, 95% CI 1.079-12.641, p = 0.037). The main cause of mortality in the group with thrombocytopenia was malignant cerebral infarction (44.4%). CONCLUSIONS Thrombocytopenia does not affect the efficacy and the risk of SICH in patients with AIS caused by anterior circulation LVO treated with MT. However, the risk of mortality is higher in patients with thrombocytopenia, mainly due to malignant cerebral infarction.
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Affiliation(s)
- Mirjana Ždraljević
- Neurology Clinic, University Clinical Center of Serbia, Dr Subotica Street 6, 11 000 Belgrade, Serbia
| | - Tatjana Pekmezović
- Institute of Epidemiology, Faculty of Medicine, Višegradska Street 26, 11 000 Belgrade, Serbia
| | - Predrag Stanarčević
- Neurology Clinic, University Clinical Center of Serbia, Dr Subotica Street 6, 11 000 Belgrade, Serbia; Faculty of Medicine, Dr Subotica Street 8, 11 000 Belgrade, Serbia
| | - Ivan Vukašinović
- Center for Radiology and MRI, Clinic for Neurosurgery, University Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, Serbia
| | - Ivana Berisavac
- Neurology Clinic, University Clinical Center of Serbia, Dr Subotica Street 6, 11 000 Belgrade, Serbia; Faculty of Medicine, Dr Subotica Street 8, 11 000 Belgrade, Serbia
| | - Marko Ercegovac
- Neurology Clinic, University Clinical Center of Serbia, Dr Subotica Street 6, 11 000 Belgrade, Serbia; Faculty of Medicine, Dr Subotica Street 8, 11 000 Belgrade, Serbia
| | - Filip Vitošević
- Center for Radiology and MRI, Clinic for Neurosurgery, University Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, Serbia
| | - Dragoslav Nestorović
- Center for Radiology and MRI, Clinic for Neurosurgery, University Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, Serbia
| | - Vladimir Cvetić
- Faculty of Medicine, Dr Subotica Street 8, 11 000 Belgrade, Serbia; Clinic for Vascular and Endovascular Surgery, University Clinical Center of Serbia, Dr Koste Todorovića Street 6, 11 000 Belgrade, Serbia
| | - Višnja Padjen
- Neurology Clinic, University Clinical Center of Serbia, Dr Subotica Street 6, 11 000 Belgrade, Serbia; Faculty of Medicine, Dr Subotica Street 8, 11 000 Belgrade, Serbia
| | - Maja Stefanović- Budimkić
- Neurology Clinic, University Clinical Center of Serbia, Dr Subotica Street 6, 11 000 Belgrade, Serbia
| | - Tamara Švabić Medjedović
- Neurology Clinic, University Clinical Center of Serbia, Dr Subotica Street 6, 11 000 Belgrade, Serbia
| | - Dejana R Jovanović
- Neurology Clinic, University Clinical Center of Serbia, Dr Subotica Street 6, 11 000 Belgrade, Serbia; Faculty of Medicine, Dr Subotica Street 8, 11 000 Belgrade, Serbia.
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Jödicke RA, Huo S, Kränkel N, Piper SK, Ebinger M, Landmesser U, Flöel A, Endres M, Nave AH. The Dynamic of Extracellular Vesicles in Patients With Subacute Stroke: Results of the "Biomarkers and Perfusion-Training-Induced Changes After Stroke" ( BAPTISe) Study. Front Neurol 2021; 12:731013. [PMID: 34819906 PMCID: PMC8606784 DOI: 10.3389/fneur.2021.731013] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/17/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Extracellular vesicles (EV) are sub-1 μm bilayer lipid coated particles and have been shown play a role in long-term cardiovascular outcome after ischemic stroke. However, the dynamic change of EV after stroke and their implications for functional outcome have not yet been elucidated. Methods: Serial blood samples from 110 subacute ischemic stroke patients enrolled in the prospective BAPTISe study were analyzed. All patients participated in the PHYS-STROKE trial and received 4-week aerobic training or relaxation sessions. Levels of endothelial-derived (EnV: Annexin V+, CD45-, CD41-, CD31+/CD144+/CD146+), leukocyte-derived (LV: Annexin V+, CD45+, CD41-), monocytic-derived (MoV: Annexin V+, CD41-, CD14+), neuronal-derived (NV: Annexin V+, CD41-, CD45-, CD31-, CD144-, CD146-, CD56+/CD171+/CD271+), and platelet-derived (PV: Annexin V+, CD41+) EV were assessed via fluorescence-activated cell sorting before and after the trial intervention. The levels of EV at baseline were dichotomized at the 75th percentile, with the EV levels at baseline above the 75th percentile classified as "high" otherwise as "low." The dynamic of EV was classified based on the difference between baseline and post intervention, defining increases above the 75th percentile as "high increase" otherwise as "low increase." Associations of baseline levels and change in EV concentrations with Barthel Index (BI) and cardiovascular events in the first 6 months post-stroke were analyzed using mixed model regression analyses and cox regression. Results: Both before and after intervention PV formed the largest population of vesicles followed by NV and EnV. In mixed-model regression analyses, low NV [-8.57 (95% CI -15.53 to -1.57)] and low PV [-6.97 (95% CI -13.92 to -0.01)] at baseline were associated with lower BI in the first 6 months post-stroke. Patients with low increase in NV [8.69 (95% CI 2.08-15.34)] and LV [6.82 (95% CI 0.25-13.4)] were associated with reduced BI in the first 6 months post-stroke. Neither baseline vesicles nor their dynamic were associated with recurrent cardiovascular events. Conclusion: This is the first report analyzing the concentration and the dynamic of EV regarding associations with functional outcome in patients with subacute stroke. Lower levels of PV and NV at baseline were associated with a worse functional outcome in the first 6 months post-stroke. Furthermore, an increase in NV and LV over time was associated with worse BI in the first 6 months post-stroke. Further investigation of the relationship between EV and their dynamic with functional outcome post-stroke are warranted. Clinical Trial Registration: clinicaltrials.gov/, identifier: NCT01954797.
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Affiliation(s)
- Ruben A Jödicke
- Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Klinik und Hochschulambulanz für Neurologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Shufan Huo
- Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Klinik und Hochschulambulanz für Neurologie, Charité-Universitätsmedizin Berlin, Berlin, Germany.,German Center for Cardiovascular Disease, Partner Site Berlin, Berlin, Germany
| | - Nicolle Kränkel
- Klinik für Kardiologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Sophie K Piper
- Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany.,NeuroCure Clinical Research Center, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Martin Ebinger
- Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Medical Park Berlin Humboldtmühle, Berlin, Germany
| | - Ulf Landmesser
- Klinik für Kardiologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Agnes Flöel
- Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Department of Neurology, University Medicine Greifswald, Greifswald, Germany.,German Center for Neurodegenerative Diseases, Rostock/Greifswald, Germany
| | - Matthias Endres
- Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Klinik und Hochschulambulanz für Neurologie, Charité-Universitätsmedizin Berlin, Berlin, Germany.,NeuroCure Clinical Research Center, Charité Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,German Center for Neurodegenerative Disease, Partner Site Berlin, Berlin, Germany
| | - Alexander H Nave
- Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Klinik und Hochschulambulanz für Neurologie, Charité-Universitätsmedizin Berlin, Berlin, Germany.,German Center for Cardiovascular Disease, Partner Site Berlin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
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İnan S, Jafarov S. Prognostic role of neutrophil lymphocyte ratio and mean platelet volume in Bell's palsy: Comparison of diabetic and non-diabetic patients. Braz J Otorhinolaryngol 2021; 89:98-103. [PMID: 34895869 PMCID: PMC9874336 DOI: 10.1016/j.bjorl.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 08/28/2021] [Accepted: 10/19/2021] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES A low Neutrophil Lymphocyte Ratio (NLR) has been shown to be associated with good prognosis in Bell's Palsy (BP). However, the effect of chronic diseases that may affect the NLR, including Diabetes Mellitus (DM), has not been clarified in this context. This study aimed to evaluate the relationship between NLR and Mean Platelet Volume (MPV) in BP according to whether it is accompanied by DM, and their relationship with prognosis. METHODS A prospective observational study was conducted from May 2014 to May 2020 in a tertiary referral center, of all 79 consecutive participants diagnosed with BP in department of otolaryngology and 110 consecutive healthy participants admitted to the check-up unit. Patients diagnosed with BP were divided into two groups according to whether they were diagnosed with DM: diabetic BP patients (DM-BP, n = 33) and non-diabetic BP patients without any chronic disease (nonDM-BP, n = 46). Neutrophil (NEUT) and Lymphocyte (LYM) counts, and Mean Platelet Volume (MPV) were assessed from peripheral blood samples, and the NLR was calculated. Prognosis was evaluated using the House-Brackmann Score (HBS) six months after diagnosis. RESULTS The mean NLR was 2.85 ± 1.85 in BP patients and 1.69 ± 0.65 in the control group. The mean NLR was significantly higher in BP patients than healthy controls (p < 0.001). The mean NLR was 2.58 ± 1.83 in the nonDM-BP group, 3.23 ± 1.83 in the DM-BP group, and 1.69 ± 0.65 in the control group. The NLR was significantly higher in the nonDM-BP and DM-BP groups than in the control group (p < 0.05). The recovery was 90% according to the HBS. The optimal cut-off value was 2.41 (p = 0.5). CONCLUSION The NLR was increased in both diabetic and non-diabetic BP and had similar prognostic value in predicting the HBS before treatment in diabetic and non-diabetic patients with BP. MPV wasn't significantly different in diabetic and non-diabetic BP patients compared with the normal population.
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Qi X, Lin H, Hou Y, Su X, Gao Y. Comprehensive Analysis of Potential miRNA-Target mRNA-Immunocyte Subtype Network in Cerebral Infarction. Eur Neurol 2021; 85:148-161. [PMID: 34544080 DOI: 10.1159/000518893] [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: 04/21/2021] [Accepted: 07/27/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Cerebral infarction (CI) is one of the leading causes of serious long-term disability and mortality. OBJECTIVE We aimed to identify potential miRNAs and target mRNAs and assess the involvement of immunocyte infiltration in the process of CI. METHODS First, miRNA and mRNA data were downloaded from the Gene Expression Omnibus database, followed by differential expression analysis. Second, correlation analysis between differentially expressed mRNAs and differential immunocyte subtypes was performed through the CIBERSORT algorithm. Third, the regulatory network between miRNAs and immunocyte subtype-related mRNAs was constructed followed by the functional analysis of these target mRNAs. Fourth, correlation validation between differentially expressed mRNAs and differential immunocyte subtypes was performed in the GSE37587 dataset. Finally, the diagnostic ability of immunocyte subtype-related mRNAs was tested. RESULTS Up to 17 differentially expressed miRNAs and 3,267 differentially expressed mRNAs were identified, among which 310 differentially expressed mRNAs were significantly associated with immunocyte subtypes. Several miRNA-target mRNA-immunocyte subtype networks including hsa-miR-671-3p-ZC3HC1-neutrophils, hsa-miR-625-CD5-monocytes, hsa-miR-122-ACOX1/DUSP1/NEDD9-neutrophils, hsa-miR-455-5p-SLC24A4-monocytes, and hsa-miR-455-5p-SORL1-neutrophils were identified. LAT, ACOX1, DUSP1, NEDD9, ZC3HC1, BIN1, AKT1, DNMT1, SLC24A4, and SORL1 had a potential diagnostic value for CI. CONCLUSIONS The network including miRNA, target mRNA, and immunocyte subtype may be novel regulators and diagnostic and therapeutic targets in CI.
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Affiliation(s)
- Xiuyan Qi
- Department of Neurology, Shijiazhuang People's Hospital, Shijiazhuang, China
| | - Huiqian Lin
- Department of Neurology, Shijiazhuang People's Hospital, Shijiazhuang, China
| | - Yongge Hou
- Department of Neurology, Shijiazhuang People's Hospital, Shijiazhuang, China
| | - Xiaohui Su
- Department of Neurology, Shijiazhuang People's Hospital, Shijiazhuang, China
| | - Yanfang Gao
- Clinical Laboratory, Hebei Red Cross Boai Hospital, Shijiazhuang, China
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Zebrafish as a preclinical model for Extracellular Vesicle-based therapeutic development. Adv Drug Deliv Rev 2021; 176:113815. [PMID: 34058284 DOI: 10.1016/j.addr.2021.05.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/13/2021] [Accepted: 05/26/2021] [Indexed: 12/19/2022]
Abstract
Extracellular Vesicles (EVs) are released during various pathophysiological processes and reflect the state of their cell of origin. Once released, they can propagate through biological fluids, target cells, deliver their content and elicit functional responses. These specific features would allow their harnessing as biomarkers, drug nano-vehicles and therapeutic intrinsic modulators. However, the further development of their potential therapeutic application is hampered by the lack of knowledge about how EVs behave in vivo. Recent advances in the field of imaging EVs in vivo now allow live-tracking of endogenous and exogenous EV in various model organisms at high spatiotemporal resolution to define their distribution, half-life and fate. This review highlights current imaging tools available to image EVs in vivo and how live imaging especially in the zebrafish embryo can bring further insights into the characterization of EVs dynamics, biodistribution and functions to potentiate their development for therapeutic applications.
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Ghodsi H, Abouei Mehrizi MA, Khoshdel AR, Shekarchi B. Evaluation of combining Alberta Stroke Program Early CT Score (ASPECTS) with mean platelet volume, plateletcrit, and platelet count in predicting short- and long-term prognosis of patients with acute ischemic stroke. Clin Neurol Neurosurg 2021; 208:106830. [PMID: 34419782 DOI: 10.1016/j.clineuro.2021.106830] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND There is controversy regarding Alberta Stroke Program Early CT Score (ASPECTS) and platelet indices as predictors of outcome in patients with acute ischemic stroke (AIS). We aimed to assess the prognostic value of ASPECTS, mean platelet volume (MPV), plateletcrit (PCT), and platelet count (Plt) in 3-month and 1-year functional outcomes of AIS patients, both independently and in combination. METHODS This prospective study was conducted in Shams Al-shomuos and Ghaem hospitals of Mashhad, Iran from June 2019 to January 2021. Overall, 553 patients above 18 years old with first-ever anterior circulation AIS met the eligibility criteria and were included. Clinical, hematologic, radiologic, and demographic data of patients were recorded at baseline. The 3-month and 1-year functional outcome was evaluated by modified Rankin Scale (mRS). Multivariate logistic regression was used to determine the independent predictors of poor functional outcome (mRS>2) and mortality. RESULTS The mean age of the patients was 65.50 ± 14.41 years and 282 patients (51%) were male. ASPECTS ≤ 7 was an independent predictor of both poor function (OR=1.94, 95%CI=1.04-3.62, P = 0.04) and mortality (OR=2.02, 95%CI=1.14-3.58, P = 0.02) at 1 year. MPV was also a strong predictor of 3-month (OR=3.88, 95%CI=2.04-7.38, P = 0.02) and 1-year (OR=3.32, 95%CI=1.91-5.78, P = 0.01) mortality, as well as 3-month (OR=3.25, 95%CI=1.80-5.86, P < 0.001) and 1-year (OR=4.35, 95%CI=2.36-8.02, P < 0.001) poor function. For 1-year poor function (OR=9.33, 95%CI=2.19-39.73, P = 0.003) and mortality (OR=6.40, 95%CI=2.09-19.64, P = 0.001), ASPECTS combined with all platelet indices found to be a more robust independent predictor compared to each variable alone. CONCLUSION Although MPV is an independent predictor of both 3-month and 1-year poor function and mortality in AIS patients, ASPECTS ≤ 7 was found to be a risk factor for 1-year poor function and mortality. Moreover, the prognostic value of both platelet indices and ASPECTS are greater when they are combined together in AIS patients.
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Affiliation(s)
- Hamidreza Ghodsi
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Ali Reza Khoshdel
- Modern Epidemiology Research Center, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Babak Shekarchi
- Department of Radiology, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran.
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Coenen DM, Heinzmann ACA, Oggero S, Albers HJ, Nagy M, Hagué P, Kuijpers MJE, Vanderwinden JM, van der Meer AD, Perretti M, Koenen RR, Cosemans JMEM. Inhibition of Phosphodiesterase 3A by Cilostazol Dampens Proinflammatory Platelet Functions. Cells 2021; 10:1998. [PMID: 34440764 PMCID: PMC8392606 DOI: 10.3390/cells10081998] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 07/29/2021] [Accepted: 07/30/2021] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE platelets possess not only haemostatic but also inflammatory properties, which combined are thought to play a detrimental role in thromboinflammatory diseases such as acute coronary syndromes and stroke. Phosphodiesterase (PDE) 3 and -5 inhibitors have demonstrated efficacy in secondary prevention of arterial thrombosis, partially mediated by their antiplatelet action. Yet it is unclear whether such inhibitors also affect platelets' inflammatory functions. Here, we aimed to examine the effect of the PDE3A inhibitor cilostazol and the PDE5 inhibitor tadalafil on platelet function in various aspects of thromboinflammation. Approach and results: cilostazol, but not tadalafil, delayed ex vivo platelet-dependent fibrin formation under whole blood flow over type I collagen at 1000 s-1. Similar results were obtained with blood from Pde3a deficient mice, indicating that cilostazol effects are mediated via PDE3A. Interestingly, cilostazol specifically reduced the release of phosphatidylserine-positive extracellular vesicles (EVs) from human platelets while not affecting total EV release. Both cilostazol and tadalafil reduced the interaction of human platelets with inflamed endothelium under arterial flow and the release of the chemokines CCL5 and CXCL4 from platelets. Moreover, cilostazol, but not tadalafil, reduced monocyte recruitment and platelet-monocyte interaction in vitro. CONCLUSIONS this study demonstrated yet unrecognised roles for platelet PDE3A and platelet PDE5 in platelet procoagulant and proinflammatory responses.
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Affiliation(s)
- Daniëlle M. Coenen
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6229 ER Maastricht, The Netherlands; (D.M.C.); (A.C.A.H.); (M.N.); (M.J.E.K.); (R.R.K.)
- Department of Molecular and Cellular Biochemistry, University of Kentucky College of Medicine, Lexington, KY 40506, USA
| | - Alexandra C. A. Heinzmann
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6229 ER Maastricht, The Netherlands; (D.M.C.); (A.C.A.H.); (M.N.); (M.J.E.K.); (R.R.K.)
| | - Silvia Oggero
- Biochemical Pharmacology, William Harvey Research Institute, Queen Mary University of London, London E1 4NS, UK; (S.O.); (M.P.)
| | - Hugo J. Albers
- BIOS Lab-on-a-Chip Group, Technical Medical Centre, MESA+ Institute for Nanotechnology, University of Twente, 7522 NB Enschede, The Netherlands;
- Applied Stem Cell Technologies Group, Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands;
| | - Magdolna Nagy
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6229 ER Maastricht, The Netherlands; (D.M.C.); (A.C.A.H.); (M.N.); (M.J.E.K.); (R.R.K.)
| | - Perrine Hagué
- Laboratory of Neurophysiology, Faculty of Medicine, Université Libre de Bruxelles, B-1070 Brussels, Belgium; (P.H.); (J.-M.V.)
| | - Marijke J. E. Kuijpers
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6229 ER Maastricht, The Netherlands; (D.M.C.); (A.C.A.H.); (M.N.); (M.J.E.K.); (R.R.K.)
| | - Jean-Marie Vanderwinden
- Laboratory of Neurophysiology, Faculty of Medicine, Université Libre de Bruxelles, B-1070 Brussels, Belgium; (P.H.); (J.-M.V.)
| | - Andries D. van der Meer
- Applied Stem Cell Technologies Group, Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands;
| | - Mauro Perretti
- Biochemical Pharmacology, William Harvey Research Institute, Queen Mary University of London, London E1 4NS, UK; (S.O.); (M.P.)
| | - Rory R. Koenen
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6229 ER Maastricht, The Netherlands; (D.M.C.); (A.C.A.H.); (M.N.); (M.J.E.K.); (R.R.K.)
| | - Judith M. E. M. Cosemans
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6229 ER Maastricht, The Netherlands; (D.M.C.); (A.C.A.H.); (M.N.); (M.J.E.K.); (R.R.K.)
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20
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Lenart-Migdalska A, Drabik L, Kaźnica-Wiatr M, Tomkiewicz-Pająk L, Podolec P, Olszowska M. Increased Levels of Platelets and Endothelial-Derived Microparticles in Patients With Non-Valvular Atrial Fibrillation During Rivaroxaban Therapy. Clin Appl Thromb Hemost 2021; 27:10760296211019465. [PMID: 34032122 PMCID: PMC8155766 DOI: 10.1177/10760296211019465] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
It is known that atrial fibrillation (AF) is associated with the procoagulant
state. Several studies have reported an increase of circulating microparticles
in AF, which may be linked to a hypercoagulable state, atrial thrombosis and
thromboembolism. We evaluated in our study alterations in both platelet (PMP,
CD42b) and endothelial-derived (EMP, CD144) microparticle levels on
anticoagulant therapy with rivaroxaban in nonvalvular AF. After administration
of rivaroxaban, PMP levels were increased (median, [IQR] 35.7 [28.8-47.3] vs.
48.4 [30.9-82.8] cells/µL; P = 0.012), along with an increase
in EMP levels (14.6 [10.0-18.6] vs. 18.3 [12.9-37.1] cells/µL,
P < 0.001). In the multivariable regression analysis,
the independent predictor of post-dose change in PMPs was statin therapy (HR
−0.43; 95% CI −0.75,−0.10, P = 0.011). The post-dose change in
EMPs was also predicted by statin therapy (HR −0.34; 95% CI −0.69, −0.01,
P = 0.046). This study showed an increase in both EMPs and
PMPs at the peak plasma concentration of rivaroxaban. Statins have promising
potential in the prevention of rivaroxaban-related PMP and EMP release. The
pro-thrombotic role of PMPs and EMPs during rivaroxaban therapy requires further
study.
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Affiliation(s)
- Aleksandra Lenart-Migdalska
- Department of Cardiac and Vascular Diseases, Faculty of Medicine, Jagiellonian University Medical College, Institute of Cardiology, John Paul II Hospital, Kraków, Poland
| | - Leszek Drabik
- Department of Cardiac and Vascular Diseases, Faculty of Medicine, Jagiellonian University Medical College, Institute of Cardiology, John Paul II Hospital, Kraków, Poland.,Department of Pharmacology, Jagiellonian University Medical College, Kraków, Poland
| | - Magdalena Kaźnica-Wiatr
- Department of Cardiac and Vascular Diseases, Faculty of Medicine, Jagiellonian University Medical College, Institute of Cardiology, John Paul II Hospital, Kraków, Poland
| | - Lidia Tomkiewicz-Pająk
- Department of Cardiac and Vascular Diseases, Faculty of Medicine, Jagiellonian University Medical College, Institute of Cardiology, John Paul II Hospital, Kraków, Poland
| | - Piotr Podolec
- Department of Cardiac and Vascular Diseases, Faculty of Medicine, Jagiellonian University Medical College, Institute of Cardiology, John Paul II Hospital, Kraków, Poland
| | - Maria Olszowska
- Department of Cardiac and Vascular Diseases, Faculty of Medicine, Jagiellonian University Medical College, Institute of Cardiology, John Paul II Hospital, Kraków, Poland
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21
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Weng Y, Zeng T, Huang H, Ren J, Wang J, Yang C, Pan W, Hu J, Sun F, Zhou X, Qiu H, Gao Y, Gao B, Chi L, Chen G. Systemic Immune-Inflammation Index Predicts 3-Month Functional Outcome in Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis. Clin Interv Aging 2021; 16:877-886. [PMID: 34040364 PMCID: PMC8143961 DOI: 10.2147/cia.s311047] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/29/2021] [Indexed: 12/16/2022] Open
Abstract
Background and Purpose Systemic immune-inflammation index (SII), a novel inflammation index derived from counts of circulating platelets, neutrophils and lymphocytes, has been studied in developing incident cancer. However, the clinical value of SII in acute ischemic stroke (AIS) patients had not been further investigated. Therefore, we aimed to explore the association between SII and severity of stroke as well as 3-month outcome of AIS patients. Methods A total of 216 AIS patients receiving intravenous thrombolysis (IVT) and 875 healthy controls (HCs) were retrospectively recruited. Blood samples were collected within 24h after admission. Severity of stroke was assessed by the National Institute of Health stroke scale (NIHSS) scores on admission and poor 3-month functional outcome was defined as Modified Rankin Scale (mRS) > 2. Results SII levels in AIS patients were higher than in HCs. The cut-off value of SII is 545.14×109/L. Patients with SII > 545.14×109/L had higher NIHSS scores (median: 5 vs 9, p < 0.001), a positive correlation between SII and NIHSS was observed (rs = 0.305, p < 0.001). Multivariate logistic regression analyses showed that high SII was one of the independent risk factors for poor prognosis at 3 months of AIS patients (OR = 3.953, 95% CI = 1.702-9.179, p = 0.001). The addition of SII to the conventional prognostic model improved the reclassification (but not discrimination) of the functional outcome (net reclassification index 39.3%, p = 0.007). Conclusion SII is correlated with stroke severity at admission and can be a novel prognostic biomarker for AIS patients treated with IVT.
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Affiliation(s)
- Yiyun Weng
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Tian Zeng
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People's Republic of China.,Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Honghao Huang
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People's Republic of China.,Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Junli Ren
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People's Republic of China.,Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Jianing Wang
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People's Republic of China.,Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Chenguang Yang
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People's Republic of China.,Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Wenjing Pan
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People's Republic of China.,Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Jingyu Hu
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People's Republic of China.,Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Fangyue Sun
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People's Republic of China.,Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Xinbo Zhou
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People's Republic of China.,Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Haojie Qiu
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People's Republic of China.,Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Yufan Gao
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, People's Republic of China.,Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Beibei Gao
- Department of Internal Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Lifen Chi
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Guangyong Chen
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
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22
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Li T, Meng Z, Zhang W, Li Y, Yu X, Du X, Liu M, Zhang Q, Gao Y, Song K, Wang X, Fan Y. No obvious association exists between mean platelet volume and hypertension subtypes. Biomark Med 2021; 15:577-584. [PMID: 33988465 DOI: 10.2217/bmm-2020-0305] [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: 11/21/2022] Open
Abstract
Aims: To determine the association between mean platelet volume (MPV) and hypertension subtypes. Participants & results: 44,281 Chinese individuals were enrolled in this cross-sectional study. The mean blood pressure decreased with increasing MPV in females (p = 0.001) and increased MPV seemed to be a potential protective factor for isolated diastolic hypertension in models 1 and 2. The OR (CI) was 0.878 (0.789-0.976) for model 1 and 0.880 (0.789-0.981) for model 2 in males and 0.646 (0.495-0.841) for model 1 and 0.657 (0.503-0.858) for model 2 in females, when MPV was analyzed as a categorical variable. The OR (CI) was 0.947 (0.911-0.985) for Model 1 and 0.947 (0.910-0.985) for Model 2 in males, and 0.886 (0.807-0.973) for Model 1 and 0.892 (0.813-0.978) for Model 2 in females when MPV was analyzed as a continuous variable. However, the statistical difference of OR disappeared when we added blood-related covariates in Model 3. Conclusion: No obvious association exists between MPV and hypertension subtypes. Other blood parameters might have a greater impact on hypertension subtypes.
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Affiliation(s)
- Tingwei Li
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Zhaowei Meng
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Wenjuan Zhang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Yongle Li
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Xuefang Yu
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Xin Du
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Ming Liu
- Department of Endocrinology & Metabolism, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Qing Zhang
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Ying Gao
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Kun Song
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Xing Wang
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Yaguang Fan
- Tianjin Key Laboratory of Lung Cancer Metastasis & Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
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23
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CD36+/CD61+ Microparticles Correlate with the Risk of Percutaneous Cardiac Interventions in Coronary Artery Disease Patients and the Effects of Ticagrelor. Cardiovasc Drugs Ther 2021; 36:455-465. [PMID: 33893936 DOI: 10.1007/s10557-021-07184-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/05/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The CD36 scavenger receptor is a mediator of both atherogenesis and thrombosis. We aimed to investigate the prognostic value of CD36+ microparticles (MPs) released from platelets for cardiovascular event presentation in coronary artery disease (CAD) patients and the effects of different antiplatelet drugs on MPs. METHODS A total of 101 aspirin-treated CAD patients, who were planned to undergo coronary angiography (CAG), were randomized to either a standard clopidogrel regimen or ticagrelor treatment. Total Annexin V-(AV)+ MPs, CD61+/AV+ MPs, and CD36+/CD61+/AV+ MPs were quantified by flow cytometry at baseline, before and immediately after the operation. The ADP-induced platelet inhibition rate was measured by thromboelastogram (TEG) examination 1 h before the operation. RESULTS The baseline levels of CD36+/CD61+/AV+ MPs were significantly increased in percutaneous coronary intervention (PCI) patients (n = 52) compared to no-PCI patients (n = 49) (p < 0.05). A ROC-curve clustered model for CD36+/CD61+/AV+ MPs at baseline predicted an increased risk of PCI [p = 0.009, AUC = 0.761 (95%CI: 0.601 to 0.922)]. Moreover, TEG examination showed that the preoperative proportion of CD36+/CD61+/AV+ MPs was significantly negatively correlated with R time and K time (r = - 0.236, p = 00.026; r = - 0.288, p = 0.006), and positively correlated with MAADP (r = 0.226, p = 0.045). Subgroup analysis of PCI group showed that the platelet inhibition rate of ticagrelor was significantly higher (66.05% ± 28.76% vs.31.01% ± 27.33%, p < 0.001), and the number of AV+ MPs, CD61+/AV+ MPs, and CD36+/CD61+/AV+ MPs before the operation was significantly lower than clopidogrel (p < 0.05, all). CONCLUSION The high levels of CD36+ MPs derived from activated platelets are related to an increased risk of PCI in CAD patients. Ticagrelor significantly reduced the number of CD61+/AV+ MPs and CD36+/CD61+/AV+ MPs. This trial registration number is ChiCTR1800014908 and the date of registration is 2018.05.01.
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24
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Aghayari Sheikh Neshin S, Shahjouei S, Koza E, Friedenberg I, Khodadadi F, Sabra M, Kobeissy F, Ansari S, Tsivgoulis G, Li J, Abedi V, Wolk DM, Zand R. Stroke in SARS-CoV-2 Infection: A Pictorial Overview of the Pathoetiology. Front Cardiovasc Med 2021; 8:649922. [PMID: 33855053 PMCID: PMC8039152 DOI: 10.3389/fcvm.2021.649922] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/01/2021] [Indexed: 12/15/2022] Open
Abstract
Since the early days of the pandemic, there have been several reports of cerebrovascular complications during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Numerous studies proposed a role for SARS-CoV-2 in igniting stroke. In this review, we focused on the pathoetiology of stroke among the infected patients. We pictured the results of the SARS-CoV-2 invasion to the central nervous system (CNS) via neuronal and hematogenous routes, in addition to viral infection in peripheral tissues with extensive crosstalk with the CNS. SARS-CoV-2 infection results in pro-inflammatory cytokine and chemokine release and activation of the immune system, COVID-19-associated coagulopathy, endotheliitis and vasculitis, hypoxia, imbalance in the renin-angiotensin system, and cardiovascular complications that all may lead to the incidence of stroke. Critically ill patients, those with pre-existing comorbidities and patients taking certain medications, such as drugs with elevated risk for arrhythmia or thrombophilia, are more susceptible to a stroke after SARS-CoV-2 infection. By providing a pictorial narrative review, we illustrated these associations in detail to broaden the scope of our understanding of stroke in SARS-CoV-2-infected patients. We also discussed the role of antiplatelets and anticoagulants for stroke prevention and the need for a personalized approach among patients with SARS-CoV-2 infection.
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Affiliation(s)
| | - Shima Shahjouei
- Neurology Department, Neuroscience Institute, Geisinger Health System, Danville, PA, United States
| | - Eric Koza
- Geisinger Commonwealth School of Medicine, Scranton, PA, United States
| | - Isabel Friedenberg
- Department of Biology, Pennsylvania State University, State College, PA, United States
| | | | - Mirna Sabra
- Neurosciences Research Center (NRC), Lebanese University/Medical School, Beirut, Lebanon
| | - Firas Kobeissy
- Program of Neurotrauma, Neuroproteomics and Biomarker Research (NNBR), University of Florida, Gainesville, FL, United States
| | - Saeed Ansari
- National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD, United States
| | - Georgios Tsivgoulis
- Second Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Jiang Li
- Department of Molecular and Functional Genomics, Geisinger Health System, Danville, PA, United States
| | - Vida Abedi
- Department of Molecular and Functional Genomics, Geisinger Health System, Danville, PA, United States.,Biocomplexity Institute, Virginia Tech, Blacksburg, VA, United States
| | - Donna M Wolk
- Molecular and Microbial Diagnostics and Development, Diagnostic Medicine Institute, Laboratory Medicine, Geisinger Health System, Danville, PA, United States
| | - Ramin Zand
- Neurology Department, Neuroscience Institute, Geisinger Health System, Danville, PA, United States
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25
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Zarmehri B, Shahi B, Rahmani S, Dehghan Tafti F, Foroughian M. Association of platelet count and mean platelet volume (MPV) index with types of stroke. CASPIAN JOURNAL OF INTERNAL MEDICINE 2021; 11:398-402. [PMID: 33680381 PMCID: PMC7911760 DOI: 10.22088/cjim.11.4.398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background: Stroke is known to be the third most prominent cause of death in the developing countries and the most common debilitating neurologic disease. This study aimed to investigate the association of platelet count (PC) and mean platelet volume (MPV) index with various stroke types. Methods: This cross-sectional study was carried out on patients over the age of 18 years who presented with signs and symptoms of the first acute stroke. Exclusion criteria were underlying chronic liver or renal disease and the time more than 6 hours from symptom initiation, hematological and infectious disorders in patients. After recording of demographic data, a complete blood cell count (CBC) test was performed. Results: From 150 patients, who enrolled in the study, 54.7% of patients were males. The initial brain CT scan was normal in 13 (8.7%) patients and showed evidence of brain infarction and intracranial hemorrhage in 84 (56%) and 53 (35.3%) patients respectively. Patients with intracranial hemorrhage had significantly higher mean of MPV index than the patients with normal brain-CT scan and patients with evidence of brain infarction (p<0.001). Conclusion: The MVP index can be a predictor of the type of hemorrhagic or ischemic finding in emergency CT scan in stroke patients. This relationship may help to better understand the physiopathologic role of platelets in the development of stroke (hemorrhagic or ischemic), but will not replace cerebral computed tomography to diagnose the type of stroke, or it may not initiate treatment for hemorrhagic stroke.
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Affiliation(s)
- Bahram Zarmehri
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Behzad Shahi
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shaghayegh Rahmani
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mahdi Foroughian
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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26
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The Relationship between the Mean Platelet Volume and Carotid Atherosclerosis and Prognosis in Patients with Acute Cerebral Infarction. BIOMED RESEARCH INTERNATIONAL 2020; 2020:6685740. [PMID: 33490251 PMCID: PMC7790567 DOI: 10.1155/2020/6685740] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 02/06/2023]
Abstract
Objective To investigate the relationship between mean platelet volume (MPV) level and carotid atherosclerosis and prognosis in patients with acute cerebral infarction. Methods. A retrospectively included 160 patients with acute cerebral infarction classified by TOAST classification as aortic atherosclerosis as the observation group. To analyze the relationship between MPV and carotid atherosclerosis, and use receiver operating characteristic (ROC) curves to analyze the role of MPV in predicting the prognosis of acute cerebral infarction in the observation group, grouping patients with different MPV by cut-off value, and analyze the differences in factors between the two groups of patients. Results MPV has a positive correlation with carotid atherosclerosis in patients with acute cerebral infarction. Multivariate logistic regression analysis revealed that increased MPV was an independent predictor of poor functional outcome in patients with acute cerebral infarction (Odds Ratio (OR): 6.152, 95% CI: 2.385-13.625, P < 0.01). ROC curve analysis showed that the area under the curve for MPV to predict poor prognosis was 0.868 (95% CI: 0.787-949, P < 0.01). The cutoff value, sensitivity, and specificity were 12.65, 76.2%, and 87.6%. Compared with patients with MPV < 12.65 at admission, patients with higher MPV levels (MPV ≥ 12.65) at admission have larger infarct size, more severe carotid artery stenosis, poor short-term prognosis, and higher mortality. Conclusion MPV level is closely related to the degree of carotid atherosclerosis in patients with acute cerebral infarction, and it is also an independent predictor of poor prognosis in patients with acute cerebral infarction at 3 months.
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27
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Huo S, Kränkel N, Nave AH, Sperber PS, Rohmann JL, Piper SK, Heuschmann PU, Landmesser U, Endres M, Siegerink B, Liman TG. Endothelial and Leukocyte-Derived Microvesicles and Cardiovascular Risk After Stroke: PROSCIS-B. Neurology 2020; 96:e937-e946. [PMID: 33184230 DOI: 10.1212/wnl.0000000000011223] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 10/05/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine the role of circulating microvesicles (MV) on long-term cardiovascular outcomes after stroke, we measured them in patients with first-ever stroke with a 3-year follow-up. METHODS In the Prospective Cohort With Incident Stroke Berlin (PROSCIS-B), patients with first-ever ischemic stroke were followed up for 3 years. The primary combined endpoint consisted of recurrent stroke, myocardial infarction, and all-cause mortality. Citrate-blood levels of endothelial MV (EMV), leukocyte-derived MV (LMV), monocytic MV (MMV), and platelet-derived MV (PMV) were measured with flow cytometry. Kaplan-Meier curves and adjusted Cox proportional hazards models were used to estimate the effect of MV levels on the combined endpoint. RESULTS Five hundred seventy-one patients were recruited (median age 69 years, 39% female, median NIH Stroke Scale score 2, interquartile range 1-4), and 95 endpoints occurred. Patients with levels of EMV (adjusted hazard ratio [HR] 2.5, 95% confidence interval [CI] 1.2-4.9) or LMV (HR 3.1, 95% CI 1.4-6.8) in the highest quartile were more likely to experience an event than participants with lower levels with the lowest quartile used as the reference category. The association was less pronounced for PMV (HR 1.7, 95% CI 0.9-3.2) and absent for MMV (HR 1.1, 95% CI 0.6-1.8). CONCLUSION High levels of EMV and LMV after stroke were associated with worse cardiovascular outcome within 3 years. These results reinforce that endothelial dysfunction and vascular inflammation affect the long-term prognosis after stroke. EMV and LMV might play a role in risk prediction for stroke patients. CLINICALTRIALSGOV IDENTIFIER NCT01363856. CLASSIFICATION OF EVIDENCE This study provides Class II evidence of the effect of MV levels on subsequent stroke, myocardial infarction, or all-cause mortality in survivors of mild stroke.
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Affiliation(s)
- Shufan Huo
- From the Center for Stroke Research Berlin CSB (S.H., A.H.N., P.S.S., J.L.R., M.E., B.S., T.G.L.), Klinik für Neurologie (S.H., A.H.N., M.E., T.G.L.), Institute of Public Health (J.L.R.), Institute of Biometry and Clinical Epidemiology (S.K.P.), Campus Benjamin Franklin (N.K., U.L.), Department of Cardiology, and Excellence Cluster Neurocure (M.E.), Charité-Universitätsmedizin Berlin; DZHK (German Centre for Cardiovascular Research), partner site Berlin (S.H., N.K., A.H.N., P.S.S., U.L., M.E., T.G.L.); Berlin Institute of Health (A.H.N., S.K.P.); Institute of Clinical Epidemiology and Biometry (P.H.), University of Würzburg; Clinical Trial Center Würzburg (P.H., U.L.), University Hospital Würzburg; and DZNE (German Center for Neurodegenerative Disease) Partner Site Berlin (M.E.), Germany.
| | - Nicolle Kränkel
- From the Center for Stroke Research Berlin CSB (S.H., A.H.N., P.S.S., J.L.R., M.E., B.S., T.G.L.), Klinik für Neurologie (S.H., A.H.N., M.E., T.G.L.), Institute of Public Health (J.L.R.), Institute of Biometry and Clinical Epidemiology (S.K.P.), Campus Benjamin Franklin (N.K., U.L.), Department of Cardiology, and Excellence Cluster Neurocure (M.E.), Charité-Universitätsmedizin Berlin; DZHK (German Centre for Cardiovascular Research), partner site Berlin (S.H., N.K., A.H.N., P.S.S., U.L., M.E., T.G.L.); Berlin Institute of Health (A.H.N., S.K.P.); Institute of Clinical Epidemiology and Biometry (P.H.), University of Würzburg; Clinical Trial Center Würzburg (P.H., U.L.), University Hospital Würzburg; and DZNE (German Center for Neurodegenerative Disease) Partner Site Berlin (M.E.), Germany
| | - Alexander Heinrich Nave
- From the Center for Stroke Research Berlin CSB (S.H., A.H.N., P.S.S., J.L.R., M.E., B.S., T.G.L.), Klinik für Neurologie (S.H., A.H.N., M.E., T.G.L.), Institute of Public Health (J.L.R.), Institute of Biometry and Clinical Epidemiology (S.K.P.), Campus Benjamin Franklin (N.K., U.L.), Department of Cardiology, and Excellence Cluster Neurocure (M.E.), Charité-Universitätsmedizin Berlin; DZHK (German Centre for Cardiovascular Research), partner site Berlin (S.H., N.K., A.H.N., P.S.S., U.L., M.E., T.G.L.); Berlin Institute of Health (A.H.N., S.K.P.); Institute of Clinical Epidemiology and Biometry (P.H.), University of Würzburg; Clinical Trial Center Würzburg (P.H., U.L.), University Hospital Würzburg; and DZNE (German Center for Neurodegenerative Disease) Partner Site Berlin (M.E.), Germany
| | - Pia Sophie Sperber
- From the Center for Stroke Research Berlin CSB (S.H., A.H.N., P.S.S., J.L.R., M.E., B.S., T.G.L.), Klinik für Neurologie (S.H., A.H.N., M.E., T.G.L.), Institute of Public Health (J.L.R.), Institute of Biometry and Clinical Epidemiology (S.K.P.), Campus Benjamin Franklin (N.K., U.L.), Department of Cardiology, and Excellence Cluster Neurocure (M.E.), Charité-Universitätsmedizin Berlin; DZHK (German Centre for Cardiovascular Research), partner site Berlin (S.H., N.K., A.H.N., P.S.S., U.L., M.E., T.G.L.); Berlin Institute of Health (A.H.N., S.K.P.); Institute of Clinical Epidemiology and Biometry (P.H.), University of Würzburg; Clinical Trial Center Würzburg (P.H., U.L.), University Hospital Würzburg; and DZNE (German Center for Neurodegenerative Disease) Partner Site Berlin (M.E.), Germany
| | - Jessica Lee Rohmann
- From the Center for Stroke Research Berlin CSB (S.H., A.H.N., P.S.S., J.L.R., M.E., B.S., T.G.L.), Klinik für Neurologie (S.H., A.H.N., M.E., T.G.L.), Institute of Public Health (J.L.R.), Institute of Biometry and Clinical Epidemiology (S.K.P.), Campus Benjamin Franklin (N.K., U.L.), Department of Cardiology, and Excellence Cluster Neurocure (M.E.), Charité-Universitätsmedizin Berlin; DZHK (German Centre for Cardiovascular Research), partner site Berlin (S.H., N.K., A.H.N., P.S.S., U.L., M.E., T.G.L.); Berlin Institute of Health (A.H.N., S.K.P.); Institute of Clinical Epidemiology and Biometry (P.H.), University of Würzburg; Clinical Trial Center Würzburg (P.H., U.L.), University Hospital Würzburg; and DZNE (German Center for Neurodegenerative Disease) Partner Site Berlin (M.E.), Germany
| | - Sophie Käthe Piper
- From the Center for Stroke Research Berlin CSB (S.H., A.H.N., P.S.S., J.L.R., M.E., B.S., T.G.L.), Klinik für Neurologie (S.H., A.H.N., M.E., T.G.L.), Institute of Public Health (J.L.R.), Institute of Biometry and Clinical Epidemiology (S.K.P.), Campus Benjamin Franklin (N.K., U.L.), Department of Cardiology, and Excellence Cluster Neurocure (M.E.), Charité-Universitätsmedizin Berlin; DZHK (German Centre for Cardiovascular Research), partner site Berlin (S.H., N.K., A.H.N., P.S.S., U.L., M.E., T.G.L.); Berlin Institute of Health (A.H.N., S.K.P.); Institute of Clinical Epidemiology and Biometry (P.H.), University of Würzburg; Clinical Trial Center Würzburg (P.H., U.L.), University Hospital Würzburg; and DZNE (German Center for Neurodegenerative Disease) Partner Site Berlin (M.E.), Germany
| | - Peter Ulrich Heuschmann
- From the Center for Stroke Research Berlin CSB (S.H., A.H.N., P.S.S., J.L.R., M.E., B.S., T.G.L.), Klinik für Neurologie (S.H., A.H.N., M.E., T.G.L.), Institute of Public Health (J.L.R.), Institute of Biometry and Clinical Epidemiology (S.K.P.), Campus Benjamin Franklin (N.K., U.L.), Department of Cardiology, and Excellence Cluster Neurocure (M.E.), Charité-Universitätsmedizin Berlin; DZHK (German Centre for Cardiovascular Research), partner site Berlin (S.H., N.K., A.H.N., P.S.S., U.L., M.E., T.G.L.); Berlin Institute of Health (A.H.N., S.K.P.); Institute of Clinical Epidemiology and Biometry (P.H.), University of Würzburg; Clinical Trial Center Würzburg (P.H., U.L.), University Hospital Würzburg; and DZNE (German Center for Neurodegenerative Disease) Partner Site Berlin (M.E.), Germany
| | - Ulf Landmesser
- From the Center for Stroke Research Berlin CSB (S.H., A.H.N., P.S.S., J.L.R., M.E., B.S., T.G.L.), Klinik für Neurologie (S.H., A.H.N., M.E., T.G.L.), Institute of Public Health (J.L.R.), Institute of Biometry and Clinical Epidemiology (S.K.P.), Campus Benjamin Franklin (N.K., U.L.), Department of Cardiology, and Excellence Cluster Neurocure (M.E.), Charité-Universitätsmedizin Berlin; DZHK (German Centre for Cardiovascular Research), partner site Berlin (S.H., N.K., A.H.N., P.S.S., U.L., M.E., T.G.L.); Berlin Institute of Health (A.H.N., S.K.P.); Institute of Clinical Epidemiology and Biometry (P.H.), University of Würzburg; Clinical Trial Center Würzburg (P.H., U.L.), University Hospital Würzburg; and DZNE (German Center for Neurodegenerative Disease) Partner Site Berlin (M.E.), Germany
| | - Matthias Endres
- From the Center for Stroke Research Berlin CSB (S.H., A.H.N., P.S.S., J.L.R., M.E., B.S., T.G.L.), Klinik für Neurologie (S.H., A.H.N., M.E., T.G.L.), Institute of Public Health (J.L.R.), Institute of Biometry and Clinical Epidemiology (S.K.P.), Campus Benjamin Franklin (N.K., U.L.), Department of Cardiology, and Excellence Cluster Neurocure (M.E.), Charité-Universitätsmedizin Berlin; DZHK (German Centre for Cardiovascular Research), partner site Berlin (S.H., N.K., A.H.N., P.S.S., U.L., M.E., T.G.L.); Berlin Institute of Health (A.H.N., S.K.P.); Institute of Clinical Epidemiology and Biometry (P.H.), University of Würzburg; Clinical Trial Center Würzburg (P.H., U.L.), University Hospital Würzburg; and DZNE (German Center for Neurodegenerative Disease) Partner Site Berlin (M.E.), Germany
| | - Bob Siegerink
- From the Center for Stroke Research Berlin CSB (S.H., A.H.N., P.S.S., J.L.R., M.E., B.S., T.G.L.), Klinik für Neurologie (S.H., A.H.N., M.E., T.G.L.), Institute of Public Health (J.L.R.), Institute of Biometry and Clinical Epidemiology (S.K.P.), Campus Benjamin Franklin (N.K., U.L.), Department of Cardiology, and Excellence Cluster Neurocure (M.E.), Charité-Universitätsmedizin Berlin; DZHK (German Centre for Cardiovascular Research), partner site Berlin (S.H., N.K., A.H.N., P.S.S., U.L., M.E., T.G.L.); Berlin Institute of Health (A.H.N., S.K.P.); Institute of Clinical Epidemiology and Biometry (P.H.), University of Würzburg; Clinical Trial Center Würzburg (P.H., U.L.), University Hospital Würzburg; and DZNE (German Center for Neurodegenerative Disease) Partner Site Berlin (M.E.), Germany
| | - Thomas Günter Liman
- From the Center for Stroke Research Berlin CSB (S.H., A.H.N., P.S.S., J.L.R., M.E., B.S., T.G.L.), Klinik für Neurologie (S.H., A.H.N., M.E., T.G.L.), Institute of Public Health (J.L.R.), Institute of Biometry and Clinical Epidemiology (S.K.P.), Campus Benjamin Franklin (N.K., U.L.), Department of Cardiology, and Excellence Cluster Neurocure (M.E.), Charité-Universitätsmedizin Berlin; DZHK (German Centre for Cardiovascular Research), partner site Berlin (S.H., N.K., A.H.N., P.S.S., U.L., M.E., T.G.L.); Berlin Institute of Health (A.H.N., S.K.P.); Institute of Clinical Epidemiology and Biometry (P.H.), University of Würzburg; Clinical Trial Center Würzburg (P.H., U.L.), University Hospital Würzburg; and DZNE (German Center for Neurodegenerative Disease) Partner Site Berlin (M.E.), Germany
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Noulsri E, Lerdwana S. Quantitation of phosphatidylserine-exposing platelets and platelet-derived microparticles in platelet products: A new strategy to improve efficacy of platelet transfusion. Med Hypotheses 2020; 145:110306. [PMID: 33032173 DOI: 10.1016/j.mehy.2020.110306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/13/2020] [Accepted: 09/23/2020] [Indexed: 11/18/2022]
Abstract
Platelet transfusion is an effective therapy to prevent or treat bleeding. Considering the different clinical purposes of transfusion, it is necessary to assess the quality of platelet products prepared in transfusion laboratories. So far, there is no solution to the problem of how best to do this. Here, we summarize the quantitation of phosphatidylserine (PS)-exposing platelets and platelet-derived microparticles (PMPs) in platelet products using previously reported data. Because PS promotes the assembly and enhances the activity of coagulation factors, classifying platelet products according to their concentrations of PS-exposing platelets and PMPs will improve the therapeutic treatment of transfusion recipients.
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Affiliation(s)
- Egarit Noulsri
- Research Division, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
| | - Surada Lerdwana
- Biomedical Research Incubator Unit, Department of Research, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Badimon L, Suades R, Vilella-Figuerola A, Crespo J, Vilahur G, Escate R, Padro T, Chiva-Blanch G. Liquid Biopsies: Microvesicles in Cardiovascular Disease. Antioxid Redox Signal 2020; 33:645-662. [PMID: 31696726 DOI: 10.1089/ars.2019.7922] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Significance: Circulating microvesicles (cMV) are small (0.1-1 μm) phospholipid-rich blebs released by almost all cell types, and their release increases with cell activation and injury, thus reflecting the state of the cell from which they are originated. Microvesicles (MV) are found in the bloodstream, and they affect the phenotype of recipient cells, after local or systemic circulation, by intercellular transfer of their molecular content. Recent Advances: Several studies suggest the use of cell-specific MV subpopulations as predictive biomarkers for cardiovascular diseases (CVDs) at different stages and degrees of severity. In this review, we describe the state of the art of cMV as noninvasive surrogate biomarkers of vascular injury and dysfunction correlated with poor clinical outcomes in CVD. Critical Issues: Despite the growing body of evidence supporting the importance of cMV as hallmarks of CVD and their utility as biomarkers of CVD, the specific roles of each phenotype of cMV in CVD burden and prognosis still remain to be elucidated and validated in large cohorts. In addition, the development of standardized and reproducible techniques is required to be used as biomarkers for disease progression in the clinical setting. Future Directions: A multipanel approach with specific cMV phenotypes, added to current biomarkers and scores, will undoubtedly provide unique prognostic information to stratify patients for appropriate therapy on the basis of their risk of atherothrombotic disease and will open a new research area as therapeutic targets for CVD. MV will add to the implementation of precision medicine by helping the cellular and molecular characterization of CVD patients.
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Affiliation(s)
- Lina Badimon
- Cardiovascular Program ICCC, Institut de Recerca de l'Hospital Santa Creu i Sant Pau-IIB Sant Pau, Barcelona, Spain.,CIBER Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Rosa Suades
- Cardiovascular Program ICCC, Institut de Recerca de l'Hospital Santa Creu i Sant Pau-IIB Sant Pau, Barcelona, Spain.,Cardiology Unit, Department of Medicine Solna, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Alba Vilella-Figuerola
- Cardiovascular Program ICCC, Institut de Recerca de l'Hospital Santa Creu i Sant Pau-IIB Sant Pau, Barcelona, Spain
| | - Javier Crespo
- Cardiovascular Program ICCC, Institut de Recerca de l'Hospital Santa Creu i Sant Pau-IIB Sant Pau, Barcelona, Spain
| | - Gemma Vilahur
- Cardiovascular Program ICCC, Institut de Recerca de l'Hospital Santa Creu i Sant Pau-IIB Sant Pau, Barcelona, Spain.,CIBER Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Rafael Escate
- Cardiovascular Program ICCC, Institut de Recerca de l'Hospital Santa Creu i Sant Pau-IIB Sant Pau, Barcelona, Spain.,CIBER Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Teresa Padro
- Cardiovascular Program ICCC, Institut de Recerca de l'Hospital Santa Creu i Sant Pau-IIB Sant Pau, Barcelona, Spain.,CIBER Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Gemma Chiva-Blanch
- Cardiovascular Program ICCC, Institut de Recerca de l'Hospital Santa Creu i Sant Pau-IIB Sant Pau, Barcelona, Spain
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30
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Kömürcü HF, Gözke E, Doğan Ak P, Kalyoncu Aslan I, Salt I, Özgenç Bi¸er Çİ. Changes in neutrophil, lymphocyte, platelet ratios and their relationship with NIHSS after rtPA and/or thrombectomy in ischemic stroke. J Stroke Cerebrovasc Dis 2020; 29:105004. [DOI: 10.1016/j.jstrokecerebrovasdis.2020.105004] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/18/2020] [Accepted: 05/20/2020] [Indexed: 12/18/2022] Open
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Stenz KT, Just J, Blauenfeldt RA, Drasbek KR. Extracellular Vesicles in Acute Stroke Diagnostics. Biomedicines 2020; 8:biomedicines8080248. [PMID: 32731351 PMCID: PMC7459954 DOI: 10.3390/biomedicines8080248] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 07/16/2020] [Accepted: 07/20/2020] [Indexed: 12/14/2022] Open
Abstract
There is a large unmet need for fast and reliable diagnostics in several diseases. One such disease is stroke, where the efficacy of modern reperfusion therapies is highly time-dependent. Diagnosis of stroke and treatment initiation should be performed as soon as possible, and preferably before arrival at the stroke center. In recent years, several potential blood biomarkers for stroke have been evaluated, but without success. In this review, we will go into detail on the possibility of utilizing extracellular vesicles (EVs) released into the blood as novel biomarkers for stroke diagnostics. EVs are known to reflect the immediate state of the secreting cells and to be able to cross the blood–brain barrier, thus making them attractive as diagnostic biomarkers of brain diseases. Indeed, several studies have reported EV markers that enable differentiation between stroke patients and controls and, to a lesser extent, the ability to correctly classify the different stroke types. Most of the studies rely on the use of sophisticated and time-consuming methods to quantify specific subpopulations of the nanosized EVs. As these methods cannot be easily implemented in a rapid point of care (POC) test, technical developments followed by prospective clinical studies are needed.
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Affiliation(s)
- Katrine Tang Stenz
- Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, Aarhus University, DK-8000 Aarhus, Denmark; (K.T.S.); (J.J.)
- Sino-Danish Center for Education and Research, Beijing 101400, China
- Sino-Danish Center for Education and Research, DK-8000 Aarhus, Denmark
| | - Jesper Just
- Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, Aarhus University, DK-8000 Aarhus, Denmark; (K.T.S.); (J.J.)
- Sino-Danish Center for Education and Research, Beijing 101400, China
- Sino-Danish Center for Education and Research, DK-8000 Aarhus, Denmark
| | - Rolf Ankerlund Blauenfeldt
- Department of Neurology, Aarhus University Hospital, DK-8200 Aarhus, Denmark;
- Department of Clinical Medicine, Aarhus University, DK-8200 Aarhus, Denmark
| | - Kim Ryun Drasbek
- Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, Aarhus University, DK-8000 Aarhus, Denmark; (K.T.S.); (J.J.)
- Sino-Danish Center for Education and Research, Beijing 101400, China
- Sino-Danish Center for Education and Research, DK-8000 Aarhus, Denmark
- Correspondence: ; Tel.: +45-3027-4779
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Platelets Extracellular Vesicles as Regulators of Cancer Progression-An Updated Perspective. Int J Mol Sci 2020; 21:ijms21155195. [PMID: 32707975 PMCID: PMC7432409 DOI: 10.3390/ijms21155195] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/19/2020] [Accepted: 07/20/2020] [Indexed: 12/14/2022] Open
Abstract
Extracellular vesicles (EVs) are a diverse group of membrane-bound structures secreted in physiological and pathological conditions by prokaryotic and eukaryotic cells. Their role in cell-to-cell communications has been discussed for more than two decades. More attention is paid to assess the impact of EVs in cancer. Numerous papers showed EVs as tumorigenesis regulators, by transferring their cargo molecules (miRNA, DNA, protein, cytokines, receptors, etc.) among cancer cells and cells in the tumor microenvironment. During platelet activation or apoptosis, platelet extracellular vesicles (PEVs) are formed. PEVs present a highly heterogeneous EVs population and are the most abundant EVs group in the circulatory system. The reason for the PEVs heterogeneity are their maternal activators, which is reflected on PEVs size and cargo. As PLTs role in cancer development is well-known, and PEVs are the most numerous EVs in blood, their feasible impact on cancer growth is strongly discussed. PEVs crosstalk could promote proliferation, change tumor microenvironment, favor metastasis formation. In many cases these functions were linked to the transfer into recipient cells specific cargo molecules from PEVs. The article reviews the PEVs biogenesis, cargo molecules, and their impact on the cancer progression.
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Wang L, Cheng Q, Peng M, Lv D, Zi W, Xu G, Liu X. The relationship between the platelet to leukocyte ratio and mechanical thrombectomy outcomes in acute ischemic stroke patients. Neurol Res 2020; 42:890-896. [PMID: 32643590 DOI: 10.1080/01616412.2020.1790868] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND PURPOSE The predictive effect of blood cell ratio on ischemic event has been widely confirmed. Whether PWR and PNR can assess the risk of endovascular treatment (EVT) is largely unclear. This study aimed to investigate the prognostic value of PNR and PWR in acute ischemic stroke patients treated with EVT. METHODS Poor functional outcome was defined as Modified Rankin Scale (mRS) of 3-6 at 3 months, Symptomatic intracranial hemorrhage (sICH) was diagnosed based on CT scan and classified according to the criterial of Heidelberg Bleeding Classification. Binary logistical regression was used to analyze the relationship of PWR, PNR with functional outcome and symptomatic intracranial hemorrhage (sICH). RESULTS Patients with good prognosis had higher PNR and PWR value (29 vs. 24, P=0.002) (22 vs. 19, P=0.009), a lower rate of sICH (2.9% vs. 24.9%, P<0.001). In model 1, the lower PNR significantly associated with poor functional outcome (OR, 0.48; 95% CI 0.26-0.88; P=0.018), and sICH (OR, 0.42; 95% CI 0.19-0.91; P=0.028). The lower PWR only significantly associated with poor prognosis (OR, 0.97; 95% CI 0.94-1.00; P=0.038), and had a trend relation with sICH (OR, 0.98; 95% CI 0.94-1.02; P=0.328). In model 2 lower PNR still significantly associated with poor functional outcome (OR, 0.53; 95% CI 0.29-0.99; P=0.047), but showed a trend for predicting sICH (OR, 0.56; 95% CI 0.25-1.25; P=0.158). CONCLUSION Platelet to leukocyte ratio may be use to assess the risk of functional outcome and sICH in patients with acute anterior circulation occlusion stroke undergoing endovascular treatment in real world China.
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Affiliation(s)
- Ling Wang
- Department of Neurology, The Fourth Affiliated Hospital of Anhui Medical University , Hefei, Anhui, China.,Department of Neurology, Jinling Hospital, Medical School of Nanjing University , Nanjing, Jiangsu, China
| | - Qiantao Cheng
- Department of Neurology, The Fourth Affiliated Hospital of Anhui Medical University , Hefei, Anhui, China
| | - Min Peng
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University , Nanjing, Jiangsu, China
| | - Daping Lv
- Department of Neurology, The Fourth Affiliated Hospital of Anhui Medical University , Hefei, Anhui, China
| | - Wenjie Zi
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University , Nanjing, Jiangsu, China.,Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University) of China , Chongqing, China
| | - Gelin Xu
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University , Nanjing, Jiangsu, China
| | - Xinfeng Liu
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University , Nanjing, Jiangsu, China
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Sheikh Hosseini M, Parhizkar Roudsari P, Gilany K, Goodarzi P, Payab M, Tayanloo-Beik A, Larijani B, Arjmand B. Cellular Dust as a Novel Hope for Regenerative Cancer Medicine. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1288:139-160. [DOI: 10.1007/5584_2020_537] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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35
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Jerez-Dolz D, Torramade-Moix S, Palomo M, Moreno-Castaño A, Lopez-Vilchez I, Hernandez R, Badimon JJ, Zafar MU, Diaz-Ricart M, Escolar G. Internalization of microparticles by platelets is partially mediated by toll-like receptor 4 and enhances platelet thrombogenicity. Atherosclerosis 2019; 294:17-24. [PMID: 31945614 DOI: 10.1016/j.atherosclerosis.2019.12.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 11/22/2019] [Accepted: 12/19/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND AIMS Circulating platelet microparticles (PMP) are the most abundant in bloodstream, are highly procoagulant and contribute to cross-talk with inflammatory cells. The aim of the present study was to investigate the interactions of PMP with platelets and explore the involvement of toll-like receptor 4 (TLR-4). METHODS PMP were separated by ultracentrifugation of expired platelet concentrates and added to: i) washed platelets, to confirm uptake, by flow cytometry and confocal and transmission electron microscopy, ii) platelet rich plasma (PRP), to assess changes in platelet function due to uptake by aggregometry in response to ADP; and iii) whole blood, to evaluate heterotypic aggregate (HA) formation by flow cytometry. Moreover, whole blood previously enriched with platelets with internalized PMP was used to explore modifications in thromboelastometry parameters (ROTEM). The inhibitory action of anti-TLR-4 was investigated. RESULTS Confocal and ultrastructural microscopy studies revealed PMP internalization by platelets. Flow cytometry showed PMP-platelet association (p < 0.01 vs controls, at different PMP dilutions). PMP, at 1/20 dilution, increased HA (p < 0.05 vs controls), the percentage of maximal platelet aggregation to ADP (p < 0.05 vs controls), and accelerated clotting and clot formation times (p < 0.05 vs controls). Incubation of platelets with anti-TLR-4 prior to exposure to PMP reduced PMP-platelet association (p < 0.05 vs absence of the antibody), prevented HA formation, reduced maximal platelet aggregation and normalized ROTEM parameters. CONCLUSIONS Platelets exhibit internalization ability towards their own PMP, a process that potentiates their thrombogenicity and is partially mediated by the innate immunity receptor TLR-4.
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Affiliation(s)
- Didac Jerez-Dolz
- Hematopathology, Pathological Anatomy, Hospital Clinic of Barcelona, Biomedical Diagnosis Centre (CDB), Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Sergi Torramade-Moix
- Hematopathology, Pathological Anatomy, Hospital Clinic of Barcelona, Biomedical Diagnosis Centre (CDB), Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Marta Palomo
- Hematopathology, Pathological Anatomy, Hospital Clinic of Barcelona, Biomedical Diagnosis Centre (CDB), Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; Josep Carreras Leukaemia Research Institute, Hospital Clinic/University of Barcelona Campus, Barcelona, Spain; Barcelona Endothelium Team, Hospital Clinic/University of Barcelona Campus, Barcelona, Spain
| | - Ana Moreno-Castaño
- Hematopathology, Pathological Anatomy, Hospital Clinic of Barcelona, Biomedical Diagnosis Centre (CDB), Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Irene Lopez-Vilchez
- Hematopathology, Pathological Anatomy, Hospital Clinic of Barcelona, Biomedical Diagnosis Centre (CDB), Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Rosa Hernandez
- Hematopathology, Pathological Anatomy, Hospital Clinic of Barcelona, Biomedical Diagnosis Centre (CDB), Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Juan Jose Badimon
- Atherothrombosis Research Unit, Icahn School of Medicine at Mount Sinai, New York, USA
| | - M Urooj Zafar
- Atherothrombosis Research Unit, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Maribel Diaz-Ricart
- Hematopathology, Pathological Anatomy, Hospital Clinic of Barcelona, Biomedical Diagnosis Centre (CDB), Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; Barcelona Endothelium Team, Hospital Clinic/University of Barcelona Campus, Barcelona, Spain
| | - Gines Escolar
- Hematopathology, Pathological Anatomy, Hospital Clinic of Barcelona, Biomedical Diagnosis Centre (CDB), Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; Atherothrombosis Research Unit, Icahn School of Medicine at Mount Sinai, New York, USA.
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Tian J, Cheng L, Cui X, Lei X, Tang J, Cheng B. Investigating the effect of age on platelet ultrastructure using transmission electron microscopy. Int Wound J 2019; 16:1457-1463. [PMID: 31486290 PMCID: PMC7949169 DOI: 10.1111/iwj.13214] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/17/2019] [Accepted: 08/18/2019] [Indexed: 12/15/2022] Open
Abstract
In the present study, the age- and sex-related differences in platelet ultrastructure were investigated using transmission electron microscopy (TEM). A total of 15 healthy volunteers were grouped according to age, with 5 people in each of the following groups: young group (25-45 years), middle-aged group (46-65 years), and old-aged group (> 65 years). In the TEM micrographs, the internal components, specifically the α-granules, dense granules, and lysosomal granules, of 20 platelets were counted for each group. Two-way analysis of variance of age and sex variance was used to compare the results. The ultrastructure of the platelets in the old-aged group was observed to be quite different from those of the young and middle-aged groups. Specifically, with ageing, the platelet membrane becomes more irregular in shape and non-smooth, and multiple platelet membrane ruptures are observed. Furthermore, the pseudopodia and protuberances become more numerous and slender, and the number of α-granules is significantly reduced. These morphological changes indicate that ageing may affect the function of platelets, which in turn affects the efficacy of platelet concentrates. Thus, the effects of age should be considered when using platelet concentrates prepared from elderly autologous blood.
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Affiliation(s)
- Ju Tian
- Department of Plastic SurgeryZhongshan City People's HospitalZhongshanGuangdongChina
- Department of Plastic SurgeryGeneral Hospital of Southern Theater Command, PLAGuangzhouGuangdongChina
- The Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area, PLAGuangzhouGuangdongChina
| | - Liu‐Hang‐Hang Cheng
- Key Laboratory of Tissue Repair and Regeneration of PLA, and Beijing Key Research Laboratory of Skin Injury, Repair and RegenerationThe Fourth Medical Center of General Hospital of PLABeijingChina
- Institute of Basic Medical SciencesGeneral Hospital of PLABeijingChina
| | - Xiao Cui
- Department of Plastic SurgeryGeneral Hospital of Southern Theater Command, PLAGuangzhouGuangdongChina
- The Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area, PLAGuangzhouGuangdongChina
- Guangdong Provincial Hospital of Chinese MedicineGuangzhouGuangdongChina
| | - Xiao‐Xuan Lei
- Department of Plastic SurgeryGeneral Hospital of Southern Theater Command, PLAGuangzhouGuangdongChina
- The Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area, PLAGuangzhouGuangdongChina
| | - Jian‐Bing Tang
- Department of Plastic SurgeryGeneral Hospital of Southern Theater Command, PLAGuangzhouGuangdongChina
| | - Biao Cheng
- Department of Plastic SurgeryGeneral Hospital of Southern Theater Command, PLAGuangzhouGuangdongChina
- The Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area, PLAGuangzhouGuangdongChina
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Woith E, Fuhrmann G, Melzig MF. Extracellular Vesicles-Connecting Kingdoms. Int J Mol Sci 2019; 20:E5695. [PMID: 31739393 PMCID: PMC6888613 DOI: 10.3390/ijms20225695] [Citation(s) in RCA: 168] [Impact Index Per Article: 33.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 11/09/2019] [Accepted: 11/12/2019] [Indexed: 12/11/2022] Open
Abstract
It is known that extracellular vesicles (EVs) are shed from cells of almost every type of cell or organism, showing their ubiquity in all empires of life. EVs are defined as naturally released particles from cells, delimited by a lipid bilayer, and cannot replicate. These nano- to micrometer scaled spheres shuttle a set of bioactive molecules. EVs are of great interest as vehicles for drug targeting and in fundamental biological research, but in vitro culture of animal cells usually achieves only small yields. The exploration of other biological kingdoms promises comprehensive knowledge on EVs broadening the opportunities for basic understanding and therapeutic use. Thus, plants might be sustainable biofactories producing nontoxic and highly specific nanovectors, whereas bacterial and fungal EVs are promising vaccines for the prevention of infectious diseases. Importantly, EVs from different eukaryotic and prokaryotic kingdoms are involved in many processes including host-pathogen interactions, spreading of resistances, and plant diseases. More extensive knowledge of inter-species and interkingdom regulation could provide advantages for preventing and treating pests and pathogens. In this review, we present a comprehensive overview of EVs derived from eukaryota and prokaryota and we discuss how better understanding of their intercommunication role provides opportunities for both fundamental and applied biology.
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Affiliation(s)
- Eric Woith
- Institute of Pharmacy, Pharmaceutical Biology, Dahlem Center of Plant Sciences, Freie Universität Berlin, Königin-Luise-Str. 2+4, D-14195 Berlin, Germany;
| | - Gregor Fuhrmann
- Helmholtz Centre for Infection Research (HZI), Biogenic Nanotherapeutics Group (BION), Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Campus E8.1, 66123 Saarbrücken, Germany
- Department of Pharmacy, Saarland University, Campus E8.1, 66123 Saarbrücken, Germany
| | - Matthias F. Melzig
- Institute of Pharmacy, Pharmaceutical Biology, Dahlem Center of Plant Sciences, Freie Universität Berlin, Königin-Luise-Str. 2+4, D-14195 Berlin, Germany;
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Taus F, Meneguzzi A, Castelli M, Minuz P. Platelet-Derived Extracellular Vesicles as Target of Antiplatelet Agents. What Is the Evidence? Front Pharmacol 2019; 10:1256. [PMID: 31780927 PMCID: PMC6857039 DOI: 10.3389/fphar.2019.01256] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 09/30/2019] [Indexed: 12/14/2022] Open
Abstract
Platelet-derived large extracellular vesicles (often referred to as microparticles in the field of cardiovascular disease) have been identified as effector in the atherothrombotic process, therefore representing a target of pharmacological intervention of potential interest. Despite that, limited evidence is so far available concerning the effects of antiplatelet agents on the release of platelet-derived extracellular vesicles. In the present narrative review, the mechanisms leading to vesiculation in platelets and the pathophysiological processes implicated will be discussed. This will be followed by a summary of the present evidence concerning the effects of antiplatelet agents under experimental conditions and in clinical settings.
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Affiliation(s)
- Francesco Taus
- Department of Medicine, Section of Internal Medicine C, University of Verona, Verona, Italy
| | - Alessandra Meneguzzi
- Department of Medicine, Section of Internal Medicine C, University of Verona, Verona, Italy
| | - Marco Castelli
- Department of Medicine, Section of Internal Medicine C, University of Verona, Verona, Italy
| | - Pietro Minuz
- Department of Medicine, Section of Internal Medicine C, University of Verona, Verona, Italy
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Yu A, Zheng H, Yan X, Wang S, Shen X, Zheng H, Meng Y, Wang L. Erythrocyte membrane affinity chromatography, solid-phase extraction and UPLC-QTOF-MS/MS to screen active ingredients of Buyang Huanwu decoction. RSC Adv 2019; 9:29217-29224. [PMID: 35528420 PMCID: PMC9071827 DOI: 10.1039/c9ra03447a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 09/09/2019] [Indexed: 01/22/2023] Open
Abstract
Buyang Huanwu decoction (BHD) is a well-known traditional Chinese medicine that has long been used to treat ischemic brain damage which is associated with hemorheology. To screen active ingredients in BHD responsible for reducing blood viscosity by reducing red blood cell (RBC) lesions to treat ischemic stroke, a method involving RBC membrane binding and solid-phase extraction (SPE) was developed in this study. The components of BHD interacting with RBC were analyzed by mass spectrometry and four compounds, calycosin, paeoniflorin, 6-hydroxy behenol-3,6-di-O-glucoside and calycosin-7-O-β-d-glucoside, showed binding affinity to RBCs. An erythrocyte activity assay revealed that the identified ingredients promoted the activities of Na+-K+-ATPase, sialic acid and superoxide dismutase and reduced the content of cholesterol on the RBC membrane, suggesting a mechanism underlying their anti-erythrocyte aggregation activity. Based on these results, the RBC membrane binding assay combined with SPE and mass spectrometry is a novel and effective approach for screening potentially anti-erythrocyte lesion constituents in traditional Chinese medicines.
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Affiliation(s)
- Aiming Yu
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine No. 232, Waihuan East Road, Panyu District Guangzhou 510006 China
| | - Huazhu Zheng
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine No. 232, Waihuan East Road, Panyu District Guangzhou 510006 China
| | - Xiangli Yan
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine No. 232, Waihuan East Road, Panyu District Guangzhou 510006 China
| | - Shengxin Wang
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine No. 232, Waihuan East Road, Panyu District Guangzhou 510006 China
| | - Xiao Shen
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine No. 232, Waihuan East Road, Panyu District Guangzhou 510006 China
| | - Haozhen Zheng
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine No. 232, Waihuan East Road, Panyu District Guangzhou 510006 China
| | - Yingjiao Meng
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine No. 232, Waihuan East Road, Panyu District Guangzhou 510006 China
| | - Lisheng Wang
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine No. 232, Waihuan East Road, Panyu District Guangzhou 510006 China
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Ulusoy B, Oğuzhan T, Akyol M, Bozdemir K, Çiftçi B, Korkmaz MH. Insufficiency of positive airway pressure treatment on increased mean platelet volume: a prospective controlled study in patients with obstructive sleep apnea syndrome. Sleep Breath 2019; 24:885-891. [PMID: 31392572 DOI: 10.1007/s11325-019-01918-z] [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: 04/30/2019] [Revised: 07/21/2019] [Accepted: 08/02/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND To analyze the association between obstructive sleep apnea syndrome (OSAS) and some hematological variables such as mean platelet volume (MPV), platelet distribution width (PDW), and the impact of positive airway pressure (PAP) treatment on these parameters. METHODS The participants of the present prospective study consist of 36 OSAS patients diagnosed with polysomnography and recommended PAP treatment and 30 healthy members as the control group. Complete blood analyses were conducted to the patient group twice; before the initiation of the PAP treatment and 1 month after regular PAP use. The control group was administered a complete blood analyses only once. Patient and control group were compared in terms of various parameters such as MPV, PDW, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), white blood cell (WBC) values, and platelet counts. RESULTS MPV value of the patient group was before and after PAP treatment significantly higher than the control group (respectively; Z = 2.246; p = 0.025, and Z = 2.033; p = 0.042). However, there were no statistically significant differences in the values before and after PAP treatment in the patient group (Z = 0.727; p = 0.467). In terms of platelet numbers and PDW values, no significant differences were determined (p > 0.05). CONCLUSION MPV value was significantly elevated in OSAS patients. However, the 1 month of PAP treatment was insufficient in decreasing elevated MPV values.
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Affiliation(s)
- Bülent Ulusoy
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Selçuk University, 42075, Konya, Turkey.
| | - Tolga Oğuzhan
- Department of Otorhinolaryngology-Head and Neck Surgery, Fatih Medical Park Hospital, Istanbul, Turkey
| | - Mesut Akyol
- Department of Biostatistics, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Kazım Bozdemir
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Bülent Çiftçi
- Department of Pulmonary Disease, Bozok University, Yozgat, Turkey
| | - Mehmet Hakan Korkmaz
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
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41
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Usta Atmaca H, Akbas F, Aral H. Relationship between circulating microparticles and hypertension and other cardiac disease biomarkers in the elderly. BMC Cardiovasc Disord 2019; 19:164. [PMID: 31288734 PMCID: PMC6617697 DOI: 10.1186/s12872-019-1148-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 07/04/2019] [Indexed: 01/22/2023] Open
Abstract
Background Microparticles are procoagulant membrane vesicles that play role in endothelium dysfunction pathogenesis and are increased in hypertension, acute/chronic vascular pathological events. Here; we aimed to compare MPs levels of hypertensive geriatric patients with healthy age-match-patients, discuss its availability as a cardiovascular biomarker and investigate its relationship with other inflammatory markers. Methods Forty seven hypertensive geriatric patients (M/F;15/32) and 47 healthy controls (M/F;19/28) were included in the study. MPs levels were examined functionally through thrombin generation test (TGT) parameters (MPS Lag time, MPS ETP, MPs Peak, MPS start Tail) and compared with CRP, N/L ratio, ALT, GGT, thrombocyte parameters. Decrease in MPS Lag time, increase in MPS ETS and MPs Peak elevation were accepted as tendency to coagulation which meant an increase in number and function of MPs. Results No significant difference was found between 2 groups for MPS tests (MPS Lag time, MPS ETP, MPs Peak, MPS start Tail). Platelet count was significantly higher in hypertensive patient group. There was a negative correlation between age and MPs Peak, MPS Lag time. There was a positive correlation between CRP and MPS ETP, MPs Peak values. Conclusions Our present findings might help to understand the hemostasis via TGT parameters, in the elderly. Contribution of MPs to thrombosis tendency seen with aging and increased number of circulating MPs caused by hypertensive endothelial dysfunction must be taken into consideration. MPs might be accepted as vascular inflammation and damage markers and used as follow up tools of medical treatment of vascular inflammation-related diseases.
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Affiliation(s)
- Hanife Usta Atmaca
- Istanbul Training and Research Hospital Internal Medicine Department, Health Sciences University, Samatya, Istanbul, Turkey.
| | - Feray Akbas
- Istanbul Training and Research Hospital Internal Medicine Department, Health Sciences University, Samatya, Istanbul, Turkey
| | - Hale Aral
- Istanbul Training and Research Hospital Biochemistry Department, Health Sciences University, Istanbul, Turkey
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42
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Platelet-to-neutrophil ratio is a prognostic marker for 90-days outcome in acute ischemic stroke. J Clin Neurosci 2019; 63:110-115. [DOI: 10.1016/j.jocn.2019.01.028] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 11/18/2018] [Accepted: 01/18/2019] [Indexed: 11/23/2022]
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43
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Understanding Platelets in Infectious and Allergic Lung Diseases. Int J Mol Sci 2019; 20:ijms20071730. [PMID: 30965568 PMCID: PMC6480134 DOI: 10.3390/ijms20071730] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 04/02/2019] [Accepted: 04/05/2019] [Indexed: 12/29/2022] Open
Abstract
Emerging evidence suggests that platelets, cytoplasmic fragments derived from megakaryocytes, can no longer be considered just as mediators in hemostasis and coagulation processes, but as key modulators of immunity. Platelets have received increasing attention as the emergence of new methodologies has allowed the characterization of their components and functions in the immune continuum. Platelet activation in infectious and allergic lung diseases has been well documented and associated with bacterial infections reproduced in several animal models of pulmonary bacterial infections. Direct interactions between platelets and bacteria have been associated with increased pulmonary platelet accumulation, whereas bacterial-derived toxins have also been reported to modulate platelet function. Recently, platelets have been found extravascular in the lungs of patients with asthma, and in animal models of allergic lung inflammation. Their ability to interact with immune and endothelial cells and secrete immune mediators makes them one attractive target for biomarker identification that will help characterize their contribution to lung diseases. Here, we present an original review of the last advances in the platelet field with a focus on the contribution of platelets to respiratory infections and allergic-mediated diseases.
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44
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El-Gamal H, Parray AS, Mir FA, Shuaib A, Agouni A. Circulating microparticles as biomarkers of stroke: A focus on the value of endothelial- and platelet-derived microparticles. J Cell Physiol 2019; 234:16739-16754. [PMID: 30912147 DOI: 10.1002/jcp.28499] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 02/20/2019] [Accepted: 03/06/2019] [Indexed: 12/20/2022]
Abstract
Stroke is one of the leading causes of mortality and disability worldwide. Numerous pathophysiological mechanisms involving blood vessels, coagulation and inflammation contribute to the vascular occlusion. Perturbations in these pathways can be detected by numerous methods including changes in endoplasmic membrane remodeling and rearrangement leading to the shedding of microparticles (MPs) from various cellular origins in the blood. MPs are small membrane-derived vesicles that are shed from nearly all cells in the body in resting state or upon stimulation. MPs act as biological messengers to transfer information to adjacent and distant cells thus regulating various biological processes. MPs may be important biomarkers and tools for the identification of the risk and diagnosis of cerebrovascular diseases. Endothelial activation and dysfunction and altered thrombotic responses are two of the main features predisposing to stroke. Endothelial MPs (EMPs) have been recognized as both biomarkers and effectors of endothelial cell activation and injury while platelet-derived MPs (PMPs) carry a strong procoagulant potential and are activated in thrombotic states. Therefore, we reviewed here the role of EMPs and PMPs as biomarkers of stroke. Most studies reported high circulating levels of EMPs and PMPs in addition to other cell origins in stroke patients and have been linked to stroke severity, the size of infarction, and prognosis. The identification and quantification of EMPs and PMPs may thus be useful for the diagnosis and management of stroke.
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Affiliation(s)
- Heba El-Gamal
- Department of Pharmaceutical Sciences, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Aijaz S Parray
- The Stroke Program, The Neuroscience Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Fayaz A Mir
- Interim Translational Research Institute (iTRI), Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Ashfaq Shuaib
- The Stroke Program, The Neuroscience Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar.,Department of Medicine (Neurology), University of Alberta, Edmonton, Alberta, Canada
| | - Abdelali Agouni
- Department of Pharmaceutical Sciences, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
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Agouni A, Parray AS, Akhtar N, Mir FA, Bourke PJ, Joseph S, Morgan DM, Santos MD, Wadiwala MF, Kamran S, Sivaraman SK, Shuaib A. There Is Selective Increase in Pro-thrombotic Circulating Extracellular Vesicles in Acute Ischemic Stroke and Transient Ischemic Attack: A Study of Patients From the Middle East and Southeast Asia. Front Neurol 2019; 10:251. [PMID: 30941096 PMCID: PMC6434679 DOI: 10.3389/fneur.2019.00251] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 02/25/2019] [Indexed: 12/14/2022] Open
Abstract
Stroke attacks were found to be present at a younger age in patients from Southeast Asia (SE) and the Middle East (ME) resident in the state of Qatar. Extracellular vesicles (EVs), which are small membrane vesicles with pro-thrombotic properties, may contribute to the high risk of stroke in this population. Thus, total and cell-specific medium size EVs were counted by flow cytometry in platelet-free plasma from healthy volunteers and patients with transient ischemic attacks (TIA) and acute ischemic stroke (AIS) from SE and ME. Acutely, within 48 h of attacks, there was an increase in total endothelial EVs in TIA (6.73 ± 1.77; P = 0.0156; n = 21) and AIS (11.23 ± 1.95; P = 0.0007; n = 66) patients compared to controls (2.04 ± 0.78; n = 24). Similar increases were also evident in EVs originating from platelets, erythrocytes, granulocytes, and leukocytes. Compared to controls, there was also an increase in EVs derived from activated endothelial cells, platelets, granulocytes, leukocytes, and pro-coagulant EVs (Annexin V+) at 5 and 30-days following the acute events, while a decrease was observed in erythrocyte-derived EVs. This is the first study characterizing EVs in TIA and AIS patients from ME and SE showing an increase in EVs associated with endothelial and platelet cell activation, which may contribute to the elevated risk of stroke at a younger age in this population.
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Affiliation(s)
- Abdelali Agouni
- Department of Pharmaceutical Sciences, College of Pharmacy, Qatar University, Doha, Qatar
| | - Aijaz S Parray
- The Stroke Program, The Neuroscience Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Naveed Akhtar
- The Stroke Program, The Neuroscience Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Fayaz A Mir
- Interim Translational Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Paula J Bourke
- The Stroke Program, The Neuroscience Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Sujata Joseph
- The Stroke Program, The Neuroscience Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Deborah M Morgan
- The Stroke Program, The Neuroscience Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Mark D Santos
- The Stroke Program, The Neuroscience Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Muhammad F Wadiwala
- The Stroke Program, The Neuroscience Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Saadat Kamran
- The Stroke Program, The Neuroscience Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Siveen K Sivaraman
- Interim Translational Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Ashfaq Shuaib
- The Stroke Program, The Neuroscience Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar.,Department of Medicine (Neurology), University of Alberta, Edmonton, AB, Canada
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Staszewski J, Pogoda A, Data K, Walczak K, Nowocień M, Frankowska E, Stępień A. The mean platelet volume on admission predicts unfavorable stroke outcomes in patients treated with IV thrombolysis. Clin Interv Aging 2019; 14:493-503. [PMID: 30880930 PMCID: PMC6398411 DOI: 10.2147/cia.s195451] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose The role of biomarkers in the prediction of acute ischemic stroke (AIS) outcome or response to thrombolytic therapy (with recombinant tissue plasminogen activator [rt-PA]) remains limited. The aim of this study was to evaluate whether mean platelet volume (MPV) could predict short-term functional outcome in patients with AIS following rt-PA treatment. Patients and methods This was a retrospective analysis of 237 AIS patients (mean age 71.04±0.8 years, 50.6% women) consecutively admitted to a tertiary care center between 2011 and 2015. Results The mean MPV in the cohort was 9.8±0.35 fL (lowest tertile <7.29 fL, median 7.29–8.8 fL, and highest tertile >8.8 fL). Patients in the lowest tertile compared to median and highest tertiles were less often dependent (modified Rankin scale [mRS] ≥3) at admission (87.2% vs 96.1% and 96.1%, respectively, P=0.04) and less often had a poor stroke outcome (mRS 4–6) at discharge (28.2% vs 55.3% and 44.7%, P<0.01). However, there was no significant difference between tertiles with regard to AIS etiology, CT (Alberta Stroke Program Early CT) score, frequency of stroke due to large artery occlusion, risk of secondary hemorrhage, and early neurologic deterioration. Multivariable analysis after adjustment for confounders showed that patients in the second and third tertiles had a significantly higher risk of poor stroke outcome (OR =1.9, 95% CI =1.01–4), lack of early improvement (OR =1.91, 95% CI =1.05–3.47), lower chance of good outcome (mRS 0–2; OR =0.38, 95% CI =0.18–0.78), or minor stroke at discharge (OR =0.47, 95% CI =0.26–0.84). Receiver operating characteristic analysis for prediction of poor stroke outcome showed that the optimal cut-off point of MPV was 8.8 fL (area under the curve 0.586 [0.512–0.659], P=0.03) with a sensitivity of 82.7% and a specificity of 43.9%. Conclusion Disabling or fatal ischemic stroke in thrombolyzed patients was observed more often in patients with high admission MPV. The prognostic value of MPV was independent of other well-defined individual risk factors.
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Affiliation(s)
- Jacek Staszewski
- Clinic of Neurology, Military Institute of Medicine, Warsaw, Poland,
| | - Aleksandra Pogoda
- Clinic of Neurology, Military Institute of Medicine, Warsaw, Poland,
| | - Kamila Data
- Clinic of Neurology, Military Institute of Medicine, Warsaw, Poland,
| | - Klaudia Walczak
- Clinic of Neurology, Military Institute of Medicine, Warsaw, Poland,
| | - Maciej Nowocień
- Department of Radiology, Military Institute of Medicine, Warsaw, Poland
| | - Emilia Frankowska
- Department of Radiology, Military Institute of Medicine, Warsaw, Poland
| | - Adam Stępień
- Clinic of Neurology, Military Institute of Medicine, Warsaw, Poland,
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Siwaponanan P, Keawvichit R, Udompunturak S, Hunnangkul S, Reesukumal K, Sukapirom K, Pattanapanyasat K, Krittayaphong R. Altered profile of circulating microparticles in nonvalvular atrial fibrillation. Clin Cardiol 2019; 42:425-431. [PMID: 30680757 PMCID: PMC6712324 DOI: 10.1002/clc.23158] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 01/16/2019] [Accepted: 01/19/2019] [Indexed: 12/12/2022] Open
Abstract
Background Nonvalvular atrial fibrillation (AF) is the most common cardiac arrhythmia, and it is associated with the prothrombotic state. Circulating microparticles (cMPs) are membrane vesicles that are shed from many cell types in response to cell activation and cell apoptosis. Several studies reported that cMPs may play a role in the hypercoagulable state that can be observed in patients with AF. The aim of this study was to determine the levels of total cMPs and characterize their cellular origins in AF patients. Methods Atotal of 66 AF patients and 33 healthy controls were enrolled. This study investigated total cMP levels and their cellular origin in AF patients using polychromatic flow cytometry. Results AF patients had significantly higher levels of total cMPs (median 36.38, interquartile range [IQR] 21.16‐68.50 × 105 counts/mL vs median 15.21, IQR 9.91‐30.86 × 105 counts/mL; P = 0.004), platelet‐derived MPs (PMPs) (median 10.61, IQR 6.55‐18.04 × 105 counts/mL vs median 7.83, IQR 4.44‐10.26 × 10/mL; P = 0.009), and endothelial‐derived MPs (EMPs CD31+ CD41−) (median 2.94, IQR 1.78‐0.60 × 105 counts/mL vs median 1.16, IQR 0.71‐2.30 × 105 counts/mL; P = 0.001) than healthy controls after adjusting for potential confounders. Phosphatidylserine positive MP (PS + MP) levels were similar compared between AF patients and healthy controls. Conclusion The results of this study revealed a marked increase in total cMP levels, and evidence of elevated endothelial damage and platelet activation, as demonstrated by increased PMP and EMP levels, in AF patients. Additional study is needed to further elucidate the role of cMPs (PMPs and EMPs) in the pathophysiology of and the complications associated with AF.
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Affiliation(s)
- Panjaree Siwaponanan
- Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.,Siriraj Center of Research Excellence in Microparticle and Exosome in Diseases, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Rassamon Keawvichit
- Siriraj Center of Research Excellence in Microparticle and Exosome in Diseases, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Suthipol Udompunturak
- Division of Clinical Epidemiology, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Saowalak Hunnangkul
- Division of Clinical Epidemiology, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kanit Reesukumal
- Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kasama Sukapirom
- Siriraj Center of Research Excellence in Microparticle and Exosome in Diseases, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kovit Pattanapanyasat
- Siriraj Center of Research Excellence in Microparticle and Exosome in Diseases, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Rungroj Krittayaphong
- Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Rosińska J, Ambrosius W, Maciejewska J, Narożny R, Kozubski W, Łukasik M. Association of platelet-derived microvesicles and their phenotypes with carotid atherosclerosis and recurrent vascular events in patients after ischemic stroke. Thromb Res 2019; 176:18-26. [PMID: 30763823 DOI: 10.1016/j.thromres.2019.01.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 12/21/2018] [Accepted: 01/21/2019] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Platelet-derived microvesicles (pMVs) exhibit procoagulant and proinflammatory properties and play a role in the development and progression of atherosclerosis. The study examined the association between the total number of pMVs and their phenotypes with carotid atherosclerosis and recurrent vascular events (VEs) in patients in the convalescent phase of ischemic stroke (IS). MATERIALS AND METHODS The study group consisted of 72 patients with IS secondary to large artery atherosclerosis (LAA) (n = 40) and small arteries occlusion (SAO) (n = 32) and 69 matched cardiovascular disease risk-factor (RF) controls. Total pMV number, defined as CD61+ microvesicles (MVs), and their phenotypes, defined as the surface expression of proinflammatory (CD40L, CD62P, CD31) and procoagulant (PS, PAC-1) markers, were characterized and quantified using flow cytometry. The mean common carotid intima-media thickness (CCA mean IMT), maximal common carotid IMT (CCA max IMT) and maximal bifurcation IMT (BIF max IMT) were measured bilaterally using B-mode, color Doppler ultrasonography. All study subjects were observed for one-year to establish the occurrence of VEs. RESULTS No differences in pMV parameters between LAA and SAO stroke subjects and between stroke subgroups and controls were found. Stroke patients with carotid atherosclerosis exhibited higher concentration of CD62P+/CD61+ and PAC-1+/CD61+ MVs compared to patients without the atherosclerosis. Positive associations between total number of pMVs, AnV+ MVs and AnV+/CD61+ MVs and atherosclerotic thickening of carotid intima-media in stroke patients were found. Elevated concentration of AnV+/CD61+, PAC-1+/CD61+, CD61P+/CD61+ and CD31+/CD61+ MVs, were revealed in stroke patients who suffered from recurrent VE in one-year follow-up period. Negative correlation of pMVs and CD62P+/CD61+ MVs concentration as well as percentage of total CD61+ in AnV+ population of MVs and time elapsed from IS in convalescent stroke subjects was revealed. CONCLUSION Our results confirm positive correlations between total pMV number, the number of PAC-1+/CD61+ and CD62+/CD61+ MVs and carotid atherosclerosis in stroke subjects. Some pMV parameters may exhibit a predictive value for the next VE in groups with a history of stroke. pMVs and some of their phenotypes decline over time elapsed from stroke in convalescent stroke subjects.
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Affiliation(s)
- Justyna Rosińska
- Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland.
| | - Wojciech Ambrosius
- Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Joanna Maciejewska
- Laboratory of Flow Cytometry and Vascular Biology, Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Robert Narożny
- Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Wojciech Kozubski
- Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Maria Łukasik
- Laboratory of Flow Cytometry and Vascular Biology, Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
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MicroRNAs as Diagnostic and Prognostic Biomarkers in Ischemic Stroke-A Comprehensive Review and Bioinformatic Analysis. Cells 2018; 7:cells7120249. [PMID: 30563269 PMCID: PMC6316722 DOI: 10.3390/cells7120249] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 12/01/2018] [Accepted: 12/02/2018] [Indexed: 12/14/2022] Open
Abstract
Stroke is the second-most common cause of death worldwide. The pathophysiology of ischemic stroke (IS) is related to inflammation, atherosclerosis, blood coagulation, and platelet activation. MicroRNAs (miRNAs) play important roles in physiological and pathological processes of neurodegenerative diseases and progression of certain neurological diseases, such as IS. Several different miRNAs, and their target genes, are recognized to be involved in the pathophysiology of IS. The capacity of miRNAs to simultaneously regulate several target genes underlies their unique value as diagnostic and prognostic markers in IS. In this review, we focus on the role of miRNAs as diagnostic and prognostic biomarkers in IS. We discuss the most common and reliable detection methods available and promising tests currently under development. We also present original results from bioinformatic analyses of published results, identifying the ten most significant genes (HMGB1, YWHAZ, PIK3R1, STAT3, MAPK1, CBX5, CAPZB, THBS1, TNFRSF10B, RCOR1) associated with inflammation, blood coagulation, and platelet activation and targeted by miRNAs in IS. Additionally, we created miRNA-gene target interaction networks based on Gene Ontology (GO) information derived from publicly available databases. Among our most interesting findings, miR-19a-3p is the most widely modulated miRNA across all selected ontologies and might be proposed as novel biomarker in IS to be tested in future studies.
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