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Bladowski M, Szahidewicz-Krupska E, Wiśniewski J, Fortuna P, Chojdak-Łukasiewicz J, Budrewicz S, Fleszar M, Doroszko A. Changes in the Plasma and Platelet Nitric Oxide Biotransformation Metabolites during Ischemic Stroke-A Dynamic Human LC/MS Metabolomic Study. Antioxidants (Basel) 2022; 11:antiox11050955. [PMID: 35624819 PMCID: PMC9137966 DOI: 10.3390/antiox11050955] [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: 04/10/2022] [Revised: 05/04/2022] [Accepted: 05/10/2022] [Indexed: 12/10/2022] Open
Abstract
Despite improvement in the management of modifiable cardiovascular risk factors, ischemic stroke remains the leading cause of morbidity and mortality in the adult population. The aim of this study was to analyze the time-dependent dynamic differences in expression of the nitric oxide (NO) metabolic pathway in the platelet and plasma compartment between subjects with and without ischemic stroke. Additionally, the interplay between these parameters and platelet aggregation was investigated. A total of 418 patients in acute phase of non-cardioembolic stroke were investigated. Following the inclusion and exclusion criteria, finally 40 subjects with stroke and 39 demographically matched healthy participants were enrolled. Neurological physical examination, followed by assessment of the platelet and plasma levels of the nitric oxide synthase (NOS) inhibitors, including asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA), as well as NOS substrate-L-Arginine were performed dynamically three times within the first 24-h, then on the 3rd and 7th day after the stroke onset, which was compared with the healthy control. The platelet L-Arginine concentration was significantly higher on the 1st and 3rd day of stroke, while the plasma levels were significantly lower on exact days in comparison to the control. The competitive NOS-inhibitors in platelets were stably elevated in stroke subjects, whereas no significant differences in plasma compartment were noted. The arachidonic-acid-induced platelet aggregation was negatively associated with the platelet NOS substrate bioavailability, as assessed by the L−Arginine ADMA-ratio on the 3rd and 7th day. Subjects with non-cardioembolic ischemic stroke are characterized by elevated platelet levels of NOS inhibitors. Management of stroke results in increasing the platelet L-Arginine concentration and subsequent NO bioavailability in the platelet compartment.
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Affiliation(s)
- Maciej Bladowski
- Department and Clinic of Internal Medicine, Hypertension and Clinical Oncology, Faculty of Medicine, Wroclaw Medical University, Borowska 213 Str., 50-556 Wroclaw, Poland; (M.B.); (E.S.-K.)
| | - Ewa Szahidewicz-Krupska
- Department and Clinic of Internal Medicine, Hypertension and Clinical Oncology, Faculty of Medicine, Wroclaw Medical University, Borowska 213 Str., 50-556 Wroclaw, Poland; (M.B.); (E.S.-K.)
| | - Jerzy Wiśniewski
- Department of Medical Biochemistry, Wroclaw Medical University, Chalubinskiego 10 Str., 50-368 Wroclaw, Poland; (J.W.); (P.F.); (M.F.)
- Department of Biochemistry, Molecular Biology and Biotechnology, Wroclaw University of Science and Technology, Wyspianskiego 27, 50-370 Wroclaw, Poland
| | - Paulina Fortuna
- Department of Medical Biochemistry, Wroclaw Medical University, Chalubinskiego 10 Str., 50-368 Wroclaw, Poland; (J.W.); (P.F.); (M.F.)
| | - Justyna Chojdak-Łukasiewicz
- Department and Clinic of Neurology, Wroclaw Medical University, Borowska 213 Str., 50-556 Wroclaw, Poland; (J.C.-Ł.); (S.B.)
| | - Slawomir Budrewicz
- Department and Clinic of Neurology, Wroclaw Medical University, Borowska 213 Str., 50-556 Wroclaw, Poland; (J.C.-Ł.); (S.B.)
| | - Mariusz Fleszar
- Department of Medical Biochemistry, Wroclaw Medical University, Chalubinskiego 10 Str., 50-368 Wroclaw, Poland; (J.W.); (P.F.); (M.F.)
| | - Adrian Doroszko
- Department and Clinic of Internal Medicine, Hypertension and Clinical Oncology, Faculty of Medicine, Wroclaw Medical University, Borowska 213 Str., 50-556 Wroclaw, Poland; (M.B.); (E.S.-K.)
- Correspondence: ; Tel.: +48-71-736-4000
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Takahashi K, Ito H, Hashimoto M, Mita K, Asakawa H, Hayashi T, Fujino K. Does antithrombotic therapy improve survival with colorectal cancer? World J Surg Oncol 2017; 15:161. [PMID: 28836988 PMCID: PMC5571652 DOI: 10.1186/s12957-017-1235-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 08/05/2017] [Indexed: 12/21/2022] Open
Abstract
Background The study aimed to evaluate the prognosis for patients with colorectal cancer who underwent surgery while receiving antithrombotic therapy (ATT) across all disease stages and for patients at disease stages 0–III. Methods This retrospective cohort study included 710 Japanese patients who underwent surgery for colorectal cancer between January 2009 and November 2015 at our institution. Approximately 35% of these patients received ATT. Of these, 199 (28.0%) received antiplatelet therapy, and 76 (10.7%) received anticoagulant therapy. We investigated the prognosis among patients with colorectal cancer receiving ATT, antiplatelet therapy, or anticoagulant therapy in all-stage and stage 0–III cancers. Results For all disease stages combined, no benefit was observed for ATT, antiplatelet therapy, and anticoagulant therapy groups in the overall survival rates (ATT: 87.8 vs. 78.4%, P = 0.23; antiplatelet therapy: 87.8 vs. 78.6%, P = 0.25; and anticoagulant therapy: 92.2 vs. 80.2%, P = 0.26). However, overall survival rates of patients with stage 0–III colorectal cancer undergoing ATT, antiplatelet therapy, and anticoagulant therapy significantly improved. (ATT: 98.5 vs. 92.7%, P = 0.01; antiplatelet therapy: 98.3 vs. 91.1%, P = 0.02; and anticoagulant therapy: 100 vs. 92.1%, P = 0.00). Conclusion Receiving ATT significantly improves overall survival rates in patients with stage 0–III colorectal cancer.
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Affiliation(s)
- Kodai Takahashi
- Department of Surgery, New-Tokyo Hospital, 1271 Wanagaya, Matsudo-city, Chiba, 270-2232, Japan.
| | - Hideto Ito
- Department of Surgery, New-Tokyo Hospital, 1271 Wanagaya, Matsudo-city, Chiba, 270-2232, Japan
| | - Masatoshi Hashimoto
- Department of Surgery, New-Tokyo Hospital, 1271 Wanagaya, Matsudo-city, Chiba, 270-2232, Japan
| | - Kazuhito Mita
- Department of Surgery, New-Tokyo Hospital, 1271 Wanagaya, Matsudo-city, Chiba, 270-2232, Japan
| | - Hideki Asakawa
- Department of Surgery, New-Tokyo Hospital, 1271 Wanagaya, Matsudo-city, Chiba, 270-2232, Japan
| | - Takashi Hayashi
- Department of Surgery, New-Tokyo Hospital, 1271 Wanagaya, Matsudo-city, Chiba, 270-2232, Japan
| | - Keiichi Fujino
- Department of Surgery, New-Tokyo Hospital, 1271 Wanagaya, Matsudo-city, Chiba, 270-2232, Japan
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Horn P, Cortese-Krott MM, Amabile N, Hundsdörfer C, Kröncke KD, Kelm M, Heiss C. Circulating microparticles carry a functional endothelial nitric oxide synthase that is decreased in patients with endothelial dysfunction. J Am Heart Assoc 2012; 2:e003764. [PMID: 23525410 PMCID: PMC3603231 DOI: 10.1161/jaha.112.003764] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Microparticles (MPs) are circulating membrane particles of less than a micrometer in diameter shed from endothelial and blood cells. Recent literature suggests that MPs are not just functionally inert cell debris but may possess biological functions and mediate the communication between vascular cells. As a significant proportion of MPs originate from platelets and endothelial cells, we hypothesized that MPs may harbor functional enzymes including an endothelial NO synthase (eNOS). Methods and Results Using immunoprecipitation and Western blot analysis, we found that human circulating MPs carry an eNOS. Ca2+ and l‐arginine‐dependent NOS activity of crude enzyme extract from MPs was determined by measuring the conversion of [3H]‐L‐arginine to [3H]‐citrulline and NOS‐dependent nitrite production. NOS‐dependent NO production in intact MPs was assessed by the NO‐specific fluorescent probe MNIP‐Cu. In patients with cardiovascular disease, endothelial dysfunction was associated with an increase in the total number of circulating MPs as well as a significant decrease in the expression and activity of eNOS in MPs. No difference in reactive oxygen species was noted in MPs isolated from either group. Conclusions Our data further support the concept that circulating MPs may not only retain phenotypic markers but also preserve the functionality of enzymes of the cells they originate from, including eNOS.
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Affiliation(s)
- Patrick Horn
- Division of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Duesseldorf, Germany
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McCarty MF. Dietary nitrate and reductive polyphenols may potentiate the vascular benefit and alleviate the ulcerative risk of low-dose aspirin. Med Hypotheses 2012; 80:186-90. [PMID: 23265354 DOI: 10.1016/j.mehy.2012.11.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Accepted: 11/17/2012] [Indexed: 12/23/2022]
Abstract
The recent revelation that daily low-dose aspirin not only lowers risk for vascular events, but also can notably decrease risk for a range of adenocarcinomas, decreasing total cancer mortality by about 20%, makes it highly desirable to implement this protective strategy on a population-wide basis. Nonetheless, the fact that low-dose aspirin approximately doubles risk for serious gastrointestinal bleeding may impede health authorities from recommending its use by people judged to be at low cardiovascular risk. Nitric oxide (NO) exerts gastroprotective effects by boosting blood flow and mucus production in the gastric mucosa - effects which demonstrably oppose the pro-ulcerative impact of aspirin and other NSAIDs. A nitrate-rich diet, as well as ingestion of reductive catechol-bearing polyphenols, can collaborate in promoting NO generation in gastric juice, and they are protective in rodent models of gastric ulceration. Moreover, a high-nitrate diet, as well as certain reductive polyphenols such as epicatechin and quercetin, can exert platelet-stabilizing effects complementary to those of aspirin, and act in other ways to preserve vascular health. Hence, diets rich in nitrate and reductive polyphenols have the potential to amplify the vascular-protective benefits of low-dose aspirin, while diminishing its pro-ulcerative risk. Low-dose aspirin may be more unequivocally recommendable within the context of such a dietary strategy.
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Affiliation(s)
- Mark F McCarty
- NutriGuard Research, 1051 Hermes Ave., Encinitas, CA 92024, United States.
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Prandota J. Migraine Associated with Patent Foramen Ovale May Be Caused by Reactivation of Cerebral Toxoplasmosis Triggered by Arterial Blood Oxygen Desaturation. Int J Neurosci 2010; 120:81-7. [DOI: 10.3109/00207450903458647] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Serebruany VL. Aggressive chronic platelet inhibition with prasugrel and increased cancer risks: revising oral antiplatelet regimens? Fundam Clin Pharmacol 2009; 23:411-7. [PMID: 19500152 DOI: 10.1111/j.1472-8206.2009.00710.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The TRITON-TIMI 38 was a head-to-head trial to assess the efficacy and safety of the experimental antiplatelet agent prasugrel vs. standard care with clopidogrel on top of aspirin. Besides some ischemic protection at expense of overwhelming bleeding disadvantage, prasugrel treated patients experienced three times higher rate of colonic neoplasms then after clopidogrel, and this difference was significant. Importantly, known gastrointestinal bleeding preceded the diagnosis of colonic neoplasms only in half of the patients. Three potential mechanisms responsible for such harmful association are reviewed, namely: (i) direct hazard of the experimental drug on cancer occurrence and progression; (ii) indirect modulation of tumor growth; and (iii) enhanced metastatic dissemination due to instability of platelet-tumor cell aggregates, or/and inability to keep the disease locally due by much more potent long-term platelet inhibition should be considered. Significant excess of cancer after prasugrel is alarming, and can be reasonably explained, with critical clinical implications not only for prasugrel further development, but also for existing and future chronic antiplatelet strategies. If the hypothesis that oral aggressive platelet inhibition cause higher cancer risks will turn out to be true, then intensity of platelet inhibition, and especially duration of chronic antiplatelet therapy should be reconsidered. More delicate platelet inhibition, and shorter exposure to oral antiplatelet agents will prevail.
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Affiliation(s)
- Victor L Serebruany
- HeartDrug Research Laboratories, Johns Hopkins University, Osler Medical Building, Towson, 21204 MD, USA.
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